You are a RN working in a busy Emergency Department (ED) caring for a patient with a stage 3 pressure injury of the right hip that is warm, and has purulent drainage. The ED physician orders an intermittent IV piggyback of the antibiotic Gentamycin to be started. What should you do prior to starting the infusion? Select the BEST answer.

Send a drug trough level to the lab

Have family members wait in the waiting room

Teach the patient the potential side effects of the medication

Send a culture & sensitivity to the lab

Answer and Explanation

The Correct Answer is D

A.   While monitoring drug levels is important, sending a trough level before the initial dose is not standard practice. Trough levels are typically checked just before the next dose of a medication is given, especially for antibiotics like Gentamicin that require monitoring for potential toxicity. Therefore, this option is not the best immediate action.
B.   While managing the environment and ensuring patient privacy is important, this option does not address any immediate medical needs related to starting the antibiotic infusion.
C.   Educating the patient about potential side effects is essential for informed consent and patient safety. However, while important, this is not the most critical action to take prior to the infusion.
D.   Before starting an antibiotic treatment, it is crucial to send a culture and sensitivity test to identify the specific pathogen causing the infection. This ensures that the selected antibiotic (Gentamicin) is appropriate for the identified bacteria, which is vital for effective treatment and to avoid antibiotic resistance.

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Correct Answer is ["A","B","D","E"]

Explanation

A. A positive pressure room helps prevent outside air (and potential pathogens) from entering the room, providing a safer environment for neutropenic patients.
B. Visitors can introduce infections, so it’s wise to restrict them, especially those who are ill or have been exposed to infectious diseases.
C. Negative pressure rooms are used for patients with airborne infections (like tuberculosis) to prevent pathogens from escaping the room. Neutropenic patients require a protected environment, not one that allows outside air to flow in.
D. Live plants and unwashed fruits can harbor bacteria and fungi that pose a risk to neutropenic patients, who have compromised immune systems.
E. Hand hygiene is one of the most effective ways to prevent the spread of infections. Everyone entering the room should wash their hands to minimize the risk of introducing pathogens.

A. Stop the transfusion B. Administer oxygen C. Obtain a blanket from the warmer D. Check the patient's oral temperature

Correct Answer is A

Explanation

A. This is the first and most critical action to take. The patient's symptoms suggest a possible transfusion reaction, which can be life-threatening. Stopping the transfusion immediately prevents further exposure to potentially harmful blood components.
B. Administering oxygen may be necessary if the patient exhibits signs of respiratory distress or hypoxia. However, this action should come after ensuring that the transfusion is stopped and the patient is stabilized, as continuing the transfusion could exacerbate the reaction.
C. While providing warmth can help alleviate chills, it is not the priority action. The patient's safety is more important, and symptoms of a transfusion reaction must be addressed first.
D. Checking the temperature can provide useful information about the patient's condition, especially if a fever is present, but it is not an immediate priority. The focus should be on stopping the transfusion and managing the acute symptoms.

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Naxlex Comprehensive Predictor Exams

You are caring for a patient with an Absolute Neutrophil Count (ANC) of 400. The physician orders the patient to be placed on neutropenic precautions. Which of the following would be appropriate to implement? (Select all that apply)

Correct Answer is ["A","B","D","E"]

Explanation

A transfusion of packed red blood cells (PRBCs) has been infusing for 5 minutes when the patient becomes flushes and tachypneic and says, "I'm having chills. Please get me a blanket." Which action should the nurse take first?

Correct Answer is A

Explanation

A nurse in the Emergency Department (ED) is caring for a client who is having acute asthma attack. Which of the following assessments indicates that the respiratory status is declining?(Select all that apply)

Your patient has suspected aplastic anemia and has just returned to the unit to be cared for by you after having bone marrow biopsy done to confirm the diagnosis. Which of the following is the MOST appropriate nursing action?

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A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate?

A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

As a nurse, you understand that when patients have latent TB: