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.

Answer and Explanation

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.

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Correct Answer is D

Explanation

Distended neck veins are a sign of increased central venous pressure, which can result from fluid volume excess. Fluid volume excess can also cause edema, crackles in the lungs, and increased blood pressure.

Choice A is wrong because decreased bowel sounds are not related to fluid volume excess.

Decreased bowel sounds can indicate ileus, obstruction, or peritonitis. Choice B is wrong because bilateral muscle weakness is not a sign of fluid volume excess.

Bilateral muscle weakness can be caused by electrolyte imbalances, neuromuscular disorders, or stroke.

Choice C is wrong because thready pulse is a sign of fluid volume deficit, not excess.

Thready pulse indicates poor perfusion and low cardiac output, which can result from dehydration, hemorrhage, or shock.

A. Store the remaining half of the pill in the automated medication dispensing system. B. Dispose of the remaining medication while another nurse observes. C. Return the remaining medication to the facility’s pharmacy. D. Place the remaining half of the pill in the unit-dose package.

Correct Answer is B

Explanation

This is because hydromorphone is a controlled substance and any unused portion should be discarded in the presence of a witness. Some possible explanations for the other choices are:

Choice A is wrong because storing the remaining half of the pill in the automated medication dispensing system could lead to errors in dosage or diversion of the drug.

Choice C is wrong because returning the remaining medication to the facility’s pharmacy is not a recommended practice for controlled substances and could also result in errors or diversion.

Choice D is wrong because placing the remaining half of the pill in the unit-dose package could compromise the integrity and stability of the medication and expose it to environmental factors.

Normal ranges for hydromorphone are not applicable as it is a synthetic opioid analgesic that does not have a therapeutic level.

However, some factors that may affect its pharmacokinetics and pharmacodynamics are age, weight, renal function, liver function, genetic polymorphisms, and drug interactions.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess?

Correct Answer is D

Explanation

A nurse is administering 4 mg of hydromorphone to a client by mouth every 4 hr. The medication is provided as hydromorphone 8 mg per tablet. Which of the following actions is appropriate for the nurse to take?

Correct Answer is B

Explanation

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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?