Nokea
A nurse needs to start methenamine for a client. The nurse checks the client's medical record for an allergy to which of the following?
- A. Sulfa
- B. Tartrazine
- C. Shellfish
- D. Penicillin
Correct Answer: B
Rationale: Clients who are allergic to tartrazine, a food dye, should not receive methenamine.
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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 caring for a client being treated with nitrofurantoin (Macrodantin) for a UTI should ask the client specifically about resolution of which of the following symptoms during ongoing assessment? Select all that apply.
- A. Urgency
- B. Frequency
- C. Pressure
- D. Burning during urination
- E. Pain during urination
Correct Answer: A,B,C,D,E
Rationale: Clinical manifestations of a UTI include urgency, frequency, pressure, burning and pain on urination, and pain caused by spasm in the region of the bladder and the suprapubic area and should be assessed by the nurse during ongoing assessment to determine effectiveness of drug therapy.
A nurse is caring for a client receiving fosfomycin for the treatment of an acute bacterial UTI. Which of the following interventions should the nurse include in the teaching plan for the client about this drug?
- A. Ensure that the drug is administered every 3 hours.
- B. Administer the drug after dissolving it in 90 to 120 mL of hot water.
- C. Ensure that the drug is administered immediately after mixing with water.
- D. Administer the drug on an empty stomach.
Correct Answer: C
Rationale: The nurse should instruct the client to take the drug immediately after mixing it with water. The nurse need not instruct the client to take the drug at an interval of 3 hours, to take the drug after dissolving it in 90 to 120 mL of hot water, or to take the drug on an empty stomach. Fosfomycin, which comes in dry form, should be dissolved in 90 to 120 mL water, but not hot water. The nurse should instruct the client to take the drug with food to prevent gastric upset, which occurs with the administration of fosfomycin.
After teaching a client about her prescribed anti-infective therapy for her UTI, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
- A. I can stop the drug once my symptoms disappear.
- B. I can take the medication with food or meals.
- C. I can drink pineapple juice to keep things acidic.
- D. I'll call my primary health care provider if I don't feel better in about 3 days.
- E. I should avoid drinking any beverages that contain alcohol.
Correct Answer: B,D,E
Rationale: The client should complete the full course of therapy even with symptom relief to ensure that all bacteria have been eliminated from the urinary tract. The client should take the drug with food or meals. Cranberry juice, prune juice, and water are recommended. Alcohol and citrus juices such as orange or pineapple juice are to be avoided. The client should notify her primary health care provider if the symptoms do not subside within 3 to 4 days.
A nurse informs a client prescribed nitrofurantoin (Macrodantin) and her family that pulmonary reactions have been reported with the drug's use hours to 3 weeks after the drug therapy is initiated. The nurse determines that the teaching was successful when the client states that she will notify the primary health care provider if which of the following occur? Select all that apply.
- A. Dyspnea
- B. Chest pain
- C. Cough
- D. Fever
- E. Chills
Correct Answer: A,B,C,D,E
Rationale: Signs and symptoms of an acute pulmonary reaction to nitrofurantoin (Macrodantin) include dyspnea, chest pain, cough, fever, and chills, and any of these should be reported to the physician immediately.