Pharm 50 quiz 3 ccsf

7. A client is ordered to receive co-trimoxazole (Bactrim, Septra). The nurse assesses for side effects. What causes the nurse the greatest concern? a. Neutropenia and agranulocytosis b. Nausea and vomiting c. Headache and vertigo d. Fatigue and anorexia

ANS: A Although all of these may be side effects of this medication, neutropenia and agranulocytosis causes most concern because of immunosuppression and the potential for infections

1. A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a: a. narrow therapeutic index. b. large therapeutic index. c. long half-life. d. short half-life.

ANS: A Medications with a narrow therapeutic index have a limited range between the therapeutic dose and the lethal dose.

12. During therapy with amphotericin B, the nurse would monitor for known adverse effects that would be reflected by which lab result? A. Serum potassium level of 2.9 mEq/L B. Serum potassium level of 5.6 mEq/L C. White blood count of 6500 mm3 D. Platelet count of 300,000 per microliter

ANS: A The nurse should monitor for hypokalemia, a possible adverse effect of amphotericin B.

11. A patient is taking nystatin (Mycostatin) lozenges because of an oral candidiasis infection resulting from inhaled corticosteroid therapy for asthma. Which instruction by the nurse is appropriate? A. "Chew the lozenges until they are completely dissolved." B. "Let the lozenge dissolve slowly and completely in your mouth without chewing it." C. "Rinse your mouth with water before taking the inhaler." D. "Rinse your mouth with mouthwash after taking the inhaler."

ANS: B Nystatin may be given orally in the form of lozenges, or troches, which should be slowly and completely dissolved in the mouth for optimal effects; they should not be chewed or swallowed whole. The other options are not correct. Patients taking an inhaled corticosteroid should rinse their mouths with water thoroughly after taking the inhaler.

10. The nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis. The patient asks, "Why do I have to take so many different drugs?" Which answer by the nurse is correct? A. "It is hoped that at least one of these drugs will work to fight the tuberculosis." B. "Taking multiple drugs reduces the chance that the tuberculosis will become drug resistant." C. "Using several drugs has a faster effect than single-drug therapy." D. "Using multiple drugs enhances the effect of each drug."

ANS: B The use of multiple medications reduces the possibility that the organism will become drug resistant. The other options are not correct.

3. When antibacterials are prescribed for the treatment of an infection and a culture is ordered, what should happen next? a. The initial dose of the antibiotic should be given before the culture is taken. b. The culture should be taken before the initial dose of the antibiotic is given. c. The culture should be taken any time after the antibiotic therapy begins. d. The culture may be taken at any time before or during antibiotic therapy.

ANS: B To obtain the most accurate culture, the specimen should be obtained before antibiotic therapy begins.

4. The client has been ordered treatment with Amoxil. The client reports to the nurse that she has developed symptoms of vaginitis. The highest priority action on the part of the nurse is to recognize this as: a. an expected side effect of the medication. b. a life-threatening reaction to the drug. c. evidence of development of a superinfection. d. evidence of an anaphylactic reaction.

ANS: C Development of vaginitis can be evidence of development of a superinfection.

8. The client is being treated with one of the sulfonamides. She complains to the nurse of experiencing a sore throat. What is the highest priority action on the part of the nurse? a. Administer the medication; this is an expected side effect of the medication. b. Call the physician; this is symptomatic of development of a superinfection. c. Call the physician; this is symptomatic of a life-threatening anemia. d. Hold the medication and call the pharmacist for clarification.

ANS: C Observe the client for hematologic reaction that may lead to life-threatening anemias. Early signs are sore throat, purpura, and decreasing white blood cell and platelet counts.

6. A client presents to the emergency department with severe flank pain and foul-smelling urine. The urine culture is positive. Because of the symptoms, the nurse anticipates that the client has: a. acute renal failure. b. a lower urinary tract infection. c. pyelonephritis. d. acute cystitis.

ANS: C Symptoms described are indicative of pyelonephritis.

5. A client with a urinary tract infection is ordered to receive phenazopyridine hydrochloride (Pyridium) as a urinary analgesic. What information will client teaching include? a. The medication has a high rate of adverse reactions. b. Discolored urine is evidence of an anaphylactic reaction. c. Side effects such as nausea, vomiting, and diarrhea must be reported. d. The medication will prevent future urinary tract infections.

ANS: C The drug can produce gastrointestinal disturbances in the client receiving treatment.

9. A patient is taking a combination of antiviral drugs as treatment for early stages of HIV infection. While discussing the drug therapy, he asks the nurse if the drugs will kill the virus. When answering him, the nurse keeps in mind the fact that antiviral drugs A. are given for palliative reasons only. B. will be effective as long as he is not exposed to the virus again. C. can be given in large enough doses to eradicate the virus without harming the body's healthy cells. D. may also kill healthy cells while killing viruses.

ANS: D Because viruses reproduce in human cells, selective killing is difficult; consequently, many healthy human cells, in addition to virally infected cells, may be killed in the process, and this results in the serious toxicities that are involved with these drugs.

2. A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction? a. Wear a Medic Alert bracelet that indicates the allergy. b. Avoid all penicillin-type drugs. c. Inform all healthcare providers of the allergy. d. Restrict fluids when taking the antibiotic.

ANS: D Fluids should be encouraged with antibiotic therapy, so such an order would need to be questioned.