pharm 1

A client receives information about rifampin for tuberculosis. Which statements indicate that the client understands this information? 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 can take an antacid 15 minutes after I take my medicine." 4. "My health care provider must be called immediately if my eyes and skin become yellow." 5. "If I can't swallow the pill, I cannot open the capsule and mix the powder with applesauce."

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." 4. "My health care provider must be called immediately if my eyes and skin become yellow."

A client with tuberculosis is to begin a medication that combines isoniazid, rifampin, and pyrazinamide, and streptomycin sulfate therapy. The client says, "I've never had to take so much medication for an infection before." What should the nurse explain? 1. "This type of organism is difficult to destroy." 2. "Streptomycin prevents side effects of the other medication." 3. "You'll only need to take the medications for a couple of weeks." 4. "Aggressive therapy is needed because the infection is well advanced."

1. "This type of organism is difficult to destroy."

What assessment findings indicate that a client is experiencing an allergic reaction to antibiotic therapy? Select all that apply. 1. Pruritus 2. Confusion 3. Wheezing 4. Muscle aches 5.Bronchospasm

1. Pruritus 3. Wheezing 5. Bronchospasm

An infant who has undergone cardiac surgery for a congenital defect is to be discharged. What should the nurse emphasize to the parents regarding administration of the prescribed antibiotic? 1. Give the antibiotic between feedings. 2. Ensure that the antibiotic is administered as prescribed. 3. Shake the bottle thoroughly before giving the antibiotic. 4. Keep the antibiotic in the refrigerator after the bottle has been opened.

2. Ensure that the antibiotic is administered as prescribed.

A client diagnosed with tuberculosis is taking isoniazid. To prevent a food and drug interaction, what should the nurse advise the client to avoid? 1. Chicken 2. Red wine 3. Sour cream 4. Apple juice

2. Red wine

A toddler with cystic fibrosis has been hospitalized with bacterial pneumonia. The nurse determines that the child has no known allergies. What does the nurse conclude is the reason that the health care provider selected a specific antibiotic? 1. Tolerance of the child 2. Sensitivity of the bacteria 3. Selectivity of the bacteria 4. Preference of the health care provider

2. Sensitivity of the bacteria

A client with a diagnosis of tuberculosis is receiving isoniazid as part of a chemotherapy protocol. The nurse assesses the client for adverse responses to the medication. The nurse determines that prompt intervention is needed for which client response? 1. Orange feces 2. Yellow sclera 3. Temperature of 96.8 F 4. Weight gain of 5 pounds

2. Yellow sclera

A patient with a viral infection is to receive ganciclovir (Cytovene) 5 mg/kg/day IVPB every morning. The patient weighs 110 pounds. How many milligrams will this patient receive for this dose?

250 mg

A client with an upper respiratory infection asks the nurse why the health care provider did not prescribe an antibiotic. What would be the best response from the nurse? 1. "I don't know. I will ask the health care provider for a prescription." 2."Antibiotics are used to treat viruses, and you have a bacterial infection." 3. "Antibiotics are ineffective for treating the bacteria that cause upper respiratory infections." 4."Upper respiratory infections generally are caused by viruses and therefore should not be treated with antibiotics."

4. "Upper respiratory infections generally are caused by viruses and therefore should not be treated with antibiotics."

A health care provider has prescribed isoniazid (Laniazid) for a client. Which instruction should the nurse give the client about this medication? 1. Prolonged use can cause dark concentrated urine. 2. The medication is best absorbed when taken on an empty stomach. 3. Take the medication with aluminum hydroxide to minimize GI upset. 4. Drinking alcohol daily can cause drug-induced hepatitis.

4. Drinking alcohol daily can cause drug-induced hepatitis.

A patient with a Pseudomonas species urinary infection will be receiving amikacin (Amikin) 15 mg/kg once daily via intravenous infusion. The patient weighs 198 pounds, and the medication is available in an injection solution strength of 250 mg/mL. How many milliliters of medication will be drawn up for this injection? (Record answer using one decimal place.)

5.4 mL Calculate the patient's weight in kilograms: 198 pounds ¸ 2.2 = 90 kg Calculate mg/kg dose: 15 mg ´ 90 kg = 1350 mg per dose Calculate milliliters needed for this dose: 250 mg : 1 mL :: 1350 mg : x mL Solve for x: (250 ´ x) = (1 ´ 1350); 250x = 1350; x = 5.4 mL

A patient with TB has been taking antitubercular drugs. A sputum culture is ordered to test for acid-fast bacilli. When is the best time for the nurse to obtain the sputum culture? A.In the morning B.Noon C.5 pm D.10 pm

A.In the morning

A patient with a diagnosis of TB will be taking INH as part of the anti-TB therapy. When reviewing the patient's chart, the nurse finds documentation that the patient is a "slow acetylator." This means that: A.the dosage of INH may need to be lower to prevent INH accumulation. B.the dosage of INH may need to be higher because of the slow acetylation process. C.he should not take INH. D.he will need to take a combination of anti-TB drugs for successful therapy.

A.the dosage of INH may need to be lower to prevent INH accumulation.

A patient is prescribed linezolid (Zyvox) to treat hospital-acquired pneumonia. It is most important for the nurse to determine if the patient is also taking which medication? A.A diuretic B.An SSRI C.A cardiac glycoside D.A thyroid replacement drug

B.An SSRI

A patient with active HIV has been taking zidovudine (Retrovir). Which potential adverse effect may limit the length of time this medication can be taken? A.Lactic acidosis B.Bone marrow suppression C.Hepatomegaly d. Fatigue

B.Bone marrow suppression

A patient is receiving Augmentin (amoxicillin and clavulanic acid) liquid solution through a percutaneous endoscopic gastrostomy tube. What is the purpose of the clavulanic acid? A.It works synergistically with the antibiotic to improve potency. B.It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria. C.It protects the antibiotic from the harmful gastric acid secretions in the stomach. D.It enhances the absorption of the antibiotic in the small intestine.

B.It inhibits the action of the enzymes produced by beta-lactamase-producing bacteria.

A patient has an extremely severe infection with a Mycobacterium that is resistant to all but one antitubercular drug; however, the patient has had an allergic reaction to that drug in the past. What does the nurse anticipate as being ordered for this patient? A.A combination of antitubercular drugs will be chosen to fight the infection. B.The patient will receive the drug and supportive care to help him tolerate the antitubercular therapy. C.The patient will remain on isolation precautions until his cough clears. There is nothing that can be done for this patient.

B.The patient will receive the drug and supportive care to help him tolerate the antitubercular therapy.

When completing an admission assessment, the patient states that she is allergic to sulfa drugs. What will the nurse do next? A.Mark the allergy on her medical record. B.Place an "allergy" armband on the patient. C.Ask the patient for more information about the allergic reaction she had. D.Notify the physician about the patient's allergy.

C.Ask the patient for more information about the allergic reaction she had.

Four weeks after beginning antitubercular drug therapy on an outpatient basis, the patient reports that he still experiences night sweats. What does the nurse identify as the main concern at this time? A.He is not taking his medication properly. B.More time is needed to see a therapeutic response. C.His infection may be resistant to the drug therapy ordered. D.He may have contracted a different strain of TB.

C.His infection may be resistant to the drug therapy ordered.

The nurse identifies Zosyn as being a member of which group? A.Cephalosporins B.Macrolides C.Penicillins D.Sulfonamides

C.Penicillins

A patient with HIV infection is seen in the clinic. The nurse notes the patient is experiencing weight loss, chronic diarrhea, fever, and dropping CD4 counts. The nurse anticipates the patient is in which stage of HIV infection? A.Stage 1 B.Stage 2 C.Stage 3 d. Stage 4

C.Stage 3

During intravenous (IV) quinolone therapy in an 88-year-old patient, which potential problem is of most concern when assessing for adverse effects? A.Hepatotoxicity B.Rhabdomyolysis C.Tendon rupture Nephrotoxicity

C.Tendon rupture

A group of office workers is concerned because a package was opened that contained a white powder substance. There is a concern that the white powder is anthrax. Which drug does the nurse anticipate being prescribed for the office workers? A.daptomycin (Cubicin) B.colistimethate (Coly-Mycin) C.ciprofloxacin (Cipro) D.quinupristin-dalfopristin (Synercid)

C.ciprofloxacin (Cipro)

A patient has a prescription for a sulfa drug as treatment for a UTI. She is also taking an oral contraceptive, an oral sulfonylurea antidiabetic drug, and phenytoin for a history of seizures. Which drug may pose a potential serious interaction with the sulfa drug? A.The oral contraceptive B.The oral antidiabetic drug C.The phenytoin D.All of these

D.All of these

An 82-year-old woman is unable to take the influenza vaccine because of allergies, but she has been exposed to the virus through a family reunion. She does not yet have symptoms of the flu. Which option would be best for her? A.She should receive the flu vaccine as soon as possible. B.She should receive zanamivir (Relenza) in the inhalation form. C.She should begin oral oseltamivir (Tamiflu) therapy when symptoms begin. D.She should begin oral oseltamivir (Tamiflu) therapy as soon as possible.

D.She should begin oral oseltamivir (Tamiflu) therapy as soon as possible.

Which of the following does the nurse identify as being a concern for patients receiving tetracycline? A.Tetracycline should not be administered to anyone older than age 65 years. B.Tetracycline has no impact on the effectiveness of oral contraceptives. C.Tetracycline used with warfarin decreases its effectiveness and enhances clot formation. D.Tetracyclines should not be administered with dairy products.

D.Tetracyclines should not be administered with dairy products.

A patient is receiving INH for the treatment of TB. Which vitamin does the nurse anticipate administering with the INH to prevent INH-precipitated peripheral neuropathies? A.Vitamin C B.Vitamin B12 C.Vitamin D D.Vitamin B6

D.Vitamin B6

A patient who is diagnosed with genital herpes is taking topical acyclovir. The nurse will provide which teaching for this patient? (Select all that apply.) a. "Be sure to wash your hands thoroughly before and after applying this medicine." b. "Apply this ointment until the lesion stops hurting." c. "Use a clean glove when applying this ointment." d. "If your partner develops these lesions, then he can also use the medication." e. "You will need to avoid touching the area around your eyes." f. "You will have to practice abstinence when these lesions are active."

a. "Be sure to wash your hands thoroughly before and after applying this medicine." c. "Use a clean glove when applying this ointment." e. "You will need to avoid touching the area around your eyes." f. "You will have to practice abstinence when these lesions are active."

A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse's best response? a. "The combined effect of both antibiotics is greater than each of them alone." b. "One antibiotic is not strong enough to fight the infection." c. "We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms." d. "We can give a reduced amount of each one if we give them together."

a. "The combined effect of both antibiotics is greater than each of them alone."

The nurse is administering intravenous acyclovir (Zovirax) to a patient with a viral infection. Which administration technique is correct? a. Infuse intravenous acyclovir slowly, over at least 1 hour. b. Infuse intravenous acyclovir by rapid bolus. c. Refrigerate intravenous acyclovir. d. Restrict oral fluids during intravenous acyclovir therapy.

a. Infuse intravenous acyclovir slowly, over at least 1 hour.

A patient is in the HIV clinic for a follow-up appointment. He has been on antiretroviral therapy for HIV for more than 3 years. The nurse will assess for which potential adverse effects of long-term antiretroviral therapy? (Select all that apply.) a. Lipodystrophy b. Liver damage c. Kaposi's sarcoma d. Osteoporosis e. Type 2 diabetes

a. Lipodystrophy b. Liver damage d. Osteoporosis e. Type 2 diabetes

A patient will be receiving nitrofurantoin (Macrodantin) treatment for a urinary tract infection. The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.) a. Liver disease b. Coronary artery disease c. Hyperthyroidism d. Type 1 diabetes mellitus e. Chronic renal disease

a. Liver disease e. Chronic renal disease

The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration? a. Monitoring blood pressure for hypertension during the infusion b. Discontinuing the drug immediately if red man syndrome occurs c. Restricting fluids during vancomycin therapy d. Infusing the drug over at least 1 hour

d. Infusing the drug over at least 1 hour

The nurse administers maraviroc (Selzentry) to a patient with HIV infection. It is most important for the nurse to monitor which of the following? A.CD4 count B.Bone marrow suppression C.Urinary output d. Liver function tests

d. Liver function tests

The nurse is administering intravenous vancomycin (Vancocin) to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate? (Select all that apply.) a. Monitoring serum creatinine levels b. Restricting fluids while the patient is on this medication c. Warning the patient that a flushed feeling or facial itching may occur d. Instructing the patient to report dizziness or a feeling of fullness in the ears e. Reporting a trough drug level of 11 mcg/mL and holding the drug f. Reporting a trough drug level of 24 mcg/mL and holding the drug

a. Monitoring serum creatinine levels c. Warning the patient that a flushed feeling or facial itching may occur d. Instructing the patient to report dizziness or a feeling of fullness in the ears f. Reporting a trough drug level of 24 mcg/mL and holding the drug

The nurse who is administering aminoglycoside therapy must monitor the patient closely for signs of toxicity as manifested by which of these conditions? (Select all that apply.) a. Electrocardiogram changes b. Hearing loss c. Dizziness d. Constipation e. Decreasing hemoglobin level f. Rising serum creatinine level

b. Hearing loss c. Dizziness f. Rising serum creatinine level

Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy? a. Constipation b. Risk for injury (renal damage) c. Disturbed body image related to gynecomastia d. Imbalanced nutrition, less than body requirements, related to nausea

b. Risk for injury (renal damage)

A patient who has undergone a lung transplant has contracted cytomegalovirus (CMV) retinitis. The nurse expects which drug to be ordered for this patient? a. acyclovir (Zovirax) b. ganciclovir (Cytovene) c. ribavirin (Virazole) d. amantadine (Symmetrel)

b. ganciclovir (Cytovene)

The nurse is providing counseling to a woman who is HIV positive and has just discovered that she is pregnant. Which anti-HIV drug is given to HIV-infected pregnant women to prevent transmission of the virus to the infant? a. acyclovir (Zovirax) b. zidovudine (Retrovir) c. ribavirin (Virazole) d. foscarnet (Foscavir)

b. zidovudine (Retrovir)

A young adult calls the clinic to ask for a prescription for "that new flu drug." He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms. What is the nurse's best response to his request? a. "Now that you've had the flu, you will need a booster vaccination, not the antiviral drug." b. "We will need to do a blood test to verify that you actually have the flu." c. "Drug therapy should be started within 2 days of symptom onset, not 4 days." d. "We'll get you a prescription. As long as you start treatment within the next 24 hours, the drug should be effective."

c. "Drug therapy should be started within 2 days of symptom onset, not 4 days."

A patient is receiving cidofovir (Vistide) as part of treatment for a viral infection, and the nurse is preparing to administer probenecid, which is also ordered. Which is the rationale for administering probenecid along with the cidofovir treatment? a. Probenecid has a synergistic effect when given with cidofovir, thus making the antiviral medication more effective. b. The probenecid also prevents replication of the virus. c. Concurrent drug therapy with probenecid reduces the nephrotoxicity of the cidofovir. d. The probenecid reduces the adverse gastrointestinal effects of the cidofovir.

c. Concurrent drug therapy with probenecid reduces the nephrotoxicity of the cidofovir.

The nurse checks the patient's laboratory work prior to administering a dose of vancomycin (Vancocin) and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next? a. Administer the vancomycin as ordered. b. Hold the drug, and administer 4 hours later. c. Hold the drug, and notify the prescriber. d. Repeat the test to verify results.

c. Hold the drug, and notify the prescriber.

When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity? a. Fever b. White blood cell count of 8000 cells/mm3 c. Tinnitus and dizziness d. Decreased blood urea nitrogen (BUN) levels

c. Tinnitus and dizziness

A patient who is diagnosed with shingles is taking topical acyclovir, and the nurse is providing instructions about adverse effects. The nurse will discuss which adverse effects of topical acyclovir therapy? a. Insomnia and nervousness b. Temporary swelling and rash c. Transient burning when applied d. This medication has no adverse effects.

c. Transient burning when applied

A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? a. metronidazole (Flagyl) b. ciprofloxacin (Cipro) c. vancomycin (Vancocin) d. tobramycin (Nebcin)

c. vancomycin (Vancocin)

A patient who is HIV-positive has been receiving medication therapy that includes zidovudine (Retrovir). However, the prescriber has decided to stop the zidovudine because of its dose-limiting adverse effect. Which of these conditions is the dose-limiting adverse effect of zidovudine therapy? a. Retinitis b. Renal toxicity c. Hepatotoxicity d. Bone marrow suppression

d. Bone marrow suppression

A 58-year-old man is receiving vancomycin as part of the treatment for a severe bone infection. After the infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports no chills or difficulty breathing. The nurse should suspect A.an allergic reaction has occurred. B.an anaphylactic reaction is about to occur. C.the medication will not be effective for the bone infection. d. IV dose may have infused too quickly.

d. IV dose may have infused too quickly.

The nurse is reviewing the medication orders for a patient who will be receiving linezolid (Zyvox) therapy. Which other medication or medication class, if ordered, would be a potential interaction concern? . a. Calcium channel blockers b. Phenytoin c. Anticoagulants d. Selective serotonin reuptake inhibitor antidepressants

d. Selective serotonin reuptake inhibitor antidepressants

A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs? a. Neuralgia b. Double vision c. Hypotension d. Tendonitis and tendon rupture

d. Tendonitis and tendon rupture

A patient is taking a combination of antiviral drugs as treatment for early stages of HIV infection. While discussing the drug therapy, the patient asks the nurse if the drugs will kill the virus. When answering, the nurse keeps in mind which fact about antiviral drugs? A. They are given for palliative reasons only. b. They will be effective as long as the patient is not exposed to the virus again. c. They can be given in large enough doses to eradicate the virus without harming the body's healthy cells. d. They may also kill healthy cells while killing viruses.

d. They may also kill healthy cells while killing viruses.

A patient has been diagnosed with Klebsiella pneumoniae carbapenemases (KPC). The nurse expects to see orders for which drug? a. dapsone (Cubicin), a miscellaneous antibiotic b. ciprofloxacin (Cipro), a quinolone c. linezolid (Zyvox), an oxazolidinone d. colistimethate sodium (Coly-Mycin), a polypeptide antibiotic

d. colistimethate sodium (Coly-Mycin), a polypeptide antibiotic

An infant has been hospitalized with a severe lung infection caused by the respiratory syncytial virus (RSV) and will be receiving medication via the inhalation route. The nurse expects which drug to be used? a. acyclovir (Zovirax) b. ganciclovir (Cytovene) c. amantadine (Symmetrel) d. ribavirin (Virazole)

ribavirin (Virazole)