A patient has been admitted with a fever of 102.8 F (39.3 C), with an unknown origin.

The patient’s urine is cloudy, foul-smelling, and dark amber.

Orders have been given to obtain urine and blood cultures immediately and to administer an antibiotic intravenously.

In what order should the nurse complete these orders?

Administer the antibiotic dose, then obtain blood and urine cultures.

Obtain urine culture, administer the antibiotic dose, then obtain blood culture.

Obtain blood culture, administer the antibiotic dose, then obtain urine culture.

Obtain blood and urine cultures, then administer the antibiotic dose.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Administering the antibiotic dose before obtaining the cultures could potentially affect the results of the cultures. Antibiotics are designed to kill or inhibit the growth of bacteria, so administering them before obtaining the cultures could lead to false negatives. This could lead to incorrect or delayed diagnosis and treatment.

Choice B rationale:

While obtaining the urine culture before administering the antibiotic dose is a good step, it should not be done before obtaining the blood culture. Blood cultures are usually obtained before urine cultures because they can help identify bacteria or fungi in the blood. This can be crucial in diagnosing conditions like sepsis. Furthermore, administering the antibiotic dose before obtaining the blood culture could affect the results of the culture.

Choice C rationale:

Obtaining the blood culture before administering the antibiotic dose is a good step, but the urine culture should also be obtained before the antibiotic dose is administered. Administering the antibiotic dose before obtaining all necessary cultures could affect the results of the cultures and lead to incorrect or delayed diagnosis and treatment.

Choice D rationale:

This is the correct sequence of actions. The nurse should first obtain both blood and urine cultures before administering the antibiotic dose. This is because the antibiotic could potentially kill or inhibit the growth of bacteria, which could affect the results of the cultures. By obtaining the cultures first, the healthcare team can ensure they are getting accurate results that have not been influenced by the antibiotics. This can lead to a more accurate diagnosis and more effective treatment plan.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Choice A rationale:

Providing written pamphlets for instruction can be a useful supplement, but it may not be the most effective method for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice and immediate feedback that can be crucial for learning a new physical skill.

Choice B rationale:

After demonstrating the procedure, allowing the patient to do several return demonstrations is considered one of the best methods for teaching a skill like self-injection of insulin. This approach, often referred to as “see one, do one, teach one,” allows the patient to observe the correct technique, practice it themselves, and then demonstrate their understanding by teaching it back. This method is particularly effective because it engages the patient in active learning and provides opportunities for immediate feedback and correction.

Choice C rationale:

Showing a video and allowing the patient to practice as needed on his own can be helpful, but it may not be as effective as other methods. This is because it lacks the immediate feedback and personalized instruction that can be provided in a one-onone teaching session. Additionally, practicing “as needed” may not provide the consistent repetition needed to master a new skill.

Choice D rationale:

Verbally explaining the procedure and providing written handouts for reinforcement can be effective, but it may not be sufficient for teaching a skill like self-injection of insulin. This is because it lacks the hands-on practice that is crucial for learning a new physical skill. Additionally, relying solely on verbal explanation and written handouts may not address all learning styles.

A. Acyclovir B. Ribavirin C. C. Foscarnet D. Zidovudine

Correct Answer is D

Explanation

Choice A rationale:

Acyclovir is an antiviral medication used to treat infections caused by certain types of viruses. It is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. However, it is not typically used as an anti-HIV drug.

Choice B rationale:

Ribavirin is an antiviral medication used to treat hepatitis C and certain other viral infections. While it has broad-spectrum antiviral activity, it is not specifically used to prevent mother-to-child transmission of HIV.

Choice C rationale:

Foscarnet is an antiviral medication used to treat or prevent cytomegalovirus (CMV) retinitis in individuals with AIDS. It is also used to treat cold sores and genital herpes. However, it is not the first-line choice for preventing mother-to-child transmission of HIV.

Choice D rationale:

Zidovudine, also known as AZT, is an antiretroviral medication used to prevent and treat HIV/AIDS. It is generally safe for use during pregnancy and is commonly used to prevent mother-to-child transmission of HIV12. It works by inhibiting the reverse transcriptase enzyme, thereby blocking viral replication. The use of Zidovudine and other antiretroviral drugs in pregnant women with HIV has significantly reduced the rate of mother-to-child transmission of the virus.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When teaching a patient a skill such as self-injection of insulin, what is the best way to set up the teaching/learning session?

Correct Answer is B

Explanation

The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant?

Correct Answer is D

Explanation

A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin Which of the following laboratory values should the nurse report to the provider before initiating the medication?

The nurse is preparing to educate a patient who has just been prescribed a sulfonamide. Which statements should be included in the teaching plan?

When a patient is undergoing aminoglycoside therapy, which indicators should the nurse monitor for potential toxicity?

A nurse is discussing the care of a client who has type 1 diabetes mellitus with an assistive personnel (AP). Which of the following situations should the nurse instruct the AP to report immediately?

Phenytoin has a narrow therapeutic index. The nurse recognizes that this characteristic indicates which of these?

The nurse is reviewing the medication orders for a patient who will be receiving aminoglycoside therapy. Which other medication or medication class, if ordered, would be a potential interaction concern?

During morning medication administration, the nurse discovered an error on the electronic Medication Administration Record (MAR) before the medication was given. What is the appropriate action for this “near-miss”?