Nursing Elites

1. A young female client prescribed amoxicillin (Amoxil) for a urinary tract infection is being taught by a nurse. Which statement should the nurse include in this client’s teaching?

• A. Use a second form of birth control while taking this medication.
• B. You will experience increased menstrual bleeding while on this medication.
• C. You may experience an irregular heartbeat while on this medication.
• D. Watch for blood in your urine while taking this drug.

Correct answer: A

Rationale: The correct statement for the nurse to include in the teaching is to advise the client to use a second form of birth control while taking amoxicillin. Penicillin, like amoxicillin, may reduce the effectiveness of estrogen-containing contraceptives, making it important to use additional contraceptive measures. The incorrect choices are B, C, and D. Increased menstrual bleeding, irregular heartbeat, or blood in the urine are not common side effects associated with amoxicillin use for a urinary tract infection.

2. When a patient is receiving high doses of a cephalosporin, which laboratory values will this patient's nurse monitor closely?

• A. Blood urea nitrogen (BUN), serum creatinine, and liver function tests
• B. Complete blood count and electrolytes
• C. Serum calcium and magnesium
• D. Serum glucose and lipids

Correct answer: A

Rationale: When a patient is receiving high doses of a cephalosporin, such as cefazolin, the nurse should closely monitor laboratory values that indicate renal and hepatic function. This includes checking the Blood Urea Nitrogen (BUN) and serum creatinine levels to assess kidney function. Additionally, monitoring liver function tests, such as AST, ALT, ALP, LDH, and bilirubin, is essential as cephalosporins can affect liver enzymes. Therefore, options B, C, and D are incorrect as they do not specifically address the parameters that are most pertinent when administering high doses of cephalosporins.

3. A nurse obtains a sterile urine specimen from a client’s Foley catheter. After applying a clamp to the drainage tubing distal to the injection port, which action should the nurse take next?

• A. Clamp another section of the tube to create a fixed sample section for retrieval.
• B. Insert a syringe into the injection port and aspirate the quantity of urine required.
• C. Clean the injection port cap of the drainage tubing with a povidone-iodine solution.
• D. Withdraw 10 mL of urine and discard it; then withdraw a fresh sample of urine.

Correct answer: C

Rationale: The correct next action for the nurse to take after applying a clamp to the drainage tubing distal to the injection port is to clean the injection port cap of the catheter drainage tubing with an appropriate antiseptic like povidone-iodine solution or alcohol. This step is crucial to prevent surface contamination before taking the urine sample. Clamping another section of the tube to create a fixed sample section or withdrawing and discarding urine are unnecessary and could lead to potential contamination. Inserting a syringe into the injection port and aspirating the required amount of urine directly from the catheter is the correct method for obtaining the urine sample, but cleaning the injection port cap should precede this step to ensure sterility.

4. The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic?

• A. Administering a small test dose to determine if hypersensitivity exists
• B. Having epinephrine available in case of a severe hypersensitivity reaction
• C. Monitoring baseline vital signs, including temperature and blood pressure
• D. Obtaining a specimen for culture and sensitivity

Correct answer: D

Rationale: The most crucial action before administering an antibiotic for a urinary tract infection is to obtain a specimen for culture and sensitivity. This ensures the accurate identification of the causative organism and helps determine the most effective antibiotic therapy. Administering a test dose to detect hypersensitivity is usually reserved for cases with a strong suspicion of allergy to a needed antibiotic. Keeping epinephrine available is important when there is a significant risk of a severe allergic reaction. Monitoring baseline vital signs is essential during antibiotic therapy but is not the top priority before administering the first dose.

5. Which of the following is a common complication of hypertension?

• A. Diabetes.
• B. Heart failure.
• C. Kidney failure.
• D. Stroke.

Correct answer: D

Rationale: The correct answer is D: Stroke. Hypertension can lead to stroke due to the increased pressure on blood vessels in the brain, which can result in reduced blood flow and oxygen to the brain tissue. While choices B (Heart failure) and C (Kidney failure) can be complications of hypertension, they are not as directly associated as stroke. Choice A, Diabetes, is not a direct complication of hypertension but rather a separate condition that can be influenced by various factors. However, stroke is more commonly linked to the increased pressure on blood vessels in the brain in individuals with hypertension.

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