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A client develops a mild skin irritation while receiving penicillin therapy. Which of the following would the nurse advise the client to avoid? Select all that apply.
- A. Harsh soaps
- B. Perfumed lotions
- C. Antipyretic creams
- D. Rubbing the irritating area
- E. Wearing rough or irritating clothing
Correct Answer: A,B,D,E
Rationale: When skin irritation is present during the administration of penicillin, the nurse should advise the client to avoid harsh soaps, perfumed lotions, rubbing the irritated area, or wearing rough or irritating clothing.
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When performing an ongoing assessment of a client receiving amoxicillin (Amoxil), the nurse should monitor the client for which of the following? Select all that apply.
- A. Relief of symptoms
- B. Development of a rash
- C. Increase in appetite
- D. Change in appearance or amount of drainage
- E. Decrease in temperature
Correct Answer: A,C,D,E
Rationale: An ongoing assessment is important in evaluating the client's response to therapy, such as a decrease in temperature, relief of symptoms caused by the infection, an increase in appetite, and a change in the appearance and amount of drainage.
After teaching a group of nursing students about penicillins, the instructor determines that the teaching was successful when the students identify which of the following as a group? Select all that apply.
- A. Synthetic penicillins
- B. Natural penicillins
- C. Penicillinase-resistant penicillins
- D. Aminopenicillins
- E. Extended-spectrum penicillins
Correct Answer: B,C,D,E
Rationale: Penicillins are categorized into four groups including the natural penicillins, penicillinase-resistant penicillins, aminopenicillins, and extended-spectrum penicillins.
The nurse is providing care to a patient who is receiving an aminoglycoside for a wound infection. The patient is also ordered to receive a cephalosporin. The nurse would carefully assess the patient for which of the following?
- A. Nausea
- B. Nephrotoxicity
- C. Increased bleeding
- D. Respiratory difficulty
Correct Answer: B
Rationale: When cephalosporin is administered with aminoglycosides, it increases the risk for nephrotoxicity and should be closely monitored. Nausea is an adverse reaction of cephalosporins in patients with gastrointestinal tract infection. The risk of bleeding increases when cephalosporin is administered with oral anticoagulants. The risk for respiratory difficulty and a disulfiram-like reaction increases if alcohol is consumed within 72 hours after administration of certain cephalosporins.
After teaching a group of nursing students about the different generations of cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a first-generation cephalosporin? Select all that apply.
- A. Cefepime (Maxipime)
- B. Cefazolin (Ancef)
- C. Cefoxitin (Mefoxin)
- D. Cephalexin (Keflex)
- E. Cefaclor (Raniclor)
Correct Answer: B,D
Rationale: Cefazolin and cephalexin are examples of first-generation cephalosporins. Cefoxitin and cefaclor are examples of second-generation cephalosporins. Cefepime is an example of a fourth-generation cephalosporin.
A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation?
- A. Instruct patient to increase dietary intake.
- B. Inform the primary health provider immediately.
- C. Record assessments on patient's chart.
- D. Inquire about any previous drug allergies.
Correct Answer: C
Rationale: When the patient declares that he is feeling better and is also showing improved health, it should be recorded on the patient's chart. If the condition of the patient has improved, the patient will show an increased appetite, but there is no need to instruct the patient to increase dietary intake. The primary health provider need not be informed about the condition immediately unless the patient shows signs of deterioration or complications. The nurse should inquire about previous drug allergies before the start of therapy.