Chapter 6
A nurse is to administer mafenide to a client. The nurse would be alert for which of the following? A) Rash, itching, or other allergic reactions B) Crystals in the urine sample C) Inflammation of the mouth D) Loss of appetite
Ans: A
After teaching the client about taking his prescribed sulfonamide therapy, the nurse determines that the client needs additional teaching when he states which of the following? A) "I should take the drug with a large glass of water each time." B) "I can take the drug at different times of the day each day." C) "I have to finish the full prescription for the medication." D) "I should call my doctor if my symptoms seem to get worse."
Ans: B
A nurse is reviewing the laboratory test results of a client receiving sulfasalazine therapy for ulcerative colitis. Which of the following would the nurse anticipate finding? Select all that apply. A) Pancytopenia B) Leukopenia C) Thrombocytopenia D) Aplastic anemia E) Iron deficiency anemia
Ans: B, C, D
A client asks the nurse why she needs to increase her fluid intake while taking sulfonamides. Which response by the nurse would be most appropriate? A) "The fluids will help to decrease your risk for kidney stones." B) "You need fluids so that you won't develop a reaction in the sunlight." C) "Fluids prevent you from getting dehydrated." D) "You need fluids to keep your blood count from dropping too l low."
Ans: A
A client is prescribed sulfadiazine one tablet twice daily for 10 days. When reviewing the client's history, the nurse notes that the client is also taking warfarin. The nurse would be alert for which of the following? A) Prolonged clotting times B) Increased risk of infection C) Decreased antibiotic effect D) Decreased white blood cell count
Ans: A
A client who is on sulfonamide therapy is about to be discharged. Which of the following precautions should the nurse instruct the client to follow to reduce the effects of photosensitivity? A) Wear protective clothing and sunscreen when outside. B) Increase fluid intake. C) Avoid lights while indoors. D) Wear protective footwear.
Ans: A
After teaching a group of nursing students about the action of sulfonamides, the instructor determines that the teaching was successful when the students state that the action of this class of drugs is primarily which of the following? A) Bacteriostatic B) Bactericidal C) Promotor of folic acid activity D) Bacterial cell metabolizer
Ans: A
A client develops a cough and fever and laboratory test results reveal leukopenia after the client receives sulfonamide therapy. When developing the client's plan of care, the nurse would identify which nursing diagnosis? A) Impaired Urinary Elimination B) Impaired Skin Integrity C) Risk for Secondary Infection D) Deficient Knowledge
Ans: C
A nurse is caring for a client who is being administered sulfasalazine. Which of the following instructions should the nurse include to ensure that the client gets the full benefits of the treatment? A) Take dosage while eating or immediately after eating. B) Increase food intake for the duration of sulfonamide therapy. C) Take the drug with a full glass of milk instead of water. D) Drink at least two to three 8-ounce glasses of fluid every day.
Ans: A
A nurse is caring for a client with a urinary tract infection. After administering a sandwich and a large glass of cranberry juice to a client, the nurse observes that the client has developed diarrhea. Which of the following is the most likely cause of the client's condition? A) Extremely large dosage of cranberry juice B) Lack of activity or exercise C) Occurrence of crystalluria D) Minimized food and fluid intake
Ans: A
After administering sulfonamides to a client, the nurse observes that he has developed a fever, cough, and muscular aches. The nurse also observes that the client has developed lesions in the form of red wheals on the neck and the mouth. The nurse interprets these findings as indicating which of the following? A) Stevens-Johnson syndrome (SJS) B) Anaphylactic shock C) Thrombocytopenia D) Leukopenia
Ans: A
The health care professional has recommended sulfonamide therapy for a client. While obtaining the client's medical history, the nurse discovers that he is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants? A) Increased action of the anticoagulant B) Increased risk of anaphylactic shock C) Rendering of sulfonamide therapy ineffective D) Development of leukopenia
Ans: A
The nurse suspects that a client who is taking a sulfonamide has leukopenia. Which assessment findings would support this suspicion? Select all that apply. A) Sore throat B) Cough C) Nausea D) Photosensitivity E) Bruising
Ans: A, B
Sulfonamides are commonly used to treat which of the following types of infections? Select all that apply. A) Ulcerative colitis B) Urinary tract infection C) Acute otitis media D) Upper respiratory tract infection E) Osteomyelitis
Ans: A, B, C
A nurse is working in an ambulatory care setting that involves seeing clients with infections that require treatment. Which of the following would be important for the nurse to assess in these clients? Select all that apply. A) Client's use of self-remedies B) Review of lab results C) Vital signs D) Client's symptoms E) Client's general appearance
Ans: A, B, C, D, E
The nurse is preparing to administer a prescribed sulfonamide. Which of the following would the nurse do? Select all that apply. A) Have the client sit up to take the drug B) Give the prescribed drug on an empty stomach C) Be sure to administer the drug immediately after a meal D) Have the client decrease his fluid intake E) Encourage the client to drink additional fluids
Ans: A, B, E
A client with a fever is ordered to receive sulfonamide therapy for an infection. The nurse needs to evaluate the client for which of the following during the course of therapy? Select all that apply. A) Response to drug therapy B) Elevated blood glucose levels C) Mental status changes D) Occurrence of adverse reactions E) Decrease in temperature
Ans: A, D, E
A nurse is applying silver sulfadiazine to a client's burn. Which of the following would be important for the nurse to do? Select all that apply. A) Clean and remove debris from the burned area before application B) Allow air drafts over the burn area to speed the healing process C) Apply a 1/2-inch-thick layer of cream to the burn D) Wear sterile gloves when applying the cream to the burn E) Warn client of burning sensation during and shortly following application
Ans: A, D, E
A group of nursing students are reviewing information about sulfonamides. Which of the following if stated by the students indicate understanding of this drug class? Select all that apply. A) Sulfonamides are well absorbed when given orally. B) Sulfonamides are poorly absorbed when given orally. C) Sulfonamides treat only gram-positive infections. D) Sulfonamides treat only gram-negative infections. E) Sulfonamides are excreted by the kidneys.
Ans: A, E
The nurse is providing care to a client with diabetes who is receiving sulfonamides. The nurse counsels the client about the increased risk of hypoglycemia, especially if the client is taking which of the following medications? Select all that apply. A) Tolbutamide (Orinase) B) Lisinopril (Prinivil) C) Simvastatin (Zocor) D) Losartan (Cozaar) E) Chlorpropamide (Diabinese)
Ans: A, E
A nurse is caring for a client with burns. The client is prescribed topical silver sulfadiazine. The nurse would be alert for which of the following? A) Facial edema B) Skin necrosis C) Headache D) Rash
Ans: B
A nurse is to administer sulfasalazine to a client with ulcerative colitis. Which of the following interventions would be most important while caring for this client? A) Stop dosage if skin turns orange-yellow color. B) Regularly inspect client's stool samples. C) Give the drug on an empty stomach. D) Administer cranberry juice to the client.
Ans: B
When developing the plan of care for a client receiving sulfonamides for treatment of a urinary tract infection, the nurse identifies actions for encouraging fluid intake and monitoring intake and output based on which nursing diagnosis? A) Risk for Fluid Imbalance B) Impaired Urinary Elimination C) Risk for Ineffective Renal Perfusion D) Stress Incontinence
Ans: B
A nurse is preparing a plan of care for an older adult client who is receiving sulfonamide therapy. Which of the following would the nurse include in the plan of care to reduce the likelihood of causing renal damage? Select all that apply. A) Administer sulfonamides once daily. B) Increase fluid intake up to 2000 mL if tolerated. C) Use sulfonamides cautiously in clients with renal impairment. D) Administer the dose intravenously instead of orally. E) Ask the prescriber to change the medication ordered.
Ans: B, C
A client is being discharged with a prescription for sulfasalazine. Which of the following would the nurse include in the discharge teaching plan? Select all that apply. A) Take the drug 1 hour before or 2 hours after meals. B) Use protective sunscreen or cover exposed areas when going outside. C) Finish the entire course of sulfonamide even if you begin feeling better. D) Decrease fluid intake to prevent increased excretion of the drug. E) Keep all follow-up appointments.
Ans: B, C, E
When reviewing the medical records of several clients who are prescribed sulfonamide therapy, the nurse would expect laboratory findings related to which bacteria? Select all that apply. A) Pseudomonas aeruginosa B) Escherichia coli C) Klebsiella pneumoniae D) Streptococcus pyogenes E) Staphylococcus aureus
Ans: B, C, E
A female client receiving methotrexate for the treatment of rheumatoid arthritis is given a prescription for trimethoprim and sulfamethoxazole (Bactrim DS). The client returns to the physician's office feeling worse than before. She now has a cough and unusual bruising on the extremities. The physician orders a complete blood count and a complete metabolic profile. Which test results would the nurse expect to find? Select all that apply. A) Increased hemoglobin B) Decreased number of white blood cells C) Increased number of red blood cells D) Decreased number of platelets E) All values should be within normal limits
Ans: B, D
A 60-year-old client who is on sulfonamide therapy has impaired urinary elimination. She does not want to increase her oral fluid intake because of fear of incontinence. Which of the following nursing interventions would be most appropriate? A) Inform the client that there is no need to increase fluid intake. B) Inform the client that increasing fluid intake will not result in incontinence. C) Teach the client the times to take fluids to maintain continence. D) Increase fluid intake by 1000 mL instead of 2000 mL to avoid incontinence.
Ans: C
Which of the following represent contraindications to treatment with a sulfonamide? Select all that apply. A) Children younger than 6 years of age B) Adults older than 65 years of age C) Lactating females D) Clients with group A beta-hemolytic streptococci infections E) Women in the second trimester of pregnancy
Ans: C, D
A client is taking trimethoprim and sulfamethoxazole (Bactrim DS) one tablet twice daily for 14 days. Which of the following would the nurse include when teaching the client about possible adverse reactions? Select all that apply. A) Muscle pain B) Blurred vision C) Anorexia D) Crystalluria E) Photosensitivity
Ans: C, D, E
After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was successful when the students identify which of the following as an example of a sulfonamide antibiotic? Select all that apply. A) Amoxicillin (Amoxil) B) Ciprofloxacin (Cipro) C) Sulfamethoxazole/trimethoprim (Bactrim) D) Clarithromycin (Biaxin) E) Silver sulfadiazine (Silvadene)
Ans: C, E
A client is diagnosed with a urinary tract infection. When obtaining the client's drug history, the client reports using an herbal product in the past to prevent and relieve the symptoms. Which of the following would the client most likely identify? A) Ginger B) Feverfew C) Saw palmetto D) Cranberry
Ans: D
A client who is being discharged has been instructed to continue with sulfonamide therapy for a week. Which of the following points should the nurse include in the teaching plan to educate the client about the therapy? A) Discontinue dosage if symptoms of infection disappear. B) Take the drug a few minutes before a meal. C) Take any off-the-shelf medication if fever occurs. D) Ensure that all follow-up appointments are met.
Ans: D
