Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A client receiving a cephalosporin has passed six distinct-smelling, unformed stools in the first 6 hours of the nurse's shift. What is the nurse's best action?
A. Stop all antibiotics and implement strict use of alcohol-based hand sanitizer.
Stopping all antibiotics and implementing strict use of alcohol-based hand sanitizer is not the appropriate response to the observed symptoms. The focus should be on addressing the potential infection.
B. Discontinue the cephalosporin and call the provider to recommend vancomycin or metronidazole.
The symptoms suggest the possibility of Clostridium difficile infection, and discontinuing the cephalosporin is crucial. Vancomycin or metronidazole is commonly used to treat C. difficile infection.
C. Call the provider to request an additional antibiotic to override the effects of the cephalosporin.
Requesting an additional antibiotic to override the effects of the cephalosporin is not the appropriate course of action. The focus should be on discontinuing the causative antibiotic.
D. Increase the dose of cephalosporin and provide isolation measures.
Increasing the dose of cephalosporin is contraindicated in the presence of suspected C. difficile infection. Isolation measures may be implemented, but the priority is discontinuing the causative antibiotic and initiating appropriate treatment for the infection.
This question is an excerpt from Nurse Dive's nursing test bank - Ramsussen Section 4 Module 11. Pharmocology For Professional Nursing Proctored Exam. Take the full exam now
Full Explanation
a) Stopping all antibiotics and implementing strict use of alcohol-based hand sanitizer is not the appropriate response to the observed symptoms. The focus should be on addressing the potential infection.
b) The symptoms suggest the possibility of Clostridium difficile infection, and discontinuing the cephalosporin is crucial. Vancomycin or metronidazole is commonly used to treat C. difficile infection.
c) Requesting an additional antibiotic to override the effects of the cephalosporin is not the appropriate course of action. The focus should be on discontinuing the causative antibiotic.
d) Increasing the dose of cephalosporin is contraindicated in the presence of suspected C. difficile infection. Isolation measures may be implemented, but the priority is discontinuing the causative antibiotic and initiating appropriate treatment for the infection.
Similar Questions
A nurse is talking with a client who has peptic ulcer disease and starting therapy with sucralfate. What must the nurse include in the client education?
A. "Take it with an antacid."
Taking sucralfate with an antacid is not recommended, as antacids can interfere with the effectiveness of sucralfate.
B. Take 30 to 60 minutes before meals.
Sucralfate should be taken 30 to 60 minutes before meals to ensure optimal binding to the gastric mucosa and to form a protective barrier.
C. "Take it whenever indigestion occurs."
Taking sucralfate whenever indigestion occurs may not provide consistent protection, as its effectiveness is enhanced when taken before meals.
D. "Take it immediately after meals."
Taking sucralfate immediately after meals is not recommended, as it may interfere with its ability to form a protective coating on the gastric mucosa.
Full Explanation
a) Taking sucralfate with an antacid is not recommended, as antacids can interfere with the effectiveness of sucralfate.
b) Sucralfate should be taken 30 to 60 minutes before meals to ensure optimal binding to the gastric mucosa and to form a protective barrier.
c) Taking sucralfate whenever indigestion occurs may not provide consistent protection, as its effectiveness is enhanced when taken before meals.
d) Taking sucralfate immediately after meals is not recommended, as it may interfere with its ability to form a protective coating on the gastric mucosa.
A nurse tells a nursing student that glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct?
A. "The negative feedback loop prevents side effects."
While the negative feedback loop plays a role in the body's natural regulation of corticosteroids, it does not eliminate the potential for side effects when exogenous glucocorticoids are administered.
B. "As long as the drug is taken as prescribed, side effects usually do not occur."
Taking the drug as prescribed does not guarantee the absence of side effects. Side effects are inherent to glucocorticoid therapy and can occur even with appropriate use.
C. "By interrupting the inflammatory process, these drugs inhibit side effects."
Interrupting the inflammatory process does not directly inhibit side effects. The anti inflammatory action is the therapeutic effect, but it does not eliminate the potential for side effects.
D. "Side effects can occur and are dependent on the dose and duration of treatment."
Glucocorticoids, even those produced naturally by the body, can cause side effects, and the likelihood and severity of these side effects depend on the dose and duration of treatment. Regular monitoring and appropriate management are essential.
Full Explanation
a) While the negative feedback loop plays a role in the body's natural regulation of corticosteroids, it does not eliminate the potential for side effects when exogenous glucocorticoids are administered.
b) Taking the drug as prescribed does not guarantee the absence of side effects. Side effects are inherent to glucocorticoid therapy and can occur even with appropriate use.
c) Interrupting the inflammatory process does not directly inhibit side effects. The anti inflammatory action is the therapeutic effect, but it does not eliminate the potential for side effects.
d) Glucocorticoids, even those produced naturally by the body, can cause side effects, and the likelihood and severity of these side effects depend on the dose and duration of treatment. Regular monitoring and appropriate management are essential.
A client who is recovering from total knee surgery is preparing for discharge. Which of these statements indicates the client needs further teaching?
A. "I can rotate acetaminophen with ibuprofen if needed for pain control, so I don't take too much of either one."
The statement about rotating acetaminophen with ibuprofen for pain control demonstrates an understanding of the principles of multimodal pain management and is appropriate.
B. "If I still have pain 10 minutes after taking 1000 mg of acetaminophen, I should take two of oxycodone-acetaminophen."
The statement about taking two oxycodone-acetaminophen tablets if pain persists after a certain time frame is appropriate and reflects awareness of appropriate pain management strategies.
C. "Taking more than 4000 mg of acetaminophen in a day can cause liver problems."
The statement about the maximum daily dose of acetaminophen and its potential to cause liver problems is accurate and indicates good knowledge.
D. "Taking acetaminophen often could mask any infection-related fevers I might have."
The statement about acetaminophen masking infection-related fevers is incorrect. While acetaminophen can reduce fever, it does not mask the presence of an infection. This statement indicates a need for further teaching.
Full Explanation
a) The statement about rotating acetaminophen with ibuprofen for pain control demonstrates an understanding of the principles of multimodal pain management and is appropriate.
b) The statement about taking two oxycodone-acetaminophen tablets if pain persists after a certain time frame is appropriate and reflects awareness of appropriate pain management strategies.
c) The statement about the maximum daily dose of acetaminophen and its potential to cause liver problems is accurate and indicates good knowledge.
d) The statement about acetaminophen masking infection-related fevers is incorrect. While acetaminophen can reduce fever, it does not mask the presence of an infection. This statement indicates a need for further teaching.