N5375 Exam 3 Quiz Questions

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A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates A. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." B. "Cephalosporins reduce bacterial resistance to aminoglycosides." C. "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." D. "Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased."

A. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching? A. "I can stop the medication as soon as the symptoms have disappeared." B. "I will drink more fluids to help clear up the infection." C. "I will stop the medication and contact the doctor if I develop a rash." D. "I should immediately report vaginal itching or discharge."

A. "I can stop the medication as soon as the symptoms have disappeared." Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve. The other responses are appropriate

The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning insulin storage? A. "I will keep my unopened vials of insulin in the refrigerator." B. "I can keep my insulin in the trunk of my car so I will have it at all times." C. "It's all right to put my unopened insulin vials in the freezer." D. "If I prefill my insulin syringes, I must use them within 1-2 days."

A. "I will keep my unopened vials of insulin in the refrigerator." This statement indicates the client understands the medication teaching. Keeping the insulin in the refrigerator will maintain the insulin's strength and potency. Once the insulin vial is opened it may be kept at room temperature for 1 month.

The patient is ordered daily divided doses of gentamycin. The patient received an intravenous dose of gentamycin at 4:00 PM. When should the nurse obtain the peak level? A. 4:30 PM B. 5:00 PM C. 5:30 PM D. 6:00 PM

A. 4:30 PM When using divided daily doses, draw blood samples for measuring peak levels 1 hour after IM injection and 30 minutes after completing an IV infusion. When a single daily dose is used, measuring peak levels is unnecessary. Draw samples for trough levels just before the next dose (when using divided daily doses) or 1 hour before the next dose (when using a single daily dose).

Proton pump inhibitors: A. All of the above B. Can increase the risk of intestinal infection with Clostridium difficile C. Are the most effective drug to reduce gastric acid production D. Can be used to treat GERD as well as gastric and duodenal ulcers

A. All of the above

Which statement about allergic reactions to penicillin does the nurse identify as true? A. Anaphylactic reactions occur more frequently with penicillins than with any other drug. B. Allergy to penicillin always increases over time. C. Benadryl is the drug of choice for anaphylaxis due to penicillin allergy. D. Patients allergic to penicillin are also allergic to vancomycin.

A. Anaphylactic reactions occur more frequently with penicillins than with any other drug. Anaphylactic reactions occur more frequently with penicillins than with any other drug. Allergy to penicillin can decrease over time. Epinephrine is the drug of choice for anaphylaxis. Vancomycin, erythromycin, and clindamycin are effective and safe alternatives for patients with penicillin allergy.

A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? A. Contact the provider and prepare to administer epinephrine. B. Withhold the next dose until symptoms subside. C. Request an order for a skin test to evaluate possible PCN allergy. D. Notify the provider if the patient develops a rash.

A. Contact the provider and prepare to administer epinephrine.

Misoprostol: A. Is used to prevent gastric ulcers in patients on long-term NSAID therapy B. All of the above C. Can cause constipation and abdominal pain D. Can be used safely in pregnancy

A. Is used to prevent gastric ulcers in patients on long-term NSAID therapy

The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? A. Make sure the client easts the food on the meal tray that is at the bedside. B. Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. C. Ensure the client is wearing a medical alert bracelet. D. Administer the dose according to the regular insulin sliding scale.

A. Make sure the client easts the food on the meal tray that is at the bedside.

Cimetidine A. Should be taken at least 1 hour before or after oral antacids B. Can help eradicate H. Pylori C. Is a Histamine H1 receptor blocker D. Enhances gastric acid production

A. Should be taken at least 1 hour before or after oral antacids

Why are antibiotics used to treat peptic ulcer disease? A. To treat H. Pylori infection B. To improve blood flow to the GI tract C. To increase gastric mucous production D. To enhance inflammatory defense mechanisms

A. To treat H. Pylori infection

A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: A. add metronidazole [Flagyl]. B. switch to gemifloxacin C. restrict dairy products. D. increase the dose of ciprofloxacin.

A. add metronidazole [Flagyl].

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: A. renal disease B. antibiotic resistance C. inter-patient variability D. liver disease

A. renal disease

The insulin produced endogenously by the pancreas has what length duration of action? A. up to 10 hours B. 1-3 hours C. up to 24 hours D. 3-5 hours

A. up to 10 hours

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? A. "Amoxicillin is too narrow in spectrum." B. "The bacteria have synthesized penicillinase." C. "The bacteria have developed a three-layer cell envelope." D. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins."

B. "The bacteria have synthesized penicillinase."

A patient is diagnosed with an infection caused by Staphylococcus aureus, and the prescriber orders intravenous gentamicin and penicillin (PCN). Both drugs will be given twice daily. What will the nurse do? A. Request an order to change the penicillin to vancomycin B. Administer gentamicin, flush the line, and then give the penicillin. C. Give the gentamicin intravenously and the penicillin intramuscularly. D. Infuse the gentamicin and the penicillin together to prevent fluid overload.

B. Administer gentamicin, flush the line, and then give the penicillin.

Which of the following is a benefit of using a combination of two or more antibiotics? A. Reduced resistance B. All of these are benefits C. Reduced risk of severe infection D. Reduced toxicity

B. All of these are benefits

Which statement about Regular insulin is correct? A. Is a cloudy solution B. Can be used IV C. It's slow acting D. peaks at 6-12 hours

B. Can be used IV

A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. What should the nurse do? A. Administer the cephalosporin as ordered. B. Contact the health care provider for a different antibiotic. C. Administer a test dose of cephalosporin to determine reactivity. D. Have an epinephrine dose available when administering the cephalosporin.

B. Contact the health care provider for a different antibiotic. A few patients with penicillin allergy (about 1%) display cross-sensitivity to cephalosporins. If at all possible, patients with penicillin allergy should not be treated with any member of the penicillin family. Use of cephalosporins depends on the intensity of the allergic response to penicillin; if the penicillin allergy is mild, use of cephalosporins is probably safe. However, if the allergy is severe, cephalosporins should be avoided.

Which of the following anti-diabetic drugs is used to treat Polycyctic Ovarian Disease (PCOS)? A. Miglitol B. Metformin C. Rapaglinide D. Glyburide

B. Metformin

A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication? A. Daptomycin B. Metronidazole C. Rifampin D. Rifaximin

B. Metronidazole Metronidazole is a drug of choice for C. difficile infection. Daptomycin has a unique mechanism and can rapidly kill virtually all clinically relevant gram-positive bacteria, including MRSA. Rifampin [Rifadin] is a broad-spectrum antibacterial agent used primarily for tuberculosis. However, the drug is also used against several nontuberculous infections. Rifampin is useful for treating asymptomatic carriers of Neisseria meningitidis. Rifaximin [Xifaxan] is an oral, nonabsorbable analog of rifampin used to kill bacteria in the gut.

A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what? A. Milk intolerance B. Skin rash, hives, or itching C. Constipation, nausea, or vomiting D. Headache, contusions, or seizures

B. Skin rash, hives, or itching Hypersensitivity reactions are common with cephalosporins. Patients should be instructed to report any signs of allergy, such as skin rash, itching, or hives. Cefditoren contains a milk protein and should not be prescribed for patients with a milk protein allergy. Cefoperazone and cefotetan can promote bleeding. Diarrhea associated with antibiotic-associated pseudomembranous colitis (AAPMC) is a possible side effect with cephalosporins.

Which of the following levels of infection control requires providers to wash hands before all procedures and after direct contact with patients, wear gloves when when in contact with non-intact skin, and where a mask during any procedure that is likely to generate aerosolized secretions? A. airborne precautions B. Standard precautions C. droplet precautions D. contact precautions

B. Standard precautions

Which statement about superinfections does the nurse identify as true? A. Superinfections are more common in patients treated with narrow-spectrum drugs. B. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection. C. Superinfections are caused by viruses. D. Superinfections are easy to treat.

B. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection. Because broad-spectrum antibiotics kill off more normal flora than do narrow-spectrum drugs, superinfections are more likely in patients receiving broad-spectrum agents. Suprainfections are caused by drug-resistant microbes; these infections are often difficult to treat.

Which of the following drugs is associated with the lowest incidence of resistance in thetreatment of H. Pylori? A. Clarithromycin B. Tetracycline C. Metronidazole D. Amoxicillin

B. Tetracycline

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin. To prevent ototoxicity, it is most important for the nurse to monitor which value(s)? A. Serum creatinine and blood urea nitrogen levels B. Trough drug levels of gentamicin C. Peak drugs levels of gentamicin D. Serum alanine aminotransferase and aspartate aminotransferase levels

B. Trough drug levels of gentamicin To minimize ototoxicity, trough levels must be sufficiently low to reduce exposure of sensitive sensory hearing cells. The risk of ototoxicity is related primarily to persistently elevated trough drug levels rather than to excessive peak levels.

A patient develops CDAD. Which antibiotic is recommended for treating this infection? A. Clindamycin [Cleocin] B. Vancomycin C. Chloramphenicol D. Linezolid [Zyvox]

B. Vancomycin

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 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. Patients taking ciprofloxacin are at risk for development of phototoxicity.

A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do? A. Question the patient about the consumption of milk and any other dairy products. B. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms. C. Instruct the patient to exercise the right foot and ankle to minimize the pain. D. Request an order to increase this patient's dose of glucocorticoids.

B. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms.

The vast majority of antibiotic use in the United States is being used... A. on crops B. for agricultural use on livestock C. to treat disease for household pets D. to treat human disease

B. for agricultural use on livestock

The nurse is teaching the client with newly diagnosed Type 1 diabetes about insulin therapy. Which of the following statements indicates the client needs more teaching? A. "If I have a headache or get nervous, I will drink some orange juice." B. "If I pass out at home, a family member should give me a glucagon injection." C. "Because I am taking my insulin daily I do not have to worry about my diet." D. "I will check my blood glucose with my glucometer at least once a day."

C. "Because I am taking my insulin daily I do not have to worry about my diet." Even with insulin therapy, the client should adhere to the ADA diet, which recommends "carbohydrate counting." This statement indicates the client needs more teaching.

A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? A. "I should not worry if I experience an acne-like rash with this medication." B. "I should take this antibiotic with a calcium supplement to improve absorption." C. "I should not take this medication with milk or other dairy products." D. "I should take an antacid, such as Tums, if I experience gastrointestinal distress."

C. "I should not take this medication with milk or other dairy products."

A client diagnosed with Type 2 diabetes is prescribed glipizide. Which statement by the client would warrant intervention by the nurse? A. "I have to eat my diabetic diet even if I am taking this medication." B. "I will need to check my blood glucose level at least once a day." C. "I usually have one glass of wine with my evening meal." D. "I do not like to walk every day, but I will if it will help my diabetes."

C. "I usually have one glass of wine with my evening meal." Sulfonylureas and biguanides may cause an antabuse-like reaction, causing the client to become nauseated and vomit. Advise the client to abstain from alcohol and to avoid liquid OTC medications that may contain alcohol. Alcohol also increases the half-life of the medication and can cause a hypoglycemic reaction.

A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? A. "Tetracycline will prevent asymptomatic urinary tract infections." B. "Tetracycline may cause allergic reactions in pregnant women." C. "Tetracycline can be harmful to the baby's teeth and should be avoided." D. "Tetracycline is safe to take during pregnancy."

C. "Tetracycline can be harmful to the baby's teeth and should be avoided."

Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A. A female patient with acute pyelonephritis B. A male patient with acute prostatitis C. A female patient with recurring acute urinary tract infections D. A male patient with acute cystitis

C. A female patient with recurring acute urinary tract infections Female patients with relapses of urinary tract infection may need long-term therapy up to 6 months with trimethoprim/sulfamethoxazole.

A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? A. Instruct the patient to take the medication with milk B. Tell the patient to take an antacid with the medication C. Give the patient food, such as crackers or toast, with the medication D. Have the patient stop the medication immediately and contact the health care provider

C. Give the patient food, such as crackers or toast, with the medication Tetracyclines form insoluble chelates with calcium, iron, magnesium, aluminum, and zinc; absorption is decreased. Tetracyclines should not be administered together with milk or antacids. Long-acting tetracyclines, such as doxycycline, may be taken with food; food does not affect absorption.

A major adverse effect of insulin that can be life-threatening is: A. Hyperglycemia B. Hypertension C. Hypoglycemia D. Hypotension

C. Hypoglycemia

Which of the following insulins can be given once daily to provide glucose control for 24 hours? A. Insulin aspart B. Regular Insulin C. Insulin glargine D. Insulin lispro

C. Insulin glargine

Antacids should be used with caution in what which patient population? A. Patients with a history of asthma B. Elderly patients C. Patients with renal impairment D. Patients with liver impairment

C. Patients with renal impairment

When people wear face masks in public to reduce the spread of COVID 19 which link in the chain of infection transmission is being interrupted? A. Port of Entry B. Reservoir C. Port of Exit AND Port of Entry D. Susceptibility of victim

C. Port of Exit AND Port of Entry

Which of the following is not a non-drug treatment option for peptic ulcer disease? A. Limit alcohol B. Smoking cessation C. Reduce number of daily meals to 2-3 D. Avoid taking Aspirin or other NSAIDS

C. Reduce number of daily meals to 2-3

The nurse is preparing to administer 30 units of NPH to client. He finds that the vial of insulin looks cloudy and uneven in appearance. Which of the following is the appropriate action? A. Hold the dose and alert the prescriber B. Discard the vial of NPH and open a new one C. Shake the vial of NPH thoroughly then administer the dose D. Give the client 10 units of regular insulin

C. Shake the vial of NPH thoroughly then administer the dose

Fluoroquinolones should be discontinued immediately if what happens? A. Nausea, vomiting, or diarrhea is experienced. B. Dizziness, headache, or confusion occurs. C. Tendon pain or inflammation develops. D. Theophylline is prescribed for asthma.

C. Tendon pain or inflammation develops. Fluoroquinolones can cause tendon rupture and should be discontinued if tendon pain or inflammation develops.

Which assessment data best indicates a client with Type 1 diabetes is adhering to the medical treatment regimen? A. The client's fasting blood glucose is 100mg/dl. B. The client's urine specimen is negative for ketones. C. The client's Hb A1c is 5.8%. D. The client's glucometer reading is 120mg/dl

C. The client's Hb A1c is 5.8%. A glycosylated hemoglobin (A1C) gives the average of the blood glucose level over the last 3 months and indicates adherence to the medical treatment regimen. A glycosylated hemoglobin level of 5.8% is close to normal (4.0-5.5%; BG level of 70-110) and indicates that the client is adhering to the treatment regimen.

Why are multiple antibiotics used in combination in the treatment of peptic ulcer disease? A. To minimize GI upset B. To enhance the growth of beneficial bacteria C. To reduce the risk of the development of drug resistance D. All of the above

C. To reduce the risk of the development of drug resistance

A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? A. Withhold the dose and request an order for an antihistamine to treat the rash. B. Request an order for intravenous TMP/SMZ, because the patient is getting worse. C. Withhold the dose and notify the provider of the symptoms. D. Administer the dose and request an order for an antipyretic medication.

C. Withhold the dose and notify the provider of the symptoms.

A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: A. nafcillin. B. ampicillin. C. amoxicillin―clavulanic acid [Augmentin]. D. penicillin G

C. amoxicillin―clavulanic acid [Augmentin].

A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to: A. obtain renal function tests to evaluate for potential nephrotoxicity. B. obtain a gentamicin trough before the next dose is given C. discontinue the gentamicin. D. give an analgesic to control headache discomfort.

C. discontinue the gentamicin.

A patient who is taking doxycycline for a serious infection contacts the nurse to report anal itching. The nurse will contact the provider to discuss: A. adding an antihistamine to the patient's drug regimen. B. ordering liver function tests to test for hepatotoxicity. C. prescribing an antifungal drug to treat a superinfection. D. testing the patient for a C. difficile secondary infection.

C. prescribing an antifungal drug to treat a superinfection.

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

D. "Cephalosporins have increased activity against gram-negative bacteria with each generation."

Which of the following drugs acts in the small intestine to delay carbohydrate absorption? A. Rosiglitazone B. Rapaglinide C. Sulfonylureas D. Acarbose

D. Acarbose

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin? A. Warfarin B. Milk products C. Digitalis D. Alcohol

D. Alcohol Cefazolin and cefotetan can cause alcohol intolerance. A serious disulfiram-like reaction may occur if alcohol is consumed. Inform patients about alcohol intolerance and warn them not to drink alcoholic beverages.

Which of the following will not promote the development of a peptic ulcer? A. Infection with H. Pylori B. Increased stomach acid production C. Chronic inflammation D. Increased mucous production

D. Increased mucous production

Why should tetracycline be avoided in young children? A. It can be ototoxic in children B. It reduces kidney function in children C. It is less effective in children D. It can stain teeth that are developing

D. It can stain teeth that are developing

The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? A. Ensure the client is wearing a medical alert bracelet. B. Administer the dose according to the regular insulin sliding scale. C. Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. D. Make sure the client easts the food on the meal tray that is at the bedside.

D. Make sure the client easts the food on the meal tray that is at the bedside. Humalog peaks in 30 mins to 1 hr; therefore, the client needs to eat when or shortly after the medication is administered to prevent hypoglycemia.

Which tetracycline may be administered with meals? A. Tetracycline B. Demeclocycline C. Doxycycline D. Minocycline

D. Minocycline Tetracycline, demeclocycline, and doxycycline should be administered on an empty stomach. Minocycline can be administered with meals.

A patient shows signs and symptoms of conjunctivitis (bacterial pink eye). Which aminoglycoside would the nurse expect to be ordered? A. Amikacin [Amikin] B. Kanamycin [Kantrex] C. Paromomycin [Humatin] D. Neomycin [Neomycin]

D. Neomycin [Neomycin]

A patient is prescribed vancomycin orally for antibiotic- associated pseudomembranous colitis. The nurse will monitor the patient for what? A. Leukopenia B. "Red man" syndrome C. Liver impairment D. Ototoxicity

D. Ototoxicity The most serious adverse effect of vancomycin is ototoxicity. "Red man" syndrome occurs only with rapid intravenous administration. Thrombocytopenia is an adverse effect of vancomycin.

A prescriber states that a patient will need to receive penicillin intravenously. The nurse anticipates administering which drug? A. Penicillin V B. Procaine penicillin G C. Benzathine penicillin G D. Potassium penicillin G

D. Potassium penicillin G When high blood levels are needed rapidly, penicillin can be administered IV. However, only the potassium salt should be administered by this route. Owing to poor water solubility, procaine and benzathine salts must never be administered IV. Penicillin V is administered orally.

Which of the following insulins is available in both 100units/ml and 500units/ml concentrations? A. Insulin lispro B. Insulin glargine C. NPH Insulin D. Regular insulin

D. Regular insulin

A nurse is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What will the nurse do? A. Suggest adding a penicillin to the patient's drug regimen. B. Contact the provider to discuss an increased risk of aminoglycoside toxicity. C. Continue giving the aminoglycoside as ordered. D. Request an order for a different class of antibiotic.

D. Request an order for a different class of antibiotic.

Which information should the nurse include when teaching a patient about rifampin therapy? A. Oral contraceptives are safe to use with rifampin therapy. B. Contact your healthcare provider immediately if the color of your body fluids changes to reddish orange. C. Rifampin is safe to use in patients who have hepatic disease. D. Rifampin may be administered intravenously.

D. Rifampin may be administered intravenously. Rifampin may be administered intravenously. Women taking oral contraceptives should consider a nonhormonal form of birth control while taking rifampin. Rifampin frequently imparts a red-orange color to urine, sweat, saliva, and tears; patients should be informed of this harmless effect. Permanent staining of soft contact lenses occasionally has occurred, so the patient should consult an ophthalmologist about contact lens use. Rifampin is toxic to the liver, posing a risk of jaundice and even hepatitis. Asymptomatic elevation of liver enzymes occurs in about 14% of patients. However, the incidence of overt hepatitis is less than 1%. Hepatotoxicity is most likely in alcohol abusers and patients with pre-existing liver disease. These individuals should be monitored closely for signs of liver dysfunction.

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? A. Nosocomial infection B. Community Acquired infection C. Antibiotic resistance D. Superinfection

D. Superinfection

A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? A. The provider may increase the clindamycin dose to treat this infection. B. This is a known side effect of clindamycin, and the patient should consume extra fluids. C. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms. D. The patient should stop taking the clindamycin now and contact the provider immediately.

D. The patient should stop taking the clindamycin now and contact the provider immediately.

The nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamycin therapy? A. Blurred vision B. Hand tremors C. Urinary frequency D. Tinnitus

D. Tinnitus Ototoxicity can result from accumulation of the drug in the inner ear. Early signs that should be reported include tinnitus or headache. Other major adverse effects include nephrotoxicity and neuromuscular blockade.

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 35.5º C D. Widespread skin lesions

D. Widespread skin lesions The most severe hypersensitivity response to sulfonamides is Stevens-Johnson syndrome, a rare reaction with a mortality rate of about 25%. Symptoms include widespread lesions of the skin and mucous membranes, combined with fever, malaise, and toxemia. Bronchospasm and hypotension, as well as tachycardia, are manifestations of anaphylactic reactions.

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: A. disinhibit transpeptidases B. inhibit autolysins. C. inhibit host cell wall function D. disrupt bacterial cell wall synthesis

D. disrupt bacterial cell wall synthesis

A nurse is preparing to administer a dose of gentamicin to a patient who is receiving the drug 3 times daily. The nurse will monitor ____ levels. A. trough B. serum levels C. peak D. peak and trough

D. peak and trough

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: A. Stevens-Johnson Syndrome B. Rhabdomyolosis C. allergic reaction D. red man syndrome.

D. red man syndrome.


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