What is the priority action for a nurse caring for a client...

What is the priority action for a nurse caring for a client with a urinary tract infection before administering prescribed antibiotics?

A. Obtain a blood pressure
B. Obtain a urine specimen for culture and sensitivity
C. Obtain a PTT
D. Obtain a platelet count .
G. B

Correct Answer: Blood pressure is routine, not priority. Urine culture identifies the bacteria and antibiotic sensitivity before treatment. PTT and platelet counts are unrelated to UTI antibiotics.

Rationale: The correct answer is B: Obtain a urine specimen for culture and sensitivity. This is the priority action because it helps identify the specific bacteria causing the UTI and determines the most effective antibiotic for treatment. This step is crucial for appropriate antibiotic therapy and to prevent antibiotic resistance. A: Obtaining a blood pressure is a routine assessment and not directly related to UTI treatment. C and D: Obtaining a PTT and platelet count are not necessary for assessing or treating a UTI; these tests are unrelated to UTI management. Therefore, the priority action for a nurse caring for a client with a UTI is to obtain a urine specimen for culture and sensitivity.

According to an evidence-based approach, what is the most productive way to treat anxiety disorders?

A. Provide the client with a powerful medication.
B. Uncover and address the cause of anxiety.
C. Allow the client to self-medicate with OTC medications.
D. Immediately start multiple-drug therapy.
G. B

Correct Answer: Medication alone isn't most productive. Cognitive behavioral therapy addressing anxiety causes is evidence-based. Self-medication and multiple drugs initially are not recommended.

Rationale: The correct answer is B: Uncover and address the cause of anxiety. An evidence-based approach for treating anxiety disorders involves cognitive behavioral therapy (CBT) to address the underlying causes of anxiety. By identifying and working through the root causes of anxiety, clients can develop coping strategies and long-term solutions. Providing powerful medications (A) may only offer temporary relief and not address the underlying issues. Allowing self-medication with OTC medications (C) can be dangerous and lead to misuse. Immediately starting multiple-drug therapy (D) can increase the risk of side effects and interactions without addressing the root cause of anxiety. Thus, focusing on uncovering and addressing the causes of anxiety through CBT is the most productive and evidence-based approach.

The nurse is caring for a patient who is experiencing anaphylaxis. The family asks the nurse why the patient is having difficulty breathing. The nurse responds based on what knowledge?

A. Bronchoconstriction in response to the allergen.
B. Compensation for a rapid fall in blood pressure.
C. Reflex tachycardia.
D. Seizures are likely to occur.
G. A

Correct Answer: Bronchoconstriction from allergens causes breathing difficulty in anaphylaxis. Hypotension, tachycardia, and seizures are secondary or unrelated.

Rationale: The correct answer is A: Bronchoconstriction in response to the allergen. During anaphylaxis, the body releases histamine causing bronchoconstriction, leading to difficulty breathing. This is a direct response to the allergen and can lead to respiratory distress. Choice B, compensation for a rapid fall in blood pressure, is incorrect as hypotension is a secondary effect of anaphylaxis. Choice C, reflex tachycardia, is also incorrect as tachycardia is a compensatory response to hypotension, not the cause of difficulty breathing. Choice D, seizures are likely to occur, is incorrect as seizures are not a common manifestation of anaphylaxis. Therefore, the correct answer is A as it directly relates to the pathophysiology of anaphylaxis.

After taking the medication guaifenesin (Mucinex), the client complains of coughing up phlegm. What is the best response by the nurse?

A. This means there is probably more pathology present.
B. This is indicative of an allergic reaction.
C. This requires further investigation.
D. This is a normal response to the medication.
G. D

Correct Answer: Guaifenesin is an expectorant that loosens mucus, making coughing up phlegm a normal response. It's not indicative of more pathology, an allergic reaction, or a need for investigation unless symptoms worsen unusually.

Rationale: Step 1: Identify the medication's action - Guaifenesin is an expectorant that helps loosen and thin mucus in the airways.
Step 2: Understand the expected response - Coughing up phlegm after taking guaifenesin is a normal response due to the medication's action.
Step 3: Evaluate the other choices - A, B, and C are incorrect because coughing up phlegm is not indicative of more pathology, an allergic reaction, or a need for further investigation in this context.
Step 4: Choose the correct response - Option G correctly acknowledges that coughing up phlegm is a normal response to guaifenesin and does not suggest any unnecessary concerns or actions.

How does drug therapy of tuberculosis differ from that of most other infections?

A. Patients with tuberculosis have no symptoms.
B. Antituberculosis drugs are used extensively for treating active disease, not prevention.
C. Patients usually require therapy for a shorter period.
D. Mycobacteria have a cell wall that is resistant to penetration by anti-infective drugs.
G. D

Correct Answer: TB patients can have symptoms. Drugs treat both active disease and prevention (latent TB). TB therapy is longer (6-9 months+). Mycobacteria's resistant cell wall necessitates prolonged, combined drug therapy.

Rationale: The correct answer is G. The rationale is as follows:
1. TB patients can have symptoms: TB can present with symptoms such as cough, fever, weight loss, and night sweats.
2. Drugs treat both active disease and prevention: Antituberculosis drugs are used for both treating active TB disease and preventing latent TB from developing into active disease.
3. TB therapy is longer: TB therapy typically lasts 6-9 months or longer due to the slow-growing nature of Mycobacterium tuberculosis and the need to prevent drug resistance.
4. Mycobacteria's resistant cell wall: Mycobacteria have a unique cell wall that is resistant to penetration by many antibiotics, necessitating prolonged and combined drug therapy for effective treatment.
In summary, the other choices are incorrect because patients with TB can have symptoms, antituberculosis drugs are used for both treatment and prevention, therapy duration is usually longer, and the unique cell wall of Mycobacteria requires specific drug regimens.

The risk for physical and psychological dependence is high from which class of medications, which is rarely used to treat insomnia or anxiety?

A. Barbiturates.
B. Nonsteroidal anti-inflammatory drugs (NSAIDs).
C. Benzodiazepines.
D. Selective serotonin reuptake inhibitors (SSRIs).
G. A

Correct Answer: Barbiturates have high dependence risk and are rarely used for insomnia/anxiety due to safer alternatives like benzodiazepines. NSAIDs, benzodiazepines, and SSRIs don't fit this profile.

Rationale: The correct answer is A: Barbiturates. Barbiturates are known to have a high risk of physical and psychological dependence due to their sedative effects. They are rarely used to treat insomnia or anxiety nowadays because safer alternatives like benzodiazepines are available. Nonsteroidal anti-inflammatory drugs (NSAIDs) are primarily used for pain and inflammation, not for insomnia or anxiety. Benzodiazepines are commonly prescribed for these conditions but have a lower risk of dependence compared to barbiturates. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants and are not typically used for the treatment of insomnia or anxiety. Therefore, the correct answer is A because barbiturates have a high dependence risk and are not commonly used for these conditions.