drug therapy with aminoglycosides and fluoroquinolones

A patient is receiving gentamicin (Garamycin) to treat meningitis. The physician has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn? A) 08:00 B) 09:00 C) 10:00 D) 12:00

A) 08:00

A patient is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism? A) Aminoglycoside B) Antifungal C) Aminopenicillin D) GABA analog

A) Aminoglycoside

A patient has been prescribed ciprofloxacin after being diagnosed with a sinus infection. Which of the following should the patient avoid taking concurrently with ciprofloxacin? A) Antacids B) Calcium channel blockers C) Beta-adrenergic blockers D) Diuretics

A) Antacids

A hospital patient has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the patient's first scheduled dose, the patient develops a pronounced rash to her chest and arms. How should the nurse respond 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 patient during the infusion D) Administer a STAT dose of acetylcysteine

A) Discontinue the infusion and inform the care provider promptly

An adult male patient with a diagnosis of osteomyelitis will soon begin treatment with gentamicin. Which of the following schedules is most likely to maximize efficacy and minimize nephrotoxicity? A) Gentamicin 500 mg IV OD at 1200 B) Gentamicin 250 mg PO BID at 07:30 and 19:30 C) Gentamicin 500 mg PO TID at 08:00, 12:00, and 17:00 D) Gentamicin 125 mg IV QID at 06:00, 1200, 18:00, and 24:00

A) Gentamicin 500 mg IV OD at 1200

A patient 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 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.

A medical nurse is aware of the need to assess for potential ototoxicity in patients who are being treated with gentamicin. Which of the following patients is likely most susceptible to developing ototoxicity secondary to gentamicin? A) A man who received his first dose of IV gentamicin 12 hours ago B) A man who has required repeated courses of gentamicin over the past several months C) A woman who has a Pseudomonas infection but who has a hypersensitivity to penicillins D) A woman who is immunocompromised and who is being treated with gentamicin

B) A man who has required repeated courses of gentamicin over the past several months

Extreme caution would be necessary with the use of gentamicin in which of the following patients? A) A patient who is morbidly obese and who has primary hypertension B) A patient who has chronic renal failure secondary to diabetes mellitus C) A patient who has bipolar disorder and who is on long-term lithium therapy D) A patient who has an atrioventricular block

B) A patient who has chronic renal failure secondary to diabetes mellitus

The nurse is preparing to administer gentamicin (Garamycin) to a patient when he mentions that he has recently been experiencing diminished hearing. What action should the nurse take based on this statement? A) Administer the dosage and notify the physician of the alteration in hearing. B) Hold the dosage and notify the physician of the alteration in hearing. C) Administer the dosage and report the alteration in hearing to the audiologist. D) Hold the dosage and document the finding in the nurses' notes.

B) Hold the dosage and notify the physician of the alteration in hearing.

A patient has a genitourinary infection and is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? A) The fluoroquinolone does not have 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.

A patient is prescribed ciprofloxacin (Cipro). Which of the following nursing interventions will best prevent crystalluria? A) The nurse should limit oral fluids to 500 mL/day. B) The nurse should administer 2000 mL of oral fluids per day. C) The nurse should insert a urinary catheter. D) The nurse should administer phenazopyridine (Pyridium).

B) The nurse should administer 2000 mL of oral fluids per day.

A nurse has informed the laboratory technician that a patient's gentamicin has finished infusing and the technician will soon draw a blood sample to determine the patient's serum drug concentration. Why is assessment of gentamicin levels necessary? A) To identify possible changes in the patient'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

A patient is scheduled for a bowel resection. He is to receive neomycin sulfate (Neo-Fradin) by mouth. The patient asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the patient? A) "The administration by mouth will prevent renal damage." B) "The administration by mouth will prevent ototoxicity." C) "The administration will decrease the risk of contamination." D) "The administration decreases the risk of airborne contamination."

C) "The administration will decrease the risk of contamination."

A patient 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.

An older adult patient is recovering in hospital from an ischemic stroke and has a feeding tube in place due to dysphagia. The patient has developed an infected pressure ulcer, and ciprofloxacin suspension has been ordered as empiric therapy. How should the nurse follow up this order? A) The nurse should flush the patient's feeding tube with free water before and after administration of the ciprofloxacin suspension. B) The nurse should dilute the suspension thoroughly before administration. C) The nurse should liaise with the care provider to provide an alternative route of administration. D) The nurse should administer small, frequent doses of the drug to minimize GI upset.

C) The nurse should liaise with the care provider to provide an alternative route of administration.

A patient has been administered an aminoglycoside. It is time for his next dose, and the nurse learns his creatinine level is elevated at 3.9 mg/dL. What action should the nurse take regarding this assessment? A) Administer the medication and report the creatinine level. B) Hold the dose until another creatinine level is assessed. C) Administer the medication with 100 mL of fluids. D) Hold the medication and assess the urine output.

D) Hold the medication and assess the urine output.

A patient is diagnosed with multidrug-resistant tuberculosis. Which of the following aminoglycoside medications is used in a 4- to 6-drug regimen? A) Tetracycline hydrochloride (Achromycin) B) Amoxicillin (Amoxil) C) Sulfadiazine (Sulfisoxazole) D) Streptomycin (Sulfate)

D) Streptomycin (Sulfate)

A patient with sepsis is being treated with gentamicin, and her medication regimen takes into account the phenomenon of postantibiotic effects. What are postantibiotic effects? A) The tendency for patients to exhibit symptoms mimicking hypersensitivity after drug administration B) The tendency for adverse effects of a drug to be masked during administration C) The ability of microorganisms to proliferate between doses of antibiotics D) The ability of an antibiotic to kill bacteria even when serum concentrations are low

D) The ability of an antibiotic to kill bacteria even when serum concentrations are low