Nokea
A client has a Cerebrospinal fluid infection with gram-negative bacteria. Which of the following Cephalosporin antibiotics should be administered IV to treat this infection?
- A. Cefaclor
- B. Cefazolin
- C. Cefepime
- D. Cephalexin
Correct Answer: C
Rationale: In treating a Cerebrospinal fluid infection caused by gram-negative bacteria, Cefepime, a fourth-generation cephalosporin, is the most suitable choice due to its enhanced efficacy against gram-negative organisms in such infections. Cefaclor (Choice A) is a second-generation cephalosporin more commonly used for respiratory tract infections. Cefazolin (Choice B) is a first-generation cephalosporin often used for skin and soft tissue infections. Cephalexin (Choice D) is a first-generation cephalosporin indicated for skin and urinary tract infections, but not the optimal choice for a Cerebrospinal fluid infection with gram-negative bacteria.
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A client has been prescribed an ACE Inhibitor for hypertension. Which of the following instructions should be included by the healthcare provider?
- A. Avoid salt substitutes.
- B. Take this medication at bedtime.
- C. Avoid foods high in potassium.
- D. Limit your fluid intake.
Correct Answer: A
Rationale: The correct answer is to 'Avoid salt substitutes.' ACE Inhibitors can increase potassium levels, so clients should avoid salt substitutes that contain potassium to prevent hyperkalemia, which is a potential side effect of ACE Inhibitors. Choice B 'Take this medication at bedtime' is incorrect as ACE Inhibitors are usually taken in the morning to avoid nocturnal diuresis. Choice C 'Avoid foods high in potassium' is incorrect because although ACE Inhibitors can increase potassium levels, clients are generally encouraged to consume potassium-rich foods in moderation unless contraindicated. Choice D 'Limit your fluid intake' is also incorrect as ACE Inhibitors do not typically require fluid restrictions unless specified by a healthcare provider for other reasons.
A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)
- A. A client at 8 weeks of gestation who asks for an Influenza immunization
- B. A client who takes Prednisone and has a possible Fungal infection
- C. A client who has chronic liver disease and is taking Hydrocodone
- D. A client who has Peptic Ulcer Disease, takes Sucralfate, and tells the nurse she has started taking OTC Aluminum Hydroxide
Correct Answer: B
Rationale: Prednisone, a glucocorticoid, should not be taken by a client who has a possible systemic fungal infection as it can worsen the infection. This combination can suppress the immune response, allowing the fungal infection to proliferate. Therefore, the nurse should contact the provider regarding this potential contraindication to medication. The other options do not present a contraindication related to the medication interactions described in the question.
When teaching a client with a prescription for Cephalexin, which of the following instructions should the nurse include?
- A. Take the medication with an antacid.
- B. Avoid dairy products while taking this medication.
- C. Expect your stools to turn black.
- D. Complete the full course of medication.
Correct Answer: D
Rationale: The correct instruction for a client prescribed with Cephalexin is to complete the full course of medication. This is crucial to ensure the infection is completely treated and to reduce the risk of antibiotic resistance. Choices A, B, and C are incorrect. Taking Cephalexin with an antacid is generally not recommended as it may reduce its effectiveness. While dairy products can interfere with certain antibiotics, they do not have a direct interaction with Cephalexin. Stools turning black is not an expected side effect of Cephalexin.
How do ACE inhibitors work?
- A. Block the vasoconstrictor and aldosterone effects of angiotensin II at the receptor site
- B. Block stimulation of beta 1 and beta 2 at the receptor sites
- C. Block the conversion of angiotensin I to the vasoconstrictor angiotensin II
- D. None of the above
Correct Answer: C
Rationale: ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor, and by blocking its production, ACE inhibitors help dilate blood vessels, reduce blood pressure, and decrease the workload of the heart. Choice A is incorrect because it describes the mechanism of action of angiotensin receptor blockers (ARBs), not ACE inhibitors. Choice B is incorrect as it describes beta-blockers, not ACE inhibitors. Choice D is incorrect as ACE inhibitors do have a specific mechanism of action.
A client has a new prescription for nitroglycerin. Which of the following adverse effects should the nurse instruct the client to report that can indicate the medication is effective?
- A. Headache
- B. Nausea
- C. Dizziness
- D. Dry mouth
Correct Answer: A
Rationale: Headache is a common side effect of nitroglycerin due to its vasodilatory effects. It can indicate that the medication is working effectively by dilating blood vessels, improving blood flow, and reducing cardiac workload. Therefore, the client should report experiencing headaches as it may suggest the therapeutic action of nitroglycerin. Nausea, dizziness, and dry mouth are not typically associated with the therapeutic effects of nitroglycerin and should be reported as adverse effects that may necessitate medical attention.