prepu ch 40
Which patient should not receive erythromycin as ordered at 8 a.m.?
The patient with elevated liver enzymes The medication is metabolized by the liver and excreted in the bile. The patient with elevated liver enzymes will not be able to tolerate this medication. There is a risk it will build up in the system.
The nurse is preparing to discharge a client who has been prescribed telithromycin. The client understands the unique adverse effect associated with this drug when the client makes which statement? a) "This drug may cause visual disturbances so I won't drive until I am finished with the medication." b) "I know that this drug can make me constipated so I will take a laxative every evening." c) "It is common to have a rash when taking this medication, so I will use an anti-itch cream." d) "Some people develop fevers while taking this drug, so I will take aspirin every four hours."
a) "This drug may cause visual disturbances so I won't drive until I am finished with the medication."
A 32-year-old female patient is admitted to the floor with a superinfection. Her orders read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over 30 to 60 minutes for five days. What would be important for the nurse to educate this patient about? a) Contraceptives b) Antihistamines c) Decongestants d) Analgesics
a) Contraceptives
A patient is admitted to the emergency room with a diagnosis of Legionnaire's disease and is placed on isolation. Which of the following medications is the drug of choice for Legionnaire's disease? a) Erythromycin (Ery-Tab) b) Meclizine (Antivert) c) Pravastatin (Pravachol) d) Loxapine hydrochloride (Loxitane)
a) Erythromycin (Ery-Tab)
A patient is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which of the following medications will be administered? a) Erythromycin (Ery-Tab) b) Atazanavir (Reyataz) c) Acamprosate calcium (Campral) d) Flumazenil (Mazicon)
a) Erythromycin (Ery-Tab)
A patient with acne vulgaris was administered macrolides, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case? a) Inspect stools for blood or mucus. b) Measure urine output. c) Obtain allergy history. d) Record symptoms of infection.
a) Inspect stools for blood or mucus.
The nurse is giving dietary instructions to a client who is taking linezolid and cautions the client to avoid eating which foods while taking this medication? Select all that apply. a) Pepperoni pizza (six slices) b) Cottage cheese (4 oz) c) Red wine (8 oz) d) Lemon lime carbonated beverage (6 oz) e) Decaffeinated coffee (2 cups)
a) Pepperoni pizza (six slices) c) Red wine (8 oz)
What patient needs more teaching from the nurse? a) The patient who takes erythromycin with grapefruit juice in the morning b) The patient who takes erythromycin with water and crackers c) The patient who takes erythromycin at night d) The patient who takes erythromycin every morning with breakfast
a) The patient who takes erythromycin with grapefruit juice in the morning
The physician considers prescribing an oral tetracycline for a patient suspected of having a urinary tract infection. What action needs to be completed before the medication can be prescribed? a) The physician should order culture and susceptibility studies. b) The patient should be assessed for penicillin allergy to rule out cross-allergenicity. c) The patient should be warned of the risk for photosensitivity. d) The patient should be taught how to store the medication appropriately.
a) The physician should order culture and susceptibility studies.
Your client is scheduled to undergo major abdominal surgery. A preoperative order for neomycin has been given. Neomycin is used preoperatively for the following reason: a) To suppress intestinal bacteria. b) To enhance intestinal bacteria. c) To sterilize intestinal bacteria. d) To produce ammonia.
a) To suppress intestinal bacteria.
The nurse receives a call from a client who is taking clindamycin (Cleocin) and reports of a burning feeling when swallowing. The nurse knows that the client has developed which adverse reaction related to this medication? a) esophagitis b) nausea c) gastritis d) peptic ulcer
a) esophagitis
A teenager asks the nurse how tetracycline (Sumycin) will improve her acne. Which of the following is the best statement the nurse can provide to the patient regarding the action of tetracycline? a) "Tetracycline treats the Chlamydia organism that causes acne." b) "Tetracycline interferes with the production of free fatty acids." c) "Tetracycline decreases redness and swelling of the pustules." d) "Tetracycline is used in combination with doxycycline to treat acne."
b) "Tetracycline interferes with the production of free fatty acids."
A patient is diagnosed with the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism? a) Antifungal b) Aminoglycosides c) GABA analog d) Aminopenicillin
b) Aminoglycosides
A patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline? a) Increased risk for digitalis toxicity b) Increased risk of bleeding c) Increased serum theophylline level d) Decreased effectiveness of tetracycline
b) Increased risk of bleeding
A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? a) It can be given without consideration to drug-drug- interactions. b) It is taken only once a day. c) The half-life of the drug is 3 to 7 hours. d) It has very few adverse effects.
b) It is taken only once a day.
Macrolides must be used with caution in clients who have which of the following conditions? a) Hypertension b) Liver dysfunction c) Glaucoma d) Diabetes mellitus
b) Liver dysfunction
Tetracyclines may decrease the requirement for which drugs? (Select all that apply) a) Vancomycin (Vancocin) b) Warfarin (Coumadin) c) Atorvastatin (Lipitor) d) Lantus (Glargine) e) Losartan (Cozaar)
b) Warfarin (Coumadin) d) Lantus (Glargine)
A patient received erythromycin before dental surgery. The patient has a past history of a cardiac surgery. The rest of the patient's history is unremarkable. What does the nurse teach the patient about this medication? a) "You cannot receive other antibiotics because of your history." b) "This medication will help them remove your tooth easier." c) "You are receiving this medication to prevent the growth of bacteria in your heart." d) "You need this medication to decrease the pain of surgery."
c) "You are receiving this medication to prevent the growth of bacteria in your heart."
Your client has been diagnosed with intermittent colitis. You know that the following antibiotic is contraindicated for use in this client: a) Doxycycline. b) Tetracycline. c) Clindamycin. d) Bactrim.
c) Clindamycin.
After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class? a) Tobramycin b) Kanamycin c) Gentamicin d) Neomycin
c) Gentamicin
Which statement is true concerning macrolides? a) Macrolides cannot kill gram-positive bacteria. b) Macrolides are not absorbed well in body tissues. c) Macrolides are bacteriocidal or bacteriostatic. d) Macrolides are not absorbed in body fluids
c) Macrolides are bacteriocidal or bacteriostatic.
Your patient is receiving a multiple-dose regimen of an aminoglycoside. On what serum drug levels will you base the patient's maintenance dose? a) Mean and trough levels b) Peak levels only c) Peak and trough levels d) Mean levels only
c) Peak and trough levels
A patient is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for Lyme disease? a) Nitrofurantoin (Macrodantin) b) Ibuprofen (Motrin) c) Tetracycline (Sumycin) d) Phenazopyridine (Pyridium)
c) Tetracycline (Sumycin)
The nurse is administering telithromycin (Ketek) to a child with Streptococcus pneumoniae infection. What nursing intervention is implemented when administering this medication? a) Administer the medication with grapefruit juice b) Increase the dose in the event of QT elongation c) Administer the medication with lovastatin d) Administer the medication with or without food
d) Administer the medication with or without food
Aminoglycosides are used primarily in the treatment on what type of infection? (Choose one) a) Fungal infections b) Viral infections c) Gram-positive infections d) Gram-negative infections
d) Gram-negative infections
patient is given tetracycline (Sumycin) to treat acne-related skin eruptions. How does tetracycline work? a) It reduces central nervous system stimulation. b) It works on the final stage of cell wall synthesis. c) It is a beta-lactam antibiotic inhibiting cell wall synthesis. d) It binds to the 30S ribosome to inhibit protein synthesis.
d) It binds to the 30S ribosome to inhibit protein synthesis.
The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize? a) Gastrointestinal function b) Muscle strength c) Nutritional status d) Renal function
d) Renal function
In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences: a) increased appetite. b) leg pain. c) pale urine. d) yellowing of the eyes or skin.
d) yellowing of the eyes or skin.
A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic. a) False b) True
true
