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.
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.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Diclofenac, like other NSAIDs, can cause gastrointestinal irritation and bleeding. The client’s symptoms of pallor and fatigue may indicate anemia due to blood loss. Reviewing the client’s hemoglobin level would help the nurse determine if the client is experiencing anemia and if further evaluation and intervention are needed.

Correct Answer is C
Explanation
Ipratropium is a medication used to treat chronic obstructive pulmonary disease (COPD)1. When using an ipratropium inhaler for the first time or if it has not been used for a while, it is important to prime the inhaler by spraying it into the air away from your face1. However, the inhaler only needs to be primed with 2 sprays, not 71. If the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.

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