Following surgery, a client is placed on cefotaxime (Claforan). The assessment for possible adverse effects should include observing for

Correct Answer: A

Rationale: Cefotaxime, a cephalosporin antibiotic, commonly causes gastrointestinal side effects such as diarrhea due to disruption of normal gut flora. While headache, constipation, and tachycardia can occur with various medications, diarrhea is a well-documented and frequent adverse effect of cephalosporins, making it a priority to monitor.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) Uterine contractions are continuous and sustained. This finding would likely prompt the nurse to stop the oxytocin infusion because continuous and sustained uterine contractions can lead to uterine hyperstimulation, which can compromise fetal oxygenation and increase the risk of fetal distress. Option B) The vaginal exam revealing the client entering transition is not a definitive reason to stop the infusion of oxytocin. Transition is a normal phase of labor and does not necessarily indicate a need to discontinue the medication. Option C) The client reporting strong uterine contractions is also not a clear indication to stop the oxytocin infusion. Strong contractions are expected during labor, and the intensity alone may not warrant stopping the medication. Option D) Uterine contractions occurring every 2 to 3 minutes and lasting 40 to 60 seconds may be within the normal range for labor progress. While frequent contractions should be monitored, they alone do not necessarily require stopping the oxytocin infusion. Educationally, understanding the potential adverse effects of oxytocin, such as uterine hyperstimulation, is crucial for nurses caring for laboring clients. Recognizing signs of uterine hyperstimulation and knowing when to intervene or stop the medication is essential to ensure the safety of both the mother and the baby during labor and delivery.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) The client is pregnant. Fluticasone (Flonase) is a corticosteroid medication used for its anti-inflammatory properties, commonly prescribed for allergic rhinitis. During pregnancy, the safety of medications is crucial as they can potentially affect the developing fetus. Fluticasone use during pregnancy has been associated with a slightly increased risk of cleft palate in the baby. Option A) The client has diabetes mellitus: Diabetes mellitus is not a contraindication for using fluticasone. Although caution may be needed in individuals with uncontrolled diabetes due to potential effects on blood sugar levels, it is not a reason to hold the drug immediately. Option C) The client has glaucoma: While corticosteroids like fluticasone can increase intraocular pressure and worsen glaucoma, this condition alone would not warrant holding the medication without further context or assessment. Option D) The client has hypertension: Hypertension is not a contraindication for fluticasone use. Corticosteroids can cause fluid retention and electrolyte imbalances which may exacerbate hypertension, but it is not a primary reason to withhold the medication in this case. Educational Context: Understanding the safety profile of medications across different populations is crucial for nurses to provide safe and effective care. Considering the potential risks and benefits of medications, especially during pregnancy, helps in making informed clinical decisions that prioritize patient safety and well-being. Nurses should always assess and consider individual patient factors before administering medications to prevent adverse outcomes.

Correct Answer: C

Rationale: In the context of safety pharmacology across the lifespan, the correct answer to the question, "The family nurse practitioner exhibits professional leadership by creating a task force to address scope-of-practice concerns," is option C. This response demonstrates professional leadership as it involves actively engaging in addressing important issues within the scope of practice. By creating a task force, the nurse practitioner is taking proactive steps to advocate for advancements and improvements in patient care delivery within their scope of practice. Option A, adding clinical protocols to the nurse practitioner scope of practice, while important, does not directly demonstrate professional leadership. It implies an individual action rather than a collaborative effort to address broader concerns. Option B, comparing the workplace roles of the registered nurse and the nurse practitioner, is more focused on understanding existing roles rather than actively leading change or improvement. Option D, lobbying to eliminate continuing education requirements, is not aligned with professional leadership in enhancing practice standards and patient care. Continuing education is essential for maintaining competence and staying updated in the rapidly evolving field of healthcare. In an educational context, this question highlights the importance of professional leadership for nurse practitioners in advocating for practice improvements and patient care enhancements. By actively engaging in addressing scope-of-practice concerns through initiatives like creating task forces, nurse practitioners can contribute to advancing the profession and ensuring quality care delivery across the lifespan.

Correct Answer: D

Rationale: In this scenario, the correct order of strength of evidence from strongest to weakest is 2) Randomized placebo-controlled trial of 1600 patients, 3) Meta-analysis of 15 double-blind RCTs, 1) Retrospective review of 1000 charts. The randomized placebo-controlled trial (option 2) is the strongest evidence as it involves a large sample size and a rigorous study design which helps establish causality. Meta-analysis of multiple double-blind RCTs (option 3) is the next strongest as it combines data from several high-quality studies to provide a comprehensive overview of the evidence. The retrospective review of charts (option 1) is the weakest evidence due to potential biases, lack of control, and lower level of evidence compared to the other options. From an educational perspective, understanding the hierarchy of evidence is crucial for healthcare providers to make informed clinical decisions. This question highlights the importance of critically appraising evidence to ensure best practices in patient care. It emphasizes the significance of relying on high-quality research findings over anecdotal or less robust sources of evidence when making clinical decisions.