A patient has been admitted with a fever of 102.8 F (39.3 C), with an unknown origin.

The patient’s urine is cloudy, foul-smelling, and dark amber.

Orders have been given to obtain urine and blood cultures immediately and to administer an antibiotic intravenously.

In what order should the nurse complete these orders?

Administer the antibiotic dose, then obtain blood and urine cultures.

Obtain urine culture, administer the antibiotic dose, then obtain blood culture.

Obtain blood culture, administer the antibiotic dose, then obtain urine culture.

Obtain blood and urine cultures, then administer the antibiotic dose.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Administering the antibiotic dose before obtaining the cultures could potentially affect the results of the cultures. Antibiotics are designed to kill or inhibit the growth of bacteria, so administering them before obtaining the cultures could lead to false negatives. This could lead to incorrect or delayed diagnosis and treatment.

Choice B rationale:

While obtaining the urine culture before administering the antibiotic dose is a good step, it should not be done before obtaining the blood culture. Blood cultures are usually obtained before urine cultures because they can help identify bacteria or fungi in the blood. This can be crucial in diagnosing conditions like sepsis. Furthermore, administering the antibiotic dose before obtaining the blood culture could affect the results of the culture.

Choice C rationale:

Obtaining the blood culture before administering the antibiotic dose is a good step, but the urine culture should also be obtained before the antibiotic dose is administered. Administering the antibiotic dose before obtaining all necessary cultures could affect the results of the cultures and lead to incorrect or delayed diagnosis and treatment.

Choice D rationale:

This is the correct sequence of actions. The nurse should first obtain both blood and urine cultures before administering the antibiotic dose. This is because the antibiotic could potentially kill or inhibit the growth of bacteria, which could affect the results of the cultures. By obtaining the cultures first, the healthcare team can ensure they are getting accurate results that have not been influenced by the antibiotics. This can lead to a more accurate diagnosis and more effective treatment plan.

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A rationale:

Amphotericin B is a potent antifungal medication used to treat severe fungal infections. However, it is typically reserved for life-threatening systemic fungal infections due to its potential for serious side effects, including kidney damage and infusion reactions. It is not commonly used as a first-line treatment for vaginal yeast infections.

Choice B rationale:

While antifungal creams can be effective for treating vaginal yeast infections, they typically require a treatment course of several days. This option may not be the best choice for a patient seeking a quicker, one-time treatment.

Choice C rationale:

A single dose of a fluconazole oral tablet is often an effective treatment for vaginal yeast infections. Fluconazole works by inhibiting the growth of the yeast causing the infection. It is convenient for patients because it only requires one dose, unlike creams or suppositories that need to be applied for several days.

Choice D rationale:

There are indeed alternatives to antifungal suppositories for treating vaginal yeast infections. As mentioned above, a single dose of fluconazole is one such alternative. Therefore, stating that there is no better alternative to the suppositories is not accurate.

A. Shortness of breath B. Black hairy tongue C. Itching D. Swelling of the tongue E. Wheezing

Correct Answer is ["A","C","D","E"]

Explanation

Choice A rationale:

Shortness of breath is a common symptom of a hypersensitivity reaction. This occurs because the body’s immune system responds to a foreign substance, known as an antigen, by producing specific antibodies. This immune response can cause inflammation and swelling in various parts of the body, including the airways, leading to shortness of breath.

Choice B rationale:

A black hairy tongue is not typically associated with a hypersensitivity reaction. It is a condition that causes the tongue to appear black and hairy, and it’s usually caused by an overgrowth of bacteria or yeast on the tongue. It’s not related to allergies or hypersensitivity reactions.

Choice C rationale:

Itching is another common symptom of a hypersensitivity reaction. When the body encounters an antigen, it triggers an immune response that releases chemicals like histamine. Histamine can cause itching, among other symptoms.

Choice D rationale:

Swelling of the tongue can be a symptom of a severe hypersensitivity reaction known as anaphylaxis. This is a medical emergency that requires immediate attention. The swelling is caused by inflammation in response to an antigen.

Choice E rationale:

Wheezing is a symptom of a hypersensitivity reaction, specifically type I hypersensitivity. This type of reaction includes allergic disorders, which affect the lungs among other parts of the body. The immune response to an antigen can cause the airways to narrow and produce a wheezing sound.

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Naxlex Comprehensive Predictor Exams

A patient has been prescribed a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, stating, “I don’t want to do this for 2 weeks!” What could be a possible alternative in this situation?

Correct Answer is C

Explanation

During antibiotic therapy, the nurse will monitor closely for signs and symptoms of a hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? (Select all that apply.)

Correct Answer is ["A","C","D","E"]

Explanation

A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?

Examine the following patient data for a patient who has been prescribed vancomycin. The nurse is evaluating a patient after administering several doses of Vancomycin IV. Which of the following changes would indicate a therapeutic response to the medication? (Select all that apply)

A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?

A nurse is reinforcing teaching with a client who has type 1 diabetes mellitus. Which statement from the client indicates that the teaching is effective?

The nurse checks the patient’s laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen?

During morning medication administration, the nurse discovered an error on the electronic Medication Administration Record (MAR) before the medication was given. What is the appropriate action for this “near-miss”?

When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?