1 :

Hint : πŸ”ŽThink about treatment needed before the exact bacteria are identified.

Correct Answers:

  • A broad-spectrum antibiotic

Rationale :

🦠Fever, chills, and an infected wound raise concern for a serious systemic bacterial infection.

πŸ§ͺBlood cultures are obtained before antibiotics so the specific causative organism can later be identified.

πŸ’‰While culture results are pending, a broad-spectrum antibiotic provides coverage against multiple likely organisms.

🎯Once culture and sensitivity results return, therapy can be narrowed to a more targeted antibiotic.

πŸ“ŒCore Message

Broad-spectrum antibiotics are commonly started empirically after cultures are obtained when a serious bacterial infection is suspected.

2 :

Hint : 🧠Think about which common pain reliever can damage the stomach lining with long-term use.

Correct Answers:

  • Naproxen

Rationale :

🩸Naproxen is an NSAID that can damage the gastric mucosa and increase the risk of GI bleeding.

πŸ§“Older adults have an increased risk of NSAID-related gastric ulcers and hemorrhage, especially with prolonged use.

⚫Dark, tarry stools represent melena, which commonly indicates upper gastrointestinal bleeding.

πŸ“…Daily use for a year significantly increases the likelihood of chronic NSAID-related gastric injury.

πŸ“ŒCore Message

Long-term NSAID use, particularly naproxen, can cause gastric ulceration and GI bleeding, producing melena.

3 :

Hint : πŸ”¬Choose the medication with antiprotozoal activity.

Correct Answers:

  • Metronidazole [Flagyl]

Rationale :

🦠Giardia is a protozoal intestinal infection commonly associated with contaminated food or water.

πŸ’ŠMetronidazole has antiprotozoal activity and is commonly used to treat giardiasis.

🚽Treatment targets the underlying organism rather than simply suppressing diarrhea.

🌍Recent international travel combined with cramping and frequent diarrhea supports the suspected parasitic infection.

πŸ“ŒCore Message

Metronidazole treats giardiasis by targeting the protozoal infection rather than only controlling symptoms.

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4 :

Fill the blanks using the list of options provided. β€œI am takingfor my asthma, but it caused a fungal infection on my tongue, so they gave meI don’t know if it’s working.β€β€œI have been takingfor my herpes, but I think it is causing stomach problems. They scheduled me for a colonoscopy, so now I have to drinkbut it makes me feel sick, so I’m not sure if I can do it.”

Hint : 🧩Match each medication with asthma, oral fungus, herpes, or bowel preparation.

Correct Answers

  • Blank 1 Correct Option: Fluticasone
  • Blank 2 Correct Option: Nystatin
  • Blank 3 Correct Option: Acyclovir
  • Blank 4 Correct Option: Polyethylene glycol
Rationale :

🫁Fluticasone is an inhaled corticosteroid used for long-term control of asthma inflammation.

πŸ‘…Inhaled corticosteroids can promote oral candidiasis, which can be treated with nystatin.

🦠Acyclovir is an antiviral medication commonly used to treat herpes infections.

πŸ₯€Polyethylene glycol solutions are frequently used as bowel preparation before a colonoscopy.

πŸ“ŒCore Message

Fluticasone treats asthma, nystatin treats oral candidiasis, acyclovir treats herpes, and polyethylene glycol prepares the bowel.

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5 :

The client is able to proceed with the scheduled colonoscopy. Unfortunately, the colonoscopy reveals colon cancer, and the client is admitted to the hospital. During the hospital stay, the client begins to experience nausea and vomiting.

Which of the following medications may be effective as antiemetics? Select all that apply.

Answer Options

Hint : 🎯Look for medications specifically used to control nausea and vomiting.

Correct Answers:

  • Ondansetron (Zofran)
  • Metoclopramide (Reglan)

Rationale :

🀒Ondansetron blocks serotonin 5-HT3 receptors and is widely used to prevent and treat nausea and vomiting.

🧠Metoclopramide has dopamine-antagonist activity and also increases gastric motility, providing antiemetic effects.

πŸ₯Both medications are commonly used in hospitalized patients experiencing nausea and vomiting.

πŸ’ŠTheir mechanisms differ, but both can effectively reduce emetic symptoms.

πŸ“ŒCore Message

Ondansetron and metoclopramide are established antiemetic medications used to manage nausea and vomiting.

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6 :

After 3 days in the hospital, the client has not had a bowel movement and reports mild abdominal discomfort rated 3/10. On assessment, the nurse notes slight abdominal distention.

Which medication is most appropriate for treating the client’s constipation?

Answer Options

Hint : πŸ”„Choose the medication that actively stimulates bowel movement.

Correct Answers:

  • Bisacodyl (Dulcolax) PO

Rationale :

🚽The client has established constipation, shown by three days without a bowel movement and mild abdominal discomfort.

πŸ’ŠBisacodyl is a stimulant laxative that promotes intestinal motility and is effective for short-term constipation.

⏱️An oral stimulant is appropriate because the symptoms are currently mild and uncomplicated.

🩺The client's condition does not suggest the need for an immediate invasive intervention such as an enema.

πŸ“ŒCore Message

Bisacodyl is appropriate for short-term treatment of established constipation because it stimulates intestinal motility.

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7 :

On day 5 of the client's admission to the hospital, they develop a bloodstream infection. A few days later, the nurse notices the client has developed a black, hairy tongue.

Which of the following actions and/or statements by the nurse are appropriate? Select all that apply.

Answer Options

Hint : πŸ”Consider whether this tongue discoloration represents toxicity or a benign medication effect.

Correct Answers:

  • Notify the provider as they will likely consider an alternative antibiotic.
  • F "I know this looks scary, but it is harmless and should go away within 14 days."

Rationale :

πŸ‘…A black hairy tongue can occur as a benign adverse effect associated with certain antibiotic therapies.

πŸͺ₯The discoloration results from elongation and staining of the filiform papillae rather than serious organ damage.

πŸ“žThe provider should be notified so the medication regimen can be reviewed and an alternative antibiotic considered if appropriate.

🌱The condition is generally harmless and reversible and usually resolves after the contributing factor is removed and oral hygiene improves.

πŸ“ŒCore Message

Black hairy tongue associated with antibiotic therapy is usually benign and reversible, but the provider should review the medication.

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8 :

Unfortunately, the client develops a pressure ulcer on their coccyx (buttocks region) that tests positive for MRSA. 

Besides wound care, which medication does the nurse anticipate the provider will order?

Answer Options

Hint : πŸ›‘οΈThink of the classic IV antibiotic used for serious resistant gram-positive infections.

Correct Answers:

  • Vancomycin

Rationale :

🦠MRSA is resistant to many standard beta-lactam antibiotics, including methicillin-related drugs.

πŸ’‰Vancomycin provides effective coverage against serious MRSA infections.

πŸ₯IV vancomycin is commonly used for significant hospitalized MRSA infections, including complicated skin and wound infections.

🎯Therapy should ultimately be guided by culture and sensitivity results.

πŸ“ŒCore Message

Vancomycin is a standard IV treatment for serious MRSA infections because it provides reliable gram-positive coverage.

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9 :

The client is started on the IV antibiotic to treat the MRSA infection and develops itchy hives and shortness of breath within 15 minutes of starting the new medication.

Fill the blanks using the list of options provided. First, the nurseNext, the nurse notifies the provider and prepares to administerThe nurse knows this medication will treat the client's condition by causing

Hint : βš•οΈThink about the first-line emergency drug that rapidly opens the airways during a severe allergic reaction.

Correct Answers

  • Blank 1 Correct Option: Stops the medication
  • Blank 2 Correct Option: Epinephrine
  • Blank 3 Correct Option: Bronchodilation
Rationale :

🚨Itchy hives and shortness of breath shortly after starting an IV antibiotic suggest anaphylaxis.

πŸ›‘The nurse should immediately stop the medication to prevent further exposure to the triggering agent.

πŸ’‰Epinephrine is the first-line medication for anaphylaxis because it rapidly reverses airway and cardiovascular compromise.

🫁Betaβ‚‚-receptor stimulation from epinephrine produces bronchodilation, helping relieve bronchospasm and improve airflow.

πŸ“ŒCore Message

Suspected anaphylaxis requires stopping the offending medication and giving epinephrine, which produces lifesaving bronchodilation.

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10 :

Hint : πŸ”Focus on medications that increase anticholinergic, bleeding, and kidney risks in older adults.

Correct Answers:

  • Non-steroidal anti-inflammatory drugs (NSAIDS) for chronic arthritis
  • Hydroxyzine for seasonal allergies
  • Antispasmodic medication for their irritable bowel syndrome

Rationale :

🩸Chronic NSAID use in older adults increases the risk of GI bleeding, renal impairment, and ulcers.

🧠Hydroxyzine has strong anticholinergic effects that can cause confusion, sedation, constipation, and falls in older adults.

🚻Many antispasmodic medications also have strong anticholinergic effects and should generally be avoided in very old clients.

πŸ‘΅At age 92, medications with significant anticholinergic or bleeding risks require careful review.

πŸ“ŒCore Message

Older adults should generally avoid medications with strong anticholinergic effects and chronic NSAID-related toxicity.

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