The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom?

Correct Answer: B

Rationale: Omeprazole, a proton pump inhibitor, is used as an antiulcer agent to reduce gastric acid secretion. The optimal intended effect of omeprazole is the relief of pain and discomfort associated with gastric irritation, commonly referred to as heartburn. Therefore, the absence of heartburn indicates that the medication is working effectively in managing the client's gastric condition.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Causes orange discoloration of sweat, tears, urine, and feces. Rifampin is a medication known to cause this distinctive side effect, which is important for the client to be aware of to prevent unnecessary concern or alarm. Educating the client about this potential side effect promotes understanding and adherence to the prescribed treatment plan. Option A) Should always be taken with food or antacids is incorrect because rifampin is actually best absorbed on an empty stomach, so taking it with food or antacids may reduce its effectiveness. Option B) Should be double-dosed if one dose is forgotten is incorrect because doubling the dose can lead to harmful effects or toxicity. It is essential to adhere to the prescribed dosing schedule and never double up on doses. Option D) May not be discontinued independently if symptoms are gone in 3 months is incorrect because rifampin is often used for long-term therapy, especially in the treatment of conditions like tuberculosis. Discontinuing the medication prematurely can result in treatment failure or the development of drug-resistant strains of bacteria. In the educational context, understanding the side effects, correct administration, and importance of adherence to prescribed medications are crucial aspects of pharmacological education for both healthcare providers and clients to ensure safe and effective treatment outcomes.

Correct Answer: B

Rationale: When a client is stabilized with daily insulin injections, it is crucial to rotate the injection sites systematically. This practice helps prevent the development of lipodystrophy, which can affect insulin absorption and lead to inconsistent glucose control. Additionally, rotating sites minimizes discomfort and tissue damage, ensuring optimal insulin delivery and effectiveness.

Correct Answer: C

Rationale: The correct answer is C. Sildenafil (Viagra) enhances the vasodilating effect of nitric oxide and is contraindicated with the concurrent use of organic nitrates and nitroglycerin. Using nitroglycerin together with Viagra can lead to severe hypotension and cardiovascular collapse, making it unsafe to combine both medications.

Correct Answer: B

Rationale: In tuberculosis treatment, Cycloserine (Seromycin) is a second-line medication that requires close monitoring due to its potential side effects. The correct answer, B) To return to the clinic weekly for serum drug-level testing, is crucial because Cycloserine has a narrow therapeutic index, meaning the difference between a therapeutic dose and a toxic dose is small. Monitoring drug levels helps ensure the medication is effective yet not causing harm. Option A) To take the medication after meals is incorrect because Cycloserine is typically taken on an empty stomach for optimal absorption. Option C) To call the health care provider if a skin rash occurs is less critical than monitoring drug levels, which directly impact treatment effectiveness and safety. Option D) To restrict alcohol intake with this medication is not specifically linked to Cycloserine; it is more relevant for other medications like Isoniazid. Educationally, understanding the rationale behind the need for weekly serum drug-level testing can help students appreciate the importance of individualized medication regimens and monitoring in tuberculosis treatment. It reinforces the concept of pharmacokinetics and pharmacodynamics in clinical practice, highlighting the role of nurses in ensuring medication safety and efficacy through diligent monitoring and patient education.