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.

Nursing Test Bank

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Correct Answer is A

Explanation

A. Morphine is a strong opioid analgesic that is effective for managing severe pain, especially in acute situations like a vaso-occlusive crisis. Administering it intravenously allows for rapid onset of pain relief, which is critical given the severity of the patient’s symptoms. Continuous dosing (ATC—around the clock) ensures that pain is managed effectively.
B. Fentanyl patches are typically used for chronic pain management and take time to reach effective levels in the bloodstream (up to 12 hours or longer). In the case of acute severe pain from a vaso- occlusive crisis, this option would not provide immediate relief.
C. While ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can help relieve mild to moderate pain, it is not adequate for severe pain management. Additionally, in the setting of sickle cell disease, patients may be at risk for renal issues, making high doses of NSAIDs potentially harmful.
D. Hydromorphone is also a strong opioid analgesic; however, administering it orally may not be effective for severe pain management in an acute situation. IV administration of opioids is preferred for immediate and potent pain relief during a vaso-occlusive crisis.

A. Use a positive pressure room if available B. Restrict any visitors until the patient's ANC counts return to normal C. Use a negative pressure room if available D. No live plants or fruits in the room E. Ensure all entrants into room wash their hands

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.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient who has sickle cell disease was admitted with a vaso-occlusive crisis and reports severe abdominal and flank pain. Which of the following analgesic medications will be MOST appropriate to administer to the patient?

Correct Answer is A

Explanation

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 nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority?

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

A nurse is teaching a client who has a new diagnosis of rheumatoid arthritis. Which of the following statements should the nurse include in the teaching?

Which of the following is are appropriate nursing interventions to ensure the safety of a patient who is receiving Total Parenteral Nutrition (TPN)? (Select all that apply)

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.)

You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

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.)