The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Hold the dose and notify the pharmacy to stop dispensing the next premixed doses.

Hold the dose and notify the healthcare provider of the changes in the laboratory studies.

Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests.

Begin the infusion and submit a drug reaction report to the nursing supervisor.

Answer and Explanation

The Correct Answer is B

A) Hold the dose and notify the pharmacy to stop dispensing the next premixed doses: This action may prevent further administration of fluconazole, but it does not address the underlying concern of rising liver enzyme levels. Holding the dose and notifying the healthcare provider directly would be more appropriate.

B) Hold the dose and notify the healthcare provider of the changes in the laboratory studies: This is the correct response. RisIng liver enzyme levels, indIcated by an increasing trend in aspartate aminotransferase (AST), suggest potential liver dysfunction or damage, which can be a serious adverse effect of fluconazole. The nurse should hold the dose and promptly inform the healthcare provider for further evaluation and management.

C) Begin the infusion and monitor the client's bl’od urea nitrogen (BUN), serum creatinine, and liver function tests: Initiating the infusion without addressing the rising liver enzyme levels could potentially worsen liver function. It is essential to hold the dose and inform the healthcare provider before proceeding with further administration.

D) Begin the infusion and submit a drug reaction report to the nursing supervisor: While it's im’ortant to document adverse reactions and submit reports as appropriate, the priority in this situation is to hold the dose and notify the healthcare provider to address the rising liver enzyme levels.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A) Recent oral intake: This information is important because pyridostigmine is typically administered orally and can interact with food, affecting its absorption. It is essential to ensure that the client has recently eaten or will eat soon to minimize gastrointestinal side effects and optimize medication absorption.

B) Trouble sleeping: While sleep disturbances can be a concern, particularly if they worsen with medication use, it may not be the most critical information to obtain before administering pyridostigmine. However, if the client experiences worsening sleep disturbances after starting the medication, it should be reported to the healthcare provider.

C) Unexplained weight loss: While weight loss can be a symptom of myasthenia gravis, it may not be directly related to the administration of pyridostigmine. However, if the client experiences significant weight loss or other unexplained symptoms, further assessment and evaluation may be necessary.

D) Difficulty with urination: Pyridostigmine can affect bladder function and may exacerbate urinary retention, especially in clients with myasthenia gravis. However, obtaining information about the client's recent oral intake is more crucial to ensure optimal medication absorption and minimize gastrointestinal side effects. Difficulty with urination should still be monitored, but it may not be the most immediate concern before administering the medication.

A. Measure the client’s vital signs. B. Obtain a fingerstick blood glucose. C. Perform a neurological exam. D. Administer glucagon intramuscularly (IM).

Correct Answer is B

Explanation

A) While measuring the client’s vital signs is a routine nursing intervention, the reported symptoms of confusion and blurred vision after receiving glipizide suggest the possibility of hypoglycemia. Vital signs may not provide immediate information about the client’s glucose levels or help confirm hypoglycemia. However, if the client’s symptoms persist or worsen, assessing vital signs becomes important to monitor for signs of shock or other complications.

B) Obtaining a fingerstick blood glucose is the priority action in this situation. Glipizide is an oral antidiabetic medication that stimulates insulin release from the pancreas, leading to lower blood glucose levels. Symptoms such as confusion and blurred vision are indicative of hypoglycemia, a potential adverse effect of glipizide. Checking the client’s blood glucose level will confirm hypoglycemia and guide further interventions.

C) While performing a neurological exam may be warranted if the client’s symptoms persist or if there are concerns about other neurological issues, confirming hypoglycemia with a fingerstick blood glucose test should be the immediate priority.

D) Administering glucagon intramuscularly (IM) is indicated for severe hypoglycemia when the client is unconscious or unable to swallow. However, in this scenario, the client is conscious and able to report symptoms. Before administering glucagon, it is essential to confirm hypoglycemia with a blood glucose measurement to avoid unnecessary interventions.

Therefore, the nurse should promptly obtain a fingerstick blood glucose to confirm hypoglycemia and initiate appropriate treatment for the client’s symptoms.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is administering IV fluconazole to a client who has systemic candidiasis. After reviewing the client's di’gnostic studies, the nurse identifies a rising trend in the liver enzyme levels for aspartate aminotransferase (AST). Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with myasthenia gravis receives a now prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

Correct Answer is A

Explanation

A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Correct Answer is B

Explanation

The nurse is providing discharge instructions for a client with metastatic cancer who is proscribed morphine for bone pain. Which information from the client indicates to the nurse an understanding of the medication?

A client with cystitis receives a prescription for phenazopyridine. Which information should the nurse explain to the client about its therapeutic effect?

The loop diuretic furosemide is prescribed for a client with a history of heart failure (HF). Which foods should the nurse encourage this client to eat?

Which instruction should the nurse include when teaching a client about self-administration of a bulk-forming laxative?

Ferrous sulfate elixir is prescribed for a client with iron deficiency anemia. Which instruction should the nurse provide this client about taking the liquid medication?

A client is receiving miotics for the treatment of open-angle glaucoma. The nurse determines that a priority nursing problem is a “Risk for injury and this is based on which etiology?