A 5-year-old patient is diagnosed with an uncomplicated urinary tract infection for the first time. The nurse practitioner should order:
cephalexin (Keflex) orally for 10 days
ciprofloxacin (Cipro) orally for 7 days.
ceftriaxone (Rocephin) IM every 24 hours for 5 days.
nitrofurantoin (Furadantin) orally for 7 days.
The Correct Answer is A
Rationale:
A. Cephalexin (Keflex) is a first-generation cephalosporin commonly used as a first-line oral treatment for uncomplicated urinary tract infections in children. A 7–10 day course is effective for eradicating infection while being well-tolerated.
B. Ciprofloxacin (Cipro) is generally avoided in children due to potential adverse effects on cartilage and is reserved for complicated or resistant infections.
C. Ceftriaxone (Rocephin) IM is typically reserved for severe infections, hospitalized patients, or when oral therapy is not feasible. It is not first-line for uncomplicated UTIs in outpatient children.
D. Nitrofurantoin (Furadantin) is effective for lower urinary tract infections but is usually avoided in children under 1 month and is less preferred in some cases for first-time infections due to limited tissue penetration.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. EPSDT is not limited to underinsured children; it is a Medicaid benefit.
B. While states administer EPSDT, it is not solely a state regulation; federal guidelines govern its implementation.
C. The federal government sets standards, but the program is administered at the state level through Medicaid.
D. EPSDT is the child health component of Medicaid that ensures children younger than 21 years old receive comprehensive and preventive healthcare services, including screening, diagnostic, and treatment services to address physical and mental health needs.
Correct Answer is B
Explanation
Rationale:
A. Recent fluid intake provides context for overall hydration but does not directly determine the safety of adding potassium.
B. Urinary output must be assessed before adding potassium to IV fluids because adequate renal function is essential for potassium excretion. Administering potassium to a patient with low or absent urine output can lead to hyperkalemia, which can cause life-threatening cardiac arrhythmias.
C. Capillary refill helps assess perfusion and dehydration but does not indicate the patient’s ability to excrete potassium.
D. Last bowel movement is not relevant to potassium administration in IV fluids, as potassium is primarily excreted via the kidneys rather than the gastrointestinal tract.
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