A. Amoxicillin/clavulanate (Augmentin): Amoxicillin/clavulanate is a broad-spectrum antibiotic but not the preferred choice for anthrax exposure.

B. Nystatin (Mycostatin): Nystatin is an antifungal medication used for treating fungal infections, such as oral thrush or cutaneous candidiasis. It is not effective against anthrax, which is a bacterial infection.

C. Ciprofloxacin (Cipro): Ciprofloxacin, a fluoroquinolone, is the recommended first-line antibiotic for treating anthrax exposure due to its efficacy against Bacillus anthracis, the bacteria causing anthrax.

D. Tamoxifen: Tamoxifen is a selective estrogen receptor modulator (SERM) used primarily in the treatment of breast cancer. It has no role in treating bacterial infections like anthrax.

A. Fluoroquinolones: Fluoroquinolones, such as ciprofloxacin and levofloxacin, are known to have the potential to prolong the QT interval, increasing the risk of arrhythmias like Torsades de Pointes.

B. Penicillins: Penicillins do not typically cause QT prolongation. Their adverse effects are more likely to include allergic reactions or gastrointestinal disturbances.

C. Macrolides: Macrolides, such as azithromycin and erythromycin, are associated with QT interval prolongation and an increased risk of cardiac arrhythmias.

D. Beta-Lactams: Beta-lactams, which include penicillins and cephalosporins, are not commonly associated with QT prolongation. They are more likely to cause allergic reactions.

E. Cephalosporins: Cephalosporins are not typically associated with QT prolongation. They share a similar beta-lactam structure to penicillins.

A. Macrolides: Macrolides, such as azithromycin or erythromycin, are often used as alternatives in clients with a penicillin allergy, as they do not have a beta-lactam ring and generally do not cause cross-reactivity.

B. Antiretrovirals: Antiretrovirals are used for treating HIV/AIDS and are unrelated to penicillin antibiotics, with no cross-sensitivity concerns.

C. Antimalarials: Antimalarial drugs are used to treat malaria and are not related to penicillin antibiotics, so they would not be a concern for cross-sensitivity.

D. Cephalosporins: Cephalosporins have a beta-lactam structure similar to penicillins, which can sometimes cause cross-reactivity in clients with a penicillin allergy. However, the risk is lower with newer generations.

A. Stops fungal growth: Methotrexate is not an antifungal medication. This mechanism of action applies to drugs like azoles or polyenes, which are used to treat fungal infections.

B. Alters pH level: Altering pH is a mechanism used by some antacids or alkalinizing agents, not methotrexate.

C. Inhibits replication by blocking folic acid synthesis: Methotrexate is an antimetabolite that inhibits dihydrofolate reductase, an enzyme involved in folic acid synthesis. This inhibition impairs DNA synthesis, which is crucial in treating leukemia and other cancers.

D. Inhibits helper T cells: This mechanism of action is more closely related to immunosuppressive agents like cyclosporine or tacrolimus, which are used for preventing transplant rejection.

A. This medication should not be taken if you are lactating: Doxycycline is contraindicated in breastfeeding women as it can affect bone and teeth development in nursing infants.

B. This medication can cause hyperglycemia: Doxycycline is not known to cause hyperglycemia. This side effect is more common with certain steroids and antidiabetic drugs.

C. This medication may cause photosensitivity - Doxycycline can cause photosensitivity, making the skin more sensitive to sunlight and increasing the risk of sunburn.

D. This medication should not be taken with antacids: Doxycycline should not be taken with antacids or supplements containing calcium, magnesium, or aluminum as they can interfere with its absorption.

E. This medication may cause discoloration of the teeth: Doxycycline can cause permanent discoloration of the teeth if used during tooth development, which is why it is generally not recommended for children under 8 years or during pregnancy.

A. Alcohol consumption: Metronidazole has a disulfiram-like reaction with alcohol, which can cause severe nausea, vomiting, flushing, and tachycardia. Clients should avoid alcohol during and for at least 48 hours after the completion of metronidazole therapy.

B. Tyramine-based foods: Avoiding tyramine-rich foods is important with certain MAOIs due to the risk of hypertensive crisis, not with metronidazole.

C. Apple Juice: There is no significant interaction between metronidazole and apple juice.

D. Soy beans: Soybeans do not have an interaction with metronidazole.

A. Alopecia: Alopecia is a common side effect of chemotherapy because these medications target rapidly dividing cells, including hair follicles.

B. Bone marrow suppression: Chemotherapy can cause bone marrow suppression, leading to decreased production of blood cells, increasing the risk of anemia, infections, and bleeding.

C. Extrapyramidal symptoms: Extrapyramidal symptoms are associated with antipsychotic medications, not chemotherapy. They include symptoms like tremors, rigidity, and bradykinesia.

D. Bleeding: Due to bone marrow suppression, chemotherapy can decrease platelet counts, increasing the risk of bleeding.

E. Nausea: Nausea and vomiting are common adverse effects of chemotherapy due to the irritation of the gastrointestinal lining and activation of the vomiting center in the brain.

A. Measles: The measles vaccine is a live-attenuated vaccine, which contains a weakened form of the virus and should be avoided in immunocompromised clients due to the risk of infection.

B. Inactivated Polio: The inactivated polio vaccine (IPV) is not a live vaccine, as it uses killed virus, making it safe for immunocompromised clients.

C. Mumps: The mumps vaccine is a live-attenuated vaccine and is part of the MMR (measles, mumps, rubella) vaccine. It should be avoided in clients with weakened immune systems.

D. Varicella: The varicella (chickenpox) vaccine is a live-attenuated vaccine. It should not be given to immunocompromised clients due to the potential risk of severe infection.

E. Rubella: The rubella vaccine is also a live-attenuated vaccine, included in the MMR vaccine, and is contraindicated in immunocompromised individuals.

A. Clotting Factors: Epoetin alfa does not directly influence clotting factors.

B. Hemoglobin & hematocrit: Epoetin alfa is used to stimulate red blood cell production, which increases hemoglobin and hematocrit levels. Monitoring these values helps determine the drug’s therapeutic effectiveness in improving anemia associated with chronic renal disease.

C. Leukocyte Count: This medication primarily affects red blood cells, not white blood cells (leukocytes).

D. ALT & AST: These are liver function tests and are not related to the therapeutic effect of epoetin alfa.

A. Retinal toxicity: Chloroquine is associated with retinal toxicity, which can lead to vision changes or damage. Regular eye exams are necessary to monitor for early signs of toxicity.

B. Tumors: Chloroquine is not associated with the development of tumors.

C. Pancytopenia: This refers to a reduction in all blood cells and is not a known adverse effect of chloroquine.

D. Cancer: Chloroquine is not linked to an increased risk of cancer.

A. Lactic acidosis: Zidovudine has a black box warning for lactic acidosis, a rare but serious complication that can be life-threatening. The nurse should educate the client about symptoms of lactic acidosis, such as muscle pain and weakness.

B. Uterine Cancer: Zidovudine is not associated with uterine cancer.

C. Oral Candidiasis: This is not a black box warning for zidovudine, though oral candidiasis can occur in immunocompromised clients.

D. Thromboembolic Events: This is not a known black box warning for zidovudine.

A. Staining of teeth: Rifampin is not known to stain teeth.

B. Orange colored secretions: Rifampin commonly causes orange discoloration of body fluids, including urine, tears, and sweat. This is harmless but can be alarming if the client is not forewarned.

C. Constipation: Constipation is not a typical side effect of rifampin.

D. White-colored stools: Rifampin does not cause white-colored stools, but bile duct obstruction could.

A. Medications will need to be taken until the Mantoux test is negative: The Mantoux test (PPD) is used for diagnosis, not for monitoring treatment efficacy.

B. A typical course of treatment usually involves 6 months of consistent medication use. TB treatment typically requires at least 6 months of consistent medication adherence to fully eradicate the bacteria and prevent resistance.

C. Medications will need to be taken for the rest of the client's life, even if the client feels better: This is inaccurate. TB treatment is time-limited, though the full course must be completed.

D. The client's family will also need to take medications to prevent infection: Prophylactic treatment is not usually required for all family members, though they may need screening.

A. Regular sun exposure is needed to maximize drug efficacy: This is incorrect; in fact, doxycycline can cause photosensitivity, and sun exposure should be minimized.

B. Avoid water while taking this medication: Water should be taken with doxycycline to help prevent esophageal irritation.

C. Take this medication with antacids to relieve gastrointestinal symptoms: Antacids can also interfere with doxycycline absorption, so they should be avoided.

D. Avoid dairy products when taking this medication: Dairy products can bind to doxycycline and reduce its absorption in the gastrointestinal tract, which decreases its effectiveness. The client should avoid dairy when taking the medication.

A. Uterine cancer: No known contraindications exist between this condition and sulfamethoxazole/trimethoprim.

B. Client taking captopril for hypertension: Sulfamethoxazole/trimethoprim can increase potassium levels, and captopril (an ACE inhibitor) also raises potassium levels. Using these drugs together increases the risk of hyperkalemia, a dangerous condition.

C. Osteoporosis: This condition does not contraindicate the use of sulfamethoxazole/trimethoprim.

D. Multiple Sclerosis: No known contraindications exist for this condition with sulfamethoxazole/trimethoprim.

A. Thromboembolic events: This is not a black box warning for ciprofloxacin.

B. This drug has a black box warning for causing tendon rupture: Ciprofloxacin, a fluoroquinolone, has a black box warning for the risk of tendonitis and tendon rupture, especially in older adults or those on corticosteroids.

C. Endometrial cancers: Ciprofloxacin is not associated with cancer.

D. Breast cancer: There is no link between ciprofloxacin and breast cancer.

A. Tendon rupture: Tendon rupture is not a side effect associated with estrogen blockers.

B. Phlebitis: While thromboembolic events are a risk, phlebitis (inflammation of a vein) is not a typical concern.

C. Increased risk of lymphomas: Estrogen blockers are not known to increase the risk of lymphomas.

D. Thromboembolic events: Estrogen blockers, such as tamoxifen, are associated with an increased risk of thromboembolic events (e.g., deep vein thrombosis, pulmonary embolism).

A. This medication should be taken with a straw to avoid discoloration of the teeth: Liquid forms of iron supplements can stain teeth, so using a straw helps prevent this discoloration.

B. This medication is to be taken at night to prevent constipation from occurring: Iron supplements are better absorbed on an empty stomach or with vitamin C (during the day), not specifically at night. Constipation can still occur regardless of timing.

C. This medication should be taken with antacids to prevent gastrointestinal distress: Antacids interfere with iron absorption and should be avoided.

D. This medication is to be taken with milk to enhance absorption: Milk contains calcium, which can reduce iron absorption. Iron supplements should not be taken with dairy products.