A client has a new prescription for allopurinol. Which of the following instructions should the nurse include?

Correct Answer: A

Rationale: The correct instruction for a client prescribed allopurinol is to drink 2 liters of water daily. This helps reduce the risk of kidney stones, a potential side effect of allopurinol use. Adequate hydration is essential to prevent kidney stone formation and maintain kidney function while taking this medication.

Correct Answer: C

Rationale: In pharmacology, understanding the administration of medications is crucial for their efficacy. In the case of levothyroxine, the correct instruction for the client is to take the medication on an empty stomach in the morning (Option C). Levothyroxine is a synthetic form of the thyroid hormone T4, and it is best absorbed when taken on an empty stomach, at least 30 minutes to 1 hour before breakfast. This ensures optimal absorption and effectiveness of the medication. Option A (take this medication at bedtime) is incorrect because it contradicts the need for an empty stomach for optimal absorption. Taking levothyroxine at bedtime may result in decreased absorption due to food interference. Option B (take this medication with food) is incorrect because, as mentioned earlier, levothyroxine should be taken on an empty stomach to prevent interactions with food that may hinder its absorption. Option D (take this medication with an antacid) is also incorrect because antacids can interfere with the absorption of levothyroxine by binding to the medication and reducing its effectiveness. Educationally, understanding the specific administration instructions for different medications is essential for safe and effective patient care. It is important for nurses to educate clients on the proper administration of medications like levothyroxine to ensure optimal therapeutic outcomes.

Correct Answer: C

Rationale: In this scenario, the nurse should report the herbal supplement Kava to the provider. Kava has been associated with hepatotoxicity, which can further worsen the client's already increased liver enzymes. The other options, Glucosamine, Saw palmetto, and St. John's wort, do not typically have strong hepatotoxic effects. Glucosamine is commonly used for joint health and is not known to significantly impact liver enzymes. Saw palmetto is often used for benign prostatic hyperplasia and has not been linked to liver enzyme elevations. St. John's wort is used for depression but is more commonly associated with drug interactions rather than liver toxicity. Educationally, this question highlights the importance of understanding the potential hepatotoxic effects of herbal supplements, especially in clients with pre-existing liver issues. It emphasizes the need for nurses to be vigilant in monitoring and reporting any concerning signs or symptoms related to herbal supplement use to ensure patient safety and well-being.

Correct Answer: B

Rationale: Isosorbide is an organic nitrate used to manage angina. Concurrent use of sildenafil with organic nitrates, like isosorbide, is contraindicated due to the risk of fatal hypotension. It is essential for clients to avoid taking nitrate medications within 24 hours of using isosorbide to prevent serious complications.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The subcutaneous site for redness following injection. Adalimumab is typically administered via subcutaneous injection for the treatment of Rheumatoid Arthritis. Monitoring the injection site for redness is crucial as it can indicate local inflammation or an allergic reaction, which are important considerations in the management of the medication. Option A) is incorrect as Adalimumab is not administered intravenously, so monitoring the vein for thrombophlebitis is not relevant. Option C) is incorrect as Adalimumab is not administered orally, so monitoring the oral mucosa for ulceration is not necessary. Option D) is incorrect as Adalimumab is not administered via a transdermal patch, so monitoring the skin for irritation following patch removal is not applicable. In an educational context, understanding the route of administration of medications is vital for nursing practice to ensure safe and effective patient care. Monitoring for and recognizing potential side effects or complications associated with specific routes of administration is essential in providing quality nursing care and promoting positive patient outcomes.