The nurse administers the initial dose of cefoxitin to a client whose medical record indicates an allergy to penicillin. Which finding is most important for the nurse to report to the healthcare provider?

Diminished renal output.

Pruritis and macular rash.

Vomiting and diarrhea.

Vaginal discharge.

Answer and Explanation

The Correct Answer is B

A) Diminished renal output:
Diminished renal output could be a potential concern with cefoxitin administration, as it is primarily excreted by the kidneys. However, it is not specifically related to the client’s allergy to penicillin. While it warrants monitoring, it is not the most critical finding to report in this context.

B) Pruritis and macular rash:
The development of pruritis (itchiness) and a macular rash (flat, discolored skin lesions) following the administration of cefoxitin in a client with a documented allergy to penicillin is a significant finding. It suggests a possible allergic reaction to cefoxitin, which belongs to the cephalosporin class of antibiotics. Cross-reactivity between penicillin and cephalosporins is well-documented, with some cephalosporins having a higher risk of allergic reactions in individuals with penicillin allergy. Therefore, pruritis and rash in this context may indicate an allergic response, and it is crucial to report this finding promptly to the healthcare provider for further evaluation and management.

C) Vomiting and diarrhea:
While gastrointestinal symptoms such as vomiting and diarrhea can occur as adverse effects of cefoxitin, they are not specific to an allergic reaction and may occur with various medications. While it is essential to monitor for these symptoms, they are not the most important findings to report in the context of a known penicillin allergy.

D) Vaginal discharge:
Vaginal discharge is not typically associated with an allergic reaction to cefoxitin. While changes in vaginal discharge may be clinically relevant in certain contexts, such as indicating a possible yeast infection or bacterial vaginosis, it is not directly related to the client’s allergy to penicillin or the administration of cefoxitin.

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Correct Answer is A

Explanation

A) Begin therapy 1 week before the next normal menstrual cycle:
Misoprostol is often prescribed to prevent gastric ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs) and is typically taken regularly with meals and at bedtime. The timing of therapy initiation is not necessarily linked to the menstrual cycle. Therefore, instructing the client to begin therapy specifically 1 week before the next normal menstrual cycle is incorrect and indicates a need for further teaching.

B) Use condoms and a backup method of birth control to prevent pregnancy:
Misoprostol is contraindicated during pregnancy due to its potential to induce uterine contractions and cause miscarriage or fetal abnormalities. Therefore, advising the client to use condoms and a backup method of birth control to prevent pregnancy while taking misoprostol is appropriate and aligns with safety precautions.

C) Ensure a negative pregnancy test result 2 weeks before therapy:
Confirming a negative pregnancy test result before initiating misoprostol therapy is essential because the medication can cause harm to a developing fetus. This instruction is correct and reinforces the importance of avoiding pregnancy while taking misoprostol.

D) Call the healthcare provider immediately if there is a chance of conception:
Given the teratogenic effects of misoprostol, advising the client to contact the healthcare provider immediately if there is a chance of conception is crucial. This instruction emphasizes the importance of avoiding pregnancy while taking the medication and seeking medical guidance promptly if pregnancy is suspected.

A. Worsening headache. B. Polyuria. C. Polydipsia. D. Low urine specific gravity.

Correct Answer is A

Explanation

A) Worsening headache:
This option is correct. Vasopressin, also known as antidiuretic hormone (ADH), acts to increase water reabsorption in the kidneys, thereby reducing urine output. However, excessive administration of vasopressin can lead to vasoconstriction, which may result in increased intracranial pressure and subsequent headaches. Therefore, worsening headache can be indicative of vasopressin overdose or adverse effects, and it should be promptly reported to the healthcare provider for evaluation and appropriate management.

B) Polyuria:
Polyuria, or excessive urine output, is the opposite effect of vasopressin. While diabetes insipidus is characterized by polyuria due to insufficient ADH secretion or renal responsiveness to ADH, administering vasopressin should decrease urine output. Therefore, polyuria would not be expected as a side effect of vasopressin administration.

C) Polydipsia:
Polydipsia, or excessive thirst, is also a symptom of diabetes insipidus but is not typically associated with vasopressin administration. Vasopressin functions to decrease urine output and, consequently, reduce thirst. Therefore, polydipsia would not be expected as a side effect of vasopressin administration.

D) Low urine specific gravity:
Vasopressin administration is expected to increase urine specific gravity by promoting water reabsorption in the kidneys, leading to more concentrated urine. Therefore, low urine specific gravity would not be an expected side effect of vasopressin administration.

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The nurse administers the initial dose of cefoxitin to a client whose medical record indicates an allergy to penicillin. Which finding is most important for the nurse to report to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client with a history of peptic ulcer disease receives a prescription for misoprostol. Which information provided by the client indicates to the nurse a need for further teaching?

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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