A client taking nitrofurantoin for cystitis develops fever, flank pain, vomiting, and costovertebral-angle tenderness. Which action is appropriate?

1 Continue the same drug because it treats every urinary infection.
2 Notify the prescriber promptly because pyelonephritis is suspected and nitrofurantoin does not achieve appropriate renal-tissue levels. ✓ Correct answer
3 Take the remaining doses only at bedtime.
4 Add an antacid containing magnesium trisilicate.

Explanation

The new systemic and flank findings suggest pyelonephritis. Nitrofurantoin is indicated for lower urinary infection, not pyelonephritis or perinephric abscess.

Next question on this topicA nurse is reviewing the morning lab results for an adult client receiving warfarin for at…

In-depth explanation

Quick answer
Escalate upper-tract infection cues during nitrofurantoin therapy.

Why this is correct
Continuing a lower-tract agent can delay effective treatment of a renal infection.

Easy analogy or mental picture
Build a medication-safety chain: identify the new cue, connect it to the drug mechanism or labeled limitation, stop preventable exposure, stabilize the client, and verify a measurable response.

Memory hook
Drug, urgent cue, protective action, and reassessment endpoint.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving indicated treatment and required monitoring.

Why the other choices are wrong
Options that continue a suspect exposure, normalize a labeled danger cue, substitute an unauthorized dose, or delay escalation leave the client at risk.

References

1DailyMed: Nitrofurantoin CapsulesLower-tract indication and lack of pyelonephritis treatment

Clinical scenario

Medication-safety review
Verify indication, current assessment, dose and route, organ function, interactions, urgent toxicity cues, authorized action, and measurable follow-up.

Browse all questions No login required

Master the NCLEX-RN with MyMerci

Thousands of NCLEX-style questions with detailed rationale — in your language. Track your progress and study smarter.

Start for free

App Store Google Play

Read in another language: English 한국어 日本語繁體中文 Tiếng Việt

For study reference only. Always follow current clinical guidelines and your institution’s protocols.

성장을 멈추지 마세요

A client taking nitrofurantoin for cystitis develops fever, flank pain, vomiting, and costovertebral-angle tenderness. Which action is appropriate?

In-depth explanation

Clinical scenario

Master the NCLEX-RN with MyMerci