Nokea
A physician is caring for a patient with a urinary tract infection. The physician would expect the plan of care to include:
- A. Antibiotics and phenazopyridine.
- B. Erythropoietin and stent placement.
- C. Hormonal therapy and intravenous fluids.
- D. Hourly urine output measurements and antibiotics.
Correct Answer: A
Rationale: The correct answer is A: Antibiotics and phenazopyridine. Antibiotics are essential to treat the bacterial infection causing the UTI. Phenazopyridine can help relieve urinary discomfort. Erythropoietin and stent placement (B) are not indicated for UTI. Hormonal therapy and IV fluids (C) are not standard treatments for UTI. Hourly urine output measurements and antibiotics (D) are not typically necessary, as antibiotics alone are sufficient for treating UTIs.
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Which of the following drug adverse reactions precludes a patient from being given the same drug in the future?
- A. GI upset from Clarithromycin
- B. Skin Rash from Ampicillin
- C. Steven-Johnson syndrome from Trimethoprim/Sulfamethoxazole
- D. Clostridium difficile superinfection from Ofloxacin
Correct Answer: C
Rationale: The correct answer is C because Steven-Johnson syndrome is a severe and life-threatening skin reaction that can occur with certain medications like Trimethoprim/Sulfamethoxazole. Once a patient experiences this reaction, they should never be given the same drug again to avoid a potentially fatal outcome. The other choices, GI upset from Clarithromycin, skin rash from Ampicillin, and Clostridium difficile superinfection from Ofloxacin, are adverse reactions that can be managed or treated without completely excluding the drug from future use.
How is an intravenous pyelogram performed?
- A. By palpating the suprapubic area.
- B. By percussing the area over the bladder.
- C. By injecting a contrast dye into the vein.
- D. By using a stethoscope to listen for abnormal sounds.
Correct Answer: C
Rationale: The correct answer is C because an intravenous pyelogram (IVP) is performed by injecting a contrast dye into the vein. This dye travels through the bloodstream, highlighting the kidneys, ureters, and bladder on X-ray images. Palpating the suprapubic area (A) involves feeling for the bladder, but it is not part of an IVP procedure. Percussing the area over the bladder (B) involves tapping to assess for fluid or air, which is not relevant to an IVP. Using a stethoscope to listen for abnormal sounds (D) is not related to the process of an IVP.
While managing a client after a medical or surgical procedure for bladder stones, when should the nurse notify the physician?
- A. Assessment of sexual habits
- B. Assessment and recognition of abnormal findings
- C. Assessment of allergies to seafood
- D. Assessment of insurance coverage
Correct Answer: B
Rationale: The correct answer is B because assessing and recognizing abnormal findings is crucial in post-procedure care for bladder stones. This includes monitoring for signs of infection, urinary retention, bleeding, or other complications that may require immediate medical intervention. Notifying the physician promptly allows for timely treatment and prevents potential complications. Choices A, C, and D are incorrect as they are not directly related to the immediate post-procedure care for bladder stones and do not require immediate physician notification.
A patient with HIV-AIDS being treated with combined antiviral drugs and immunosuppressive agents, develops an opportunistic infection caused by Pneumocystis carinii. Which of the following drugs most likely be used in the treatment of pulmonary infection caused by P. carinii?
- A. Metronidazole
- B. Carbenicillin
- C. Trimethoprim/Sulfamethoxazole
- D. Penicillin G
Correct Answer: C
Rationale: The correct answer is C: Trimethoprim/Sulfamethoxazole. This combination is the first-line treatment for Pneumocystis carinii pneumonia in patients with HIV-AIDS due to its efficacy against the organism. Trimethoprim inhibits dihydrofolate reductase, while sulfamethoxazole inhibits dihydropteroate synthase, both essential enzymes for folate synthesis in bacteria and protozoa like P. carinii. Metronidazole (A) is used for anaerobic infections, Carbenicillin (B) is a penicillinase-resistant penicillin used for Gram-negative infections, and Penicillin G (D) is a narrow-spectrum antibiotic mainly used for Gram-positive infections.
This is Mr. Taylor’s first postoperative day. The urinary bladder drainage has become darker in color. Your initial action would be to
- A. call the attending physician
- B. irrigate with a piston syringe
- C. check the flow to maintain a light pink drainage
- D. Nothing; this is expected at this time
Correct Answer: C
Rationale: Correct Answer (C): Check the flow to maintain a light pink drainage.
Rationale:
1. Darker bladder drainage may indicate blood in the urine, which could be a sign of internal bleeding postoperatively.
2. Checking the flow allows you to assess the amount and color of drainage to ensure it stays light pink, indicating no significant bleeding.
3. Monitoring the drainage color helps in early detection of complications and prompt intervention if needed.
Incorrect Choices:
A: Calling the attending physician is not the initial action as it may delay necessary intervention.
B: Irrigating with a piston syringe can disrupt the natural drainage pattern and should not be done without a healthcare provider's order.
D: Ignoring the change in color as expected can lead to overlooking a potentially serious issue.