A nurse is providing teaching to a client who is taking tetracycline to treat acne. Which of the following instructions should the nurse include?

"Take the medication with an antacid if gastrointestinal upset occurs."

"Use a hormonal contraceptive when sexually active."

"Avoid taking this medication with milk."

"Exposure to direct sunlight can help this medication improve acne."

Answer and Explanation

The Correct Answer is C

Rationale:

A. "Take the medication with an antacid if gastrointestinal upset occurs.": Antacids can bind to tetracycline and significantly reduce its absorption, making the antibiotic less effective. Clients should be instructed to avoid taking tetracycline simultaneously with antacids.

B. "Use a hormonal contraceptive when sexually active.": Tetracycline can decrease the effectiveness of hormonal contraceptives, so clients should use an additional form of contraception rather than relying solely on hormonal methods. This statement should emphasize using a backup method rather than suggesting hormonal contraceptives alone.

C. "Avoid taking this medication with milk.": Calcium-containing products, including milk, can bind to tetracycline and impair absorption. Clients should take the medication with water and separate it from dairy products by at least 2 hours to ensure effectiveness.

D. "Exposure to direct sunlight can help this medication improve acne.": Tetracycline increases photosensitivity, making clients more prone to sunburn. Clients should avoid direct sunlight and use protective measures such as sunscreen, hats, and protective clothing, rather than seeking sun exposure.

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Correct Answer is A

Explanation

A. A client who has depression and anxiety with an established plan of care: A medical-surgical nurse can safely care for a client with stable mental health conditions when a clear, established plan of care is in place. This client does not require constant psychiatric interventions, making it appropriate for assignment.

B. A client who is trying to engage in self-harm and does not understand why they cannot leave the facility: This client is high-risk and requires a nurse with specialized mental health training to implement safety measures and therapeutic interventions. Assigning this client to a medical-surgical nurse could compromise safety.

C. A client who is being discharged and needs information on substance abuse counseling: Discharge teaching and counseling for substance abuse require specialized knowledge and therapeutic communication skills typical of mental health nurses. A medical-surgical nurse may not have the expertise to provide adequate education and support.

D. A client who has been placed in restraints and requires documentation every 15 min: Clients in restraints require frequent monitoring, crisis intervention, and mental health expertise. This high-acuity situation is not appropriate for a nurse without psychiatric training.

A. BUN 22 mg/dL (10 to 20 mg/dL) B. WBC count 15.000/mm3 (5,000 to 10,000/mm3) C. Urine specific gravity 1.04 (1.005 to 1.03) D. Platelets 80,000/mm3 (150,000 to 400.000/mm3)

Correct Answer is D

Explanation

A. BUN 22 mg/dL (10 to 20 mg/dL): A slightly elevated BUN indicates mild renal impairment or dehydration but does not typically require withholding enoxaparin. Monitoring renal function is important, but this value alone is not a contraindication for anticoagulation.

B. WBC count 15,000/mm3 (5,000 to 10,000/mm3): An elevated WBC suggests possible infection or inflammation. While it may warrant further assessment, it does not directly increase the risk of bleeding and is not a reason to withhold enoxaparin.

C. Urine specific gravity 1.04 (1.005 to 1.03): A high specific gravity may indicate dehydration but is not a contraindication for enoxaparin administration. The medication can be given with caution while monitoring renal function and fluid status.

D. Platelets 80,000/mm3 (150,000 to 400,000/mm3): Thrombocytopenia significantly increases the risk of bleeding while on enoxaparin, which is an anticoagulant. Withholding the dose and notifying the provider is essential to prevent hemorrhagic complications and ensure safe management of the client.

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A nurse is providing teaching to a client who is taking tetracycline to treat acne. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

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