The nurse is caring for a client following the insertion of a Nexplanon rod. Which priority instruction should the nurse provide this client?
Back up methods are required for the first 24-hours following insertion.
Smoking cessation is required to prevent thrombolytic events from occurring.
This implant is associated with weight loss so make sure you consume enough calories.
Prevention rate with Nexplanon is 100%.
The Correct Answer is A
A. Following the insertion of the Nexplanon rod, it is important to inform the client that backup contraception methods are needed for the first 24 hours to ensure pregnancy prevention while the implant becomes effective.
B. While smoking cessation is advised due to the increased risk of thrombotic events with hormonal contraceptives, it is not the priority instruction immediately following the insertion of Nexplanon.
C. The statement regarding weight loss is incorrect; Nexplanon is more commonly associated with weight gain rather than loss, so advising clients on calorie consumption is misleading.
D. Although Nexplanon has a high efficacy rate in preventing pregnancy, stating a prevention rate of 100% is inaccurate and misleading, as no contraceptive method is completely foolproof.
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Correct Answer is ["B","C","F"]
Explanation
A. Morphine administered intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect entirely.
B. Diphenhydramine in tablet form is absorbed through the gastrointestinal tract and undergoes significant first-pass metabolism in the liver, affecting its bioavailability.
C. Famotidine in tablet form is also subject to first-pass metabolism, which can reduce its effectiveness.
D. Nitroglycerin sublingual tablets are designed to bypass the first-pass metabolism by being absorbed directly into the bloodstream through the mucous membranes.
E. The same applies to nitroglycerin 10mg sublingual tablets; they also avoid the first-pass effect due to sublingual administration.
F. Acetaminophen is taken orally and undergoes first-pass metabolism in the liver, which can significantly affect its overall bioavailability.
Correct Answer is C
Explanation
A. Hydrochlorothiazide is a thiazide diuretic that can be used for hypertension and edema but is not specifically indicated for open-angle glaucoma.
B. Furosemide is a loop diuretic used primarily for fluid overload conditions and does not have a specific role in the treatment of open-angle glaucoma.
C. Acetazolamide is a carbonic anhydrase inhibitor that reduces aqueous humor production and is specifically used to lower intraocular pressure in clients with open-angle glaucoma.
D. Spironolactone is a potassium-sparing diuretic used mainly for conditions like heart failure and hypertension, and it is not indicated for the treatment of open-angle glaucoma.