Page 1914 - Saunders Comprehensive Review For NCLEX-RN

pain, chills, fever, cough, and alveolar infiltrates. These symptoms resolve 2 to 4
days after discontinuing the medication. Acute pulmonary responses are thought to
be hypersensitivity reactions. Subacute reactions are rare and occur during
prolonged treatment. Symptoms (e.g., dyspnea, cough, malaise) usually regress over
weeks to months following nitrofurantoin withdrawal. However, in some clients,
permanent lung damage may occur. The remaining options are incorrect
interpretations.
Test-Taking Strategy: Focus on the subject, interpreting the client’s complaints,
and the information in the question. Note the relationship of the information in the
question and the words pulmonary reaction in the correct option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Nursing Process—Analysis
Content Area: Pharmacology: Renal and Urinary Medications: Urinary tract
antiseptics
Health Problem: Adult Health: Renal and Urinary: Inflammation/ Infections
Priority Concepts: Clinical Judgment; Infection
Reference: Lilley et al. (2017), pp. 636, 638.

663. Answer: 2

Rationale: Each dose of trimethoprim-sulfamethoxazole should be administered
with a full glass of water, and the client should maintain a high fluid intake to avoid
crystalluria. The medication is more soluble in alkaline urine. The client should not
be instructed to taper or discontinue the dose. Clients should be advised to use
sunscreen since the skin becomes sensitive to the sun. Some forms of trimethoprim-
sulfamethoxazole cause urine to turn dark brown or red. This does not indicate the
need to notify the PHCP.
Test-Taking Strategy: Focus on the subject, client instructions for trimethoprim-
sulfamethoxazole. Recalling that this medication is used to treat urinary tract
infections will direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Pharmacology: Renal and Urinary Medications: Sulfonamides
Health Problem: Adult Health: Renal and Urinary: Inflammation/ Infections
Priority Concepts: Client Teaching; Infection
Reference: Ignatavicius, Workman, Rebar (2018), p. 1360.

664. Answer: 4

Rationale: Clients taking trimethoprim-sulfamethoxazole should be informed
about early signs and symptoms of blood disorders that can occur from this
medication. These include sore throat, fever, and pallor, and the client should be
instructed to notify the primary health care provider (PHCP) if these occur. The
other options do not require PHCP notification.
Test-Taking Strategy: Focus on the subject, the symptoms to report. Knowledge

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