A patient that has delivered a 8.2 lb. baby boy 3 days ago via c-section, reports white patches on her breast that aren't going away. Which of the following medications may be necessary?
- A. Nystatin
- B. Atropine
- C. Amoxil
- D. Loritab
Correct Answer: A
Rationale: Thrush, a fungal infection, may be occurring, and Nystatin is an antifungal medication used to treat it.
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The nurse is caring for a postpartum woman who has relinquished her baby for adoption. The care plan for the client should include which of the following priority strategies?
- A. Make a referral for grief counseling
- B. Allow the woman to see her baby initially, and then discourage further visits
- C. Provide opportunities for the woman to express her feelings
- D. Inform the woman she has the right to change her mind about relinquishment
Correct Answer: C
Rationale: Providing opportunities to express feelings addresses the immediate emotional needs of grief, loneliness, and guilt, which is a priority for supporting the woman's psychological well-being.
A client's central venous access device (CVAD) becomes infected. Why might the physician order antibiotics to be given through the line rather than through a peripheral IV line?
- A. to prevent infiltration of the peripheral line
- B. to reduce the pain and discomfort associated with antibiotic administration in a small vein
- C. to lessen the chance of an allergic reaction to the antibiotic
- D. to attempt to eliminate microorganisms in the catheter and prevent having to remove it
Correct Answer: D
Rationale: Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed. CVAD use lessens the need for peripheral IV lines and thus the risk of infiltration. In this case, however, the antibiotics are given to eradicate microorganisms from the CVAD. CVAD use has the effect described in Choice 2, but in this case, the antibiotics are given through the CVAD to eliminate the infective agent. The route does not prevent an allergic reaction.
An example of an extended care facility is a:
- A. home health agency.
- B. suicide prevention center.
- C. state-owned psychiatric hospital.
- D. nursing facility.
Correct Answer: D
Rationale: When an elderly client has been hospitalized for an illness, under Medicare he or she can be transferred to a nursing facility.
Medication bound to protein can have which of the following effects?
- A. enhancement of drug availability
- B. rapid distribution of the drug to receptor sites
- C. less availability to produce desired medicinal effects
- D. increased metabolism of the drug by the liver
Correct Answer: C
Rationale: Protein-bound drugs are inactive and less available for therapeutic effects until unbound. This does not enhance availability, speed distribution, or increase metabolism.
A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:
- A. a maintenance dose.
- B. a loading dose.
- C. a medication with no first-pass effect.
- D. the medication to be given intravenously.
Correct Answer: B
Rationale: A loading or priming dose rapidly establishes a therapeutic plasma drug level. It can be calculated by multiplying the volume of distribution by the desired plasma drug concentration.
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