Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?

Recommend use of an over-the-counter antipyretic.

Determine if other adverse effects have developed.

Ask if the medication has been kept refrigerated.

Instruct the client to increase oral fluid intake.

Answer and Explanation

The Correct Answer is B

Recommend use of an over-the-counter antipyretic: While treating fever with an antipyretic like acetaminophen or ibuprofen may provide symptomatic relief, the priority in this scenario is to assess for other adverse effects of the medication. Fever can be a sign of an allergic reaction or other adverse effects to the antibiotic. Therefore, it is important to first assess for other symptoms before recommending symptomatic treatment.

B) Determine if other adverse effects have developed: This is the correct answer. The onset of a low-grade fever after starting a new medication, such as amoxicillin, warrants further assessment for other adverse effects. The nurse should inquire about other symptoms the client may be experiencing, such as rash, itching, swelling, difficulty breathing, or gastrointestinal disturbances, which could indicate an allergic reaction or other adverse effects.

C) Ask if the medication has been kept refrigerated: While it is important to ensure proper storage of medications, such as amoxicillin, which may require refrigeration, the onset of a low-grade fever is not typically related to medication storage. Therefore, this action would not address the client’s current symptoms and concerns.

D) Instruct the client to increase oral fluid intake: While maintaining adequate hydration is important for overall health and may help manage symptoms of illness, such as fever, the priority in this scenario is to assess for other adverse effects of the medication. Therefore, increasing oral fluid intake alone would not address the potential adverse effects of amoxicillin.

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Correct Answer is C

Explanation

A) A decreased peak and trough level may indicate subtherapeutic levels of the medication but do not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

B) A decreased trough level alone may suggest a need for dosage adjustment but does not present an immediate risk to the client. It is important to monitor therapeutic drug levels, but this finding does not require immediate reporting to the healthcare provider.

C) An increased peak and trough level indicates potential toxicity of the medication. Increased peak levels can lead to nephrotoxicity, while increased trough levels can lead to ototoxicity. Both conditions are serious and require immediate action to prevent harm to the client. The nurse should report this finding immediately to the healthcare provider for further evaluation and possible adjustment of the medication regimen.

D) A decreased peak level alone may indicate subtherapeutic levels of the medication, but it does not pose an immediate risk to the client. Adjustments to the dosing regimen may be needed, but this finding does not require immediate action.

A. Obtain another transdermal patch and position it on the client’s left upper chest. B. Withhold further doses of nitroglycerin until contacting the healthcare provider. C. Leave the patch in place and administer a PRN dose of sublingual nitroglycerin. D. Reassure the client that the patch will begin to take effect within a few minutes.

Correct Answer is C

Explanation

A) Applying another transdermal patch is not recommended without healthcare provider approval. Doubling the dose of nitroglycerin could increase the risk of hypotension and other adverse effects.

B) Withholding further doses of nitroglycerin without healthcare provider guidance may lead to inadequate control of angina symptoms. However, in this scenario, the client has already received a dose of transdermal nitroglycerin, so withholding further doses may not be appropriate if the client’s symptoms persist.

C) Leaving the patch in place and administering a sublingual dose of nitroglycerin is the correct action in this situation. Sublingual nitroglycerin provides rapid relief of angina symptoms by dilating blood vessels and improving myocardial oxygen supply. The transdermal patch may not have reached therapeutic levels yet, but the sublingual form can provide more immediate relief.

D) While it’s important to reassure the client, especially during an episode of chest pain, relying solely on the transdermal patch to take effect may not provide timely relief. Administering sublingual nitroglycerin allows for faster absorption and symptom relief.

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Six days after starting a prescription of an oral amoxicillin solution, a client calls the clinic to report the onset of a low grade fever. Which action should the nurse Implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A peak and trough level was obtained from a client receiving an aminoglycoside IV every 8 hours. Which finding presents the highest risk for the client and should be reported immediately to the healthcare provider?

Correct Answer is C

Explanation

A client with a history of angina reports the onset of chest pain. The nurse determines that the heart rate is 104 beats/minute and the blood pressure is 138/86 mm Hg. A transdermal nitroglycerin patch was applied 30 minutes ago to the right upper chest. Which action should the nurse take?

Correct Answer is C

Explanation

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