Exam 3 Quiz Qs
A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates -"Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased." -"Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." -"Cephalosporins reduce bacterial resistance to aminoglycosides." -"Cephalosporins prevent neuromuscular blockade associated with aminoglycosides."
-"Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."
A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? -"Cephalosporins are assigned to generations based on their relative costs to administer." -"First-generation cephalosporins have better penetration of the cerebrospinal fluid." -"Later generations of cephalosporins have lower resistance to destruction by beta-lactamases." -"Cephalosporins have increased activity against gram-negative bacteria with each generation."
-"Cephalosporins have increased activity against gram-negative bacteria with each generation."
A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? -"I should not take this medication with milk or other dairy products." -"I should take this antibiotic with a calcium supplement to improve absorption." -"I should not worry if I experience an acnelike rash with this medication." -"I should take an antacid, such as Tums, if I experience gastrointestinal distress."
-"I should not take this medication with milk or other dairy products."
Which of the following drugs acts in the small intestine to delay carbohydrate absorption? -Acarbose -Sulfonylureas -Rapaglinide -Rosiglitazone
-Acarbose
A patient is diagnosed with an infection caused by Staphylococcus aureus, and the prescriber orders intravenous gentamicin and penicillin (PCN). Both drugs will be given twice daily. What will the nurse do? -Request an order to change the penicillin to vancomycin -Give the gentamicin intravenously and the penicillin intramuscularly. -Administer gentamicin, flush the line, and then give the penicillin. -Infuse the gentamicin and the penicillin together to prevent fluid overload.
-Administer gentamicin, flush the line, and then give the penicillin.
Proton pump inhibitors: -All of the above -Can increase the risk of intestinal infection with Clostridium difficile -Can be used to treat GERD as well as gastric and duodenal ulcers -Are the most effective drug to reduce gastric acid production
-All of the above
The nurse is preparing to administer 30 units of NPH to client. He finds that the vial of insulin looks cloudy and uneven in appearance. Which of the following is the appropriate action? -Give the client 10 units of regular insulin -Hold the dose and alert the prescriber -Discard the vial of NPH and open a new one -Shake the vial of NPH thoroughly then administer the dose
-Shake the vial of NPH thoroughly then administer the dose
Cimetidine -Is a Histamine H1 receptor blocker -Enhances gastric acid production -Can help eradicate H. Pylori -Should be taken at least 1 hour before or after oral antacids
-Should be taken at least 1 hour before or after oral antacids
Which of the following levels of infection control requires providers to wash hands before all procedures and after direct contact with patients, wear gloves when in contact with non-intact skin, and wear a mask during any procedure that is likely to generate aerosolized secretions? -Standard precautions -airborne precautions -contact precautions -droplet precautions
-Standard precautions
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 etiology of the thrush? -Nosocomial infection -Superinfection -Antibiotic resistance -Community Acquired infection
-Superinfection
Which of the following drugs is associated with the lowest incidence of resistance in the treatment of H. Pylori? -Clarithromycin -Metronidazole -Tetracycline -Amoxicillin
-Tetracycline
A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? -Withhold the dose and request an order for an antihistamine to treat the rash. -Request an order for intravenous TMP/SMZ, because the patient is getting worse. -Withhold the dose and notify the provider of the symptoms. -Administer the dose and request an order for an antipyretic medication.
-Withhold the dose and notify the provider of the symptoms.
A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: -restrict dairy products. -switch to gemifloxacin -increase the dose of ciprofloxacin. -add metronidazole [Flagyl].
-add metronidazole [Flagyl].
The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? -Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. -Ensure the client is wearing a medical alert bracelet. -Make sure the client easts the food on the meal tray that is at the bedside. -Administer the dose according to the regular insulin sliding scale.
-Make sure the client easts the food on the meal tray that is at the bedside.
Which of the following anti-diabetic drugs is used to treat Polycyctic Ovarian Disease (PCOS)? -Metformin -Rapaglinide -Miglitol -Glyburide
-Metformin
A patient shows signs and symptoms of conjunctivitis (bacterial pink eye). Which aminoglycoside would the nurse expect to be ordered? -Amikacin [Amikin] -Neomycin [Neomycin] -Kanamycin [Kantrex] -Paromomycin [Humatin]
-Neomycin [Neomycin]
A patient develops CDAD. Which antibiotic is recommended for treating this infection? -Vancomycin -Chloramphenicol -Clindamycin [Cleocin] -Linezolid [Zyvox]
-Vancomycin
A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do? -Question the patient about the consumption of milk and any other dairy products. -Instruct the patient to exercise the right foot and ankle to minimize the pain. -Request an order to increase this patient's dose of glucocorticoids. -Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.
-Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.
A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: -amoxicillin―clavulanic acid [Augmentin]. -ampicillin. -penicillin G -nafcillin..
-amoxicillin―clavulanic acid [Augmentin].
A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: -liver disease -renal disease -inter-patient variability -antibiotic resistance
-renal disease
The insulin produced endogenously by the pancreas has what length duration of action? -up to 10 hours -up to 24 hours -1-3 hours -3-5 hours
-up to 10 hours
A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? -"Tetracycline may cause allergic reactions in pregnant women." -"Tetracycline can be harmful to the baby's teeth and should be avoided." -"Tetracycline is safe to take during pregnancy." -"Tetracycline will prevent asymptomatic urinary tract infections."
-"Tetracycline can be harmful to the baby's teeth and should be avoided."
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? -"The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." -"The bacteria have developed a three-layer cell envelope." -"Amoxicillin is too narrow in spectrum." -"The bacteria have synthesized penicillinase."
-"The bacteria have synthesized penicillinase."
Which of the following is a benefit of using a combination of two or more antibiotics? -Reduced toxicity -Reduced risk of severe infection -Reduced resistance -All of these are benefits
-All of these are benefits
Which statement about Regular insulin is correct? -peaks at 6-12 hours -Can be used IV -Is a cloudy solution -It's slow acting
-Can be used IV
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? -Request an order for a skin test to evaluate possible PCN allergy. -Contact the provider and prepare to administer epinephrine. -Withhold the next dose until symptoms subside. -Notify the provider if the patient develops a rash.
-Contact the provider and prepare to administer epinephrine.
A major adverse effect of insulin that can be life-threatening is: -Hypoglycemia -Hypotension -Hyperglycemia -Hypertension
-Hypoglycemia
Which of the following will not promote the development of a peptic ulcer? -Chronic inflammation -Increased stomach acid production -Increased mucous production -Infection with H. Pylori
-Increased mucous production
Which of the following insulins can be given once daily to provide glucose control for 24 hours? -Regular Insulin -Insulin aspart -Insulin glargine -Insulin lispro
-Insulin glargine
Misoprostol -Is used to prevent gastric ulcers in patients on long-term NSAID therapy -All of the above -Can cause constipation and abdominal pain -Can be used safely in pregnancy
-Is used to prevent gastric ulcers in patients on long-term NSAID therapy
Why should tetracycline be avoided in young children? -It is less effective in children -It reduces kidney function in children -It can stain teeth that are developing -It can be ototoxic in children
-It can stain teeth that are developing
Antacids should be used with caution in what which patient population? -Elderly patients -Patients with liver impairment -Patients with renal impairment -Patients with a history of asthma
-Patients with renal impairment
When people wear face masks in public to reduce the spread of COVID 19 which link in the chain of infection transmission is being interrupted? -Reservoir -Port of Entry -Port of Exit AND Port of Entry -Susceptibility of victim
-Port of Exit AND Port of Entry
Which of the following is not a non-drug treatment option for peptic ulcer disease? -Avoid taking Aspirin or other NSAIDS -Limit alcohol -Smoking cessation -Reduce number of daily meals to 2-3
-Reduce number of daily meals to 2-3
Which of the following insulins is available in both 100units/ml and 500units/ml concentrations? -NPH Insulin -Insulin glargine -Insulin lispro -Regular insulin
-Regular insulin
A nurse is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What will the nurse do? -Suggest adding a penicillin to the patient's drug regimen. -Request an order for a different class of antibiotic. -Contact the provider to discuss an increased risk of aminoglycoside toxicity. -Continue giving the aminoglycoside as ordered.
-Request an order for a different class of antibiotic.
A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? -The provider may increase the clindamycin dose to treat this infection. -The patient should stop taking the clindamycin now and contact the provider immediately. -This is a known side effect of clindamycin, and the patient should consume extra fluids. -The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms.
-The patient should stop taking the clindamycin now and contact the provider immediately.
Why are multiple antibiotics used in combination in the treatment of peptic ulcer disease? -To minimize GI upset -All of the above -To enhance the growth of beneficial bacteria -To reduce the risk of the development of drug resistance
-To reduce the risk of the development of drug resistance By combining 2 or more antibiotics in the treatment of peptic ulcer disease, it is likely that there will be less antibiotic resistance, which will then make the treatment more effective
Why are antibiotics used to treat peptic ulcer disease? -To improve blood flow to the GI tract -To enhance inflammatory defense mechanisms -To increase gastric mucous production -To treat H. Pylori infection
-To treat H. Pylori infection
A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to: -obtain a gentamicin trough before the next dose is given -give an analgesic to control headache discomfort. -discontinue the gentamicin. -obtain renal function tests to evaluate for potential nephrotoxicity.
-discontinue the gentamicin.
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: -inhibit host cell wall function -disrupt bacterial cell wall synthesis -disinhibit transpeptidases -inhibit autolysins.
-disrupt bacterial cell wall synthesis
The vast majority of antibiotic use in the United States is being used... -on crops -to treat disease for household pets -to treat human disease -for agricultural use on livestock
-for agricultural use on livestock
A nurse is preparing to administer a dose of gentamicin to a patient who is receiving the drug 3 times daily. The nurse will monitor ____ levels. -serum levels -peak and trough -trough -peak
-peak and trough
A patient who is taking doxycycline for a serious infection contacts the nurse to report anal itching. The nurse will contact the provider to discuss: -testing the patient for a C. difficile secondary infection. -prescribing an antifungal drug to treat a superinfection. -adding an antihistamine to the patient's drug regimen. -ordering liver function tests to test for hepatotoxicity.
-prescribing an antifungal drug to treat a superinfection.
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: -Rhabdomyolosis -allergic reaction -red man syndrome. -Stevens-Johnson Syndrome
-red man syndrome.