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 A
Explanation
Choice A reason: Ferrous sulfate is best absorbed on an empty stomach, so waiting 2 hours after meals to take the tablet will enhance its effectiveness. Food can interfere with iron absorption, especially dairy products, eggs, coffee, tea, and antacids.
Choice B reason: Bedtime is not the best time to take the tablet, because lying down after taking iron can cause gastrointestinal upset, such as nausea, vomiting, constipation, or diarrhea. The client should take the tablet with a full glass of water and remain upright for at least 30 minutes.
Choice C reason: Taking the tablet with a daily multivitamin is not recommended, because some vitamins and minerals can reduce iron absorption, such as calcium, zinc, copper, and vitamin E. The client should avoid taking iron with other supplements unless advised by the healthcare provider.
Choice D reason: Crushing the tablets and mixing with pudding is not advisable, because enteric-coated tablets are designed to dissolve slowly in the intestine and protect the stomach from irritation. Crushing them will destroy their coating and reduce their effectiveness. The client should swallow the tablets whole and not chew or crush them.
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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