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A patient who has been taking the antibiotic, penicillin to treat a strep infection for five days. This patient presents to the clinic reporting abdominal cramping and multiple episodes of watery diarrhea for the last 2 days. The patient also reports a single episode of diarrhea with small amounts of blood. What is the nurse's best response?

“I will speak to the doctor about a prescription for loperamide to help ease the diarrhea while you complete your antibiotics.”

"You need to stop taking the medication immediately. The doctor will prescribe a different antibiotic to treat your new symptoms."

"Gl symptoms are expected side effects when taking antibiotics. Start taking the medication with food to minimize this and follow up in two days."

"This sounds like an allergic reaction. Take some diphenhydramine and follow up in two days."

Answer and Explanation

The Correct Answer is B

A. “I will speak to the doctor about a prescription for loperamide to help ease the diarrhea while you complete your antibiotics.": Using antidiarrheal medications like loperamide can worsen antibiotic-associated colitis if the diarrhea is due to Clostridioides difficile infection. Symptom management without addressing the underlying cause is unsafe.

B. "You need to stop taking the medication immediately. The doctor will prescribe a different antibiotic to treat your new symptoms.": Watery diarrhea with abdominal cramping and blood after several days of antibiotic use suggests possible C. difficile infection, a serious complication. Immediate discontinuation of the offending antibiotic and notifying the healthcare provider is essential for patient safety and treatment of the infection.

C. "GI symptoms are expected side effects when taking antibiotics. Start taking the medication with food to minimize this and follow up in two days.": While mild GI upset can occur with antibiotics, the presence of blood in the stool, prolonged diarrhea, and cramping indicates a potentially serious complication rather than a routine side effect.

D. "This sounds like an allergic reaction. Take some diphenhydramine and follow up in two days.": Allergic reactions to penicillin typically present with rash, hives, or anaphylaxis, not bloody diarrhea. Treating with diphenhydramine would not address the gastrointestinal complication and could delay appropriate care.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Place one finger across the acromion process and measure fingerbreadth below to the midpoint and center of the lateral aspect of the upper arm: This technique accurately identifies the deltoid muscle injection site, avoiding the acromion and underlying nerves or blood vessels. Proper site selection ensures safe and effective intramuscular administration of the hepatitis B vaccine.

B. Locate the center of the arm between the elbow and the shoulder: This is too vague and does not ensure injection into the deltoid muscle belly. Administering here may risk injecting into subcutaneous tissue or near nerves.

C. Locate the middle third of the anterior thigh between the greater trochanter of the femur and the lateral femoral condyle: This describes the vastus lateralis site, used for infants or adults who cannot use the deltoid. It is not appropriate for routine adult deltoid injections.

D. Find the center of the anterior aspect of the thigh: This incorrectly identifies the anterior thigh (rectus femoris) rather than the lateral thigh (vastus lateralis) or deltoid. This site is less recommended for adults due to pain and proximity to nerves.

A. Calf strain B. Peripheral artery disease (PAD) C. Deep vein thrombosis (DVT) D. Cellulitis

Correct Answer is C

Explanation

A. Calf strain:A calf strain usually presents with localized pain and mild swelling after a known injury or overuse. It is less likely to cause significant redness, unilateral swelling of one inch, or progressive pain with activity without a precipitating trauma.

B. Peripheral artery disease (PAD):PAD typically causes pain in the lower extremities with exertion (claudication) but is associated with cool, pale skin, diminished pulses, and hair loss, rather than redness, swelling, and unilateral calf enlargement.

C. Deep vein thrombosis (DVT):DVT presents with unilateral calf pain, redness, swelling, and increased calf circumference. Oral contraceptive use is a known risk factor due to increased clotting tendency, making DVT the most likely condition in this patient.

D. Cellulitis:Cellulitis presents with redness, warmth, and swelling, but it is usually associated with systemic symptoms such as fever and may not cause significant unilateral calf circumference changes. DVT should be ruled out first due to risk of pulmonary embolism.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer the hepatitis B vaccine to a client. Which of the following techniques should the nurse use to locate the deltoid muscle?

Correct Answer is A

Explanation

A patient who has been taking oral contraceptives reports to the clinic with complaints of left calf pain that worsens with activity. On assessment the nurse notices that the left calf is red and measures one inch larger than the right calf. Which condition should the nurse suspect?

Correct Answer is C

Explanation

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