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Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address?

A.

Reported history of alcoholism.

B.

Toenails appear thick and yellow.

C.

Employed as a construction worker.

D.

White blood cell count of 8,500/mm³ (8.5 x 10⁹/L).

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

Reported history of alcoholism is the most important assessment finding to address before administering terbinafine HCL. Terbinafine is metabolized by the liver, and clients with a history of alcoholism may have impaired liver function, increasing the risk of hepatotoxicity. Monitoring liver function and assessing for signs of liver damage are crucial before starting treatment.

 

Choice B rationale

 

Toenails appear thick and yellow is a common symptom of fungal toenail infection, but it is not the most critical assessment finding to address before administering terbinafine HCL. The focus should be on assessing liver function.

 

Choice C rationale

 

Employed as a construction worker is not the most critical assessment finding to address before administering terbinafine HCL. While occupational exposure to fungi may be relevant, the primary concern is liver function.

 

Choice D rationale

 

White blood cell count of 8,500/mm³ (8.5 x 10⁹/L) is within the normal range and is not the most critical assessment finding to address before administering terbinafine HCL. The primary concern is liver function.


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View Related questions

Correct Answer is D

Explanation

Choice A rationale

Flatulence is not a specific indicator of a serious complication related to a gallstone lodged in the common bile duct.

Choice B rationale

Amber urine is normal and does not indicate a serious complication.

Choice C rationale

Belching is not a specific indicator of a serious complication related to a gallstone lodged in the common bile duct.

Choice D rationale

Yellow sclera indicates jaundice, which is a sign of bile duct obstruction and requires immediate medical attention.

Correct Answer is C

Explanation

Choice A rationale

Auscultating bowel sounds is important for assessing gastrointestinal function, but it is not directly related to the administration of vancomycin for Clostridium difficile infection.

Choice B rationale

Measuring oxygen saturation is important for assessing respiratory function, but it is not directly related to the administration of vancomycin for Clostridium difficile infection.

Choice C rationale

Checking serum creatinine is crucial before administering vancomycin because this medication can be nephrotoxic. Monitoring kidney function helps prevent potential renal damage.

Choice D rationale

Assessing body temperature is important for monitoring infection, but it is not directly related to the administration of vancomycin for Clostridium difficile infection.

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