Final exam study session
A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client? 1. Pregnancy should be avoided while taking phenytoin (Dilantin). 2. The client may stop taking the phenytoin (Dilantin) if it is causing severe gastrointestinal effects. 3. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). 4. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and birth control pills together.
3. The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin).
In the administration of a drug such as levothyroxine (Synthroid), the nurse should teach the client: A) That therapy typically lasts about 6 months. B) That weekly laboratory tests for T4 levels will be required. C) To report weight loss, anxiety, insomnia, and palpitations. D) That the drug may be taken every other day if diarrhea occurs.
C) To report weight loss, anxiety, insomnia, and palpitations.
Which assessment findings indicate hyperthyroidism? (SATA) a. Weight loss with increased appetite b. Constipation c. Increased heart rate d. Insomnia e. Decreased libido f. Heat intolerance
a c d f
A physician prescribes levothyroxine sodium (Synthroid), 0.15 mg orally daily, for a client with hypothyroidism. The nurse will prepare to administer this medication: a) in the morning to prevent insomnia b) only when the client complains of fatigue and cold intolerance c) at various times during the day to prevent tolerance from occurring d) three times daily in equal doses of 0.5 mg each to ensure consistent serum drug levels
a) in the morning to prevent insomnia
A patient has a Pseudomonas aeruginosa infection that is sensitive to aminoglycosides, and the prescriber orders gentamicin. The patient tells the nurse that a friend received amikacin [Amikin] for a similar infection and wonders why amikacin was not ordered. What will the nurse tell the patient? a. "Amikacin is given when infectious agents are resistant to other aminoglycosides." b. "Amikacin is more vulnerable to inactivation by bacterial enzymes." c. "Amikacin is a narrow-spectrum drug and will probably not work for this infection." d. "Gentamicin is less toxic to the ears and the kidneys."
a. "Amikacin is given when infectious agents are resistant to other aminoglycosides."
A patient has a Pseudomonas aeruginosa infection that is sensitive to aminoglycosides, and the prescriber orders gentamicin. The patient tells the nurse that a friend received amikacin [Amikin] for a similar infection and wonders why amikacin was not ordered. What will the nurse tell the patient? a. "Amikacin is given when infectious agents are resistant to other aminoglycosides." b. "Amikacin is more vulnerable to inactivation by bacterial enzymes." c. "Amikacin is a narrow-spectrum drug and will probably not work for this infection." d. "Gentamicin is less toxic to the ears and the kidneys."
a. "Amikacin is given when infectious agents are resistant to other aminoglycosides."
A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? a. "I should not take this medication with milk or other dairy products." b. "I should not worry if I experience an acnelike rash with this medication." c. "I should take an antacid, such as Tums, if I experience gastrointestinal distress." d. "I should take this antibiotic with a calcium supplement to improve absorption."
a. "I should not take this medication with milk or other dairy products."
he nurse has given medication instructions to a patient receiving phenytoin (Dilantin). Whichstatement by the patient indicates that the patient has an adequate understanding of theinstructions? a. "I will need to take extra care of my teeth and gums while on this medication." b. "I can go out for a beer while on this medication." c. "I can skip doses if the side effects bother me." d. "I will be able to stop taking this drug once the seizures stop.
a. "I will need to take extra care of my teeth and gums while on this medication
The nurse notes in the patient's medication history that the patient is taking cyclobenzaprine(Flexeril). Based on this finding, the nurse interprets that the patient has which disorder? a. A musculoskeletal injury b. Insomnia c. Epilepsy d. Agitation
a. A musculoskeletal injury
A patient begins using timolol [Timoptic] to treat primary open-angle glaucoma (POAG). The nurse gives a dose and notes that the patient develops shortness of breath. The nurse assesses the patient and auscultates wheezes in both lungs. The nurse will ask this patient about a history of which condition? a. Asthma b. Atrioventricular heart block c. Pulmonary hypertension d. Sinus bradycardia
a. Asthma
Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? a. Diarrhea b. Headache c. Nausea d. Vomiting
a. Diarrhea
A patient is experiencing status epilepticus. The nurse prepares to give which drug of choice forthe treatment of this condition? a. Diazepam (Valium) b. Midazolam (Versed) c. Valproic acid (Depakote) d. Carbamazepine (Tegretol)
a. Diazepam (Valium)
A patient is taking gabapentin (Neurontin), and the nurse notes that there is no history of seizures on his medical record. What is the best possible rationale for this medication order? a. The medication is used for the treatment of neuropathic pain .b. The medication is helpful for the treatment of multiple sclerosis. c. The medication is used to reduce the symptoms of Parkinson's disease. d. The medical record is missing the correct information about the patient's history of seizures
a. The medication is used for the treatment of neuropathic pain
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]
During drug therapy for pneumonia, a female patient develops a vaginal superinfection. Thenurse explains that this infection is caused by: a. large doses of antibiotics that kill normal flora. b. the infection spreading from her lungs to the new site of infection. c. resistance of the pneumonia-causing bacteria to the drugs. d. an allergic reaction to the antibiotics.
a. large doses of antibiotics that kill normal flora.
A patient shows loss of consciousness, jaw clenching, contraction and relaxation of muscle groups, and periods of cyanosis. The nurse correctly identifies this as which type of seizure? a.Tonic-clonic b.Petit mal c.Myoclonic d.Atonic
a.Tonic-clonic
Tetracycline (doxycycline) is the medication of choice for patient with ___ after the patient has tried regular traditional over the counter solutions for the managment of acne
acne vulgaris
A patient has prescriptions for two inhalers. One inhaler is a bronchodilator, and the other is acorticosteroid. Which instruction regarding these inhalers will the nurse give to the patient? a. "Take the corticosteroid inhaler first." b. "Take the bronchodilator inhaler first." c. "Take these two drugs at least 2 hours apart." d. "It does not matter which inhaler you use first.
b. "Take the bronchodilator inhaler first."
A patient is in an urgent care center with an acute asthma attack. The nurse expects that whichmedication will be used for initial treatment? a. An anticholinergic such as ipratropium (Atrovent) b. A short-acting beta2 agonist such as albuterol (Proventil) c. A long-acting beta2 agonist such as salmeterol (Serevent) d. A corticosteroid such as fluticasone (Flovent)
b. A short-acting beta2 agonist such as albuterol (Proventil)
A patient who has been taking antihypertensive drugs for a few months complains of having apersistent dry cough. The nurse knows that this cough is an adverse effect of which class ofantihypertensive drugs? a. Beta blockers b. Angiotensin-converting enzyme (ACE) inhibitors c. Angiotensin II receptor blockers (ARBs) d. Calcium channel blockers
b. Angiotensin-converting enzyme (ACE) inhibitors
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 with a history of congestive heart failure and renal impairment has esophageal candidiasis. Which antifungal agent would the nurse anticipate giving to this patient? a. Amphotericin B [Abelcet] b. Fluconazole [Diflucan] c. Itraconazole [Sporanox] d. Voriconazole [Vfend]
b. Fluconazole [Diflucan]
After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office fora follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months? a. Hemoglobin levels b. Hemoglobin A1C level c. Fingerstick fasting blood glucose level d. Serum insulin levels
b. Hemoglobin A1C level
The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg.The nurse will contact the provider to request an order for which drug? a. Angiotensin-converting enzyme (ACE) inhibitor b. Hydralazine (Apresoline) c. Magnesium sulfate d. Sodium nitroprusside
b. Hydralazine (Apresoline)
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
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 recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilationby stimulating which type of receptors? a. Dopaminergic b. Beta1 adrenergic c. Beta2 adrenergic d. Alpha1 adrenergic
c. Beta2 adrenergic
The nurse is reviewing drug therapy for hypertension. According to the JNC-8 guidelines,antihypertensive drug therapy for a newly diagnosed hypertensive African-American patientwould most likely include which drug or drug classes? a. Vasodilators alone b. ACE inhibitors alone c. Calcium channel blockers with thiazide diuretics d. Beta blockers with thiazide diuretics
c. Calcium channel blockers with thiazide diuretics
When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics? a. Tetracyclines b. Sulfonamides c. Cephalosporins d. Quinolones
c. Cephalosporins
The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection.Which laboratory value would indicate therapeutic effectiveness of this therapy? a. Increased red blood cell count b. Increased hemoglobin level c. Decreased white blood cell count d. Decreased platelet count
c. Decreased white blood cell count
A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the nurse will expect to administer which antibiotic? a. Clindamycin [Cleocin] b. Doxycycline [Vibramycin] c. Erythromycin ethylsuccinate d. Penicillin G
c. Erythromycin ethylsuccinate
A patient is taking gentamicin [Garamycin] and furosemide [Lasix]. The nurse should counsel this patient to report which symptom? a. Frequent nocturia b. Headaches c. Ringing in the ears d. Urinary retention
c. Ringing in the ears
When a patient is on aminoglycoside therapy, the nurse will monitor the patient for whichindicators of potential toxicity? a. Fever b. White blood cell count of 8000 cells/mm3 c. Tinnitus and dizziness d. Decreased blood urea nitrogen (BUN) levels
c. Tinnitus and dizziness
A patient has been taking haloperidol (Haldol) for 3 months for a psychotic disorder, and the nurse is concerned about the development of extrapyramidal symptoms. The nurse will monitor the patient closely for which effects? a. Increased paranoia b. Drowsiness and dizziness c. Tremors and muscle twitching d. Dry mouth and constipation
c. Tremors and muscle twitching
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 [Monurol] d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection.The nurse will monitor for which adverse effect that is associated with these drugs? a. Neuralgia b. Double vision c. Hypotension d. Tendonitis and tendon rupture
d. Tendonitis and tendon rupture
A patient has been taking antitubercular therapy for 3 months. The nurse will assess for whatfindings that indicate a therapeutic response to the drug therapy? a. The chronic cough is gone. b. There are two consecutive negative purified protein derivative (PPD) results over 2months. c. There is increased tolerance to the medication therapy, and there are fewer reportsof adverse effects. d. There is a decrease in symptoms of tuberculosis along with improved chest x-raysand sputum cultures.
d. There is a decrease in symptoms of tuberculosis along with improved chest x-raysand sputum cultures.
After undergoing a subtotal thyroidectomy, a female client develops hypothyroidism. Dr. Smith prescribes levothyroxine (Levothroid), 25 mcg P.O. daily. For which condition is levothyroxine the preferred agent? A. Primary hypothyroidism B. Graves' disease C. Thyrotoxicosis D. Euthyroidism
A. Primary hypothyroidism
The nurse reviews a patient's glycosylated hemoglobin (Hb A1C) results to evaluate A. Fasting preprandial glucose levels. B. Glucose levels 2 hours after a meal. C. Glucose control over the past 90 days. D. Hypoglycemic episodes in the past 3 months.
C. Glucose control over the past 90 days.
A 28-year-old female patient presents to the clinic with complaints of severe vaginal itching and discharge. She tells the nurse that she is usually very healthy but has been taking antibiotics for an ear infection. What does the nurse recognize as a possible cause of her vaginal itching and discharge? A: Anaphylaxis B: hypersensitivity C: nephrotoxicity D: superinfection
D: superinfection
A child with an upper respiratory infection caused by B. pertussis is receiving erythromycin ethylsuccinate. After 2 days of treatment, the parent asks the nurse why the child's symptoms have not improved. Which response by the nurse is correct? a. "Erythromycin eliminates the bacteria that causes the infection, but not the toxin that causes the symptoms." b. "We may need to add penicillin or another antibiotic to increase the antimicrobial spectrum." c. "We will need to review the culture sensitivity information to see whether a different antibiotic is indicated." d. "Your child may have developed a suprainfection that we need to culture and treat."
a. "Erythromycin eliminates the bacteria that causes the infection, but not the toxin that causes the symptoms."
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Request an order for a gentamicin peak level. b. Suspect ototoxicity and notify the prescriber. c. Tell the patient to ask for help with ambulation. d. Tell the patient to report any tinnitus.
b. Suspect ototoxicity and notify the prescriber.
The nurse is developing a care plan for a patient who is taking an anticholinergic drug. Whichnursing diagnosis would be appropriate for this patient? a. Diarrhea b. Urinary retention c. Risk for infection d. Disturbed sleep pattern
b. Urinary retention
A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question? a. Bumetanide [Bumex] b. Furosemide [Lasix] c. Spironolactone [Aldactone] d. Hydrochlorothiazide [HydroDIURIL]
c. Spironolactone [Aldactone]
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."
The nurse will assess the patient for which potential contraindication to antitubercular therapy? a. Glaucoma b. Anemia c. Heart failure d. Hepatic impairment
d. Hepatic impairment
Before a patient receives triptans for the treatment of migraines, the nurse will assess for the presence of which condition, which is a contraindication if present? a. hypotension b. renal disease c. liver damage d. cardiovascular disease
d. cardiovascular disease
A patient is taking nystatin (Mycostatin) oral lozenges to treat an oral candidiasis infectionresulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse isappropriate? a. "Chew the lozenges until they are completely dissolved." b. "Let the lozenge dissolve slowly and completely in your mouth without chewingit." c. "Rinse your mouth with water before taking the inhaler." d. "Rinse your mouth with mouthwash after taking the inhaler."
"Let the lozenge dissolve slowly and completely in your mouth without chewingit."
Isotretinoin (Amnesteem) and tretinoin (Retin-A) are common dermatologic drugs used to treat which condition? A. Acne vulgaris B. Keloid scarring C. Fungal infections D. Male pattern baldness
A. Acne vulgaris
A patient is diagnosed with a lung infection caused by P. aeruginosa. The culture and sensitivity report shows sensitivity to all aminoglycosides. The nurse knows that the rate of resistance to gentamicin is common in this hospital. The nurse will expect the provider to order which medication?
Amikacin [Amikin]
A patient is admitted with complaints of palpations, excessive sweating, and unable to tolerate heat. In addition, the patient voices concern about how her appearance has changed over the past year. The patient presents with protruding eyeballs and pretibial myxedema on the legs and feet. Which of the following is the likely cause of the patient's signs and symptoms?* A. Thyroiditis B. Deficiency of iodine consumption C. Grave's Disease D. Hypothyroidism
C. Grave's Disease
A client is admitted to the intensive care unit with acute pulmonary edema. Which diuretic does the nurse anticipate will be prescribed?Furosemide Chlorothiazide Spironolactone Acetazolamide
Furosemide
A nurse is planning to screen a school-aged child for impaired hearing because the child is receiving an antibiotic that affects hearing. Which medication does the nurse suspect may have caused hearing impairment? Amoxicillin Ciprofloxacin Clindamycin Gentamicin
Gentamicin
The nurse finds that a client undergoing treatment for osteomyelitis is showing signs of Achilles tendon rupture. Which medication does the nurse ask the primary healthcare provider to reconsider? Gentamycin Levofloxacin Acetaminophen Cyclobenzaprine
Levofloxacin
When educating a patient recently placed on inhaled corticosteroids, the nurse will discuss which potential adverse effects? a. Fatigue and depression b. Anxiety and palpitations c. Headache and rapid heart rated. d. Oral candidiasis and dry mouth
Oral candidiasis and dry mouth
A nurse administers carbidopa-levodopa to a client with Parkinson disease. Which therapeutic effect does the nurse expect the medication to produce? Increase in acetylcholine production Regeneration of injured thalamic cells Improvement in myelination of neurons Replacement of a neurotransmitter in the brain
Replacement of a neurotransmitter in the brain
which statement is true regarding benzodiazepines?
These drugs may be habit forming.
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 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? a. "Tetracycline can be harmful to the baby's teeth and should be avoided." b. "Tetracycline is safe to take during pregnancy." c. "Tetracycline may cause allergic reactions in pregnant women." d. "Tetracycline will prevent asymptomatic urinary tract infections."
a. "Tetracycline can be harmful to the baby's teeth and should be avoided
A patient is recovering from a minor automobile accident that occurred 1 week ago. He is takingcyclobenzaprine (Flexeril) for muscular pain and goes to physical therapy three times a week.Which nursing diagnosis would be appropriate for him? a. Risk for injury related to decreased sensorium b. Risk for addiction related to psychologic dependency c. Decreased fluid volume related to potential adverse effects d. Disturbed sleep pattern related to the drug's interference with REM sleep
a. Risk for injury related to decreased sensorium
During drug therapy for pneumonia, a female patient develops a vaginal superinfection. Thenurse explains that this infection is caused by: a. large doses of antibiotics that kill normal flora. b. the infection spreading from her lungs to the new site of infection. Chapter 38: Antibiotics Part 1 208 c. resistance of the pneumonia-causing bacteria to the drugs. d. an allergic reaction to the antibiotics.
a. large doses of antibiotics that kill normal flora.
When teaching a patient who is beginning antilipemic therapy about possible drug-food interactions, the nurse will discuss which food? a. Oatmeal b. Grapefruit juice c. Licorice d. Dairy products
b. Grapefruit juice
Nurse Oliver should expect a client with hypothyroidism to report which health concerns? a. Increased appetite and weight loss b. Puffiness of the face and hands c. Nervousness and tremors d. Thyroid gland swelling
b. Puffiness of the face and hands
A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriberwrites an order for an angiotensin-converting enzyme (ACE) inhibitor. What is the main reasonfor prescribing this class of drug for this patient? a. Cardioprotective effects b. Renal protective effects c. Reduces blood pressure d. Promotes fluid output
b. Renal protective effects
Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy? a. Constipation b. Risk for injury (renal damage) c. Disturbed body image related to gynecomastia d. Imbalanced nutrition, less than body requirements, related to nausea
b. Risk for injury (renal damage)
An incoherent female client with a history of hypothyroidism is brought to the emergency department by the rescue squad. Physical and laboratory findings reveal hypothermia, hypoventilation, respiratory acidosis, bradycardia, hypotension, and nonpitting edema of the face and pretibial area. Knowing that these findings suggest severe hypothyroidism, nurse Libby prepares to take emergency action to prevent the potential complication of: a. Thyroid storm. b. Cretinism. c. Myxedema coma. d. Hashimoto's thyroiditis.
c. Myxedema coma.
A female client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg P.O. daily. Which finding should nurse Hans recognize as an adverse drug effect? a. Dysuria b. Leg cramps c. Tachycardia d. Blurred vision
c. Tachycardia
When treating patients with medications for Parkinson's disease, the nurse knows that the wearing-off phenomenon occurs for which reason? a. There are rapid swings in the patient's response to levodopa. b. The patient cannot tolerate the medications at times. c. The medications begin to lose effectiveness against Parkinson's disease. d. The patient's liver is no longer able to metabolize the drug
c. The medications begin to lose effectiveness against Parkinson's disease.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw? a. The patient's original infection has not responded to the antibiotic therapy. b. The patient is showing typical adverse effects of antibiotic therapy c. The patient needs to be tested for Clostridium difficile infection. d. The patient will need to take a different antibiotic.
c. The patient needs to be tested for Clostridium difficile infection.
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today thepatient tells the nurse that he has had watery diarrhea since the day before and is havingabdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, whichconclusion will the nurse draw? a. The patient's original infection has not responded to the antibiotic therapy. b. The patient is showing typical adverse effects of antibiotic therapy. c. The patient needs to be tested for Clostridium difficile infection. d. The patient will need to take a different antibiotic.
c. The patient needs to be tested for Clostridium difficile infection.
Which statements are true regarding the selective serotonin reuptake inhibitors (SSRIs)? (Select all that apply.) a. Avoid foods and beverages that contain tyramine. b. Monitor the patient for extrapyramidal symptoms. c. Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started. d. If the patient has been on an MAOI, a 2- to 5-week or longer time span is required before beginning an SSRI medication. e. These drugs have anticholinergic effects, including constipation, urinary retention, dry mouth, and blurred vision. f. Cogentin is often also prescribed to reduce the adverse effects that may occur.
c. Therapeutic effects may not be seen for about 4 to 6 weeks after the medication is started.
A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially? a. Loop diuretics b. Osmotic diuretics c. Thiazide diuretics d. Potassium-sparing diuretics
c. Thiazide diuretics
A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that containsmultidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to bechosen for therapy? a. Metronidazole (Flagyl) b. Ciprofloxacin (Cipro) c. Vancomycin (Vancocin) d. Tobramycin (Nebcin)
c. Vancomycin (Vancocin)
To prevent yellow or brown discoloration of teeth in children, tetracyclines should not be given: a. to children once the permanent teeth have developed b. to patients taking calcium supplements. c. to pregnant patients after the fourth month of gestation. d. with dairy products or antacids.
c. to pregnant patients after the fourth month of gestation.
A patient newly diagnosed with tuberculosis (TB) has been taking antitubercular drugs for 1week calls the clinic and is very upset. He says, "My urine is dark orange! What's wrong with me?" Which response by the nurse is correct? a. "You will need to stop the medication, and it will go away." b. "It's possible that the TB is worse. Please come in to the clinic to be checked." c. "This is not what we usually see with these drugs. Please come in to the clinic to be checked."
d. "This is an expected side effect of the medicine. Let's review what to expect."
A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6months. The patient wants to go to a party and asks the nurse, "Will just one beer be a problem?"Which advice from the nurse is correct? a. "You can drink beer as long as you have a designated driver. "b. "Now that you've had the last dose of that medication, there will be no further dietary restrictions. "c. "If you begin to experience a throbbing headache, rapid pulse, or nausea, you'll need to stop drinking. d. "You need to avoid all foods that contain tyramine, including beer, while takingthis medication.
d. "You need to avoid all foods that contain tyramine, including beer, while takingthis medication.
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."
A patient has experienced insomnia for months, and the physician has prescribed a medication tohelp with this problem. The nurse expects which drug to be used for long-term treatment ofinsomnia? a. Secobarbital (Seconal), a barbiturate b. Diazepam (Valium), a benzodiazepine c. Midazolam (Versed), a benzodiazepine d. Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid
d. Eszopiclone (Lunesta), a nonbenzodiazepine sleep aid
A patient with coronary artery disease asks the nurse about the "good cholesterol" laboratoryvalues. The nurse knows that "good cholesterol" refers to which lipids? a. Triglycerides b. Low-density lipoproteins (LDLs) c. Very-low-density lipoproteins (VLDLs) d. High-density lipoproteins (HDLs)
d. High-density lipoproteins (HDLs)
A patient has a new order for a catechol ortho-methyltransferase (COMT) inhibitor as part of treatment for Parkinson's disease. The nurse recognizes that which of these is an advantage of this drug class? a. It has a shorter duration of action. b. It causes less gastrointestinal distress. c. It has a slower onset than traditional Parkinson's disease drugs. d. It is associated with fewer wearing-off effects
d. It is associated with fewer wearing-off effects
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
A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate? a. Administer the medications as ordered. b. Ask the patient about the use of salt substitutes. c. Contact the provider to request an order for serum electrolytes. d. Request an order for furosemide [Lasix].
d. Request an order for furosemide [Lasix].
The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics? a. Hydrochlorothiazide (HydroDIURIL) b. Furosemide (Lasix) c. Acetazolamide (Diamox) d. Spironolactone (Aldactone)
d. Spironolactone (Aldactone)
A patient with hypertension is taking furosemide [Lasix] for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication will the nurse expect to be ordered for this patient? a. Bumetanide [Bumex] b. Chlorothiazide [Diuril] c. Hydrochlorothiazide [HydroDIURIL] d. Spironolactone [Aldactone]
d. Spironolactone [Aldactone]
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? a. Antibiotic resistance b. Community-acquired infection c. Nosocomial infection d. Superinfection
d. Superinfection
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan? a. Minimize the amount of fluid taken while on this drug b. Discontinue the medication if adverse effects occur. c. Take the medication on an empty stomach to enhance absorption. d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth
d. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth
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: a. antibiotic resistance. b. interpatient variation. c. liver disease. d. renal disease.
d. renal disease.
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for depression for several months tells the provider that the medication has not helped with symptoms. The provider plans to switch the patient to an SSRI. The nurse will teach this patient to: a. start taking the SSRI and stop the MAOI when symptoms improve. b. start taking the SSRI and then gradually withdraw the MAOI. c. stop taking the MAOI and wait 5 weeks before starting the SSRI. d. stop taking the MAOI 2 weeks before starting the SSRI.
d. stop taking the MAOI 2 weeks before starting the SSRI.
The nurse is teaching a psychiatric client about her prescribed drugs, chlorpromazine and benztropine. Why is benztropine administered?
to reduce extrapyramidal symptoms
What does amitriptyline (Elavil) treat?
treatment of major depression, migraine prophylaxis, neuropathic pain disorders, fibromyalgia, and nocturnal enuresis.