Nokea
A nurse caring for a client taking which of the following drugs may notice increased adverse reactions if the client was prescribed nitrofurantoin (Macrodantin) resulting from an increased absorption of nitrofurantoin (Macrodantin)? Select all that apply.
- A. Benztropine (Cogentin)
- B. Simvastatin (Zocor)
- C. Tiotropium (Spiriva)
- D. Albuterol (Proventil)
- E. Dicyclomine (Bentyl)
Correct Answer: A,C,E
Rationale: Anticholinergic drugs, like benztropine (Cogentin), tiotropium (Spiriva), and dicyclomine (Bentyl), can cause delayed gastric emptying, leading to increased absorption of nitrofurantoin (Macrodantin), which may result in increased adverse reactions.
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A nurse is to obtain a daily urine pH as ordered. The client would most likely be receiving which of the following anti-infectives for a UTI because they work better in acidic urine? Select all that apply.
- A. Methenamine (Hiprex)
- B. Amoxicillin (Amoxil)
- C. Fosfomycin (Monurol)
- D. Nitrofurantoin (Macrodantin)
- E. Nalidixic (NegGram)
Correct Answer: A,D
Rationale: A daily urine pH level may be ordered by the physician for clients taking methenamine (Hiprex) or nitrofurantoin (Macrodantin) for a UTI because they work better in acidic urine.
When describing the adverse reactions associated with anti-infectives for UTIs, which of the following would the nurse explain as being most common?
- A. Gastrointestinal
- B. Dermatologic
- C. Neurologic
- D. Urologic
Correct Answer: A
Rationale: Although dermatologic reactions such as rash, pruritus, and photosensitivity reactions can occur and neurologic reactions such as dizziness, drowsiness, headache, blurred vision, and weakness can occur, adverse reactions associated with anti-infectives are primarily gastrointestinal in nature.
A nurse is educating a client undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the client as part of the client teaching plan?
- A. Notify the primary health care provider if abdominal pain occurs.
- B. Discontinue the therapy if symptoms vanish.
- C. Decrease fluid intake if symptoms subside.
- D. Increase fluid intake to at least 2000 mL/day.
Correct Answer: D
Rationale: The nurse should instruct the client to increase the fluid intake to at least 2000 mL/day to help remove bacteria from the genitourinary tract when caring for a client with a genitourinary tract bacterial infection. The nurse should stress the importance of continued therapy even if symptoms vanish or the client feels better after a few doses. The nurse should encourage continued increased fluid intake even if the symptoms subside. Abdominal pain is not commonly associated with genitourinary tract bacterial infections, so this instruction would not be necessary.
When describing the use of anti-infectives to treat urinary tract infections, which of the following would the nurse identify as the most common structure affected?
- A. Bladder
- B. Kidney
- C. Prostate gland
- D. Urethra
- E. Ureters
Correct Answer: A
Rationale: The urinary tract consists of the following anatomic structures: kidneys, ureters, bladder, prostate gland, and urethra. UTIs most commonly affect the bladder.
A nurse is conducting an in-service presentation for a group of nurses about UTIs and hospitalized clients. When discussing preventive measures, the nurse would identify which of the following as the primary nursing intervention for prevention?
- A. Proper perineal hygiene
- B. Use of urinary acidifiers
- C. Hand hygiene
- D. Routine urinalysis
Correct Answer: C
Rationale: UTIs may affect the hospitalized client or nursing home resident with an indwelling catheter or a disorder such as a stone in the urinary tract. The primary nursing intervention to prevent UTIs in the hospitalized client is good hand hygiene or handwashing. Proper perineal hygiene may be helpful but not as effective as hand hygiene. The use of urinary acidifiers is appropriate to maintain pH of the urine but not prevent UTIs. Routine urinalysis would help identify potential infections but not prevent them.