Nokea
The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action?
- A. Administer the drug since these are harmless side effects
- B. Hold the drug and notify the provider of these adverse reactions
- C. Obtain an order for an oral form of this medication
- D. Request an order for serum electrolytes
Correct Answer: B
Rationale: Polymyxin neurotoxicity (dizziness, numbness) warrants holding and reporting; these aren't harmless , and it's not oral . Polymyxins can cause nephrotoxicity and neurotoxicity.
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A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?
- A. One
- B. Two
- C. Three
- D. Four
Correct Answer: A
Rationale: A long half-life of 4 days means the drug remains effective for an extended period, typically requiring once-daily dosing.
Conjunctivitis in a child that is accompanied by acute otitis media is treated with:
- A. Sulfacetamide 10% ophthalmic solution (Bleph-10)
- B. Bacitracin/polymyxin B (Polysporin) ophthalmic drops
- C. Ciprofloxacin (Ciloxan) ophthalmic drops
- D. High-dose oral amoxicillin
Correct Answer: D
Rationale: Conjunctivitis with otitis suggests bacterial cause (e.g., H. influenzae), treated with oral amoxicillin.
The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurse's priority action?
- A. Discard the entire bottle and contents and obtain a new bottle.
- B. Find the drug information and create a new label for the bottle.
- C. Ask another nurse to verify the contents of the bottle.
- D. Administer the medication if the name of the drug can be clearly read.
Correct Answer: A
Rationale: When the drug label is soiled obscuring some information the safest action by the nurse is to discard the bottle and contents because drug labels contain a great deal of important information, far more than just the name of the drug. Concentration of the drug, expiration date, administration directions, and precautions may be missing from the label and so put the patient at risk. Looking up drug information in a drug handbook or consulting with another nurse will not supply the expiration date or concentration of medication. Be safe and discard the bottle and its contents.
Choose a drug that is used for both non-Hodgkin's lymphoma and rheumatoid arthritis:
- A. Doxorubicin
- B. Vincristine
- C. Infliximab
- D. Rituximab
Correct Answer: D
Rationale: Rituximab targets CD20 in lymphoma and is also used in rheumatoid arthritis.
The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
- A. Perfusion of blood to the subcutaneous tissue
- B. Integrity of the mucous membranes
- C. Environmental temperature
- D. Blood flow to the gastrointestinal tract
Correct Answer: C
Rationale: A cold environmental temperature can cause blood vessels to vasoconstrict and decreases absorption or in a hot environment vasodilate and increase absorption of IM medications. Blood flow to the subcutaneous tissues interferes with subcutaneous injection and blood flow to the gastrointestinal (GI) tract causes alterations in absorption for oral medications. The condition of mucous membranes can interfere with sublingual (under the tongue) and buccal (in the cheek) administration of drugs.