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 D

Explanation

Choice A rationale:

Bounding peripheral pulses are not typically associated with diabetes insipidus. Diabetes insipidus is a condition characterized by excessive thirst and excretion of large amounts of severely dilute urine.

Choice B rationale:

Moist mucous membranes are not a common finding in diabetes insipidus. In fact, due to excessive urination, patients may experience dehydration which can lead to dry mucous membranes.

Choice C rationale:

Bradycardia, or a slower than normal heart rate, is not a typical symptom of diabetes insipidus. The condition does not directly affect the heart rate.

Choice D rationale:

Decreased urine specific gravity is a key finding in diabetes insipidus. The condition causes an imbalance of water in the body, leading to the production of large amounts of dilute (or low specific gravity) urine.

Please note that these rationales are based on general knowledge about diabetes insipidus and the specific symptoms mentioned in the choices. For a more detailed understanding, it’s recommended to refer to medical textbooks or consult with healthcare professionals.

A. “We’ll get you a prescription. B. As long as you start treatment within the next 24 hours, the drug should be effective.” C. “We will need to do a blood test to verify that you actually have the flu.” D. “Drug therapy should be started within 2 days of symptom onset, not 4 days.”

Correct Answer is C

Explanation

Choice A rationale:

This choice is incorrect. While it’s true that antiviral drugs can be effective in treating the flu, they’re most effective when started within 48 hours of symptom onset. Starting treatment after 4 days may not provide the same benefits.

Choice B rationale:

This choice is incorrect. While a blood test can confirm the presence of the flu virus, it’s not typically necessary to diagnose the flu. Diagnosis is usually based on symptoms and the fact that the flu is widespread in the community.

Choice C rationale:

This choice is correct. Antiviral drugs are most effective when started within 2 days of symptom onset. After this time, the benefits of these drugs decrease. Therefore, starting treatment 4 days after symptoms begin may not significantly reduce the duration or severity of symptoms.

Choice D rationale:

This choice is incorrect. While it’s true that getting a flu vaccine is important, it’s not the best response in this situation. The flu vaccine won’t treat current illness. It’s designed to prevent future infections. In this case, the individual is already sick, so a booster vaccination wouldn’t be the most effective course of action.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has diabetes insipidus. Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A young adult calls the clinic to ask for a prescription for a new flu drug. He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse’s best response to his request?

Correct Answer is C

Explanation

A nurse is caring for a client who has recurrent kidney stones and a history of diabetes mellitus. The client is scheduled for an intravenous Pyelogram (IVP). The nurse should collect additional data about which of the following statements made by the client?

A 6-year-old child who has chickenpox also has a fever of 102.9 F (39.4 C). The child’s mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?

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”?

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

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?

A patient has been prescribed a 2-week course of antifungal suppositories for a vaginal yeast infection. She asks the nurse if there is an alternative to this medication, stating, “I don’t want to do this for 2 weeks!” What could be a possible alternative in this situation?

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?

A nurse is caring for a client who was exposed to anthrax. Which of the following antibiotics should the nurse plan to administer?