NRSG 245 Study guide exam 2
The nurse identifies which statements about frequent urinary tract reinfections as true? (Select all that apply.) a Reinfections are considered frequent if the individual has three or more a year. b Prophylactic therapy should continue for at least 2 months. c If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. d Single-dose nitrofurantoin 50 mg taken 1 hour before intercourse has been found to reduce the rate of reinfection. e If a symptomatic episode occurs, the standard therapy for acute cystitis should be used.
A C e Prophylactic therapy should continue for at least 6 months. Single-dose trimethoprim/sulfamethoxazole, taken after intercourse, has been found to reduce the risk of reinfection. The other three statements are true.
The nurse should include which instructions when teaching a patient about tigecycline therapy? (Select all that apply.) a "Use sunscreen when you are outside." b "If you have diarrhea more than five times a day, notify your healthcare provider." c "Avoid using this drug if you are pregnant." d "Stop taking the drug if you experience nausea." e "Stop taking the drug if you experience vomiting."
A B C
Which outcomes should a nurse establish when planning care for a patient taking methenamine [Mandelamine]? (Select all that apply.) a Maintains a urine pH of 5.5 or lower. b Consumes 3000 mL of liquid daily. c Uses an enteric-coated formulation. d Avoids sulfonamide medications. e No elevation in liver enzymes.
A C D Under acidic conditions, methenamine makes formaldehyde, which causes bacterial cell death. Formaldehyde requires an acid urine to be released. To prevent the dose from being converted to formaldehyde in an acidic stomach, an enteric-coated formula may be used. Ingestion of large volumes of fluid dilutes methenamine and raises the urinary pH. Hepatotoxicity is not associated with methenamine [Mandelamine].
A patient is receiving penicillin G [Bicillin C-R]. Which assessment should the nurse monitor as an indicator of an undesired effect? a Cardiac rhythm b Serum sodium level c Lung sounds d Red blood cell (RBC) count
A Penicillin G in high IV doses may cause hyperkalemia, which can result in dysrhythmias or cardiac arrest. Hypernatremia occurs with high IV doses of ticarcillin. Lung sounds and the RBC count are unrelated to the administration of penicillin G.
It would be a priority to report which diagnostic test if a patient is prescribed tetracycline? a. glucose - 6 phosphate dehydrogenase 8.3 U/g of hemoglobin b. human chorionic gonadotropic 5325 mIU/mL c. International normalized ratio 1.1 d. sodium 132 mEq/L
B - tetracycline should be avoided during pregnancy due to risk for bone/teeth discoloration of fetus
A nurse assesses the history of a patient who has had multiple complicated UTIs for which risk factors? (Select all that apply.) a Female gender, child-bearing age b Indwelling catheter c Prostate hypertrophy d Fair skin tone e Urinary tract stones
B C E
The nurse identifies which host factor as the most important when choosing an antimicrobial drug? a Age b Competent immune function c Genetic heritage d Previous medication reactions
B Two factors—host defenses and the site of infection—are unique to the selection of antibiotics. It is critical for success that antibiotics act synergistically with the immune system to subdue infection. Other host factors, such as age, genetic heritage, and previous drug reactions, are the same factors that must be considered when choosing any other medication.
A nurse removes a central line access device once the patient no longer requires intravenous (IV) antibiotics. This action is an example of which strategy to prevent antimicrobial resistance established by the Centers for Disease Control and Prevention (CDC)? a Preventing transmission b Proper diagnosis c Preventing infection d Prudent antibiotic use
C The CDC's campaign to prevent the development of antimicrobial resistance in hospitals focuses on four approaches: (1) prevent infection, (2) diagnose and treat infection effectively, (3) use antimicrobials wisely, and (4) prevent transmission. Expeditious removal of invasive devices, such as IV catheters, and restricting these devices to essential use are examples of the CDC's strategy to prevent infection.
Which of these lab tests would be priority for the nurse to access when a patient is receiving an amino glycoside? a. creatine b. fasting blood glucose c. Hemoglobin and hematocrit d. INR
a
Which statement about syphilis does the nurse identify as true? a. Penicillin G is the drug of choice for all stages of syphilis b. early signs of congenital syphilis include purulent discharge from the urethra c. the risk of neurosyphilis is decreased in individuals with HIV infection d. Syphilis develops in one abrupt stage
a
A 17 year old male patient asks about treatment options for Chlamydia trachomatis infection. Which response by nurse is appropriate? a. "Chlamydia is bacteria and is treated with azithromycin" b. "This infection is treatable but is prevented best with vaccination" c. "This disease is viral and will be treated with valacyclovir" d. "This infection is fungal, and metronizaole will be prescribed"
a
A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take? a Reduce the infusion rate. b Administer diphenhydramine [Benadryl]. c Change the IV tubing. d Check the patency of the IV
a
A patient who is prescribed tobramycin (amino glycoside) complains of a headache. What is the priority nursing action a. assess the onset, characteristics, and associated symptoms of the headache b. medicate with acetaminophen and reassess in 1 hour c. withhold the tobramycin and notify the prescriber when making rounds d. withhold the tobramycin and notify the prescriber STAT
a
Fluoroquinolone's should be discontinued immediately if a. tendon pain or inflammation develop b. nausea, vomitting or diarrhea are experienced c. dizziness, headache, or confusion occur d. theophylline is prescribed for asthma
a
The nurse is caring for a patient receiving gentamicin IV. What statement by the patient would concern the nurse.. "I am experiencing.... a. high pitched ringing in my ears b. dizziness c. ear pain d. tone deafness
a
The nurse is preparing to administer 8am meds to a patient who is to receive nafcillin 2 g via secondary IV infusion. The drug is dissolved in 100ml of normal saline solution. The drug handbook states the drug should be infused over 30-90 min. Just before the nurse hangs the nafcillin, the nurse is informed the patient is to be placed on a cart to go off the unit for a diagnostic test in 30-45 min. The patient is expected to be off the floor in 30 min. What should the nurse do? A. hold the drug infusion until the patient returns from test B. infuse the drug in 30 min before placing the patient on the cart c. infusing the drug in 45 min while loading the patient on the cart d. set the infusion to run over 90 min
a
Which assessment is of greatest priority for the nurse to compete before administering a penicillin antibiotic a. allergy history. b. Blood urea nitrogen c. temperature d. would drainage
a
the nurse is caring for a patient receiving gentamicin IV. what statement by patient would be most concerning a. high-pitched drinking in ears b. dizziness c. ear pain d. tone deafness
a
which statement will the nurse include when teaching a patient with HIV about management of the disease a. HIV is considered chronic disease b. HIV infection can be cured with 1 year of therapy c. drug resistance doesn't occur in HIV treatment d. blood cultures and red blood cell counts are the principle lab tests to guide HIV treatments
a
A patient is admitted to the hospital with a medical diagnosis of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). When taking the patient's history, a nurse recognizes which information as the most important? a Plays a contact sport and is an athlete b Currently resides in a long-term care facility c Did not complete the last course of antibiotics d Had gallbladder surgery in the previous month
a CA-MRSA is transmitted by skin-to-skin contact and by contact with contaminated objects, such as sports equipment and personal items. It is seen in young, healthy people without recent exposure to healthcare facilities, which is one of the biggest risk factors for CA-MRSA. Not completing an antibiotic course is unrelated.
When ceftriaxone is administered intravenously, it is most important for the nurse to avoid mixing it with what? a Ringer's lactate b Normal saline c Sterile water d D5 0.45% NS
a Mixing ceftriaxone with calcium causes precipitates to form. Ringer's lactate contains calcium; therefore, it should not be mixed with ceftriaxone. It is safe to mix normal saline, sterile water, and D5 0.45% NS with ceftriaxone.
The nurse is working with a patient who has a UTI. Because patient adherence to a medication regimen is a concern, the nurse anticipates use of which medication? a Fosfomycin b Amoxicillin c Cephalexin d Trimethoprim
a When adherence is a concern, fosfomycin, which requires just one dose, is an attractive choice. As a rule, amoxicillin and cephalexin are avoided, because they are less effective than the alternatives and are less well tolerated. Trimethoprim requires a longer course of therapy than fosfomycin.
Both IV ampicillin/sulbactam [Unasyn] and gentamicin are ordered for a patient. When administering these medications, the nurse will do what? a Ensure that separate IV solutions are used. b Use two different peripheral IV sites. c Administer the gentamicin first. d There are no necessary precautions.
a When penicillins are present in high concentrations, they interact chemically with aminoglycosides, causing inactivation of the aminoglycosides. Therefore, penicillins and aminoglycosides should not be mixed in the same IV solution. Rather, these drugs should be administered separately. Two different peripheral IV sites are not necessary. Administering the gentamicin first does not ensure separation of the two medications.
A patient is being discharged with continued ciprofoxacin history. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops? a. pain in the heel of the foot b. nausea c. diarrhea d. headache
a - ciprofloxacin can cause tendon rupture so it needs to be stopped right away
The nurse identifies which drug as a short-acting tetracycline? a Tetracycline (generic) b Declomycin c Vibramycin d Minocin
a Generic tetracycline is a short-acting tetracycline. Declomycin is an intermediate-acting tetracycline, and Vibramycin and Minocin are long-acting
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? a White blood cell (WBC) count of 1200 units/L b Hemoglobin (Hgb) level of 18 g/dL Incorrect c Potassium level of 3.0 mEq/dL d Glucose level of 200 mg/dL
a Linezolid can cause reversible myelosuppression, manifesting as anemia, leukopenia, or even pancytopenia. The potassium and blood glucose levels are not affected by linezolid.
A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take? a Reduce the infusion rate. b Administer diphenhydramine [Benadryl]. c Change the IV tubing. d Check the patency of the IV
a When vancomycin is infused too rapidly, histamine release may cause the patient to develop hypotension accompanied by flushing and warmth of the neck and face; this phenomenon is called red man syndrome. Diphenhydramine is not necessary if the infusion is administered slowly over at least 60 minutes. Changing the IV tubing would not help the symptoms. The patency of the IV needs to be checked before the administration is started.
Which statements about vancomycin [Vancocin] does the nurse identify as true? (Select all that apply.) a Vancomycin is the most widely used antibiotic in U.S. hospitals. b Vancomycin is effective in the treatment of Clostridium difficile infection. c Vancomycin is effective in the treatment of MRSA infections. d Patients who are allergic to penicillin are also allergic to vancomycin. e The major toxicity of vancomycin therapy is liver failure.
a b c
The nurse identifies appropriate use of antimicrobials to prevent infection in which situations? (Select all that apply.) a Cardiac surgery b Recurrent urinary tract infections in women c Anemia d Treatment of fever of unknown origin e Hysterectomy
a b e
Which lab result if identified in a patient who is receiving dalfopristin and quinilopristin should the nurse report to prescriber immediately? a. ALT 250 b. BUN 20mg/dL c. CK-MM 50mL/IU d. FBG 250mg/dL
a because an adverse effect of streptogrmmins is hepatotoxicity
Which laboratory result if present would be a reason to withhold administering cefotetan to an adult male and to notify the prescriber? a. alanine aminotransferaste (ALT) 354 international units/L b. blood urea nitrogen 34 mg/dL c. creatinine 2.1 mg/dL d. fasting blood glucose 239mg/dL
a because drug can cause elevation in liver enzymes.
Which instructions will the nurse include when teaching a patient about cephalosporin therapy? (Select all that apply.) a "Notify your healthcare provider if you develop diarrhea." b "Take aspirin if you develop a headache." c "Notify your healthcare provider if you develop a rash." d "Cephalosporins may not be taken with food." e "Do not take cephalosporins if you have lactose intolerance."
a c
Which medications does the nurse identify as having antibacterial properties? (Select all that apply.) a Rifampin b Zidovudine c Imipenem d Amphotericin B e Amantadine
a c
A nurse should recognize that antibiotic prophylaxis is appropriate in patients with which medical conditions? (Select all that apply.) a Aortic valve replacement b Ruptured appendix c Bronchitis d Neutropenia e Chickenpox
a d
Major adverse effects of amino glycoside antibiotics include (select all) a. cochlea b. heart c. kidneys d. lungs e. stomach f. vestibular apparatus
a, c, f
A patient asks the nurse what he can do to prevent influenza. What should the nurse do? a. teach the patient about antiviral medications b. instruct the patient to obtain an influenza vaccination c. tell the patient that frequent hand washing is effective d. have the patient wear a mask in public areas
b
A patient has been prescribed oral ciprofloxacin for a skin infection. When administering the medication the nurse will: a. monitor for a decrease in prothrombin time (PT) if the patient is also taking warfarin (Coumadin) b. withhold antacids and milk products for 6 hours before or 2 hours after c. inform the healthcare provider if the patient has a history of asthma d. assess the skin for stevens-johnsons syndrome
b
A patient is admitted to a medical unit and prescribed IV ampicillin/sulbactam after a specimen was sent for culture/sensitivity from the ed. The nurse knows the priority reason for notifying the prescriber of culture results as soon as they are available is that ampicillin/sulbactam a. has many more adverse effects than most other antibiotics b. is a broad spectrum antibiotic, and there may be an effective narrow-spectrum antibiotic c. is a very expensive antibiotic d. is a narrow spectrum antibiotic and may not be effective for the cultured organism
b
A patient is prescribed acyclovir by mouth. The nurse should assess the patient for which adverse effects associated with oral acyclovir therapy? a. stomatitis and gastritis b. nausea, vomiting, and diarrhea c. hives, difficulty breathing, and angioedema d. tinnitus and decreased hearing
b
Because they are broad-spectrum antibiotics, tetracyclines can cause: a. targeted kill of susceptible microbes b. superinfection, especially with C. difficile and yeast c. eradication of candida in mouth, pharynx, vagina, and bowel d. growth suppression in children
b
The nurse is reviewing laboratory values from a patient who has been prescribed Gentamicin (garamycin). To prevent ototoxicity, the nurse will monitor a. serum creatine and BUN b. trough levels of gentamicin c. peak drug levels of gentamicin d. serum alanine amainotransferase (ALT) and aspartate aminotransferase (AST) levels
b
The patient is diagnosed with C. Difficile infection. The nurse anticipates administering which medication a. daptomycin b. metronidazole c. rifampin d. rifaximin
b
Which is the preferred drug or drugs for treating gonorrhea? a. doxycycline and azithromycin b. ceftriaxone c. metronidazole d. Acyclovir
b
Which of the following patients would most likely need intravenous antibiotic therapy to treat a UTI? a. a patient with uncomplicated UTI caused by escherichia coli b. a patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain c. a patient with acute cystitis complaining of dysuria, frequency, and urgency d. a patient with acute bacterial prosthesis with mild fever and nocturne
b
the nurse is working at a STD clinic and a patient has been diagnosed with an STD and will be treated with penicillin G. The nurse understands that Penicillin G is the drug of choice for treatment of a. gonorrhea b. syphilis c. genital herpes d. chlamydia
b
A patient is taking nitrofurantoin [Macrodantin]. Which finding should a nurse recognize as an indication that the treatment is having an undesired effect? a Hyperpigmentation of the palms b Dyspnea with chill c Gum irritation with bleeding d Scalp tenderness and thinning hair
b Nitrofurantoin, a urinary tract antiseptic, may induce a pulmonary reaction that manifests with dyspnea, chest pain, and chills. These symptoms, which resolve 2 to 4 days after the drug is stopped, are thought to be hypersensitivity reactions. Hyperpigmentation of the palms, gum irritation with bleeding, and scalp tenderness and thinning hair are not side effects associated with nitrofurantoin.
A patient is prescribed trimethoprim-sulfamethoxazole (bacterium) to treat a UTI. Which of the following statements made by the patient indicate that teaching was effective? a. it is safe to take this medication if i become pregnant b. i will drink at least 8-10 glasses of water every day c. i will be able to stop this medication when I'm symptom free d. i may have increased blood sugar when taking this medication
b - to prevent crystals from forming in urine
A patient who has acute cystitis is receiving treatment with trimethoprim/sulfamethoxazole. Which manifestation should indicate to a nurse that the patient's condition is worsening? a Incontinence b Flank pain c 3+ pedal edema d Hyperactive bowel sounds
b Flank pain may indicate continued infection or pyelonephritis. When acute cystitis is treated with a traditional agent of choice, such as trimethoprim/sulfamethoxazole, manifestations of dysuria, urinary urgency and frequency, suprapubic discomfort, and bacteriuria improve. Incontinence, 3+ pedal edema, and hyperactive bowel sounds are unrelated to acute cystitis.
Because of risk of hyperkalemia when prescribed trimethoprim its priority to report? a. bruising b. weakness c. pallor d. sore throat
b because hyperkalemia can cause muscle weakness, tiredness, tingling, nausea
When performing shift assessment, the nurse notes a maculopapular rash over the trunk of a patient who has been taking a ceftriaxone for four days. What is the nursing priority action? a. administer standing order for epinephrine as needed b. complete the assessment c. consult the prescriber d. withhold the ceftriaxone
b because hypersensitivity is a common adverse effect and because rash is less severe the assessment needs to be completed in order to give completed information to the prescriber
When imipenem and valproate are prescribed for a patient what is the priority concern? a. hydration b. safety c. nutrition d. skin integrity
b because impeninem decreases levels of the anti seizure medication valproate and can increase risk for seizures
When performing a skin test for penicillin allergy, the nurse will do what? (Select all that apply.) a Inject a tiny amount of the allergen subcutaneously. b Observe for a local allergic response. c Have epinephrine readily available. d Have respiratory support readily available. e Administer diphenhydramine [Benadryl] as the first-line agent should anaphylaxis occur.
b c d
Which statements about CDAD associated with clindamycin therapy does the nurse identify as true? (Select all that apply.) a Leukopenia commonly occurs. b It is a potentially fatal condition. c Patients usually experience abdominal pain. d Anticholinergics are effective in treating the diarrhea. e Clindamycin therapy should be discontinued and vancomycin started.
b c e CDAD is a potentially fatal condition in which patients experience abdominal pain. If CDAD develops, clindamycin therapy should be stopped and vancomycin or metronidazole therapy started. Leukocytosis, not leukopenia, develops. Anticholinergics can make the diarrhea worse and therefore, should be avoided.
Which are examples of the improper use of antibiotic therapy? (Select all that apply.) a Using surgical drainage as an adjunct to antibiotic therapy b Treating a viral infection c Basing treatment on sensitivity reports d Treating fever in an immunodeficient patient e Using dosing that results in a superinfection
b e
A nurse is assessing the effects of antimicrobial therapy in a patient with pneumonia. The nurse should establish which outcomes when planning care? (Select all that apply.) a Potassium level of 4 mEq/dL b Reduction of fever c Sterile sputum cultures d Oxygen saturation of 98% e Elastic skin turgor
b, c, d
the nurse teaches a patient who has been prescribed oral tetracycline that the medication shouldn't be taken with which over the counter medications (select all) a. ascorbic acid b. centrum silver c. ferrous sulfate d. folic acid e. TUMS
b, c, e
8 hours after administering a sulfonamide, the nurse notes that a patient has a temp of 104, pulse 112, bp of 104/52 respiration of 20.min, malaise, and widespread sessions of the skin mucous membranes. The nurses would be correct to suspect. a. superinfection b. systemic mycoses c. stevens johnsons syndrome d. red man syndrome
c
A patient is prescribed doxycycline (Vibramycin). If the patient complains of gastric irritation, the nurse should: A. instruct patient to take med with milk B. Tell the patient to take an antacid with the medication C. give the patient food such as crackers or toast with med D. have the patient stop the medication and contact healthcare provider
c
A patient is presided doxycycline. If the patient complains of GI irritation, the nurse should a. instruct patient to take med with milk b. tell patient to take an antacid with med c. give patient food such as crackers/toast with med d. have patient stop med immediately and contact the healthcare provider
c
A patient received a neuromuscular blocking agent during surgery. In the post anesthesia care unit, the prescriber orders gentamicin 40 mg IV STAT what is the most appropriate action? a. administer drug as quick as possible b. assess the patients vital signs c. clarify the order d. refuse to administer the drug
c
A patient who takes warfarin is prescribed itraconazole to treat a fungal infection. The nurse will tach the patient to then do what? a. take the medication with famotidine to reduce gastric upset b. Prepare for long-term intravenous administration of itraconazole c. avoid taking esomeprazole with itraconazole therapy d. double the dose of warfarin
c
In most infections, the level of antibiotic at the site of infection needs to be: a. at the minimum inhibitory concentration b. 2-3 times the MIC c. 4-8 times the MIC d. 10-20 times the MIC
c
Metronidazole is ordered for a patient being prepared for colorectal surgery. The nurse understands that the rationale for administration of metronidazole is that a. inhibits the C. difficile toxin b. can treat the fungal infection c. serves as prophylaxis for infection d. is a broad spectrum antibiotic
c
The nurse has consulted the prescriber because a patient reports an allergy to the prescribed penicillin antibiotic. The prescriber is aware of the allergy but the patient is experiencing a life threatening infection and no other antibiotic is available. What is the priority nursing action a. administer the antibiotic b. ask the patient if he or she is willing to the the med c. Obtain orders for treatment of a possible allergic reaction d. Refuse to administer the antibiotic
c
The nurse reviews correct lab tests results before administering piperacillin/tazobactam. It would be priority to report which laboratory result to the provider? a. brain natriuretic peptide 65 pictograms/dL b. BUN 22mg/dL c. Platelets 100,000/mL d. White blood cell count 15,000/mm3
c
Which assessment finding would be a priority to report the prescriber if it occurred after administration of a large IV dose of penicillin a. discomfort at IV site b. fever higher than 100.4 c. wheezing d. shivering
c
Which drug does the nurse identify as a UTI antiseptic a. ciprofloxacin b. ceftriaxone c. nitrofurantoin d. ceftazidime
c
Which lab test is greatest priority to review before administering nitrofuratonin a. ALT b. Bilirubin c. Estimated glomerular filtration d. sodium
c
Which lab test result would be a priority to report to the prescriber of a sulfonamide? a. neutrophils 65% b, platelets 200,000/m3 c. RBC distribution 18.4% d. WBC count 11,800
c
Which patient would most likely have an infection that is resistant to antibiotic therapy a. a child with asthma who develops pneumonia b. an adult construction worker who drinks from a worksite water supply and develops giardiasis c. an adult who developed a wound infection while in the hospital after surgery d. an older adult who got an infected paper cut
c
The nurse is aware that acute cystitis occurs most often in which patient population? a Older-adult male patients b Children younger than 12 years c Women of child-bearing age d Women older than 50 years
c Acute cystitis is a lower urinary tract infection that occurs most often in women of child-bearing age.
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 1000mL of 0.9% saline d. Administer the medication orally
c - .9% saline is normal saline
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? a An allergic reaction has developed to the drug solution. b The drug has infiltrated the extravascular tissues. c Phlebitis of the vein used for the antibiotic has developed d Local infection from bacterial contamination has occurred.
c IV cephalosporins may cause thrombophlebitis. To minimize this, the injection site should be rotated and a dilute solution should be administered slowly. An allergic response would be shown as itching, redness, and swelling. Infiltration would show as a pale, cool, and puffy IV site. Infection would show as pus, tenderness, and redness.
A patient is receiving vancomycin [Vancocin]. The nurse identifies what as the most common toxic effect of vancomycin therapy? a Ototoxicity b Hepatotoxicity c Renal toxicity d Cardiac toxicity
c The most common toxic effect of vancomycin [Vancocin] therapy is renal toxicity. Although ototoxicity may occur, it is rare. The liver and heart are not affected when vancomycin is used.
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? a Regular insulin b Ampicillin [Polycillin] c Naproxen [Naprosyn] d Bisacodyl [Dulcolax]
c Three cephalosporins—cefmetazole [Zefazone], cefoperazone [Cefobid], and cefotetan [Cefotan]—cause bleeding tendencies. Caution should be used during concurrent use of anticoagulants and other nonsteroidal medications. Regular insulin, ampicillin, and bisacodyl are unrelated to adverse effects with cefotetan.
which result would be of greatest priority to report to the prescriber of cefotaxime? a. albumin 3.4 g/dL b. alanine aminotransferase (ALT) 158 international units/L c. Estimated glomerular filtration rate (eGFR) 48 ml/mn d. international normalized ratio 1
c because cefotaxime is eliminated by kidneys
Which result would be of greatest priority to report to prescriber of ceftriaxone? a. albumin 3.4 g/dL b. eGFR 88ml/min c. Hemoglobin 9.2 g/dL and hematocrit 27% d. INR 1
c because ceftriaxone can cause bleeding tendencies
An alert and oriented patient with a history of penicillin allergy is prescribed cephalexin. What is the priority action by the nurse? A. administer the cephalexin b. administer the cephalexin and carefully assess for allergic reaction c. assess the type of reaction the patient had to the penicillin d. notify prescriber of allergy and ask for different antibiotic order
c because for patients with mild reactions to penicillin, they can take cephalosporins.
It would be priority to monitor which lab test when patient is prescribed linezolid? a. AST and ALT b. Bun c. CBC and differential d. Fasting blood glucose
c because linolzolid can cause myelosuppresion and manifest as leukopenia and thrombocytopenia
A patient is prescribed tetracycline for Chlamydia trachomatis. Which change in assessment finding would be a priority to report? a. boring on urination b. perineal itching c. watery stool d. vaginal discharge
c tetracycline is broad spectrum and can cause superinfection like C. Diff
Important for nurse to monitor which lab test when a patient is prescribed azithromycin or erythromycin and warfarin? a. BUN b. CK-MM c. INR d. RBC count
c. INR because warfarin is a blood thinner and macrolide can increase effects of warfarin
The nurse is assessing for adverse effects of IV tobramycin. Which change would be priority to report to prescriber? a. dilute urine b. headache c. limp/weak muscles d. ringing in ears
c. tobramycin is an aminioglycoside that can cause neuromuscular blockage causing flaccid paralysis or respiratory depression
A patient is prescribed in intravenous gentamicin (garamycin) for a sever bacterial infection. To monitor for adverse effects of this medication, the nurse will teach the patient to immediately report: a. blurred vision b. hand tremors c. urinary frequency d. tinnitus
d
A patient is presided IV gentamicin for a severe bacterial infection. To monitor for adverse effects of this med, the nurse will teach the patient to immediately report a. blurred vision b. hand tremors c. urinary frequency d. tinnitus
d
A patient who recently discharged from the hospital and prescribed ciprofloxzcin phones the prescriber office complaining of pain above the heel while walking or stretching. the nurse expects the patient to be instructed to a. avoid the treadmill and apply ice to area b. try isometric exercises prior to walking or stretching c. continue the med and watch for sighs of redness or swelling d. discontinue the med and avoid weight bearing on the ankle
d
A patient who was recently discharged from the hospital and prescribed Ciprofloxacin is complaining of pain above the heel while walking/stretching. The nurse expects the patient to be instructed to a/ avoid the treadmill and apply ice b. try isometric exercises prior to walking or stretching c. continue the med and watch fro signs of redness or swelling d. discontinue the med and avoid weight bearing on the ankle
d
A pregnant adolescent asks the nurse whether it would be all right to continue to take her prescription for tetracycline to clear up acne. What response provides the best info.. a. tetracycline is effective in clearing acne b. tetracycline may cause allergic reaction in pregnant women c. tetracycline will resolve an asymptomatic UTI d. tetracycline could be harmful to the baby teeth and should be avoided
d
Aminioglycosides are first line drugs for a. oral therapy of a serious systemic infection b. patients with history of hearing impairment associated with loud noise exposure c. against infections with a mixture of aerobic and anaerobic microbes. d. to treat infections with aerobic gram - bacilli
d
Before administering erythromycin to a patient for an upper respiratory tract infection, it is the most important for the nurse to determine if the patient is also prescribed which drug? A. Guaifenesin (guiatuss) B. hydrocodone (vicodin) C. Nitroglycerin (tridil) D. verapamil (Calan)
d
Erythromycin is an example of an a. aminoglycoside b. cephalosporin c. anti fungal d. macrolide
d
What is the drug of choice for MRSA? a. dicloxacillin b. naficillin c. oxacillin d. doxycycline
d
Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin [Biaxin] and warfarin [Coumadin]? a Activated partial thromboplastin time (aPTT) b Platelet count c Erythrocyte sedimentation rate (ESR) d International normalized ratio (INR)
d
Which sings would most likely indicate the start of Stevens Johnsons disease when receiving sulfonamide? a. amber color rash on checks b. papular rash on shoulders c. pruritic rash on lower arms d. blisters in the mouth
d
Which statement by a new nurse about IV administration of amphotericin B indicates the nurse needs more education. a. almost all patients receiving amphotericin B experience some degree of nephrotoxicity b. patients receiving amphotericin B should be under close supervision in a hospital c. Heparin can be used in the infusion site to prevent phlebitis associated with amphotericin B therapy d. Diphenhydramine plus acetaminophen can minimize rigors associated with amphotericin B therapy
d
Which test is the most widely used method for assessing drug sensitivity? a Minimum inhibitory concentration (MIC) b Minimum bacterial concentration (MBC) c Broth dilution d Disk diffusion
d
With the exception of pyelonephritis, the nurse is aware that most urinary tract infections are treated by which method? a IV antibiotics at the hospital b IV antibiotics in the urgent care setting c IM antibiotics at the primary physician's office d Oral antibiotics in the home setting
d
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)? a Rigidity bIleus c Ascites d Diarrhea
d AAPMC, which is manifested initially by diarrhea and abdominal cramping, especially may develop with the use of broad-spectrum cephalosporins. Rigidity, ileus, and ascites are unrelated to cephalosporin use.
A patient is to begin taking nitrofurantoin [Macrodantin]. The nurse should teach the patient that which manifestation should be the priority to report to the healthcare provider? a Headache and drowsiness b Brown-colored urine c Nausea and vomiting d Muscle weakness and tingling
d Nitrofurantoin is used in acute infections of the lower urinary tract only. Muscle weakness and tingling may indicate irreversible damage to sensory and motor nerves caused by demyelinization of nerves. Patients should be informed of these symptoms and taught to report them immediately. Gastrointestinal (GI) effects may be minimized by taking the drug with milk or food. Brown urine is a harmless effect of the urinary excretion of the medication. Headache and drowsiness are less common adverse effects that are readily reversible.