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 B

Explanation

Sumatriptan succinate is a medication used to treat migraine headaches by narrowing blood vessels in the brain. It is important to determine if the client has a history of coronary artery disease before administering the initial dose because the medication can also cause narrowing of the coronary arteries and potentially lead to a heart attack or other cardiac events.

Type 2 diabetes mellitus (a), seasonal allergic rhinitis (c), and irritable bowel syndrome (d) are not directly related to the use of sumatriptan succinate. However, it is still important to consider the client's medical history and overall health status when prescribing or administering any medication.

A. Administer both prescribed medications as scheduled. B. Hold the calcitriol but administer the calcium carbonate as scheduled. C. Hold the calcium carbonate but administer the calcitriol as scheduled. D. Hold both medications until contacting the healthcare provider.

Correct Answer is D

Explanation

A total calcium level of 14 mg/dL (3.5 mmol/L) is higher than the normal range of 2.2 to 2.6 millimoles per liter (mmol/L)1. Calcitriol and calcium carbonate are both medications used to increase calcium levels in the blood2. Since the client’s calcium level is already high, it would be important for the nurse to hold both medications and contact the healthcare provider for further instructions.

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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

Before administering initial dose of sumatriptan succinate to a client with a migraine headache, it is most to determine if the client’s history includes which problem?

Correct Answer is B

Explanation

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the total level of calcium is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?

Correct Answer is D

Explanation

A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a marathon. Which instruction should the nurse emphasize?

The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching?

A male client has been receiving the antibiotic gentamicin sulfate IV piggyback every 12 hours for several days. Which observations by the nurse indicate that the client may be experiencing an adverse eﬀect of gentamicin?

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this patient’s plan of care?

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?

The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client action requires intervention by the nurse?

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client’s skin and sclera. Which lab results should the nurse review?