A client with a fungal infection of the toenail reports to the nurse that the client has been applying an over-the-counter (OTC) triple antibiotic ointment to the infection daily for two weeks without any improvement. Which action should the nurse take?

Instruct the client to obtain a prescription for oral terbinafine.

Advise the client to obtain a prescription-strength formulation of the ointment.

Reassure the client that treatment of fungus infected toenails often takes several months.

Suggest that the client use the ointment twice a day to be more effective.

Answer and Explanation

The Correct Answer is A

A. Instruct the client to obtain a prescription for oral terbinafine: Since the client has been using an over-the-counter triple antibiotic ointment for two weeks without improvement, it indicates that the treatment is ineffective for fungal infections. Over-the-counter ointments are typically not effective for toenail fungal infections, which often require prescription-strength antifungal treatment. Oral terbinafine is a prescription antifungal medication that is more effective for treating such infections, so advising the client to obtain a prescription is the most appropriate action.
B. Advise the client to obtain a prescription-strength formulation of the ointment: Prescription-strength topical treatments are often used for fungal infections, but toenail fungal infections usually require oral antifungal medications to penetrate the nail effectively. Advising the client to obtain a prescription-strength ointment may not address the root cause, which often involves systemic treatment.
C. Reassure the client that treatment of fungus-infected toenails often takes several months: While it is true that toenail fungal infections can take several months to treat, the lack of improvement with the current treatment suggests that a more effective treatment is needed. Reassuring the client about the duration of treatment without addressing the ineffectiveness of the current treatment does not resolve the issue.
D. Suggest that the client use the ointment twice a day to be more effective: Increasing the frequency of application of the triple antibiotic ointment is unlikely to improve its effectiveness against a fungal infection. Fungal infections typically require specific antifungal agents, and simply using the current ointment more frequently will not address the underlying issue.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. Determine presence of abdominal pain: Chronic use of ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), can lead to gastrointestinal issues such as ulcers or bleeding. Abdominal pain is a critical symptom that can indicate these serious side effects. Therefore, assessing for abdominal pain is the most important action to identify potential adverse effects related to prolonged NSAID use.
B. Palpate volume of pedal pulses: While assessing pedal pulses is important for evaluating circulation and potential peripheral vascular issues, it is not the primary concern related to the long-term use of ibuprofen. This assessment does not directly address the potential gastrointestinal complications of NSAID use.
C. Assess back pain using numeric scale: Although it is important to monitor the effectiveness of ibuprofen in managing back pain, this assessment does not address the potential side effects of prolonged use. Evaluating pain levels is useful for treatment efficacy but is secondary to monitoring for adverse effects.
D. Evaluate ongoing sleep patterns: While sleep patterns can be affected by pain or medication, they are not the most immediate concern regarding the side effects of long-term ibuprofen use. The potential gastrointestinal issues related to NSAID use take precedence.

A. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately. B. Request a prescription to change the route of administration and use the available heparin. C. Calculate and administer the equivalent dose of the available low molecular weight heparin. D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration.

Correct Answer is A

Explanation

A. Advise the pharmacy of the need to deliver a vial of heparin to the nursing unit immediately: This is the appropriate action. The prescription is for standard heparin, which is different from low molecular weight heparin (LMWH) in both its formulation and use. Standard heparin must be administered intravenously and requires a different preparation than LMWH, which is typically administered subcutaneously. The nurse should request the correct form of heparin (standard heparin) to ensure the client receives the prescribed medication safely and effectively.
B. Request a prescription to change the route of administration and use the available heparin: Changing the route of administration would be inappropriate without proper authorization from the healthcare provider. Low molecular weight heparin is not used for intravenous administration in this context, so this option does not address the need for the correct medication form.
C. Calculate and administer the equivalent dose of the available low molecular weight heparin: Low molecular weight heparin and standard heparin are not interchangeable, and the dosing and administration routes are different. Attempting to convert the dose of LMWH to standard heparin is not advisable without proper guidance, as this could lead to incorrect dosing and potential harm.
D. Dilute the available heparin in 250 mL of normal saline solution prior to IV administration: This is not applicable to low molecular weight heparin. Standard heparin, if available, may require dilution for IV administration, but LMWH is not used for IV administration and should not be substituted in this manner

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A client with a fungal infection of the toenail reports to the nurse that the client has been applying an over-the-counter (OTC) triple antibiotic ointment to the infection daily for two weeks without any improvement. Which action should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with chronic lower back pain has been taking ibuprofen PO twice a day for several months. Which assessment is most important for the nurse to complete?

Correct Answer is A

Explanation

A client has a prescription for heparin 1,000 units IV STAT. Several pre-filled syringes of low molecular weight heparin are available in the client's medication drawer. Which action should the nurse implement?

Correct Answer is A

Explanation

The nurse is providing discharge instructions to a client who has been prescribed gabapentin 300 mg by mouth (PO) three times a day for postherpetic neuralgia. Which symptom should the nurse tell the client to report to the healthcare provider?

Which intervention is most important for the nurse to implement for a client with type 2 diabetes mellitus (DM) who is receiving insulin lispro?

A client who is newly diagnosed with diabetes insipidus (DI) is receiving a synthetic vasopressin intravenously. Which side effect of vasopressin reported by the client should the nurse report to the healthcare provider?

A male client receives a scopolamine transdermal patch 2 hours before surgery. Four hours after surgery, the client tells the nurse that he is experiencing pain and asks why the patch is not working. Which action should the nurse take?

The nurse observes that a client has become lethargic 30 minutes after receiving an opioid injection for pain. Which vital sign should the nurse obtain first?

A client receives a prescription for penicillin 2 million units IM. The available vial is labeled, "600,000 units/2 mL." How many mL should the nurse administer? (Enter numeric value only.)

The healthcare provider prescribes propylthiouracil (PTU) and Lugol's solution, a strong iodine solution, for a client with hyperthyroidism. How should the nurse schedule the administration of these medications?

The nurse is reviewing the client's laboratory values. Which serum laboratory value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?