A client receiving a cephalosporin has passed six distinct-smelling, unformed stools in the first 6 hours of the nurse's shift. What is the nurse's best action?

Stop all antibiotics and implement strict use of alcohol-based hand sanitizer.

Discontinue the cephalosporin and call the provider to recommend vancomycin or metronidazole.

Call the provider to request an additional antibiotic to override the effects of the cephalosporin.

Increase the dose of cephalosporin and provide isolation measures.

Answer and Explanation

The Correct Answer is B

a) Stopping all antibiotics and implementing strict use of alcohol-based hand sanitizer is not the appropriate response to the observed symptoms. The focus should be on addressing the potential infection.

b) The symptoms suggest the possibility of Clostridium difficile infection, and discontinuing the cephalosporin is crucial. Vancomycin or metronidazole is commonly used to treat C. difficile infection.

c) Requesting an additional antibiotic to override the effects of the cephalosporin is not the appropriate course of action. The focus should be on discontinuing the causative antibiotic.

d) Increasing the dose of cephalosporin is contraindicated in the presence of suspected C. difficile infection. Isolation measures may be implemented, but the priority is discontinuing the causative antibiotic and initiating appropriate treatment for the infection.

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Correct Answer is A

Explanation

a) St. John's Wort is known to increase the risk of bleeding, especially when used with anticoagulant medications. This effect is particularly concerning and may require adjustments in the treatment plan.

b) While St. John's Wort can interact with various drugs, increasing the risk of bleeding is a more immediate concern.

c) St. John's Wort does not counteract the effects of CNS depressants; it may actually enhance the effects of these drugs.

d) St. John's Wort is known to induce the metabolism of some drugs, potentially reducing their effectiveness, but this is not as immediately concerning as the risk of bleeding.

A. Discuss possible opiate dependence with the client's provider. B. Note the effectiveness of the analgesia in the client's chart. C. Encourage the client to turn over, and cough and take deep breaths. D. Prepare to administer naloxone and provide respiratory support.

Correct Answer is D

Explanation

a) While discussing possible opiate dependence is important, the immediate concern is the client's respiratory depression and altered level of consciousness, which may require naloxone administration.

b) Noting the effectiveness of analgesia is relevant but does not address the current respiratory depression and lethargy observed in the client.

c) Encouraging the client to turn over and cough may not be effective in addressing severe respiratory depression, and immediate intervention is needed.

d) The client's symptoms, including drowsiness, lethargy, pinpoint pupils, and respiratory depression, are consistent with opioid overdose. Naloxone is the antidote for opioid toxicity and should be administered promptly.

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A client receiving a cephalosporin has passed six distinct-smelling, unformed stools in the first 6 hours of the nurse's shift. What is the nurse's best action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is obtaining a history from a client who discloses daily use of St. John's Wort in addition to prescription drugs. Which effect of this dietary supplement would most concern the nurse?

Correct Answer is A

Explanation

A client on a morphine PCA pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals: pulse 84 beats/minute, respiratory rate 10 breaths/minute, blood pressure 90/50 mm Hg. What is the nurse's best action?

Correct Answer is D

Explanation

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