Advanced Pharmacology Exam #1
An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin? A. altered cognition B. diarrhea C. hematuria D. respiratory depression
B. diarrhea
The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity? A. Visual disturbances B. Yellowing of the skin C. A decrease in urine output D. Ringing noise in the ears
C. A decrease in urine output
A patient has been diagnosed with osteomyelitis (bone infection) and has begun treatment with IV vancomycin. Which of the nursing following teaching points relates most directly to the potential adverse effects of vancomycin? A. "Make sure to tell your nurse if you experience any changes in your hearing." B. "You may get hot flashes and break out in a sweat but this is due to the drug itself rather than your infection." C. "You might experience some waves of anxiety but these will pass." D. "Some patients experience a throbbing type of headache with this drug, but you can get painkillers if this happens."
A. "Make sure to tell your nurse if you experience any changes in your hearing."
A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed HTN and has been prescribed a new medication to decrease her BP. While planning the patient's care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics? A. Absorption B. Distribution C. Metabolism D. Elimination
A. Absorption
Pong-tai is a 12-month-old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to: A. Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily. B. Change the antibiotic to one that is less of a gastrointestinal irritant. C. Order stool cultures for suspected viral pathogens not treated by the amoxicillin. D. Recommend increased fluids and fiber in his diet.
A. Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily.
A nurse is caring for a patient who has an acute bacterial exacerbation of chronic bronchitis and who has been prescribed telithromycin (Ketek). Before therapy begins, the nurse will assess the patient for a history of which of the following? A. Arrhythmias B. infection of the eye C. Ulcerative colitis D. Hearing loss
A. Arrhythmias
A client has been prescribed doxycycline. Which teaching instruction is a priority with this medication? A. Avoid sun exposure B. Avoid unprotected sexual activity C. Administer with an antacid D. Chew the tablets
A. Avoid sun exposure
The penicillins are ranked as FDA pregnancy risk category: A. B B. C C. D D. X
A. B
The NP orders a specific medication to an older adult patient every 4 hours. The patient has a history of chronic renal failure. Why would this patient be at risk for toxic drug levels? A. Cumulative Effect B. First-pass effect C. Drug interactions D. Cross-tolerance effect
A. Cumulative Effect
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? A. Discontinue the infusion and inform the care provider promptly B. Slow down the rate so that the infusion takes place over 2 hours C. Administer oral diphenhydramine to the client during the infusion D. Administer a STAT dose of acetylcysteine
A. Discontinue the infusion and inform the care provider promptly
What potential adverse reaction is most likely to develop during cefazolin therapy? A. GI upset B. Dry skin and pruritis C. Drowsiness D. Orthostatic hypotension
A. GI upset
If a drug is highly protein bound, a low albumin level can result in? A. Increased levels of free drug B. Decreased level of free drug C. No change in free drug concentration D. Cardiac Arrhythmias
A. Increased levels of free drug
A client is given tetracycline to treat acne-related skin eruptions. How does tetracycline work? A. It binds to the 30S ribosome to inhibit protein synthesis B. It reduces central nervous system stimulation C. It is a beta-lactam antibiotic inhibiting cell wall synthesis D. It works on the final stage of cell wall synthesis
A. It binds to the 30S ribosome to inhibit protein synthesis
A client is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside? A. It blocks protein synthesis of the cell wall B. it blocks the process of DNA replication C. It destroys the integrity of the cell wall structure D. It increases white blood cell viability
A. It blocks protein synthesis of the cell wall
How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media? A. It extends the spectrum of antibacterial activity of penicillin B. It extends the spectrum of the beta-lactamase inhibitor C. It decreases the side effects of high-dose penicillin D. It increases the absorption of the penicillin
A. It extends the spectrum of antibacterial activity of penicillin
A 34-year-old woman has a UTI and has been prescribed SMZ-TMP. She has had chronic urethritis for the past 4 years. The nurse has instructed the patient to drink 1.5L of water daily, and they have discussed the drug and its adverse effects. Further instruction to the patient should include which of the following? A. Performing periodic urine testing to check for crystals B. Performing random glucose testing while taking the medication C. The need to administer an aminoglycoside drug along with the SMZ-TMP to treat urosepsis D. Advising the patient to take bubble baths to ensure cleanliness
A. Performing periodic urine testing to check for crystals
The monobactam-aztreonam is best described as: A. Possessing a b-lactam ring and inhibits cell wall synthesis B. similar to cephalosporins but inhibit protein synthesis C. Produce beta-lactamase and destroy the bacterial wll D. Inhibit DNA replication
A. Possessing a b-lactam ring and inhibits cell wall synthesis
When educating a patient concerning how the environment affects safe drug administration, the nurse will include the importance of A. Rapport between the patient and the health care provider B. A well-balanced life including work and family C. Taking medication in a private, rather than public, setting D. Proper methods to discard unneeded medications
A. Rapport between the patient and the health care provider
A nurse is preparing to administer an oral dose of SMZ-TMP to a patient with an uncomplicated UTI. The nurse understands that this combination of 2 different drugs is used because A. SMZ and TMP are weakly bactericidal when given alone but strongly bactericidal in combination B. SMZ is necessary to potentiate the effects of TMP on bacterial replication C. TMP mitigates the profound adverse effects that result when SMZ is given alone D. SMZ affects gram-positive bacteria and TMP affects gram-negative bacteria
A. SMZ and TMP are weakly bactericidal when given alone but strongly bactericidal in combination
Joe is a 17 year old male on the swim team at school. He is in for a clinic visit with acute otitis externa (swimmer's ear) and an intact tympanic membrane. First line therapy includes: A. Swim-ear drops (acetic acid) B. Hydrocortisone drops C. amoxicillin D. cloxacillin
A. Swim-ear drops (acetic acid)
What assessment finding would signal the nurse to the possibility that the client's infusion is running too quickly? A. The client is flushed and has a visible skin rash B. The client's apical heart rate is irregular C. The client is reporting nausea D. The client reports pain at the IV access site
A. The client is flushed and has a visible skin rash
A 69-year-old responded well to inclient treatment with a 3rd generation cephalosporin. After being largely symptom free for 48 hours, the woman has developed a fever of 38.6C and an elevated white cell count. What phenomenon may account for the client's current clinical presentation? A. The client may be infected with microorganisms that were resistant to the cephalosporin B. The client may be experiencing a delayed (type IV) hypersensitivity reaction to the cephalosporin C. The client may be developing glomerulonephritis secondary to the nephrotoxic cephalosporin D. The cephalosporin may have initially caused leukopenia and made the client susceptible to secondary infection
A. The client may be infected with microorganisms that were resistant to the cephalosporin
A patient has been receiving regular doses of an agonist for 2 weeks. Which of the following should the nurse anticipate? A. The drug will decrease in effectiveness B. The drug will increase in effectiveness C. There will be a steady state with no anticipated changes D. The drug will cause excessive therapeutic effects even when administered in small doses
A. The drug will decrease in effectiveness
A nurse who provides care in a long-term care facility is documenting a new resident's medication regimen on the resident's intake admission. The nurse is documenting the generic, rather than proprietary, names of the resident's current drugs because A. There is a potential for confusion and miscommunication if proprietary names are used B. Proprietary names of drugs can vary from state to state C. Documentation of trade names for drugs requires permission from the manufacturer D. Drugs with generic names are prescribed and used differently than proprietary drugs
A. There is a potential for confusion and miscommunication if proprietary names are used
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures reveal the presence of MRSA in the patient's blood. The nurse will anticipate that this patient will likely require IV administration of what antibiotic? A. Vancomycin B. Penicillin G C. Cefazolin D. Doripenem (Doribax)
A. Vancomycin
A client has been prescribed ciprofloxacin after being diagnosed with a sinus infection. What medication should the client avoid taking concurrently with ciprofloxacin? A. antacids B. calcium channel blockers C. Beta-adrenergic blockers D. Diuretics
A. antacids
Which group of penicillins has the narrowest spectrum of activity? A. natural penicillins B. penicillinase-resistant penicillin (methicillin, cloxacillin) C. aminopenicillins (amoxicillin) D. extended-spectum penicillins/antipseudomonas
A. natural penicillins
A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient? A. "Adequate studies in pregnant women have been demonstrated there is no risk to the fetus." B. "Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women." C. "Animal studies have show an adverse effect on the fetus, but there are not adequate studies in pregnant women." D. There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks."
B. "Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women."
An older adult client has sought care for a dermatological health problem that most often requires treatment with an oral corticosteroid. When considering whether to prescribe steroids to this client, the care provider should prioritize which question? A. "Should the client receive a medication that was likely tested on younger adults?" B. "Do the potential benefits of this medication outweigh the potential harm?" C. "Are there plausible herbal or complementary alternatives to this medication?" D. "Is there a younger adult who can oversee this client's medication regimen?"
B. "Do the potential benefits of this medication outweigh the potential harm?"
The student nurse asks the instructor why a patient with a CNS infection is receiving antibiotics that will not cross the blood-brain barrier. What is the instructor's most correct response? A. A severe infection alters the blood-brain barrier to allow the drug to cross B. A medication that is water soluble is more likely to cross the blood-brain barrier C. Antibiotics are the exception to the blood-brain barrier and cross easily D. An infection that spreads outside the CNS helps drugs cross the barrier
B. A medication that is water soluble is more likely to cross the blood-brain barrier
Jacob has been diagnosed with sinusitis (gram + strep). He is the parent of a child in daycare. Treatment for sinusitis in an adult who has a child in daycare is: A. Penicillin G B. Amoxicillin-clavulanate C. Ciprofloxacin D. Imipenem
B. Amoxicillin-clavulanate
Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her? A. Encourage increased fluids and fiber. B. Assess her for pseudomembranous colitis. C. Advise her to eat yogurt daily to help restore her gut bacteria. D. Start her on an antidiarrheal medication.
B. Assess her for pseudomembranous colitis.
A physician has ordered subQ injection of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a: A. C-I drug B. C-II drug C. C-III drug D. C-IV drug
B. C-II drug
When treating a woman with a urinary tract infection who is 28 wks pregnant, the NP prescribes: A. TMP-SMX B. Cefexime (3rd gen cephalosporin) C. Ciprofloxacin D. Doxycycline
B. Cefexime (3rd gen cephalosporin)
Which antibiotic is most associated with C-Difficile infections? A. Penicillin G B. Ciprofloxacin C. Vancomycin D. Clindamycin
B. Ciprofloxacin
Which of the following represents the best choice of clinical agents for a child who has a SEVERE penicillin allergy who requires antimicrobial therapy? A. Ciprofloxacin B. Clarithromycin C. Amoxicillin D. Cefexime
B. Clarithromycin
A patient has endocarditis and is taking gentamicin. The NP will be sure to monitor which of the following? A. Potassium level B. Creatinine clearance C. Serum albumin level D. Prothrombin time
B. Creatinine clearance
Sadie is a 90-year-old patient who requires a new prescription. What changes in drug distribution with aging would influence prescribing for Sadie? A. Increased volume of distribution B. Decreased lipid solubility C. Decreased plasma proteins D. Increased muscle-to-fat ratio
B. Decreased lipid solubility
Glen is an 82-year-old patient who needs to be prescribed a new drug. What changes in elimination should be taken into consideration when prescribing for Glen? A. Increased glomerular filtration rate (GFR) will require higher doses of some renally excreted drugs. B. Decreased tubular secretion of medication will require dosage adjustments. C. Thin skin will cause increased elimination via sweat. D. Decreased lung capacity will lead to measurable decreases in lung excretion of drugs.
B. Decreased tubular secretion of medication will require dosage adjustments.
A client is prescribed imipenem-cilastatin for the treatment of an E. coli infection. The nurse should be aware that cilastatin is combined with the imipenem for what purpose? A. To eliminate adverse effects of imipenem B. To inhibit the destruction of imipenem C. To potentiate the therapeutic effects of imipenem D. To allow imipenem to cross the blood-brain barrier
B. To inhibit the destruction of imipenem
Mr. Thiessen is a 60-year-old man whose bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in Mr. Thiessen's condition and the effect of the drug treatment on his blood cultures. During morning care, he has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this patient's complaints? A. Document the patient's complaints and integrate them into his plan of care B. Hold the next scheduled dose of gentamicin until the physician has been consulted C. Administer the next scheduled dose of gentamicin over 90 minutes to 2 hours D. Administer the gentamicin as ordered and continue to monitor the patient's symptoms
B. Hold the next scheduled dose of gentamicin until the physician has been consulted
A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begins taking. Efficacy of a drug means which of the following? A. The amount of the drug that must be given to produce a particular response B. How well a drug produces its desired effect C. A drug's strength of attraction for a receptor site D. A drug's ability to stimulate its receptor
B. How well a drug produces its desired effect
An immunocompromised cancer patient has developed cryptococcal meningitis and admitted to ICU for treatment with amphotericin B. How should the nurse most safely administer this drug? A. Hang the drug by piggyback with LR and infuse over several hours to minimize the risk of infusion reaction B. Infuse the drug over 2-4 hours into a central like using an infusion pump C. Flush the patient's central line with normal saline and infuse the amphotericin B by IV push over 5-7 minutes D. Place the patient on a constant infusion of amphotericin B at a rate determined by the patient's body weight
B. Infuse the drug over 2-4 hours into a central like using an infusion pump
A nurse is helping with the discharge of a 92-year-old female patient who has been hospitalized for a serious upper UTI. The patient will continue taking SMZ-TMP at home. She is to be discharged into her daughter's care. The nurse will instruct the daughter to watch for which of the following most common adverse effects of the drug? A. Urticaria B. Nausea and vomiting C. Photosensitivity D. Jaundice
B. Nausea and vomiting
A 44-year-old woman has presented to her local clinic with complaints of burning and pain when voiding. In addition to prescribing an antibiotic, the clinician has recommended the use of phenazopyridine (Pyridium). What is the rationale for including phenazopyridine in this patient's plan of care? A. Phenazopyridine potentiates the effects of many antibiotics that are used in the treatment of UTIs B. Phenazopyridine provides topical relief to many of the painful symptoms of UTIs C. Phenazopyridine increases the pH of the urine D. PHenazopyridine dilates the urethra, allowing for more complete bladder emptying and relief from frequency
B. Phenazopyridine provides topical relief to many of the painful symptoms of UTIs
A nurse is caring for a 68-year-old woman who is on amphotericin B therapy. The patient is complaining of discomfort due to infusion reactions. Which of the following nursing actions will help reduce this discomfort? A. Reduce the drug dosage B. Provide extra blankets, diversion therapy, or warm fluids C. Keep the bed in a low position and the side rails up at all times D. Encourage the patient to drink 8-8oz glasses of water a day
B. Provide extra blankets, diversion therapy, or warm fluids
A client, diagnosed with a GU infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? A. The fluoroquinolone does not have any adverse effects B. The fluoroquinolone can be given orally C. The fluoroquinolone has a nearly immediate peak D. The fluoroquinolone has a broader spectrum
B. The fluoroquinolone can be given orally
An elderly female patient with a complicated UTI was prescribed ciprofloxacin 6 days ago. The patient's nurse should consider which of the following assessment findings as a potential adverse effect of the patient's antibiotic therapy? A. The patient has had only 1 BM since beginning treatment and her bowel sounds are faint B. The patient has developed a cheese-like vaginal discharge with perineal erythema C. The patient's gums began bleeding when the nurse provided mouth care this morning D. The patient's SBP and DBP are 10-20 mmHg lower than her normal baselines
B. The patient has developed a cheese-like vaginal discharge with perineal erythema
A 30-year-old woman who is in the first trimester of pregnancy has presented to her PCP with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? A. Ciprofloxacin is safe to use in pregnancy and the patient may use the same dose and route as a nonpregnant patient B. The use of ciprofloxacin is contraindicated in pregnancy C. It is safe for the patient to use topical ciprofloxacin but the oral route is potential teratogenic D. The patient will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult patient
B. The use of ciprofloxacin is contraindicated in pregnancy
What is the mechanism of Cephalosporin antibiotic? A. These agents inhibit the action of DNA gyrase B. These agents inhibit the actions of the cell wall C. These agents bind to penicillin binding proteins D. These agents bind to 50S ribosomal subunit inhibiting protein synthesis
B. These agents inhibit the actions of the cell wall
Why is it important to monitor the results of a serum gentamicin level? A. To identify possible changes in the client's serum osmolality B. To identify whether the drug is at a therapeutic level C. To identify whether the drug is causing hepatotoxicity D. To identify possible hemolysis following administration
B. To identify whether the drug is at a therapeutic level
The nurse is educating a client diagnosed with a UTI about the prescribed TMP-SMZ. The client has a history of type 2 DM and currently takes a sulfonylurea. Which statement made by the client establishes the need for further clarification? A. "I will monitor my blood sugar carefully since the drug may lower it." B. "I will take the drug with 8oz of water before or after meals." C. "The drug will not affect the herbal supplement, ginseng that I take." D. "If a rash develops, the drug will be discontinued and my prescriber notified."
C. "The drug will not affect the herbal supplement, ginseng that I take."
The patient is a 6-year-old child who is taking 125mg of amoxicillin every 6 hours. Assuming that the half-life of Amoxicillin is 3 hours, how much Amoxicillin would be in the child's body at the time of the next administration of the drug? A. 62.5 mg B. 48.875 mg C. 31.25 mg D. 15.625 mg
C. 31.25 mg
It would be most important for a nurse to monitor which of the following patients for ototoxicity while on gentamicin therapy? A. A 43-year-old male with Parkinson disease B. A 32-year-old mother who is breast-feeding C. A 25-year-old make who has a hearing impairment D. A 22-year-old female who has just found out she's pregnant
C. A 25-year-old make who has a hearing impairment
A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining A. blood glucose levels daily for 1 week B. Establishing the patient's auditory abilities C. A baseline CBC D. Liver enzymes weekly until the drug therapy is completed
C. A baseline CBC
A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient? A. Injury, Risk to the fetus related to adverse effects of maternal drug therapy B. Injury, Risk to the patient related to failure to receive needed drug therapy C. Anxiety related to perceived danger of drug therapy to fetus or infant D. Noncompliance with Drug Therapy
C. Anxiety related to perceived danger of drug therapy to fetus or infant
A patient is taking an antibiotic that is known to cause photosensitivity in some patients. Which of the following nursing measures would ensure the comfort of this patient and hopefully prevent serious adverse effects? A. Avoiding the use of aspirin and other OTC pain products B. Getting a wig of other head cover to avoid heat loss C. Avoiding exposure to sunlight and use a sunscreen and protective clothing if exposure is inevitable D. Providing frequent rest periods in a dark room
C. Avoiding exposure to sunlight and use a sunscreen and protective clothing if exposure is inevitable
Culture and sensitivity testing of a patient's sacral ulcer reveals the presence of gram-negative aerobic bacteria and the care team is opting for treatment with a monobactam antibiotic. The patient will likely be prescribed A. Penicillin G B. Bacitracin C. Aztreonam D. Imipenem
C. Aztreonam
There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because: A. Renal excretion is similar in both classes of drugs. B. When these drug classes are metabolized in the liver they both produce resistant enzymes. C. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. D. There is not an issue with cross-resistance between the penicillins and cephalosporins.
C. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms
A nurse is instructing a client on the antibiotic regimen for the treatment of pneumonia. Which statement is most important to share with the client? A. Take the medication with orange juice B. Supplement the medication with multivitamins C. Complete the entire prescription of medication D. Administer the medication with dairy products
C. Complete the entire prescription of medication
Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction? A. Take the first dose together with diphenhydramine to reduce the chance of an allergic reaction B. Take the drug immediately before a meal, unless the meal will contain large amounts of fat C. Drink a full glass of water when taking a dose of the drug D. Taper off the drug rather than abruptly stopping it
C. Drink a full glass of water when taking a dose of the drug
A client is allergic to penicillin and has been diagnosed with a GU infection caused by Chlamydia trachomatis. Which medication will most likely be prescribed? A. Acamprosate calcium B. atazanavir C. Erythromycin D. Flumazenil
C. Erythromycin
An adult client with an autoimmune disorder regularly takes oral corticosteroids. The nurse knows that corticosteroids can be used in the successful treatment of inflammation but that they also create risk for: A. Bleeding B. Leukocytosis C. Infection D. Electrolyte imbalances
C. Infection
A patient has been prescribed penicillin G for pharyngitis. She is upset that she has to take the antibiotic around the clock. The nurse will base a response to the patient on the fact that penicillin G A. Has an average peak drug effect of 4 hours B. Needs to bind to plasma protein C. Is rapidly cleared unchanged from the plasma by the kidneys D. Does not penetrate the blood-brain barrier
C. Is rapidly cleared unchanged from the plasma by the kidneys
A client is prescribed a lipid formulation of amphotericin B, asks what the advantage of this formulation is over traditional amphotericin B. What should the nurse use as the basis for the response? A. It is a newer medication with a lower cost B. It is the same as amphotericin B in hepatotoxicity C. It reaches higher concentration in diseased tissue D. It constricts afferent renal arterioles to reduce blood flow
C. It reaches higher concentration in diseased tissue
A client has been prescribed a once-daily aminoglycoside. What is the advantage of this method of administration? A. It is associated with less hepatotoxicity B. It is significantly more cost-effective C. It reduces the risk of nephrotoxicity D. It increases adherence to treatment
C. It reduces the risk of nephrotoxicity
A 34-year old female patient is taking oral cephradine, a first-gen cephalosporin, at regular intervals with a 2-hour gap before meals. The patient reports GI distress. The nurse will encourage the patient to A. Drink plenty of fluids B. Change the drug dosage C. Take the drug with food D. Administer the drug IV
C. Take the drug with food
Fluoroquiolones have a Black Box Warning regarding __________ even months after treatment. A. Renal Dysfunction B. Hepatic Toxicity C. Tendon Rupture D. Development of Glaucoma
C. Tendon Rupture
Culture and sensitivity testing of a patient's sputum sample indicated that his pneumonia could be treated with IV cefazolin. This treatment was initiated 6 days ago and this morning the nurse's assessment reveals no adventitious lung sounds, a respiratory rate of 22 breaths/min, O2 saturation of 93% on room air, and an oral temperature of 98.4F. Based on the apparent resolution of the patient's respiratory infection, the nurse should recognize that A. The next scheduled dose of cefazolin should be withheld B. The patient will require 8-10 days of continued treatment to prevent resistance or recurrence C. The patient will continue treatment with cefazolin for 2 more days. D. The patient's antibiotic treatment will be discontinued after the next scheduled dose
C. The patient will continue treatment with cefazolin for 2 more days.
A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? A. The patient's blood pressure B. The patient's ideal body weight C. The patient's peak and trough levels D. Other patient medications
C. The patient's peak and trough levels
A client diagnosed with B. fragilis, an anaerobic organism resistant to most drugs. What is the drug of choice to treat this microorganism? A. cefaclor B. cefamandole nafate C. cefoxitin D. cefuroxime sodium
C. cefoxitin
A patient has been admitted to the ICU with signs and symptoms of sepsis and preliminary results of the patient's initial blood cultures reveal the presence of MRSA. This finding is an indication for treatment with A. ciprofloxacin B. levofloxacin C. daptomycin D. polymyxin B
C. daptomycin
A 66-year-old woman with a history of recurrent UTIs has been admitted to the hospital with a diagnosis of pyelonephritis. The patient began treatment 36 hours ago with IV gentamicin and is being monitored closely. The nurse is aware that the therapeutic effect of the patient's drug regimen is primarily a result of A. alterations in the osmolarity of bacterial cytoplasm B. lysis of the bacterial cell walls C. interference with bacterial reproduction D. enhancement of the patient's immune function
C. interference with bacterial reproduction
Numerous residents of a long-term care facility have developed Clostridium difficile-associated diarrhea over the past week. The nurses at this facility would anticipate that many residents would require which medication therapy? A. linezolid B. daptomycin C. metronidazole D. chloramphenicol
C. metronidazole
A client prescribed metronidazole to treat C. difficile is also prescribed which medication orally to assist in restructuring the flora of the intestinal tract? A. spectinomycin B. rifaximin C. vancomycin D. quinupristin-dalfopristin
C. vancomycin
A patient is pregnant and is at 7 weeks gestation. She has type 1 diabetes and has been taking insulin since she was 13 years old. She asks the NP if the insulin will be harmful to her baby. The best response to the patient by the NP would be: A. "I will tell your physician that you are concerned about taking insulin during your pregnancy." B. "You will have to discontinue the insulin therapy during your pregnancy, but you will resume the medication after delivery." C. "You will need to continue taking your insulin because hyperglycemia is thought to contribute to low birth weight." D. "Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta."
D. "Insulin is usually the drug of choice for controlling blood glucose levels during pregnancy because it does not cross into the placenta."
A nurse has been performing vigilant assessments of a patient who is receiving doses of IV gentamicin, each over 30 minutes. A blood sample for peak gentamicin levels should be drawn A. as soon as possible after the patient awakens in the morning B. immediately after the 3rd IV dose of the drug C. at the midpoint between scheduled doses D. 30 minutes after the drug has finished infusing
D. 30 minutes after the drug has finished infusing
A patient is receiving vancomycin IV. The nurse will most likely administer the medication over a period of A. 1 minute B. 10 minutes C. 30 minutes D. 60 minutes
D. 60 minutes
Providers should use an antibiogram when prescribing. An antibiogram is: A. The other name for the CDC guidelines for prescribing antibiotics B. An algorithm used for prescribing antibiotics for certain infections C. The reference also known as the Pink Book, published by the CDC D. A chart of the local resistance patterns to antibiotics developed by laboratories
D. A chart of the local resistance patterns to antibiotics developed by laboratories
Tetracyclines should not be prescribed to children younger than 8 years due to: A. Risk of developing cartilage problems B. Development of significant diarrhea C. Risk of kernicterus D. Adverse effects on bone growth/staining of teeth
D. Adverse effects on bone growth/staining of teeth
A medication review of an elderly person's medications involves: A. Asking the patient to bring a list of current prescription medications to the visit B. Having the patient bring all of their prescription, over-the-counter, and herbal medications to the visit C. Asking what other providers are writing prescriptions for them D. All of the above
D. All of the above
Talwin given in combination with Vistaril diminishes the adverse effects of nausea caused by the Talwin. This drug interaction affecting the pharmacodynamics of the Talwin is: A. An additive effect B. A synergistic effect C. A potentiated effect D. An antagonistic effect
D. An antagonistic effect
Jonathan (age 16 yrs) has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin, he developed a red, blotchy rash with hives all over his body. An appropriate antibiotic to prescribe would be: A. Penicillin V, because his rash does not sound like a serious rash B. Amoxicillin C. Cefadroxil (Duricef) D. Azithromycin
D. Azithromycin
A nurse is instructing a diabetic patient, who has a severe respiratory infection caused by Streptococcus pneumoniae, how to monitor his glucose levels while taking cefazolin. The nurse will instruct the patient to use A. Fehling solution for testing B. Benedict solution for testing C. Clinitest tablets for urine testing D. Blood testing for glucose level
D. Blood testing for glucose level
The pathophysiology class is learning how microorganisms develop resistance to anti-infective drugs. What is one way the nursing students would learn that microorganisms develop resistance to anti-infective drugs? A. By rearranging their deoxyribonucleic acid to produce membranes that are permeable to the drug B. By producing an enzyme that stimulates the drug C. By changing the cellular membrane to allow the drug entry into the cell D. By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
D. By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
A patient as administered the monobactam aztreonam (azactam). What is the major advantage of this monobactam over the aminoglycosides in treating P. aeruginosa? A. It is a lower-cost medication B. It is administered orally C. It causes less GI distress D. It has lower risk for hearing loss
D. It has lower risk for hearing loss
A client is prescribed penicillin V orally for strep throat. What is the mechanism of action of this medication? A. It inhibits protein synthesis B. It lowers the pH of cellular contents C. it causes mutations D. It inhibits cell wall synthesis
D. It inhibits cell wall synthesis
A mother has brought her 6-year-old child to the clinic. The child has a fever of 102.8F and is diagnosed with the flu. What medication will the nurse suggest for this child? A. Amoxicillin B. Penicillin V C. Cephalosporin D. None of the Above
D. None of the Above
Which medication should be administered as prophylaxis for rheumatic fever? A. Cyclacillin B. Amoxicillin C. Dicloxacillin D. Penicillin G benzathine
D. Penicillin G benzathine
The FDA has established a system that classifies drugs according to the safety of their use in pregnancy. The ACE inhibitor ramipril is labeled "X" for use in the second and third trimesters. Class "X" indicates that: A. The drug crosses the placenta B. Adequate safety studies have not been conducted C. Human studies show no risk, but teratogenic effects were seen in animal studies D. Proven risks outweigh any possible benefit
D. Proven risks outweigh any possible benefit
Prior to and following a transurethral prostatic resection (TUPR), a 73-year-old man has been scheduled to receive a total of five intravenous doses of cefazolin. Which of the following nursing diagnoses should the nurse associate with this antibiotic therapy? A. Risk for seizures related to adverse drug effects B. Risk for constipation related to drug effects C. Risk for pain related to vascular irritation D. Risk for infection related to overgrowth of nonsusceptible organisms
D. Risk for infection related to overgrowth of nonsusceptible organisms
A nurse is monitoring the fluid input and output of a 26-year-old woman who is on amphotericin B. Which of the following would the nurse report immediately to the physician? A. Orange-colored urine B. Urine output of 75 mL/hr C. a high concentration of the drug in the urine D. Serum creatinine level of 3.5 mg/dL
D. Serum creatinine level of 3.5 mg/dL
What aspect of a client's history would contraindicate imipenem-cilastatin drug therapy? A. The client has a history of type 1 diabetes mellitus B. The client is showing signs and symptoms of fluid volume excess C. The client's most recent creatinine level was 140 mmol/L (high) D. The client has a documented allergy to penicillin
D. The client has a documented allergy to penicillin
A client diagnosed with a fungal infection is prescribed itraconazole. Prior to administration, the nurse notes that the client is taking carbamazepine for a seizure disorder. Based in this medication regime, what information should the nurse share with the client? A. The serum level of carbamazepine will be increased B. The client's carbamazepine should be discontinued C. The client's antiseizure medication should be changed D. The client will require a higher dose of itraconazole
D. The client will require a higher dose of itraconazole
A 64-year-old client seeking care for the treatment of a UTI was prescribed nitrofurantoin. What change in the client's health status would prompt the use of an alternative medication? A. The client develops a fluid volume deficit B. UA reveals the presence of ketones C. The client develops leukocytosis D. The client's UTI progresses to urosepsis
D. The client's UTI progresses to urosepsis
What is the mechanism of a macrolid antibiotic? A. These agents inhibit the action of DNA gyrase B. These agents inhibit the action of cell wall C. These agents bind to penicillin binding proteins D. These agents bind to 50S ribosomal subunit inhibiting protein synthesis
D. These agents bind to 50S ribosomal subunit inhibiting protein synthesis
Which of the following is a beta-lactamase inhibitor? A. clavulanic acid B. sulbactam C. Tazobactam D. all of the above
D. all of the above
Which drug is a first-generation cephalosporin used as surgical prophylaxis? A. cefotetan B. cefoxitin C. ceftriaxone D. cefazolin
D. cefazolin
A woman is seen in the clinic for treatment of vaginal itching and discharge. The nurse should be prepared to provider the client with information concerning which single dose medication? A. capsofungin B. terbinafine C. ketoconazole D. fluconazole
D. fluconazole
An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on A. the osmolarity of fungal intracellular fluid B. protein synthesis of fungal cells C. the production and maturation of CD4+ T cells D. the permeability of fungal cell walls
D. the permeability of fungal cell walls
