Antibiotics

A health care provider prescribes vancomycin peak and trough levels for a client who is receiving vancomycin intravenous piggyback (IVPB). When should the nurse have the laboratory obtain a blood sample to determine a peak level of the antibiotic? 1 Halfway between two doses of the drug 2 Between 30 and 60 minutes after a dose 3 Immediately before the medication is administered 4 Anytime it is convenient for the client and the laboratory

3

A nurse is caring for a female client who is receiving rifampin for tuberculosis. Which statements indicate that the client understands the teaching about rifampin? Select all that apply 1 "This drug may be hard on my liver so I must avoid alcoholic drinks while taking it." 2 "This drug may reduce the effectiveness of the oral contraceptive I am taking." 3 "I cannot take an antacid within 2 hours before taking my medicine. 4 "My healthcare provider must be called immediately if my eyes and skin become yellow.

1,2,4

A client is receiving penicillin G and probenecid for syphilis. What rationale should the nurse give for the need to take these two drugs? 1 Each drug attacks the organism during different stages of cell multiplication. 2 The penicillin treats the syphilis, whereas the probenecid relieves the severe urethritis. 3 Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods. 4 Probenecid decreases the potential for an allergic reaction to penicillin, which treats the syph

3

A client has an anaphylactic reaction after receiving intravenous penicillin. What does the nurse conclude is the cause of this reaction? 1 An acquired atopic sensitization occurred. 2 There was passive immunity to the penicillin allergen. 3 Antibodies to penicillin developed after a previous exposure. 4 Potent antibodies were produced when the infusion was instituted

3 Antibodies to penicillin developed after a previous exposure.

A client is diagnosed with pulmonary tuberculosis, and the healthcare provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the drug is effective when the client reports which action as most important? 1 "Report any changes in vision." 2 "Take the medicine with my meals. 3 "Call my doctor if my urine or tears turn red-orange." 4 "Continue taking the medicine even after I feel better.

4

Which statement about allergic reactions to penicillin does the nurse identify as true? A. Anaphylactic reactions occur more frequently with penicillins than with any other drug. B. Allergy to penicillin always increases over time. C. Benadryl is the drug of choice for anaphylaxis due to penicillin allergy. D. Patients allergic to penicillin are also allergic to vancomycin.

A. Anaphylactic reactions occur more frequently with penicillins than with any other drug.

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching? A. "I can stop the medication as soon as the symptoms have disappeared." B. "I will drink more fluids to help clear up the infection." C. "I will stop the medication and contact the doctor if I develop a rash." D. "I should immediately report vaginal itching or discharge."

A: Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve. The other responses are appropriate

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin? A. Warfarin B. Milk products C. Digitalis D. Alcohol

Alcohol

A client develops a fever after surgery. Ceftriaxone is prescribed. For which potential adverse effect should the nurse monitor the client? 1 Dehydration 2 Heart failure 3 Constipation 4 Allergic response

Allergic Response

A patient has been prescribed oral ciprofloxacin [Cipro] for a Skin infection. When administering the medication, it is most important for the nurse to do what? D A. Monitor for a decrease in the prothrombin time (PT) if the patient is also taking warfarin [Coumadin] B. Withhold antacids and milk products for 6 hours before or 2 hours afterward C. Inform the healthcare provider if the patient has a history of asthma D. Assess the skin for Stevens- Johnson syndrome

Answer: B Rationale: Absorption of ciprofloxacin can be reduced by ingestion of antacids and milk products. Ingestion of these products should occur at least 6 hours before ciprofloxacin or 2 hours afterward. Ciprofloxacin can increase the PT if the patient is also taking warfarin. Use of ciprofloxacin is contraindicated in patients with a history of myasthenia gravis. Patients taking ciprofloxacin are at risk for development of phototoxicity.

A patient is receiving amphotericin B to treat a systemic fungal infection. To prevent renal damage, it is most important for the nurse to do what? A. Administer the medication through a central venous access device B. Administer potassium supplements C. Administer 1000 mL of 0.9% saline D. Administer the medication orally

Answer: C Rationale: Amphotericin B causes renal injury in most patients. Kidney damage can be minimized by infusing 1 L of saline on the davs amphotericin is infused

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin (Garamycin). To prevent ototoxicity, the nurse will monitor which value(s)? A. Serum creatinine and blood urea nitrogen levels B.Trough drug levels of gentamicin C.Peak drugs levels of gentamicin D. Serum alanine aminotransferase and aspartate aminotransferase levels

B Rationale: To minimize ototoxicity, trough levels must be sufficiently low to reduce exposure of sensitive sensory hearing cells. The risk of ototoxicity is related primarily to persistently elevated trough drug levels rather than to excessive peak levels.

Which statement about superinfections does the nurse identify as true? A. Superinfections are more common in patients treated with narrow-spectrum drugs. B. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection. C. Superinfections are caused by viruses. D. Superinfections are easy to treat.

B: Because broad-spectrum antibiotics kill off more normal flora than do narrow-spectrum drugs, superinfections are more likely in patients receiving broad-spectrum agents. Suprainfections are caused by drug-resistant microbes; these infections are often difficult to treat

Which patient should receive prophylactic (preventative) antibiotic therapy? A. A patient who is to have his teeth cleaned B. A patient who is scheduled for a hysterectomy C. A patient with a white blood cell count of 8000 cells/mm3 D. A patient with a high fever without an identifiable cause

B: Patients who undergo a hysterectomy (and other specific surgeries) may have a decreased incidence of infection if antibiotics are administered before or during surgery. Use of prophylactic antibiotics are not indicated for the other conditions.

Which patient receiving trimethoprim-sulfamethoxazole (Bactrim) would be most likely to develop kernicterus? A. A 56-year-old patient with AIDS B. A 42-year-old patient with chronic alcoholism C. A 22-year-old patient who is at 35 weeks' gestation D. A 4-year-old patient with Down's syndrome

C

In explaining the benefits of the combination anti-infective drug code tri- moxazole/TMP-SMZ (bactrium) to a client receiving the medication for a urinary tract infection, more rationale to the nurse provide? -A. Each drug could cause damage to the kidneys if taken separately -B. One drug reduces the risk of side effects caused by the drug -C. While one drug provide reliet, the other fights the infection -D.the two drugs work together to reduce resistance of the bacterial infection of symptoms

D rationale the combination of drugs and bacteria work synergistically to reduce bacterial resistance enterprise D, thereby increasing the drug therapeutic benefits answer choices a B &C are incorrect rationales

A prescriber states that a patient will need to receive penicillin intravenously. The nurse anticipates administering which drug? A. Penicillin V B. Procaine penicillin G C. Benzathine penicillin G D. Potassium penicillin G

D. Potassium penicillin G

A nurse determines that the teaching about the side effects of azithromycin has been understood when the adolescent client identities which problem as the most common side effect of this medication? 1. Tinnitus 2. Diarrhea 3. Headache 4. Dizziness

Diarrhea

A patient is prescribed vancomycin orally for antibiotic- associated pseudomembranous colitis. The nurse will monitor the patient for what? A. Leukopenia B. "Red man" syndrome C. Liver impairment D. Ototoxicity

Ototoxity

A client receiving intravenous vancomycin reports ringing in both ears. Which initial action should the nurse take? 1 Notify the primary healthcare provider. 2 Consult an audiologist. 3 Stop the infusion. 4 Document the finding and continue to monitor the client

Stop the infusion

A mother complains that her child's teeth have become yellow in color. With prolonged use, which medication may be responsible for the child's condition? 1 Tetracycline 2 Promethazine 3 Chloramphenicol 4 Fluoroquinolones

Tetracycline

A client who is diagnosed with methicillin-resistant staphylococcus aureus receives a prescription for vancomycin (Vancocin). Which assessment should the nurse perform to identify a potential adverse effect? A. Whisper test B. Romberg test C. Tactile discrimination D. Skin turgor

Whisper Test