The patient has been started on treatment with amphotericin B for systemic
fungal infection. To prevent renal damage, the most important action by the
nurse will be to:
A.Administer the medication through a central venous access device.
B.Administer potassium supplements.
C. Administer 1000 mL of 0.9% saline.
D Administer the medication orally. - ANSWER Answer: C
Rationale: Amphotericin B is nephrotoxic in the majority of patients.
Nephrotoxicity can be reduced by infusing 1 L of saline on days amphotericin
is infused.
Which patient would be at greatest risk to develop a venous
thromboembolism (VTE) if a combination oral contraceptive were prescribed?
A.A 25-year-old patient who drinks 3 to 4 alcoholic drinks a day
B.A 45 yr old patient with family history of stroke
C.A 22-year-old patient who smokes 2 packs of cigarettes a day
D.A 29-year-old patient who has used birth control pills for 9 years -
,ANSWER Answer: C
Rationale: Heavy smoking, history of thromboembolism, and thrombophilias
(thrombosis-causing genetic disorders) are the most important
risk-increasing factors for thromboembolism with combination oral
contraceptives in women. Other risk factors include diabetes, hypertension,
cerebral vascular disease, coronary artery disease, and surgery involving
increased immobilization, thereby increasing the risk for postoperative
thrombosis.
A patient calls a clinic nurse to ask what she should do because she forgot to
take her oral contraceptive [Ortho Tri-Cyclen] for the last 2 days of the first
week of a 28-day pack. Which response by the nurse would be most
appropriate?
A."Take the missed two doses with the next dose."
B."Take two doses daily for the next 2 days."
C."Continue the oral contraceptive until the next menstruation."
D."Take a dose now and continue with the scheduled doses." - ANSWER
Answer: B
Rationale: Ortho Tri-Cyclen is a combination estrogen-progestin
contraceptive on a 28-day cycle. If 1 or more pills are missed in the first
week, instruct the patient to take 1 pill as soon as possible and continue with
, pack; also, instruct the patient to use an additional form of contraception for
7 days.
The nurse is instructing a client about Camila. Which statement by the client
indicates that the nurse needs to intervene?
n
A."I may experience some unusual bleeding with this medication."
B."These pills don't typically cause blood clots."
C."I have to take this medicine at the same time daily ." D."This drug acts
mainly by inhibiting ovulation." - ANSWER Answer: D
Rationale: Camila is a progestin-only contraceptive. The contraceptive effects
of Camila result largely from changing the cervical glands to produce a thick,
sticky mucus that acts as a barrier to penetration by sperm. Progestins
change the endometrium to make it less favorable for nidation. Compared
with combination oral contraceptives, Camila is a weak inhibitor of ovulation;
thus, this mechanism contributes little to their effects.
Camila does not contain estrogen and will not cause thromboembolic
disorders. Compared with combination oral contraceptives, Camila is more
likely to cause irregular bleeding. Camila is taken every day and should be
taken at the same time each day.
A nurse teaches a patient the use of combination oral contraceptives for
contraception. The nurse has evaluated teaching as effective if the patient
says which of the following?
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