Study questions
The nurse us administering vancomycin to a patient. Which nursing interventions are appropriate? Monitor the patient for ______? (select all that apply) a. Adequate hearing b. Appropriate IV rate c. Pseudomembranous colitis d. Stevens-Johnson syndrome e. Hypotension and tachycardia f. Redness of the face, neck, and chest
A,B,D,E, and F. Rationale: The side effects/adverse effects of vancomycin include otoxicity, Stevens-Johnson syndrome, tachycardia, red man syndrome (hypotension, red blotching of the face, neck, and chest when the IV is too rapid) Pseudomembranous colitis is not an adverse effect of vancomycin.
A client is being treated for tuberculosis. Which medications are used to treat this condition? Select all that apply a. Streptomycin sulfate b. Ethambutol (Myambutol) c. Gentamicin (Garamycin) d. Rifabutin (Mycobutin) e. Ethinoamide (trecator-SC) f. Pyrazinamide
All but C
Which diseases are caused by herpes viruses? Select all that apply a. Chicken pox b. Hepatitis c. Influenza d. Mononucleosis e. Shingles
Chicken pox, mono, and shingles
A patient who has tuberculosis asks the nurse why three drugs are used to treat this disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of?
Drug resistance
The nurse is caring for a patient who is diagnosed with tuberculosis. That patient tells the nurse that the provider plans to order a prophylactic antitublar drug for family members and asks which drug will be ordered. The nurse will suspect the provider to order which drug?
Isoniazid (INH)
The nurse is teaching a nursing student about the anti fungal drug amphotericin B. which statement by the student indicates a need for further teaching? a. "Amphotericin may be given intravenously or by mouth" b. Patients who take this drug should have potassium and magnesium levels assessed" c. "Patients with renal disease should not take amphotericin B" d. "This drug is used for severe systemic infections"
a. "Amphotericin may be given intravenously or by mouth" Rationale is because the drug cannot be given by mouth
The nurse is teaching a group of parents about the use of syrup of ipecac. Which instruction will the nurse provide? a. "Do not administer ipecac without consulting a poison control center" b. "Expect the onset of emesis to be immediate" c. "Give ipecac with a glass of milk to increase its emetic effect" d. "Use ipecac fluid extract and not ipecac syrup"
a. "Do not administer ipecac without consulting a poison control center" Rationale: Always want to consult with poison control center to make sure the poison is not contraindicated with ipecac
The nurse is teaching a patient who is about to take a long car trip about using dimenhydrinate (Dramamine) to prevent motion sickness. What information is important to include when teaching this patient? a. "Do not drive while taking this medication" b. "Dry mouth is a sign of toxicity with this medication" c. "Take the medication 1 to 2 hours prior to beginning the trip" d. "Take 100 mg up to 6 times daily for best effect"
a. "Do not drive while taking this medication"
A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time? a. 5 minutes before eating b. 15 minutes after eating c. 30 minutes before eating d. 10 minutes after eating
a. 5 minutes before eating
A patient is preparing to travel to a country with prevalent malaria. To prevent contracting the disease, the provider has ordered chloroquine HCl (Aralen). The nurse will instruct the patient to take this drug according to which schedule? a. 500 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel b. 1000 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel c. 500 mg once followed by 500 mg per dose in 6 hours, 24 hours, and 48 hours d. 1000 mg once followed by 500 mg per dose in 6 hours, 24 hours, and 48 hours
a. 500 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel
A child is brought to the emergency department after ingestion of a toxic substance. The child is alert and conscious and is reported to have ingested kerosene 20 minutes prior. The nurse will anticipate administering? a. Activated charcoal b. An anticholinergic antiemetic c. Gastric lavage d. Syrup of ipecac
a. Activated charcoal Rationale: Since kerosene is a petroleum distillate vomiting should be avoided and activated charcoal should be given
A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next? a. Ask about alcohol consumption b. Reassure her that these are harmless side effects c. Tell her that this signals a worsening of her infection d. Tell her to go to the emergency department immediately
a. Ask about alcohol consumption Rationale is because alcohol causes serious adverse reactions and should be avoided at least 48 hours after treatment. It produces a disulfiram reaction
A patient who recently began having mild symptoms of GERD is reluctant to take medication. What measures will the nurse recommend to minimize this patient's symptoms (select all that apply a. Avoiding hot, spicy foods b. Avoiding tobacco products c. Drinking a glass of red wine with dinner d. Eating a snack before bedtime e. Taking ibuprofen with food f. Using a small pillow for sleeping g. Wearing well fitted clothing
a. Avoiding hot, spicy foods, b. Avoiding tobacco products, g. Wearing well fitted clothing, e. Taking ibuprofen with food
Which medication is indicated in the treatment of hypotonic or atonic bladder? a. Bethanechol (Urecholine) b. Oxybutynin (Ditropan) c. Tolterodine (Detrol) d. Solifenacin (VESIcare)
a. Bethanechol (Urecholine)
A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient? a. Blood urea nitrogen (BUN) and creatinine b. Electrolytes c. Fluconazole levels d. Glucose
a. Blood urea nitrogen (BUN) and creatinine Rationale is because BUN is excreted renally
The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the nurse expect the patient to experience? a. Inadequate drug effects b. Increased risk for superinfection c. Minimal adverse effects d. Slowed onset of action
a. Inadequate drug effects Rationale: Low peak levels may indicate that the medication is below the therapeutic level. They do not indicate altered risk for superinfection a decrease in adverse effects, or a slowed onset of action.
When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives highest priority to teaching the patient to? a. Increase fluid intake b. Report signs of ringing in the ears or loss of hearing c. Expect the color of their urine to change to a reddish orange d. Take this drug with dairy products or antacids to protect the stomach
a. Increase fluid intake Rationale: Fluid intake should be increased to at least 2000 mL/day when taking sulfonamides to prevent crystalluria. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not change colors. Dairy products or antacids should not be taken at the same time as sulfonamides because they decrease absorption
The patient is being discharged with continued ciprofloxacin therapy. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops? a. Pain in the heel of the foot b. Nausea c. Diarrhea d. Headache
a. Pain in the heel of the foot Rationale: Rarely, ciprofloxacin and other fluoroquinolones have caused tendon rupture, usually of the achilles tendon. The incidence is 1 in 10,000 or less. Because tendon injury is reversible if diagnosed early, fluoroquinolones should be discontinued at the first sign of tendon pain, swelling, or inflammation.
A patient reports having three to four stools, which are sometimes hard, per week. The nurse will preform which action? a. Recommend increased fluids and dietary fiber b. Request an order for a laxative as needed c. Request an order for a stool softener d. Suggest discussing chronic constipation with the provider
a. Recommend increased fluids and dietary fiber Rationale: Increased fluids and fiber will help soften stools
The nurse is instructing a patient who will take psyllium (Metamucil) to treat constipation. What information will the nurse include when teaching this patient a. The importance of consuming adequate amounts of water b. The need to monitor for systemic side effects c. The onset of action of 30 to 60 minutes after administration d. The need to use the dry form of Metamucil to prevent cramping
a. The importance of consuming adequate amounts of water Rationale: Avoid esophageal or intestinal obstruction
An appropriate goal when teaching a patient who has diarrhea is that the patient a. Will have less frequent, more formed stools b. Will not have a stool for 1 to 2 days c. Will receive adequate intravenous fluids d. Will receive appropriate antibiotic therapy
a. Will have less frequent, more formed stools Rationale: You want the patient to have less bowel movements and more formed stools
A patient asks the nurse the best way to prevent traveler's diarrhea. The nurse will provide which recommendation to the patient? a. "Ask your provider for prophylactic antibiotics" b. "Drink bottled water and eat only well cooked meats" c. Eat fresh, raw fruits and vegetables" d. "Take loperamide (Imodium) every day"
b. "Drink bottled water and eat only well cooked meats" Rationale: Traveler's diarrhea is usually caused by E. Coli so drinking bottled water and eating only well cooked meats will prevent the spread of E. Coli
A patient is receiving a glucocorticoid medication to treat an inflammatory condition, and the provider has ordered a slow taper in order to discontinue this medication. The nurse explains to the patient that this is done to prevent which condition? a. Acromegaly b. Adrenocortical insufficiency c. Hypertensive crisis d. Thyroid storm
b. Adrenocortical insufficiency
A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication the nurse will review which laboratory values in the patients medical record? a. Complete blood count (CBC) with differential white cell count b. Blood urea nitrogen (BUN) and creatinine c. Potassium and magnesium levels d. Serum fasting glucose
b. Blood urea nitrogen (BUN) and creatinine Rationale is these tests help test for nephrotoxicity
The nurse is caring for a patient who is being treated for hypothyroidism. The patient reports insomnia, nervousness, and flushing of the skin. Before notifying the provider, the nurse will preform which action? a. Assess serum glucose to evaluate possible hypoglycemia b. Check the patient's heart rate to assess for tachycardia c. Perform an assessment of hydration status d. Take the patient's temperature to evaluate for infection
b. Check the patient's heart rate to assess for tachycardia These are signs and symptoms of thyroid crisis
The nurse receives the following order for insulin: IV NPH (Humulin NPH) 10 units. The nurse will preform which action? a. Administer the dose as ordered b. Clarify the insulin type and route c. Give the drug subcutaneously d. Question the insulin dose
b. Clarify the insulin type and route
The patient has been ordered treatment with rimantadine (Flumadine). The patient has renal impairment. The nurse anticipates what change to the dose of medication? a. Increased b. Decreased c. Unchanged d. Held
b. Decreased
The nurse caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The nurse will contact the provider to? a. Discuss giving a smaller dose of penicillin b. Discuss using erythromycin (E-mycin) instead of penicillin c. Request an order for diphenhydramine (Benadryl) d. Suggest that the patient receives cefuroxime (Ceftin)
b. Discuss using erythromycin (E-mycin) instead of penicillin Rationale: Erythromycin is the drug of choice when penicillin is not an option. Giving smaller doses of penicillin does not prevent hypersensitivity reactions. Benadryl is useful when a hypersensitivity reaction has occured
A patient has administered regular insulin 30 minutes prior but has not received a breakfast tray. The patient is experiencing nervousness and tremors. What is the nurse's first action? a. Administer glucagon b. Give the patient 4 oz orange juice c. Give the patient 8 oz orange juice d. Preform bedside glucose testing
b. Give the patient 4 oz orange juice
The nurse is preparing to administer bethanechol chloride (Urecholine) to a patient. The nurse understands that this drug acts to: a. Block parasympathetic nerve impulses b. Increase the tone of the urinary detrusor muscle c. Relax smooth muscles in the urinary tract d. Relieve urinary pain and burning
b. Increase the tone of the urinary detrusor muscle
The nurse is caring for a patient who has unexplained recurrent vomiting and who is unable to keep anything down. Until the cause of the vomiting is determined, the nurse will anticipate administering which medications? a. Antibiotics and antiemetics b. Intravenous fluids and electrolytes c. Non-prescription antiemetics d. Prescription antiemetics
b. Intravenous fluids and electrolytes
A patient who is taking acyclovir (Zovirax) to treat an oral HSV-1 infection asks the nurse why oral care is so important. The nurse will tell the patient that meticulous oral care helps to? a. Minimize transmission of disease b. Prevents gingival hyperplasia c. Reduce viral resistance to the drug d. Shorten the duration of drug therapy
b. Prevents gingival hyperplasia
A patient who is taking metronidazole (Flagyl) reports reddish brown urine. Which action will the nurse take? a. Obtain an order for BUN and creatinine levels b. Reassure the patient that this is a harmless effect c. Request an order for a urinalysis d. Test her urine for occult blood
b. Reassure the patient that this is a harmless effect Rationale is because these side effects are more common in higher doses and pose no threat
The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min. The nurse notes red blotches on the patient's face, neck, and chest and assesses a blood pressure of 80/55 mm Hg. Which action will the nurse take? a. Request an order for IV epinephrine to treat anaphylactic shock b. Slow the infusion to 10 mg/min and observe the patient closely c. Stop the infusion and obtain an order for a BUN and serum creatinine d. Suspect Stevens-Johnson syndrome and notify the provider immediately
b. Slow the infusion to 10 mg/min and observe the patient closely Rationale: When vancomycin is infused too rapidly "red man" syndrome may occur; the rate should be 10 mg/min to prevent this. This is a toxic reaction, not an allergic one, so epinephrine is not indicated. Stevens-Johnson syndrome is characterized by a rash and fever. Red man syndrome is not related to renal function.
A patient is diagnosed with histoplasmosis and will begin taking ketoconazole. What information will the nurse include when teaching this patient about this medication? a. Take the medicine twice daily b. Take the medication with food c. You may consume small amounts of alcohol d. You will not need lab tests while taking this drug
b. Take the medication with food Rationale is because taking with food helps prevent GI discomfort
A patient is admitted to the health care facility with methicillin resistant Staphylococcus aureus (MRSA). The nurse anticipates administration of which drug? a. Nafcillin (Nallpen) b. Vancomycin (Vancocin) c. Aztreonam (Azactam) d. Piperacillin-tazobactam (Zosyn)
b. Vancomycin (Vancocin) Rationale: The treatment of choice for MRSA is vancomycin (Vancocin)
A patient has been prescribed oral ciprofloxacin (Cipro) for a skin infection. When administering the medication, it is most important for the nurse to do what? a. Monitor for a decrease in the prothrombin time (PT) if the patient is also taking warfarin (Coumadin) b. Withhold antacids and milk products for 6 hours before or 2 hours afterward c. Inform the healthcare provider if the patient has a history of asthma d. Assess the skin for Stevens-Johnson syndrome
b. Withhold antacids and milk products for 6 hours before or 2 hours afterward Rationale: Absorption of ciprofloxacin can be reduced by ingestion of antacids and milk products. Ingestion of these products should occur at least 6 hours before ciprofloxacin or 2 hours afterward. Ciprofloxacin can increase the PT if the patient is also taking warfarin. Use of ciprofloxacin is contraindicated in patients with a history of myasthenia gravis.
A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug which statement will the nurse include? a. "If you become pregnant, it is safe to take sulfadiazine" b. "You should limit your fluid intake while taking sulfadiazine" c. "Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin" d. "You will most likely need to have an increase in the dose of warfarin while taking sulfadiazine"
c. "Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin" Rationale: Sulfonamides can cause kernicterus in newborns so these drugs should not be given to pregnant women. They can be damaging to the kidneys so hydration is necessary. Instruct patients to complete the prescribed course of treatment, even though symptoms may abate before the full course is over
The nurse provides teaching for a patient who will begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. Which statement by the patient indicates understanding of teaching a. "If I experience gastrointestinal upset, I may take an antacid" b. "I should notify my provider immediately if my urine is brown c. "I should take the drug with food and increase my fluid intake" d. "Tingling of my fingers is a harmless side effect of this drug"
c. "I should take the drug with food and increase my fluid intake"
The nurse is teaching a patient who is newly diagnosed with type 1 diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching? a. "I may use a chosen site daily for up to a week" b. "I should give each injection a knuckle length away from a pervious injection" c. "I will not be concerned about a raised knot under my skin from injecting insulin" d. "Insulin is absorbed better from subcutaneous sites on my abdomen"
c. "I will not be concerned about a raised knot under my skin from injecting insulin"
A patient os suspected to have peptic ulcer disease from H. pylori. The patient asks the nurse what kind of testing will be done to determine the cause of the peptic ulcer. The nurse will inform the patient that a. Blood cultures will need to be drawn b. A biopsy of the stomach will be done c. A breath test will be preformed d. Computerized scanning will identify if H. pylori is present
c. A breath test will be preformed
The nurse is teaching a nursing student about the minimal effective concentration (MEC) of antibiotics. Which statement by the nursing student indicates understanding of this concept? a. A serum drug level greater than the MEC ensures that the drug is bacteriostatic b. A serum drug level greater than the MEC broadens the spectrum of the drug c. A serum drug level greater than the MEC helps eradicate bacterial infections d. A serum drug level greater than the MEC increases the therapeutic index
c. A serum drug level greater than the MEC helps eradicate bacterial infections Rationale: The MEC is the minimum amount if drug needed to halt the growth of a microorganism. A level greater than the MEC helps eradicate infections. Drugs at or above the MEC are usually bactericidal, not bacteriostatic. Raising the drug level does not usually broaden the spectrum or increase the therapeutic index of a drug
A patient will take an anthelmintic medication and asks the nurse about side effects. The nurse will tell the patient that anthelmintic drugs? a. Can cause hepatic toxicity b. Cause orthostatic hypotension c. Commonly have GI side effects d. Have many adverse reactions
c. Commonly have GI side effects
The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take? a. Administer the amoxicillin and have epinephrine available b. Ask the provider to order an antihistamine c. Contact the provider to discuss using a different antibiotic d. Request an order for a beta-lactamase resistant drug
c. Contact the provider to discuss using a different antibiotic Rationale: Patients who have previously experienced manifestations of allergy to a penicillin should not use penicillins again unless necessary. The nurse should contact the provider to discuss using another antibiotic from a different class. Epinephrine and antihistamines are useful when patients are experiencing allergic reactions, depending on severity.
A patient enters the emergency department with a draining wound. Once the patient is admitted and assessed, the priority nursing intervention is to? a. Administer the ordered antibiotics b. Teach the patient about the ordered antibiotics c. Culture the wound d. Enforce droplet isolation precautions
c. Culture the wound Rationale: The priority nursing intervention is to obtain a culture and antibiotic sensitivity testing of infective organism (C&S)
The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question? a. Azithromycin (Zithromax) 500 mg IV in 500 mL fluid b. Azithromycin (Zithromax) 500 mg PO once daily c. Erythromycin 300 mg IM QID d. Erythromycin 300 mg PO QID
c. Erythromycin 300 mg IM QID Rationale: Erythromycin and other macrolides should not be given intramuscularly because they cause painful tissue irritation
The nurse is caring for a patient who is ordered to receive PO trimethoprim-sulfamethoxazole (TMP-SMX) 160/800 QID to treat a urinary tract infection caused by E. coli. The nurse will contact the provider to clarify the correct? a. Dose b. Drug c. Frequency d. Route
c. Frequency Rationale: TMP-SMX is taken twice daily. This is the correct dose, drug, and route to treat this condition
A patient reports experiencing flatulence and abdominal distension to the nurse. Which over the counter medication will the nurse recommend? a. Alka-Seltzer b. Maalox c. Mylicon d. Tums
c. Mylicon
A patient is ordered to receive vancomycin (Vancocin) for a severe infection. It is mot important for the nurse to assess the patient for the development of? a. Neurotoxicity b. Hepatotoxicity c. Ototoxicity d. Cardiotoxicity
c. Ototoxicity Rationale: Vancomycin may cause nephrotoxicity and ototoxicity. Ototoxicity results in damage to the auditory or vestibular branch of cranial nerve VIII. Such damage can result in permanent hearing loss.
A 25 year old female patient reports urinary frequency with pain on urination, flank pain, fever, and chills. The nurse recognizes these symptoms as characteristics of which condition? a. Cystitis b. Dysuria c. Pyelonephritis d. Urethritis
c. Pyelonephritis
A day later the patient is ordered phenazopyridine hydrochloride. The most likely rationale for administration of this agent is? a. Treatment of the bacterial infection b. Increase of bladder tone c. Relief of urinary pain and burning d. Increase of urinary output
c. Relief of urinary pain and burning
A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim, Septra) to treat a urinary tract infection reports vaginal itching and discharge. The nurse will preform which action? a. Ask the patient is she might be pregnant b. Reassure the patient that this is a normal side effect c. Report a possible superinfection to the provider d. Suspect that the patient is having a hematologic reaction
c. Report a possible superinfection to the provider Rationale: Superinfection can occur with a secondary infection. Vaginal itching and discharge is a sign of superinfection. This is not symptomatic of pregnancy
A patient has adrenocortical insufficiency and was taking hydrocortisone (Solu-Cortef) 240 mg every 12 hours IV. Before discharge the drug was switched to prednisone (Deltasone). Which is appropriate teaching for discharging a patient with oral prednisone? a. Stop the drug when feeling better b. Prednisone is always given by injection c. The dose needs to be tapered off over 1 to 2 weeks d. Hyperkalemia is common
c. The dose needs to be tapered off over 1 to 2 weeks
A woman who is 2 months pregnant reports having morning sickness every day and asks if she can take any medication to treat this problem. The nurse will recommend that the patient take which action first? a. Contact the provider to discuss a possible need for intravenous fluids b. Contact the provider to discuss a prescription antiemetic c. Use non-pharmacologic measures such as saltines d. Take over the counter antiemetics such as diphenhydramine
c. Use non-pharmacologic measures such as saltine
The nurse is teaching a patient who is receiving chloroquine (Aralen) for malaria prophylaxis. Which statement by the patient indicates a need for further teaching? a. "I may experience hair discoloration while taking this drug" b. "I should not take this drug with lemon juice" c. "I should use sunscreen while taking this drug" d. "If I have GI upset, I should take an antacid"
d. "If I have GI upset, I should take an antacid"
A patient who has pain with urination associated with cystitis will be discharged home with a prescription for phenazopyridine (Pyridium). What instruction will the nurse include when teaching the patient about this drug? a. "Do not take this drug concurrently with an antibiotic" b. "Report reddish-brown urine to the provider immediately" c. "This drug has antiseptic and analgesic properties" d. "The drug provides symptomatic relief of pain"
d. "The drug provides symptomatic relief of pain"
The nurse is caring for a hospitalized patient who has symptoms characteristic of pyelonephritis. Before administering the first dose of the intravenous antibiotic the nurse will ensure that which action is preformed? a. An antipyretic is administered b. A dose of oral antibiotic is given c. A urinary analgesic is given d. A urine culture is obtained
d. A urine culture is obtained
The nurse is caring for for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs? a. Drugs with a broad spectrum b. Drugs with a narrow spectrum c. Drugs with a broad therapeutic index d. Drugs with a narrow therapeutic index
d. Drugs with a narrow therapeutic index Rationale: Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose. It is important to monitor these medications closely by evaluating regular serum peak and trough levels
Patient taking methenamine (Urex) for urinary tract infections are counseled to drink cranberry juice in order to? a. Ensure a brisk urine flow b. Increase the alkalinity of the urine c. Decrease urinary retention d. Lower the pH of the urine
d. Lower the pH of the urine
A nurse has been teaching a patient about levothyroxine (Synthroid). Which side effect should the nurse teach the patient to observe for? a. Somnolence b. Bradycardia c. Constipation d. Nervousness
d. Nervousness
A 48 year old patient has been admitted with abdominal pain and states that she has not has a bowl movement for 4 days. Her abdomen is distended and slightly tender. Which laxative would be appropriate for this patient? a. Milk of magnesia b. A bulk forming laxative c. Mineral oil d. No laxative should be given at this time
d. No laxative should be given at this time
Which statement about sulfonamide therapy is true? a. When used with sulfonylureas, sulfonamides decrease hypoglycemic effect b. When sulfonamides are used with warfarin, the anticoagulant effect is decreased c. Sulfonamides must be taken with antacids to prevent gastric ulceration d. Patients on sulfonamide therapy need to increase their fluid intake
d. Patients on sulfonamide therapy need to increase their fluid intake Rationale: Patients taking sulfonamides need to drink several quarts of fluid daily to avoid the complication of crystalluria. These drugs increase the hypoglycemic effect of sulfonylureas, increase the anticoagulant effect of warfarin, and should not be taken with antacids because antacids decrease the absorption rate.
During a diagonstic test for parathyroid function, a patient asks the nurse what the parathyroid gland does. The nurse correctly informs the patient that the parathyroid gland is responsible for? a. Regulating the body's metabolism b. Maintaining blood glucose levels c. Controlling the release of glucocorticoids d. Regulating calcium levels
d. Regulating calcium levels
An elderly patient reports using Maalox frequently to treat acid reflux. The nurse should notify the patient's provider to request an order for which laboratory tests? a. Liver enzymes and serum calcium b. Liver enzymes and serum magnesium c. Renal function tests and serum calcium d. Renal function tests and serum magnesium
d. Renal function tests and serum magnesium Rationale: Assess kidney function and test for hypermagnesia
The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin. Which is an important nursing action? a. Administer each antibiotic to infuse over 15 to minutes b. Order serum peak and trough levels of ampicillin c. Prepare the schedule so that the drugs are given at the same time d. Set up separate tubing sets for each drug labeled with the drug name and date
d. Set up separate tubing sets for each drug labeled with the drug name and date Rationale: Intravenous amino-glycosides can be given with penicillin and cephalosporins but should not be mixed in the same container. The IV line should be flushed between antibiotics or separate tubing sets may be set up. Gentamicin must be infused over 30 to 60 minutes. It is not necessary to measure ampicillin peak and trough levels. Giving the drugs at the same time increases the risk of mixing them together
A patient who has oral candidiasis will begin nystatin suspension to treat the infection. What information will the nurse include when teaching this patient? a. Coat the buccal mucosa with drug and then rinse your mouth b. Gargle with the nystatin and then spit it out without swallowing c. Mix the suspension with 4 ounces of water and then drink it d. Swish the liquid in your mouth and the swallow after a few minutes
d. Swish the liquid in your mouth and the swallow after a few minutes
The nurse is caring for a 7-year-old patient who will receive oral antibiotics. Which antibiotic order will the nurse question for this patient? a. Azithromycin (Zithromax) b. Clarithromycin (Biaxin) c. Clindamycin (Cleocin) d. Tetracycline (Sumycin)
d. Tetracycline (Sumycin) Rationale: Tetracyclines should not be given to children younger than 8 years of age because they irreversibly discolor permanent teeth
A patient will begin taking a urinary antimuscarinic medication. Which symptom should the patient report immediately? a. Dry mouth b. Fatigue c. Increased heart rate d. Urinary retention
d. Urinary retention
A patient has been prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The nurse realizes that this drug is most likely used to treat which condition? a. Gonorrhea b. Rickettsial infection c. Chlamydial infection d. Urinary tract infection
d. Urinary tract infection Rationale: TMP-SMZ is used to treat urinary tract infections, otitis media, bronchitis, pneumonia, rheumatic fever, and burns. It does not treat gonorrhea, rickettsial or chlamydial infections
A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? a. Hypotension b. Bronchospasm c. Temperature of 35.5 C d. Widespread skin lesions
d. Widespread skin lesions Rationale: Symptoms of Stevens-Johnson syndrome include widespread lesions of the skin, and mucous membranes, combined with fever, malaise, and toxemia.
A child is being treated for pinworms and the parent asks the nurse how to prevent spreading this to other family members. What will the nurse tell the parent? a. Give your child baths every day b. Obtain a daily stool specimen from your child c. Wash your child's clothing in hot water d. Your child should wash hands well after using the toilet
d. Your child should wash hands well after using the toilet
