Quiz #8

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. nafcillin c. ampicillin d. penicillin G

A

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. Obtaining all cultures before the antibiotic is administered (not the results of the cultures) b. Administering the antibiotic immediately c. Delaying administration of the antibiotic until the culture results are available d. Administering antipyretics as soon as possible

A

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a. "Cephalosporins are assigned to generations based on their relative costs to administer." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation." c. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." d. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases

B

A patient is receiving tobramycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? a. 7:00AM b. 7:45AM c. 4:00AM d. 8:45AM

B

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? a. The provider may increase the clindamycin dose to treat this infection. b. The patient should stop taking the clindamycin now and contact the provider immediately. c. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms d. This is a known side effect of clindamycin, and the patient should consume extra fluids

B

Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? a. Headache b. Diarrhea c. None of the above d. Nausea

B

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? a. Notify the provider if the patient develops a rash. b. Request an order for a skin test to evaluate possible PCN allergy. c. Contact the provider and prepare to administer epinephrine. d. Withhold the next dose until symptoms subside.

C

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. community-aquired infection b. nosocomial infection c. superinfection d. Antibiotic resistance

C

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. Tell the patient to ask for help with ambulation. c. Tell the patient to report any tinnitus. d. Suspect ototoxicity and notify the prescriber.

D

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: a. add metronidazole [Flagyl]. b. restrict dairy products. c. switch to gemifloxacin. d. increase the dose of ciprofloxacin.

A

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. "With good hand washing, your child should not get strep throat." b. "Because strep throat is likely, your child should be treated empirically." c. "Your child should come to the clinic to have a throat culture done today." d. "Your child probably has strep throat, so your provider will order an antibiotic."

C

A pregnant 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 is safe to take during pregnancy." b. "Tetracycline will prevent asymptomatic urinary tract infections." c. "Tetracycline can be harmful to the baby's teeth and should be avoided." d. "Tetracycline may cause allergic reactions in pregnant women."

C

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? a. Potassium b. Magnesium c. Calcium d. Sodium

A

A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Tell the patient to ask for help with ambulation. b. Suspect ototoxicity and notify the prescriber c. Tell the patient to report any tinnitus d. Request an order for a gentamicin peak level

B

A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn? a. A peak level is not indicated with twice-daily dosing. b. 1 hour before administration of the IV infusion c. 30 minutes after the IV infusion is complete d. 1 hour after the IV infusion is complete

C

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. treat symptomatically, because antibiotics are usually ineffective against bronchitis c. order empiric antibiotics while waiting for sputum culture results d. treat the patient with more than one antibiotic without obtaining cultures.

C

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/min, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. allergic reaction. b. Stevens-Johnson syndrome. c. red man syndrome d. rhabdomyolysis.

C

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 penicillin-binding proteins (PBPs) that have a low affinity for penicillins." c. "The bacteria have developed a three-layer cell envelope." d. "The bacteria have synthesized penicillinase."

D

A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct, and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result? a. The drug was not completely dissolved in the IV solution. b. A loading dose was not given. c. The medication is being given at a frequency that is longer than its half-life. d. The patient is taking another medication that binds to serum albumin.

D

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? a. Suggest that a fixed-dose combination of piperacillin and tazobactam [Zosyn] be used b. Make sure to administer the drugs at different times using different IV tubing. c. Watch the patient closely for allergic reactions, because this risk is increased with this combination d. Suggest giving larger doses of piperacillin and discontinuing the amikacin.

B