A nurse is preparing to administer a new prescription for ampicillin 1.5g IV every 6 hr to a client who has an upper respiratory infection. The client also has a prescription for a sputum specimen for culture and sensitivity. Which of the following actions should the nurse plan to take? (Select all that apply.)

Verify the prescription.

Administer the medication at 1000, 1400, 1800, and 2200.

Assess the client for an allergy to penicillin

Document giving the medications

Obtain a sputum for culture and sensitivity

Answer and Explanation

Correct Answer : A,C,D,E

The nurse should plan to take the following actions:

A.Verify the prescription: Before administering any medication, the nurse must verify the prescription to ensure accuracy, appropriateness, and that it matches the provider's order.

Regarding option B, administering the medication at 1000, 1400, 1800, and 2200 may not be appropriate. The prescription states that ampicillin should be administered every 6 hours. The nurse should administer the medication at equally spaced intervals throughout the day. If the medication is prescribed every 6 hours, the appropriate administration times would be 0600, 1200, 1800, and 2400. However, the question does not provide sufficient information to determine the exact administration times, so option B cannot be definitively selected.

C. Assess the client for an allergy to penicillin: Since ampicillin is a penicillin-class antibiotic, it is essential for the nurse to assess the client for any history of allergies to penicillin or other beta-lactam antibiotics. A penicillin allergy could lead to a severe allergic reaction, so it is crucial to identify any potential allergies before administering the medication.

D. Document giving the medications: After administering the ampicillin, the nurse should document the administration in the client's medical record, including the time, dose, route, and any relevant observations or assessments.

E. Obtain a sputum for culture and sensitivity: The client's new prescription for ampicillin may be related to an infection. To ensure appropriate and effective treatment, obtaining a sputum specimen for culture and sensitivity is necessary. This will help identify the specific bacteria causing the respiratory infection and determine which antibiotics will be most effective in treating it.

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Correct Answer is C

Explanation

Exenatide is a medication used to treat type 2 diabetes mellitus. The nurse should plan to administer exenatide via the subcutaneous route.

Subcutaneous administration involves injecting the medication into the fatty tissue just below the skin. Exenatide is available as a subcutaneous injection and is typically given in the abdomen, thigh, or upper arm.

Let's go through the other options:

A. Oral: Exenatide is not available in an oral form. It is a peptide-based medication that would be destroyed by stomach acid and digestive enzymes if taken orally. Therefore, it must be administered via injection to be effective.

B. Intramuscular: Exenatide is not administered intramuscularly. Intramuscular injections are given deep into the muscle tissue, and exenatide is not formulated or intended for this route of administration.

D. Intravenous: Exenatide is not administered intravenously. Intravenous injections are given directly into the bloodstream, and exenatide is not suitable for this route of administration.

A. Insert the needle at a 45 angle B. Inject the medication into a muscle C. Rub the injection site following administration D. Expel the air bubble prior to injecting the medication

Correct Answer is D

Explanation

When providing discharge teaching to a client with a prescription for enoxaparin, the nurse should include the instruction to expel the air bubble prior to injecting the medication. Enoxaparin is a type of anticoagulant medication that is administered as a subcutaneous injection.

Here's why the other options are incorrect:

A. Insert the needle at a 45 angle: Enoxaparin is typically administered as a subcutaneous injection, where the needle is inserted at a 90-degree angle (straight into the skin). A 45-degree angle is used for intramuscular injections, but it is not appropriate for enoxaparin administration.

B. Inject the medication into a muscle: Enoxaparin is not intended to be injected into a muscle. It is a low-molecular-weight heparin designed for subcutaneous administration, meaning it is injected just below the skin into the fatty tissue.

C. Rub the injection site following administration: Rubbing the injection site after administering enoxaparin or any other subcutaneous medication is not recommended. Rubbing the site can cause irritation and bruising. Instead, the nurse should apply gentle pressure with a cotton ball or gauze pad for a few seconds after the injection to help minimize bleeding.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer exenatide for a client who has type 2 diabetes mellitus. Which of the following routes of administration should nurse plan to use?

Correct Answer is C

Explanation

A nurse is providing discharge teaching to a client who has a prescription for enoxaparin. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

A nurse is caring for a client who is starting to take aspirin 81 mg daily. Which of the following findings should the nurse identify as a risk factor for the client's development of an aspirin-induced ulcer?

A nurse discovers that a client has been administered a higher dose of oxybutynin than the prescription indicates. The nurse should assess the client for which of the following adverse effects?

A nurse is caring for a client who is receiving long-term treatment with oral doses of prednisone. For which of the following adverse effects should the nurse monitor?

A nurse is planning care for a client who has a new prescription to receive a continuous infusion of total parenteral nutrition (TPN) Which of the following interventions should the nurse implement?

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A nurse is providing teaching for a client who has a new prescription for promethazine tablets. Which of the following client statements indicates an understanding of the teaching?

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