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 A reason: Replacing leafy vegetables with a protein source is not necessary or advisable for a vegetarian client who takes warfarin. Leafy vegetables are rich in vitamin K, which can interfere with warfarin's anticoagulant effect, but they also provide other nutrients and benefits for health. Protein sources such as nuts or beans may also contain vitamin K or other substances that can affect warfarin's action.
Choice B reason: Commending the client for her healthy lifestyle and encouraging her to continue her current diet habits is not appropriate or safe for a vegetarian client who takes warfarin. Leafy vegetables can alter warfarin's anticoagulant effect and increase the risk of bleeding or clotting complications if not monitored closely by the healthcare provider.
Choice C reason: Advising the client that the healthcare provider needs to be made aware of her current diet is the best response for a vegetarian client who takes warfarin. Leafy vegetables can affect warfarin's anticoagulant effect by increasing vitamin K levels in the body, which counteracts warfarin's action. The healthcare provider can adjust the warfarin dose accordingly and monitor the client's international normalized ratio (INR), which is a measure of blood clotting time.
Choice D reason: Confirming that her diet choices will help the medication be more effective in preventing blood clots is incorrect and misleading for a vegetarian client who takes warfarin. Leafy vegetables can decrease warfarin's anticoagulant effect by increasing vitamin K levels in the body, which enhances blood clotting. This can reduce the effectiveness of warfarin and increase the risk of thromboembolic events, such as stroke or pulmonary embolism.
Correct Answer is D
Explanation
Choice A reason: Recent use of other antidepressants is important to know, as duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) that can interact with other antidepressants, especially monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs). However, this information is not as important as liver function laboratory results, as duloxetine can cause hepatotoxicity in some clients.
Choice B reason: Weight change in the last month is relevant to monitor, as duloxetine can cause weight loss or gain in some clients. However, this information is not as important as liver function laboratory results, as duloxetine can cause liver damage in some clients.
Choice C reason: Family history of mental illness is useful to assess, as duloxetine may be more effective or less effective in clients with certain genetic factors. However, this information is not as important as liver function laboratory results, as duloxetine can cause liver failure in some clients.
Choice D reason: Liver function laboratory results are most important to obtain, as duloxetine is metabolized by the liver and can cause hepatotoxicity in some clients. The nurse should monitor the client's liver enzymes and bilirubin levels before and during treatment with duloxetine and report any signs of liver impairment, such as jaundice, dark urine, abdominal pain, or fatigue.
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