A 46-year-old female patient returns to the clinic with continued dysuria after being treated with trimethoprim and sulfamethoxazole for 3 days. Which action will the nurse plan to take?
Remind the patient about the need to drink 1000 mL of fluids daily.
Obtain a midstream urine specimen for culture and sensitivity testing.
Suggest that the patient use acetaminophen (Tylenol) to relieve symptoms.
Tell the patient to take trimethoprim and sulfamethoxazole for 3 days.
The Correct Answer is B
This is because the persistent dysuria suggests that the initial treatment was not effective, and there may be a possibility of a resistant organism. Obtaining a midstream urine specimen for culture and sensitivity testing will help identify the specific microorganism causing the infection and determine the most effective antibiotic to use. The nurse should also instruct the patient to continue to drink plenty of fluids, as this will help flush out the bacteria and relieve symptoms. The nurse may suggest the use of acetaminophen (Tylenol) to relieve discomfort, but this should not be the only action taken, as treating the underlying infection is crucial. The nurse should not tell the patient to take trimethoprim and sulfamethoxazole for an additional three days, as the initial treatment was not effective, and a different course of treatment may be required based on the results of the urine culture and sensitivity testing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The nurse should quickly assess the patient's vital signs to check for signs of shock and instability. If the vital signs are unstable, the nurse should initiate appropriate interventions to stabilize the patient, such as administering oxygen, starting IV fluids, and providing continuous cardiac monitoring. Based on the sudden onset of severe upper abdominal pain, diaphoresis, and a firm abdomen, the nurse should suspect a possible perforation or bleeding related to the peptic ulcer. This is a medical emergency that requires immediate intervention. Therefore, the nurse should prioritize notifying the healthcare provider and preparing the patient for urgent medical evaluation.
Option A, irrigating the NG tube, is not appropriate in this situation and may further exacerbate the patient's condition if the ulcer has perforated.
Option B, elevating the foot of the bed, is also not appropriate as it does not address the patient's current symptoms.
Option C, giving the ordered antacid, may not be effective in addressing the severity of the patient's symptoms and should be postponed until the healthcare provider has evaluated the patient.
Correct Answer is D
Explanation
Cushing syndrome is caused by excessive cortisol production by the adrenal glands, which can result in weight gain and redistribution of fat to the abdomen, giving it a characteristic rounded appearance.
The other options mentioned in the question are not typically associated with Cushing syndrome. Chronically low blood pressure is not typically seen in Cushing syndrome, as cortisol is a hormone that can raise blood pressure. A bronzed appearance of the skin is more commonly seen in conditions like Addison's disease, where there is a deficiency of cortisol. Decreased axillary and pubic hair is not a common finding in Cushing syndrome, although excessive hair growth (hirsutism) may occur due to the excess of androgens produced by the adrenal glands.
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