Evolve Test 3

A patient is receiving local applications of mafenide [Sulfamylon] to burn areas. Before application, it is most important for the nurse to do what?

Administer a pain medication.

Which approach should a nurse take when administering an oral dose of levofloxacin [Levaquin]?

Give the medication with or without food

Before administering a cephalosporin to a patient, it is most important for the nurse to assess the patient for an allergy history to what?

Penicillins

A nurse observes a red streak and palpates the vein as hard and cordlike at the intravenous (IV) site of a patient receiving cefepime [Maxipime]. Which assessment should the nurse make about the IV site?

Phlebitis of the vein used for the antibiotic has developed

A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid [Zyvox]. Which laboratory result indicates that the patient is having an adverse effect?

White blood cell (WBC) count of 1200 units/L

A patient who is receiving vancomycin [Vancocin] IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make?

"It is more effective by IV, because the pill form will stay in the digestive tract."

Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline?

"Use sunscreen and protective clothing when outdoors."

The nurse should include which instructions when teaching a patient about tigecycline therapy? (Select all that apply.) "Use sunscreen when you are outside." "If you have diarrhea more than five times a day, notify your healthcare provider." "Avoid using this drug if you are pregnant." "Stop taking the drug if you experience nausea." "Stop taking the drug if you experience vomiting."

"Use sunscreen when you are outside." "If you have diarrhea more than five times a day, notify your healthcare provider." "Avoid using this drug if you are pregnant."

A nurse is administering a daily dose of tobramycin at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level?

0900

When caring for a patient receiving mafenide [Sulfamylon] for treatment of a severe burn, it is most important for the nurse to monitor which laboratory value?

Acid-base status

The nurse notices tan lines around the arms of a female patient who is taking levofloxacin [Levaquin]. Which action should the nurse take?

Advise the patient to avoid sun exposure and wear sun screen when outside.

Before administering trimethoprim, it is most important for the nurse to assess the patient for a history of what?

Alcoholism

A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering?

Calcium gluconate [Kalcinate]

The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients?

Ciprofloxacin [Cipro]

A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action?

Discontinue the medication, because severe damage can result.

A patient taking gemifloxacin develops a rash. The nurse anticipates the healthcare provider to take which action?

Discontinue the medication.

Which manifestations does the nurse associate with the development of hemolytic anemia? (Select all that apply.)

Fever Pallor Jaundice

What does the nurse identify as an adverse effect of clindamycin [Cleocin] therapy?

Frequent loose, watery stools with mucus and blood

A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first?

Headache

Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin [Biaxin] and warfarin [Coumadin]?

International normalized ratio (INR)

Which statements about CDAD associated with clindamycin therapy does the nurse identify as true? (Select all that apply.) Leukopenia commonly occurs. It is a potentially fatal condition. Patients usually experience abdominal pain. Anticholinergics are effective in treating the diarrhea. Clindamycin therapy should be discontinued and vancomycin started.

It is a potentially fatal condition. Patients usually experience abdominal pain. Clindamycin therapy should be discontinued and vancomycin started.

A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse anticipates administration of which antibiotic if a stool sample tests positive for Clostridium difficile?

Metronidazole [Flagyl]

A patient is taking daptomycin [Cubicin]. The nurse should obtain a creatine phosphokinase (CPK) level when the patient shows what?

Muscle pain and weakness

Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what?

Myasthenia gravis

A patient who is receiving ceftriaxone has all of these medications ordered. The nurse monitors the patient for an adverse effect related to an interaction with which medication?

Naproxen [Naprosyn]

Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin [Ery-Tab] therapy?

Prolonged QT interval

A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin?

Protein

A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take?

Reduce the infusion rate.

A patient is receiving vancomycin [Vancocin]. The nurse identifies what as the most common toxic effect of vancomycin therapy?

Renal toxicity

A patient who has acquired immunodeficiency syndrome (AIDS) is receiving trimethoprim/sulfamethoxazole [Bactrim]. Which response should a nurse expect if the medication is achieving the desired effect?

Resolution of pneumonia

When ceftriaxone is administered intravenously, it is most important for the nurse to avoid mixing it with what?

Ringer's lactate

A nurse should recognize that which sulfonamide, applied topically, has the greatest therapeutic benefit for burns?

Silver sulfadiazine [Silvadene]

The nurse is assessing a patient who is receiving a sulfonamide for treatment of a urinary tract infection. To monitor the patient for the most severe response to sulfonamide therapy, the nurse will assess for what?

Skin rash and lesions

A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response?

Some hearing loss may have occurred.

The nurse identifies which drug as a short-acting tetracycline?

Tetracycline (generic)

Which statements about ototoxicity and aminoglycosides does the nurse identify as true? (Select all that apply.) The risk of ototoxicity is related primarily to excessive peak levels. The first sign of impending cochlear damage is headache. The first sign of impending vestibular damage is headache. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

The first sign of impending vestibular damage is headache. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant?

The patient takes antacids on a daily basis

The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high?

Trough

The nurse identifies rifampin as useful in the treatment of which disorders? (Select all that apply.) Tuberculosis Active meningococcal infection Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae C. difficile infection

Tuberculosis Active meningococcal infection Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae

Which instructions will the nurse include when teaching a patient about cephalosporin therapy? (Select all that apply.) -"Notify your healthcare provider if you develop diarrhea." -"Take aspirin if you develop a headache." -"Notify your healthcare provider if you develop a rash." -"Cephalosporins may not be taken with food." -"Do not take cephalosporins if you have lactose intolerance."

-"Notify your healthcare provider if you develop diarrhea. -"Notify your healthcare provider if you develop a rash."

The healthcare provider orders levofloxacin [Levaquin] 500 mg PO every day for 7 days. The available medication is levofloxacin 250-mg tablets. How many tablets should the patient take each day?

2

When providing patient teaching for oral sulfonamide therapy, the nurse should instruct the patient to take the sulfonamide in what way?

Between meals with a full cup of water

When administering an aminoglycoside to a patient with myasthenia gravis, it is most important for the nurse to assess what?

Breath sounds

It is most important for the nurse to assess a patient receiving a cephalosporin for the development of which manifestation of antibiotic-associated pseudomembranous colitis (AAPMC)?

Diarrhea

A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child?

Discoloration of the teeth

Which statements about vancomycin [Vancocin] does the nurse identify as true? (Select all that apply.) -Vancomycin is the most widely used antibiotic in U.S. hospitals. -Vancomycin is effective in the treatment of Clostridium difficile infection. - Vancomycin is effective in the treatment of MRSA infections. - Patients who are allergic to penicillin are also allergic to vancomycin. -The major toxicity of vancomycin therapy is liver failure.

-Vancomycin is the most widely used antibiotic in U.S. hospitals. -Vancomycin is effective in the treatment of Clostridium difficile infection. - Vancomycin is effective in the treatment of MRSA infections.

Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery?

Neomycin

A patient taking a sulfonamide is breast-feeding an infant. Which complication in the infant would the nurse associate with kernicterus?

Neurologic deficits

The nurse identifies which statements about Stevens-Johnson syndrome as true? (Select all that apply.) Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Short-acting sulfonamides do not induce Stevens-Johnson syndrome. Patients with Stevens-Johnson syndrome usually are hypothermic. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.

Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.

The nurse identifies tigecycline [Tygacil] as a derivative of what?

Tetracyclines