A nurse is caring for a client who has an infection and has been taking penicillin. Which of the following statements by the client should the nurse identify as the priority to report to the provider?
"I have vomited several times."
"I am having diarrhea."
"I am having trouble swallowing."
"My skin feels itchy all over."
The Correct Answer is C
A. "I have vomited several times.": Vomiting can be a side effect of penicillin, but it is usually manageable and not immediately life-threatening unless severe dehydration occurs.
B. "I am having diarrhea.": Mild diarrhea is a common side effect of antibiotics. It is important to monitor for signs of C. difficile infection, but occasional loose stools are not immediately critical.
C. "I am having trouble swallowing.": Difficulty swallowing may indicate oropharyngeal edema, which can be a sign of a severe allergic reaction to penicillin. This requires immediate attention as it can progress to airway obstruction.
D. "My skin feels itchy all over.": Generalized itching may indicate a mild allergic reaction. While it should be monitored, it is less urgent than symptoms suggesting airway compromise.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Take the medication in the morning: Simvastatin is more effective when taken in the evening because cholesterol synthesis is higher at night. Taking it in the morning may reduce its lipid-lowering effect.
B. Report muscle tenderness: Muscle pain, tenderness, or weakness can indicate myopathy or rhabdomyolysis, serious adverse effects of statins. Clients should report these symptoms promptly for evaluation and possible medication adjustment.
C. This medication can cause kidney damage: Simvastatin primarily affects the liver and muscles. While rhabdomyolysis can indirectly impact kidney function, kidney damage is not a common direct effect of the medication.
D. Avoid drinking grapefruit juice for 3 hr after taking this medication: Grapefruit juice can inhibit metabolism of simvastatin, increasing the risk of toxicity. Avoiding grapefruit entirely, rather than timing it around the dose, is the recommended precaution.
Correct Answer is D
Explanation
A. Administer the injection IM: Insulin should be administered subcutaneously, not intramuscularly, because IM injections can lead to faster absorption and increase the risk of hypoglycemia.
B. Roll the vial to mix the particulate matter within the suspension: Regular insulin is a clear solution and does not contain particulate matter, so rolling the vial is unnecessary. Only cloudy or suspension insulins, like NPH, require gentle mixing.
C. Draw up the insulin with a U-500 syringe: U-500 syringes are reserved for clients requiring very high insulin doses. Most standard doses of regular insulin are drawn using U-100 syringes, and using a U-500 syringe unnecessarily increases the risk of dosing errors.
D. Verify the dosage with another nurse: Verification by another nurse is a critical safety step, particularly for high-alert medications like insulin. It helps prevent dosing errors and ensures safe administration to the client.
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