A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the healthcare provider's office that a dose was taken this morning. The nurse determines that:

Correct Answer: A

Rationale: The correct answer is A) The client should reschedule the appointment. Fexofenadine is a second-generation antihistamine that can interfere with allergy skin testing results by blocking the histamine response. This interference can lead to false-negative results if the test is conducted while the medication is still in the client's system. Option B) and C) are incorrect because adjusting the allergen dose would not address the interference caused by the antihistamine in the system. Option D) is also incorrect because delaying the reading of the skin test would not eliminate the impact of fexofenadine on the test results. In an educational context, it is important for healthcare providers to be aware of how various medications can affect diagnostic tests to ensure accurate results and appropriate patient care. Understanding the pharmacological properties of medications and their potential interactions with diagnostic procedures is crucial for safe and effective practice.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Cough and chest pain. Nitrofurantoin is known to cause serious side effects such as pulmonary toxicity, which can manifest as cough and chest pain. These symptoms indicate a potentially severe adverse reaction that requires immediate medical attention and discontinuation of the medication to prevent further complications. Option A) Nausea is a common side effect of nitrofurantoin but does not typically warrant discontinuation of the medication unless it is severe or persistent. Option B) Diarrhea is another common side effect that may improve with symptomatic treatment or dose adjustment without requiring cessation of therapy. Option C) Anorexia is not a typical side effect associated with nitrofurantoin and would not necessitate stopping the medication based on this symptom alone. From an educational perspective, it is crucial for healthcare providers to be aware of the potential serious side effects of medications like nitrofurantoin to ensure patient safety. Understanding the specific adverse reactions associated with each medication is essential for timely identification and appropriate management of side effects to optimize patient outcomes. In this case, recognizing the significance of cough and chest pain as potential indicators of pulmonary toxicity highlights the importance of thorough assessment and prompt intervention in clinical practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Monitor bowel activity. Codeine sulfate is an opioid analgesic that can cause constipation as a common side effect. By monitoring the client's bowel activity, the nurse can assess for any signs of constipation and implement appropriate interventions such as increasing fluid intake, dietary modifications, or stool softeners to prevent complications. Option A) Restrict fluid intake is incorrect because limiting fluid intake can exacerbate constipation, which is a common side effect of opioids like codeine sulfate. Adequate hydration is essential to prevent constipation. Option C) Monitor for hypertension is incorrect because codeine sulfate is not typically associated with causing hypertension. Monitoring blood pressure is important in some situations but not directly related to codeine sulfate use. Option D) Monitor peripheral pulses is incorrect because this action is not specifically related to the side effects or monitoring requirements of codeine sulfate. Monitoring peripheral pulses is more relevant in the context of assessing circulation and vascular status in conditions like peripheral arterial disease. Educationally, this question highlights the importance of understanding the side effects of opioid medications like codeine sulfate and the need for vigilant monitoring to prevent and manage potential adverse effects. It emphasizes the role of the nurse in assessing and managing common side effects to ensure the safety and well-being of the client.

Correct Answer: B

Rationale: The priority when administering etanercept (Enbrel) to a client with rheumatoid arthritis is to monitor white blood cell counts and platelet counts. Etanercept can lead to infections and pancytopenia, making it crucial to assess for changes in these blood parameters to detect any potential complications early on.

Correct Answer: B

Rationale: Insulin glargine (Lantus) is a long-acting insulin with a duration of action of approximately 24 hours, making it suitable for once-daily dosing at the same time each day. This regimen helps maintain consistent blood glucose levels and simplifies the client's treatment routine. Taking insulin glargine once daily provides basal insulin coverage throughout the day, reducing the risk of hypoglycemia compared to short-acting insulins that are taken before each meal.