Nursing Elites

1. A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?

• A. Cefaclor
• B. Cefazolin
• C. Cefepime
• D. Cephalexin

Correct answer: C

Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.

2. A healthcare professional is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The healthcare professional should recognize that the medication affected which of the following systems in the client?

• A. Cardiovascular
• B. Immune
• C. Central nervous
• D. Gastrointestinal

Correct answer: C

Rationale: The correct answer is C: Central nervous. Extrapyramidal effects are movement disorders caused by certain medications affecting the central nervous system. These effects can include symptoms like tremors, rigidity, and bradykinesia. Medications like typical antipsychotics induce extrapyramidal effects by interfering with dopamine transmission in the central nervous system. Choices A, B, and D are incorrect as extrapyramidal effects are specifically related to the central nervous system and not the cardiovascular, immune, or gastrointestinal systems.

3. A client with Bipolar disorder has a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• A. This medication can safely be taken during pregnancy.
• B. Eliminate grapefruit juice from your diet.
• C. You will need to have a complete blood count and carbamazepine levels drawn periodically.
• D. Notify your provider if you develop a rash.

Correct answer: B

Rationale: The correct answer is B: "Eliminate grapefruit juice from your diet." Grapefruit juice affects carbamazepine metabolism and should be avoided. It can lead to increased levels of the medication, potentially causing toxicity. Monitoring carbamazepine blood levels and the complete blood count (CBC) is essential to ensure the medication's efficacy and safety. Although choice A is incorrect (This medication can safely be taken during pregnancy), carbamazepine is classified as a Pregnancy Category D drug, which means there is positive evidence of human fetal risk. Choice D (Notify your provider if you develop a rash) is also important because carbamazepine can cause serious adverse effects like Stevens-Johnson syndrome, which can be life-threatening. Regular monitoring and prompt reporting of any rash are crucial. Therefore, choices C and D are also relevant instructions for the client.

4. A healthcare provider plans to administer Morphine IV to a postoperative client. Which of the following actions should the provider take?

• A. Monitor for seizures and confusion with repeated doses.
• B. Protect the client's skin from severe diarrhea associated with morphine.
• C. Withhold this medication if the respiratory rate is less than 12/min.
• D. Administer Morphine intermittently via IV bolus over 30 seconds or less.

Correct answer: C

Rationale: The correct action for the provider is to withhold morphine if the client's respiratory rate is 12/min or less. Respiratory depression is a serious side effect of morphine and other opioids. Withholding the medication and informing the healthcare provider is essential to prevent further respiratory compromise in the client. Choices A, B, and D are incorrect because monitoring for seizures and confusion, protecting the client's skin from severe diarrhea, and administering morphine via IV bolus over 30 seconds or less are not the primary actions to ensure client safety when administering morphine IV. Respiratory status is crucial due to the risk of respiratory depression associated with opioid administration.

5. A client is receiving discharge teaching for Metronidazole prescribed for an infection. Which statement by the client indicates an understanding of the teaching?

• A. I should avoid drinking alcohol while taking this medication.
• B. I should take this medication with food.
• C. I should increase my intake of dairy products while taking this medication.
• D. I should avoid taking dairy products while taking this medication.

Correct answer: A

Rationale: The correct answer is A. Alcohol should be avoided while taking Metronidazole because it can lead to a disulfiram-like reaction, causing severe nausea and vomiting. It is important for the client to understand this to prevent adverse reactions and ensure the effectiveness of the medication in treating the infection. Choices B, C, and D are incorrect because taking Metronidazole with food is recommended to decrease gastrointestinal upset, and there is no specific need to increase or avoid dairy products while taking this medication.

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