You are a RN working in a busy Emergency Department (ED) caring for a patient with a stage 3 pressure injury of the right hip that is warm, and has purulent drainage. The ED physician orders an intermittent IV piggyback of the antibiotic Gentamycin to be started. What should you do prior to starting the infusion? Select the BEST answer.

Send a drug trough level to the lab

Have family members wait in the waiting room

Teach the patient the potential side effects of the medication

Send a culture & sensitivity to the lab

Answer and Explanation

The Correct Answer is D

A.   While monitoring drug levels is important, sending a trough level before the initial dose is not standard practice. Trough levels are typically checked just before the next dose of a medication is given, especially for antibiotics like Gentamicin that require monitoring for potential toxicity. Therefore, this option is not the best immediate action.
B.   While managing the environment and ensuring patient privacy is important, this option does not address any immediate medical needs related to starting the antibiotic infusion.
C.   Educating the patient about potential side effects is essential for informed consent and patient safety. However, while important, this is not the most critical action to take prior to the infusion.
D.   Before starting an antibiotic treatment, it is crucial to send a culture and sensitivity test to identify the specific pathogen causing the infection. This ensures that the selected antibiotic (Gentamicin) is appropriate for the identified bacteria, which is vital for effective treatment and to avoid antibiotic resistance.

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 B

Explanation

A. While obtaining a sputum culture is important for diagnosing a potential respiratory infection, it is not the immediate priority. The patient’s vital signs and oxygenation status need to be assessed first to ensure safety and to inform clinical decisions.
B. Assessing the patient’s vital signs and oxygen saturation is critical in this situation. The symptoms of disorientation, chills, and chest pain could indicate a serious condition such as pneumonia or pulmonary embolism.
C. Gathering a complete history is valuable for understanding the patient's condition and underlying causes of symptoms. However, this action should follow immediate assessments of vital signs and oxygen saturation, especially in a potentially unstable patient.
D. Administering the pneumococcal vaccine is important for prevention but is not an urgent action in this acute situation. The patient’s current symptoms require immediate assessment and intervention rather than preventive measures.

A. Hgb of less than 11 B. aPTT of 120 seconds C. Hgb of more than 11 D. PT/INR of 3.5

Correct Answer is C

Explanation

A. Epoetin Alfa is typically used to treat anemia, and it is often indicated when hemoglobin (Hgb) levels are below 11 g/dL. Therefore, if the Hgb is less than 11, it would be appropriate to administer the medication to help increase red blood cell production.
B. Do not hold. An activated partial thromboplastin time (aPTT) of 120 seconds indicates a prolonged coagulation time, which increases the risk of bleeding. However, Epoetin Alfa does not have a direct impact on coagulation, so this value alone would not warrant holding the medication.
C. Epoetin Alfa is generally not indicated if the Hgb level is already above 11 g/dL, particularly if there’s a risk of increasing the Hgb above the recommended therapeutic range (often above 12 g/dL). If the Hgb exceeds this level, the medication should be held to prevent complications such as thromboembolic events.
D. A PT/INR of 3.5 indicates a significantly prolonged prothrombin time, suggesting a high risk of bleeding. However, Epoetin Alfa does not directly cause bleeding.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who, upon awakening, was disoriented to person, place, and time. The client reports chills and chest pain that is worse upon inspiration. Which of the following actions is the nursing PRIORITY?

Correct Answer is B

Explanation

Your cancer patient has bone marrow suppression from their chemotherapy treatments, and is scheduled to receive Epoetin Alfa shots 3 times per week. Which of the following lab values would cause you to hold the administration of the medication for safety concerns?

Correct Answer is C

Explanation

The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

An RN is caring for a patient with Tuberculosis who is to receive a new prescription for Isoniazid (INH). The nurse knows that INH can cause peripheral neuropathy. To help prevent this from happening, the nurse can ask the provider for:

Your patient with Iron deficiency anemia is receiving Iron Dextran when their blood pressure suddenly starts to drop, their respiratory rate increases, and their breath becomes wheezy- sounding. Your PRIORITY intervention will be:

You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

A nurse is teaching a client who has SLE (Lupus) about self-care. Which of the following statements by the client indicates an understanding of the teaching?