Pharm (Test 4) Chapter 9: Antibiotics PrepU
To prevent resistance
A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? To decrease allergic response of medications To decrease length of drug therapy To prevent resistance To prevent adverse reactions
Harsh soaps Perfumed lotions Rubbing the irritating area Wearing rough or irritating clothing
A client develops a mild skin irritation while receiving penicillin therapy. Which products or actions would the nurse advise the client to avoid? Select all that apply. Antipyretic creams Perfumed lotions Rubbing the irritating area Harsh soaps Wearing rough or irritating clothing
"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response? "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control." "The antibiotics are only effective against some types of bacteria." "The antibiotics are only effective in killing off some of the bacteria in the body."
"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."
A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction? "Take the medication with a full glass of water to prevent the mouth from becoming dry during therapy." "Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur." "Avoid excessive caffeine intake because this could increase the side effects of the medication." "Make sure to limit your protein intake, as increased protein delays absorption of the medication."
It is effective against many pathogens that have developed resistance to penicillins
A client has been prescribed oxacillin after the prescriber reviewed the results of culture and sensitivity testing. The nurse should explain what unique benefit of this medication? It does not require monitoring in an intensive care or critical care setting It is effective against many pathogens that have developed resistance to penicillins It has not appreciable adverse effects on the gastrointestinal system It can be administered by an intramuscular depot route, requiring only a one-time dose
Nausea Headache Dizziness
A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions? (Select all that apply.) Headache Constipation Nausea Dizziness Profuse sweating
Take precautions to prevent photosensitivity.
A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan? Take a missed dose, even if close to the next dose. Take precautions to prevent photosensitivity. Avoid foods high in sodium such as processed meats. Take the necessary vitamins along with the drug.
Photosensitivity
A client is prescribed demeclocycline. The nurse would teach the client to be alert for which signs or symptoms? Blood dyscrasias Abdominal pain Cramping Photosensitivity
It inhibits cell wall synthesis.
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? It inhibits protein synthesis. It inhibits cell wall synthesis. It causes mutations. It lowers the pH of cellular contents.
Liver function studies
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? Pulmonary function studies Liver function studies Audiometric studies Urine culture
Renal damage
A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client? Bone marrow depression Renal damage Congestive heart failure Liver toxicity
Diarrhea
A client is taking clindamycin for an infectious process and presents to the health care provider's office with symptoms of dehydration. The nurse understands that the client is experiencing what adverse reaction from the administration of clindamycin? Dysphasia Diuresis Diarrhea Diaphoresis
Auditory function
A client is to receive gentamicin for treatment of an infection. Which of the following would be most important for the nurse to assess to establish a baseline? Auditory function Gastrointestinal function Muscle strength Nutritional status
changing to a different antibiotic
A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety? changing to a different antibiotic supplementing the antibiotic with vitamin K increasing the dose of rifaximin changing to parenteral administration of rifaximin
"The administration will decrease the growth of intestinal bacteria."
A client scheduled for a bowel resection is to receive neomycin sulfate by mouth. The client asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the client? "The administration decreases the risk of airborne contamination of the wound." "The administration by mouth will prevent renal damage from occurring." "The administration will decrease the growth of intestinal bacteria." "The administration by mouth will minimize the risk of ototoxicity."
isoniazid..
A nurse is administering an antitubercular drug that exhibits bactericidal activity. Which drug will the nurse administer? ethambutol pyrazinamide isoniazid rifampin
Discoloration of the teeth
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child? Epigastric distress Visual disturbances Abdominal pain or cramping Discoloration of the teeth
Rifampin and isoniazid
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client? Pyrazinamide and dapsone Dapsone and isoniazid Rifampin and isoniazid Rifampin and Pyrazinamide
Arrhythmias
A nurse is caring for a patient who has an acute bacterial exacerbation of chronic bronchitis and who has been prescribed telithromycin (Ketek). Before therapy begins, the nurse will assess the patient for a history of which of the following? Infection of the eye Hearing loss Ulcerative colitis Arrhythmias
Inflammation of the tongue and mouth
A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for? Severe hypotension Sudden loss of consciousness Inflammation of the tongue and mouth Impaired oral mucous membranes
Urinary tract infections
A nurse is conducting an in-service about antibacterial drugs such as penicillins and cephalosporins. During the question-and-answer period, the audience asks for examples of conditions that can be treated by cephalosporins. Which examples would the nurse include in the response? Nausea and diarrhea Hemolysis Urinary tract infections Jaundice
Jaundice
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication? Weight gain Fever Arthralgia Jaundice
bacteriostatic
After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which type of medication? bacteriostatic bacteriophage bacteriostationary bactericidal
Nausea
A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client? Nausea Excessive tearing Hypotension Chest pain
on an empty stomach.
A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how? at bedtime only. take with a meal. with milk or fruit juice. on an empty stomach.
metronidazole
A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example? gemifloxacin ciprofloxacin levofloxacin metronidazole
natural penicillins
A nurse is conducting an in-service education program for a group of nurses. When describing the action of the various classes of penicillins, which class would the nurse identify as having the narrowest spectrum of activity? extended-spectrum penicillins natural penicillins penicillinase-resistant penicillins aminopenicillins
Renal disease
A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted? Headache Aplastic anemia Abdominal cramps Renal disease
Inform the primary healthcare provider.
A nurse needs to administer a cephalosporin to a client. The client informs the nurse that he is allergic to penicillin. Which action by the nurse would be most appropriate? Administer an antipyretic drug. Inform the primary healthcare provider. Obtain the client's occupational history. Obtain specimens for kidney function tests.
Amikacin Kanamycin
A nursing instructor determines a teaching session about aminoglycosides is successful when the students correctly choose which drugs belonging in this class of drugs? Select all that apply. Azithromycin Vancomycin Kanamycin Amoxicillin Amikacin
interfering with DNA synthesis in the bacterial cell
A nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which would the instructor include? interfering with DNA synthesis in the bacterial cell blocking ribosomal reading of mRNA disrupting the bacterial cell wall interfering with protein synthesis
Take the drug on an empty stomach.
A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? Take the drug immediately after meals. Take the drug along with a meal. Take the drug along with milk or fruit juice. Take the drug on an empty stomach.
The peak and trough blood levels
A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize? Other patient medications The peak and trough blood levels The patient's blood pressure The patient's ideal body weight
Avoid the consumption of alcohol.
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract? Double the dose if earlier dose is missed. Avoid the consumption of alcohol. Take prescribed Ethambutol with food. Take prescribed Pyrazinamide without regard to food.
Imipenem-cilastatin Meropenem
After teaching a group of students about antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the students identify which of the following as an example of a carbapenem? Select all that apply. Meropenem Aztreonam Ceftriaxone Imipenem-cilastatin Vancomycin
Ulcerative Colitis
The nurse is caring for a client who has been prescribed a sulfonamide but does not have an infection. The nurse is aware that the medication has been prescribed to treat what condition? Ulcerative Colitis Crystalluria Gastritis Stomatitis
A 25-year-old male who has a hearing impairment
The nurse is providing education to an older adult client who has been prescribed tetracycline. Which statement should the nurse include in the teaching? "Brush your teeth twice a day to prevent discoloration." "Temporarily withhold your other medications while taking tetracycline." "Increase your fluids to 2 L or more per day to prevent renal crystals." "Return in 5 days for a urine test to check kidney function."
All the above
Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Lymph nodes GI/GU tract Kidneys All the above
It is inactivated by gastric acid, therefore it is only given by injection
Your client is being treated for streptococcal pharyngitis and is NPO. The health care provider has ordered penicillin G to be given IM. The client wants to know why the medication cannot be taken via an oral route. Which is the best response from the nurse? It is inactivated by gastric acid, therefore it is only given by injection The dose would be too high to give orally Giving it by injection will help prevent side effects Streptococcal infections respond better to injections versus the oral route
amoxicillin
A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? ciprofloxacin amoxicillin ibuprofen neomycin-polymyxin B
visual acuity and establish a baseline.
A 19-year-old Mexican American is about to start taking ethambutol (Myambutol). Before beginning drug therapy, it would be critical for the nurse to assess the patient's gross hearing and establish a baseline. alcohol use and that it is carefully documented. blood glucose level. visual acuity and establish a baseline.
oral contraceptives
A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of: alcohol. oral contraceptives. nicotine. fats in her diet.
numbness and tingling in his feet
A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away? numbness and tingling in his feet changes in his bowel elimination pattern a persistent cough since starting the medication a slight decrease in his blood glucose levels
staining of permanent teeth.
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause orange-tinged urine. staining of permanent teeth. sleep deprivation. deep muscle pain.
Cefadroxil
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity? Kanamycin Cefadroxil Lactulose Ketoconazole
Severe hypertension
A client, receiving linezolid, is fond of eating chocolates and drinking coffee. When teaching the client about this drug which adverse effect should the nurse point out presents the greatest risk to this client? Nervousness Drowsiness Severe hypertension Nausea
Risk of toxicity
A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions? Respiratory depression Increase in serum levels Risk of toxicity Increase in serum theophylline level
dapsone
After teaching a group of students about antitubercular therapy, the instructor determines that additional teaching is needed when the students identify which drug as an antitubercular agent? dapsone isoniazid rifampin ethambutol
Confirm the client's allergy status.
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose? Swab the client's nares for the presence of MRSA. Administer a 500-mL bolus of normal saline. Confirm the client's allergy status. Teach the client to expect discolored urine during treatment.
Confirm the client's allergy status.
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose? Teach the client to expect discolored urine during treatment. Swab the client's nares for the presence of MRSA. Confirm the client's allergy status. Administer a 500-mL bolus of normal saline.
Culture and sensitivity
Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order? Electrolyte panel White blood count Culture and sensitivity Complete blood count
Penicillins
Cephalosporins are structurally and chemically related to which classes of antibiotics? Aminoglycosides Tetracyclines Fluoroquinolones Penicillins
The patient will require vigilant monitoring of blood glucose levels.
Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment? The patient will require vigilant monitoring of blood glucose levels. The patient will require oral antihyperglycemics because exogenous insulin will be contraindicated. The patient will require intramuscular, rather than oral, administration of INH. The patient will require positive-pressure isolation because he will be immunocompromised.
Gram-negative bacteria
Compared with penicillins, cephalosporins more appropriate for treating infection by what type of microorganism? Fungi Viruses Gram-negative bacteria Gram-positive bacteria
They prevent cell reproduction.
Different classes of anti-infective drugs work differently on bacteria. What action do fluoroquinolone drugs such as levofloxacin have on bacteria? They inhibit bacterial growth. They affect protein synthesis. They affect the cell wall. They prevent cell reproduction.
Syphilis
Erythromycin is sometimes used as a penicillin substitute. For prevention of what condition might a nurse note a substitute of erythromycin for penicillin? Botulism Meningitis Syphilis Community-acquired pneumonia
A client who has chronic renal failure secondary to diabetes mellitus
Extreme caution would be necessary with the use of gentamicin in which client? A client who has bipolar disorder and who is on long-term lithium therapy A client who is morbidly obese and who has primary hypertension A client who has chronic renal failure secondary to diabetes mellitus A client who has an atrioventricular block
osteomyelitis
Gentamicin therapy is indicated in the treatment of what medical diagnosis? myasthenia gravis osteomyelitis acute renal failure multiple sclerosis
Block a step in bacterial protein synthesis. Disrupt the functional ability of the bacterial cell wall. Block bacterial RNA synthesis.
How do aminoglycosides elicit their bactericidal effects? Select all that apply. Disrupt the functional ability of the bacterial cell wall. Inhibit bacterial binding to the host cell. Inhibit bacterial DNA gyrase. Block bacterial RNA synthesis. Block a step in bacterial protein synthesis.
Penicillin
Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies? Vancomycin Tetracycline Penicillin Cephalosporin
"I will need to take the medication daily for up to 2 years."
Ms. Jones is admitted to the hospital with the diagnosis of rule-out tuberculosis. She is placed in isolation. The diagnosis is confirmed 72 hours after admission, based on sputum cultures and chest x-ray findings. She has been prescribed three different drugs for the treatment of TB. The nurse is completing discharge teaching with Ms. Jones. Which statement indicates that Ms. Jones understands the drug therapy? "The health care provider will stop the medication in 1 to 2 months." "I will only be taking one medication at home for the next 6 months." "I will contact the provider to renew the prescription every month." "I will need to take the medication daily for up to 2 years."
Metronidazole
Numerous residents of a long-term care facility have developed Clostridium difficile-associated diarrhea over the past week. The nurses at this facility would anticipate that many residents would require which medication therapy? Metronidazole Linezolid Chloramphenicol Daptomycin
Increasing resistance
Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason? Intermittent resistance Decreased resistance Increased susceptibility Increasing resistance
increase fluid intake.
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which? restrict sodium intake. increase fluid intake. increase sodium intake. restrict fluid intake.
Notify the health care provider
The client is being started on oral ciprofloxacin (Cipro). The nurse identifies that the client is also taking corticosteroids. What is the most appropriate action of the nurse? Monitor for adverse reactions Notify the health care provider Decrease the dosage of Cipro Teach about adverse reactions
"Limit your exposure to the sun."
The clinic nurse is responsible for teaching a client about a new prescription for doxycycline. The nurse should increase which instruction in the teaching? "Limit your exposure to the sun." "Chew the tablets completely before swallowing." "Consider going on oral contraception to avoid pregnancy." "Take an antacid with the drug if nausea occurs."
Teeth
The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age? Teeth Vision Hearing Kidneys
Administer the drug with food.
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? Discontinue the drug. Administer an antacid. Lower the dosage. Administer the drug with food.
Erythromycin
The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe? Erythromycin Pravastatin Loxapine hydrochloride Meclizine
Nephrotoxicity
The nurse is providing care to a client who is receiving an aminoglycoside and cephalosporin. Which assessment is a priority of care? Increased bleeding Nephrotoxicity Respiratory difficulty Nausea
It will interfere with enamel development.
What is the rationale for not administering tetracycline to children under the age of 8 years? It will increase the risk of heart failure. It will not treat the infection effectively. It will interfere with enamel development. It will increase the risk for future infections.
Gastrointestinal upset
What potential adverse reaction is most likely to develop during cefazolin therapy? Orthostatic hypotension Drowsiness Dry skin and pruritus Gastrointestinal upset
Thrombophlebitis can occur when cephalosporins are given IV. Pain can occur when cephalosporins are given IM. Tenderness can occur when cephalosporins are given IM. Inflammation can occur when cephalosporins are given IM.
Which of the following is true of cephalosporins given via injection? (Select all that apply.) Tenderness can occur when cephalosporins are given IM. Pain can occur when cephalosporins are given IM. Phlebitis can occur when cephalosporins are given IM. Inflammation can occur when cephalosporins are given IM. Thrombophlebitis can occur when cephalosporins are given IV.
interference with bacterial reproduction.
A 66-year-old woman with a history of recurrent urinary tract infections has been admitted to the hospital with a diagnosis of pyelonephritis. The client began treatment 36 hours ago with intravenous gentamicin and is being monitored closely. The nurse is aware that the therapeutic effect of the client's drug regimen is primarily a result of: lysis of the bacterial cell walls. enhancement of the client's immune function. interference with bacterial reproduction. alterations in the osmolarity of bacterial cytoplasm.
"Have you had any alcohol to drink in the past 72 hours?"
A client comes to the emergency department reporting a throbbing headache, nausea, vomiting, chest pain, dyspnea, vertigo, and blurred vision. The client reveals taking cefaclor for an infection. Which question would the nurse ask next? "Are you taking an oral anticoagulant such as warfarin?" "Have you had any alcohol to drink in the past 72 hours?" "Did the doctor prescribe any other antibiotics with this one?" "Have you been drinking enough fluids with the medicine?"
Penicillin G
A client has been diagnosed with streptococcal pharyngitis. What drug would the nurse expect to be prescribed by the health care provider? Amoxicillin Cephalexin Dicloxacillin Penicillin G
10 lb weight loss
A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide? Loose stools for the last two days Decreased appetite 10 lb weight loss Unable to eat spicy foods
225 mg
A client is caring for an 8-year-old child who weighs 30 kg. The health care provider orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?
Erythromycin
A client is diagnosed with an infectious process that is sensitive to penicillin. The client is allergic to penicillin, so the health care provider orders a drug with a similar antibacterial spectrum. The nurse anticipates that the provider will order what antibiotic? Dicloxacillin Streptomycin Erythromycin Vancomycin
60 minutes
A client is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame? 45 minutes 30 minutes 15 minutes 60 minutes
Decreased absorption of tetracycline
A client who routinely takes antacids has been prescribed tetracycline. The nurse explains to the client that there is an increased risk of which effect related to this combination? Decreased absorption of tetracycline Increased action of neuromuscular blocking drugs Increased risk of bleeding Increased profound respiratory depression
Rifampin
A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option? Kanamycin Ciprofloxacin Rifampin Capreomycin
Rash, itching, or other allergic reactions
A nurse is about to administer mafenide to a client. The nurse would be alert for which possible reaction? Loss of appetite Crystals in the urine sample Rash, itching, or other allergic reactions Inflammation of the mouth
minimize the adverse reactions related to histamine release
The nurse is preparing to administer vancomycin intravenously (IV) to a client. In preparation, the nurse dilutes the medication into 0.9% NaCl for what reason? minimize an allergic reaction to vancomycin prevent a decrease in serum levels of the drug. manage pain at the IV insertion site minimize the adverse reactions related to histamine release
"Increase your fluids to 2 L or more per day to prevent renal crystals."
The nurse is providing education to an older adult client who has been prescribed tetracycline. Which statement should the nurse include in the teaching? "Brush your teeth twice a day to prevent discoloration." "Temporarily withhold your other medications while taking tetracycline." "Increase your fluids to 2 L or more per day to prevent renal crystals." "Return in 5 days for a urine test to check kidney function."
Recurring symptoms of infection
The nurse is teaching a client about his prescription for a macrolide antibiotic. What should the nurse teach the client to report? Increased urinary output Lessening of symptoms of infection Missed doses Recurring symptoms of infection
Photosensitivity Diarrhea Stomatitis
The nurse is teaching a client about possible adverse reactions that can occur with tetracyclines. The nurse determines that the teaching was successful when the client identifies which reaction? Select all that apply. Diarrhea Photosensitivity Hypotension Stomatitis Hypoglycemia
The use of ciprofloxacin is contraindicated in pregnancy.
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? The use of ciprofloxacin is contraindicated in pregnancy. Ciprofloxacin is safe to use in pregnancy and the client may use to same dose and route as a nonpregnant client. It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client.
Teach the client the times to take fluids to maintain continence.
A 60-year-old client with altered urinary elimination is prescribed sulfonamide and instructed to increase daily fluid intake. Which nursing intervention would be most appropriate to address the fear of incontinence? Inform the client that increasing fluid intake will not result in incontinence. Inform the client that there is no need to increase fluid intake. Teach the client the times to take fluids to maintain continence. Increase fluid intake by 1000 mL instead of 2000 mL to avoid incontinence.
Each successive generation is more effective against gram-negative microorganisms.
A client being treated for cellulitis with a cephalosporin asks what the essential difference is between generations of this medication. The nurse should respond to the client's question based on what fact? Each successive generation is more effective against gram-negative microorganisms. Each generation of cephalosporins has a different mechanism of action. The generations of cephalosporins represent formulations that produce fewer side effects. The generations represent the order in which the drugs should be utilized clinically.
fluids
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 proteins calories vitamin D
Response to drug therapy Occurrence of adverse reactions Decrease in temperature
A febrile client is ordered to receive sulfonamide therapy for an infection. The nurse needs to evaluate the client for what during the course of therapy? Select all that apply. Occurrence of adverse reactions Decrease in temperature Response to drug therapy Elevated blood glucose Mental status changes
It is metabolized in the liver.
A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice? It is metabolized in the liver. It is metabolized in the kidneys. It is excreted into the bloodstream. It is excreted into the GI tract.
Inspect mouth and gums regularly.
After completing several days of penicillin therapy, a client presents with new reports of inflamed oral mucous membranes and tongue and gum swelling. What is a priority action in regards to this new finding? Instruct client to avoid brushing teeth. Instruct the client to gargle every 2 hours. Inspect mouth and gums regularly. Offer client a liquid diet.
Instituting seizure precautions
The nurse is caring for a client who has been prescribed metronidazole. Which intervention implemented by the nurse indicates an understanding of a possible adverse effect associated with therapy? Educating the client on selecting foods appropriate for a low sodium diet Instituting seizure precautions Encouraging the client to stay in an upright position for 2 hours after eating Requesting a PRN prescription for constipation management
Tendon pain
The nurse is caring for a client who is taking ciprofloxacin for treatment of necrotizing otitis externa. The nurse instructs the client to notify the health care provider immediately if the client experiences what symptom? Diarrhea Sunburn Dizziness Tendon pain
Vaginal itching and discharge
The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician? Nausea Vaginal itching and discharge Abdominal pain Swelling and itching of the throat
extrapulmonary
The nurse understands that tuberculosis (TB) can affect other organs of the body. The term used for TB outside the lungs called which? extrapulmonary. interstitial. metastasized. encapsulated.
Tetracycline for acne
The nurse will notify the health care provider immediately if the client taking amoxicillin for otitis media is also taking what medication?
A 13-year-old client
The nurse would contact the physician if ciprofloxacin was prescribed for which client diagnosed with a urinary tract infection? A 13-year-old client A 44-year-old client A 65-year-old client A 25-year-old client
Gram-positive and gram-negative organisms
The tetracyclines are effective against a wide range of which type of organisms? Gram-negative organisms Beta-lactamase-positive organisms Gram-positive organisms Gram-positive and gram-negative organisms
isoniazid
When a person is diagnosed with tuberculosis, the nurse prepares the family members to be treated prophylactically with which drug? ethambutol isoniazid rifampin pyrazinamide
inner ears
When considering known adverse reactions to gentamicin therapy, the nurse should focus assessment of what body structure? eyes oral cavity lymph nodes inner ears
inhibiting bacterial protein synthesis
When describing how tetracyclines treat infection, the nurse would incorporate which information into the description? inhibiting bacterial protein synthesis depolarizing the bacterial cell wall inhibiting bacterial cell wall synthesis inhibiting bacterial DNA gyrase
every hour
When fluoroquinolones are administered intravenously, the nurse would check the needle site and area around the needle site for extravasation at which frequency? every 6 hours every 2 hours every 4 hours every hour
Vaginal candidiasis Pseudomembranous colitis
Which of the following is a superinfection that may occur in a client being given a cephalosporin? Select all that apply. Osteomyelitis Conjunctivitis Otitis media Vaginal candidiasis Pseudomembranous colitis
Allergy history Medical history Medication history Current symptoms
Which of the following should be included in the nurse's pre-administration assessment prior to a client receiving a penicillin? Select all that apply. Allergy history Medication history Blood glucose Medical history Current symptoms
Clindamycin
Which of the following would a nurse identify as the prototype lincosamide drug? Erythromycin Clarithromycin Clindamycin Lincomycin
Anaphylactic shock
While obtaining a medication history on a 48-year-old client who is to receive penicillin for an ear infection, the nurse learns the client takes a beta-adrenergic blocker for hypertension. The nurse develops appropriate nursing goals as this client is at increased risk for which adverse reaction if penicillin is administered? Excess bleeding Higher blood pressure Heart attack Anaphylactic shock
Asking the client if she is pregnant
A 25-year-old female client who presents at the clinic with vaginal discharge and discomfort is diagnosed with chlamydia. The nurse knows that the drug of choice to treat this infection is doxycycline. What would be a priority assessment for this client before beginning the medication? Measuring the client's blood pressure Asking the client if she is allergic to sulfonamides Asking the client if she has had an allergic reaction to a penicillin Asking the client if she is pregnant
Serum alanine transaminase, aspartate transaminase, and bilirubin
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Fasting blood sugar and 2-hour postprandial blood sugar Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels Serum alanine transaminase, aspartate transaminase, and bilirubin Red blood count, white blood count, and differential
Sulfonamides can cause a life-threatening toxicity for the fetus.
A client who is 32 weeks pregnant has been diagnosed with a urinary tract infection. The nurse would immediately question any prescription for a sulfonamide based on what risk? Sulfonamides can cause a life-threatening toxicity for the fetus. Sulfonamides are ineffective against urinary tract infections. The mother may develop osteoporosis. These drugs can cause the client's teeth to be discolored.
Ensure that all follow-up appointments are met.
A client who is being discharged has been instructed to continue with sulfonamide therapy for a week. Which point should the nurse include in the teaching plan to educate the client about the therapy? Take the drug a few minutes before a meal. Take any off-the-shelf medication if fever occurs. Discontinue dosage if symptoms of infection disappear. Ensure that all follow-up appointments are met.
decreased absorption
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic? Decreased absorption Decreased elimination Increased elimination Increased absorption
trimethoprim-sulfamethoxazole
A client with a deep wound producing large amounts of purulent drainage is prescribed an antibiotic. The nurse should express concern about the potential effectiveness of the treatment if which medication is prescribed? trimethoprim-sulfamethoxazole doxycycline tetracycline penicillin
route.
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the: frequency. route. dose. choice of drug.
culture and sensitivity test
A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client? complete blood count renal and hepatic function tests urinalysis culture and sensitivity test
Erythromycin -
A client with a history of valvular heart disease reports having had a "bad reaction" after receiving penicillin in the past. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug? clindamycin erythromycin vancomycin metronidazole
BUN and creatinine
A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal? BUN and creatinine Amylase and lipase Sodium and potassium Red blood cells and white blood cells
Obtain a culture of the client's infection.
A client with an infected ulcer on the foot has been prescribed daptomycin. What action should the nurse ensure has been taken to determine that the drug will be effective in treating the infection? Obtain a culture of the client's infection. Educate the client of the need to report any muscle pain immediately. Determine whether the client has a known allergy to any lipopeptide class drug Assess whether the client is being treated for hypercholesterolemia.
Review lab results to confirm normal liver function.
A client, being treated in the intensive care unit, has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy? Review the medical for a history of nephrotoxic signs or symptoms. Review lab results to confirm normal liver function. Confirm the ability to safely swallow oral medication. Question the client about any history of gastrointestinal upset.
The fluoroquinolone can be given orally.
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? The fluoroquinolone does not have adverse effects. The fluoroquinolone can be given orally. The fluoroquinolone has a broader spectrum. The fluoroquinolone has a nearly immediate peak.
Drug-resistant tuberculosis
A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause? Methicillin-resistant Staphylococcus aureus Human immunodeficiency virus Drug-resistant tuberculosis Vancomycin-resistant Staphylococcus aureus
decrease in drug dose
A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do? Increase the drug dose. Decrease the drug dose. Maintain the drug dose. Administer the drug via an intramuscular route.
It slows drug elimination.
A female client is diagnosed with hepatitis C as well as a urinary tract infection. The organism is sensitive to tetracycline. Why is the health care provider reluctant to order tetracycline in a client with hepatic impairment? It slows drug elimination. It eliminates absorption of the medication. It increases drug elimination. It causes intermittent drug elimination.
"Has your child been swimming a lot lately?"
A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem? "Has your child been swimming a lot lately?" "Has your child been spending quite a bit of time around animals lately?" "Are all of your child's immunizations up-to-date?" "How would you describe your child's overall level of hygiene?"
Toxic effects to the developing fetus
A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which can be an adverse effect of the drug? Yellow-gray-brown discoloration of the teeth Toxic effects to the developing fetus Increase in the blood pressure Bacterial overgrowth of nonsusceptible organisms
Acute otitis media
After teaching a group of nursing students about indications for linezolid (Zyvox), the instructor determines a need for additional teaching when the students choose which disorder as an indication? Community-acquired pneumonia (CAP) Acute otitis media Methicillin-resistant Staphylococcus aureus (MRSA) Vancomycin-resistant Enterococcus faecium (VREF)
Bactericidal
After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms? bacteriostatic bactericidal fungicidal fungistatic
An increase in sensitivity of gram-negative microorganisms. A decrease in the sensitivity of gram-positive microorganisms.
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-positive microorganisms. A decrease in the sensitivity of gram-positive microorganisms. An increase in the sensitivity of viral microorganisms. A decrease in sensitivity of gram-negative microorganisms. An increase in sensitivity of gram-negative microorganisms.
doxycycline
In the event of a bioterrorism attack with anthrax, the health care team should anticipate the use of which tetracycline? demeclocycline hydrochloride minocycline doxycycline tetracycline hydrochloride
a skin test.
In the rare instance in which penicillin is considered essential, hypersensitivity can be assessed by administering: a loading dose of the medication. the medication in a controlled environment. the medication by the intravenous route only. a skin test.
Continue to monitor vital signs.
The client has been taking levofloxacin IV since admission 12 hours ago for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response? Administer an antipyretic. Notify the health care provider. Continue to monitor vital signs. Administer an extra dose of levofloxacin.
"Make sure to avoid drinking any alcohol for the next three days."
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client? "Make sure to avoid drinking any alcohol for the next three days." "It's possible that your urine might be pink-tinged for the next little while, but that's expected and it will resolve." "You might develop a mild fever when you finish your antibiotics, but that doesn't mean your infection has returned." "Remember to have your required blood work drawn in 48 hours."
"If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."
The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media and prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse? "The entire course of the amoxicillin should be taken as directed on the bottle and completed." "Sudden development of a rash, shortness of breath, or wheezing should be reported immediately." "If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used." "I should see an improvement in my baby in 24 hours from the time the drugs are started."
"The drug will not affect the herbal supplement, ginseng that I take."
The nurse is educating a client diagnosed with a urinary tract infection about the prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The client has a history of type 2 diabetes and currently takes a sulfonylurea. Which statement made by the client establishes the need for further clarification? "If a rash develops, the drug will be discontinued and my prescriber notified." "I will take the drug with 8 ounces of water before or after meals." "I will monitor my blood sugar carefully since the drug may lower it." "The drug will not affect the herbal supplement, ginseng that I take."
methicillin-resistant Staphylococcus aureus (MRSA) infection
The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem? endocarditis chlamydial infection methicillin-resistant Staphylococcus aureus (MRSA) infection encephalitis
Has the child taken tetracycline for treatment?
The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent? Has the child taken a corticosteroid for treatment? Has the child taken a cephalosporin for treatment? Has the child taken a sulfonamide for treatment? Has the child taken tetracycline for treatment?
Diarrhea and nausea
The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug? Headache and dizziness Diarrhea and nausea Superinfections and phlebitis Lethargy and paresthesias
Vomiting and diarrhea
The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects? Phlebitis Headache and dizziness Vomiting and diarrhea Superinfections
"Are you taking any medications for depression right now?"
The nurse is preparing to administer linezolid to a client. What assessment question should the nurse ask the client before administering the drug? "Have you ever had your bone density tested?" "Do you suffer from heartburn or acid reflux?" "Are you taking any medications for depression right now?" "Do you take iron supplements on a regular basis?"
Prolonged clotting times
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? Decreased antibiotic effect Prolonged clotting times Decreased white blood cell count Increased risk of infection
Inflammation is decreased because of interaction with intestinal bacteria.
The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action? All intestinal bacteria are destroyed by the medication. It causes intestinal bacteria to replicate and repopulate. Bacteria causing ulcerative colitis are killed off. Inflammation is decreased because of interaction with intestinal bacteria.
Taking medications as prescribed
The nurse understands that which is the highest priority when teaching about antitubercular medications? Staying hydrated Taking medications as prescribed Monitoring sputum Eating a well balanced diet
