CH 20 Tetracyclines, Sulfonamides, and Urinary Antiseptics (E1)
A 64-year-old client seeking care for the treatment of a urinary tract infection (UTI) was prescribed nitrofurantoin. What change in the client's health status would prompt the use of an alternative medication? A) The client develops a fluid volume deficit. B) Urinalysis reveals the presence of ketones. C) The client develops leukocytosis. D) The client's UTI progresses to urosepsis.
D
T/F: Tetracyclines are rarely used for systemic infections.
True
A client has been prescribed doxycycline. Which teaching instruction is a priority with this medication? A) Avoid sun exposure. B) Avoid unprotected sexual activity. C) Administer with an antacid. D) Chew the tablets.
A
A client is given tetracycline to treat acne-related skin eruptions. How does tetracycline work? A) It binds to the 30S ribosome to inhibit protein synthesis. B) It reduces central nervous system stimulation. C) It is a beta-lactam antibiotic inhibiting cell wall synthesis. D) It works on the final stage of cell wall synthesis.
A
A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What would contraindicate the use of sulfamethoxazole-trimethoprim with this client? A) liver failure B) rheumatoid arthritis C) bone marrow depression D) congestive heart failure
A
A nurse preparing to administer a client's first scheduled dose of tetracycline should first ensure that the client has not recently eaten what type of foods? A) dairy products B) leafy green vegetables C) any high-fat foods D) acidic foods
A
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamide that will most likely be prescribed? A) trimethoprim-sulfamethoxazole B) tetracycline C) doxycycline D) demeclocycline
A
Phenazopyridine, a urinary antiseptic, turns urine what color? A) Reddish-orange B) Reddish- black C) Greenish-blue D) it has no effect on urine color
A
A nurse is teaching a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include? SELECT ALL THAT APPLY. A) Observe for bruising on the skin. B) Take the medication with milk or meals. C) Expect brown discoloration of urine. D) Crush the medication if it is difficult to swallow. E) Expect insomnia when taking it.
A, B, C
A nurse is teaching a client who has a severe UTI about ciprofloxacin. Which of the following information about adverse reactions should the nurse include? SELECT ALL THAT APPLY. A) Observe for pain and swelling of the Achilles tendon. B) Watch for a vaginal yeast infection. C) Expect excessive nighttime perspiration. D) Inspect the mouth for cottage-cheese like lesions. E) Take the medication with a dairy product.
A, B, D
The nurse prepares to administer tetracycline 500 mg PO every 6 hours to an adult client newly diagnosed with Lyme's disease. The client takes an oral contraceptive for birth control. Which measures would the nurse provide for safe and effective drug administration? SELECT ALL THAT APPLY. A) Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). B) Administer the medication with milk or food to decrease gastrointestinal side effects. C) Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D) Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E) Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber.
A, C, D, E
A nurse reviewing a client's medication history notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? SELECT ALL THAT APPLY. A) Hydrochlorothiazide B) Metoprolol C) Acetaminophen D) Glipizide E) Furosemide
A, D, E
A client is administered a sulfonamide for a urinary tract infection. Which nursing intervention is most appropriate to increase the alkalinity of the client's urine and so increasing the medication's effectiveness? A) Provide at least 2000 mL of water daily. B) Administer sodium bicarbonate. C) Recommend a tub bath every evening. D) Provide orange juice daily.
B
A client is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for treating the infection associated with Lyme's disease? A) ibuprofen B) tetracycline C) phenazopyridine D) nitrofurantoin
B
A client, who sustained a burn from a gas grill, has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection? A) intrathecal B) topical C) parenteral D) oral
B
A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? A) Administer a concentrated solution. B) Infuse the medication over 60 minutes. C) Infuse the solution through the primary IV's tubing. D) Choose a small peripheral vein for administration.
B
A nurse is teaching a client about taking tetracycline to treat a GI infection due to H. pylori. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A) I will take this medication with 8 oz of milk. B) I will let my doctor know if I start having diarrhea. C) I can stop taking this medication when I feel completely well. D) I can take this medication just before bedtime.
B
A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI? A) vaginitis B) Chlamydia C) human papillomavirus D) trichomoniasis
B
The nurse prepares to administer nitrofurantoin 100 mg PO every 12 hours to an adult client newly diagnosed with a urinary tract infection. Which measures would the nurse provide for safe and effective drug administration? SELECT ALL THAT APPLY. A) Instruct the client that the drug is a urinary analgesic to provide pain relief of urinary tract infection symptoms. B) Inform the client that the medication may cause the urine to turn a harmless brown coloration. C) Administer the drug with a meal or snack because food helps with drug absorption and decreases onset of GI distress. D) Administering with antacids with magnesium increase the drug absorption of the nitrofurantoin. E)Educate the client that the drug is safe with pregnancy and has no adverse effects on fetal development.
B, C
A client has been prescribed phenazopyridine for urinary tract symptoms related to the infection. The client asks why she is taking this medication. What is the most appropriate response by the nurse? A) "This medicine is used to treat urinary retention." B) "This medicine will stop the blood in your urine." C) "This medicine will decrease the pain of your infection." D) "This medicine will prevent hesitancy when you're passing urine."
C
A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim-sulfamethoxazole. Which of the following information should the nurse include? A) Take the medication even if pregnant. B) Maintain a fluid restriction while taking it. C) Take it on an empty stomach. D) Stop taking it when manifestations subside.
C
A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinical 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence? A) a delayed (type IV) hypersensitivity reaction B) the fact that the client may have chewed the capsules prior to swallowing them C) superinfection following the eradication of normal oral flora D) a type I hypersensitivity reaction
C
Nitrofurantoin, a urinary antiseptic, turns urine what color? A) Red B) Green C) Brown D) Orange
C
The nurse is educating a client diagnosed with a urinary tract infection about the prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The client has a history of type 2 diabetes and currently takes a sulfonylurea. Which statement made by the client establishes the need for further clarification? A) "I will monitor my blood sugar carefully since the drug may lower it." B) "I will take the drug with 8 ounces of water before or after meals." C) "The drug will not affect the herbal supplement, ginseng that I take." D) "If a rash develops, the drug will be discontinued and my prescriber notified."
C
What is the rationale for not administering tetracycline to children under the age of 8 years? A) It will not treat the infection effectively. B) It will increase the risk of heart failure. C) It will interfere with enamel development. D) It will increase the risk for future infections.
C
A 9-year-old has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the admission orders and notes that IV demeclocycline has been ordered. After beginning this treatment, the nurse should confirm the results of what laboratory test? A) mean corpuscular volume (MCV) B) D-dimer C) bilirubin D) blood urea nitrogen (BUN)
D
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? A) assessing for the presence of asthma B) assessing for hypertension C) assessing for diabetes mellitus D) assessing for renal insufficiency
D
A teenager asks the nurse how tetracycline will improve the acne. Which statement should the nurse provide to the client regarding the action of tetracycline? A) "Tetracycline decreases redness and swelling of the pustules." B) "Tetracycline treats the Chlamydia organism that causes acne." C) "Tetracycline is used in combination with doxycycline to treat acne." D) "Tetracycline interferes with the production of free fatty acids."
D
The nurse is educating a client newly diagnosed with a urinary tract infection about the prescribed phenazopyridine hydrochloride. Which statement made by the client establishes the need for further clarification? A) "The drug is an azo dye that acts directly on urinary tract mucosa to provide pain relief." B) "If I develop a sore throat, bleeding, or bruising, I will report the symptoms to my prescriber." C) "I will need to take the drug with food to decrease stomach upset." D) "I should report reddish-orange urine immediately to the prescriber."
D
