A client with bronchitis is taking trimethoprim/sulfamethoxazole 160/800 mg orally, twice daily. Before administering the third dose, the nurse observes the client has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats/min. The client looks ill and reports not feeling well. What is the nurse's response?

Request an order for intravenous trimethoprim/sulfamethoxazole.

Administer the dose and request an order for an antipyretic medication.

Withhold the treatment and notify the provider of the symptoms.

Initiate probiotics and tell the client to taper off the medication.

Answer and Explanation

The Correct Answer is C

a) Intravenous trimethoprim/sulfamethoxazole may still induce an adverse reaction, and withholding the oral medication is the more prudent initial action.

b) Administering the dose may worsen the client's condition, and addressing the symptoms requires notifying the provider first.

c) Withholding the treatment and promptly notifying the provider about the observed symptoms is the correct immediate response to potential adverse reactions.

d) Initiating probiotics and tapering off the medication may be considerations, but the urgent action is to withhold the medication and inform the provider.

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Free Nursing Study Resources

Correct Answer is D

Explanation

a) While the negative feedback loop plays a role in the body's natural regulation of corticosteroids, it does not eliminate the potential for side effects when exogenous glucocorticoids are administered.

b) Taking the drug as prescribed does not guarantee the absence of side effects. Side effects are inherent to glucocorticoid therapy and can occur even with appropriate use.

c) Interrupting the inflammatory process does not directly inhibit side effects. The anti inflammatory action is the therapeutic effect, but it does not eliminate the potential for side effects.

d) Glucocorticoids, even those produced naturally by the body, can cause side effects, and the likelihood and severity of these side effects depend on the dose and duration of treatment. Regular monitoring and appropriate management are essential.

A. Concurrent use of acetaminophen for pain. B. An activated partial thromboplastin time (aPTT) of 80 seconds. C. An international normalized ratio (INR) of 0.8. D. Evidence of dark, tarry stools.

Correct Answer is B

Explanation

a) Concurrent use of acetaminophen is not directly related to heparin therapy for atrial fibrillation. It may need attention but does not warrant immediate reporting.

b) An aPTT of 80 seconds is significantly prolonged and may indicate a risk of bleeding due to excessive anticoagulation. This finding requires immediate notification to the healthcare provider.

c) An INR of 0.8 is within the normal range and does not pose an immediate concern in the context of heparin infusion.

d) Dark, tarry stools could indicate gastrointestinal bleeding but may not be directly related to heparin therapy. It should be monitored and reported, but it's not an immediate concern for heparin infusion.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse tells a nursing student that glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct?

Correct Answer is D

Explanation

A client with a new diagnosis of atrial fibrillation is receiving a continuous infusion of heparin. Which finding will the nurse report immediately?

Correct Answer is B

Explanation

A client weighs 214 lb. What is the clients weight in kg? (Record answer to the nearest tenth, or one decimal place. Do not use a trailing zero.)

A client arrives in the emergency department with localized swelling of the lips and tongue. The client's medication list includes the following medications. Which of these medications does the nurse anticipate the provider discontinuing?

Which statement by the client shows a correct understanding of how they should take their levothyroxine?

A client who is receiving a final dose of intravenous cephalosporin complains of pain and irritation at the infusion site. The nurse observes signs of redness at the intravenous insertion site and along the vein. What is the nurse's action?

A nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. To evaluate the risk of hemorrhage, the nurse will ask the client about antiplatelet and anticoagulant medications as well as which dietary supplement?

A prescriber has ordered medication for a newborn that is eliminated primarily by hepatic metabolism. What would the nurse expect the prescriber to order?

A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned?

A client who reports routine consumption of more than three alcoholic beverages per day asks about taking acetaminophen when needed for occasional recurrent pain. What will the nurse tell the client?