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 recommendation aims to reduce the risk of kidney stones, a potential side effect associated with allopurinol use. Adequate hydration helps prevent the formation of uric acid crystals in the kidneys, which can lead to kidney stones. Therefore, encouraging increased water intake is essential in the management of clients taking allopurinol.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Kava. Kava is known to potentially cause hepatotoxicity and liver enzyme elevation. Therefore, it is crucial for the nurse to report the client's use of Kava to the healthcare provider to assess for any adverse effects on liver function. Option A) Glucosamine is commonly used for joint health and is not typically associated with liver enzyme elevation to the extent that would warrant immediate reporting. Option B) Saw palmetto is primarily used for benign prostatic hyperplasia and has minimal impact on liver enzymes. Option D) St. John's wort is often used for depression but is more commonly associated with drug interactions rather than liver enzyme elevation. Educationally, this question highlights the importance of understanding the potential adverse effects of herbal supplements, especially on liver function. Nurses need to be vigilant in assessing clients' use of herbal products and be aware of the specific risks associated with each supplement to ensure client safety and well-being.

Correct Answer: B

Rationale: Isosorbide, an organic nitrate used for angina, is contraindicated with sildenafil due to the risk of fatal hypotension. Concurrent use of these medications can lead to severe hypotension. Patients are advised to avoid taking nitrate medications for 24 hours after using isosorbide to prevent this dangerous interaction.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The subcutaneous site for redness following injection. Adalimumab is typically administered subcutaneously for the treatment of Rheumatoid Arthritis. Monitoring the injection site for redness is essential as it can indicate a local reaction or infection. This monitoring helps in early detection of any adverse effects and allows for prompt intervention if needed. Option A) monitoring the vein for thrombophlebitis during IV administration is incorrect because Adalimumab is not administered intravenously, making this monitoring unnecessary and irrelevant to this medication. Option C) monitoring the oral mucosa for ulceration after oral administration is also incorrect as Adalimumab is not administered orally. It is essential to match the appropriate route of administration with the monitoring parameters. Option D) monitoring the skin for irritation following removal of a transdermal patch is also incorrect since Adalimumab is not administered via transdermal patches. Understanding the correct route of administration for each medication is crucial in determining the appropriate monitoring parameters. Educationally, this question highlights the importance of understanding the routes of administration of medications and the corresponding monitoring requirements. Nurses need to be knowledgeable about the specific characteristics of each medication to provide safe and effective care to their patients. Monitoring for adverse effects is a crucial aspect of pharmacological management, and this question reinforces the significance of vigilance in assessing patients for potential complications related to medication administration.

Correct Answer: B

Rationale: In this scenario, with a serum calcium level of 8.8 mg/dL, the nurse should anticipate administering Calcium carbonate (option B). Calcium carbonate is a medication used to increase calcium levels in the body, making it the appropriate choice for a client with low serum calcium levels. Calcitonin-salmon (option A) is used to lower high levels of calcium in conditions such as hypercalcemia, which is the opposite of what the client in this case needs. Zoledronic acid (option C) and Ibandronate (option D) are both bisphosphonates used to treat conditions like osteoporosis by inhibiting bone resorption, but they do not directly address low serum calcium levels. From an educational perspective, understanding the specific indications of medications is crucial in pharmacology practice. Nurses need to be able to differentiate between medications that increase or decrease calcium levels based on the client's condition. This question highlights the importance of medication knowledge and its application in clinical scenarios to provide safe and effective patient care.