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: Nighttime awakenings more than twice weekly indicate step 2, requiring maintenance therapy. Step 1 uses albuterol as needed, so this is incorrect.
Choice B reason: Twice-daily glucocorticoids are for step 2 or higher, not step 1, where albuterol is used as needed. This is incorrect for step 1 management.
Choice C reason: LABAs are used in step 3 or higher, not step 1, where albuterol alone is sufficient as needed. This is incorrect for the asthma step.
Choice D reason: At step 1, albuterol is used as a rescue inhaler for acute asthma symptoms. This is the standard approach, making it the correct choice.
Correct Answer is A
Explanation
Choice A reason: Patient weight: 198 lbs ÷ 2.2 = 90 kg. Dose: 1 mg/kg × 90 kg = 90 mg. Volume: 90 mg ÷ (30 mg/0.3 mL) = 90 × 0.3/30 = 0.9 mL. This delivers the correct anticoagulant dose for conditions like DVT, making it the accurate choice.
Choice B reason: For 90 kg (198 lbs ÷ 2.2), the dose is 90 mg. Volume: 90 mg ÷ (30 mg/0.3 mL) = 0.9 mL. Choice B (1.2 mL) delivers 120 mg (1.2 × 30/0.3), overdosing Lovenox, increasing bleeding risk, making it incorrect.
Choice C reason: The correct volume for 90 mg is 0.9 mL (90 ÷ 30 mg/0.3 mL). Choice C (0.6 mL) delivers 60 mg (0.6 × 30/0.3), underdosing Lovenox, reducing anticoagulant efficacy, which could fail to prevent thrombosis, making this choice incorrect.
Choice D reason: For 90 mg, the volume is 0.9 mL. Choice D (0.3 mL) delivers 30 mg (0.3 × 30/0.3), significantly underdosing Lovenox for a 90 kg patient, risking inadequate anticoagulation and thrombotic events, making this choice incorrect.
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