Pharm Final
A male patient asks the nurse why he has to continue to take medication after completion of the initial induction phase if his sputum is "clean." What does the nurse say? A. Dormant bacteria are still present inside cells and can become active at a later time. B. Sputum cultures are not sensitive enough to ensure that the active bacteria are eliminated. C. Sputum cultures are not specific for mycobacterium. D. This therapy is in case the patient comes into contact with the person who originally infected him.
A. Dormant bacteria are still present inside cells and can become active at a later time.
A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which of these outcomes should a nurse expect if the medication is achieving the desired therapeutic effect? A. Neutralized gastric acid B. Reduced stomach motility C. Increased barrier to pepsin D. Reduced duodenal pH
A. Neutralized gastric acid
A male patient who has been diagnosed with active TB has been prescribed isoniazid, rifampin, ethambutol, and pyrazinamide. The patient asks the nurse why he has to take so many drugs. The basis of the nurse's response should include that this multidrug therapy has which effect(s)? (Select all that apply.) A. Decreased adverse effects. B. Decreased risk of relapse. C. No increased risk of suprainfection. D. Elimination of actively dividing and resting tuberculosis mycobacteria. E. Prevention of mycobacteria from developing resistance to a drug.
B. Decreased risk of relapse. C. No increased risk of suprainfection. D. Elimination of actively dividing and resting tuberculosis mycobacteria
The nurse knows that oral rifampin may not reach therapeutic levels if it is administered: A. on an empty stomach. B. with food. C. with other drugs that are metabolized by the hepatic cytochrome P450 enzymes. D. with protease inhibitors and non nucleoside reverse transcriptase inhibitors (NNRTIs) for HIV infection.
B. with food.
A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which of these actions is the priority a nurse takes? A) Ask the care provider for a reduction in dose. B) Encourage the patient to increase dietary fiber. C) Administer with an aluminum hydroxide antacid. D) Instruct the patient to keep an accurate stool count.
C) Administer with an aluminum hydroxide antacid.
A patient with a history of peripheral vascular disease, type 2 diabetes mellitus, and latent TB is prescribed isoniazid and pyridoxine. What is the purpose of the pyridoxine? A. Improve arterial blood flow. B. Prevent hypoglycemia. C. Prevent peripheral neuropathy. D. Treat resting mycobacteria within cells.
C. Prevent peripheral neuropathy.
A nurse should recognize that for maximum therapeutic effects against the influenza virus, oseltamivir (Tamiflu) should be taken when? A. Two days or more after symptom onset B. When lung crackles are present C. Within 12 hours of symptom onset D. Only when fever is above 102 °F
C. Within 12 hours of symptom onset
A nurse is planning care for a patient who has peptic ulcer disease and is taking amoxicillin (Amoxil). Which of these should the nurse establish as therapeutic medication outcomes? A) Inhibition of an enzyme to block acid secretion B) Coating of the ulcer crater as a barrier to acid C) Selective blockade of parietal cell histamine2 receptors D) Disruption of bacteria cell wall to cause lysis and death
D) Disruption of bacteria cell wall to cause lysis and death
A patient is receiving weekly subcutaneous injections of peg-interferon-alfa-2a (Pegasys) for chronic hepatitis C. A nurse teaches the patient that which adverse effect will diminish with continued therapy? A. Black, sticky, tarry stools B. Lower leg muscle weakness C. Dyspnea and wheezing D. Flulike symptoms
D. Flulike symptoms
A nurse is receiving isoniazid therapy for latent TB. It would be of greatest priority to contact the prescriber if the nurse experiences. A. Frontal headache. B. Dry mouth. C. Heartburn at night. D. Persistent nausea.
D. Persistent nausea.
A patient is receiving amphotericin B. The nurse identifies which medication as useful in preventing adverse effects of amphotericin B? A. Furosemide (Lasix) B. Insulin C. Vitamin K D. Potassium
D. Potassium
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 acne like 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. "I should not take this medication with milk or other dairy products."
The nurse is providing education to a patient who has been prescribed both an antacid and cimetidine [Tagamet]. Which instruction should the nurse give the patient about taking the medications? a. "Take the antacid 1 hour after the ranitidine." b. "The antacid and ranitidine should be taken at the same time for better effect." c. "Take the antacid 15 minutes before the ranitidine." d. "Take the antacid 30 minutes after the ranitidine."
a. "Take the antacid 1 hour after the ranitidine."
A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse's best response? a. "The combined effect of both antibiotics is greater than each of them alone." b. "One antibiotic is not strong enough to fight the infection." c. "We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms." d. "We can give a reduced amount of each one if we give them together."
a. "The combined effect of both antibiotics is greater than each of them alone."
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. 30 minutes after the IV infusion is complete
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. Acetaminophen
A patient is diagnosed with peptic ulcer disease. The patient is otherwise healthy. The nurse learns that the patient does not smoke and that he drinks 1 or 2 glasses of wine with meals each week. The nurse anticipates that the provider will prescribe which drugs? a. Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec] b. Amoxicillin [Amoxil], metronidazole [Flagyl], and cimetidine [Tagamet] c. Clarithromycin, metronidazole [Flagyl], and omeprazole [Prilosec] d. Tetracycline, cimetidine [Tagamet], and lansoprazole [Prevacid]
a. Amoxicillin [Amoxil], clarithromycin, and omeprazole [Prilosec]
A patient asks a nurse about ways to minimize side effects of chemotherapy. Which response is correct? a."Avoid contact with people who are ill." b."Take antiemetics immediately after receiving chemotherapy." c."Treat fevers immediately with ibuprofen." d."Use a firm-bristled toothbrush to stimulate gums."
a."Avoid contact with people who are ill."
A patient with cancer who is receiving chemotherapy develops a fever. The patient's chest radiograph is normal. The patient's neutrophil count is 750/mm3. The nurse expects the provider to: a.begin empiric therapy with intravenous antibiotics. b.obtain cultures and wait for results before prescribing antibiotics. c.order colony-stimulating factor to minimize neutrophilia. d.reassure the patient that serious infection is unlikely.
a.begin empiric therapy with intravenous antibiotics.
A patient is about to begin treatment for latent tuberculosis. The patient is an alcoholic, has difficulty complying with drug regimens, and has mild liver damage. What will the nurse tell this patient? a. "You must stop drinking before adequate treatment can begin." b. "You must take isoniazid with close monitoring of hepatic function." c. "You must take rifampin daily for 4 months." d. "You will begin a regimen of isoniazid and rifampin."
b. "You must take isoniazid with close monitoring of hepatic function."
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 [Vancocin], to the patient's regimen b. Discontinuing the cephalosporin and beginning metronidazole [Flagyl] c. Discontinuing all antibiotics and providing fluid replacement d. Increasing the dose of the cephalosporin and providing isolation measures
b. Discontinuing the cephalosporin and beginning metronidazole [Flagyl]
A patient who takes the loop diuretic ethacrynic acid is given intravenous gentamicin for an infection. After several days of treatment with gentamicin, the nurse reviews the patient's most recent laboratory results and notes a gentamicin trough of 2.1 mcg/mL and normal blood urea nitrogen (BUN) and serum creatinine levels. The nurse will question the patient about: a. gastrointestinal (GI) symptoms. b. headache, dizziness, or vertigo. c. presence of rash. d. urine output.
b. headache, dizziness, or vertigo.
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. peak b. peak and trough c. serum drug d. trough
b. peak and trough
A patient's provider has recommended a bulk-forming laxative for occasional constipation. Which statement by the patient indicates understanding of the teaching about this agent? a. "I can take this medication long term." b. "I should not take this drug if I have diverticulitis." c. "I should take each dose with a full glass of water." d. "This drug can cause severe diarrhea.
c. "I should take each dose with a full glass of water."
A 30-year-old male patient will begin a three-drug regimen to treat peptic ulcer disease. The regimen will consist of bismuth subsalicylate, tetracycline, and cimetidine [Tagamet]. The nurse will include which information when teaching this patient about this drug regimen? a. Black discoloration of the tongue and stools should be reported immediately. b. Central nervous system depression and confusion are likely to occur. c. Decreased libido, impotence, and gynecomastia are reversible side effects. d. Staining of the teeth may occur and is an indication for discontinuation of these drugs.
c. Decreased libido, impotence, and gynecomastia are reversible side effects.
A patient with a history of chronic alcohol abuse has been admitted to the unit with cirrhosis. Upon review of the patient's laboratory test results, the nurse notes that the patient's ammonia level is elevated at 218 μg/dL. What medication should the nurse prepare to administer? a. 0.9% NS b. Docusate sodium [Colace] c. Lactulose d. Polyethylene glycol [MiraLax]
c. Lactulose
A patient is taking gentamicin (Garamycin) and furosemide (Lasix). The nurse should counsel this patient to report which symptom? a. Frequent nocturia b. Headaches c. Ringing in the ears d. Urinary retention
c. Ringing in the ears
When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity? a. Fever b. White blood cell count of 8000 cells/mm3 c. Tinnitus and dizziness d. Decreased blood urea nitrogen (BUN) levels
c. Tinnitus and dizziness
A young, nonpregnant female patient with a history of a previous urinary tract infection 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. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]
Which cephalosporin may be used to treat meningitis? a. Cefaclor b. Cefazolin c. Cefoxitin d. Cefotaxime
d. Cefotaxime
A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA). What is an appropriate treatment for this patient? a. Cefaclor b. Cefazolin c. Cefotaxime d. Ceftaroline
d. Ceftaroline
A patient develops CDAD. Which antibiotic is recommended for treating this infection? a. Chloramphenicol b. Clindamycin [Cleocin] c. Linezolid [Zyvox] d. Vancomycin
d. Vancomycin
A patient has just been diagnosed with cancer and will begin chemotherapy. The patient asks the nurse about the possibility of nausea and vomiting. The nurse will tell the patient that: a. nausea and vomiting can be avoided by having a snack before chemotherapy. b. nausea and vomiting are common side effects and will abate over time. c. nausea and vomiting are common and will be treated with antiemetics when they occur. d. the provider will order drugs to help prevent nausea and vomiting before each dose.
d. the provider will order drugs to help prevent nausea and vomiting before each dose.
A nurse administers which of these medications to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? A) Omeprazole (Prilosec) B) Famotidine (Pepcid) C) Misoprostol (Cytotec) D) Ranitidine (Zantac)
A) Omeprazole (Prilosec)
Which approach should a nurse take to administer intravenous (IV) acyclovir (Zovirax) to an immunocompromised patient? A. Infuse IV fluids during administration of the dose and for 2 hours afterward. B. Administer IV acyclovir diluted in 20 mL normal saline (NS) over 10 minutes. C. Only infuse the drug if the white blood cell (WBC) count is above 2500/mm3. D. Ask the provider to change the route to subcutaneous (subQ) injection.
A. Infuse IV fluids during administration of the dose and for 2 hours afterward.
A nurse administering flu vaccines at an annual clinic should recognize that which individuals should be vaccinated, as recommended by the Advisory Committee on Immunization Practices (ACIP)? (Select all that apply.) A. Women who will be pregnant during flu season B. All children 6 months and older and older adults C. Those who report severe allergy to chicken eggs D. Those who have a history of Guillain-Barré syndrome E. Those 6 months to 18 years old receiving aspirin therapy
A. Women who will be pregnant during flu season B. All children 6 months and older and older adults E. Those 6 months to 18 years old receiving aspirin therapy
A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. The patient's breath test result should reveal the absence of which of these if the treatment has been effective? A) Bicarbonate B) H. pylori C) Histamine2 D) Prostaglandins
B) H. pylori
Why is the interaction if isoniazid and phenytoin especially important? A. Isoniazid levels can become sub therapeutic. B. Phenytoin has a narrow therapeutic range. C. Phenytoin levels can become sub therapeutic. D. The risk of hepatotoxicity increases.
B. Phenytoin has a narrow therapeutic range.
A patient is scheduled to receive intravenous amphotericin B. Which medication should a nurse administer as pretreatment before the infusion? A. 10 units of regular insulin intravenously B. 20 mg famotidine (Pepcid) in 50 mL of 5% dextrose C. 50 mg of diphenhydramine (Benadryl) and 650 mg of acetaminophen D. 1 g of calcium gluconate in 100 mL of normal saline
C. 50 mg of diphenhydramine (Benadryl) and 650 mg of acetaminophen
The nurse identifies which medication as the drug of choice for most infections caused by herpes simplex viruses and varicella-zoster virus? A. Ganiciclovir B. Amantadine C. Acyclovir D. Oseltamivir
C. Acyclovir
A nurse is providing teaching to a group of patients regarding flu season in the United States. Which statement should the nurse include in the teaching? A. In the United States, flu season usually peaks in October or November. B. To insure full protection, the best time to vaccinate is September. C. For people who missed the best time, vaccinating as late as April may be of help. D. The influenza vaccine may not be administered at the same time as the pneumococcal vaccine.
C. For people who missed the best time, vaccinating as late as April may be of help.
A nurse is teaching a patient who is scheduled to start taking itraconazole (Sporanox). Which statement by the patient would indicate understanding of the teaching? A. "I'll take diphenhydramine (Benadryl) before this medication so I don't have a reaction." B. "It's important to remember to wear sunscreen while taking this medicine." C. "I'll avoid citrus foods, such as oranges and grapefruits, while taking this medication." D. "If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider."
D. "If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider."
A patient is receiving amphotericin B. It is most important for the nurse to monitor which laboratory result? A. Serum pH B. Protein level C. Glucose level D. Creatinine level
D. Creatinine level
Which antifungal agent is used as a one-time oral dose to treat vaginal yeast infections? A. Nystatin (Mycostatin) B. Caspofungin (Cancidas) C. Voriconazole (Vfend) D. Fluconazole (Diflucan)
D. Fluconazole (Diflucan)
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 understanding of the teaching? a. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls." b. "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." c. "Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased." d. "Cephalosporins reduce bacterial resistance to aminoglycosides."
a. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."
Which condition would cause the nurse to withhold a PRN order for magnesium hydroxide? a. Chronic renal failure b. Cirrhosis c. Hemorrhoids d. Prostatitis
a. Chronic renal failure
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. allergic reaction. b. red man syndrome. c. rhabdomyolysis. d. Stevens-Johnson syndrome.
b. red man syndrome.
A hospitalized patient with cancer is receiving chemotherapy and reports oral pain. Inspection of this patient's oral mucosa reveals erythema and inflammation without denudation or ulceration. The nurse understands that: a. chemotherapy will have to be stopped until healing of the oral mucosa occurs. b. the patient can use a mouthwash with a topical anesthetic to control pain. c. the patient will need an antifungal agent to treat Candida albicans. d. the patient will need systemic opioids to control discomfort.
b. the patient can use a mouthwash with a topical anesthetic to control pain.
Which are potentially worrisome adverse effects associated with proton pump inhibitor use in older patients? (Select all that apply.) a. Gastric cancer b. Headaches c. Medication interactions d. Osteoporosis e. Vitamin and mineral deficiencies
c. Medication interactions d. Osteoporosis e. Vitamin and mineral deficiencies
A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with: a. cephalexin [Keflex]. b. fosfomycin [Monurol]. c. methenamine [Hiprex]. d. nitrofurantoin [Macrodantin].
c. methenamine [Hiprex].
The nurse is reviewing the medication orders for a patient who will be receiving gentamicin therapy. Which other medication or medication class, if ordered, would be a potential interaction concern? a. Calcium channel blockers b. Phenytoin c. Proton pump inhibitors d. Loop diuretics
d. Loop diuretics
A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which of these medications from the patient's history should the nurse recognize as a contributing factor? A) Amoxicillin (Amoxil) B) Cimetidine (Tagamet) C) Metronidazole (Flagyl) D) Omeprazole (Prilosec)
B) Cimetidine (Tagamet)
A patient has received instruction regarding TB therapy with rifampin. Which of these statements made by the patient would indicate the patient needs further teaching? A. "I should contact my ophthalmologist regarding use of my contact lenses." B. "I should contact my prescriber if I experience reddish-colored urine." C. "My oral contraceptive birth control may not control." D. "This drug can stain my contact lenses."
B. "I should contact my prescriber if I experience reddish-colored urine."
The public health nurse would withhold administration of TB drug therapy with rifampin and pyrazinamide and contact the prescriber if the patient's laboratory test results include: A. AST 75 international units/L. B. bilirubin, total 3 mg/mL. C. BUN 22 mg/dL. D. creatinine 1 mg/dL.
B. bilirubin, total 3 mg/mL.
It is of greatest priority to teach a patient who is prescribed ethambutol to: A. call the prescriber if experiencing nausea. B. contact the prescriber if experiencing any visual changes. C. take the drug on an empty stomach with or without food. D. take the drug with food if it causes upset stomach.
B. contact the prescriber if experiencing any visual changes.
A 19-year-old nursing student with no history of medical problems, no symptoms of disease, and no risk factors for contracting TB is being screened for TB before starting a clinical nursing course. He has a 20-mm area of erythema surrounding an 11-mm area of induration 48 hours after receiving a PPD tuberculin test. Chest x-ray and sputum culture are negative. The nurse would expect prophylactic treatment to involve: A. multidrug therapy. B. watchful waiting. C. isoniazid. D. rifampin
B. watchful waiting.
A patient takes prophylactic warfarin because of a history of atrial fibrillation. The patient has recently been diagnosed with TB and is prescribed antimicrobial drugs, including rifampin. Because of the interaction between warfarin and rifampin, it is important for the nurse to assess the patient for which symptom? A. Abdominal pain. B. Bleeding. C. Change in mental status. D. Oliguria.
C. Change in mental status.
It is most important for the nurse to assess a patient taking itraconazole (Sporanox) for the development of what? A. Hair loss B. Skin rash C. Pedal edema D. Joint pain
C. Pedal edema
A nurse is providing teaching for a patient who will begin taking clarithromycin ER [Biaxin XL] to treat an Helicobacter pylori infection. Which statement by the patient indicates understanding of the teaching? a. "I may experience distorted taste when taking this medication." b. "I should take 1 tablet twice daily for 10 days." c. "I should take this medication on an empty stomach." d. "This medication does not interact with other drugs."
a. "I may experience distorted taste when taking this medication."
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. "Tetracycline can be harmful to the baby's teeth and should be avoided."
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. Administer gentamicin, flush the line, and then give the penicillin.
When metronidazole [Flagyl] is a component of the H. pylori treatment regimen, the patient must be instructed to do what? a. Avoid any alcoholic beverages b. Avoid foods containing tyramine c. Take the drug on an empty stomach d. Take the drug with food
a. Avoid any alcoholic beverages
A patient is receiving intravenous vincristine [Oncovin]. The patient complains of pain at the IV insertion site. The nurse examines the site and notes an area of erythema and edema. What will the nurse do? a. Change the IV site and notify the provider of the extravasation. b. Contact the provider to suggest using a different chemotherapeutic agent. c. Obtain an order for a topical anesthetic to minimize discomfort. d. Slow the rate of infusion to reduce the patient's discomfort.
a. Change the IV site and notify the provider of the extravasation.
A patient is about to begin therapy with ethambutol. The nurse knows that, before initiating treatment with this drug, it is important to obtain which test(s)? a. Color vision and visual acuity b. Complete blood cell (CBC) count c. Hearing testing and a tympanogram d. Hepatic function tests
a. Color vision and visual acuity
Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug? a. Diarrhea b. Headache c. Nausea d. Vomiting
a. Diarrhea
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. Uncomplicated lower urinary tract infection treatable with short-course therapy
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. another birth control method
A hospitalized patient is being treated for tuberculosis with a drug regimen that includes pyrazinamide. The patient complains of pain in the knee and shoulder joints. The nurse will contact the provider to request an order for: a. ibuprofen. b. renal function tests. c. discontinuation of the pyrazinamide. d. measurement of uric acid levels.
a. ibuprofen.
A patient is receiving an intraperitoneal aminoglycoside during surgery. To reverse a serious side effect of this drug, the nurse may expect to administer which agent? a. Amphotericin B b. Calcium gluconate c. Neuromuscular blocker d. Vancomycin
b. Calcium gluconate
A patient is about to begin treatment for latent tuberculosis with a short course of daily rifampin. The patient asks why rifapentine [Priftin] cannot be used, because it can be given twice weekly. What will the nurse tell this patient about rifapentine? a. It is more toxic than rifampin. b. It is not approved for treatment of latent TB. c. It is not well absorbed and thus not as effective. d. It will stain contact lenses orange.
b. It is not approved for treatment of latent TB.
A patient will undergo a colonoscopy, and the provider has ordered sodium phosphate as a bowel cleanser before the procedure. The nurse reviews the patient's chart and notes that the patient's creatinine clearance and blood urea nitrogen are both elevated. What will the nurse do? a. Reduce the amount of fluid given with the laxative to prevent fluid retention. b. Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead. c. Suggest that the patient reduce the dietary sodium intake. d. Suggest using a suppository laxative instead.
b. Request an order to give polyethylene glycol and electrolytes (PEG-ELS) instead.
A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do? a. Request an order for a gentamicin peak level. b. Suspect ototoxicity and notify the prescriber. c. Tell the patient to ask for help with ambulation. d. Tell the patient to report any tinnitus.
b. Suspect ototoxicity and notify the prescriber.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a. Apply warm packs to the arm, and infuse the medication at a slower rate. b. Continue the infusion while elevating the arm. c. Select an alternate intravenous site and administer the infusion more slowly. d. Request central venous access.
c. Select an alternate intravenous site and administer the infusion more slowly.
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. The patient should stop taking the clindamycin now and contact the provider immediately.
A patient has been taking isoniazid 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. order pyridoxine 100 mg per day.
A patient is admitted with lower abdominal pain and nausea. The nurse performing the initial assessment notesthat the patient's abdomen isdistended and firm, and hypoactive bowelsounds are present. The patient has not had a stool for 3 days. The nurse will contact the provider, who will: a. order a bulk-forming laxative. b. order extra fluids and fiber. c. perform diagnostic tests. d. prescribe a cathartic laxative
c. perform diagnostic tests.
A patient with renal disease is scheduled for a colonoscopy. Before the procedure, the nurse will anticipate administering: a. glycerin suppository. b. magnesium hydroxide (MOM). c. polyethylene glycol and electrolytes. d. sodium phosphate
c. polyethylene glycol and electrolytes.
To prevent yellow or brown discoloration of teeth in children, tetracyclines should not be given: a. to children once the permanent teeth have developed. b. to patients taking calcium supplements. c. to pregnant patients after the fourth month of gestation. d. with dairy products or antacids.
c. to pregnant patients after the fourth month of gestation.
The nurse wants to evaluate a nursing student's understanding of chemotherapy. The nurse asks, "Which factor would be a major obstacle to successful chemotherapy?" What is the student's best response? a."The patient's reluctance about the doses administered." b."The patient's degree of nausea." c."The toxicity of anticancer drugs to normal tissues." d."The difficulty attaining and maintaining venous access.
c."The toxicity of anticancer drugs to normal tissues."
These patients are receiving chemotherapy. Which patient should the nurse see first? a.The patient with lightly bleeding gums b.The patient with nausea and vomiting c.The patient with a fever of 100.3°F d.The patient with diarrhea and stomatitis
c.The patient with a fever of 100.3°F
A patient who has gastroesophageal reflux disease (GERD) receives a prescription for a proton pump inhibitor (PPI) medication. What will the nurse include when teaching the patient about this drug? a. "The FDA has determined that there is a gastric cancer risk with this drug." b. "This drug will be given on a short-term basis only." c. "You may experience hypermagnesemia when taking this drug." d. "You should report any fever and cough to your provider."
d. "You should report any fever and cough to your provider."
A patient is beginning treatment for active tuberculosis (TB) in a region with little drug- resistant TB. Which treatment regimen will be used initially? a. Isoniazid and pyrazinamide b. Isoniazid, pyrazinamide, and ethambutol c. Rifampin, pyrazinamide, and ethambutol d. Isoniazid, rifampin, pyrazinamide, and ethambutol
d. Isoniazid, rifampin, pyrazinamide, and ethambutol
A patient has been taking psyllium [Metamucil] two to three times daily for several days. The patient complains of stomach pain but has not had a stool. What will the nurse do? a. Ask the patient to drink a full glass of water. b. Give another dose of the psyllium. c. Request an order for a bisacodyl [Dulcolax] suppository. d. Palpate the patient's abdomen and auscultate for bowel sounds
d. Palpate the patient's abdomen and auscultate for bowel sounds
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. Red-orange-tinged urine
A patient will begin receiving vincristine [Oncovin] to treat Hodgkin's lymphoma. Which side effect(s) will the nurse tell the patient to report immediately? a. Diarrhea, nausea, and vomiting b. Hair loss c. Headaches d. Tingling of the extremities
d. Tingling of the extremities
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. Tingling of the fingers
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. monitoring phenytoin levels.
A patient stops taking a proton pump inhibitor (PPI) after 6 weeks of therapy for treatment of peptic ulcer disease. The patient reports symptoms of dyspepsia to the nurse. The nurse will tell this patient to: a. come to the clinic to be tested for Clostridium difficile. b. resume taking the PPI, because long-term therapy is necessary. c. resume taking the PPI until symptoms resolve completely. d. try an antacid to see whether it relieves these symptoms.
d. try an antacid to see whether it relieves these symptoms.