Pathopharm- antibiotics
A male patient with hepatitis C will begin triple drug therapy with pegylated interferon alfa 2a [Pegasys], ribavirin [Ribasphere], and boceprevir [Victrelis]. The patient tells the nurse that his wife is pregnant. What will the nurse tell him? a. Boceprevir is contraindicated in males whose partners are pregnant. b. He should use a barrier contraceptive when having sex. c. He should use dual drug therapy with pegylated interferon alfa and ribavirin only. d. This combination drug therapy is safe for him to use.
a
A nurse is preparing to administer medications to a patient who has recently started on delavirdine [Rescriptor]. Which concurrent prescription should the nurse question before administration? a. Alprazolam [Xanax] b. Diphenhydramine [Benadryl] c. Morphine d. Penicillin
a
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 take this medication with milk or other dairy products. b.I should not worry if I experience an acnelike rash with this medication. c.I should take an antacid, such as Tums, if I experience gastrointestinal distress. d.I should take this antibiotic with a calcium supplement to improve absorption.
a
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? a.Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600. b.Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1200 and 2400. c.Give the penicillin at 0600, 1400, and 2200; give the gentamicin [Garamycin] at 0600 and 1800. d.Give the penicillin every 8 hours; give the gentamicin [Garamycin] simultaneously with two of the penicillin doses.
a
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.discontinue the gentamicin. b.obtain a gentamicin trough before the next dose is given. c.give an analgesic to control headache discomfort. d.obtain renal function tests to evaluate for potential nephrotoxicity.
a
A patient is admitted to the unit for treatment for an infection. The patient receives IV amikacin [Amikin] twice a day. When planning for obtaining a peak aminoglycoside level, when should the nurse see that the blood is drawn? a.30 minutes after the IV infusion is complete b.1 hour after the IV infusion is complete c.1 hour before administration of the IV infusion d.A peak level is not indicated with twice-daily dosing.
a
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.Administer gentamicin, flush the line, and then give the penicillin. b.Give the gentamicin intravenously and the penicillin intramuscularly. c.Infuse the gentamicin and the penicillin together to prevent fluid overload. d.Request an order to change the penicillin to vancomycin.
a
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
A patient newly diagnosed with tuberculosis asks the nurse why oral medications must be given in the clinic. The nurse will tell the patient that medications are given in the clinic so that: a.clinic staff can observe adherence to drug regimens. b.nurses can monitor for drug toxicities. c.providers can adjust doses as needed. d.the staff can ensure that the U.S. Food and Drug Administration (FDA) regulations are met.
a
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.increase the dose of ciprofloxacin. c.restrict dairy products. d.switch to gemifloxacin.
a
A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications? a.Acetaminophen b.Aspirin c.Ibuprofen d.Morphine
a
A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient, the nurse will tell the patient that it will be important to: a.drink 8 to 10 glasses of water each day. b.eat foods that are high in potassium. c.take the medication with food. d.take folic acid supplements.
a
A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a.Abstain from alcohol consumption during therapy. b.Avoid dairy products while taking this drug. c.Take an antihistamine if a rash occurs. d.Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.
a
A patient with high-risk factors for tuberculosis will begin therapy for latent TB with isoniazid and rifampin. The nurse learns that this patient takes oral contraceptives. The nurse will counsel this patient to discuss ____ with her provider. a.another birth control method b.reducing the rifampin dose c.reducing the isoniazid dose d.increasing the oral contraceptive dose
a
The nurse is preparing to administer amphotericin B intravenously. The nurse will expect to pretreat the patient with which medications? a. Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol] b. Aspirin, diphenhydramine [Benadryl], and meperidine [Demerol] c. Ibuprofen [Motrin], diphenhydramine [Benadryl], and meperidine [Demerol] d. Morphine sulfate [Morphine] and acetaminophen [Tylenol]
a
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. Cephalosporins are assigned to generations based on their relative costs to administer. b. Cephalosporins have increased activity against gram-negative bacteria with each generation. c.First-generation cephalosporins have better penetration of the cerebrospinal fluid. d.Later generations of cephalosporins have lower resistance to destruction by beta-lactamases.
b
A patient asks the nurse what he can do to prevent influenza. What should the nurse do? A.Teach the patient about antiviral medications. B.Instruct the patient to obtain an influenza vaccination. C.Tell the patient that frequent hand washing is effective. D.Have the patient wear a mask when in public areas.
b
A patient has a positive test for hepatitis C and is admitted to the hospital. The admission laboratory tests reveal a normal ALT, and a liver biopsy is negative for hepatic fibrosis and inflammation. The nurse will prepare this patient for: a. dual therapy with pegylated interferon alfa and ribavirin. b. no medication therapy at this time. c. pegylated interferon alfa only until ALT levels are elevated. d. triple drug therapy with pegylated interferon alfa, ribavirin, and boceprevir.
b
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
A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication? A.Daptomycin B.Metronidazole C.Rifampin D.Rifaximin
b
A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the superinfection. What will the nurse do? a.Administer the erythromycin and the ketoconazole as ordered. b.Contact the provider to discuss changing to a different antifungal medication. c.Contact the provider to discuss increasing the dose of erythromycin. d.Contact the provider to suggest using erythromycin stearate.
b
A patient is taking oral ketoconazole [Nizoral] for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole [Prilosec] for reflux disease. Which action should the nurse take? a. Administer the omeprazole 1 hour before the ketoconazole. b. Administer the omeprazole at least 2 hours after the ketoconazole. c. Confer with the prescriber about a potential hazardous interaction. d. The nurse should not administer the omeprazole to a patient receiving ketoconazole.
b
A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient? a.Adding an antibiotic, such as vancomycin, to the patient's regimen b.Discontinuing the cephalosporin and beginning fidaxomicin c.Discontinuing all antibiotics and providing fluid replacement d.Increasing the dose of the cephalosporin and providing isolation measures
b
A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What will the nurse tell her? a. This indicates that she should begin taking oral contraceptives. b. This is caused by a reversible effect on estradiol synthesis. c. This is a serious side effect that warrants discontinuation of the drug. d. This is a sign of hepatic toxicity, and the drug dose should be lowered.
b
A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching? a.I may have abdominal pain and nausea, but these are usually mild. b.I should take this medication with food or milk to improve absorption. c.I should stop taking the medication immediately if I experience heel pain. d.I will need to use sunscreen every time I go outdoors.
b
Before administering gentamycin, it is most important for the nurse to assess the patient for a history of what? A.Hypertension B.Myasthenia gravis C.Diabetes mellitus D.Asthma
b
Which patient should receive prophylactic antibiotic therapy? A.A patient who is to have his teeth cleaned B.A patient who is scheduled for a hysterectomy C.A patient with a white blood cell count of 8000 cells/mm3 D.A patient with a high fever without an identifiable cause
b
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
A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient? a.Make sure you void after intercourse and drink extra fluids to stay well hydrated. b.We will treat each infection as a separate infection and treat with short-course therapy. c.You will need to take a low dose of medication for 6 months to prevent infections. d.You will need to take antibiotics for 4 to 6 weeks each time you have an infection.
c
A child has ringworm on the scalp. A culture of the lesion reveals a dermatophytic infection. The nurse teaching the child's parents about how to treat this infection will include which statement? a. Adverse effects of the medication include itching, burning, and erythema. b. Apply the topical medication daily until at least 1 week after the rash is gone. c. Your child will need to take this oral medication for 6 to 8 weeks. d. You will use an antifungal shampoo to treat this infection.
c
A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely? a.Calcium b.Chloride c.Potassium d.Sodium
c
A nursing student asks a nurse why pegylated interferon alfa is used instead of regular interferon for a patient with hepatitis C. The nurse will tell the student that pegylated interferon: a. decreases the need for additional medications. b. has fewer adverse effects than interferon. c. is administered less frequently than interferon. d. may be given orally to increase ease of use.
c
A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do? a.Administer the medication as ordered. b.Contact the provider to suggest giving the drug IV. c.Question the need for a penicillinase-resistant penicillin. d.Suggest ordering vancomycin to treat this infection.
c
A patient has been taking isoniazid [Nydrazid] for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. The nurse expects the provider to: a.discontinue the isoniazid. b.lower the isoniazid dose and add rifampin. c.order pyridoxine 100 mg per day. d.recheck the tuberculin skin test to see whether it worsens.
c
A patient who has been taking linezolid [Zyvox] for 6 months develops vision problems. What will the nurse do? a.Reassure the patient that this is a harmless side effect of this drug. b.Tell the patient that blindness is likely to occur with this drug. c.Tell the patient that this symptom is reversible when the drug is discontinued. d.Tell the patient to take tyramine supplements to minimize this effect.
c
A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: a. antiviral medications are not safe during pregnancy. b. intravenous antiviral agents will be used if an outbreak occurs. c. oral acyclovir [Zovirax] may be used during pregnancy. d. topical acyclovir [Zovirax] must be used to control outbreaks.
c
A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a.Immunosuppressed patients are folate deficient. b.Patients who are immunosuppressed are more likely to develop resistance. c.Sulfonamides are bacteriostatic and depend on host immunity to work. d.Sulfonamides intensify the effects of immunosuppression.
c
A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug, which statement will the nurse include? A."If you become pregnant, it is safe to take sulfadiazine." B."You should limit your fluid intake while taking sulfadiazine." C."Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin." D."You will most likely need to have an increase in the dose of warfarin while taking sulfadiazine."
c
A patient who takes warfarin is prescribed itraconazole [Sporanox] to treat a fungal infection. The nurse will teach the patient to do what? A.Take the medication with famotidine [Pepcid] to reduce gastric upset. B.Prepare for long-term intravenous administration of itraconazole. C.Avoid taking esomeprazole [Nexium] with itraconazole therapy. D.Double the dose of warfarin.
c
A patient with HIV is prescribed saquinavir [Invirase]. It is most important for the nurse to monitor which laboratory value? A.Hemoglobin levels B.Platelet count C.Blood glucose levels D.Serum potassium levels
c
A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives? a.Allowing patients to stop antibiotics when symptoms subside b.Allowing prescribers to develop their own prescribing guidelines c.Increased adherence to prescribed antibiotics d.Increased use of antibiotics among parents of young children
c
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
Which drug does the nurse identify as a urinary tract antiseptic? A.Ciprofloxacin B.Ceftriaxone C.Nitrofurantoin D.Ceftazidime
c
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
Which statement about enfuvirtide does the nurse identify as true? A.The drug is administered intravenously. B.Enfuvirtide is one of the least expensive drugs used to treat HIV. C.Enfuvirtide is reserved for treating HIV-1 infection that has become resistant to other antiretroviral agents. D.This drug is most effective when used alone.
c
Which statement about oseltamivir [Tamiflu] does the nurse identify as true? A.Oseltamivir must be administered on an empty stomach. B.The drug is administered via an inhaler. C.Oseltamivir can be used to treat and prevent influenza. D.The drug is approved for use in infants 6 months of age or older.
c
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
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 developed a three-layer cell envelope. c.The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins. d.The bacteria have synthesized penicillinase.
d
A nurse is caring for a patient who has a superficial fungal infection and notes that the provider has ordered 200 mg of ketoconazole [Nizoral], 200 mg PO once daily. Which action by the nurse is correct? a. Administer the drug as ordered. b. Contact the provider to discuss twice daily dosing. c. Discuss a 400-mg daily drug regimen with the provider. d. Request an order for a different antifungal medication.
d
A nurse is caring for an African American patient who has been admitted to the unit for long-term antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would be correct to suspect that the patient has developed: a.Stevens-Johnson syndrome. b.kernicterus. c.hepatotoxicity. d.hemolytic anemia.
d
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.antibiotic resistance. b.interpatient variation. c.liver disease. d.renal disease.
d
A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a.I need to drink extra fluids while taking this medication. b.I need to use sunscreen when taking this drug. c.I should call my provider if I develop a rash while taking this drug. d.I should stop taking this drug when my symptoms are gone.
d
A patient develops CDAD. Which antibiotic is recommended for treating this infection? a.Chloramphenicol b.Clindamycin [Cleocin] c.Linezolid [Zyvox] d.Vancomycin
d
A patient has been prescribed docosanol [Abreva] cream for herpes labialis. Which statement will the nurse include in patient teaching? A.Apply the cream twice a day. B.Use of the cream will cut the duration of the herpes simplex lesion in half. C.Many serious adverse effects are associated with use of this medication. D.Apply the cream at the first sign of recurrence.
d
A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin [Dilantin] for seizures. The nurse will contact the provider to discuss: a.increasing the phenytoin dose. b.reducing the isoniazid dose. c.monitoring isoniazid levels. d.monitoring phenytoin levels.
d
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
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
A patient who is taking calcium supplements receives a prescription for ciprofloxacin [Cipro] for a urinary tract infection. The nurse will teach this patient to: a.consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. b.stop taking the calcium supplements while taking the ciprofloxacin. c.take the two medications together to increase the absorption of both. d.take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.
d
A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication? a.Anorexia, nausea, and vomiting b.Brown-colored urine c.Drowsiness d.Tingling of the fingers
d
A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? A.Hypotension B.Bronchospasm C.Temperature of 35.5°C D.Widespread skin lesions
d
A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) [Bactrim] for a urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: a.birth defects. b.hypoglycemia. c.rash. d.kernicterus.
d
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
A young, nonpregnant female patient is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective? a.A 14-day course of amoxicillin with clavulanic acid [Augmentin] b.A 7-day course of ciprofloxacin [Cipro] c.A single dose of fosfomycin [Monurol] d.A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
d
The nurse is caring for a patient who will begin receiving intravenous ciprofloxacin [Cipro] to treat pyelonephritis. The nurse learns that the patient has a history of myasthenia gravis. Which action by the nurse is correct? a.Administer the ciprofloxacin and monitor the patient for signs of muscle weakness. b.Ask the provider whether the ciprofloxacin can be given orally. c.Request an order for concurrent administration of metronidazole [Flagyl]. d.Suggest that the provider order a different antibiotic for this patient.
d
Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics? a.A 5-year-old child with a fever of 100.5°F, dysuria, and bacteriuria b.A pregnant woman with bacteriuria, suprapubic pain, and fever c.A young man with dysuria, flank pain, and a previous urinary tract infection d.An older adult man with a low-grade fever, flank pain, and an indwelling catheter
d
Which statement by a new nurse about intravenous administration of amphotericin B indicates the nurse needs more education? A.Almost all patients receiving amphotericin B experience some degree of nephrotoxicity. B.Patients receiving amphotericin B should be under close supervision in a hospital. C.Heparin can be used in the infusion site to prevent phlebitis associated with amphotericin B therapy. D.Diphenhydramine plus acetaminophen can minimize rigors associated with amphotericin B therapy.
d
Which tetracycline may be administered with meals? A.Tetracycline B.Demeclocycline C.Doxycycline D.Minocycline
d
A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment? a.Uncomplicated lower urinary tract infection treatable with short-course therapy b.Complicated lower urinary tract infection treatable with single-dose therapy c.Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics d.Complicated upper urinary tract infection requiring parenteral antibiotics
a
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
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
Which statement will the nurse include when teaching a patient with HIV about management of the disease? A.HIV is considered a chronic disease. B.HIV infection can be cured with 1 year of therapy. C.Drug resistance does not occur in HIV treatment. D.Blood cultures and red blood cell counts are the principal laboratory tests to guide HIV treatment protocols.
a
Which superficial mycosis is generally treated with oral antifungal agents? a. Tinea capitis b. Tinea corporis c. Tinea cruris d. Tinea pedis
a
A patient is prescribed acyclovir [Zovirax] by mouth. The nurse should assess the patient for which adverse effects associated with oral acyclovir therapy? A.Stomatitis and gastritis B.Nausea, vomiting, and diarrhea C.Hives, difficulty breathing, and angioedema D.Tinnitus and decreased hearing
b
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
A patient who sustained second- and third-degree burns has been prescribed mafenide. Which statement about mafenide does the nurse identify as true? A.Use of mafenide can cause alkalosis. B.Mafenide is painful upon application. C.A blue-green to gray discoloration of the skin occurs with mafenide therapy. D.Mafenide exerts its therapeutic effect by the release of free silver.
b
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 healthcare 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
A patient with a history of congestive heart failure and renal impairment has esophageal candidiasis. Which antifungal agent would the nurse anticipate giving to this patient? a. Amphotericin B [Abelcet] b. Fluconazole [Diflucan] c. Itraconazole [Sporanox] d. Voriconazole [Vfend]
b
A woman complains of burning on urination and increased frequency. The patient has a history of frequent urinary tract infections (UTIs) and is going out of town in 2 days. To treat the infection quickly, the nurse would expect the healthcare provider to order: a.aztreonam [Azactam]. b.fosfomycin [Monurol]. c.trimethoprim/sulfamethoxazole [Bactrim]. d.vancomycin [Vancocin].
b
An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to: a.obtain a sputum culture and wait for the results before prescribing an antibiotic. b.order empiric antibiotics while waiting for sputum culture results. c.treat symptomatically, because antibiotics are usually ineffective against bronchitis. d.treat the patient with more than one antibiotic without obtaining cultures.
b
The nurse is preparing to discharge a patient with HIV who will continue to take enfuvirtide [Fuzeon] at home. The nurse is providing patient education about the medication. What information about the administration of enfuvirtide is most appropriate for the patient? a. The importance of injecting the drug into two alternating sites daily b. How to reconstitute and self-administer a subcutaneous injection c. The importance of taking the drug with high doses of vitamin E d. Likely drug interactions between enfuvirtide and other antiretroviral drugs
b
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
Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A.A patient with an uncomplicated urinary tract infection caused by Escherichia coli B.A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C.A patient with acute cystitis who complains of dysuria, frequency, and urgency D.A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia
b
A patient is receiving amphotericin B to treat a systemic fungal infection. To prevent renal damage, it is most important for the nurse to do what? A.Administer the medication through a central venous access device. B.Administer potassium supplements. C.Administer 1000 mL of 0.9% saline. D.Administer the medication orally.
c
A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9°F, a pulse of 92 beats/min, respirations of 24 breaths per minute, and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of: a.acute cystitis. b.urinary tract infection. c.pyelonephritis. d.prostatitis.
c
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 stop taking the clindamycin now and contact the provider immediately. d.The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms.
c
Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug? A.Guaifenesin [Guiatuss] B.Hydrocodone [Vicodin] C.Nitroglycerin [Tridil] D.Verapamil [Calan]
d
A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the two are similar products, and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine? a.It causes increased pain when the medication is applied. b.It has a broader spectrum of antimicrobial sensitivity. c.It has antibacterial effects related to release of free silver. d.It suppresses renal excretion of acid, causing acidosis.
c
After starting an antiviral protease inhibitor, a patient with HIV telephones the nurse, complaining, I'm so hungry and thirsty all the time! I'm urinating 10 or 12 times a day. The nurse recognizes these findings to be consistent with: a. pancreatic infiltration by HIV. b. allergic reaction. c. nonadherence to the antiviral regimen. d. hyperglycemia.
d
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.Antibiotic resistance b.Community-acquired infection c.Nosocomial infection d.Superinfection
d
The nurse is administering efavirenz [Sustiva] to a patient with AIDS. What will the nurse do? A.Offer St. John's wort with the medication to decrease depression. B.Have the patient take the medication with ice cream or a milkshake. C.Give the medication without regard to meals. D.Administer the medication on an empty stomach at bedtime.
d
The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? a.Administering the antibiotic immediately b.Administering antipyretics as soon as possible c.Delaying administration of the antibiotic until the culture results are available d.Obtaining all cultures before the antibiotic is administered
d
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 can be harmful to the baby's teeth and should be avoided. b.Tetracycline is safe to take during pregnancy. c.Tetracycline may cause allergic reactions in pregnant women. d.Tetracycline will prevent asymptomatic urinary tract infections.
a
The nurse is caring for a patient receiving intravenous acyclovir [Zovirax]. To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: a. hydrate the patient during the infusion and for 2 hours after the infusion. b. increase the patient's intake of foods rich in vitamin C. c. monitor urinary output every 30 minutes. d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.
a
A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin [Amoxil] as a child 20 years earlier. What will the nurse do? a.Ask the provider to order a cephalosporin. b.Reassure the patient that allergic responses diminish over time. c.Request an order for a skin test to assess the current risk. d.Suggest using a desensitization schedule to administer the drug.
c
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 healthcare provider.
c
A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin [Rifadin]. What would be an expected finding? a.Crystalluria b.Myopathy c.Peripheral neuropathy d.Red-orange-tinged urine
d
A patient who has drug-sensitive tuberculosis has completed 2 months of the standard four-drug therapy and asks the nurse how long he will have to take medication. Which response by the nurse is correct? a.As long as you remain symptomatic, you will not have to take more medication. b.The four-drug regimen will continue for 3 more months. c. You will have to take maintenance drugs indefinitely. d.You will need to take only two drugs for the next 4 months.
d