Nokea
A nurse is caring for a client who has cellulitis and is to begin antibiotic therapy. The client has a history of anaphylactic reaction to penicillin. Which of the following medications is contraindicated for this client?
- A. Fluconazole
- B. Tetracycline
- C. Acyclovir
- D. Cephalexin
Correct Answer: D
Rationale: The correct answer is D: Cephalexin. Cephalexin is a first-generation cephalosporin antibiotic, which shares a similar beta-lactam ring structure with penicillin. Due to the client's history of anaphylactic reaction to penicillin, there is a high risk of cross-reactivity and potential severe allergic reaction if cephalexin is administered. Therefore, it is contraindicated for this client.
Choice A: Fluconazole is an antifungal medication and does not have cross-reactivity with penicillin.
Choice B: Tetracycline is a broad-spectrum antibiotic that is not related to penicillin.
Choice C: Acyclovir is an antiviral drug and is not contraindicated in a client with a penicillin allergy.
You may also like to solve these questions
A nurse is planning care for a client who has angina and a new prescription for nitroglycerin ointment. Which of the following actions should the nurse plan to take?
- A. Cover the administration area with plastic wrap.
- B. Massage the ointment into the skin.
- C. Spread the ointment in a 10 cm2 (4in2) area.
- D. Apply the ointment in a thick layer.
Correct Answer: A
Rationale: The correct answer is A. The nurse should cover the administration area with plastic wrap when applying nitroglycerin ointment to prevent accidental exposure to others and to ensure proper absorption of the medication. This step helps to enhance the drug's efficacy by promoting direct contact with the skin and preventing it from being rubbed off onto clothing or other surfaces. Massaging the ointment into the skin (B) may alter the absorption rate and distribution of the medication. Spreading the ointment in a 10 cm2 area (C) may lead to inaccurate dosing. Applying the ointment in a thick layer (D) may result in overdose or underdose due to inconsistent dosing.
A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Hyperglycemia
- D. Hypokalemia
Correct Answer: B
Rationale: The correct answer is B: Hyperkalemia. Spironolactone is a potassium-sparing diuretic and can lead to an increase in potassium levels (hyperkalemia). Lisinopril, an ACE inhibitor, can also contribute to this effect. Monitoring for hyperkalemia is crucial as it can lead to serious cardiac complications.
A: Hypoglycemia is not typically associated with spironolactone or lisinopril.
C: Hyperglycemia is not a common adverse effect of spironolactone or lisinopril.
D: Hypokalemia is unlikely with spironolactone, as it tends to increase potassium levels.
In summary, monitoring for hyperkalemia is essential when a client is taking spironolactone and lisinopril due to the potential for adverse cardiac events.
A nurse is reinforcing teaching about fluticasone topical lotion with the parent of a 9-month-old infant who has atopic dermatitis on the wrist. Which of the following instructions should the nurse include?
- A. Place a thick layer of the medication on open areas.'
- B. Rub the medication until it disappears.'
- C. Cover the area with an occlusive dressing.'
- D. Apply the medication to your infant's entire arm.'
Correct Answer: B
Rationale: The correct answer is B: Rub the medication until it disappears. This instruction is appropriate because it ensures proper absorption of the medication into the skin, maximizing its effectiveness. Rubbing the lotion helps distribute it evenly and facilitates absorption, which is crucial for treating atopic dermatitis.
Choice A is incorrect because applying a thick layer can lead to overuse of the medication and potential side effects. Choice C is incorrect as using an occlusive dressing can increase the risk of skin irritation and worsen the condition. Choice D is incorrect because applying the medication to the entire arm may not be necessary and could lead to unnecessary exposure. It is essential to focus on the affected area only.
A nurse is reviewing the medication administration record of a client who has a wound infection. The client has prescriptions for cefotetan and an NSAID. The nurse should monitor for which of the following medication interactions?
- A. Bleeding
- B. Dysrhythmias
- C. Dizziness
- D. Jaundice
Correct Answer: A
Rationale: The correct answer is A: Bleeding. Cefotetan is a cephalosporin antibiotic that can increase the risk of bleeding when taken with NSAIDs due to their additive effects on platelet function. The combination can lead to gastrointestinal bleeding or bruising. Dysrhythmias (choice B) are not typically associated with this drug combination. Dizziness (choice C) and jaundice (choice D) are not common interactions with cefotetan and NSAIDs.
A nurse is preparing to administer enoxaparin 5,000 units subcutaneous to a client. Which of the following actions should the nurse take?
- A. Insert the needle at a 45° or 90° angle.
- B. Hold the skin taut during administration
- C. Massage the injection site after administrating the enoxaparin.
- D. Use a 4 cm (1.6in) needle
Correct Answer: A
Rationale: The correct answer is A: Insert the needle at a 45° or 90° angle. When administering enoxaparin subcutaneously, the nurse should insert the needle at a 45° or 90° angle to ensure proper delivery into the subcutaneous tissue. Angling the needle helps prevent injecting the medication too deeply or too superficially, ensuring optimal absorption and effectiveness. Holding the skin taut (choice B) is not required for subcutaneous injections. Massaging the injection site (choice C) after administering enoxaparin is not recommended as it can cause irritation or bruising. Using a 4 cm needle (choice D) is not specified for enoxaparin administration and may not be appropriate for all clients.