A nurse is providing discharge instructions to a client who has a complicated urinary tract infection (UTI) and is taking ciprofloxacin, a quinolone antiinfective. Which of the following instructions should the nurse give to the client?

"If the medicine causes an upset stomach, take an antacid at the same time."

"Limit your daily fluid intake while taking this medication."

"This medication will affect your eyesight, wear sunglasses while outside"

"You should report any discomfort in your tendons while taking this medication."

Answer and Explanation

The Correct Answer is D

A. "If the medicine causes an upset stomach, take an antacid at the same time.": Ciprofloxacin should not be taken with antacids containing magnesium or aluminum because these reduce the medication’s absorption and effectiveness.

B. "Limit your daily fluid intake while taking this medication.": Clients should be encouraged to increase, not limit, fluid intake when taking ciprofloxacin. Adequate hydration helps prevent crystalluria and protects renal function.

C. "This medication will affect your eyesight, wear sunglasses while outside.": Ciprofloxacin does not typically cause vision changes or photosensitivity requiring sunglasses. It is not a significant or common side effect of quinolones.

D. "You should report any discomfort in your tendons while taking this medication.": Ciprofloxacin carries a risk for tendinitis and tendon rupture, especially in older adults and those taking corticosteroids. Reporting tendon pain early allows the healthcare provider to discontinue the drug and prevent permanent tendon damage.

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Correct Answer is B

Explanation

A. Gram-negative bacteria have a thinner peptidoglycan layer compared to Gram-positive bacteria. The thicker peptidoglycan of Gram-positive bacteria is more easily targeted by certain antibiotics like penicillin.

B. Gram-negative bacteria have an outer membrane with lipopolysaccharides, which acts as a barrier to many antibiotics. This structural complexity often necessitates the use of antibiotics that can penetrate the outer membrane or have mechanisms to bypass this barrier.

C. Gram-negative bacteria are more prone to developing antibiotic resistance due to their outer membrane and efflux pumps. This complicates treatment decisions rather than simplifying them, requiring vigilance in antibiotic selection and monitoring.

D. While Gram-negative bacteria do have a thinner peptidoglycan layer, their outer membrane protects them from many antibiotics, so they are not inherently more susceptible. Treatment must consider this additional barrier to ensure efficacy.

A. No CNS effects, diphenhydramine doesn't cross the blood brain barrier. B. Diphenhydramine is known to cause seizures in elderly clients C. Diphenhydramine can cause confusion and sedation in an elderly client D. Diphenhydramine can cause euphoria in an elderly client

Correct Answer is C

Explanation

A. No CNS effects, diphenhydramine doesn't cross the blood brain barrier.: Diphenhydramine readily crosses the blood-brain barrier, which is why it causes central nervous system effects such as sedation.

B. Diphenhydramine is known to cause seizures in elderly clients: Seizures are not a typical side effect of diphenhydramine. While high doses may lower seizure threshold in rare cases, confusion and sedation are far more common CNS effects in older adults.

C. Diphenhydramine can cause confusion and sedation in an elderly client: Elderly patients are particularly sensitive to anticholinergic effects of diphenhydramine, leading to sedation, dizziness, and confusion. These CNS effects can increase fall risk and impair cognitive function, making careful monitoring essential.

D. Diphenhydramine can cause euphoria in an elderly client: Euphoria is not a standard effect of diphenhydramine. The drug primarily causes sedation and anticholinergic side effects rather than mood elevation in older adults.

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A nurse is providing discharge instructions to a client who has a complicated urinary tract infection (UTI) and is taking ciprofloxacin, a quinolone antiinfective. Which of the following instructions should the nurse give to the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient with a confirmed Gram-negative bacterial infection. The healthcare provider has prescribed an antibiotic regimen. Which of the following considerations is most important when treating Gram-negative organisms compared to Gram-positive organisms?

Correct Answer is B

Explanation

A nurse is caring for an elderly patient who has been taking diphenhydramine (Benadryl) for insomnia. Which central nervous system effect is the nurse most likely to observe in this patient?

Correct Answer is C

Explanation

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