A nurse is providing medication teaching about disulfiram for a client who has alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?

"I will plan to continue taking this medication for at least 5 years."

"My provider wants me to take this medication for 2 weeks before I try to quit drinking."

"I should avoid over-the-counter medications that contain alcohol."

"I will need to get a monthly injection of this medication."

Answer and Explanation

The Correct Answer is C

Rationale:
A. "I will plan to continue taking this medication for at least 5 years.": Disulfiram therapy is not prescribed for a fixed duration such as 5 years. The length of treatment depends on the client’s motivation and response, typically continuing until long-term abstinence is maintained.

B. "My provider wants me to take this medication for 2 weeks before I try to quit drinking.": Disulfiram must be started only after the client has abstained from alcohol for at least 12 hours, not before quitting. Taking it while alcohol is still in the system can trigger severe reactions such as flushing, nausea, vomiting, and hypotension.

C. "I should avoid over-the-counter medications that contain alcohol.": Even small amounts of alcohol—such as in cough syrups, mouthwash, or sauces—can cause a dangerous disulfiram-alcohol reaction. Clients must avoid all alcohol-containing products.

D. "I will need to get a monthly injection of this medication.": Disulfiram is taken orally, usually once daily, and does not come in injectable form. The injectable medication used for alcohol dependence is naltrexone (Vivitrol).

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Correct Answer is C

Explanation

Rationale:
A. "I should clean my stoma with moisturizing soap.": Moisturizing soaps can leave a residue that interferes with the adhesive seal of the ostomy pouch. The stoma and surrounding skin should be cleaned gently with mild, non-moisturizing soap and water to maintain skin integrity and pouch adhesion.

B. "I should expect my stoma to be blistered.": A healthy stoma should appear pink to red and moist. Blistering indicates trauma, irritation, or infection, which requires assessment and intervention, so this expectation is incorrect.

C. "I should cut my pouch opening 1/8 inch larger than my stoma.": Proper pouch sizing ensures a secure fit around the stoma while protecting the surrounding skin from effluent. Cutting the opening slightly larger than the stoma prevents pressure and irritation.

D. "I should change my stoma pouch 30 minutes after meals.": Ostomy pouch changes should be scheduled when effluent is minimal, typically every 3–7 days or when the pouch is leaking. Timing changes specifically after meals is unnecessary.

A. Decreased serum uric acid B. Increased protein in urine C. Increased platelet count D. Decreased BUN

Correct Answer is B

Explanation

Rationale:
A. Decreased serum uric acid: In preeclampsia, serum uric acid levels are elevated, not decreased, due to reduced renal clearance and tissue ischemia. Increased uric acid is often one of the earliest laboratory indicators of preeclampsia.

B. Increased protein in urine: Proteinuria is a key diagnostic feature of preeclampsia resulting from glomerular endothelial damage that increases permeability to proteins. The presence of protein in the urine reflects kidney involvement and helps distinguish preeclampsia from gestational hypertension.

C. Increased platelet count: Preeclampsia is typically associated with thrombocytopenia (low platelet count) due to platelet aggregation and consumption within damaged blood vessels. An increased platelet count would not be expected in this condition.

D. Decreased BUN: In preeclampsia, renal perfusion is reduced, leading to elevated BUN and creatinine levels. A decrease in BUN would indicate improved kidney function, which is inconsistent with the pathophysiology of preeclampsia.

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A nurse is providing medication teaching about disulfiram for a client who has alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?

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