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.

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Correct Answer is B

Explanation

A. Assess urine output: While assessing urine output is important in managing benign prostatic hyperplasia (BPH) and evaluating the effectiveness of tamsulosin, it is not the primary intervention for monitoring adverse reactions. Tamsulosin is intended to improve urinary flow and symptoms of BPH, but adverse reactions are more closely related to blood pressure.
B. Monitor blood pressure: This is the most crucial intervention for monitoring an adverse reaction to tamsulosin. Tamsulosin is an alpha-1 blocker that can cause orthostatic hypotension, leading to dizziness, lightheadedness, or even fainting. Monitoring blood pressure helps to detect any significant drops that might indicate orthostatic hypotension or other cardiovascular effects.
C. Obtain daily weights: Daily weights are important for monitoring fluid status and potential fluid retention, but they are not directly related to monitoring adverse reactions specific to tamsulosin. The primary concern with tamsulosin is related to blood pressure changes rather than fluid balance.
D. Perform a bladder scan: A bladder scan is useful for assessing bladder volume and urinary retention but is not specifically used to monitor for adverse reactions to tamsulosin. The main adverse effects to monitor for involve blood pressure changes due to the medication's impact on vascular tone.

A. Initiate cardiopulmonary resuscitation (CPR). B. Prepare to assist with chest tube insertion. C. Determine Glasgow Coma Scale score. D. Administer a second dose of naloxone.

Correct Answer is D

Explanation

A. Initiate cardiopulmonary resuscitation (CPR):
While initiating CPR is critical for clients experiencing cardiac or respiratory arrest, it is not the immediate action in this scenario. The client’s respiratory depression is most likely related to opioid toxicity, which can sometimes be reversed with naloxone. Before resorting to CPR, the priority is to address the potential cause of the respiratory depression.
B. Prepare to assist with chest tube insertion:
Chest tube insertion is typically indicated for conditions such as pneumothorax or pleural effusion, not for opioid-induced respiratory depression. In this case, the client’s symptoms are likely related to the effects of opioids and naloxone administration, not a need for chest tube insertion
C. Determine Glasgow Coma Scale score:
While assessing the Glasgow Coma Scale (GCS) score is important for evaluating the client's level of consciousness and neurological status, it does not address the immediate need to counteract opioid toxicity. The priority is to manage the respiratory depression that could be life-threatening.
D. Administer a second dose of naloxone:
Administering a second dose of naloxone is the most appropriate action in this scenario. Naloxone is used to reverse opioid-induced respiratory depression, and if the initial dose did not fully counteract the effects of the opioid, a second dose may be necessary. The client's severe respiratory depression and low oxygen saturation indicate that opioid effects may still be present, warranting additional naloxone administration.

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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 benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction?

Correct Answer is B

Explanation

The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?

Correct Answer is D

Explanation

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