Pharm ch 9
A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug? A. vancomycin B. warfarin C. atorvastatin D. losartan
B
The nurse should monitor the client for which common side effects of erythromycin therapy? a. Urticaria and opthalmic drainage B. Headache and fever C. Nausea, vomiting, and diarrhea D. Shortness of breath and sore throat
c
The nurse understands that which is the highest priority when teaching about antitubercular medications? a. Staying hydrated B. Monitoring sputum C. Taking medications as prescribed D. Eating a well balanced diet
c
Drugs that destroy bacteria are known as which type of drug? a. bacteriostationary B. bacteriophage C. bacteriocidal D. bacteriostatic
c
A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as; a. superinfection. B. allergy. C. allergic reaction. D. skin rash. E. analphylactic reaction.
a
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? a. assessing for renal insufficiency B. assessing for the presence of asthma C. assessing for hypertension D. assessing for diabetes mellitus
a
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? a. Serum BUN and creatinine levels B. Coagulation studies C. Complete blood count D. Signs of disulfiram-like reaction
a
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? A. Liver function studies B. Audiometric studies C. Pulmonary function studies D. Urine culture
a
A client is taking rifampin (Rifadin) for active TB. The nurse should stress that what may be caused by the use of this drug? a. body fluids such as urine, saliva, tears, and sputum may become discolored. B. the drug usually causes cardiac arrhythmias. C. facial flushing may appear but will go away once therapy is concluded. D. the drug frequently causes seizure activity.
a
A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety? a. changing to a different antibiotic B. changing to parenteral administration of rifaximin C. supplementing the antibiotic with vitamin K D. increasing the dose of rifaximin
a
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the A. route. B. choice of drug. C. frequency. D. dose.
a
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to A. complete the entire course of drug therapy. B. take the drug only in safe and secure home settings. C. reduce the dosage of ciprofloxacin gradually. D. take the drug through subcutaneous injection if it tastes bad.
a
A patient with a throat infection has been recommended penicillin therapy by the primary health care provider. Before administering the first dose of penicillin to the patient, which interventions should the nurse perform as part of the pre-administration assessment? a. Obtain patient's general health history. B. Evaluate the patient's lifestyle and diet. C. Perform renal and hepatic function tests. D. Inspect patient's stools.
a
After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement? a. "I need to wear protective clothing when I'm out in the sun." B. "I will take the drug with an antacid to prevent an upset stomach." C. "I should limit the amount of fluids that I drink." D. "I should chew gum and chocolate if my mouth gets sore."
a
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins A. can cause allergic reactions in clients who are allergic to penicillins. B. can cause kidney damage in clients who are allergic to penicillins. C. are derived from penicillin. D. are ineffective in clients who are allergic to penicillins.
a
The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring? a. Red man syndrome B. Gray syndrome C. Cushing's syndrome D. Serotonin syndrome
a
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? a. antacids B. antidiabetic agents C. oral contraceptives D. antihypertensives
a
What antibiotic is contraindicated for the treatment of intermittent colitis? A. clindamycin B. doxycycline C. telithromycin D. erythromycin
a
What event triggers the development of a superinfection? a. proliferation of antibiotic-resistant microorganisms B. the infection is well established before antibiotic treatment begins C. bone marrow suppression triggered by antibiotic treatment D. unforeseen interactions between the antibiotic and other prescribed medications
a
Which would be considered a penicillinase-resistant antibiotic? A. Ticarcillin B. Amoxicillin C. Carbenicillin D. Nafcillin
a
If a fetus or young infant receives a sulfonamide by placental transfer, in breast milk, or by direct administration, the drug displaces bilirubin from binding sites on albumin. As a result, what may the fetus experience? a. Hyperbilirubinemia B. Hyperkalemia C. Kernicterus D. Hypernatremia
a,c
A client asks how tetracycline works on acne. What is the nurse's best response? A. "Tetracycline changes the chemical structure of your skin so it's less hospitable to bacteria." B. "Tetracycline interferes with the growth of the bacteria causing the pimples." C. "Tetracycline interferes with components of bacterial protein synthesis." D. "Tetracycline reduces the number of bacteria in the blood running through your skin."
b
A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? a. To prevent adverse reactions B. To prevent resistance C. To decrease allergic response of medications D. To decrease length of drug therapy
b
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response? A. "The antibiotics are only effective against some types of bacteria." B. "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." C. "The antibiotics are only effective in killing off some of the bacteria in the body." D. "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control."
b
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication? a. weight gain B. jaundice C. fever D. arthralgia
b
A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client? a. Stop the medication and the health care provider will order you a different antibiotic. B. These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. C. Continue to take the medication as prescribed; these are expected side effects from the medication. D. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction.
b
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic? a. The client has a history of not adhering to treatment B. The client has chronic renal failure C. The client has type 2 diabetes, controlled with oral antihyperglycemics D. The client has a known latex allergy
b
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction? A. Antacids delay metabolism of the drug. B. Antacids decrease the absorption of the drug. C. Antacids can exacerbate nausea and reflux. D. Antacids cause a dangerous rise in gastric pH.
b
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? a. Fatigue B. Photosensitivity C. Weakness D. Muscle cramping
b
The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug? A. Headache and dizziness B. Diarrhea and nausea C. Lethargy and paresthesias D. Superinfections and phlebitis
b
Which of the following drugs would be classified as an aminoglycoside? a. Cefaclor B. Gentamicin C. Levofloxacin D. Clarithromycin
b
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection? a. Respiratory difficulty B. Nephrotoxicity C. Increased bleeding D. Nausea
b
Which statement by a client taking a sulfonamide requires further instruction? a. "I will be sure to drink a full glass of water every time I take my medicine." B. "I will make sure to use extra sunscreen when I go to the tanning booth." C. "I will take all of my medicine even if my symptoms go away." D. "I will take my medicine with my meals like it says on the prescription bottle."
b
Which of the following are examples of fluoroquinolones? Select all that apply. A. Spectinomycin (Trobicin) B. Levofloxacin (Levaquin) C. Amoxicillin (Amoxil) D. Ciprofloxacin (Cipro) E. Cephalexin (Keflex)
b,d
A nurse is preparing to administer a fluoroquinolone. Which infections are treated with fluoroquinolones? Select all that apply. a. upper respiratory infections B. urinary tract infections C. ear infections D. skin infections E. sexually transmitted disease
b,d,e
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug a. intravenously with the assistance of a home health nurse. B. with a sip of water 1 hour before mealtime. C. with a glass of water 1 hour before or 2 hours after a meal. D. immediately before or with a meal.
c
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day? a. 2 B. 6 C. 8 D. 4
c
A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism? a. GABA analog B. aminopenicillin C. aminoglycoside D. antifungal
c
A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client? a. Bone marrow depression B. Congestive heart failure C. Renal damage D. Liver toxicity
c
A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy? a. A cancer client B. An obese 45-year-old man C. An HIV-positive client D. A new mother who is nursing
c
After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following? A. "I only need to take one pill every day for this medicine to work." B. "I need to take the medicine with a meal so I don't get an upset stomach." C. "I should drink a full 8-oz glass of water when I take the medicine." D. "I might have some bloody diarrhea after using this medicine."
c
After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which types of medication? a. bacteriophage B. bacteriostationary C. bacteriostatic D. bacteriocidal
c
A 25-year-old female client who presents at the clinic with vaginal discharge and discomfort is diagnosed with chlamydia. The nurse knows that the drug of choice to treat this infection is doxycycline. What would be a priority assessment for this client before beginning the medication? A. Asking the client if she has had an allergic reaction to a penicillin B. Measuring the client's blood pressure C. Asking the client if she is allergic to sulfonamides D. Asking the client if she is pregnant
d
A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient? a. Monitoring fluid intake. B. Testing for occult blood. C. Testing for increased glucose levels. D. Monitoring blood creatinine levels.
d
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform? a. Assess the child for allergies to salicylates. B. Assess whether the child has ever had tuberculosis skin test. C. Assess the child's immunization status. D. Assess the child for allergies to penicillins.
d
A client diagnosed with tuberculosis (TB) has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question? a. "Multiple drugs are used to speed up the course of treatment." B. "Multiple drugs are prescribed because the final testing results for TB can take up to 3 months." C. "Multiple drugs are used because health care providers aren't sure which drug will kill a particular TB strain." D. "The use of multiple drugs prevents the development of drug-resistant TB."
d
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication? A. weight gain B. arthralgia C. fever D. jaundice
d
A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client? a. "Call your health care provider if you experience headache or dizziness." B. "You might experience some nausea or stomach upset." C. "The drug can cause an allergic reaction." D. "Your urine or sweat may become orange in color."
d
A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal? a. Red blood cells and white blood cells B. Sodium and potassium C. Amylase and lipase D. BUN and creatinine
d
A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? A. Take the drug along with a meal. B. Take the drug immediately after meals. C. Take the drug along with milk or fruit juice. D. Take the drug on an empty stomach.
d
A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections? a. Monitor signs of liver dysfunction weekly. B. Monitor patient's vital signs each morning. C. Administer streptomycin to promote nutrition. D. Rotate injection sites for frequent parenteral injections.
d
Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies? a. Cephalosporin B. Tetracycline C. Vancomycin D. Penicillin
d
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9 degrees ferenheit. The health care provider has written the following orders; acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first? a. Provide client with eight ounces of fluid. B. Administer acetaminophen for temperature. C. Administer sulfasalazine (Azulfidine). D. Obtain urine for culture and sensitivity.
d
The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age? A. Penicillins B. Cephalosporins C. Aminoglycosides D. Tetracyclines
d
The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse? A. "I should see an improvement in my baby in 24 hours from the time the drugs are started." B. "Sudden development of a rash, shortness of breath, or wheezing should be reported immediately." C. "The entire course of the amoxicillin should be taken as directed on the bottle and completed." D. "If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."
d
The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration? a. Nausea B. Thrombocytopenia C. Pain during administration D. Phlebitis
d
What organ system is responsible for the excretion of cefotaxime sodium from the body? a. gastrointestinal B. hepatic C. respiratory D. renal
d
What potential adverse reaction is most likely to develop during cefazolin therapy? a. dry skin and pruritus B. orthostatic hypotension C. drowsiness D. gastrointestinal upset
d
