A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for
the nurse to provide this client?
Breast feeding is not recommended while taking this medication.
Baseline liver function results must be obtained during therapy.
Do not take multiple vitamins that contain vitamin A while taking this drug.
The Correct Answer is D
Choice A reason: Breast feeding is not recommended while taking this medication, as isotretinoin can pass into breast milk and harm
the nursing infant. However, this information is not as important as choice d, as the client may not be breast feeding or planning to breast feed.
Choice B reason: Baseline liver function results must be obtained during therapy, as isotretinoin can cause liver damage and increase liver enzymes. However, this information is not as important as choice d, as the client may not have liver problems or need liver function tests.
Choice C reason: Do not take multiple vitamins that contain vitamin A while taking this drug, as isotretinoin is a derivative of vitamin A and can cause vitamin A toxicity if taken in excess. However, this information is not as important as choice d, as the client may not take multiple vitamins or have vitamin A toxicity.
Choice D reason: Discontinue this medication one month before attempting to conceive, as isotretinoin can cause severe birth defects and miscarriages if taken during pregnancy. Therefore, this information is most important for the nurse to provide this client, as the client is planning to become pregnant and should avoid isotretinoin exposure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice B reason: Epoetin alfa is a synthetic form of erythropoietin, a hormone that stimulates the production of red blood cells (RBCs) in the bone marrow. Epoetin alfa is used to treat anemia, or low RBC count, which can be caused by CKD, chemotherapy, HIV infection, or other conditions. Anemia can cause symptoms such as weakness, fatigue, shortness of breath, pale skin, and chest pain. Hemoglobin is the protein in RBCs that carries oxygen throughout the body. The normal range of hemoglobin for males is 14 to 18 g/dL (8.7 to 11.2 mmol/L). Therefore, an increase in hemoglobin from below normal to within normal indicates that epoetin alfa has been effective in increasing RBC production and improving oxygen delivery. The nurse should monitor the client's hemoglobin level regularly and adjust the dose of epoetin alfa as needed.
Choice A reason:While iron therapy supports the effectiveness of epoetin alfa by providing the necessary substrate for erythropoiesis, tolerating iron therapy is not an indicator of epoetin alfa's efficacy.
Choice C reason: Epoetin alfa is used to treat anemia associated with chronic kidney disease (CKD) by stimulating erythropoiesis (red blood cell production). The primary measure of its effectiveness is an increase in hemoglobin (Hgb) levels toward the target range. The hemoglobin level increasing to 12 g/dL (7.45 mmol/L) reflects a significant improvement from an anemic state and is within the target range for patients receiving epoetin alfa therapy (generally 10–12 g/dL). This is the most objective and definitive indicator of the medication's effectiveness.
Choice D reason: Taking concurrent iron therapy without adverse effects is not a finding that best indicates that the medication is effective, but rather a preventive measure that can reduce the risk of iron deficiency and improve the efficacy of epoetin alfa. Iron therapy refers to taking oral or intravenous iron supplements to increase iron levels in the blood. Iron therapy can cause side effects such as nausea, vomiting, constipation, diarrhea, dark stools, metallic taste, or allergic reactions. The nurse should instruct the client on how to take iron therapy safely and monitor for any adverse effects.
Correct Answer is A
Explanation
Choice A reason: Hematemesis is the vomiting of blood, which can indicate a serious gastrointestinal bleeding caused by ibuprofen. This is a life-threatening condition that requires immediate medical attention. Therefore, the nurse should report this finding to the healthcare provider as soon as possible.
Choice B reason: Insomnia is the difficulty in falling asleep or staying asleep. It can be a side effect of ibuprofen, but it is not as serious or urgent as hematemesis. The nurse can advise the client to take ibuprofen with food or milk, avoid caffeine and alcohol, and practice good sleep hygiene.
Choice C reason: Dizziness is the feeling of lightheadedness, faintness, or unsteadiness. It can also be a side effect of ibuprofen, but it is usually mild and transient. The nurse can instruct the client to rise slowly from a sitting or lying position, drink plenty of fluids, and avoid driving or operating machinery if dizzy.
Choice D reason: Nausea is the feeling of discomfort or unease in the stomach that may lead to vomiting. It can also be a side effect of ibuprofen, but it is usually manageable with simple measures. The nurse can suggest the client to take ibuprofen with food or milk, eat small and frequent meals, and avoid spicy or fatty foods.
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