the nurse provides home care instructions for a patient who will take a high dose of azithromycin after discharge from the hospital which statement by
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Nursing Elites

HESI RN

HESI Medical Surgical Practice Quiz

1. The patient will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching?

Correct answer: A

Rationale: The correct answer is A. Azithromycin peak levels may be reduced by antacids when taken at the same time, so patients should be cautioned to take antacids 2 hours before or 2 hours after taking the drug. Choice B is incorrect because high-dose azithromycin carries a risk for hepatotoxicity when taken with other potentially hepatotoxic drugs such as acetaminophen. Choice C is incorrect as diarrhea may indicate pseudomembranous colitis and should be reported, not expected as a common mild side effect. Choice D is incorrect; there is no restriction for dairy products while taking azithromycin.

2. The client with chronic renal failure is being taught about the importance of fluid restrictions. Which of the following statements by the client indicates that the teaching has been effective?

Correct answer: B

Rationale: The correct answer is B: 'I will need to limit my fluid intake to prevent fluid overload.' In chronic renal failure, fluid restrictions are crucial to prevent fluid overload and further damage to the kidneys. Option A is incorrect as unrestricted fluid intake can worsen the condition. Option C is also incorrect as total fluid intake needs to be restricted, not just other fluids. Option D is not ideal because thirst may not accurately reflect the body's fluid needs in chronic renal failure.

3. The healthcare provider caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The healthcare provider will contact the provider to

Correct answer: B

Rationale: When a patient reports a previous rash with amoxicillin, which is a type of penicillin, there is a concern for a penicillin allergy. In such cases, using an alternative antibiotic like erythromycin, which is not a penicillin, is the appropriate approach to avoid potential cross-reactivity and allergic reactions. Giving smaller doses of penicillin does not address the underlying allergy issue and can still lead to severe hypersensitivity reactions. Diphenhydramine (Benadryl) is used to manage allergic reactions but should not be the first choice in changing the antibiotic. While some patients allergic to penicillins may also be allergic to cephalosporins like cefuroxime, it is not the best immediate alternative in this scenario.

4. The nurse is assessing a client with chronic kidney disease (CKD). Which finding is most important for the nurse to respond to first?

Correct answer: A

Rationale: The correct answer is A. Potassium level of 6.0 mEq/L indicates hyperkalemia, which is a critical electrolyte imbalance in clients with chronic kidney disease. Hyperkalemia can lead to life-threatening arrhythmias, making it the priority finding to address. Choice B, a daily urine output of 400 ml, may indicate decreased kidney function but does not pose an immediate life-threatening risk compared to hyperkalemia. Peripheral neuropathy (Choice C) and uremic fetor (Choice D) are common manifestations of CKD but are not as urgent as addressing a potentially fatal electrolyte imbalance like hyperkalemia.

5. The provider has ordered Kayexalate and sorbitol to be administered to a patient. The nurse caring for this patient would expect which serum electrolyte values prior to administration of this therapy?

Correct answer: C

Rationale: Severe hyperkalemia, with a potassium level of 6.9 mEq/L, requires aggressive treatment with Kayexalate and sorbitol to increase the body’s excretion of potassium. The normal range for serum potassium is 3.5 to 5.5 mEq/L, so patients with the other potassium levels would not be treated aggressively or would need potassium supplementation. Therefore, option C (Sodium 135 mEq/L and potassium 6.9 mEq/L) is the correct choice as it indicates severe hyperkalemia warranting the administration of Kayexalate and sorbitol. Options A, B, and D have either potassium levels within normal limits, which would not necessitate this aggressive treatment, or potassium levels that are lower than what would typically prompt the need for Kayexalate and sorbitol.

Similar Questions

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