Correct Answer: D

Rationale: The correct answer is D: Discontinue this medication one month before attempting to conceive. Isotretinoin is a teratogenic medication that can cause serious birth defects. It is crucial for the client to discontinue the medication before attempting to conceive to prevent harm to the fetus. Baseline liver function tests are important but not the most critical information in this scenario. Breastfeeding is not recommended while taking isotretinoin due to its potential harm to the infant, but the client is planning to become pregnant, not breastfeed. Avoiding multiple vitamins containing vitamin A is important to prevent vitamin A toxicity but not the most important consideration when planning pregnancy.

Correct Answer: B

Rationale: The correct answer is B: Hypertension. Methylphenidate is a central nervous system stimulant used to treat narcolepsy. It can increase blood pressure and heart rate, so it is crucial to review the client's medical record for hypertension to ensure the medication is safe to administer. Reviewing for hypercholesterolemia (choice
A), diabetes mellitus (choice
C), or bronchitis (choice
D) is not directly related to the potential side effects or contraindications of methylphenidate in a client with narcolepsy.
Therefore, these conditions are not the priority for review in this case.

Correct Answer: C

Rationale: The correct answer is C: Ask the client to describe how she takes the medication. This response is appropriate because increasing heartburn may be a sign of esophageal irritation, which can be caused by improper administration of oral bisphosphonates like risedronate. By asking the client to describe how she takes the medication, the nurse can assess if the client is following the proper administration instructions, which include taking the medication on an empty stomach with a full glass of water and remaining upright for at least 30 minutes after taking it to prevent esophageal irritation. This step allows the nurse to identify any potential issues with medication administration and provide appropriate education to address the client's symptoms.

Incorrect choices:
A: Suggest use of an antacid two hours after the medication - This choice does not address the potential issue of improper medication administration leading to esophageal irritation.
B: Remind the client to take the medication with plenty of water - While adequate water intake is important, this

Correct Answer: D

Rationale: The correct answer is D: Notify the healthcare provider. An INR of 2.8 indicates that the client's blood is not within the therapeutic range for warfarin. The nurse should notify the healthcare provider to discuss adjusting the dosage to ensure that the client's INR falls within the desired range of 2-3 for atrial fibrillation. Giving the next dose (
A) without consulting the provider could lead to potential bleeding complications. Obtaining another blood sample (
B) may delay necessary adjustments in medication. Monitoring for signs of bleeding (
C) is important but should not be the first action when the INR is subtherapeutic.

Correct Answer: B

Rationale:
To determine the correct dose of enoxaparin sodium to administer, we can use the formula:

Dose ordered (80 mg) / Dose on hand (60 mg) x Quantity on hand (0.6 mL) = X mL to administer

80 mg / 60 mg x 0.6 mL = 0.8 mL


Therefore, the nurse should administer 0.8 mL of enoxaparin sodium.
Choice A (0.6 mL) is incorrect because it is the amount in the preloaded syringe, but the prescribed dose is higher.

Choices C (1.0 mL) and D (1.2 mL) are incorrect as they do not match the calculated dose.