A med-surg patient is scheduled to receive docusate (Colace) at 9am. The night nurse advises the patient had two loose stools during her shift. The nurse would anticipate:

Administering half of the scheduled dose of Colace

Administering the scheduled dose of Colace

Inserting a rectal tube to prevent excoriation

Holding the scheduled dose of Colace and notifying the ordering physician

Answer and Explanation

The Correct Answer is D

Choice A reason: Administering half of the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering half of the scheduled dose of Colace may not be enough to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.

Choice B reason: Administering the scheduled dose of Colace is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Administering the scheduled dose of Colace may not be necessary to prevent constipation, and it may also worsen diarrhea by adding more water and fat to the stool.

Choice C reason: Inserting a rectal tube to prevent excoriation is not the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. A rectal tube is a device that is inserted into the rectum and connected to a drainage bag, which collects the stool and prevents leakage and skin irritation. A rectal tube is used for patients who have fecal incontinence, which is the inability to control bowel movements. A rectal tube is not indicated for patients who have diarrhea, which is a condition of frequent and loose bowel movements. Inserting a rectal tube may not be effective to prevent excoriation, and it may also cause complications such as infection, bleeding, or perforation.

Choice D reason: Holding the scheduled dose of Colace and notifying the ordering physician is the correct action for the nurse who is caring for a patient who had two loose stools during the night shift. Colace is the brand name of docusate, which is a stool softener that works by increasing the amount of water and fat in the stool, making it easier to pass. Colace is used to treat and prevent constipation, which is a condition of infrequent or hard bowel movements. Colace is not indicated for diarrhea, which is a condition of frequent and loose bowel movements. Holding the scheduled dose of Colace may be appropriate to avoid further diarrhea, and notifying the ordering physician may be necessary to determine the cause and the treatment of diarrhea

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Correct Answer is C

Explanation

Choice A reason: This is incorrect. Antibiotics are not a term for a drug model, but a class of drugs that are used to treat bacterial infections. Antibiotics can have different chemical structures, mechanisms of action, and modes of action. For example, penicillin is a prototype drug of the beta lactam antibiotics, which inhibit the synthesis of bacterial cell walls¹.

Choice B reason: This is incorrect. Pharmacologic drug is not a term for a drug model, but a general term for any substance that has a physiological effect on the body. Pharmacologic drugs can belong to different classes, such as analgesics, antihistamines, or antivirals. For example, aspirin is a prototype drug of the nonsteroidal anti-inflammatory drugs (NSAIDs), which reduce pain, inflammation, and fever.

Choice C reason: This is correct. Prototype drug is the term used for a well understood drug model with which other drugs in its representative class are compared. A prototype drug is an individual drug that has similar chemical structure, mechanism of action, and mode of action as other drugs in its class. A prototype drug is often the first developed or the most important drug in its class, and is used as a reference for comparison. For example, morphine is a prototype drug of the opioid analgesics, which relieve pain by binding to opioid receptors in the brain and spinal cord.

Choice D reason: This is incorrect. Therapeutic drug is not a term for a drug model, but a term for any drug that is used to treat or prevent a disease or disorder. Therapeutic drugs can belong to different classes, such as antibiotics, antihypertensives, or antidepressants. For example, metformin is a prototype drug of the biguanide antidiabetic drugs, which lower blood glucose levels by reducing glucose production in the liver and increasing glucose uptake in the muscles.

A. A recent history of diarrhea for 3 days B. Serum creatinine 0.8 mg/dL C. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride D. A severe allergy to penicillins

Correct Answer is D

Explanation

Choice A reason: This is incorrect. A recent history of diarrhea for 3 days is not a contraindication for receiving a cephalosporin antibiotic. However, the nurse should monitor the client for signs of dehydration and electrolyte imbalance, and advise the client to drink plenty of fluids and avoid caffeine and alcohol. The nurse should also be aware that cephalosporins can cause or worsen diarrhea in some people, especially if they disrupt the normal flora of the gut. In rare cases, cephalosporins can cause a serious infection called Clostridioides difficile (C. difficile) colitis, which is characterized by severe diarrhea, abdominal pain, fever, and blood or pus in the stool. The nurse should instruct the client to report any of these symptoms and to avoid taking antidiarrheal drugs without consulting the doctor.

Choice B reason: This is incorrect. Serum creatinine 0.8 mg/dL is not a contraindication for receiving a cephalosporin antibiotic. Serum creatinine is a measure of kidney function, and a normal range for adults is 0.6 to 1.2 mg/dL. A high serum creatinine level may indicate kidney damage or impairment, which can affect the clearance of cephalosporins and increase the risk of toxicity. Therefore, the dose of cephalosporins may need to be adjusted in people with kidney problems, except for ceftriaxone and cefoperazone, which are excreted mainly through the bile. The nurse should check the client's renal function tests and the doctor's orders before administering a cephalosporin antibiotic.

Choice C reason: This is incorrect. A history of phlebitis following an IV infusion of 0.9% sodium chloride with 10 mEq of potassium chloride is not a contraindication for receiving a cephalosporin antibiotic. Phlebitis is the inflammation of a vein, which can be caused by mechanical, chemical, or infectious factors. Some IV solutions, such as potassium chloride, can irritate the vein and cause phlebitis. However, this does not mean that the client is allergic or intolerant to cephalosporins, which are usually well tolerated by the veins. The nurse should assess the client's IV site for signs of phlebitis, such as redness, swelling, pain, or warmth, and change the site if needed. The nurse should also dilute the cephalosporin antibiotic according to the manufacturer's instructions and administer it slowly over the recommended time to minimize the risk of phlebitis.

Choice D reason: This is correct. A severe allergy to penicillins is a contraindication for receiving a cephalosporin antibiotic. Penicillins and cephalosporins belong to the same class of beta lactam antibiotics, which share a similar chemical structure. Therefore, people who are allergic to penicillins have a higher chance of being allergic to cephalosporins, especially the first and secondgeneration ones. An allergic reaction to cephalosporins can range from mild skin rashes to life-threatening anaphylaxis, which is a severe hypersensitivity reaction that causes difficulty breathing, low blood pressure, and shock. The nurse should ask the client about their allergy history and the type and severity of their reactions. The nurse should report any history of penicillin allergy to the doctor and avoid giving cephalosporins to the client unless the doctor confirms that it is safe to do so..

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A med-surg patient is scheduled to receive docusate (Colace) at 9am. The night nurse advises the patient had two loose stools during her shift. The nurse would anticipate:

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Naxlex Comprehensive Predictor Exams

What is the term used for a well understood drug model with which other drugs in its representative class are compared?

Correct Answer is C

Explanation

A nurse is reviewing the medical record of a client who is to receive the first dose of a cephalosporin antibiotic via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication for the client to receive a cephalosporin and report to the provider?

Correct Answer is D

Explanation

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