Pharmacology Chapter 9

bactericidal

Drugs that destroy bacteria are known as which type of drug?

gram-positive bacteria

Penicillins are most effective when used to treat what type of microorganisms?

methicillin-resistant Staphylococcus aureus (MRSA) infection

The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?

amoxicillin

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe?

The use of ciprofloxacin is contraindicated in pregnancy.

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

Serum alanine transaminase, aspartate transaminase, and bilirubin

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

with a glass of water 1 hour before or 2 hours after a meal.

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug

Monitor for appearance of adverse reactions.

A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?

To prevent resistance

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?

photosensitivity

A client comes to the clinic for a follow-up visit. The nurse notes a sunburn-like appearance to the client's skin. The client's history reveals the use of ciprofloxacin. The nurse interprets which adverse effect regarding this finding?

"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."

A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response?

Photosensitivity

A client has been prescribed lomefloxacin (Maxaquin) for a respiratory infection. What must the nurse closely monitor for in this client?

INH, rifampin, pyrazinamide, ethambutol

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

Erythromycin

A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?

They interfere with the DNA of the bacteria.

A client is asking how fluoroquinolones work. What is the nurse's best response?

The client has a new onset of jaundice and edema

A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?

225 mg

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?

Blood dyscrasias

A client is diagnosed with VRE, and the health care provider orders chloramphenicol. The nurse should monitor the client for the development of which side effect?

Aminoglycoside

A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?

Take precautions to prevent photosensitivity.

A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?

phlebitis

A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?

A cross-sensitivity reaction.

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

changing to a different antibiotic

A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?

Cefadroxil

A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?

ALT and AST

A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in the great toes. Which laboratory values should be assessed?

"The administration will decrease the growth of intestinal bacteria."

A client scheduled for a bowel resection is to receive neomycin sulfate by mouth. The client asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the client?

Decreased absorption

A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic?

Pseudomonas aeruginosa

A client with a diagnosis of necrotizing otitis externa has been prescribed ciprofloxacin. What microorganism is the most likely cause of the disorder?

Obtain a culture of the client's infection.

A client with an infected ulcer on the foot has been prescribed daptomycin. What action should the nurse ensure has been taken to determine that the drug will be effective in treating the infection?

drop in blood pressure increase in respiratory rate sudden increase in temperature

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.

Review lab results to confirm normal liver function.

A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Orally, on an empty stomach

A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client?

Drug-resistant tuberculosis

A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?

on an empty stomach.

A female client is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the client that she will need to take the capsule

Urinary tract infections

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?

By administering the drug in separate IV bags

A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?

Liver function

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test?

Photosensitivity

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for?

Discoloration of the teeth

A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child?

Rifampin and isoniazid

A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?

Inflammation of the tongue and mouth

A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?

Renal disease

A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted?

Cheese, dairy products, and bananas

A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods?

warfarin

A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug?

"I will only drink enough water to swallow the drug."

A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?

Take the drug on an empty stomach.

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?

The peak and trough blood levels

A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?

"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."

A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?

Photosensitivity

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction?

"I should drink a full 8-oz glass of water when I take the medicine."

After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following?

Cefuroxime

After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?

gram-negative infections

After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication?

Diarrhea

An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin?

trimethoprim-sulfamethoxazole

An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed?

patient will continue treatment with cefazolin for 2 more days.

Culture and sensitivity testing of a patient's sputum sample indicated that the client's pneumonia could be treated with intravenous cefazolin. This treatment was initiated 6 days ago and this morning the nurse's assessment reveals no adventitious lung sounds, a respiratory rate of 22 breaths/minute, oxygen saturation of 93% on room air, and an oral temperature of 98.4°F. Based on the apparent resolution of the patient's respiratory infection, the nurse should recognize that the:

An increase in sensitivity of gram-negative microorganisms. A decrease in the sensitivity of gram-positive microorganisms.

In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply.

a skin test.

In the rare instance in which penicillin is considered essential, hypersensitivity can be assessed by administering:

Liver dysfunction

In which condition present in the client should macrolides be used with caution?

The client has developed a superinfection.

The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?

Continue to monitor vital signs.

The client has been taking levofloxacin IV since admission 12 hours ago for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response?

The health care provider should order culture and susceptibility studies.

The health care provider considers prescribing an oral tetracycline for a client suspected of having a urinary tract infection. What action needs to be completed before the medication can be prescribed?

can cause allergic reactions in clients who are allergic to penicillins.

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:

shortness of breath

The nurse has administered a client's first scheduled dose of amoxicillin. What subsequent client report should prompt the nurse to seek the discontinuation of this drug?

To identify whether the drug is at a therapeutic level

The nurse is caring for a client who is receiving gentamicin therapy. Why will the nurse monitor the results of a serum gentamicin level?

Stomatitis

The nurse is caring for a client who is taking tetracycline for Rocky Mountain spotted fever. The nurse notices that the client has developed painful mouth ulcers. The nurse knows that the client has developed what adverse reaction to the medication?

"If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."

The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media and prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse?

Respiratory assessment

The nurse is providing care for a client who has been prescribed telithromycin (Ketek). When assessing the client's underlying health problem, what assessment should the nurse prioritize?

alcohol

The nurse is providing health education to a client prescribed isoniazid. What should the nurse instruct the client to avoid?

antacids

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?

leprosy.

The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease is which?

Inhibiting cell wall synthesis

The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?

Primaxin

What drug belongs to the group of carbapenems?

proliferation of antibiotic-resistant microorganisms

What event triggers the development of a superinfection?

suppression of intestinal bacteria

What is the treatment goal for a preoperative prescription for neomycin?

Renal

What organ system is responsible for the excretion of cefotaxime sodium from the body?

Distribution

What pharmacologic principle causes nephrotoxicity when gentamicin is administered?

oral (PO)

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?

Ototoxicity and nephrotoxicity

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?

Oral

When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route?

A client who has required repeated courses of gentamicin over the past several months

Which client has the highest risk of developing ototoxicity secondary to gentamicin?

Cefazolin

Which drug is a first-generation cephalosporin used as a surgical prophylaxis?

Vaginal candidiasis Oral candidiasis C. difficile colitis

Which of the following are examples of a secondary infection? Select all that apply.

Levofloxacin (Levaquin) Ciprofloxacin (Cipro)

Which of the following are examples of fluoroquinolones? Select all that apply.

Gentamicin

Which of the following drugs would be classified as an aminoglycoside?

Tetracyclines should be administered with a full glass of water.

Which statement is true in regards to the oral administration of tetracyclines?

Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.

Your client is being treated for streptococcal pharyngitis and is NPO. Her health care provider has ordered Penicillin G to be given IM. She wants to know why she cannot take her medications via an oral route. Your best response is: