A nurse is reviewing the medical record of a client who has sinusitis and a new prescription for cefuroxime.
Which of the following client information is the priority for the nurse to report to the provider?
The client has a BUN level of 18 mg/dL.
The client reports a history of nausea with cefuroxime.
The client has a history of a severe penicillin allergy.
The client takes an aspirin daily.
The Correct Answer is C
This is the priority for the nurse to report to the provider because cefuroxime is a cephalosporin antibiotic that can cause serious or life-threatening allergic reactions in people who are allergic to penicillin. The nurse should not administer cefuroxime to this client until the provider is notified and an alternative antibiotic is prescribed.
Choice A is wrong because the client has a BUN level of 18 mg/dL, which is within the normal range of 7 to 20 mg/dL.
This does not indicate any renal impairment or adverse reaction to cefuroxime.
Choice B is wrong because the client reports a history of nausea with cefuroxime, which is a common side effect of this drug.
The nurse should instruct the client to take cefuroxime with food to reduce nausea, but this is not a priority to report to the provider.
Choice D is wrong because the client takes aspirin daily, which does not interact with cefuroxime.
The nurse should monitor the client for any signs of bleeding or bruising while taking aspirin, but this is not a priority to report to the provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Lithium can cause hyponatremia by increasing the secretion of antidiuretic hormone and reducing the renal clearance of sodium.
Strenuous exercise can also cause hyponatremia by increasing sweat loss and fluid intake. Therefore, a client who is taking lithium and starting a new exercise program is at risk of developing hyponatremia.
Choice A is wrong because hypomagnesemia is not a common side effect of lithium or exercise.
Choice B is wrong because hypocalcemia is not a common side effect of lithium or exercise.
Choice D is wrong because hypokalemia is not a common side effect of lithium or exercise.
However, lithium can interact with some diuretics that can cause hypokalemia, so the client should avoid taking these drugs without consulting their doctor. Normal ranges for electrolytes are:
Sodium: 135-145 mmol/L
Magnesium: 0.7-1.1 mmol/L
Calcium: 2.1-2.6 mmol/L
Potassium: 3.5-5.0 mmol/L
Correct Answer is A
Explanation
The correct sequence for mixing regular insulin and NPH insulin in the same syringe is important to ensure proper dosing. The nurse should follow these steps:
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Inject air into the NPH (intermediate-acting) insulin vial: Injecting air into the NPH vial first helps to equalize the pressure in the vial, making it easier to withdraw the insulin later. This step is done first to avoid contaminating the regular insulin vial with NPH insulin.
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Inject air into the regular insulin vial: Next, inject an amount of air equal to the intended regular insulin dose into the regular insulin vial.This also helps to equalize the pressure and makes it easier to withdraw the insulin.
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Withdraw the regular insulin from the vial: The nurse should withdraw the regular insulin first because it is clear and not contaminated. This prevents any NPH insulin from mixing into the regular insulin vial.
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Withdraw the regular insulin from the vial: Finally, the nurse withdraws the NPH insulin. Since the regular insulin has already been drawn up, there is no risk of contaminating the regular insulin with NPH insulin.
This sequence ensures that you don't contaminate the vials, and you accurately withdraw the appropriate doses of each insulin type.
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