The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

Protect the skin from sunlight while taking the drug.

Take with orange juice to enhance GI absorption.

Return to the clinic weekly to obtain serum drug levels.

Take with milk or antacids to prevent gastrointestinal (GI) irritation.

Answer and Explanation

The Correct Answer is A

Choice A reason: Tetracycline HCl can cause photosensitivity, which increases the risk of sunburn and skin damage. The client should avoid direct sunlight and use sunscreen and protective clothing while taking the drug.

Choice B reason: Orange juice is acidic and can decrease the absorption of tetracycline HCl. The client should take the drug with water and avoid acidic foods and beverages.

Choice C reason: Serum drug levels are not routinely monitored for tetracycline HCl. The client should follow the prescribed dosage and duration of the therapy.

Choice D reason: Milk and antacids can interfere with the absorption of tetracycline HCl. The client should take the drug at least 1 hour before or 2 hours after meals and avoid dairy products and antacids.

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Correct Answer is D

Explanation

Choice A reason: This is not an appropriate action for the nurse to take. Increasing the intake of saturated fats will worsen the side effects of orlistat, which inhibits the absorption of fats in the intestine. The client should be advised to follow a low-fat diet while taking orlistat.

Choice B reason: This is not an appropriate action for the nurse to take. Oily stools and flatus are common and expected side effects of orlistat, and they do not indicate a serious adverse reaction. The client does not need to stop taking the drug or contact her healthcare provider unless the symptoms are severe or persistent.

Choice C reason: This is not an appropriate action for the nurse to take. Obtaining a stool specimen to evaluate for occult blood and fat content is not necessary for a client taking orlistat. The presence of fat in the stool is normal and expected with orlistat, and there is no evidence of bleeding in the client's case.

Choice D reason: This is the appropriate action for the nurse to take. Asking the client to describe her dietary intake history for the last several days will help the nurse assess the client's compliance with the recommended low-fat diet and provide education and counseling as needed. The nurse can also monitor the client's weight loss progress and adjust the dosage of orlistat accordingly.

A. St. John's Wort can decrease plasma concentrations of cyclosporine. B. Adding the herb can decrease the need for corticosteroids. C. The client probably used this herb to treat depression. D. Ingestion of St. John's Wort can reduce the client's intake of sodium.

Correct Answer is A

Explanation

Choice A reason: This is the most significant information about this finding. St. John's Wort is an herbal supplement that is used for various conditions, such as depression, anxiety, or insomnia. However, it can also interact with many medications, including cyclosporine, which is an immunosuppressant drug that is used to prevent organ rejection after transplantation. St. John's Wort can induce the activity of certain enzymes in the liver that metabolize cyclosporine, leading to lower levels of the drug in the blood and reduced efficacy. This can increase the risk of graft rejection and complications. The nurse should inform the healthcare provider and educate the client about the potential interaction and the importance of avoiding St. John's Wort and other herbal products without consulting the provider.

Choice B reason: This is not significant information about this finding. Adding the herb can not decrease the need for corticosteroids, which are another type of immunosuppressant drug that are used to prevent organ rejection after transplantation. St. John's Wort does not have any anti-inflammatory or immunomodulatory effects that can reduce the dosage or frequency of corticosteroids. On the contrary, it can interfere with the metabolism and absorption of corticosteroids, as well as other medications, and cause adverse effects or reduced efficacy. The nurse should advise the client to follow the prescribed regimen of corticosteroids and other drugs, and not to self-medicate with herbal products.

Choice C reason: This is not significant information about this finding. The client probably used this herb to treat depression, which is a common condition among transplant recipients, due to the stress, anxiety, and lifestyle changes associated with the procedure. However, this does not explain the cause of the graft rejection, nor does it justify the use of St. John's Wort without consulting the healthcare provider. St. John's Wort is not a proven or safe treatment for depression, and it can interact with many antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs), and cause serious side effects, such as serotonin syndrome. The nurse should assess the client's mental health status and refer the client to a mental health professional if needed.

Choice D reason: This is not a significant information about this finding. Ingestion of St. John's Wort can not reduce the client's intake of sodium, which is an electrolyte that is essential for the fluid balance and nerve function in the body. St. John's Wort does not have any diuretic or sodium-lowering effects that can affect the sodium levels in the blood or urine. The nurse should monitor the client's sodium levels and fluid intake and output, and report any abnormal findings to the healthcare provider. The nurse should also teach the client about the dietary sources and recommendations of sodium, and the signs and symptoms of hyponatremia or hypernatremia.

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The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Correct Answer is A

Explanation

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