chapter 9 pharm
When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions? The need to increase fluid intake for the duration of treatment The need to take the medication on an empty stomach The fact that the drug should be discontinued once symptoms subside The fact that a mild rash frequently follows the first few doses
The need to take the medication on an empty stomach
A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? amoxicillin ciprofloxacin ibuprofen neomycin-polymyxin B
amoxicillin
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? antidiabetic agents antacids oral contraceptives antihypertensives
anatcids
After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example? Ertapenem Doripenem Imipenem-cilastatin Cefuroxime
cefuroxime
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? Administer an extra dose of levofloxacin. Administer an antipyretic. Notify the health care provider. Continue to monitor vital signs.
continue to monitor vital signs
Prior to administration of fluoroquinolones, which laboratory test should be obtained? Renal function Hepatic function Complete blood counts Culture and sensitivity
culture sensitivity
A client reports having had a "bad reaction" the last time receiving penicillin. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug? vancomycin clindamycin metronidazole erythromycin
erythromycin
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? Severe hypotension Inflammation of the tongue and mouth Impaired oral mucous membranes Sudden loss of consciousness
inflammation of tongue and rash
A 66-year-old woman with a history of recurrent urinary tract infections has been admitted to the hospital with a diagnosis of pyelonephritis. The client began treatment 36 hours ago with intravenous gentamicin and is being monitored closely. The nurse is aware that the therapeutic effect of the client's drug regimen is primarily a result of: alterations in the osmolarity of bacterial cytoplasm. lysis of the bacterial cell walls. enhancement of the client's immune function. interference with bacterial reproduction.
interference with bacterial reproduction
A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of: oral contraceptives. nicotine. fats in her diet. alcohol.
oral contraceptives.
Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies? Penicillin Vancomycin Tetracycline Cephalosporin SUBMIT ANSWER
penicillin
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the: choice of drug. frequency. dose. route
route.
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause orange-tinged urine. deep muscle pain. staining of permanent teeth. sleep deprivation.
staining of permanent teeth.
A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as: superinfection. skin rash. allergic reaction. allergy. anaphylactic reaction.
superinfection
Tetracyclines should not be used in children younger than 8 years of age because of their effects on:
teeth and bones.
A client is receiving gentamicin to treat meningitis. The health care provider has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn? 09:00 10:00 08:00 12:00
08:00
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? Lactulose Kanamycin Ketoconazole Cefadroxil
Cefadroxil
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?
Chlamydia
Aminoglycosides are contraindicated for all of the following clients EXCEPT: Clients with acute renal failure. Clients with drug-resistant TB. Clients with multiple sclerosis. Clients with myasthenia gravis.
Clients with drug-resistant TB.
An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH? Hypovolemia Hypoxemia Renal failure Hepatotoxicity
Hepatotoxicity
The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction? Hyperglycemia Elevated temperature Increased bruising Hypoglycemia
Hypoglycemia
Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic? Inhibition of cell wall osmosis Inhibition of synthesis of bacterial proteins Inhibition of mitochondrial reproduction Inhibition of synthesis of DNA only
Inhibition of synthesis of bacterial proteins
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection? Nephrotoxicity Nausea Increased bleeding Respiratory difficulty
Nephrotoxicity
What drug belongs to the group of carbapenems? Primaxin
Primaxin
A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option? Kanamycin Rifampin Ciprofloxacin Capreomycin
Rifampin
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? Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels Red blood count, white blood count, and differential Fasting blood sugar and 2-hour postprandial blood sugar Serum alanine transaminase, aspartate transaminase, and bilirubin
Serum alanine transaminase, aspartate transaminase, and bilirubin
Common, potentially serious, adverse effects of antibiotic drugs include: Hypopnea Pain Constipation Skin rash
Skin rash
The nurse understands that which is the highest priority when teaching about antitubercular medications? Staying hydrated Taking medications as prescribed Eating a well balanced diet Monitoring sputum
Taking medications as prescribed
A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client? These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. Stop the medication and the health care provider will order you a different antibiotic. Continue to take the medication as prescribed; these are expected side effects from the medication.
These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.
When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element? direct sunlight unpasteurized dairy products alcohol foods containing purines
alcohol
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. increase in respiratory rate drop in blood pressure sudden increase in temperature regular urine output pulse rate within usual parameters
drop in blood pressure increase in respiratory rate sudden increase in temperature
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? drug- resistant TB Vancomycin-resistant Staphylococcus aureus Methicillin-resistant Staphylococcus aureus Human immunodeficiency virus
drug- resistant TB
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? gram-positive infections viral infections gram-negative infections fungal infections
gram-negative infections
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 on an empty stomach. with or without food. with food. immediately after she eats.
on an empty stomach
The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age? Teeth Kidneys Hearing Vision
teeth
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? vancomycin warfarin losartan atorvastatin
warfarin
After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class? Tobramycin Neomycin Kanamycin Gentamicin
Gentamicin
Penicillins and cephalosporins are used cautiously in neonates due to what factor? Immature kidney function Immature liver function Immature immune function Immature pancreatic function
Immature kidney function
A client with a diagnosis of necrotizing otitis externa has been prescribed ciprofloxacin. What microorganism is the most likely cause of the disorder? Escherichia coli Candida albicans Pseudomonas aeruginosa Aspergillus
Pseudomonas aeruginosa
After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement? "I will take the drug with an antacid to prevent an upset stomach." "I need to wear protective clothing when I'm out in the sun." "I should limit the amount of fluids that I drink." "I should chew gum and chocolate if my mouth gets sore."
"I need to wear protective clothing when I'm out in the sun."
The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe? Meclizine Loxapine hydrochloride Erythromycin Pravastatin
Erythromycin
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? "I only need to take one pill every day for this medicine to work." "I might have some bloody diarrhea after using this medicine." "I should drink a full 8-oz glass of water when I take the medicine." "I need to take the medicine with a meal so I don't get an upset stomach."
I should drink a full 8-oz glass of water when I take the medicine."
Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason? Intermittent resistance Increasing resistance Decreased resistance Increased susceptibility
Increasing resistance
A client being treated for tuberculosis is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis? Propranolol and sotalol Carbamazepine and phenytoin Dextroamphetamine and doxapram Isoniazid and rifampin
Isoniazid and rifampin
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? It lowers the pH of cellular contents. It inhibits cell wall synthesis. It causes mutations. It inhibits protein synthesis.
It inhibits cell wall synthesis.
A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice? It is excreted into the GI tract. It is excreted into the bloodstream. It is metabolized in the liver. It is metabolized in the kidneys.
It is metabolized in the liver.
Which of the following are examples of fluoroquinolones? Select all that apply. Cephalexin (Keflex) Levofloxacin (Levaquin) Spectinomycin (Trobicin) Amoxicillin (Amoxil) Ciprofloxacin (Cipro)
Levofloxacin (Levaquin) Ciprofloxacin (Cipro)
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? Review the medical for a history of nephrotoxic signs or symptoms. Review lab results to confirm normal liver function. Question the client about any history of gastrointestinal upset. Confirm the ability to safely swallow oral medication.
Review lab results to confirm normal liver function.
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? "The administration will decrease the growth of intestinal bacteria." "The administration decreases the risk of airborne contamination of the wound." "The administration by mouth will minimize the risk of ototoxicity." "The administration by mouth will prevent renal damage from occurring."
The administration decreases the risk of airborne contamination of the wound."
What assessment finding may be attributable to an adverse effect of erythromycin? The client was incontinent of urine during the night. The client is uncharacteristically euphoric. The client slept poorly due to a dry cough. The client's systolic blood pressure is approximately 20 mm Hg below the norm.
The client is uncharacteristically euphoric.
A client is prescribed rifampin. What information should the nurse include in the client's medication education? It has an increased serum half-life, so it is more effective than rifabutin. When taking it with warfarin, an increased anticoagulant effect occurs. The urine, tears, sweat, and other body fluids will be a discolored red-orange. It decreases hepatic enzymes and decreases metabolism of drug
The urine, tears, sweat, and other body fluids will be a discolored red-orange
A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? To decrease allergic response of medications To prevent adverse reactions To prevent resistance To decrease length of drug therap
To prevent resistance
Which of the following are examples of a secondary infection? Select all that apply. C. difficile colitis Vaginal candidiasis Otitis media Oral candidiasis Endocarditis SUBMIT ANSWER
Vaginal candidiasis Oral candidiasis C. difficile colitis
Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Kidneys GI/GU tract Lymph nodes All the above
all the above
Drugs that destroy bacteria are known as which type of drug? bactericidal bacteriophage bacteriostationary bacteriostatic
bactericidal
A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately? The client has a new onset of jaundice and edema The client is tearful and expresses fear of a bad prognosis The client's peripheral IV site has gone interstitial The client vomited 20 minutes ago and still reports nausea
he client has a new onset of jaundice and edema
A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform? Offer patient a liquid diet. Instruct the patient to gargle every two hours. Inspect mouth and gums regularly. Instruct patient to avoid brushing teeth.
inspect mout hand gums regularly
A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client? Nausea Excessive tearing Hypotension Chest pain
nausea
A nurse is assessing a client for possible adverse reactions associated with fluoroquinolone therapy. Which possible reactions would the nurse attribute to this therapy? Select all that apply. nausea abdominal discomfort diminished urine output diarrhea ringing in the ears
nausea diarrhea abdominal discomfort
What event triggers the development of a superinfection? unforeseen interactions between the antibiotic and other prescribed medications proliferation of antibiotic-resistant microorganisms the infection is well established before antibiotic treatment begins bone marrow suppression triggered by antibiotic treatment
proliferation of antibiotic-resistant microorganisms
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? shortness of breath heartburn nausea frontal lobe headache
shortness of breath
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? The client should be warned of the risk for photosensitivity. The health care provider should order culture and susceptibility studies. The client should be assessed for penicillin allergy to rule out cross-allergenicity. The client should be taught how to store the medication appropriately.
the health care provider should order culture and susceptibility studies.
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? ALT and AST Urine culture and sensitivity Hematocrit and hemoglobin Complete blood count (CBC) with differential
ALT and AST
A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods? Citrus fruits Chicken and fish Potatoes and root vegetables Cheese, dairy products, and bananas
Cheese, dairy products, and bananas
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? Respiratory depression Altered cognition Diarrhea Hematuria
Diarrhea
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? It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. The use of ciprofloxacin is contraindicated in pregnancy. The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client. Ciprofloxacin is safe to use in pregnancy and the client may use to same dose and route as a nonpregnant client.
the use of ciprofloxacin is contraindicated in pregnancy.
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? "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control." "The antibiotics are only effective against some types of bacteria." "The antibiotics are only effective in killing off some of the bacteria in the body."
Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect? DNA replication Protein synthesis Cell wall synthesis Cell division
Cell wall synthesis
Which statement by a client taking a sulfonamide requires further instruction? "I will take all of my medicine even if my symptoms go away." "I will make sure to use extra sunscreen when I go to the tanning booth." "I will take my medicine with my meals like it says on the prescription bottle." "I will be sure to drink a full glass of water every time I take my medicine."
"I will make sure to use extra sunscreen when I go to the tanning booth."
A 20-year-old female is being treated with rifampin and INH. The nurse is teaching the client about birth control recommendations while on these medications. What method would the nurse recommend? The use of condoms Oral contraceptives and condoms concurrently Depo-Provera injections Any of the above
any of the above
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?
Confirm the client's allergy status.
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: Penicillin G is inactivated by gastric acid, therefore it is only given IM. Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV. Penicillin G can be given orally but requires higher doses. Penicillin G is no longer used for this problem.
Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.
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? Avoid foods high in sodium such as processed meats. Take precautions to prevent photosensitivity. Take the necessary vitamins along with the drug. Take a missed dose, even if close to the next dose.
Take precautions to prevent photosensitivity.
A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client? urinalysis renal and hepatic function tests complete blood count culture and sensitivity test
culture and sensitivity test
A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component? proteins fluids vitamin D calories
fluids
A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed? tetracycline hydrochloride amoxicillin tetracycline phenazopyridine hydrochloride
tetracycline
In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences: increased appetite. leg pain. pale urine. yellowing of the eyes or skin.
yellowing of the eyes or skin.
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? "I may have some abdominal pain with this medication." "If I have trouble breathing, I will call 911." "I will take all of my antibiotics." "I will only drink enough water to swallow the drug."
"I will only drink enough water to swallow the drug."
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client? "Remember to have your required blood work drawn in 48 hours." "Make sure to avoid drinking any alcohol for the next three days." "You might develop a mild fever when you finish your antibiotics, but that doesn't mean your infection has returned." "It's possible that your urine might be pink-tinged for the next little while, but that's expected and it will resolve."
"Make sure to avoid drinking any alcohol for the next three days."
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? "Otic medications are contraindicated during pregnancy. Do not take it." "If the infection seems the same, then you could try using the same prescription." "Ofloxacin drops are used in children, so it is probably okay to use when pregnant." "The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."
"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."
The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse? "You are experiencing an adverse affect of the medication. Those symptoms will decrease over time." "You are allergic to the medication. Stop taking it immediately." "You may be experiencing an additional infection. I will discuss this with your health care provider." "That is the medication working. Continue to take as directed."
"You may be experiencing an additional infection. I will discuss this with your health care provider."
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day? 2 8 6 4
8
A client has been diagnosed with an infected postoperative wound, and cultures reveal methicillin-resistant Staphylococcus aureus (MRSA). The client is currently receiving intravenous cefazolin because in vitro testing indicates susceptibility. When considering the effectiveness of this client's treatment, what is the nurse's best action? Monitor the client closely for signs of hepatotoxicity. Administer the medication as prescribed and monitor for expected outcomes. Contact the health care provider because the medication should be changed to the oral route. Contact the health care provider because the medication is not known to be clinically effective.
Administer the medication as prescribed and monitor for expected outcomes.
In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply. A decrease in the sensitivity of gram-positive microorganisms. A decrease in sensitivity of gram-negative microorganisms. An increase in sensitivity of gram-negative microorganisms. An increase in sensitivity of gram-positive microorganisms. An increase in the sensitivity of viral microorganisms.
An increase in sensitivity of gram-negative microorganisms. A decrease in the sensitivity of gram-positive microorganisms.
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract? Take prescribed Ethambutol with food. Double the dose if earlier dose is missed. Take prescribed Pyrazinamide without regard to food. Avoid the consumption of alcohol.
Avoid the consumption of alcohol.
Which drug is a first-generation cephalosporin used as a surgical prophylaxis? Cefoxitin Cefotetan Cefazolin Ceftriaxone
Cefazolin
After 3 weeks of drug therapy for TB, a client is not showing reduction of symptoms. Repeated lab work shows positive cultures. What issues should the nurse consider? (Select all that apply.) Client noncompliance Drug resistance Defective medication Intermittent administration
Client noncompliance Drug resistance
A nurse is caring for a 35-year-old male taking telithromycin. For what type of infection is this client being treated? Bacterial colitis Community-acquired pneumonia Streptococcal meningitis Streptococcal sinusitis
Community-acquired pneumonia
Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order? Culture and sensitivity Electrolyte panel Complete blood count White blood count
Culture and sensitivity
A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do? Increase the drug dose. Administer the drug via an intramuscular route. Decrease the drug dose. Maintain the drug dose.
Decrease the drug dose.
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? Increased elimination Increased absorption Decreased absorption Decreased elimination
Decreased absorption
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? Discoloration of the teeth Visual disturbances Abdominal pain or cramping Epigastric distress
Discoloration of the teeth
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? Administer oral diphenhydramine to the client during the infusion. Slow down the rate so that the infusion takes place over 2 hours. Discontinue the infusion and inform the health care provider promptly. Administer an STAT dose of acetylcysteine.
Discontinue the infusion and inform the health care provider promptly.
A client is diagnosed with an infectious process that is sensitive to penicillin. The client is allergic to penicillin, so the health care provider orders a drug with a similar antibacterial spectrum. The nurse anticipates that the provider will order what antibiotic? Erythromycin Dicloxacillin Vancomycin Streptomycin
Erythromycin
What potential adverse reaction is most likely to develop during cefazolin therapy? Dry skin and pruritus Orthostatic hypotension Drowsiness Gastrointestinal upset
Gastrointestinal upset
A client being treated for tuberculosis is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis? Dextroamphetamine and doxapram Isoniazid and rifampin Propranolol and sotalol Carbamazepine and phenytoin
Isoniazid and rifampin
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? Urine culture Audiometric studies Liver function studies Pulmonary function studies
Liver function studies
Penicillins are utilized in the treatment of which of the following bacterial infections? (Select all that apply) Osteomyelitis Syphilis Intra-abdominal infections Meningitis Upper respiratory tract infections
Meningitis Syphilis Intra-abdominal infections Upper respiratory tract infections
Which of the following are true of sulfonamides? Select all that apply. Sulfonamides are poorly absorbed when given orally. Sulfonamides treat only gram-negative infections. Sulfonamides are well-absorbed when given orally. Sulfonamides are excreted by the kidneys. Sulfonamides treat only gram-positive infections.
Sulfonamides are well-absorbed when given orally. Sulfonamides are excreted by the kidneys.
The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present? Perform a lumbar puncture to assess cerebrospinal fluid. Assess serum electrolyte levels. Perform a complete blood count (CBC) test. Perform culture and susceptibility tests.
Perform culture and susceptibility tests.
The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring? Serotonin syndrome Red man syndrome Gray syndrome Cushing's syndrome
Red man syndrome
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? Headache Renal disease Aplastic anemia Abdominal cramp
Renal disease
Cephalosporins should be used cautiously in clients with which of the following? Select all that apply. Known penicillin allergy Renal disease Bleeding disorder Hepatic impairment Diabetes
Renal disease Hepatic impairment Bleeding disorder Known penicillin allergy
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? Rifampin and Pyrazinamide Pyrazinamide and dapsone Rifampin and isoniazid Dapsone and isoniazid
Rifampin and isoniazid
The health care provider orders an aminoglycoside for a ventilator-dependent client who is admitted to the critical care unit. The client's current diagnoses include respiratory arrest, type 2 diabetes, hepatitis C, and chronic obstructive pulmonary disease. Which statement indicates the risk of using this class of medication in this client? Risk for hepatic impairment is significant, because the drug is metabolized in the liver. Risk for hepatic impairment is not significant, because the drug is excreted through the kidneys. Risk for hepatic impairment is significant because of a higher risk for toxicity. Risk for hypertensive crisis is increased.
Risk for hepatic impairment is not significant, because the drug is excreted through the
A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions? Increase in serum theophylline level Increase in serum levels Respiratory depression Risk of toxicity
Risk of toxicity
The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client? Do not take your oral contraceptives while you are taking this medication. Use a type of barrier birth control while you are taking this antibiotic. Taking this antibiotic with your oral contraceptives will cause an increased chance of bleeding. Your menstrual cycle will have a heavier flow while on this medication.
Use a type of barrier birth control while you are taking this antibiotic.
The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician? Abdominal pain Vaginal itching and discharge Nausea Swelling and itching of the throat
Vaginal itching and discharge
The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects? Vomiting and diarrhea Headache and dizziness Phlebitis Superinfections
Vomiting and diarrhea
When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline? leukocyte count of 11.6/mm3 (high) potassium of 3.4 mEq/L (3.40 mmol/L) (low) creatinine of 2.8 mg/dL (247.52 µmol/L) (high) hemoglobin of 10.5 g/dL (105.00 g/L) (low)
creatinine of 2.8 mg/dL (247.52 µmol/L) (high)
A nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which action would the instructor most likely include? interfering with protein synthesis interfering with DNA synthesis in the bacterial cell blocking ribosomal reading of mRNA disrupting the bacterial cell wall
interfering with DNA synthesis in the bacterial cell
The client has developed a pressure area on her hip that has become infected. If the wound culture reveals vancomycin-resistant enterococci (VRE), which medication will the nurse expect to be prescribed? chloramphenicol linezolid quinupristin-dalfopristin clindamycin
linezolid
The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem? encephalitis chlamydial infection endocarditis methicillin-resistant Staphylococcus aureus (MRSA) infection
methicillin-resistant Staphylococcus aureus (MRSA) infection
A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away? a persistent cough since starting the medication a slight decrease in his blood glucose levels numbness and tingling in his feet changes in his bowel elimination pattern
numbness and tingling in his feet
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? oral (PO) subcutaneous (SQ) intravenous (IV) intramuscular (IM)
oral
A critical care nurse is caring for a client taking aminoglycosides. The dosage may need to be adjusted if the nurse finds monitored changes in what system? intestinal function lung function renal function cardiac function
renal function
A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug? skin rash or itching tachycardia polydipsia dizziness
skin rash or itching
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? Take the drug immediately after meals. Take the drug along with milk or fruit juice. Take the drug on an empty stomach. Take the drug along with a meal.
take the drug on an empty stomach
A teenager is admitted to a health care facility for a fungal infection. It has been determined that the infection was present for a long time, but there was no treatment undertaken. The teenager now has a systemic fungal infection for which flucytosine is prescribed. Which would be most important for the nurse to assess before beginning therapy? weight vaginal discharge hydration status oral mucosa
weight
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 immediately before or with a meal. with a sip of water 1 hour before mealtime. intravenously with the assistance of a home health nurse. with a glass of water 1 hour before or 2 hours after a meal.
with a glass of water 1 hour before or 2 hours after a meal.
