Nursing Elites

1. A female patient will receive doxycycline to treat a sexually transmitted infection (STI). What information will the nurse include when teaching this patient about this medication?

• A. Nausea and vomiting are uncommon adverse effects.
• B. The drug may cause possible teratogenic effects.
• C. Increase intake of dairy products with each dose of this medication.
• D. Use a backup method of contraception if taking oral contraceptives.

Correct answer: D

Rationale: The correct answer is D. The desired action of oral contraceptives can be reduced when taken with tetracyclines like doxycycline. Therefore, patients on oral contraceptives should be advised to use a backup contraception method while taking doxycycline. Choice A is incorrect because nausea and vomiting are common adverse effects of doxycycline. Choice B is incorrect because doxycycline is not known for causing teratogenic effects. Choice C is incorrect because dairy products can interfere with the absorption of doxycycline, so they should be avoided when taking this medication.

2. A client recovering from extracorporeal shock wave lithotripsy for renal calculi has an ecchymotic area on the right lower back. What action should the nurse take?

• A. Administer fresh-frozen plasma.
• B. Apply an ice pack to the site.
• C. Place the client in the prone position.
• D. Obtain serum coagulation test results.

Correct answer: B

Rationale: After extracorporeal shock wave lithotripsy, ecchymosis can occur due to bleeding into the tissues from the shock waves. Applying an ice pack helps reduce the extent and discomfort of bruising. Administering fresh-frozen plasma and obtaining coagulation test results are not necessary as ecchymosis after this procedure is common and does not indicate a bleeding disorder that requires immediate intervention. Placing the client in the prone position will not address the bleeding or bruising in this situation.

3. A client is receiving a continuous infusion of normal saline at 125 ml/hour post abdominal surgery. The client is drowsy and complaining of constant abdominal pain and a headache. Urine output is 800 ml over the past 24 hours with a central venous pressure of 15 mmHg. The nurse notes respiratory crackles and bounding central pulse. Vital signs: temperature 101.2 F (38.4 C), heart rate 96 beats/minute, respiration 24 breaths/minute, and blood pressure of 160/90 mmHg. Which intervention should the nurse implement first?

• A. Calculate total intake and output for the last 24 hours.
• B. Administer a PRN dose of acetaminophen.
• C. Decrease IV fluids to a keep vein open (KVO) rate.
• D. Review the last administration of IV pain medication.

Correct answer: C

Rationale: In this scenario, the client is showing signs of fluid volume excess, such as drowsiness, abdominal pain, headache, crackles in the lungs, bounding pulse, and elevated blood pressure. Decreasing the IV fluids to a keep vein open (KVO) rate is crucial to prevent further fluid overload. This intervention helps in balancing fluid intake and output to prevent complications associated with fluid volume excess. Calculating total intake and output (Choice A) may be necessary but not the immediate priority in managing fluid overload. Administering acetaminophen (Choice B) may help with managing the fever but does not address the underlying issue of fluid overload. Reviewing the last administration of IV pain medication (Choice D) is not the priority in this situation where fluid overload is a concern.

4. An obese client with emphysema who smoked at least a pack of cigarettes daily is admitted after experiencing a sudden increase in dyspnea and activity intolerance. Oxygen therapy is initiated, and it is determined that the client will be discharged with oxygen. Which information is most important for the nurse to emphasize in the discharge teaching plan?

• A. Methods for weight loss
• B. Guidelines for oxygen use
• C. Approaches to conserve energy
• D. Strategies for smoking cessation

Correct answer: B

Rationale: In this scenario, the priority for the nurse to emphasize in the discharge teaching plan is the 'Guidelines for oxygen use.' As the client with emphysema is being discharged with oxygen therapy, it is crucial for the nurse to ensure that the client understands how to use oxygen properly to prevent complications and promote effective management of the condition. While weight loss, conserving energy, and smoking cessation are important aspects of care for this client, in this specific case, ensuring the safe and appropriate use of supplemental oxygen takes precedence to optimize the client's respiratory function and overall well-being.

5. The patient will begin taking penicillin G procaine (Wycillin). The nurse notes that the solution is milky in color. What action will the nurse take?

• A. Call the pharmacist and report the milky color.
• B. Add normal saline to dilute the medication.
• C. Call the physician and report the milky appearance.
• D. Administer the medication as ordered by the physician.

Correct answer: D

Rationale: The correct answer is to administer the medication as ordered by the physician. Penicillin G procaine (Wycillin) is known to have a milky appearance, which is normal. The milky color should not raise concerns for the nurse as it is an expected characteristic of this medication. Calling the pharmacist (choice A) or the physician (choice C) unnecessarily would delay the administration of the medication. Adding normal saline to dilute the medication (choice B) is not appropriate and could alter the medication's effectiveness. Therefore, the nurse should proceed with administering the medication as prescribed without any further action based on its milky appearance.

Similar Questions