A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Stop the oral contraceptive immediately.

Take the medications at least 12 hours apart.

Use an additional form of contraception.

Avoid prolonged exposure to direct sunlight.

Answer and Explanation

The Correct Answer is C

Choice A reason: Stopping the oral contraceptive immediately is not necessary and may increase the risk of unintended pregnancy. Erythromycin can reduce the effectiveness of oral contraceptives by interfering with their metabolism, but it does not make them completely ineffective.

Choice B reason: Taking the medications at least 12 hours apart is not sufficient to prevent the interaction between erythromycin and oral contraceptives. The interaction can occur regardless of the timing of the doses.

Choice C reason: Using an additional form of contraception is the best instruction for the client who is taking an oral contraceptive and erythromycin. This can prevent pregnancy in case the oral contraceptive fails due to the interaction with erythromycin. The additional form of contraception should be non-hormonal, such as a barrier method or a copper intrauterine device.

Choice D reason: Avoiding prolonged exposure to direct sunlight is a good advice for anyone taking erythromycin, as it can cause photosensitivity and increase the risk of sunburn. However, this is not related to the interaction with oral contraceptives and does not affect their efficacy.

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Correct Answer is A

Explanation

Choice A reason: This is the best option to measure the peak and trough levels of vancomycin, as it reflects the highest and lowest concentrations of the drug in the blood. The peak level indicates the efficacy and potential toxicity of vancomycin, while the trough level indicates the clearance and potential subtherapeutic effect of vancomycin. The peak level should be drawn immediately after completion of the IV dose, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level should be drawn 30 minutes before the next administration of the medication, as it represents the lowest concentration of vancomycin in the blood before it is replenished by another dose.

Choice B reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may not capture the true highest and lowest concentrations of the drug in the blood. The peak level may be lower than expected, as it takes about 30 minutes for vancomycin to reach its maximum concentration in the blood. The trough level may be higher than expected, as it is drawn too close to the next administration of the medication.

Choice C reason: This is not a good option to measure the peak and trough levels of vancomycin, as it does not reflect the highest and lowest concentrations of the drug in the blood. The peak level is drawn too early, as vancomycin has not reached its maximum concentration in the blood yet. The trough level is drawn too late, as vancomycin has already started to decline in the blood.

Choice D reason: This is not a good option to measure the peak and trough levels of vancomycin, as it may miss the highest and lowest concentrations of the drug in the blood. The peak level is drawn too late, as vancomycin may have already started to decline in the blood. The trough level is drawn too early, as vancomycin may have not reached its minimum concentration in the blood yet.

A. Bronchodilation and wheezing. B. Unpleasant smell when using the medication. C. Increased sputum, requiring suctioning. D. Hypotension.

Correct Answer is C

Explanation

Choice C reason: Acetylcysteine is a mucolytic agent that breaks down mucus and makes it easier to cough up or suction out. This helps to clear the airways and improve oxygenation. The nurse should expect to see increased sputum production after administering acetylcysteine and provide frequent suctioning as needed.

Choice A reason: Bronchodilation and wheezing are not therapeutic responses of acetylcysteine, but rather possible adverse effects. Acetylcysteine can cause bronchospasm or bronchoconstriction in some clients, especially those with asthma or chronic obstructive pulmonary disease (COPD). The nurse should monitor the client's breath sounds and oxygen saturation and report any signs of respiratory distress.

Choice B reason: Unpleasant smell when using the medication is not a therapeutic response of acetylcysteine, but rather a common side effect. Acetylcysteine has a rotten egg odor that can be unpleasant for both the client and the nurse. The nurse can minimize this by using a mouthwash or a flavored lozenge before and after administering acetylcysteine.

Choice D reason: Hypotension is not a therapeutic response of acetylcysteine, but rather a rare but serious adverse effect. Acetylcysteine can cause vasodilation or hypovolemia in some clients, leading to low blood pressure and shock. The nurse should monitor the client's vital signs and report any signs of hypotension.

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A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

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