A nurse is preparing to administer the initial dose of ceftriaxone to a client who has endometritis. Which of the following statements by the client should cause the nurse to hold the medication and consult the provider?

"I have a severe allergy to amoxicillin."

"I get sick when I take diuretics."

"I have a history of hearing problems."

"I take prednisone for my asthma."

Answer and Explanation

The Correct Answer is A

A. "I have a severe allergy to amoxicillin." A severe allergy to amoxicillin suggests a potential cross-reactivity with ceftriaxone, as both belong to the beta-lactam antibiotic class. While cross-reactivity between penicillins and cephalosporins is lower with third-generation cephalosporins like ceftriaxone, a history of severe allergic reactions, such as anaphylaxis, warrants consultation with the provider before administration.

B. "I get sick when I take diuretics." Adverse effects from diuretics do not typically indicate a contraindication to ceftriaxone. While diuretics like furosemide can interact with aminoglycosides to increase nephrotoxicity, ceftriaxone does not share this risk. Monitoring for individual tolerances is important, but this statement does not require holding the medication.

C. "I have a history of hearing problems." Ceftriaxone is not associated with ototoxicity, unlike aminoglycosides or vancomycin. A history of hearing problems does not necessitate withholding the medication, though the nurse should monitor for any new or worsening symptoms if concurrent ototoxic medications are prescribed.

D. "I take prednisone for my asthma." Corticosteroid use does not directly contraindicate ceftriaxone administration. While prolonged corticosteroid therapy may increase the risk of infections or mask symptoms of an allergic reaction, it does not warrant holding the antibiotic. The nurse should continue routine monitoring but can safely proceed with administration.

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Correct Answer is D

Explanation

A. The advice of an expert nephrology nurse. While experienced nurses provide valuable clinical insights, their knowledge may be based on personal experience rather than the latest evidence-based research. Best practices should be supported by scientific studies rather than anecdotal expertise.

B. Retrospective chart reviews. Chart reviews can offer useful data on past interventions and outcomes, but they do not always reflect the most current evidence-based practices. Additionally, they may contain inconsistencies or lack standardized guidelines necessary for broad application.

C. Facility critical pathway. Critical pathways are developed based on evidence-based guidelines, but they may not always reflect the most up-to-date research. These protocols are useful for standardizing care within a specific institution but should be supplemented with current peer-reviewed research to ensure best practices.

D. A recent peer-reviewed nursing research article. Peer-reviewed nursing research articles provide the most current and scientifically validated evidence. These sources undergo rigorous evaluation before publication, ensuring that recommendations are based on high-quality research rather than opinion or outdated protocols.

A. "The client has a new prescription for incentive spirometry." B. "The client's partner plans to return later today." C. "The client has no living family members." D. "I initiated a consultation by a nutritionist."

Correct Answer is ["A","B","C"]

Explanation

A. Speech-language pathologist: A speech-language pathologist specializes in assessing and treating swallowing disorders (dysphagia). They conduct swallowing evaluations and recommend appropriate strategies, exercises, and diet modifications to ensure safe swallowing and reduce the risk of aspiration.

B. Occupational therapist: An occupational therapist helps clients regain the ability to perform daily activities, including self-feeding. They provide adaptive strategies, recommend assistive devices, and work on improving fine motor skills to enhance independence during meals.

C. Dietitian: A dietitian assesses the client’s nutritional needs and recommends appropriate diet modifications, such as texture-altered foods or thickened liquids, to ensure adequate nutrition while reducing the risk of choking or aspiration. They collaborate with other team members to create a safe and balanced meal plan.

D. Psychologist: While a psychologist can help address emotional and psychological challenges following a stroke, they are not directly involved in managing swallowing difficulties. Their role focuses more on mental health, coping strategies, and emotional adjustment rather than dysphagia management.

E. Pharmacy technician: A pharmacy technician primarily assists with medication dispensing and does not have a role in evaluating or managing swallowing difficulties. Medication concerns related to swallowing would be addressed by a pharmacist rather than a pharmacy technician.

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A nurse is preparing to administer the initial dose of ceftriaxone to a client who has endometritis. Which of the following statements by the client should cause the nurse to hold the medication and consult the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning a staff education program to review nursing interventions for clients who have kidney failure. Which of the following sources should the nurse identify as the best resource for obtaining evidence-based information?

Correct Answer is D

Explanation

A newly licensed nurse is giving a change-of-shift report using Introductions, Situation, Background, Assessment, Recommendation (ISBAR) to an oncoming nurse. Which of the following statements by the newly licensed nurse should be included in the "Background" portion of the report?

Correct Answer is ["A","B","C"]

Explanation

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