pharm antibiotics

814.A nurse is caring for an African-American patient who has been admitted to the unit for long- term antibiotic therapy with sulfonamides. The patient develops fever pallor and jaundice. The nurse would be correct to suspect that the patient has developed

hemolytic anemia.

752. 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].

880. Which superficial mycosis is generally treated with oral antifungal agents

Tinea capitis

882.A nursing student asks a nurse to explain the differences between amphotericin B [Abelcet] and the azoles group of antifungal agents. Which statement by the nurse is correct

"Azoles have lower toxicity than amphotericin B."

876.A patient is taking oral ketoconazole [Nizoral] for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole [Prilosec] for reflux disease. What action should the nurse take

Administer the omeprazole at least 2 hours after the ketoconazole.

740. A patient has a viral sinus infection and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct

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

812.A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching

"I should stop taking this drug when my symptoms are gone."

826.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 100000/mL of urine. The nurse caring for this patient knows that which treatment is most effective

A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]

823.A patient with a history of renal calculi has fever flank pain and bacteriuria. The nurse caring for this patient understands that it is important for the provider to

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

872. A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What will the nurse tell her?

a. This is caused by a reversible effect on estradiol synthesis.

858. A provider orders intravenous moxifloxacin [Avelox] for a patient who has sinusitis.Before administering the drug the nurse will review this patient's chart for

a. recent serum electrolyte levels.

860. 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

add metronidazole [Flagyl].

755. 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

disrupt bacterial cell wall synthesis.

813.A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient the nurse will tell the patient that it will be important to

drink 8 to 10 glasses of water every day.

866. A patient is being treated with amphotericin B [Abelcet] for a systemic fungal infection. After several weeks of therapy the provider orders flucytosine [Ancobon] in addition to the amphotericin. The nurse understands that the rationale for this combination is that it

lowers the dose of amphotericin B and reduces toxicity.

829. A pregnant female patient with bacteriuria suprapubic pain urinary urgency and frequency and a low-grade fever is allergic to sulfa ciprofloxacin and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with

methenamine [Hiprex].

856. A nurse is preparing to administer oral ofloxacin to a patient. While taking the patient's medication history the nurse learns that the patient takes warfarin and theophylline. The correct action by the nurse is to request an order to

monitor coagulation levels.

833. An older male patient comes to the clinic with complaints of chills malaise myalgia localized pain dysuria nocturia and urinary retention. The nurse would most likely suspect that the patient has

prostatitis.

854. A nurse is preparing to administer an antibiotic to a patient with methicillin-resistant Staphylococcus aureus (MRSA). The nurse would expect the health care provider to order which antibiotic

Daptomycin [Cubicin]

834. A patient presents to the emergency department with complaints of chills severe flank pain dysuria and urinary frequency. The patient has a temperature of 102.9° F a pulse of 92 beats/minute respirations of 24 breaths/minute and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of

pyelonephritis.

760.A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss

reducing the dose of piperacillin.

855. A patient who is taking calcium supplements receives a prescription for ciprofloxacin [Cipro] for a urinary tract infection. The nurse will teach this patient to

take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

862. A patient is being treated for a systemic fungal infection with amphotericin B [Abelcet] and will be discharged home from the hospital to complete every-other-day infusions of the medication for 6 to 8 weeks. The nurse provides discharge teaching before dismissal. Which statement by the patient indicates a need for further teaching

"I may experience headaches and pain in my lower back legs and abdomen."

859. A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching

"I should take this medication with food or milk to improve absorption."

869. A nurse is discussing intravenous amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching

"Infusions of amphotericin B should be administered over 1 to 2 hours."

762.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

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

881.A nursing student asks a nurse about flucytosine [Ancobon]. Which statement by the nurse is correct

"Resistance is common with this medication."

821.A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching

"Resistance to sulfonamides is less common than resistance totrimethoprim."

749. The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching

"Some agents cause phagocytosis of bacterial cells."

820.A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct

"Sulfonamides are bacteriostatic and depend on host immunity to work."

758. 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 synthesized penicillinase."

835. A pregnant patient with fever flank pain and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her

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

870.A patient has come to the clinic with tinea corporis and the prescriber has ordered clotrimazole. When educating the patient about this medication the nurse will include which statement

"Use the medication for at least 1 week after the symptoms have cleared."

824.A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient

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

830. The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn't just order an antibiotic for the child's current symptoms of low-grade fever flank pain and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse

"Your child may need tests to assess for urinary tract abnormalities."

748. 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

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

863. A child has ringworm of the scalp. A culture ofthe lesion reveals a dermatophytic infection. The nurse teaching the child's parents about how to treat this infection will include which statement

"Your child will need to take this oral medication for 6 to 8 weeks."

817.A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin glipizide and a thiazide diuretic. Based on this assessment the nurse will expect the provider to

monitor the patient's coagulation levels.

747. A patient has a localized skin infection which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available the nurse will expect the provider to order a -spectrum agent

narrow; topical

875.A patient will begin treatment with posaconazole [Noxafil] to treat oropharyngeal candidiasis that has not responded to fluconazole. The provider has ordered 200 mg three times daily. Which action by the nurse is correct

Discuss a 400-mg twice-daily drug regimen with the provider.

741. 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

order empiric antibiotics while waiting for sputum culture results.

864. The nurse is preparing to administer amphotericin B intravenously. The nurse will expect to pretreat the patient with which medications

Acetaminophen [Tylenol] diphenhydramine [Benadryl] and meperidine [Demerol]

878.A patient has a systemic candidal infection and the provider has ordered oral fluconazole [Diflucan] 400 mg on day 1 and 200 mg once daily thereafter. What will the nurse do

Administer the drug as ordered.

757. The parent of an infant with otitis media asks the nurse why the prescriber has ordered amoxicillin [Amoxil] and not ampicillin [Unasyn]. What will the nurse tell the parent

Ampicillin is not as acid stable as amoxicillin.

831. Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics

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

811.A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon] because the two are similar products and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine

It has antibacterial effects related to release of free silver.

759. 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

Contact the provider and prepare to administer epinephrine.

761.A nurse is preparing to administer intramuscular penicillin to a patient who is infected with Treponema pallidum and notes that the order is for sodium penicillin G. Which action is correct

Contact the provider to discuss changing the drug to benzathine penicillin G.

822.A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do

Contact the provider to request a different antibiotic for this patient.

815.A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) [Bactrim] for a urinary tract infection at 32 weeks' gestation. A week later the woman delivers her infant prematurely. The nurse will expect to monitor the infant for

kernicterus.

877.A nurse is caring for a patient who is receiving amphotericin B [Abelcet] for a systemic fungal infection. In spite of receiving diphenhydramine and acetaminophen before initiation of treatment the patient has fever and chills with rigors. The nurse will contact the provider to discuss the addition of which drug

Dantrolene

744. A child has received amoxicillin [Amoxil] for three previous ear infections but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism

Drug inactivation

828. Before giving methenamine [Hiprex] to a patient, it is important for the nurse to review the patient's history for evidence of which problem?

Elevated blood urea nitrogen and creatinine

874.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

Fluconazole [Diflucan]

754. A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs

Give the penicillin at 0800 1600 and 2400; give the gentamicin [Garamycin] at 1800 and 0600.

745. A recent campaign initiated by the Centers for Disease Control (CDC) to delay the emergence of antibiotic resistance in hospitals has what as one of its objectives

Increased adherence to prescribed antibiotics

751. A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin both to be given intravenously. What will the nurse do

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

879.A patient with histoplasmosis is being treated with itraconazole [Sporanox]. The nurse will teach this patient to report which symptoms

Nausea vomiting and anorexia

717. 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?

Obtaining all cultures before the antibiotic is administered

868. A provider has ordered oral voriconazole [Vfend] for a patient who has a systemic fungal infection. The nurse obtains a medication historyand learns that the patient takes phenobarbital for seizures. The nurse will contact the provider to discuss which possibility

Using a different antifungal agent

867. A patient will begin taking an immunosuppressant medication. The nurse learns that the patient has a history of frequent candidal infections. The nurse will expect the provider to order which drug as prophylaxis

Posaconazole [Noxafil]

816.A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely

Potassium

756. A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do

Question the need for a penicillinase-resistant penicillin.

873.A patient is receiving intravenous voriconazole [Vfend]. Shortly after the infusion starts the patient tells the nurse "Colors look different and the light hurts my eyes." What will the nurse do

Reassure the patient that these effects will subside in about 30 minutes.

865. A nurse is caring for a patient who has a superficial fungal infection and notes that the provider has ordered 200 mg of ketoconazole [Nizoral] 200 mg PO once daily. Which action by the nurse is correct

Request an order for a different antifungal medication.

750. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history the nurse learns that the patient experienced a rash when given amoxicillin [Amoxil] as a child 20 years earlier. What will the nurse do

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

753. A patient is receiving intravenous potassium penicillin G 2 million units to be administered over 1 hour. At 1900 the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do

Request an order for serum electrolytes and cardiac monitoring.

746. A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say

Spontaneous mutation leads to resistance to only one antimicrobial agent.

861. The nurse is caring for a patient who will begin receiving intravenous ciprofloxacin [Cipro] to treat pyelonephritis. The nurse learns that the patient has a history of myasthenia gravis. Which action by the nurse is correct

Suggest that the provider order a different antibiotic for this patient.

743. 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

Superinfection

871.A patient has an invasive aspergillosis infection. Which antifungal agent is the drug of choice for this infection

Voriconazole [Vfend]

819.A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection and the prescriber orders TMP/SMZ. What will the nurse tell the patient

The patient should check the blood glucose level more often while taking TMP/SMZ.

827.A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication

Tingling of the fingers

832. A 20-year-old female patient has suprapubic discomfort pyuria dysuria and bacteriuria greater than 100000/mL of urine. Which are the most likely diagnosis and treatment

Uncomplicated lower urinary tract infection treatable with short-course therapy

818.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/minute. The patient looks ill and reports not feeling well. What will the nurse do

Withhold the dose and notify the provider of the symptoms.

857. 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

Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.

825.A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. The nurse anticipates that the prescriber will

begin a 2-week course of antibiotics.