Nokea
A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation?
- A. Instruct patient to increase dietary intake.
- B. Inform the primary health provider immediately.
- C. Record assessments on patient's chart.
- D. Inquire about any previous drug allergies.
Correct Answer: C
Rationale: When the patient declares that he is feeling better and is also showing improved health, it should be recorded on the patient's chart. If the condition of the patient has improved, the patient will show an increased appetite, but there is no need to instruct the patient to increase dietary intake. The primary health provider need not be informed about the condition immediately unless the patient shows signs of deterioration or complications. The nurse should inquire about previous drug allergies before the start of therapy.
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A nurse is preparing to administer a prescribed cephalosporin by injection. Which of the following would be most important for the nurse to keep in mind? Select all that apply.
- A. Thrombophlebitis can occur when cephalosporins are given IV.
- B. Phlebitis can occur when cephalosporins are given IM.
- C. Pain can occur when cephalosporins are given IM.
- D. Tenderness can occur when cephalosporins are given IM.
- E. Swelling can occur when cephalosporins are given IM.
Correct Answer: A,C,D,E
Rationale: Administration route reactions include pain, tenderness, and inflammation at the injection site when cephalosporins are given IM, and phlebitis and thrombophlebitis along the vein may occur when cephalosporins are given IV.
A group of nursing students are reviewing the different groups of penicillins. The students demonstrate understanding when they identify which of the following as an example of a penicillinase-resistant penicillin? Select all that apply.
- A. Dicloxacillin
- B. Penicillin G
- C. Nafcillin
- D. Oxacillin
- E. Ampicillin
Correct Answer: A,C,D
Rationale: Dicloxacillin, nafcillin, and oxacillin are examples of penicillinase-resistant penicillins. Penicillin G is an example of a natural penicillin. Ampicillin is an example of an aminopenicillin.
A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins. The nurse determines that the teaching was successful when the patient identifies which of the following? Select all that apply.
- A. Drowsiness
- B. Headache
- C. Constipation
- D. Heartburn
- E. Vomiting
Correct Answer: B,D,E
Rationale: Common adverse reactions to cephalosporins include nausea, vomiting, diarrhea, headache, dizziness, malaise, heartburn, and fever.
A nurse is preparing to administer penicillin therapy. The nurse would expect to administer penicillins cautiously to clients with which of the following? Select all that apply.
- A. History of allergies
- B. Diabetes
- C. Asthma
- D. Bleeding disorders
- E. Hypertension
Correct Answer: A,C,D
Rationale: Penicillins should be used cautiously in clients with renal disease, asthma, bleeding disorders, GI disease, pregnancy or lactation, and a history of allergies.
A nurse needs to administer a cephalosporin to a patient. The patient informs the nurse that he is allergic to penicillin. Which action by the nurse would be most appropriate?
- A. Inform the primary health care provider.
- B. Obtain the patient's occupational history.
- C. Administer an antipyretic drug.
- D. Obtain specimens for kidney function tests
Correct Answer: A
Rationale: Patients with a history of an allergy to penicillin may also be allergic to cephalosporin, so the nurse needs to inform the primary health care provider before the first dose of the drug is given. An antipyretic drug is administered when there is an increase in the body temperature of a patient receiving cephalosporin. Liver and kidney function tests may be ordered by the primary health care provider, not the nurse. Occupational history should be obtained before administration of any drug, irrespective of the patient's allergies.