EDAPT: Infection
The nurse is reviewing instructions for vaginal antifungal drugs with a client. Which statement by the nurse is appropriate instruction regarding these drugs?
"Abstain from sexual intercourse until the treatment has been completed and the infection has resolved."
When teaching a client who is taking acyclovir for genital herpes, which statements by the healthcare professional are accurate? Select all that apply.
"Acyclovir slows replication of the virus." "Do not use creams or lotions over the area." "Take all of this medication as prescribed."
During a telehealth visit after taking ribavirin to treat hepatitis C, the client shares that their grandson is taking the same medication as a breathing treatment. They would like to know if they should be doing the same. What is the best response by the nurse?
"Although it is the same medication, the oral form is indicated for treating hepatitis."
In providing Gladys' discharge instructions, which of Gladys' responses indicate the need for further education? Select all that apply.
"Ciprofloxacin should work because another healthcare provider gave me the same prescription about a month ago." "I will save any extra ciprofloxacin in case I get another infection." "I will stop taking medication when I feel better."
Which statement, made by the mother of a 13-year-old being treated for a herpes simplex infection on the right forearm, indicates a need for further treatment?
"He has an area on his stomach starting to ooze and crust."
A client is prescribed cephalexin 500 mg every 6 hours for 7 days for a skin infection. Which statement by the client suggests that further teaching may be required?
"I can stop this medication when my wound heals."
The nurse is caring for a 27-year-old client who has been newly diagnosed with hepatitis. The healthcare provider has prescribed the following medication as adjunct therapy with ribavirin and pegainterferon alfa: Simeprevir 150 mg daily by mouth The nurse is providing medication administration teaching. Which statement by the client indicates further teaching is needed?
"I will stop the ribavirin while taking this new medication."
During discharge planning, the nurse prepares to teach the client about an amoxicillin prescription. Which response by the client indicates further instruction is needed?
"If I get a rash, it should go away in a day or two."
A client has just been diagnosed as human immunodeficiency virus (HIV)-positive and asks the nurse, "Does this mean I have AIDS?" Which response would be most appropriate?
"It varies with every individual, but the average time is 8 to 10 years from the time a person is infected, and some go much longer."
A client is taking nystatin oral lozenges to treat an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate?
"Let the lozenge dissolve slowly and completely in your mouth without chewing it."
Amanda (pronouns: she/her/hers) was prescribed azithromycin 250 mg orally daily for 5 days. She takes estradiol for birth control and uses warfarin 5 mg orally daily for chronic atrial fibrillation. Which statement suggests that additional education is needed?
"My birth control will continue to be effective."
A client is instructed to complete a sputum collection first thing in the morning and asks why this is necessary. Which response to the client is the most appropriate?
"Studies have shown that early morning sputum collection has a higher accuracy rate for diagnosis compared to sputum collected later in the day."
A client diagnosed with a herpes simplex infection asks, "When will the virus be completely out of my body?" What is the best response provided by the nurse?
"The antiviral medications decrease the amount of virus so your body can control or eliminate the virus—so it may never be completely gone."
Which statements made by an individual with a prescription for acyclovir to treat genital herpes indicate to the nurse that they understand the expected outcomes of the drug therapy? Select all that apply.
"The medication will slow viral replication to allow my immune system the chance to work." "As the lesions dry and heal, the amount of virus shed will get less. But I should still cover the area." "My breakouts will heal faster with the medication."
When teaching a client who is taking acyclovir for genital herpes, which statements by the healthcare professional are accurate? Select all that apply.
"This drug will help the lesions dry and crust over." "Acyclovir slows the replication of the virus."
When teaching a client who is taking oseltamivir for influenza, which statement by the health professional is accurate?
"This will make your symptoms less severe so you can rest and heal."
An individual recently prescribed sofosbuvir asks if they can keep taking St. John's wort before going to bed since sofosbuvir is taken in the morning. What is the best response provided by the healthcare professional?
"Unfortunately, no. Due to the long half-life, the sofosbuvir remains active within the bloodstream all day."
During a telehealth visit, an individual taking acyclovir shares that they missed their last dose and asks if they should take the missed dose now. What is the best response by the health professional?
"Unless it is near the time for the next dose, take the missed dose."
The parent of an adolescent recently prescribed topical acyclovir to treat herpes simplex virus asks why the child is not taking an oral antibiotic like ciprofloxacin. What is the nurse's best response?
"Using topical acyclovir treats the viral infection effectively without the potential side effects of taking the same medicine orally."
Due to a sore throat, a client asks if it is safe to open the capsule and mix the medication in pudding. What is the best response by the healthcare provider?
"Yes, it is safe to take this medication in that way."
As part of Gladys's discharge instructions, which response regarding client outcomes should the nurse include?
"You may be on the wrong antibiotic if you are not better in a few days."
What is the nurse's best response to address Omar's concerns?
"You will need to return frequently to check your labs for medication success. We will monitor your viral load and CD4 counts throughout therapy to ensure the medications are working properly. I hear you are upset about the diagnosis. May I share with you the goals and benefits of treatment?"
Drag and drop each drug to match what it is used to treat.
*Amphotericin B* - Severe systemic fungal infections *Nystatin* - Oral candidiasis *Miconazole* - Vulvovaginal candidiasis *Clotrimazole* - Tinea corporis, tinea pedis, tinea versicolor, cutaneous candidiasis, and vaginal yeast infections *Fluconozale* - Esophageal, oropharyngeal, peritoneal, urinary tract, and vaginal candidiasis
Match each drug by dragging it to the group of monitoring criteria.
*Amphotericin B* - Blood urea nitrogen (BUN); creatinine at baseline, then frequently; complete blood count (CBC); electrolytes; liver function tests *Nystatin* - No routine tests recommended *Fluconozale* - Creatinine at baseline; liver function tests (LFTs)
Match each safety concern with its preventative action.
*Antibiotic allergies are common* - Check allergy band or chart to ensure there are no known antibiotic allergies. *Antibiotics can interact with food* - Review possible food or medication interactions with the client. *Antibiotic resistance can occur if not used for the full course* - Finish full courses of antibiotics as prescribed. *Antibiotics are an expectation for many provider visits* - Use antibiotics sparingly. *Antibiotics can metabolize poorly in liver or kidney failure* - Monitor kidney and liver function before starting.
Match the drug category to the unpleasant symptoms it is used to treat or prevent.
*Antipyretics* - Fever *Corticosteroids* - Hyperactive response *Antiemetics* - Nausea and vomiting *Antihistamines* - Allergic type reactions, but not anaphylaxis
For each condition below, indicate if it is a contraindication or adverse effect of oseltamivir.
*Contraindication:* End stage renal disease clients not receiving dialysis History of hypersensitivity *Adverse Effect:* Seizures Nausea and vomiting Hallucinations Confusion Agitation
Drag and drop the items to complete the table below.
*Gram-Positive Cocci:* Methicillin-resistant Staphylococcus aureus (MRSA) Methicillin-susceptible staphylococcus aureus (MSSA) Strep *Gram-Negative Bacilli:* E. Coli, P mirabilis, Klebsiella Pseudomonas *Gram-Negative Cocci:* N. Gonorrhoeae, N. Meningitis
Drag and drop each image to the description it best fits. Each image may be used more than once.
*HIV Molecule:* • These molecules damage the immune system by killing CD4 cells. • The goal of medication treatment is to decrease these. *CD4 Cells:* • The goal of medication treatment is to improve the number of these. • These cells are part of the body's immune system.
Drag and drop each drug into the correct class based on the primary condition treated.
*Herpes Virus:* Acyclovir Trifluridine *Hepatitis:* Sofosbuvir *Influenza:* Amantadine Oseltamivir
Drag and drop each drug to match with its example.
*Imidazoles and triazoles* - Ketoconazole, fluconazole, itraconazole, and voriconazole *Echinocandins* - Caspofungin, micafungin, and anidulafungin *Polyenes* - Amphotericin B and nystatin
The nurse is compiling a document of teaching points to make for Omar (pronouns: he/him/his) and a sheet to print out for him to take home. Which instructions regarding antiretroviral medications will the nurse include?
*Include:* • Remain upright when taking medications and for 30 minutes afterward to prevent esophageal ulceration. • Follow-up exams, including taking blood, are essential to monitor for side effects and determine if the medication regimen is working. • Avoid taking other medications, including over-the-counter medications and herbal supplements, until speaking with your provider. • Do not discontinue any medications without talking with your provider. • Change positions slowly as the medications may cause dizziness and syncope. • Take missed doses as soon as you remember, unless it is time for the next dose. • Take medications with food to prevent gastrointestinal (GI) upset. *Do Not Include:* • Take on an empty stomach. • Take medications exactly as indicated, around the clock, but do not interrupt sleep. • If you miss a dose, take a double dose next time.
Which medication instructions should be given to a client with newly diagnosed human immunodeficiency virus (HIV) being discharged home?
*Include:* • Take the medications with food. • Store medications out of sunlight and at room temperature. • If you experience trouble breathing, fever, or changes in mouth/oral mucosa, notify the prescriber immediately. • Remain consistent and be sure to take in evenly spaced intervals to ensure therapeutic benefits. • Remain upright when taking the medication and for 30 minutes after to prevent esophageal ulcers. *Do Not Include:* • Take medications on an empty stomach. • You may crush or break capsules if needed to tolerate the medication better. • Lay down for 30 minutes after taking your medications to prevent dizziness. • You may note changes in your mouth/oral mucosa; this is normal.
Drag each image to match the correct factors provided.
*Induration of 0-4 mm* Negative *Induration of 5-9 mm* Positive in: • Human immunodeficiency virus (HIV) infected persons. • Recent contact of a person with tuberculosis (TB) disease. • Persons with fibrotic changes on chest radiograph consistent with prior TB. • Clients with organ transplants. • Persons who are immunosuppressed for other reasons. *Induration of 10-14 mm* Positive in: • Recent immigrants (< 5 years) from high-prevalence countries injection drug users. • Residents and employees of high-risk congregate settings mycobacteriology laboratory personnel. • Persons with clinical conditions that place them at high risk children < 4 years of age. • Infants, children, and adolescents exposed to adults in high-risk categories. *Induration of ≥ 15 mm* Postive in: • Any person, including persons with no known risk factors for TB. Targeted skin testing programs should only be conducted among high-risk groups.
Drag each contraindication to the correct box matching the antifungal medication in the row.
*Itraconazole* - Severe cardiac problems *Voricanazole* - Pregnancy *Griseofulvin* - Porphyria
Complete the table by dragging the information listed to the corresponding cell in the table.
*Lab test:* Creatinine clearance *Medicine:* Isoniazid Pyrazinamide *Adverse effect:* Nephrotoxicity
Drag and drop to match the medication class with the appropriate action.
*Nucleoside reverse transcriptase inhibitors (NRTIs)* - Acts as a decoy to nucleosides, which is missing a component that prevents it from attaching to another nucleoside. *Fusion inhibitors* - Binds to the virus proteins Gp120 or Gp41 and prevents HIV from binding to and entering CD4 cells. *CCR5 antagonists* - Coats and blocks the proteins from entering the cell. *Protease inhibitors* - Prevents protease from binding to the viral polyprotein, which blocks it from maturing.
Using a drug guide for reference, indicate which herpes infections are treated with the listed administration forms of acyclovir by placing a check in the correct cell. Each infection may be treated with more than one route of administration.
*Oral:* Chickenpox Initial genital herpes Herpes zoster *Topical:* Herpes labialis *Intravenous:* Herpes simplex encephalitis Initial genital herpes *Buccal:* Herpes labialis
Drag the mechanism of action to match the drugs listed.
*Polyenes: amphotericin B and nystatin* - Binds to sterols in cell membrane lining. *Imidazoles and triazoles: ketoconazole, fluconazole, itraconazole, voriconazole* - Inhibits fungal cell cytochrome P-450 enzymes, resulting in cell membrane leaking. *Echinocandins: caspofungin, micafungin, and anidulafungin* - Prevents the synthesis of glucans (essential components of fungal cell walls).
Drag and drop each drug to match its mechanism of action.
*Protein Wall Synthesis:* Streptomycin Rifabutin Rifampin *Cell Wall Synthesis Inhibitors:* Cycloserine Ethionamide Isoniazid (INH)
Match the mechanism of action on the left to the drug on the right.
*Simeprevir* - Inhibits viral replication; a direct-acting antiviral (DAA). *Oseltamivir* - Inhibits the enzyme neuraminidase, which may alter virus particle aggregation and release. *Acyclovir* - Interferes with viral deoxyribonucleic acid (DNA) synthesis.
Drag and drop each disease to classify whether it can or cannot be treated with antivirals.
*Treated by Antivirals:* Chickenpox Cold sores Hepatitis *Not Treated by Antivirals:* Pneumococcal pnemonia Syphilis Strep throat
Drag each descriptor into the correct box to differentiate between yeast and mold.
*Yeast:* Single-cell Reproduced by budding *Mold:* Multicellular Characterized by long, branching filaments
Many medications in the non-human immunodeficiency virus (HIV) antiviral class have names that end with the suffix __________.
-vir
Drag each drug name to the corresponding list of infections it is used to treat.
1. Itraconazole 2. Fluconazole 3. Voriconazole
Drag the medications to the classification in which each belongs.
1. Trifluridine 2. Ribavirin 3. Sofosbuvir 4. Zanamivir
A client should notice an improvement in tuberculosis (TB) symptoms how long after starting treatment?
2 weeks
Omar comes back for a follow-up appointment and the nurse looks at Omar's chart. Which viral loads would indicate the medication therapy is working? Select all that apply.
33 copies/mL 45 copies/mL
Treatment for tuberculosis may last a minimum duration of what time?
6 months
Prophylactic human immunodeficiency virus (HIV) treatment is recommended in which situations? Select all that apply.
A healthcare worker exposed to a needle stick injury from an HIV-positive client. Newborn infant born to an HIV-positive mother. HIV-positive pregnant women.
Linda has been on erythromycin for almost the entire course, but has called the nurse practitioner due to severe vaginal itching. Linda has also noticed a thick, whitish vaginal discharge. What would the nurse practitioner suspect?
A superinfection has developed.
Antiretroviral drugs are for __________ human immunodeficiency virus (HIV) infections. As the disease progresses, __________ increase and __________ decrease. Antiretroviral medications can __________ by decreasing the HIV load and improving CD4 cell counts.
Active HIV molecules CD4 cells Slow disease progression
When obtaining a medication history from a client diagnosed with genital herpes, which medication is the individual most likely to be taking?
Acyclovir
Which antiviral medication is used to treat the herpes virus?
Acyclovir
The nurse is reviewing the orders for a client who has been admitted for the treatment of pneumonia. The client is being started on doxycycline 500 mg every 12 hours for 10 days. The nurse notes that the client's allergy band says, "doxy." Asking what happened when the client took doxycycline in the past, the client states that they had an upset stomach. What is the nurse's first action at this time?
Administer the drug as ordered and include a small snack.
Ciprofloxacin is ordered for a client admitted with pyelonephritis. The allergy band says that the client is allergic to all cephalosporins. Which expected action will the nurse take next?
Administer the medication as prescribed.
During treatment with oseltamivir, a client should contact their healthcare provider if they experience which adverse effects? Select all that apply.
Agitation Hallucinations Seizures
Select the data that should be collected by the nurse prior to administering the first dose of a prescribed antiviral medication for a cold sore.
Allergies Energy level Nutritional Status Vital Signs
A client is taking nystatin in an oral troche form for oral candidiasis. Which instruction is correct?
Allow the troche to dissolve slowly in the mouth.
When giving simultaneously with ciprofloxacin, which medication is known to cause a prolonged QT interval?
Amiodarone
Of the drugs listed, which has the more severe and concerning side effects?
Amphotericin B
Antifungals may be administered via multiple routes, including systemically. Some of the most common systemic antifungals are __________ and __________. An example of a topical antifungal is __________.
Amphotericin B Fluconazole Nystatin
What is beta-lactamase?
An enzyme that destroys penicillin.
Griseofulvin is __________ medication used to treat __________ fungal infections.
An oral Systemic
"Great! Clients that are treated with __________ medications that you are going to be prescribed, often do not even make it through to the last stage. Progression is drastically __________ by taking your medications."
Antiretroviral Slowed
How does taking medication to treat a viral illness promote healing of the individual who is ill?
Antivirals reduce the number of viruses present to support the immune system.
Which laboratory tests should be monitored for a client taking a four-drug regimen to treat tuberculosis? Select all that apply.
Aspartate transaminase (AST) Alanine transaminase (ALT) Uric acid Creatinine
Before administering non-human immunodeficiency virus (HIV) antiviral medication, what nursing actions should be completed? Select all that apply.
Assess vital signs Verify known allergies Review current medication use Perform a physical assessment
When administering ointments to a client that is human immunodeficiency virus (HIV) positive, what precautions should the nurse take? Select all that apply.
Avoid exposure of medication on your skin or in your eyes. Wash hands before and after administration of the medication. Wear gloves.
What is the vaccine for tuberculosis (TB) disease called?
Bacille Calmette-Guérin
The nurse is reviewing the orders for a bacteriostatic antibiotic. Which statement best describes a bacteriostatic compound?
Bacteriostatic antibiotics prevent bacteria from multiplying.
Which antiviral medication indicated for the treatment of influenza is available as a single dose administered orally?
Baloxavir
A client calls the clinic wanting to know what they can take "because I was exposed to the flu over the weekend at a family reunion and I do not want to get sick." Which antiviral medication might be prescribed in this situation?
Baloxavir marboxil Oseltamivir Zanamivir
The nurse is preparing an infusion of amphotericin B for a client who has a severe fungal infection. Which intervention is appropriate regarding the potential adverse effects of amphotericin B?
Before beginning the infusion, administer an antipyretic and an antiemetic drug.
A client has started on ciprofloxacin for a complicated urinary tract infection. A quinolone antibiotic was selected for which reason?
Better penetration of the genitourinary tract
What is the action of fusion inhibitors?
Binds to the virus proteins Gp 120 or Gp 41 and prevents HIV from binding to and entering CD4 cells.
A client was started on cefepime, a 4th generation cephalosporin for urinary tract infection. Which advantage of the 4th generation cephalosporin makes it superior to the first generation for the client's diagnosis?
Broad spectrum activity
If a client has a penicillin allergy, what other antibiotic might they also react to?
Cephalosporins
Acetylation is a __________ that happens in the body to form protein, regulate deoxyribonucleic acid (DNA), and aid the __________ of certain drugs.
Chemical reaction Biotransformation
Complete the table by dragging and dropping the brand and half-life to the proper generic drug.
Ciprofloxacin - 4 hours Levofloxacin - 8 hours Moxifloxacin - 12 hours Gemifloxacin - 7 hours
An antibiotic is prescribed based on which factors? Select all that apply.
Client's symptoms Most likely causative bacteria Laboratory testing
What is the action of CCR5?
Coats and blocks the proteins from entering the cell.
The nurse notes in the client's medication history that the client with a new prescription for acyclovir is currently taking theophylline. Based on this finding, what is the best action for the nurse to take?
Contact the prescribing healthcare provider.
A client started an antibiotic for a skin infection 2 days ago. The prescription says to take cephalexin 500 mg every 6 hours for 10 days. The client's skin infection appears to be gone. Which action would be appropriate for the client to take?
Continue the antibiotic for the 7 days as instructed.
Which set of symptoms are most likely to be present in an individual with a tuberculosis (TB) infection?
Cough for longer than 3 weeks, anorexia, fever
Select the words and phrases that are cues to Liliana's illness. In October 2008, Liliana (pronouns: she/her/hers) was excitedly preparing for her wedding. Throughout that year, she and her fiancé worked very hard and went to the gym so they could look their best for the wedding. But shortly before her wedding date, Liliana started coughing. Not wanting to be sick for the big event, Liliana went to see a doctor and was told she had bronchitis. The doctor gave Liliana a shot of antibiotics and prescribed an inhaler. Liliana's symptoms went away and she quickly felt better. But in December, after her honeymoon, Liliana's cough came back even worse. Deciding it was time to see a specialist, she went to a pulmonologist who sent Liliana for a chest x-ray and prescribed an inhaler and antibiotics. Liliana says, "I was better for a while and never heard back from the doctor." In February, Liliana's cough returned. She scheduled another appointment with the same pulmonologist. "This time, when the nurse came in, she was wearing a mask," said Liliana. "I found out that the doctor had looked at my x-ray. They sent me to get blood work and sputum tests done. And that is when it all started."
Coughing Cough came back even worse Was better for a while Liliana's cough returned
Oral forms of acyclovir are most effective for herpes infections to __________ and __________.
Decrease pain Shorten healing time
The pharmacological action of antiretrovirals is __________ the viral load. A viral load of less than __________ is the goal of therapy.
Decreasing 50 copies/mL
What information is essential to communicate to a newly diagnosed client with human immunodeficiency virus (HIV) who is starting antiretroviral therapy? Select all that apply.
Do not donate blood. Consult your healthcare provider before taking additional medications or herbal supplements. Antiretroviral therapy does not cure HIV. Avoid sharing needles. Follow up frequently to determine progress and monitor side effects.
"Antiretroviral therapy __________ cure human immunodeficiency virus (HIV)." "Antiretroviral therapy __________ decrease disease progression." "__________ wear a condom during sex." "__________ avoid sharing needles." "__________ donate blood." "Antiretroviral therapy __________ eliminate the risk of transmission of HIV to others."
Does not Does Do Do Do not Does not
A client has a new prescription for oseltamivir and asks for advice on how to take this medication to decrease potential irritation of their peptic ulcer disease. What is the best response to the client's inquiry?
Drink a glass of milk when taking each dose.
Which priority assessments should be completed before administering antiviral medication? Select all that apply.
Drug-to-drug interactions Baseline vital signs Known allergies
When is the best time to collect a sputum specimen to test for acid-fast bacilli?
Early in the morning
The nurse is preparing to administer the aerosol form of ribavirin to an infant. The parents and grandparents are present in the room. What action will the nurse take to promote the safe use of this inhalant? Select all that apply.
Explain that the inhaled medication may be present in the air during treatment and ask that everyone wear a mask. The nurse will wear a mask while handling and administering the medication. Ask females of reproductive potential if they are pregnant or actively trying to conceive.
Which organs and body systems may be impacted by antitubercular treatment? Select all that apply.
Eye Liver Peripheral nervous system
What macronutrient is it important to consume when taking griseofulvin?
Fat
Of the medications listed, which two can be used to treat oral candidiasis?
Fluconazole Nystatin
If a client has a ciprofloxacin allergy, what antibiotic class might they react to?
Fluroquinolones
There are __________ types of fungal infections.
Four
A dose-limiting toxicity of __________ treatment is __________. Monitoring requires close review of the client's __________ results.
Ganciclovir Bone marrow suppression Complete blood cell count (CBC)
After surgery for organ transplantation, a client is receiving ganciclovir, even though they do not have a viral infection. Which statement best explains the rationale for this medication therapy?
Ganciclovir is given to prevent cytomegalovirus (CMV) infection.
A client is taking erythromycin 500 mg orally three times daily for 10 days. What does the nurse need to be concerned about while the client takes this drug? Select all that apply.
Gastrointestinal (GI) upset Vomiting Nausea
Ciprofloxacin was selected to treat a client's complicated urinary tract infection. This antibiotic was selected for which reasons? Select all that apply.
Good penetration of the genitourinary tract Broad spectrum activity
Fusion inhibitors bind to the virus proteins __________ and prevent human immunodeficiency virus (HIV) from binding to and entering __________. CCR5 antagonists __________ the proteins from entering the cell.
Gp120 or Gp41 CD4 cells Coat and block
Clients taking oseltamivir should be advised to report __________ or __________ to their healthcare provider immediately.
Hallucinations Confusion
Why is Charles susceptible to lung infections? Select all that apply.
He has chronic obstructive pulmonary disease (COPD), which makes him more susceptible to lung infections. He has a chronic condition that weakens the immune system. His age creates a weaker immune system.
Viruses reproduce in human cells, but selective killing is difficult. Consequently, many human cells that are __________, in addition to virally infected cells, may be killed in the process. This results in __________ serious toxicities for these drugs.
Healthy More
A new varicella vaccine, zoster vaccine live, has been approved to prevent the development of what condition in adults older than the age of 50 years?
Herpes zoster
Which client history finding is important before administering ciprofloxacin?
History of tendonitis
__________ treatment is recommended for HIV-positive pregnant women, newborn infants born to HIV-positive mothers, and healthcare workers who __________ an HIV-positive client.
Human immunodeficiency virus (HIV) prophylactic Received a needle stick injury from
Which instructions are important for human immunodeficiency virus (HIV)/acquired immune deficiency (AIDS) antiretroviral medication administration? Select all that apply.
If the client experiences trouble breathing, fever, or changes in oral mucosa (opportunistic infection), notify the prescriber immediately. Instruct the client to remain upright while administering the medication and for up to 30 minutes afterward to prevent esophageal ulceration. Administer at evenly spaced intervals around the clock to ensure steady-state levels.
A client has been given penicillin for strep throat. Which statement is true when educating the client about penicillin therapy?
If the client is taking an oral contraceptive, they must be cautioned to use an alternate form of birth control while being treated with penicillin.
A client was prescribed ciprofloxacin 500 mg every 12 hours for 3 days for a urinary tract infection. When should the client stop taking the antibiotic?
In three days
When a client with chronic obstructive pulmonary disease is taking theophylline and also receives ciprofloxacin, which interaction could occur?
Increased levels of theophylline
How do antiretroviral medications slow the progression of human immunodeficiency virus (HIV) to acquired immunodeficiency syndrome (AIDS)? Select all that apply.
Increasing CD4 cells Decreasing HIV molecules
Two days after starting oseltamivir, a client is admitted to the hospital with pneumonia. Based on knowledge of this medication and the pathophysiology of pneumonia, the health professional concludes that the client is experiencing a complication of which condition?
Influenza A
While admitting a client to the hospital with pneumonia, the health professional notes that the client began taking oseltamivir 2 days ago. Based on knowledge of this medication, the health professional concludes that the pneumonia is a complication of which condition?
Influenza A
A client was ordered cefazolin 100 mg diluted in 0.9% NaCL 100 mL to run over 60 minutes. They currently have one intravenous (IV) site with 0.9% NaCl with potassium chloride 20 mEq running at 100 mL/hr. Which nursing action is most appropriate in delivering this piggyback antibiotic? (Hint: Review your drug book about IV administration.)
Infuse the antibiotic through a Y site on the current intravenous line.
A client was prescribed ciprofloxacin for a complicated urinary tract infection. Fluroquinolones work by which of the following?
Inhibit DNA gyrase
What is oseltamivir's mechanism of action?
Inhibits the enzyme neuraminidase
The nurse is preparing to administer ciprofloxacin intravenously (IV) through a continuously infusing IV which contains magnesium sulfate. What action should the nurse take to administer the ciprofloxacin safely? (Hint: Refer to the drug reference guide.)
Insert a separate IV.
__________ inhibitors stop the enzyme from bringing viral DNA into the nucleus. __________ inhibitors prevent protease from binding to the viral polyprotein, which blocks it from maturing.
Integrase Protease
Before administering antifungal medication, which criteria should be considered? Select all that apply.
Interactions with herbal medications or compounds Interactions with other drugs Drug allergies
What is the mechanism of action of acyclovir?
Interferes with viral DNA replication
The medication regimen to treat active tuberculosis (TB) __________ the same regimen used to treat latent TB.
Is not
Which statements are true regarding proper medication use with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)? Select all that apply.
It decreases the overall viral load of HIV in the body. It reduces the risk of transmission from a mother to fetus. It reduces the occurrence of opportunistic infections.
Antiviral medications that treat hepatitis include __________ and __________.
Lamivudine Simeprevir
Isoniazid (INH) and rifampin have adverse effects that impact the __________ while ethambutol has adverse effects that impact the __________.
Liver Eyes
Antiretroviral medication adverse effects may include which undesirable changes in the body? Select all that apply.
Liver disease Insulin resistance Bone demineralization Redistribution of body fat
Which organ is infected when someone has an invasive aspergillosis infection?
Lungs
Which antibiotic class inhibits protein synthesis of the bacteria by binding to 50S ribosomal subunits in the bacteria?
Macrolides
A client is prescribed tetracycline. Which drink taken with the medication would reduce the absorption of tetracycline?
Milk
Why are labs monitored during various stages of human immunodeficiency virus (HIV) antiretroviral treatment?
Monitor viral load
Which type of tuberculosis is resistant to more than one anti-tuberculosis (TB) drug and at least isoniazid (INH) and rifampin (RIF)?
Multidrug-resistant tuberculosis
A client has been started on cephalexin for a skin infection. What are the most common side effects that the client may experience? Select all that apply.
Nausea Diarrhea Vomiting
An older adult taking oral acyclovir is encouraged to remain hydrated to decrease which adverse effect of the medication?
Nephrotoxicity
Select the symptoms that are more likely to be active tuberculosis (TB) as compared to other upper respiratory infections.
Night sweats Coughing up blood
A client with a complicated urinary tract infection has been taking ciprofloxacin for three days. The client continues to have an elevated temperature and dysuria on day 3. What should be the priority consideration for the nurse?
Notify the healthcare provider about the lack of improvement.
The nurse receives Gladys' culture and sensitivity results from the lab. She has been on ciprofloxacin for 2 days. Gladys states that her symptoms are unchanged. The report indicates the following: Amoxicillin = Susceptible Cefazolin = Susceptible Ceftriaxone = Susceptible Ciprofloxacin = Resistant Nitrofurantoin = Resistant Piperacillin/tazobactam = Susceptible In evaluating Gladys' response to the antibiotic, which action should the nurse take?
Notify the healthcare provider to request a change in the antibiotic.
George develops a cellulitis from a previous intravenous site he had during hospitalization. A second-generation cephalosporin is ordered for a new skin infection. A day after starting, the client develops a rash. Which nursing action is appropriate?
Notify the prescriber about the rash and a possible change in antibiotics.
Theo (pronouns: he/him/his) has recently been diagnosed with hepatitis C after being exposed to contaminated blood during his work as a medical researcher. When educating him about the prescribed ribavirin, what medication-specific instructions does the nurse include? Select all that apply.
Notify the prescribing healthcare provider if you experience difficulty breathing. Two forms of birth control should be used while taking this medication. Take the medication as prescribed to maintain a therapeutic level in the body. Do not share this medication with others.
__________ act as a decoy to nucleosides, which are missing a component that prevents them from attaching to another nucleoside. __________ gum up the reverse transcriptase enzyme, which inhibits reverse transcriptase from occurring.
Nucleoside reverse transcriptase inhibitors (NRTIs) Nonnucleoside reverse transcriptase inhibitors (NNRTIs)
Which medication is used to treat oral candidiasis?
Nystatin
Candidiasis is a/an __________ fungal infection caused by C. albicans and occurs in clients taking broad-spectrum antibiotics, antineoplastics, or immunosuppressants, as well as in __________ persons. When candidiasis occurs in the __________, it is commonly called thrush.
Opportunistic Immunocompromised Mouth
When providing health education at a senior center, the health professional will include information about which medication used to decrease the duration of influenza A and B?
Oseltamivir
A client presents to the urgent care with dysuria and insists that they have a urinary tract infection. The healthcare provider finds nothing to suggest this. During the discharge process, the client tells the nurse that they are not leaving without a prescription for an antibiotic. Which is true regarding antibiotic therapy?
Over-prescribing of antibiotics can lead to antibiotic resistance.
Gladys (pronouns: she/her/hers) is a 56-year-old female who presented to the clinic with symptoms of dysuria. A urinalysis revealed a urinary tract infection. Her urine was sent to the lab to obtain a culture and sensitivity, which should be available in about 4 days. The nurse is reviewing Gladys's current medication list for possible interactions using the drug interaction checker in preparation for discharge teaching on amoxicillin. Select all the findings that the nurse should be concerned about.
Penicillin Warfarin
When giving ciprofloxacin, which medications are known to interact with this medication? Select all that apply.
Phenytoin Fluoxetine Warfarin
Liliana's current medications include dicyclomine, phenytoin, an oral contraceptive, and occasional use of acetaminophen for aches and pains. Which of the medications require either further client teaching or alternative drug dosing due to drug-to-drug interactions with common antitubercular treatment? Select all that apply.
Phenytoin Oral contraceptive
During the client's previous infusion of amphotericin B, the client reported fever, chills, muscle pain, and nausea. What is the nurse's priority with this infusion of amphotericin B?
Premedicate per provider for expected side effects.
What are the contradictions to the administration of oral antifungal therapy? Select all that apply.
Previous hypersensitivity reactions Liver failure Kidney failure
For which new medication prescribed for a client taking acyclovir should the nurse seek clarification from the healthcare provider?
Probenecid
What is the goal of antiretroviral therapy for a client with human immunodeficiency virus (HIV)?
Prolong life by decreasing the viral load.
While assessing a client who is receiving levofloxacin for pneumonia, the nurse notices that the client has a history of heart problems. The nurse will monitor for which potential cardiac effect of fluroquinolone therapy?
Prolonged QT interval
A client has an automatic internal cardiac defibrillator (AICD) and is taking amiodarone for dysrhythmias. When the client starts on ciprofloxacin, which abnormality puts them at higher risk for life-threatening arrhythmia?
Prolonged QT syndrome
A client is scheduled for a dental cleaning tomorrow and has been diagnosed with a heart murmur in the past. The client's cardiologist prescribed azithromycin 500 mg orally x 1 dose about 1 hour before the cleaning. Why is the client being prescribed this antibiotic?
Prophylactic treatment
A client has been tired, aching, and feverish with a sore throat and cough for the past 18 hours. The client called the healthcare provider's office for an appointment, but none are available. Based on the symptoms, the provider is concerned that the client may have the flu and recommends going to a nearby urgent care center today. Why should the client be seen as soon as possible in urgent care? Select all that apply.
Quick treatment will decrease the chance of the client spreading the virus to the family. Treatment for influenza illness should be started as quickly as possible from the onset of symptoms. Urgent care will provide a definitive diagnosis of the flu.
The simple structure of a __________ based viral genome allows for __________ during replication that leads to viral __________ and makes the virus __________ to treat with medications.
RNA Instability Mutation More difficult
Needle stick injuries can happen to healthcare workers. Risk is __________, when proper precautions are followed. Prophylactic treatment __________ to healthcare workers exposed to a needle stick injury from a human immunodeficiency virus (HIV) positive client.
Rare Is available
A client started an antibiotic yesterday. Which assessment finding indicates an immediate need to stop the antibiotic?
Rash
Complete the dosing information for oseltamivir by dragging the missing values to the correct cell.
Reason: Treatment of influenza Frequency: 2 times per day Duration: 5 days Reason: Prevention of influenza Frequency: 1 time per day Duration: At least 10 days
Antivirals can significantly __________, thereby reducing human immunodeficiency virus (HIV) symptoms and complications and prolonging the individual's life.
Reduce the viral load
Of the available non-human immunodeficiency virus (non-HIV) antiviral medications, which is effective across the broadest spectrum of viruses?
Ribavirin
__________ may be present in the body for 6 months after exposure. At least __________ of reliable contraception must be used beginning with the first dose until __________ months after treatment ends.
Ribavirin Two types 6
A woman of child-bearing age is diagnosed with an active tuberculosis (TB) infection. Which medication, if prescribed, might interfere with her oral contraceptives?
Rifampin
Complete the pharmacokinetic information for ribavirin by dragging the missing information to the correct place on the table.
Route: Inhalation Onset: Unknown Peak: End of inhalation Half-life: 1.4-2.5 hours Duration: Variable Route: PO Onset: Unknown Peak: 2-3 hours Half-life: 120-170 hours Duration: Unknown
Complete the acyclovir dosing information by dragging the missing values to the correct cells.
Route: Intravenous (IV) Dose: 5-10 mg/kg Duration: 7-10 days Route: Orally (PO) Dose: 200-800 mg Duration: 7-10 days
Use the drop-down menus to fill in the missing information related to dosing of sofosbuvir.
Route: Oral Dose: 400mg Frequency: Once daily Considerations: Take with or without food
Complete the acyclovir pharmacokinetics table by dragging the missing values to the correct cells.
Route: Orally (PO) Half-life: 2-3 hours Duration: 10-15 hours Route: Intravenous (IV) Half-life: 3 hours Duration: 8 hours
Complete the table by dragging the missing values to the correct cell.
Route: PO Onset: Unknown Peak: 1-2 hr Half-life: 1-3 hr Duration: 5-15 hr
A client is taking oseltamivir for influenza infection. The nurse instructs the individual to seek emergency medication assistance for which known adverse reaction?
Seizures
During therapy with amphotericin B, the nurse will monitor the client for known adverse effects that would be reflected by which laboratory result?
Serum potassium level of 2.7 mEq/L
Which condition presents a contraindication to the use of acyclovir?
Severe allergic reaction to acyclovir
When educating a person starting medication to treat tuberculosis (TB), which activities or actions are safe? Select all that apply.
Sharing a TV remote Touching bed linens or toilet seats Sharing food or drink Shaking someone's hand
When educating a person starting medication to treat tuberculosis (TB), which activities or actions are safe? Select all that apply.
Sharing toothbrushes Kissing Shaking someone's hand Touch bed linens or toilet seats Sharing food or drink
What teaching is important to provide for Liliana at this time? Select all that apply.
She should be warned not to consume alcohol while taking antitubercular drugs as this may cause liver toxicity. She needs to take her medication as ordered. She should be encouraged to take care of herself by ensuring adequate nutrition, rest, and relaxation. Compliance with therapy is essential for achieving a cure.
What are the goals of antivirals or antiretrovirals related to human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)? Select all that apply.
Slow advancement of HIV to AIDS Prolong life by decreasing the viral load Relieve the symptoms
A 35-year-old pregnant client just received lab results stating they are positive for human immunodeficiency virus (HIV). What is the most important intervention at this time?
Starting prophylactic antiretroviral treatment.
How do antibiotics treat infection? Select all that apply.
Stop bacteria from producing proteins Stop bacterial cell wall creation Disrupt cell metabolism
What is the action of integrase inhibitors?
Stop the enzyme from bringing viral DNA into the nucleus..
Select the words or phrases that indicate the individual speaking may be taking their prescribed influenza medication incorrectly. Three days after beginning oseltamivir to treat influenza symptoms, Narottam (pronouns: he/him/his) is feeling better and his 7-year-old daughter has a fever, body aches, and fatigue. He is not able to make an appointment with his daughter's pediatrician until 2 days from now. Understanding that early treatment helps shorten influenza infection, he stops taking his oseltamivir and gives it to his daughter. Narottam's daughter is feeling better by the time she sees her pediatrician.
Stops taking his oseltamivir Gives it to his daughter
Which are the main teaching points to focus on for children like 4-year-old Jessica? Select all that apply.
Store at room temperature away from moisture, heat, and light. Shake the oral suspension (liquid) before measuring a dose. Use the dosing syringe provided or use a medicine dose-measuring device (not a kitchen spoon). Griseofulvin could make sunburning easier. Avoid sunlight. Wear protective clothing and use sunscreen (SPF 30 or higher) when outdoors. Use this medicine for the full prescribed length of time, even if symptoms quickly improve. Skipping doses can increase the risk of infection that is resistant to medication.
Which of the infection types can be fungal? Select all that apply.
Subcutaneous Cutaneous Superficial Systemic
A client is prescribed a cephalosporin antibiotic for a complex infection. After being on the antibiotic for a month, the client experiences white oral plaques and a sore throat. What is the likely cause?
Superinfection
A client has been experiencing severe diarrhea for the last 2 weeks after completing a four-week course of antibiotics. The diarrhea is best described as what?
Superinfection related to antibiotic use
What is the most important thing a person can do to prevent the spread of multidrug-resistant tuberculosis (MDR TB)?
Take all medications exactly as prescribed by the healthcare provider.
When an antibiotic is bacteriostatic, it means what?
The antibiotic reduces the replication of the bacteria.
Which statement accurately describes a broad spectrum antibiotic?
The antibiotic treats a wide variety of bacteria.
A client has a seizure disorder that is well controlled with phenytoin. They were recently prescribed ciprofloxacin for a urinary tract infection. What might the nurse expect when these two drugs are given together? Select all that apply.
The client could become toxic from phenytoin due to increased blood levels. The client may be at higher risk of seizures.
After identifying that Gladys is allergic to amoxicillin, the primary healthcare provider gave Gladys a prescription for ciprofloxacin 500 mg twice daily for 5 days. The nurse reviews Gladys' history in preparation for discharge teaching. Which information would require further analysis and possible nursing action?
The client has a history of Achilles tendonitis and still has problems with it.
The provider has prescribed amoxicillin 875 mg one tablet twice daily for strep throat. Which information would require further analysis?
The client has an allergy to penicillin.
A client is started on ciprofloxacin for symptoms of a urinary tract infection. They were seen by a telemedicine provider and urine was not collected. Which statement is accurate about the client's treatment?
The client is being treated empirically with the antibiotic.
A client taking isoniazid (INH) for the last 2 weeks is reporting numbness and tingling in their fingers for the last 24-48 hours. What is the most likely cause for these symptoms?
The client is most likely of the phenotype that metabolizes drugs slowly, such as INH, resulting in toxicity.
Linda was prescribed erythromycin for a urinary tract infection. During client education regarding this oral macrolide, the nurse will include which information? Select all that apply.
The client may take the drug with a small snack to reduce gastrointestinal (GI) irritation. Use another form of birth control if the client is taking oral contraceptives.
George is discharged from the hospital and is prescribed tetracycline 500 mg four times daily for continued treatment of his pneumonia. When the nurse teaches George about drug-related precautions, which is the most important information to convey?
The client needs to use sunscreen or avoid exposure to sunlight.
Six weeks after beginning antitubercular drug therapy on an outpatient basis, the client reports that they still experience night sweats. What does the nurse identify as the main concern at this time?
The client's infection may be resistant to the drug therapy ordered.
A client with a history of liver failure will be given a dose of cefazolin prior to abdominal surgery. Based on knowledge of the metabolism of this antibiotic, which statement is accurate?
The dosage can remain the same because it is primarily metabolized by the kidney.
Four weeks after beginning antitubercular drug therapy on an outpatient basis, the client reports that they still experience hemoptysis (bloody sputum with cough). What does the healthcare professional identify as the main concern at this time?
The infection may be resistant to the drug therapy ordered.
The nurse is administering one of the lipid formulations of amphotericin B. Why is the use of the lipid formulation preferred?
The lipid formulations are associated with fewer adverse effects than the older drugs.
What causes penicillin resistance?
The production of beta-lactamase by the bacterial cell.
When tuberculosis (TB) skin testing is performed, which is measured for a positive result?
The raised area
A client has been taking antitubercular medications for an active infection for the last 4 months. What findings indicate a therapeutic response?
There is a decrease in symptoms of tuberculosis along with improved chest x-ray and sputum cultures.
When giving cephalosporin medications, which statement is accurate?
They are primarily metabolized through the kidney, so dosage reductions may be needed in renal insufficiency.
Who is at risk of getting multidrug-resistant tuberculosis (MDR TB)? Select all that apply.
They do not take their TB medicine regularly. They have spent time with someone known to have drug-resistant TB disease. They come from areas of the world where drug-resistant TB is common.
A client has a positive tuberculosis (TB) skin test and a negative chest x-ray for tuberculosis. How could this happen?
They either had the infection previously or had a vaccine for tuberculosis.
In reviewing the advantages of a 4th generation cephalosporin, which statements are accurate? Select that all apply.
They have a broader spectrum. They have better penetration of gram-negative bacterial cell walls.
How do non-human immunodeficiency virus (non-HIV) antiviral medications kill or suppress viruses? Select all that apply.
They prevent viral nucleic acid synthesis by blocking polymerase. They block the virus from getting into the host cell.
Since starting amoxicillin, a client has been experiencing blurred vision. Which statement is accurate regarding the client's condition?
This is probably not related to amoxicillin. The client should continue taking the drug and notify their provider.
A nursing student is speaking to their nurse about medication used to treat a non-human immunodeficiency virus (non-HIV). Which statement indicates an understanding of how non-HIV antiviral medications kill or suppress a virus?
This medication blocks the virus from entering the host cell.
An individual with isoniazid (INH) toxicity may present with which symptoms? Select all that apply.
Tingling Numbness Burning sensation in extremities
George is admitted to the hospital with pneumonia. His white blood cell (WBC) count is elevated, he has a fever of 101.5 °F (38.6 °C), and he is short of breath. The provider immediately orders a sputum culture and sensitivity to determine which bacteria might be causing the pneumonia. The results will not be back for 3 days. Levofloxacin 750 mg orally is ordered to start now. Which is the correct rationale for this antibiotic order that the nurse should know?
To provide empiric therapy
Which antifungals are the most commonly used or prescribed?
Topical
A client was prescribed ciprofloxacin for a urinary tract infection. They are currently taking a nonsteroidal anti-inflammatory drug, a tricyclic antidepressant, an antianxiety drug, and a probiotic. When giving intravenous quinolones, which class of drugs may have serious interactions with ciprofloxacin?
Tricyclic antidepressant
When assessing a client for a possible penicillin allergy, which symptoms would be consistent with a hypersensitivity reaction? Select all that apply.
Urticaria Shortness of breath Wheezing Rash
A female who is diabetic, pregnant, and just finished a long round of antibiotics is at high risk for what subsequent infection?
Vaginal candidiasis
What is the priority action before starting antibiotic therapy?
Verify that the client does not have an allergy to an antibiotic.
__________ are more challenging to treat than __________ because replication occurs __________ the host cells, so medications must __________.
Viruses Bacteria Inside Enter the cell
The nurse administering influenza vaccines is asked why a flu shot is needed every year. What information will the nurse include when responding?
Viruses mutate, so each year the vaccine is for the new virus.
Why are viral infections and viruses more difficult to eradicate than bacteria?
Viruses replicate only inside host cells and medications must enter the cell to be effective.
A client is receiving isoniazid (INH) for the treatment of tuberculosis (TB) and has been taking vitamin B12 after hearing from a friend that it would help prevent complications. The healthcare provider's best response is to tell the client to change vitamin B12 for which vitamin?
Vitamin B6
What are the common side effects of penicillin? Select all that apply.
Vomiting Nausea Diarrhea
A client was prescribed cefalexin for a skin infection. When should the client stop taking the antibiotics?
When it says to on the prescription
__________ are single-cell fungi that may be harmful (e.g., causing infections) or helpful (e.g., aiding in baking or brewing beer). __________ are multicellular and are characterized by long, branching filaments called hyphae.
Yeasts Molds
