On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?
Monitor for signs of sodium and fluid retention.
Wound and blood specimens for culture and sensitivity.
Complete blood count and serum electrolytes.
Irrigation and topical antibiotic application to wound area.
The Correct Answer is B
Choice A reason: Monitoring for signs of sodium and fluid retention is not relevant to this situation, as broad spectrum antibiotics do not affect sodium or fluid balance. Sodium and fluid retention may be caused by other conditions such as heart failure, kidney disease, or liver disease.
Choice B reason: Obtaining wound and blood specimens for culture and sensitivity is most important before administering the first dose of a broad spectrum antibiotic, as this can help identify the specific type and strain of bacteria causing the infection and determine which antibiotic is most effective against it. Broad spectrum antibiotics are effective against a wide range of bacteria, but they may also kill beneficial bacteria and increase the risk of resistance or superinfection.
Choice C reason: Obtaining a complete blood count and serum electrolytes is not necessary before administering the first dose of a broad spectrum antibiotic, as these tests do not provide information about the type or severity of infection. A complete blood count may show an elevated white blood cell count or other changes in response to infection, but it does not identify the causative organism. Serum electrolytes may show abnormalities due to dehydration, vomiting, diarrhea, or other factors, but they do not indicate infection.
Choice D reason: Performing irrigation and topical antibiotic application to wound area is not sufficient before administering the first dose of a broad spectrum antibiotic, as this may not reach all sites of infection or eradicate all bacteria. Irrigation and topical antibiotic application may help clean and prevent further contamination of wound area, but they do not replace systemic antibiotic therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Chest tube insertion is not indicated for respiratory depression caused by opioid overdose. It is a procedure used to treat pneumothorax, hemothorax, or pleural effusion.
Choice B reason: CPR is not the first-line intervention for respiratory depression. It is only indicated when the client has no pulse or signs of life.
Choice C reason: Glasgow Coma Scale score is a tool to assess the level of consciousness of a client. It is not an intervention that can reverse respiratory depression.
Choice D reason: Naloxone is an opioid antagonist that can reverse the effects of opioid overdose. It has a short half-life and may need to be repeated if the client's condition does not improve or worsens.
Correct Answer is B
Explanation
Choice A reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.
Choice B reason: Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.
Choice C reason: Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.
Choice D reason: Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma. The nurse should assess the client for other signs of bleeding, such as hematuria, hematemesis, or melena.
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