Nursing Elites

1. 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.

2. Which of the following is most important for assessing when evaluating the effects of peritoneal dialysis?

• A. Serum potassium levels
• B. Blood pressure
• C. Daily weight
• D. Serum sodium levels

Correct answer: C

Rationale: Daily weight is the most crucial parameter to assess when evaluating the effects of peritoneal dialysis because it directly reflects fluid balance. Peritoneal dialysis involves the removal of excess fluid and waste products from the body. Monitoring daily weight enables the healthcare provider to track changes in fluid status, ensuring that the dialysis treatment is effective. While serum potassium levels, blood pressure, and serum sodium levels are important parameters to monitor in patients undergoing dialysis, they are not as directly indicative of the immediate effects of peritoneal dialysis on fluid balance as daily weight.

3. The nurse is collecting information from a client with chronic pancreatitis who reports persistent gnawing abdominal pain. To help the client manage the pain, which assessment data is most important for the nurse to obtain?

• A. Presence and activity of bowel sounds
• B. Color and consistency of feces
• C. Eating patterns and dietary intake
• D. Level and amount of physical activity

Correct answer: C

Rationale: In chronic pancreatitis, managing abdominal pain is crucial, and assessing the client's eating patterns and dietary intake is essential. Dietary modifications can help alleviate symptoms and reduce the workload on the pancreas. Choices A, B, and D are not directly related to pain management in chronic pancreatitis. Bowel sounds, fecal characteristics, and physical activity may provide important information in other conditions but are not the priority in this scenario.

4. Which of the following lab values would be most concerning in a patient receiving heparin therapy?

• A. Elevated hemoglobin levels.
• B. Low platelet count.
• C. High potassium levels.
• D. Low sodium levels.

Correct answer: B

Rationale: A low platelet count is most concerning in patients receiving heparin therapy due to the risk of heparin-induced thrombocytopenia. Heparin can sometimes cause a drop in platelet count, leading to a potentially serious condition where blood does not clot as it should. This can result in excessive bleeding or clot formation in blood vessels. Elevated hemoglobin levels, high potassium levels, and low sodium levels are not typically associated with heparin therapy and are less likely to cause immediate concerns or complications in this context.

5. The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient’s chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse’s next action?

• A. Administer the drug and observe closely for hypersensitivity reactions.
• B. Ask the provider whether a cephalosporin from a different generation may be used.
• C. Contact the provider to report drug hypersensitivity.
• D. Notify the provider and suggest an oral cephalosporin.

Correct answer: A

Rationale: When a patient has a history of a rash with amoxicillin, a beta-lactam antibiotic like ceftriaxone should be administered cautiously due to a possible cross-reactivity. The nurse should still administer the drug but closely monitor the patient for any signs of hypersensitivity reactions. Asking for a different generation of cephalosporin or suggesting an oral form does not address the potential cross-reactivity issue. Contacting the provider to report drug hypersensitivity would delay care when the patient needs immediate treatment.

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