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The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: A) hydrate the patient during the infusion and for 2 hours after the infusion. B) increase the patient's intake of foods rich In vitamin C. C) monitor urinary output every 30 minutes. D) provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.

A) hydrate the patient during the infusion and for 2 hours after the infusion.

A patient comes to the clinic and receives valacyclovir (Valtrex) for a herpes-zoster virus. The nurse instructs the patient to take the medication: A) without regard to meals. B) without any dairy products. C) each morning. D) on a empty stomach

A) without regard to meals.

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? A) "Cephalosporins are assigned to generations based on their relative costs to administer." B) "Cephalosporins have increased activity against gram-negative bacteria with each generation." C) "First-generation cephalosporins have better penetration of the cerebrospinal fluid." D) "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases."

B) "Cephalosporins have increased activity against gram-negative bacteria with each generation."

A patient who experiences motion sickness is about to go on a cruise. The prescriber orders transdermal scopolamine (Transderm Scop). The patient asks the nurse why an oral agent is not ordered. The nurse will explain that the transdermal preparation: A) can be applied as needed at the first sign of nausea. B) has less intense anticholinergic effects than the oral form. C) is less sedating than the oral preparation. D) provides direct effects, because it is placed close to the vestibular apparatus of the ear.

B) has less intense anticholinergic effects than the oral form.

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir (Tamiflu). The nurse will tell the patient that oseltamivir: A) may decrease symptom duration by 2 or 3 days. B) may not be effective because of the delay in starting treatment. C) may reduce the severity but not the duration of symptoms. D) will alleviate symptoms within 24 hours of the start of therapy.

B) may not be effective because of the delay in starting treatment.

A patient has a positive test for hepatitis C and is admitted to the hospital. The admission laboratory tests reveal a normal ALT, and a liver biopsy is negative for hepatic fibrosis and inflammation. The nurse will prepare this patient for: A) dual therapy with pegylated interferon alfa and ribavirin. B) no medication therapy at this time. C) pegylated interferon alfa only until ALT levels are elevated. D) triple drug therapy with pegylated interferon alfa, ribavirin, and boceprevir.

B) no medication therapy at this time.

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin (Amoxil) with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? A) "Amoxicillin is too narrow in spectrum." B) "The bacteria have developed a three-layer cell envelope." C) "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." D) "The bacteria have synthesized penicillinase."

D) "The bacteria have synthesized penicillinase."

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective? A) A 14-day course of amoxicillin with clavulanic acid (Augmentin) B) A 7-day course of ciprofloxacin (Cipro) C) A single dose of fosfomycin (Monurai) D) A 3-day course of trimethoprim/sulfamethoxazole (Bactrim)

D) A 3-day course of trimethoprim/sulfamethoxazole (Bactrim)

Which cephalosporin may be used to treat meningitis? A) Cefaclor B) Cefazolln C) Cefoxitin D) Cefotaxime

D) Cefotaxime

A nursing student is discussing with a nurse the plan of care for a patient about to undergo a third round of chemotherapy with cisplatin. Which statement by the nursing student about the treatment of CINV is correct? A) "Aprepitant (Emend) will be necessary to treat CINV caused by cisplatin." B) "Antiemetics are most effective if given just as the chemotherapy is finished." C) "Lorazepam probably would not be helpful for this patient." D) "This patient will need intravenous antiemetics for best effects."

A) "Aprepitant (Emend) will be necessary to treat CINV caused by cisplatin."

A nurse explains to a nursing student why opiold antidiarrheal medications are classified as drugs with little or no abuse potential. Which statement by the student indicates·a need for further teaching? A) "Formulations for the treatment of diarrhea have very short half-lives." B) "Opioid antidiarrheal drugs contain other drugs with unpleasant side effects at higher doses." C) "Some opioid antidiarrheal drugs do not cross the blood-brain barrier." D) "Some opioid antidiarrheal medications are not water soluble and cannot be given parenterally."

A) "Formulations for the treatment of diarrhea have very short half-lives."

A nurse is discussing methicillin-resistant Staphylococcus aureus (MRSA) with a group of nursing students. Which statement by a student correctly identifies the basis for MRSA resistance? A) "MRSA bacteria have developed PBPs with a low affinity for penicillins." B) "MRSA bacteria produce penicillinases that render penicillin ineffective." C) "MRSA occurs because of host resistance to penicillins." D) "MRSA strains replicate faster than other Staphylococcus aureus strains."

A) "MRSA bacteria have developed PBPs with a low affinity for penicillins."

A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her? A) "This agent is not effective against infections of the upper urinary tract." B) "This antiseptic agent is safe for use during pregnancy and has no drug resistance." C) "This drug is linked to many serious birth defects and is not recommended during pregnancy." D) "You will need to take this medication with meals to avoid gastric upset."

A) "This agent is not effective against infections of the upper urinary tract."

A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? A) Abstain from alcohol consumption during therapy. B) Avoid dairy products while taking this drug. C) Take an antihistamine if a rash occurs. D) Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.

A) Abstain from alcohol consumption during therapy.

A prescriber has ordered cefoxltin for a patient who has an infection caused by a gram-negative bacteria. The nurse taking the medication history learns that the patient experienced a maculopapular rash when taking amoxicillln (Amoxil) several years earlier. What will the nurse do? A) Administer the cefoxitin and observe for any side effects. B) Give the cefoxitin and have epinephrine and respiratory support available. C) Request an order for a different, nonpenicillin, noncephalosporin antibiotic. D) Request an order to administer a skin test before giving the cefoxitin.

A) Administer the cefoxitin and observe for any side effects.

A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? A) Administer the medication as prescribed. B) Contact the provider to ask about giving the drug in divided doses. C) Discuss increasing the interval between doses with the provider. D) Discuss reducing the dose with the provider.

A) Administer the medication as prescribed.

A patient who is in her first trimester of pregnancy asks the nurse to recommend nonpharmaceuticai therapies for morning sickness. What will the nurse suggest? A) Avoiding fatty and spicy foods B) Consuming extra clear fluids C) Eating three meals daily D) Taking foods later in the day

A) Avoiding fatty and spicy foods

A male patient with hepatitis C will begin triple drug therapy with pegylated interferon alfa 2a (Pegasys), ribavirin (Ribasphere), and boceprevir (Victrelis). The patient tells the nurse that his wife is pregnant. What will the nurse tell him? A) Boceprevir is contraindicated in males whose partners are pregnant. B) He should use a barrier contraceptive when having sex. C) He should use dual drug therapy with pegylated interferon alfa and ribavirin only. D) This combination drug therapy is safe for him to use.

A) Boceprevir is contraindicated in males whose partners are pregnant.

A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? A) Contact the provider and prepare to administer epinephrine. B) Notify the provider if the patient develops a rash. C) Request an order for a skin test to evaluate possible PCN allergy. D) Withhold the next dose until symptoms subside.

A) Contact the provider and prepare to administer epinephrine.

Before giving methenamine (Hiprex) to a patient, it is important for the nurse to review the patient's history for evidence of which problem? A) Elevated blood urea nitrogen and creatinine B) History of reactions to antibiotic agents C) Possibility of pregnancy D) Previous resistance to antiseptic agents

A) Elevated blood urea nitrogen and creatinine

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? A) First-generation cephalosporin B) Second-generation cephalosporin C) Third-generation cephalosporin D) Fourth-generation cephalosporin

A) First-generation cephalosporin

A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? A) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1800 and 0600. B) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1200 and 2400. C) Give the penicillin at 0600, 1400, and 2200; give the gentamicin (Garamycin) at 0600 and 1800. D) Give the penicillin every 8 hours; give the gentamicin (Garamycin) simultaneously with two of the penicillin doses.

A) Give the penicillin at 0800, 1600, and 2400; give the gentamicin (Garamycin) at 1800 and 0600.

A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? A) Make sure to administer the drugs at different times using different IV tubing. B) Suggest giving larger doses of plperacillin and discontinuing the amikacin. C) Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used. D) Watch the patient closely for allergic reactions, because this risk Is increased With this combination.

A) Make sure to administer the drugs at different times using different IV tubing.

A patient with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What will the nurse do? A) Notify the provider and request an order for a serum calcium level. B) Notify the provider of potential foscarnet overdose. C) Request an order for a creatinine clearance level. D) Request an order of IV saline to be given before the next dose.

A) Notify the provider and request an order for a serum calcium level.

A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment? A) Uncomplicated lower urinary tract infection treatable with short-course therapy B) Complicated lower urinary tract infection treatable with single-dose therapy C) Uncomplicated upper urinary tract Infection requiring 14 days of oral antibiotics D) Complicated upper urinary tract infection requiring parenteral antibiotics

A) Uncomplicated lower urinary tract infection treatable with short-course therapy

A child with an ear infection is not responding to treatment with amoxicillin (Amoxil). The nurse will expect the provider to order: A) amoxicillin-clavulanic acid (Augmentin). B) ampicillin. C) nafcillin. D) penicillin G (Benzylpenicillin).

A) amoxicillin-clavulanic acid (Augmentin).

A patient has a positive urine culture 1week after completion of a 3-day course of antibiotics. The nurse anticipates that the prescriber will: A) begin a 2-week course of antibiotics. B) evaluate for a structural abnormality of the urinary tract. C) initiate long-term prophylaxis with low-dose antibiotics. D) treat the patient with intravenous antibiotics.

A) begin a 2-week course of antibiotics.

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to: A) begin antibiotic therapy after urine culture and sensitivity results are available. B) give prophylactic antibiotics for 6 weeks after the acute Infection has cleared. C) initiate immediate treatment with broad-spectrum antibiotics. D) refer the patient for intravenous antibiotics and hospitalization.

A) begin antibiotic therapy after urine culture and sensitivity results are available.

A nurse is discussing the use of immunosuppressants for the treatment of inflammatory bowel disease (IBD) with a group of nursing students. Which statement by a student Indicates understanding of the teaching? A) "Azathioprine (Imuran) helps induce rapid remission of IBD." B) "Cyclosporine (Sandimmune) can be used to induce remission of IBD." C) "Cyclosporine (Sandimmune) does not have serious adverse effects." D) "Methotrexate is used long term to maintain remission of IBD."

B) "Cyclosporine (Sandimmune) can be used to induce remission of IBD."

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct? A) "Antibiotics are mutagenic and can produce changes that cause resistance," B) "Even normal flora can develop resistance and transfer this to pathogens." C) "Host cells become resistant to antibiotics with repeated use." D) "Patients who overuse antibiotics are more likely to have nosocomial infections."

B) "Even normal flora can develop resistance and transfer this to pathogens."

A nurse is teaching a group of nursing students about influenza prevention. Which statement by a student indicates understanding of the teaching? A) "I may develop a mild case of influenza if Ireceive the vaccine by injection." B) "I should receive the vaccine every year in October or November." C) "If Ihave a cold Ishould postpone getting the vaccine." D) "The antiviral medications are as effective as the flu vaccine for preventing the flu."

B) "I should receive the vaccine every year in October or November."

The nurse is providing education to a patient with ulcerative colitis who is being treated with sulfasalazine (Azulfidine). What statement by the patient best demonstrates understanding of the action of sulfasalazine? A) "It treats the infection that triggers the condition." B) "It reduces the inflammation." C) "It enhances the immune response." D) "It increases the reabsorption of fluid."

B) "It reduces the inflammation."

A nurse fs providing teaching to a nursing student about to care for a woman with irritable bowel syndrome with diarrhea (IBS-D) who is receiving alosetron (Lotronex). Which statement by the student indicates a need for further teaching? A) "I should evaluate the patient's abdomen for distension and bowel sounds." B) "Patients with diverticulitis and IBS-C may take this drug." C) "There are no known serious drug interactions with alosetron." D) "This drug is given only to women with severe IBS-D."

B) "Patients with diverticulitis and IBS-C may take this drug."

A child has received amoxicillin (Amoxil) for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism? A) Alteration of drug target molecules B) Antagonist production C) Drug inactivation D) Reduction of drug concentration at the site of action

B) Antagonist production

A patient has lamlvudine-sensitive hepatitis Band is taking entecavir (Baraclude) 0.5 mg per day. The nurse reviews the patient's laboratory values and notes a creatinine clearance of 40 ml/min. What will the nurse discuss with the patient's provider? A) Continuing the entecavir at the same dose B) Decreasing the entecavir dose to 0.25 mg per day C) Discontinuing the entecavir and considering dialysis D) Increasing the entecavir dose to 1mg per day

B) Decreasing the entecavir dose to 0.25 mg per day

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What Is an appropriate treatment for this patient? A) Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen B) Discontinuing the cephalosporin and beginning metronidazole (Flagyl) C) Discontinuing all antibiotics and providing fluid replacement D) Increasing the dose of the cephalosporin and providing isolation measures

B) Discontinuing the cephalosporin and beginning metronidazole (Flagyl)

A patient is taking bismuth subsalicylate (Pepto-Bismol) to prevent diarrhea. The nurse performing an assessment notes that the patient's tongue is black. What will the nurse do? A) Assess further for signs of gastrointestinal (GI) bleeding. B) Reassure the patient that this is an expected side effect of this drug. C) Request an order for liver function tests to evaluate for hepatotoxicity. D) Withhold the drug, because this is a sign of bismuth overdose.

B) Reassure the patient that this is an expected side effect of this drug.

A pregnant patient who is taking ondansetron (Zofran) for morning sickness tells the nurse she is experiencing headache and dizziness. What will the nurse tell her? A) It is not safe to take this drug during pregnancy. B) These are common side effects of ondansetron. C) She should stop taking the ondansetron immediately. D) She should report these adverse effects to her provider.

B) These are common side effects of ondansetron.

A patient with hepatitis B begins treatment with adefovir (Hepsera) and asks the nurse how long the drug therapy will last. The nurse will tell the patient that the medication will need to be taken for: A) a lifetime. B) an indefinite, prolonged period of time. C) forty-eight weeks. D) until nephrotoxicity occurs.

B) an indefinite, prolonged period of time.

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: A) disinhibit transpeptidases. B) disrupt bacterial cell wall synthesis. C) inhibit autolysins. D) inhibit host cell wall function.

B) disrupt bacterial cell wall synthesis.

A patient complains of burning on urination and increased frequency. The patient has a history of frequent urinary tract infections (UTis) and is going out of town in 2 days. To treat the infection quickly, the nurse would expect the healthcare provider to order: A) aztreonam (Azactam). B) fosfomycin (Monurol). C) trimethoprim/sulfamethoxazole (Bactrim). D) vancomycin (Vancocin).

B) fosfomycin (Monurol).

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir (Zovirax) 400 mg PO BID for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. The nurse will expect the provider to: A) extend this patient's drug therapy to BID for 12 months. B) give intravenous foscarnet every 8 hours for 2 to 3 weeks. C) increase the acyclovir dose to 800 mg PO 5 times daily. D) order intravenous valacyclovir (Valtrex) 1gm PO BID for 10 days.

B) give intravenous foscarnet every 8 hours for 2 to 3 weeks.

An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5° C. The nurse will expect the provider to: A) obtain a sputum culture and wait for the results before prescribing an antibiotic. B) order empiric antibiotics while waiting for sputum culture results. C) treat symptomatically, because antibiotics are usually ineffective against bronchitis. D) treat the patient with more than one antibiotic without obtaining cultures.

B) order empiric antibiotics while waiting for sputum culture results.

The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: A) allergic reaction. B) red man syndrome. C) rhabdomyolysis. D) Stevens-Johnson syndrome.

B) red man syndrome.

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching? A) "Some agents disrupt the bacterial cell wall;" B) "Some agents act to block the conversion of para-aminobenzoic acid (PABA) to folic acid." C) "Some agents cause phagocytosis of bacterial cells." D) "Some agents weaken the cell wall, causing cell wall lysis."

C) "Some agents cause phagocytosis of bacterial cells."

A nurse provides teaching for a patient with cytomegalovirus (CMV) retinitis who will receive the ganciclovir ocular implant (Vitrasert). Which statement by the patient indicates a need for further teaching? A) "My vision may be blurred for 2 to 4 weeks after receiving the implant." B) "Surgical placement of the implant Is an outpatient procedure." . C) "The implant will remain in place permanently." D) "The implant will slow progression of CMV retinitis."

C) "The implant will remain in place permanently."

A patient with Crohn's disease will begin receiving an initial infusion of infliximab (Remicade). The nurse explains how this drug works to treat this disease. Which statement by the patient indicates a need for further teaching? A) "I may have an increased risk of infections, such as tuberculosis, when taking infliximab." B) "I should report chills, fever, itching, and shortness of breath while receiving the infusion." C) "This drug sometimes provides a complete cure of inflammatory bowel disease." D) "I will take the second dose in 2 weeks, the third dose in 6 weeks, and then a dose every 8 weeks thereafter."

C) "This drug sometimes provides a complete cure of inflammatory bowel disease."

A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient? A) "Make sure you void after intercourse and drink extra fluids to stay well hydrated." B) "We will treat each infection as a separate infection and treat with short-course therapy." C) "You will need to take a low dose of medication for 6 months to prevent infections." D) "You will need to take antibiotics for 4 to 6 weeks each time you have an infection."

C) "You will need to take a low dose of medication for 6 months to prevent infections."

A patient is receiving intravenous promethazine (Phenergan) 25 mg for postoperative nausea and vomiting. What is an important nursing action when giving this drug? A) Giving the dose as an IV push over 3 to 5 minutes B) Infusing the dose with microbore tubing and an infusion pump C) Observing the IV insertion site frequently for patency D) Telling the patient to report dry mouth and sedation

C) Observing the IV insertion site frequently for patency

A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do? A) Administer the medication as ordered. B) Contact the provider to suggest giving the drug IV. C) Question the need for a penicillinase-resistant penicillin. D) Suggest ordering vancomycin to treat this infection.

C) Question the need for a penicillinase-resistant penicillin.

A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? A) Ask the provider to order a cephalosporin. B) Reassure the patient that allergic responses diminish over time. C) Request an order for a skin test to assess the current risk. D) Suggest using a desensitization schedule to administer the drug.

C) Request an order for a skin test to assess the current risk.

A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do? A) Assess the skin at the infusion site for signs of tissue necrosis. B) Observe the patient closely for confusion and other neurotoxic effects. C) Request an order for serum electrolytes and cardiac monitoring. D) Watch the patient's actions and report any bizarre behaviors.

C) Request an order for serum electrolytes and cardiac monitoring.

A nurse caring for a patient who is undergoing a third round of chemotherapy is preparing to administer ondansetron (Zofran) 30 minutes before initiation of the chemotherapy. The patient tells the nurse that the ondansetron did not work as well the last time as It had the first time. What will the nurse do? A) Administer the ondansetron at the same time as the chemotherapy. B) Contact the provider to suggest using high-dose intravenous dolasetron (Anzemet). C) Request an order to administer dexamethasone with the ondansetron. D) Suggest to the provider that loperamide (Lomotil) be given with the ondansetron.

C) Request an order to administer dexamethasone with the ondansetron.

A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? A) Apply warm packs to the arm, and infuse the medication at a slower rate. B) Continue the infusion while elevating the arm. C) Select an alternate intravenous site and administer the infusion more slowly. D) Request central venous access.

C) Select an alternate intravenous site and administer the infusion more slowly.

A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say? A) Conjugation results in a gradual increase in resistance. B) Conjugation results in random changes in the microbe's DNA. C) Spontaneous mutation leads to resistance to only one antimicrobial agent. D) Spontaneous mutation can transfer DNA from one organism to another.

C) Spontaneous mutation leads to resistance to only one antimicrobial agent.

A patient is being treated for chemotherapy-induced nausea and vomiting (CINV) with ondansetron (Zofran) and dexamethasone. The patient reports getting relief during and immediatefy after chemotherapy but has significant nausea and vomiting several days after each chemotherapy treatment. What will the nurse do? A) Contact the provider to discuss increasing the dose of ondansetron. B) Suggest giving prolonged doses of dexamethasone. C) Suggest adding aprepitant (Emend) to the medication regimen. D) Tell the patient to ask the provider about changing the ondansetron to aprepitant.

C) Suggest adding aprepitant (Emend) to the medication regimen.

A nursing student asks a nurse why pegylated interferon alfa is used instead of regular interferon for a patient with hepatitis C. The nurse will tell the student that pegylated interferon: A) decreases the need for additional medications. B) has fewer adverse effects than interferon. C) is administered less frequently than interferon. D) may be given orally to increase ease of use.

C) is administered less frequently than interferon.

A nurse is admitting a patient to the hospital who reports having recurrent, crampy abdominal pain followed by diarrhea. The patient tells the nurse that the diarrhea usually relieves the pain and that these symptoms have occurred daily for the past 6 months. The patient undergoes a colonoscopy, for which the findings are normal. The nurse will plan to teach this patient to: A) use antispasmodic.medications. B) avoid food containing lactose and gluten. C) keep a food, stress, and symptom diary. D) use antidiarrheal drugs to manage symptoms

C) keep a food, stress, and symptom diary.

A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with: A) cephalexin (Keflex). B) fosfomycin (Monural). C) methenamine (Hiprex). D) nitrofurantoin (Macrodantin).

C) methenamine (Hiprex).

A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: A) antiviral medications are not safe during pregnancy. B) intravenous antiviral agents will be used if an outbreak occurs. C) oral acyclovir (Zovirax) may be used during pregnancy. D) topical acyclovir (Zovirax) must be used to control outbreaks.

C) oral acyclovir (Zovirax) may be used during pregnancy.

A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The vital signs are temperature of 102.9° F, pulse of 92 beats per minute, respirations of 24 breaths per minute, and blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of: A) acute cystitis. B) urinary tract infection. C) pyelonephritis. D) prostatitis.

C) pyelonephritis.

A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: A) adding an aminoglycoside. B) changing to penicillin G. C) reducing the dose of piperacillin. D) ordering nafcillin.

C) reducing the dose of piperacillin.

A patient with gastroesophageal reflux disease (GERD) iS to begin taking oral metoclopramide (Reglan). The patient asks the nurse about the medication. Which response by the nurse is correct? A) "After 3 months, if the drug is not effective, you may need to increase the dose." B) "Metoclopramide may cause hiccups, especially after meals:' C) "Serious side effects may occur but will stop when the drug is discontinued." D) "You should take the drug 30 minutes before each meal and at bedtime."

D) "You should take the drug 30 minutes before each meal and at bedtime."

A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response? A) "Because strep throat is likely, your child should be treated empirically." B) "With good hand washing, your child should not get strep throat." C) "Your child probably has strep throat, so your provider will order an antibiotic." D) "Your child should come to the clinic to have a throat culture done today."

D) "Your child should come to the clinic to have a throat culture done today."

The parent of an infant with otitis media asks the nurse why the prescriber has ordered amoxiciliin (Amoxil) and not ampicillin (Unasyn). What will the nurse tell the parent? A) Amoxicillin is a broader spectrum antibiotic than ampicillin. B) Amoxiciliin is not inactivated by beta-lactamases. C) Ampicillin is associated with more allergic reactions. D) Ampicillin is not as acid stable as amoxicillin.

D) Ampicillin is not as acid stable as amoxicillin.

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics? A) A 5-year-old child with a fever of 100.5° F, dysuria, and bacteriuria B) A pregnant woman with bacteriuria, suprapubic pain, and fever C) A young man with dysuria, flank pain, and a previous urinary tract infection D) An older adult man with a low-grade fever, flank pain, and an indwelling catheter

D) An older adult man with a low-grade fever, flank pain, and an indwelling catheter

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? A) Administering the antibiotic immediately B) Administering antipyretics as soon as possible C) Delaying administration of the antibiotic until the culture results are available D) Obtaining all cultures before the antibiotic is administered

D) Obtaining all cultures before the antibiotic is administered

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etibltlgy of the thrush? A) Antibiotic resistance B) Community-acquired infection C) Nosocomial Infection D) Suprainfection

D) Suprainfection

A patient with recurrent bacterial pneumonia is treated with an antibiotic that has worked previously but is not working to reduce symptoms in a current infection. The nurse caring for this patient understands that this is likely for which reason? A) The antibiotic altered the genetic makeup of the bacterial strain causing this infection. B) The antibiotic caused host cells to change and become more susceptible to bacterial effects. C) The antibiotic caused a mutation of the organism leading to reduced drug sensitivity. D) The antibiotic destroyed competing organisms that secrete substances toxic to the pathogen.

D) The antibiotic destroyed competing organisms that secrete substances toxic to the pathogen.

A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication? A) Anorexia, nausea, and vomiting B) Brown-colored urine C) Drowsiness D) Tingling of the fingers

D) Tingling of the fingers

A patient is preparing to travel to perform missionary work in a region with poor drinking water. The provider gives the patient a prescription for ciprofioxacin (Cipro) to take on the trip. What will the nurse instruct this patient to do? A) Combine the antibiotic with an antidiarrheal medication, such as loperamide. B) Start taking the ciprofloxacin 1week before traveling. C) Take 1tablet of ciproftoxacin with each meal for best results. D) Use the drug If symptoms are severe or do not improve in a few days.

D) Use the drug If symptoms are severe or do not improve in a few days.

A nurse is caring for a patient with cancer who has been undergoing chemotherapy. The patient has oral mucositis as a result of the chemotherapy, and the provider has ordered palifermin (Kepivance). Which is an appropriate nursing action when giving this drug? A) Administering the drug as a slow IV infusion B) Flushing the IV line with heparin before infusing the drug C) Giving the drug within 6 hours of the chemotherapy D) Warning the patient about the potential for distortion of taste

D) Warning the patient about the potential for distortion of taste

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a ____ spectrum _____ agent. A) broad; systemic B) broad; topical C) narrow; systemic D) narrow; topical

D) narrow; topical

An older male patient comes to the clinic with complaints of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The nurse would most likely suspect that the patient has: A) acute cystitis. B) urinary tract infection. C) pyelonephritis. D) prostatitis.

D) prostatitis.

A female patient who has hepatitis C is being treated with pegylated interferon alfa and ribavirin (Ribasphere). It will be important for the nurse to teach this patient that: A) if she gets pregnant, she should use the inhaled form of ribavirin (Virazole). B) if she is taking oral contraceptives, she should also take a protease inhibitor. C) she should use a hormonal contraceptive to avoid pregnancy. D) she will need a monthly pregnancy test during her treatment.

D) she will need a monthly pregnancy test during her treatment.