A nurse is caring for a 50-year-old female client in the emergency department.
For each prescriber prescription, click to specify if the prescription is anticipated or contraindicated for this client.
Clindamycin 600 mg IV every 8 hours
Albuterol 2.5 mg/3 mL aerosol
Acetaminophen 325 mg PO
Piperacillin-tazobactam 4500 mg IV
Oxygen via nasal cannula at 8 L/min
0.9% sodium chloride (NaCl) at 200 mL/hr
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"},"F":{"answers":"A"}}
Indicated Actions:
Clindamycin 600 mg IV every 8 hours: This is an appropriate antibiotic choice for someone with a penicillin allergy. Clostridium infections and Streptococcus species can be treated with clindamycin.
Albuterol 2.5 mg/3 mL aerosol: This medication is used to relieve dyspnea by bronchodilation, which is beneficial for a client with chronic obstructive pulmonary disease.
Acetaminophen 325 mg PO: This is used to manage fever. The client's temperature is elevated at 38.7°C (101.7°F), so this prescription is indicated.
Oxygen via nasal cannula at 8 L/min: The client's SpO₂ level has dropped to 87% on room air, indicating the need for supplemental oxygen to maintain adequate oxygen saturation.
0.9% sodium chloride (NaCl) at 200 mL/hr: Intravenous fluid administration is necessary to maintain hydration and improve blood pressure in a client with hypotension.
Not Indicated Action:
Piperacillin-tazobactam 4500 mg IV: This antibiotic is contraindicated due to the client's documented penicillin allergy. Piperacillin is a penicillin derivative, and administering it could trigger a severe allergic reaction.
Each of these actions has been considered carefully based on the client's medical history, current condition, and standard medical practices.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Magnesium level of 2.5 mEq/L is slightly above the normal range (1.3 to 2.1 mEq/L) but does not necessitate discontinuation of clozapine, as it does not indicate a serious adverse effect.
Choice B rationale
Potassium level of 5.4 mEq/L is marginally elevated above the normal range (3.5 to 5 mEq/L) but is not a critical concern for discontinuing clozapine, which is more closely monitored for hematologic effects.
Choice C rationale
A WBC count of 2,500/mm³ is significantly below the normal range (5,000 to 10,000/mm³). Clozapine can cause agranulocytosis, a severe decrease in white blood cells, necessitating immediate discontinuation.
Choice D rationale
Sodium level of 134 mEq/L is slightly below the normal range (136 to 145 mEq/L) but does not require discontinuation of clozapine. This mild hyponatremia can be monitored and managed without stopping the medication.
Correct Answer is D
Explanation
Choice A rationale
Verapamil is a calcium channel blocker that typically reduces heart rate rather than increasing it by inhibiting calcium ion influx in the heart muscle, which decreases the heart's workload.
Choice B rationale
Verapamil generally lowers blood pressure by relaxing the smooth muscles in blood vessels, leading to vasodilation, not an increase in blood pressure.
Choice C rationale
Verapamil helps reduce pulmonary congestion by decreasing the workload on the heart, which can help alleviate symptoms of heart failure, but this is not the primary therapeutic effect in post-myocardial infarction patients.
Choice D rationale
Verapamil decreases anginal pain by relaxing coronary blood vessels, improving blood flow to the heart, and reducing myocardial oxygen demand, which is a primary therapeutic response.
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