Exam 6 Answers

The nurse is providing care for an older adult who has a urinary tract infection. What aspect of this client's current health status should the nurse focus on when ensuring safe and effective antibiotic therapy? The client has a history of cirrhosis. The client has type 2 diabetes controlled with diet. The client uses bronchodilators for the treatment of asthma. The client had a hip fracture 8 months ago.

The client has a history of cirrhosis

What assessment finding would signal the nurse to the possibility that the client's infusion of vancomycin is running too quickly? The client is flushed and has a visible skin rash. The client's apical heart rate is irregular. The client is reporting nausea. The client reports pain at the intravenous access site.

The client is flushed and has a visible skin rash.

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? 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. It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client.

The use of ciprofloxacin is contraindicated in pregnancy.

A client is asking how fluoroquinolones work. What is the nurse's best response? They inhibit the growth of the bacteria. They disrupt the cell membrane of the bacteria. They interfere with the DNA of the bacteria. They promote WBC development from the bone marrow.

They interfere with the DNA of the bacteria.

A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which can be an adverse effect of the drug? Yellow-gray-brown discoloration of the teeth Toxic effects to the developing fetus Increase in the blood pressure Bacterial overgrowth of nonsusceptible organisms

Toxic effects to the developing fetus

A premenopausal woman has been bothered with recurrent urinary tract infections. What antibiotic after sexual intercourse would assist in preventing the recurrence of infection? Amoxicillin (Amoxil) Trimethoprim-sulfamethoxazole (Bactrim) Pyridium (phenazopyridine hydrochloride) Anaspaz (hyoscyamine sulfate)

Trimethoprim-sulfamethoxazole (Bactrim)

Fluoroquinolones, such as norfloxacin (Noroxin), are commonly prescribed antibiotics given to treat which of the following? Yeast infections Respiratory infections Severe skin infections Urinary tract infections

Urinary tract infections

Which client would be at risk of developing an infection? Select all that apply. a client with an impaired immune system a client who performs daily hygiene care a client experiencing diarrhea chronically an elderly client who has one chronic disease a client who takes nutritional supplements

a client with an impaired immune system a client experiencing diarrhea chronically an elderly client who has one chronic disease

What are classified as anti-infectives? (Select all that apply.) antihelmintics antifungals antiprotozoals anticonvulsants antimetabolites

antihelmintics antifungals antiprotozoals

Which of the following would a nurse identify as being classified as a macrolide? Azithromycin Gentamicin Doxycycline Cephalexin

azithromycin

A client has endocarditis and is taking gentamicin. The nurse will be sure to monitor the client's: potassium level. creatinine clearance. serum albumin level. prothrombin time.

creatinine clearance.

A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse should first ensure that the client has not recently eaten what type of foods? dairy products leafy green vegetables any high-fat foods acidic foods

dairy products

A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs? Increased risk of bleeding Increased action of neuromuscular-blocking drugs Increased profound respiratory depression Decreased absorption of tetracycline

decreased absorption of tetracycline

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. drop in blood pressure increase in respiratory rate sudden increase in temperature regular urine output pulse rate within usual parameters

drop in blood pressure increase in RR sudden increase in temperature

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

erythromycin

Which medication is the drug of choice for Legionnaires disease? erythromycin loxapine hydrochloride meclizine pravastatin

erythromycin

A client is admitted to the unit. The nurse knows that the client is at high risk for infection. What factors predispose the client to infection? (Mark all that apply.) Impaired blood supply Hypertension Suppression of immune system Advanced age Decreased amalyse levels

impaired blood supply suppression of immune system advanced age

When describing how tetracyclines treat infection, the nurse would incorporate which information into the description? inhibiting bacterial protein synthesis inhibiting bacterial cell wall synthesis inhibiting bacterial DNA gyrase depolarizing the bacterial cell wall

inhibiting bacterial protein synthesis

A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? The half-life of the drug is 3 to 7 hours. It is taken only once a day. It has very few adverse effects. It can be given without consideration to drug-drug- interactions.

it is taken only once a day

In which condition present in the client should macrolides be used with caution? Glaucoma Liver dysfunction Diabetes mellitus Hypertension

liver dysfunction

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example? metronidazole ciprofloxacin levofloxacin gemifloxacin

metronidazole

Which nursing action is most important in achieving successful antimicrobial therapy with vancomycin? Provide maximum physical comfort to the client. Monitor serum drug level. Taper down the drug dosage gradually. Promote adequate intake of fluids and nutrients.

monitor serum drug level

A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for? Photosensitivity Abdominal pain Cramping Blood dyscrasias

photosensitivity

Aminoglycosides fight infection by interfering with what process within the causative bacterium? Protein synthesis DNA synthesis Cell wall synthesis Drainage

protein synthesis

A nurse is caring for a client who is receiving IV aminoglycosides for an intractable infection in one leg. What would it be important for the nurse to monitor for? Visual disturbances Liver dysfunction Serum glucose levels Renal dysfunction

renal dysfunction

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? polydipsia tachycardia skin rash or itching dizziness

skin rash or itching

A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that: the microorganism causing the infection is likely known. the client likely has compromised immune function. broad spectrum antibiotics were likely administered without success. the care team wished to reduce the client's risk of adverse effects.

the microorganism causing the infection is likely known.

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

trimethoprim-sulfamethoxazole

A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic. True False

true

A patient has been diagnosed with trichomoniasis. Before the client begins tinidazole therapy, the nurse should learn about the client's: working conditions. use of alcohol. recent visit to a beach or desert. possibly having AIDS.

use of alcohol

A client, taking metronidazole for the past 4 days, reports to the nurse that the most recent dose caused the client to feel "flushed, sweaty, and sick in the stomach." What assessment is most likely to address the cause of this phenomenon? "Do you know if you've ever had an allergic reaction to penicillin?" "Did you drink any alcoholic beverages around the time of taking the drug?" "Did you take this dose on an empty stomach?" "Are you taking any over-the-counter antihistamines?"

"Did you drink any alcoholic beverages around the time of taking the drug?"

The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask? "Has she ever received tetracycline?" "Has she ever received gentamicin?" "Has she ever received ampicillin?" "Has she ever received cephalexin?"

"Has she ever received tetracycline?"

Which statement by a client taking a sulfonamide requires further instruction? "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." "I will take all of my medicine even if my symptoms go away." "I will take my medicine with my meals like it says on the prescription bottle."

"I will make sure to use extra sunscreen when I go to the tanning booth."

The nurse admits a client with septicemia (infection in the bloodstream). The client denies any allergies and the provider has ordered cefuroxime based on blood culture and sensitivity testing. The client states, "I'd prefer vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response? "Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work." "There are some resistant infections that require vancomycin so you are right to prefer a stronger antibiotic." "I appreciate your concern but you can certainly rest assured that the health care provider ordered the right medication for your needs." "You can't believe anything you read on the Internet because most of it is just someone's opinion and not fact."

"Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work."

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 allergic to the medication. Stop taking it immediately." "That is the medication working. Continue to take as directed." "You are experiencing an adverse affect of the medication. Those symptoms will decrease over time." "You may be experiencing an additional infection. I will discuss this with your health care provider."

"You may be experiencing an additional infection. I will discuss this with your health care provider."

A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide? 10 lb weight loss Loose stools for the last two days Unable to eat spicy foods Decreased appetite

10 lb weight loss

The pediatric nurse is caring for a 9-year-old client who has been diagnosed with amebiasis. The client weighs 82.5 lbs. and has been prescribed metronidazole 40 mg/kg/day in three divided doses for 10 days. How many 250-mg tablets should the nurse administer for each dose? 0.5 1 2 4

2

A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day? 180 mg 225 mg 36 mg 600 mg

225 mg

The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate? A client with signs of infection who is awaiting the results of laboratory testing A client with pneumonia who has a confirmed allergy to penicillins A client who is being treated for a urinary tract infection for the third time this year A client with an infected surgical wound

A client with signs of infection who is awaiting the results of laboratory testing

How should the nurse adapt the plan of care when caring for an older adult receiving an antiprotozoal agent? Clients should be monitored more closely for toxic adverse effects. The drug dosage should be lowered for all older adults. Antiprotozoal agents should not be administered to older adults. Female clients of appropriate age should be advised to use barrier contraceptives to prevent genitourinary infections.

Clients should be monitored more closely for toxic adverse effects.

Infections caused by protozoa are relatively rare in the United States, but with people moving throughout the world in increasing numbers, it is not unusual to find a person who returns home from travel with a fully developed protozoal infection. Which of the following areas are where protozoa infections are most prevalent? Select all that apply. Columbia Canada Thailand Egypt Ireland

Columbia Thailand Egypt

A client is started on trimethoprim and sulfamethoxazole for a urinary tract infection. The client reports nausea, anorexia, and abdominal pain. What intervention does the nurse discuss with the client? Drink frequent sips of water. Consume the medication with food. Call the prescriber for pain medication. Avoid driving and performing tasks that require alertness.

Consume the medication with food

Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic? Inhibition of synthesis of bacterial proteins Inhibition of synthesis of DNA only Inhibition of mitochondrial reproduction Inhibition of cell wall osmosis

Inhibition of synthesis of bacterial proteins

A client, diagnosed with Trichomonas vaginalis, is being treated with metronidazole orally. What instruction is most important for the nurse to provide this client to minimize the spread of this infection? Instruct her on safe sex. Instruct her to drink red wine. Instruct her to take two tablets if a dose is missed. Instruct her to have her partner treated.

Instruct her to have her partner treated.

What information about antibiotic therapy should the nurse include in a client's medication education? Bacteria can remain in the body for up to 48 to 72 hours after the completion of antibiotic therapy. Maintenance of normal bacterial flora is essential to health during the therapy. The healthy human body hosts dozens of minor infections at any given time. An aseptic internal environment only exists in young adults.

Maintenance of normal bacterial flora is essential to health during the therapy.

The nurse should monitor the client for which common side effects of erythromycin therapy? Headache and fever Urticaria and opthalmic drainage Nausea, vomiting, and diarrhea Shortness of breath and sore throat

Nausea, vomiting, diarrhea

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? oral (PO) intravenous (IV) subcutaneous (SQ) intramuscular (IM)

PO

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? Gray syndrome Red man syndrome Serotonin syndrome Cushing's syndrome

Red man syndrome

A client has been taking vancomycin 750 mg PO q6h for the past four days to treat Clostridium difficile-related diarrhea. The nurse learns that the client's 24-hour urine output was 550 mL yesterday and that is has been 125 mL over the past 12 hours. What is the nurse's best action? Report the findings promptly to the client's care provider. Encourage oral fluid intake and monitor closely. Recognize and document the expected adverse effects of vancomycin. Ask about the client's pre-illness levels of urine output.

Report the findings promptly to the client's care provider.

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the health care provider before administering the ordered medication? Takes high-dose furosemide (Lasix) daily Had prostate surgery 3 months ago History of hypothyroidism Allergy to peanuts and peanut products

Take high-dose furosemide (Lasix) daily