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.

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Correct Answer is A

Explanation

Choice A rationale:

Zidovudine, also known as AZT, is a medication used for the treatment of human immunodeficiency virus (HIV) infection. One of the major dose-limiting toxic effects of Zidovudine is hematologic toxicity, which manifests clinically as anemia, neutropenia, and sometimes as platelet deficits with onset after several weeks of treatment. This hematologic toxicity is essentially a form of bone marrow suppression. Therefore, bone marrow suppression is the dose-limiting adverse effect of zidovudine therapy.

Choice B rationale:

Retinitis is not a known dose-limiting adverse effect of zidovudine. While zidovudine has a range of side effects, retinitis is not commonly associated with its use.

Choice C rationale:

Renal toxicity is not a known dose-limiting adverse effect of zidovudine. While zidovudine can have various side effects, renal toxicity is not typically one of them.

Choice D rationale:

Hepatotoxicity is not the dose-limiting adverse effect of zidovudine. While severe hepatomegaly with steatosis, including fatal cases, have been reported with the use of zidovudine, it is not considered the dose-limiting adverse effect. The dose-limiting adverse effect is more specifically related to hematologic toxicity, which includes bone marrow suppression.

Correct Answer is ["2"]

Explanation

Let’s solve the medication math problem step by step:

Step 1: Identify the total daily dose of amoxicillin. The total daily dose is 2 gm/day.

Step 2: Convert the total daily dose from grams to milligrams, as the available medication is in milligrams. We know that 1 gm = 1000 mg, so 2 gm = 2000 mg.

Step 3: The total daily dose is divided into two doses. So, each dose will be 2000 mg ÷ 2 = 1000 mg.

Step 4: Determine the number of tablets for each dose. Each tablet contains 500 mg of amoxicillin. So, the number of tablets for each dose is 1000 mg ÷ 500 mg/tablet = 2 tablets.

So, the nurse should administer 2 tablets of amoxicillin with each dose.

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Naxlex Comprehensive Predictor Exams

A patient who is HIV-positive has been receiving medication therapy that includes zidovudine. The prescriber has decided to stop the zidovudine due to its dose-limiting adverse effect. Which of these conditions is the dose-limiting adverse effect of zidovudine therapy?

Correct Answer is A

Explanation

A nurse is preparing to administer amoxicillin 2 gm/day PO divided into two doses. The amount available is amoxicillin 500 mg tablets. How many tablets should the nurse administer with each dose?

Correct Answer is ["2"]

Explanation

When given a scheduled morning medication, the patient states, “I haven’t seen that pill before. Are you sure it’s correct?” The nurse checks the medication administration record and verifies that it is listed. Which is the nurse’s best response?

The physician orders an injection of dexamethasone (Decadron) 6mg IM for a patient. The available stock is dexamethasone 4mg/1ml in a 5ml multidose vial. How many mLs of this medication will the nurse prepare?

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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?

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A 79-year-old patient is receiving a quinolone for treatment of a complicated incision infection. For which adverse effect associated with these drugs should the nurse monitor?