Nokea
The 17-year-old female is about to have a drug screen test for employment. The adolescent tells the nurse of a recent UTI that was treated with antibiotics. Which antibiotic, if identified by the client, could produce a false-positive urine screening test for opioids?
- A. Cephalexin
- B. Ceftazidime
- C. Amoxicillin
- D. Ciprofloxacin
Correct Answer: D
Rationale: A: Cephalexin (Keflex) does not interfere with urine testing for opioids. B: Ceftazidime (Fortaz), a cephalosporin, does not interfere with urine testing for opioids. C: Amoxicillin (Amoxil), an aminopenicillin, does not interfere with urine testing for opioids. D: Fluoroquinolones, such as ciprofloxacin (Cipro), can cause false-positive urine opiate screens.
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Which of the following symptoms is most characteristic of a client with cancer of the lungs?
- A. Exertional dyspnea
- B. Persistent changing cough
- C. Air hunger; dyspnea
- D. Cough with night sweats
Correct Answer: B
Rationale: A persistent, changing cough is the most characteristic symptom of lung cancer, distinguishing it from symptoms associated with COPD, asthma, or tuberculosis.
The nurse is discharging the child with sickle cell disease who has undergone a splenectomy. The child has an allergy to penicillin. The nurse should anticipate teaching about which prophylactic medication?
- A. Epoetin
- B. Amoxicillin
- C. Morphine sulfate
- D. Erythromycin ethylsuccinate
Correct Answer: D
Rationale: A: Epoetin (Epogen) stimulates the bone marrow to produce RBCs. In sickle cell disease, increasing the production of sickled RBCs can worsen the condition. B: Amoxicillin (Amoxil) is contraindicated when allergies to penicillin are present. C: Opioids such as morphine sulfate are administered in sickle cell crises or for severe pain; it is usually not given prophylactically. D: The ability to fight infection is decreased following a splenectomy. Daily prophylactic antibiotics are given. Erythromycin ethylsuccinate (E.E.S.) is a macrolide antibiotic and safe to administer when a penicillin allergy exists.
The nurse is developing the plan of care for the 4-year-old client who is taking metronidazole for giardiasis. Which measures should be included in the plan of care? Select all that apply.
- A. Assess cardiac status.
- B. Assess for signs of infection.
- C. Reinforce strict hand washing.
- D. Give metronidazole with food.
- E. Monitor results of stool samples.
Correct Answer: B,C,E
Rationale: A: Metronidazole is not associated with any cardiac changes or adverse events. B: Giardiasis is an infectious diarrheal disease; the plan of care should include assessing for infection. Infection should subside when treated with metronidazole (Flagyl). C: Giardiasis is an infectious diarrheal disease; the plan of care should include reinforcing strict hand washing. D: Metronidazole should be given on an empty stomach. E: Giardiasis is an infectious diarrheal disease; the plan of care should include monitoring the results of stool samples.
The nurse is teaching the parent of the 3-year-old being treated with vincristine sulfate for Wilms' tumor. The nurse should inform the parents to immediately notify the HCP of which most significant adverse effect?
- A. The child develops diarrhea.
- B. The child's hair begins to fall out.
- C. The child develops dysphagia and paresthesia.
- D. The child has signs or symptoms of depression.
Correct Answer: C
Rationale: A: Both diarrhea and severe constipation are adverse effects of vincristine, and prophylactic treatment is implemented at the beginning of therapy to decrease the potential of these occurring. B: Hair loss is a common adverse reaction to the medication and is reversible. C: Dysphagia and paresthesia are CNS adverse effects from vincristine sulfate (Oncovin). The nurse should teach the parent to notify the HCP immediately if these occur. D: Three-year-olds may not show signs or symptoms of depression. If present, the signs and symptoms should be distinguished as being associated with the neoplastic disease itself or as side effects of the medication.
The client taking lithium for bipolar disorder participated in a recreational game of basketball in the mental health unit gym. The client is now feeling nauseated and shaky, has blurred vision, and is finding it hard to stand. Considering this information, which action should be taken by the nurse?
- A. Instruct the client to sit and rest for a while in a cool place.
- B. Call the HCP to request an order for a STAT serum lithium level.
- C. Give the prn prescribed antiemetic with a large glass of cold water.
- D. Alert the emergency team for the client's impending cardiac arrest.
Correct Answer: B
Rationale: The client is showing signs of lithium (Lithane) toxicity, especially apparent after high levels of physical activity. The HCP should be notified for a STAT lithium level and corrective action.