An adolescent with pelvic inflammatory disease (PID) is admitted to the hospital after 14 days of taking levofloxacin 500 mg PO daily and metronidazole 500 mg IV piggyback (IVPB) twice daily (BID). She asks the nurse, "Why do I have to be in the hospital? Why can't I get my treatment at home?" Which purpose should the nurse provide that supports an effective outcome?

Detection of early symptoms of Jarisch-Herxheimer reaction.

Collection of serial anaerobic cultures of vaginal discharge.

Administration of a supervised parenteral antibiotic protocol.

Implementation of contact precautions to prevent spread of infection.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Jarisch-Herxheimer reaction is seen in spirochete infections like syphilis or Lyme disease, not typically in pelvic inflammatory disease (PID) treated with antibiotics like levofloxacin and metronidazole.

Choice B rationale

Serial anaerobic cultures are not routine for PID management. Diagnosis and management focus more on clinical symptoms and empirical antibiotic therapy rather than continuous culture monitoring.

Choice C rationale

Supervised parenteral antibiotic protocols ensure proper dosage and administration, crucial for severe infections requiring hospitalization. Monitoring treatment in a controlled environment increases effectiveness and reduces complications.

Choice D rationale

While infection control is important, PID typically spreads through sexual contact, and hospital admission for infection control is not the primary reason. The focus is more on effective treatment delivery in severe cases. .

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Correct Answer is A

Explanation

Choice A rationale

Reporting the findings immediately to the healthcare provider is crucial in this scenario. Intense testicular pain with erythema and swelling can indicate testicular torsion, which is a medical emergency requiring prompt surgical intervention to preserve testicular function. Delays in treatment can result in loss of the affected testicle.

Choice B rationale

Obtaining a swab of secretions from the penis and urethra is not the immediate priority in this situation. While it can be important for diagnosing infections, the acute nature of the symptoms suggests a more urgent condition, such as testicular torsion, which needs immediate attention from a healthcare provider.

Choice C rationale

Providing the adolescent with a urinal for urinary hesitancy does not address the immediate concern of intense pain and significant swelling. The symptoms suggest a possible emergency, and addressing urinary hesitancy can wait until after more urgent conditions are ruled out or treated.

Choice D rationale

Collecting a sterile urine sample for culture and sensitivity is not the immediate priority. While it might be useful for diagnosing infections, the symptoms of intense pain, erythema, and swelling in the testicular area suggest an urgent condition like testicular torsion, which requires immediate evaluation and treatment.

A. Place the client in Trendelenburg. B. Notify the operating room team. C. Administer oxygen via face mask. D. Administer a fluid bolus of 500 mL. E. Administer a fluid bolus of 500 mL.

Correct Answer is A

Explanation

Choice A rationale

Placing the client in Trendelenburg position is the first action as it helps to relieve pressure off the umbilical cord by using gravity to shift the fetus away from the pelvis. This position helps to prevent cord compression and maintain blood flow to the fetus.

Choice B rationale

Notifying the operating room team is important but should be done after immediately addressing the umbilical cord prolapse to prevent fetal hypoxia. Initial physical intervention takes priority.

Choice C rationale

Administering oxygen via face mask is beneficial for the mother and fetus but is not the immediate first action. Positioning the client to relieve pressure off the umbilical cord is more urgent.

Choice D rationale

Administering a fluid bolus of 500 mL can help maintain maternal blood pressure, but it is not the first action. The priority is to reposition the client to prevent cord compression.

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Naxlex Comprehensive Predictor Exams

A male adolescent arrives at the clinic and reports intense pain in the testicular area that occurred during football practice at high school. The nurse observes the scrotum and identifies significant erythema and swelling. Which action should the nurse take?

Correct Answer is A

Explanation

A client who is in labor states, "I think my water just broke!" The nurse notes that the umbilical cord is on the perineum. Which action should the nurse perform first?

Correct Answer is A

Explanation

A one-month-old infant admitted to the hospital with dehydration and failure to thrive receives a prescription for enteral feedings. To maintain normal growth and development of the infant, which action should the nurse include?

Following a vaginal delivery, the nurse places the neonate under the radiant warmer to elicit spontaneous respirations. The newborn has a heart rate of 100 beats per minute and remains apneic when the nurse flicks the soles of the feet. Which action should the nurse implement next?

A nurse is speaking with a client who is addicted to heroin and who just learned that she is pregnant. The client states, "I just started taking methadone. Is there anything else I can do to make sure my baby is healthy?" Which information should the nurse provide?

The mother of a 4-month-old baby girl asks the nurse when she should introduce solid foods to her infant.The mother states, "My mother says I should put rice cereal in the baby's bottle now.”. The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?

A child with hemophilia arrives at the clinic with a swollen knee after falling off a bicycle. Which action should the nurse implement first?

A mother brings her male preschooler to the clinic because he has had diarrhea, vomiting, and high fevers for the past three days. The child begins to cry and cling to his mother when the nurse enters the examination room. Which action should the nurse implement to get the child to cooperate?