Exhibits

For each potential provider prescription, click to specify if the prescription is expected or unexpected for the adolescent. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Insert a peripheral IV catheter.

Place the adolescent on a cooling blanket.

Administer IV acyclovir.

Place on seizure precautions.

Keep adolescent flat in bed for 24 hr post lumbar puncture.

Administer IV cefotaxime.

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"}}

Rationale:

Insert a peripheral IV catheter: A peripheral IV catheter is essential for administering fluids and medications, which is critical for this adolescent, especially with the concern for bacterial meningitis.
Place the adolescent on a cooling blanket: The adolescent has a high fever (39°C), which needs to be managed promptly to prevent further complications. A cooling blanket helps reduce the fever and manage the patient’s temperature.
Administer IV acyclovir: Acyclovir is an antiviral medication typically used to treat viral infections such as herpes simplex virus or varicella-zoster virus, not bacterial meningitis. Given the CSF findings and suspected bacterial meningitis, acyclovir is not appropriate. Antibiotics like cefotaxime are indicated instead.
Place on seizure precautions: Given the adolescent's symptoms (e.g., headache, photophobia, lethargy), the risk of seizures is elevated, especially if meningitis is suspected. Seizure precautions are important to prevent injury during a potential seizure.
Keep adolescent flat in bed for 24 hr post lumbar puncture: After a lumbar puncture, keeping the adolescent flat in bed for 24 hours helps prevent post-lumbar puncture headaches and minimizes the risk of cerebrospinal fluid leaks or complications.
Administer IV cefotaxime: IV cefotaxime is an appropriate antibiotic for treating bacterial meningitis. Given the abnormal CSF results (low glucose, high protein, elevated WBC), the adolescent is at high risk for bacterial meningitis, and IV cefotaxime is expected to be part of the treatment plan.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is ["C","D"]

Explanation

A. "There is nothing we can do to minimize overgrowth of their gum tissue.": Incorrect. Gingival hyperplasia is a known side effect of phenytoin, but good oral hygiene and regular dental care can help minimize its severity.
B. "They will need to take 400 IU of vitamin E while on this medication.": Incorrect. Routine vitamin E supplementation is not standard or necessary with phenytoin unless specifically indicated by a provider.
C. "We will need to periodically have their blood drawn to check phenytoin levels.": Correct. Phenytoin has a narrow therapeutic index, so serum drug levels must be monitored regularly to avoid toxicity or subtherapeutic dosing.
D. "This medication may cause their eyes to, at times, move quickly back and forth.": Correct. Nystagmus is a known dose-related side effect of phenytoin, especially at higher levels.
E. "This drug won't decrease the effectiveness of their oral contraceptive medication.": Incorrect. Phenytoin is a hepatic enzyme inducer and can reduce the effectiveness of hormonal contraceptives, so alternate or additional contraceptive methods should be recommended.

A. Collect a stool specimen for occult blood. B. Draw a blood culture. C. Conduct a tape test. D. Obtain a stool specimen for culture.

Correct Answer is D

Explanation

A. Collect a stool specimen for occult blood: A stool specimen for occult blood is typically used to check for hidden blood in the stool, which might suggest conditions like gastrointestinal bleeding or certain infections. It is not the primary test for diagnosing C. difficile infection.

B. Draw a blood culture: Blood cultures are used to identify bacteria or other pathogens in the blood, but they are not appropriate for diagnosing Clostridium difficile infection, which primarily affects the gastrointestinal system.

C. Conduct a tape test: A tape test is used for diagnosing pinworm infections, not for Clostridium difficile. It involves placing a piece of tape on the child's anal area to collect eggs for examination under a microscope. It is not relevant to the suspicion of C. difficile.

D. Obtain a stool specimen for culture: The most appropriate action is to collect a stool specimen for culture to identify C. difficile. The diagnosis of C. difficile infection is typically confirmed by stool testing, which may include testing for toxins produced by the bacteria.

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Exhibits For each potential provider prescription, click to specify if the prescription is expected or unexpected for the adolescent. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits The nurse has reviewed information regarding the adolescent's medication for home use with the guardian and adolescent. Select the 2 statements that demonstrate the guardian's understanding of their child's medication.

Correct Answer is ["C","D"]

Explanation

A nurse is caring for a toddler whose guardian reports multiple episodes of diarrhea. The provider suspects Clostridium difficile. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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Exhibits

For each potential provider prescription, click to specify if the prescription is expected or unexpected for the adolescent. There must be at least 1 selection in every row. There does not need to be a selection in every column.