A nurse is preparing to administer fluoxetine 30 mg PO daily to a client. The amount available is fluoxetine 10 mg tablets. How many tablets should the nurse administer per dose?

(Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)

Choice A reason:

A sudden decrease in abdominal pain can indicate that the appendix has perforated. When the appendix bursts, the pressure is relieved, leading to a temporary reduction in pain. However, this is quickly followed by severe pain and signs of peritonitis, such as a rigid abdomen and high fever.

Choice B reason:

The absence of Rovsing’s sign is not a specific indicator of a perforated appendix. Rovsing’s sign is a clinical test used to diagnose appendicitis, where pain is elicited in the right lower quadrant when the left lower quadrant is palpated. Its absence does not necessarily indicate perforation.

Choice C reason:

A low-grade fever is a common symptom of appendicitis but does not specifically indicate perforation. A perforated appendix typically leads to a high fever due to the spread of infection within the abdomen.

Choice D reason:

A rigid abdomen is a sign of peritonitis, which can occur after the appendix has perforated. While this is an important symptom, the sudden decrease in pain followed by severe symptoms is more indicative of perforation.

Choice A reason: Smallpox

Smallpox is a viral disease caused by the variola virus. It was eradicated globally in 1980 through a successful vaccination campaign. Treatment for smallpox primarily involves supportive care and antiviral medications, such as tecovirimat, rather than antibiotics like ciprofloxacin. Ciprofloxacin is ineffective against viral infections, including smallpox.

Choice B reason: Anthrax

Anthrax is a serious infectious disease caused by the bacterium Bacillus anthracis. Ciprofloxacin is one of the primary antibiotics used for the treatment and post-exposure prophylaxis of anthrax. It works by inhibiting bacterial DNA gyrase, which is essential for bacterial replication. Ciprofloxacin is effective against both cutaneous and inhalational forms of anthrax, making it a critical component in the management of anthrax exposure.

Choice C reason: Ebola virus

Ebola virus disease (EVD) is caused by the Ebola virus, a member of the Filoviridae family. Treatment for EVD primarily involves supportive care, including rehydration and management of symptoms. Antiviral medications, such as remdesivir, may also be used. Ciprofloxacin, being an antibiotic, is not effective against viral infections like Ebola.

Choice D reason: Sarin gas

Sarin gas is a highly toxic nerve agent used in chemical warfare. Exposure to sarin gas requires immediate medical intervention, including the administration of antidotes such as atropine and pralidoxime, as well as supportive care. Antibiotics like ciprofloxacin are not used in the treatment of chemical agent exposure, as they do not counteract the effects of nerve agents.