A female patient is questioning the nurse on why she can’t explain the same 5-day antibiotic (Zithromax) that her husband received. The patient is 65 with a history of and has an abnormal heart rhythm. The nurse explains that:
Zithromax can cause cancer in women.
Your medical conditions, age, and gender make you susceptible to QT prolongation, a known risk of this antibiotic.
This antibiotic is less effective in women.
Zithromax is expensive, so your insurance won’t pay for it.
The Correct Answer is B
Choice A reason is that Zithromax (azithromycin) is not linked to cancer in women; this is inaccurate. QT prolongation is a known risk, especially in elderly patients with cardiac issues, so this is incorrect.
Choice B reason: Azithromycin can prolong the QT interval, risking arrhythmias, particularly in older women with heart rhythm issues. This explains the different prescribing, making it the correct choice.
Choice C reason: Zithromax’s effectiveness is not gender-specific; efficacy depends on the infection, not sex. The cardiac risk is the concern, so this is incorrect for the explanation.
Choice D reason: Cost or insurance is irrelevant to the medical decision. QT prolongation risk in this patient’s profile drives the choice, so this is incorrect.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Checking blood sugar daily or more is appropriate for diabetes management with glipizide. This shows understanding, so it is not concerning and incorrect.
Choice B reason: Moderate alcohol (e.g., one glass of wine) is generally safe with glipizide if blood sugar is controlled. This is less concerning than grapefruit, so it’s incorrect.
Choice C reason: Taking glipizide once daily with breakfast is correct, as it enhances insulin release with meals. This is appropriate, so it is not concerning and incorrect.
Choice D reason: Grapefruit juice can inhibit CYP enzymes, potentially increasing glipizide levels and hypoglycemia risk. This misunderstanding is dangerous, making it the correct concerning statement.
Correct Answer is D
Explanation
Choice A reason: NPH insulin is not mixed with insulin glargine, as glargine’s pH and formulation cause precipitation or altered pharmacokinetics when combined. NPH can be mixed with regular insulin, as they are compatible, making this choice incorrect for the patient’s reported practice.
Choice B reason: NPH and regular insulin are compatible and routinely mixed in one syringe to provide both intermediate and short-acting coverage. They don’t react chemically or lose efficacy when combined properly, making this choice incorrect, as mixing is a standard practice in diabetes management.
Choice C reason: Mixing NPH and regular insulin does not increase potency; it combines their pharmacokinetics for basal and prandial glucose control. The mixture delivers the additive effects of each insulin’s profile without enhancing overall potency, making this choice inaccurate for their combined action.
Choice D reason: Mixing NPH (intermediate-acting) and regular insulin (short-acting) is an accepted practice to manage type 1 diabetes with one injection, covering basal and prandial needs. Proper technique (drawing regular insulin first) ensures stability, making this the correct choice for the patient’s reported insulin administration.
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