Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

Reported history of alcoholism.

Toenails appear thick and yellow.

White blood cells count of 8,500/mm3 or 85 x 109 /L (SI).

Employed as a construction worker.

Answer and Explanation

The Correct Answer is A

Terbinafine HCL is primarily metabolized by the liver, and a history of alcoholism may indicate liver dysfunction or damage, which could aﬀect the metabolism and clearance of the drug. The nurse should assess the client's liver function, including liver enzymes, bilirubin levels, and albumin levels, before administering terbinafine HCL.

While options b, c, and d may be important assessment findings, they are not as crucial as a history of alcoholism when it comes to administering terbinafine HCL.

The thick and yellow toenails (option b) are typical symptoms of a fungal toenail infection, which is the reason for prescribing terbinafine HCL.

The white blood cell count (option c) is within normal range.

Being employed as a construction worker (option d) does not have a direct impact on the use of terbinafine HCL.

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Correct Answer is D

Explanation

The client is experiencing syncope (fainting) due to a drop in blood pressure to 70/40 mm Hg, which is too low. This suggests that the client's blood pressure medications are reducing their blood pressure too much, resulting in hypotension. The rationale for the nurse's decision to hold the client's scheduled antihypertensive medications is to prevent further hypotension and allow the client's blood pressure to stabilize at a safer level.

Option a is incorrect because diuresis (increased urine output) is not a likely cause of the client's hypotension.

Option b is incorrect because the client's symptoms suggest hypotension due to reduced blood pressure, rather than drug toxicity.

Option c is incorrect because the antagonistic interaction among blood pressure medications would result in reduced eﬀectiveness but would not necessarily cause hypotension.

A. CT scan that was performed 6 months earlier. B. Takes metformin hydrochloride for type 2 diabetes. C. Metal hip prosthesis was placed two years ago. D. Report on client’s sobriety for the last five years.

Correct Answer is B

Explanation

Metformin is a medication that can aﬀect kidney function. Since contrast dye used in CT scans is processed through the kidneys, it is important for the nurse to follow up on the client’s use of metformin before the CT scan with contrast. The client may need to temporarily stop taking metformin before and after the procedure to prevent any potential harm to their kidneys.

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Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who receives multiple antihypertensive multiple medications experiences syncope due to a drop in blood pressure to 70/40 mm Hg. Which is the rationale for the nurse’s decision to hold the client’s scheduled antihypertensive medications?

Correct Answer is D

Explanation

A client is scheduled for a spiral computed topography (CT) scan with contrast to evaluate for pulmonary embolism. Which information in the client’s history requires follow-up by the nurse?

Correct Answer is B

Explanation

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