Pharm (3)
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones A nurse has been performing vigilant assessments of a patient who is receiving doses of intravenous gentamicin, each over 30 minutes. A blood sample for peak gentamicin levels should be drawn
30 minutes after the drug has finished infusing.
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is to mixed yielding 250 mg/15 mL. How many mL should be drawn up in the syringe?
45
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose?
81-325 mg
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents Penicillin would NOT be indicated for which of the following clients?
A client with gram-negative bacteria allergic to penicillin
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A patient is required to be administered vancomycin for treatment of an abdominal abscess. What should the nurse ensure when monitoring the IV infusion of vancomycin in the patient when caring for him?
Administer each dose over 60 minutes
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents The nurse administers cefuroxime to a client at least 1 hour before meals, as prescribed; however, the client experiences GI upset. Which action would be most appropriate for the nurse to do?
Administer the drug with food.
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents A 26-year-old female client with a skin infection has been prescribed 400 mg ampicillin to be taken orally. Which instruction should the nurse include in the client teaching plan?
Ampicillin will reduce the effectiveness of birth control pills.
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?
An HIV-positive client
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply.
An increase in sensitivity of gram-negative microorganisms, A decrease in the sensitivity of gram-positive microorganisms.
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A nurse is preparing to teach a client about aspirin. Which actions will the nurse explain to the client? Select all that apply.
Analgesic, Antipyretic, Anti-inflammatory
Chapter 23: Drug Therapy for Viral Infections Which statement regarding antiviral medications is true?
Antivirals do not eliminate existing viruses from tissues
Chapter 24: Drug Therapy for Fungal Infections A parent has informed the nurse that she has been applying an OTC antifungal to her infant's buttocks and perineal region. What question related to safety should the nurse ask the parent?
Are there any open wounds on the areas where you're putting the ointment?
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A nursing instructor has finished teaching about sulfonamides. The instructor determines the students have grasped the basics by articulating which factors concerning this drug class? Select all that apply.
Are well absorbed when given orally, Are excreted by the kidneys
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A 79-year-old nursing home resident has been prescribed clindamycin. When the resident develops persistent diarrhea, the nurse will include what intervention to help rule out the presence of pseudomembranous colitis?
Assess the stool for the presence of blood and mucus
Chapter 17: Drug Therapy with Corticosteroids The nurse is teaching a client who will require long-term corticosteroid therapy how to reduce the risk of infection. What suggestions will the nurse include?
Avoid large crowds of people in confined spaces
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents A nurse suspects that a client receiving oral penicillin therapy is developing pseudomembranous colitis based on which assessment finding?
Bloody diarrhea
Chapter 15: Drugs Affecting Inflammation and Infection Administration of what type of antibiotic by the nurse would be most likely to cause a superinfection?
Broad spectrum
Chapter 24: Drug Therapy for Fungal Infections The nurse is caring for an obese female client who is also HIV positive. The nurse takes special care to dry all skin folds in the client after her bath to prevent which fungal infection?
Candidiasis
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A nurse is presenting an educational event for a group of new parents. A participant has asked about the safe use of acetaminophen in children. What should the nurse teach the parents?
Check the label of over-the-counter medications carefully to see if they include acetaminophen.
Chapter 24: Drug Therapy for Fungal Infections What would the nurse include in the teaching plan for a client about the use of an antifungal cream preparation for the treatment of ringworm in the ambulatory care setting? Select all that apply.
Clean involved area before applying cream Keep towels and washcloths for bathing separate from other family members during treatment.
Chapter 15: Drugs Affecting Inflammation and Infection A nurse is asked to explain the difference between community-acquired infections and hospital-acquired infections. What response best describes the difference?
Community-acquired infections are usually less severe and easier to treat since hospital-acquired infections often involve drug-resistant microorganisms.
Chapter 17: Drug Therapy with Corticosteroids A male client taking oral prednisone informs the home care nurse that the medication is upsetting his stomach. What guidance can the nurse provide to help the client?
Confirm that the client takes the medication with a meal.
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones 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
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease The nurse is teaching a client taking isoniazid. The client also suffers from occasional acid reflux. What should the nurse teach this client about?
Decreased absorption of isoniazid
Chapter 17: Drug Therapy with Corticosteroids A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction the nurse provide the client's family about this drug?
Don't stop this medication suddenly; you will have to taper dosage gradually
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones You are preparing to discharge a patient who is taking ciprofloxacin. What guidance would you offer this patient to prevent crystalluria?
Drink at least 2 liters of fluids per day
Chapter 24: Drug Therapy for Fungal Infections A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment?
Electrolytes, blood urea nitrogen, and creatinine
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents Rifaximin (Xifaxan) is effective to treat traveler's diarrhea from which of the following organisms?
Escherichia coli
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics The nurse is caring for a client with ulcerative colitis who is taking sulfasalazine. What instruction will the nurse give this client?
Expect your urine to turn yellow-orange
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation The nurse is caring for a client with gout that is taking colchicine. In addition to the administration of this medication, what education can the nurse provide to help with the prevention of future episodes of gout?
Follow a low purine diet
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones Which of the following drugs would be classified as an aminoglycoside?
Gentamicin
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A 78-year-old male client calls the clinic and reports severe pain and swelling in his right great toe. The client states that the pain is worse at night and has been present for at least 2 weeks. The nurse understands that this client has what type of inflammatory disorder?
Gout
Chapter 24: Drug Therapy for Fungal Infections A client has been diagnosed with a fungal infection and been prescribed a topical antifungal medication. What assessment question should the nurse ask when addressing the possible etiology of the fungal infection?
Have you been prescribed any antibiotics in the recent past?
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A nurse has admitted a 10-year-old to the short-stay unit. The child reports chronic headaches, and his mother states that she gives the child acetaminophen at least twice a day. What will the nurse evaluate?
Hepatic function
Chapter 23: Drug Therapy for Viral Infections Antivirals are used to treat infections caused by viruses. In particular, acyclovir is useful to treat which infection?
Herpes zoster
Chapter 23: Drug Therapy for Viral Infections A nursing instructor determines a class on the various antiviral drugs is successful after the students correctly choose which viruses as being susceptible to antiviral medications? Select all that apply.
Human immunodeficiency virus (HIV) Herpes simplex virus (HSV) Cytomegalovirus (CMV)
Chapter 23: Drug Therapy for Viral Infections The nurse admits a client for treatment of cytomegalovirus (CMV). The client has been ordered foscarnet, 40 mg/kg q12h given over 2 hours. By what route should the nurse expect to administer this drug?
IV
Chapter 24: Drug Therapy for Fungal Infections Amphotericin B is given by which route?
IV
Chapter 23: Drug Therapy for Viral Infections The patient receiving IV acyclovir should be monitored for which adverse reaction?
Increased BUN and creatinine levels
Chapter 17: Drug Therapy with Corticosteroids You are talking to your class of nursing students about the adverse effects of corticosteroid therapy. What dietary change would you tell the students may help prevent osteoporosis related to long-term corticosteroid administration?
Increasing vitamin D intake
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A client develops a cough and fever and laboratory test results reveal leukopenia after receiving sulfonamide therapy. When developing the client's plan of care, the nurse would determine which nursing diagnosis is most appropriate?
Infection (Secondary) Risk
Chapter 15: Drugs Affecting Inflammation and Infection Antimicrobials work by several different mechanisms of action. How do the penicillins work?
Inhibiting cell wall synthesis
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A nursing instructor is preparing a class that will teach about aspirin. Which action would the instructor include about aspirin's effects on platelets? Select all that apply.
Inhibits platelet aggregation, Effect is irreversible.
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A client has returned to the clinic for follow-up of an infection which is being treated with an aminoglycoside and reports ringing in the ears and dizziness. When developing this client's plan of care, which nursing diagnosis would be the priority?
Injury Risk
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A client diagnosed with gout reports having no symptoms of the disease and asks why allopurinol was prescribed. How will the nurse best respond?
It is used to prevent or treat hyperuricemia, which occurs with gout.
Chapter 15: Drugs Affecting Inflammation and Infection The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug?
It will directly cause the death of pathogenic cells.
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents In which condition present in the client should macrolides be used with caution?
Liver dysfunction
Chapter 23: Drug Therapy for Viral Infections A client with a diagnosis of HIV has impaired renal function due to a concurrent diagnosis of diabetic nephropathy. What medication is most appropriate to treat this client's HIV?
Nelfinavir
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A 3-year-old has a history of recurrent urinary tract infections (UTI). Which practice implemented by the parents for the child indicates an understanding of preventive measures regarding these infections?
No use of bubble bath liquids or salts
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A nurse knows that promoting an optimal response to drug therapy is a desired outcome for clients on fluoroquinolones. One important action the nurse should include in the plan of care is which?
Observe the client for the first 48 hours for adverse reactions to the drug
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A nurse is caring for a client with severe and life-threatening pseudomembranous colitis caused by C. difficile. Which drug would the nurse expect the client's provider to order?
Oral vancomycin
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order?
Peak and trough serum levels
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents Cephalosporins are structurally and chemically related to which classes of antibiotics?
Penicillins
Chapter 23: Drug Therapy for Viral Infections An HIV-positive client is being treated with didanosine as part of the antiretroviral therapy. When assessing the client, the nurse would immediately report which finding to the primary health care provider?
Peripheral neuropathy
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration?
Phlebitis
Chapter 24: Drug Therapy for Fungal Infections A nurse is caring for a patient who is taking cyclosporine following a heart transplant. The patient is subsequently found to have a systemic Aspergillus infection. Which of the following antifungals, if administered to treat the infection, can increase serum levels of cyclosporine?
Potentially significant interactions exist between the azole antifungals and other drugs. Ketoconazole, fluconazole, and itraconazole are some of the azoles that increase serum levels of cyclosporine.
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease What therapeutic drug regimen will ensure client compliance?
Prescribe fixed-dose combinations of drugs
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics The nurse is preparing to administer sulfadiazine to a client who is also taking warfarin. The nurse would be alert for which potential adverse effect?
Prolonged clotting times
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A health care provider is deciding what medication to prescribe for a client with an upper respiratory infection. What principles guide the provider's decision? Select all that apply.
Resistance of the bacteria, Other drugs the client is taking daily, The client's ability to tolerate the drug
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents A nurse is required to administer a parenteral form of penicillin to a client. Which intervention would be most appropriate for the nurse to do when preparing penicillin in parenteral form?
Shake the vial well to distribute the drug evenly
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones A client scheduled to undergo major abdominal surgery has been prescribed preoperative neomycin. Neomycin is used preoperatively for what reason?
Suppress intestinal bacteria.
Chapter 17: Drug Therapy with Corticosteroids The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?
Take it first thing in the morning
Chapter 17: Drug Therapy with Corticosteroids The home health nurse is making a plan of care for a new client who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone?
Take with a meal
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease The nurse understands that which is the highest priority when teaching about antitubercular medications?
Taking medications as prescribed
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A client has been prescribed daptomycin for treatment of an infection. What instruction is most important for the nurse to tell this client?
Tell the health care provider immediately if you develop any muscle pain
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?
The client diagnosed with peptic ulcers
Chapter 24: Drug Therapy for Fungal Infections A client tells the nurse that she has taken several doses of over-the-counter fluconazole to treat a "yeast infection." When assessing the client's risk for drug toxicity, what aspect of the client's health status should the nurse prioritize?
The client has decreased renal function following recent pyelonephritis
Chapter 23: Drug Therapy for Viral Infections A client's health care provider is considering the addition of efavirenz to the client's drug regimen for the treatment of recently diagnosed HIV. Which aspects of the client's medical history should prompt the nurse to question the use of this drug?
The client has hepatitis C and a history of heavy alcohol use.
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A client is scheduled for abdominal surgery and is ordered to receive neomycin. The client asks the nurse why this drug is prescribed. Which response by the nurse would be most appropriate?
The drug helps eliminate bacteria so that your GI tract is as clean as possible for surgery
Chapter 24: Drug Therapy for Fungal Infections Ms. Jones, 64 years old, is placed on IV amphotericin B for a systemic fungal infection. Part of your care involves the development of a nursing plan of care. You identify the following nursing problem: ineffective protection related to drug-induced leukopenia and thrombocytopenia. What would be the most appropriate goal for this patient?
The patient will remain free from nosocomial infections during the hospital stay.
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons?
To prevent resistance
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?
Tuberculosis is an infectious disease that usually affects the lungs but may involve most parts of the body, including lymph nodes, meninges, bones, joints, kidneys, and the gastrointestinal tract.
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?
Urinary tract infections
Chapter 18: Drug Therapy With Beta-Lactam Antibacterial Agents 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?
Use a type of barrier birth control while you are taking this antibiotic.
Chapter 17: Drug Therapy with Corticosteroids A child is to receive a topical corticosteroid agent. Which statement by the parents indicates a need for additional teaching?
We need to cover the area snugly with plastic wrap to prevent scratching
Chapter 16: Drug Therapy to Decrease Pain, Fever, and Inflammation A client is asking the nurse about changing from aspirin to using willow bark. Which advantage of willow bark would the nurse integrate into the answer?
Willow bark has fewer adverse reactions than other salicylates.
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?
You will have multidrug therapy for 6 to 24 months
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones When describing the action of fluoroquinolones to treat infection to a group of nursing students, which would the instructor include?
bactericidal
Chapter 15: Drugs Affecting Inflammation and Infection A drug that does not actually cause the death of a cell but does interfere with its ability to reproduce is said to be:
bacteriostatic
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics The primary health care provider has prescribed mafenide for a client with second-degree burns. The nurse would be alert for which effect as the most frequent adverse reaction associated with the topical application of mafenide on the affected area?
burning sensation during application
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease A nurse teaching the client with tuberculosis (TB) should state that ethambutol can:
cause optic neuritis
Chapter 15: Drugs Affecting Inflammation and Infection A client has been diagnosed with an infection. The nurse can help to ensure the success of anti-infective treatment by:
confirming that the medication prescribed is the drug of choice for the specific microorganism
Chapter 15: Drugs Affecting Inflammation and Infection A client with an infection has been prescribed metronidazole, a bactericidal antibiotic. What should the nurse determine is the therapeutic effect of the medication?
death of the microbial cells
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A client who is hospitalized develops a UTI and is receiving anti-infective therapy. The nurse would expect to monitor the client's intake and output at which frequency?
every 8 hours
Chapter 17: Drug Therapy with Corticosteroids A nurse taking a medical history on a client prescribed a corticosteroid medication should focus on which condition?
infections
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease The nurse is assessing a client who has been prescribed treatment with isoniazid. What assessment finding would most likely necessitate contacting the health care provider to recommend discontinuing treatment?
jaundice
Chapter 22: Drug Therapy for Tuberculosis and Mycobacterium avium Complex Disease A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?
optic neuritis
Chapter 23: Drug Therapy for Viral Infections An immunocompromised 3-year-old has been exposed to avian flu. The client is brought to the clinic, and the mother reports that the client has had flu-like symptoms for the past 12 hours. What medication should the nurse expect to administer?
oseltamivir
Chapter 17: Drug Therapy with Corticosteroids A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?
potassium
Chapter 15: Drugs Affecting Inflammation and Infection A client is informed of a need for extensive dental surgery. The dentist prescribes a course of antibiotic therapy before beginning the procedure and continuing for 5 days after the procedure. What is this is an example of?
prophylaxis
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents A client is receiving fluoroquinolone therapy. Which finding would the nurse most likely report to the primary health care provider immediately when conducting an ongoing assessment of the client?
significant drop in blood pressure
Chapter 17: Drug Therapy with Corticosteroids Minimizing the effects of what process is typically the primary goal of alternate-day administration of corticosteroids?
suppression of normal adrenal function
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to
take the vitamins at least 2 hours before or after taking ciprofloxacin
Chapter 23: Drug Therapy for Viral Infections The nurse is caring for a 3-year-old with HIV. The nurse knows that, when administering antiviral drug therapy in young children with HIV, dosage calculations are typically based on:
the client's weight.
Chapter 24: Drug Therapy for Fungal Infections A client has just been prescribed fluconazole 150 mg PO as a single dose. The nurse recognizes which diagnosis is likely?
vaginal candidiasis
Chapter 19: Drug Therapy With Aminoglycosides and Fluoroquinolones A 60-year-old male client with a diagnosis of bacteremia is being treated with intravenous gentamicin. After 4 days of treatment, the care team is pleased with the improvement in the client's condition and the effect of the drug treatment on his blood cultures. During morning care, the client has told the nurse that he is having ringing in his ears and woke up this morning with a pounding headache. How should the nurse respond to this client?
Hold the next scheduled dose of gentamicin until the health care provider has been consulted.
Chapter 15: Drugs Affecting Inflammation and Infection A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?
Refer the client to the health care provider because the client may be experiencing resistance.
Chapter 21: Drug Therapy With Macrolides and Miscellaneous Anti-Infective Agents 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.
decrease in blood pressure, increase in respiratory rate, sudden increase in temperature
Chapter 20: Drug Therapy With Tetracyclines, Sulfonamides, and Urinary Antiseptics A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component?
fluids
Chapter 15: Drugs Affecting Inflammation and Infection What is a mechanism of action found in some antimicrobial drugs?
inhibition of bacterial cell wall synthesis
