Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond?
A. Determine if the full course of the initial prescription of medication was taken.
Option a is important to consider, but it does not address the potential adverse effect of the medication.
B. Explain that the diarrhea may be an adverse effect that requires further evaluation.
Nitrofurantoin is an antibiotic commonly used to treat urinary tract infections. One of the adverse effects of nitrofurantoin is diarrhea, which may be severe and watery. Therefore, it is important for the home care nurse to inform the client that the diarrhea may be a side effect of the medication and requires further evaluation. The nurse should instruct the client to stop taking the medication and contact their healthcare provider for further assessment and treatment. The nurse should also assess the client's fluid and electrolyte status and monitor for signs of dehydration.
C. Offer instructions about the use of an over-the-counter antidiarrheal medication.
Option c may be appropriate in some cases, but it is not the priority intervention at this time.
D. advise that the infection has returned, and additional medication will be needed.
Option d is not necessarily true and may cause unnecessary alarm to the client.
This question is an excerpt from Nurse Dive's nursing test bank - HESI Pharmacology Proctored Exam. Take the full exam now
Full Explanation
Nitrofurantoin is an antibiotic commonly used to treat urinary tract infections. One of the adverse effects of nitrofurantoin is diarrhea, which may be severe and watery. Therefore, it is important for the home care nurse to inform the client that the diarrhea may be a side effect of the medication and requires further evaluation. The nurse should instruct the client to stop taking the medication and contact their healthcare provider for further assessment and treatment. The nurse should also assess the client's fluid and electrolyte status and monitor for signs of dehydration.
Option a is important to consider, but it does not address the potential adverse effect of the medication.
Option c may be appropriate in some cases, but it is not the priority intervention at this time.
Option d is not necessarily true and may cause unnecessary alarm to the client.
Similar Questions
An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client’s signs and symptoms, which data from the medical history has the most significance when planning this client’s care?
A. A coronary artery bypass procedure was performed in 1995.
B. Suffered with depression following death of spouse in 1999.
C. Digoxin and furosemide daily since 1996.
Digoxin is a medication commonly used to treat heart failure by strengthening the heart's contractions and slowing down the heart rate. However, it can also cause nausea, vomiting, and loss of appetite, especially when levels in the body are too high. Furosemide is a diuretic medication that helps to remove excess fluid from the body, which is often necessary in heart failure. However, it can also cause electrolyte imbalances, such as low potassium levels, which can contribute to nausea and vomiting. Therefore, in a client with heart failure who is experiencing these symptoms, it is important to assess their medication regimen, including dosages and serum levels, to ensure that they are not experiencing medication side effects or toxicity. Adjustments may need to be made to the client's medication regimen to manage symptoms effectively and prevent further complications. Options (a), (b), and (d) do not have as direct a correlation to the current symptoms and would not have the same level of significance when planning care for this client.
D. A Colonoscopy was performed for routine screening six months ago.
Full Explanation
Digoxin is a medication commonly used to treat heart failure by strengthening the heart's contractions and slowing down the heart rate. However, it can also cause nausea, vomiting, and loss of appetite, especially when levels in the body are too high. Furosemide is a diuretic medication that helps to remove excess fluid from the body, which is often necessary in heart failure. However, it can also cause electrolyte imbalances, such as low potassium levels, which can contribute to nausea and vomiting.
Therefore, in a client with heart failure who is experiencing these symptoms, it is important to assess their medication regimen, including dosages and serum levels, to ensure that they are not experiencing medication side effects or toxicity.
Adjustments may need to be made to the client's medication regimen to manage symptoms effectively and prevent further complications. Options (a), (b), and (d) do not have as direct a correlation to the current symptoms and would not have the same level of significance when planning care for this client.
A client with chemotherapy induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
A. Unusual irritability.
B. Diarrhea
C. Nausea
D. Involuntary movements.
Metoclopramide is a medication used to treat nausea and vomiting, including those caused by chemotherapy. However, it has a potential adverse effect of causing extrapyramidal symptoms (EPS), which are involuntary movements of the body, such as muscle spasms, twitching, or restlessness. These symptoms can be distressing for patients and can interfere with their quality of life. EPS can be a sign of tardive dyskinesia, a serious and irreversible neurological disorder. Therefore, it is essential for the nurse to monitor the client for any signs of EPS and report them immediately to the healthcare provider to prevent further complications. Unusual irritability, diarrhea, and nausea are also potential adverse effects of metoclopramide, but they are not as concerning as EPS.
Full Explanation
Metoclopramide is a medication used to treat nausea and vomiting, including those caused by chemotherapy. However, it has a potential adverse effect of causing extrapyramidal symptoms (EPS), which are involuntary movements of the body, such as muscle spasms, twitching, or restlessness. These symptoms can be distressing for patients and can interfere with their quality of life. EPS can be a sign of tardive dyskinesia, a serious and irreversible neurological disorder.
Therefore, it is essential for the nurse to monitor the client for any signs of EPS and report them immediately to the healthcare provider to prevent further complications. Unusual irritability, diarrhea, and nausea are also potential adverse effects of metoclopramide, but they are not as concerning as EPS.
A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?
A. Attaches spacer device to the inhaler.
B. Stores the medication at room temperature.
C. Primes the inhaler with 7 pumps.
Ipratropium is a medication used to treat chronic obstructive pulmonary disease (COPD)1. When using an ipratropium inhaler for the first time or if it has not been used for a while, it is important to prime the inhaler by spraying it into the air away from your face1. However, the inhaler only needs to be primed with 2 sprays, not 71. If the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.
D. Rinses mouth after each use.
Full Explanation
Ipratropium is a medication used to treat chronic obstructive pulmonary disease (COPD)1. When using an ipratropium inhaler for the first time or if it has not been used for a while, it is important to prime the inhaler by spraying it into the air away from your face1. However, the inhaler only needs to be primed with 2 sprays, not 71. If the client primes the inhaler with 7 pumps, it indicates that additional teaching is needed.
