A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

"Plan to self-administer this medication for the next 6 months."

"Administer the medication into one nostril once per week."

"Lie down for 1 hour after administering the medication."

"Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose."

Answer and Explanation

The Correct Answer is B

A. "Plan to self-administer this medication for the next 6 months": The duration of treatment may vary based on individual circumstances and medical evaluation. It's not appropriate to make a blanket statement about the treatment duration.
B. "Administer the medication into one nostril once per week."
Cyanocobalamin is a form of vitamin B12 that is used to treat pernicious anemia. It can be administered via nasal spray in some cases. The appropriate dosing for nasal cyanocobalamin usually involves administration once a week. The client should be instructed to administer the medication into one nostril as directed by their healthcare provider.
C. "Lie down for 1 hour after administering the medication": There is no need for the client to lie down for an extended period after administering nasal cyanocobalamin.
D. "Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose": This is not a standard recommendation for administering nasal cyanocobalamin. The client should follow the specific instructions provided by their healthcare provider.

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Correct Answer is A

Explanation

A. Estrogen-progestin combination:
Correct Answer: This medication interacts with carbamazepine.
Explanation: Carbamazepine is known to induce certain liver enzymes, including cytochrome P450 enzymes. These enzymes play a role in the metabolism of various medications, including estrogen-containing oral contraceptives (estrogen-progestin combinations). Carbamazepine can increase the metabolism of estrogen-progestin combinations, potentially reducing their effectiveness and increasing the risk of contraceptive failure. Therefore, this interaction can lead to decreased contraceptive efficacy and the potential for unintended pregnancy.
B. Nicotine transdermal system:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Nicotine replacement therapies, such as nicotine transdermal systems, are not known to have significant interactions with carbamazepine. These therapies are primarily used to aid in smoking cessation and do not share metabolic pathways with carbamazepine.
C. Diphenhydramine:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Diphenhydramine is an antihistamine used for allergies and as a sleep aid. It does not have a well-established interaction with carbamazepine. However, it's important to note that carbamazepine can have central nervous system (CNS) effects, so caution should be exercised when combining it with other medications that also have CNS effects.
D. Beclomethasone:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Beclomethasone is a corticosteroid used to manage inflammation associated with conditions like asthma and allergic rhinitis. It is not known to interact with carbamazepine. These two medications have different mechanisms of action and do not share significant metabolic pathways.

A. Taking an HMG CoA reductase inhibitor B. Having a 10-year history of COPD C. Having a prolapsed mitral valve D. Taking a high-ceiling diuretic

Correct Answer is D

Explanation

A. Taking an HMG CoA reductase inhibitor (commonly known as statins) is not directly associated with digoxin toxicity. Statins are used to lower cholesterol levels.
B. Having a 10-year history of COPD (chronic obstructive pulmonary disease) is not directly linked to an increased risk of digoxin toxicity.
C. Having a prolapsed mitral valve is a valvular disorder and is not a primary factor that contributes to digoxin toxicity.
D. Taking a high-ceiling diuretic
The factor that predisposes the client to develop digoxin toxicity is taking a high-ceiling diuretic.
Digoxin toxicity can be influenced by several factors. One important factor is the levels of potassium in the blood. High-ceiling diuretics, also known as loop diuretics (e.g., furosemide), can lead to potassium loss through increased urinary excretion. Low levels of potassium (hypokalemia) can increase the risk of digoxin toxicity, as digoxin has a greater effect on the heart when potassium levels are low.

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A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the list of current medications for a client who is to start a new prescription for carbamazepine. The nurse should identify which of the following medications interacts with carbamazepine.

Correct Answer is A

Explanation

A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to develop digoxin toxicity?

Correct Answer is D

Explanation

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