Unit II Study Guide
A client is taking oral amoxicillin to treat otitis media for the past 6 days. The client has told the nurse that "my ear is now back to normal" and asks about stopping the antibiotics. How should the nurse respond? A) "That's excellent that you're feeling better, but it's important to keep taking the antibiotics until they're all finished." B) "Try reducing your dose by half. If your ear infection gets worse, resume the dose you've been taking until now." C) "You should stop taking the antibiotics because if you don't, it could cause antibiotic resistance." D) "You can likely stop taking the antibiotics, but keep them on hand in case your infection returns."
A) "That's excellent that you're feeling better, but it's important to keep taking the antibiotics until they're all finished."
What health education should the nurse provide to a client prior to the instillation of atropine eyedrops? A) "These drops might sting a little bit, and they will make you temporarily sensitive to light." B) "These eyedrops will make it more difficult to close your eyes, but this will pass in a few hours." C) "These drops will make your pupil temporarily constrict so that your eye can be examined more closely." D) "These drops will make your eyes very bloodshot and sensitive, but this is only temporary."
A) "These drops might sting a little bit, and they will make you temporarily sensitive to light."
The nurse prepares to administer tetracycline 500 mg PO every 6 hours to an adult client newly diagnosed with Lyme's disease. The client takes an oral contraceptive for birth control. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. A) Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). B) Administer the medication with milk or food to decrease gastrointestinal side effects. C) Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D) Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E) Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber
A) Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG). C) Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D) Educate importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E) Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber
The nurse prepares to administer amoxicillin to an adult client newly diagnosed with acute otitis media of right ear. Which measures would the nurse provide for safe and effective drug administration? Select all that apply. A) Check for possible drug interactions and report to prescriber. B) Provide divided doses around the clock 2 hours after meals. C) Report sudden onset of rash, wheezing, or shortness of breath. D) Inspect right ear with otoscope before inspecting left ear using the same speculum. E) Assess for improvement of otalgia, otorrhea, and improvement of hearing.
A) Check for possible drug interactions and report to prescriber. C) Report sudden onset of rash, wheezing, or shortness of breath. E) Assess for improvement of otalgia, otorrhea, and improvement of hearing
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? A) Discontinue the infusion and inform the care provider promptly. B) Slow down the rate so that the infusion takes place over 2 hours. C) Administer oral diphenhydramine to the client during the infusion. D) Administer an STAT dose of acetylcysteine.
A) Discontinue the infusion and inform the care provider promptly.
A client is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside? A) It blocks protein synthesis of the cell wall. B) It blocks the process of DNA replication. C) It destroys the integrity of the cell wall structure. D) It increases white blood cell viability
A) It blocks protein synthesis of the cell wall
How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media? A) It extends the spectrum of antibacterial activity of penicillin. B) It extends the spectrum of the beta-lactamase inhibitor. C) It decreases the side effects of high-dose penicillin. D) It increases the absorption of the penicillin.
A) It extends the spectrum of antibacterial activity of penicillin.
A client, being treated in the intensive care unit, has been diagnosed with ventilatorassociated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assess is most appropriate to rule out contraindications for this medication therapy? A) Review lab results to confirm normal liver function. B) Question the client about any history of gastrointestinal upset. C) Review the medical for a history of nephrotoxic signs or symptoms. D) Confirm the ability to safely swallow oral medication.
A) Review lab results to confirm normal liver function.
Why is concomitant use of erythromycin and corticosteroids contraindicated? A) The client may be unable to adequately metabolize the corticosteroid. B) The effect of the corticosteroid may be greatly increased. C) The client may have an increased risk of thromboembolism. D) The corticosteroid may negate the efficacy of the erythromycin.
A) The client may be unable to adequately metabolize the corticosteroid.
A client with a diagnosis of breast cancer is administered a corticosteroid in addition to chemotherapy agents. What effect will the corticosteroids have on this client's course of recovery? A) The corticosteroid will decrease signs and symptoms of cancer. B) The corticosteroid will alter the action of the chemotherapy agent. C) The corticosteroid will decrease metastasis to distant sites. D) The corticosteroid will decrease hepatic effects of the chemotherapy.
A) The corticosteroid will decrease signs and symptoms of cancer
Which is the antidote for acetaminophen poisoning? A) acetylcysteine B) allopurinol C) diclofenac sodium D) ketorolac
A) acetylcysteine
Which medication can be applied to the lesion related to a bacterial skin infection? A) bacitracin B) benzoyl peroxide C) butenafine D) clotrimazole
A) bacitracin
A nurse preparing to administer a client's first scheduled dose of tetracycline should first ensure that the client has not recently eaten what type of foods? A) dairy products B) leafy green vegetables C) any high-fat foods D) acidic foods
A) dairy products
What is the expected result of timolol maleate therapy? A) decreased intraocular pressure (IOP) B) constriction of pupils C) promotion of lacrimation D) improved visual acuity
A) decreased intraocular pressure (IOP)
The presence of what eye disorder would cause the nurse to question the prescription of dexamethasone eyedrops? A) fungal infection B) nearsightedness C) cataracts D) bacterial conjunctivitis
A) fungal infection
What potential adverse reaction is most likely to develop during cefazolin therapy? A) gastrointestinal upset B) dry skin and pruritus C) drowsiness D) orthostatic hypotension
A) gastrointestinal upset
A client being treated for tuberculosis (TB) is determined to be drug resistant. Which medications no longer be effective in the treatment of the tuberculosis? A) isoniazid (INH) and rifampin (RIF) B) carbamazepine and phenytoin C) dextroamphetamine and doxapram D) propranolol and sotalol
A) isoniazid (INH) and rifampin (RIF)
An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom? A) jaundice B) weight gain C) iron deficiency anemia D) hematuria
A) jaundice
The nurse, providing education to a client prescribed erythromycin, recognizes a need for additional instruction when the client makes which suggestion? Select all that apply. A) taking the medication with or without food B) avoiding grapefruit juice while taking the medication C) recognizing dark urine is a normal side effect D) stomach cramping is considered an adverse effect E) swallowing the medication with milk
A) taking the medication with or without food C) recognizing dark urine is a normal side effect D) stomach cramping is considered an adverse effect
When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions? A) the need to take the medication on an empty stomach B) the fact that a mild rash frequently follows the first few doses C) the need to increase fluid intake for the duration of treatment D) the fact that the drug should be discontinued once symptoms subside
A) the need to take the medication on an empty stomach
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamide that will most likely be prescribed? A) trimethoprim-sulfamethoxazole B) tetracycline C) doxycycline D) demeclocycline
A) trimethoprim-sulfamethoxazole
What information should the nurse include when discussing sun protection with parents of young children? A) "Try to keep the children indoors as much as possible." B) "Apply SPF 30 sunscreen before going out in the sun." C) "Be sure that each child wears a hat at the beach." D) "Get sunscreen that blocks UVA rays especially."
B) "Apply SPF 30 sunscreen before going out in the sun."
A client diagnosed with tuberculosis (TB) and begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question? A) "Multiple drugs are used because doctors aren't sure which drug will kill a particular TB strain." B) "The use of multiple drugs prevents the development of drug-resistant TB." C) "Multiple drugs are prescribed because the final testing results for TB can take up to 3 months." D) "Multiple drugs are used in order to speed up the course of treatment."
B) "The use of multiple drugs prevents the development of drug-resistant TB."
A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in his or her great toes. Which laboratory values should be assessed? A) hematocrit and hemoglobin B) ALT and AST C) urine culture and sensitivity D) complete blood count (CBC) with differential
B) ALT and AST
The nurse is preparing to administer gentamicin when the client mentions having experienced diminished hearing. What action should the nurse take based on this statement? A) Administer the dosage and notify the health care provider of the alteration in hearing. B) Hold the dosage and notify the health care provider of the alteration in hearing. C) Administer the dosage and report the alteration in hearing to the audiologist. D) Hold the dosage and document the finding in the nurses' notes.
B) Hold the dosage and notify the health care provider of the alteration in hearing.
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease nephrotoxicity and ototoxicity? Select all that apply. A) Draw the trough level 30 to 60 minutes after drug is administered, and report level above 10 to 12 mcg/mL. B) Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. C) Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. D) Obtain peak level before administering next dose of drug, and report level above 2 mcg/mL. E) Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated
B) Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. C) Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. E) Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated.
A 4-year-old was diagnosed with acute otitis media and began a course of oral amoxicillin. The parent has contacted the clinic and states that there has been no significant improvement in the child's ear infection since beginning oral amoxicillin 3 days ago. The nurse should consider which explanation for this phenomenon? A) The medication has been administered consistently. B) The ear infection has a viral etiology. C) The infection is caused by an antibiotic-resistant microorganism. D) The medication would be more effective if prescribed parenterally
B) The ear infection has a viral etiology.
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? A) The fluoroquinolone does not have adverse effects. B) The fluoroquinolone can be given orally. C) The fluoroquinolone has a nearly immediate peak. D) The fluoroquinolone has a broader spectrum.
B) The fluoroquinolone can be given orally.
Which client has the highest risk of developing ototoxicity secondary to gentamicin? A) a man who received his first dose of IV gentamicin 12 hours ago B) a man who has required repeated courses of gentamicin over the past several months C) a woman who has a Pseudomonas infection but who has a hypersensitivity to penicillins D) a woman who is immunocompromised and who is being treated with gentamicin
B) a man who has required repeated courses of gentamicin over the past several months
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? A) acetaminophen B) acetylsalicylic acid C) ibuprofen D) ascorbic acid
B) acetylsalicylic acid
What over-the-counter (OTC) medication is most likely to be safe and effective in the treatment of pain and fever associated with otitis media? A) concurrent use of aspirin and ibuprofen for 3 days B) alternating doses of acetaminophen and ibuprofen C) monotherapy with aspirin until symptoms improve D) use of an OTC antihistamine and acetaminophen
B) alternating doses of acetaminophen and ibuprofen
A client is prescribed ibuprofen for knee pain. When the client is admitted to the hospital with abdominal pain, which assessment should the nurse prioritize? A) assessment for diarrhea B) assessment for occult blood C) assessment for hematuria D) assessment for hemoptysis
B) assessment for occult blood
Which is the drug of choice for surgical prophylaxis associated with a vaginal hysterectomy? A) cefadroxil B) cefazolin sodium C) cephalexin D) cephradine
B) cefazolin sodium
A child who has not received the chickenpox vaccine has developed the chickenpox virus. The child has itching related to the chickenpox pustules. What herbal preparations should the nurse suggest when asked about interventions to decrease itching triggered by chickenpox pustules? A) coal tar B) colloidal oatmeal C) clindamycin D) bacitracin
B) colloidal oatmeal
A client is to be started on an antibiotic. Which factor is most important to take into consideration before beginning the antibiotic regimen? A) duration of symptoms B) culture and sensitivity C) the client's hydration status D) the client's age and weight
B) culture and sensitivity
The client with elevated intraocular pressure (IOP) is at risk for what ocular condition? A) cataracts B) glaucoma C) myopia D) conjunctivitis
B) glaucoma
A client is administered a third-generation cephalosporin. The broad-spectrum agents like cephalosporins are most effective in treating which type of microorganism? A) gram positive B) gram negative C) fungi D) virus
B) gram negative
A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common in acute or chronic overdose of acetaminophen? A) nephrotoxicity B) hepatotoxicity C) pulmonary insufficiency D) pancreatitis
B) hepatotoxicity
Which medication will be administered for the treatment of salicylate overdose? A) intravenous meperidine B) intravenous sodium bicarbonate C) intravenous furosemide D) inhaled acetylcysteine
B) intravenous sodium bicarbonate
A client is allergic to acetylsalicylic acid. Which medication is contraindicated due to crosshypersensitivity reactions? A) acetaminophen B) naproxen sodium C) morphine sulfate D) naloxone
B) naproxen sodium
A client, diagnosed with tuberculosis, will soon begin first-line drug treatment. How will rifampin most likely be administered to this client? A) orally, with food B) orally, on an empty stomach C) intramuscularly D) intravenously, as bolus
B) orally, on an empty stomach
Necrotizing otitis externa has the potential to progress to which condition? A) meningitis B) osteomyelitis C) necrotizing fasciitis D) epiglottitis
B) osteomyelitis
7. A client is prescribed acetylsalicylic acid for fever and headache. What is the action of acetylsalicylic acid? A) inhibiting prostaglandin synthesis in the central and peripheral nervous system B) providing selective action by inhibiting prostaglandin synthesis in the CNS C) inhibiting the release of norepinephrine to increase blood pressure D) suppressing the function of the hypothalamus to decrease inflammation
B) providing selective action by inhibiting prostaglandin synthesis in the CNS
A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject? A) the fact that nonadherence to treatment exacerbates the risks of adverse effects B) the need to consistently take the prescribed drugs in order to cure TB C) the need to match drug dosages carefully to signs and symptoms D) the fact that nonadherence will necessitate the use of antiretrovirals
B) the need to consistently take the prescribed drugs in order to cure TB
Why is important to monitor the results of a serum gentamicin level? A) to identify possible changes in the client's serum osmolality B) to identify whether the drug is at a therapeutic level C) to identify whether the drug is causing hepatotoxicity D) to identify possible hemolysis following administration
B) to identify whether the drug is at a therapeutic level
A client is prescribed imipenem-cilastatin for the treatment of an E. coli infection. The nurse should be aware that cilastatin is combined with the imipenem for what purpose? A) to eliminate adverse effects of imipenem administration B) to inhibit the destruction of imipenem C) to potentiate the therapeutic effects of imipenem D) to allow imipenem to cross the blood-brain barrier
B) to inhibit the destruction of imipenem
A client, who sustained a burn from a gas grill, has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection? A) intrathecal B) topical C) parenteral D) oral
B) topical
A client diagnosed with a tumor of the spinal cord is prescribed a corticosteroid. What statement by the client demonstrates an accurate understanding of this treatment? A) "This drug will cause my tumor to be more susceptible to treatment." B) "This drug will decrease my chance of infection and meningitis." C) "This drug won't cure my cancer, but it may help me feel much better." D) "This drug will stop my cancer cells from growing further."
C) "This drug won't cure my cancer, but it may help me feel much better."
A nurse is instructing a client on the antibiotic regimen for the treatment of pneumonia. Which statement is most important to share with the client? A) Take the medication with orange juice. B) Supplement the medication with multivitamins. C) Complete the entire prescription of medication. D) Administer the medication with dairy products.
C) Complete the entire prescription of medication.
A client has been prescribed a once-daily aminoglycoside. What is the advantage of this method of administration? A) It is associated with less hepatotoxicity. B) It is significantly more cost-effective. C) It reduces the risk of nephrotoxicity. D) It increases adherence to treatment.
C) It reduces the risk of nephrotoxicity.
What is the rationale for not administering tetracycline to children under the age of 8 years? A) It will not treat the infection effectively. B) It will increase the risk of heart failure. C) It will interfere with enamel development. D) It will increase the risk for future infections.
C) It will interfere with enamel development
What microorganism is the most likely cause of necrotizing otitis externa? A) Aspergillus B) Candida albicans C) Pseudomonas aeruginosa D) Escherichia coli
C) Pseudomonas aeruginosa
What ocular condition is generally treated with a prescription for ciprofloxacin eyedrops? A) astigmatism B) cataracts C) conjunctivitis D) increased intraocular pressure (IOP)
C) conjunctivitis
A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon? A) immunocompromised state resulting from sleep deprivation while on vacation B) the potential for foodborne pathogens ingested while on vacation C) frequent swimming and water sports while the child was on vacation D) ear trauma related to pressurization and depressurization while flying
C) frequent swimming and water sports while the child was on vacation
What eye disorder would contraindicate long-term use of ophthalmic corticosteroids? A) conjunctivitis B) hordeolum C) glaucoma D) blepharitis
C) glaucoma
An adult client with an autoimmune disorder regularly takes oral corticosteroids. The nurse knows that corticosteroids can be used in the successful treatment of inflammation but that they also create a risk for: A) bleeding. B) leukocytosis. C) infection. D) electrolyte imbalances.
C) infection
When administering azoles in the home setting, the home health nurse should prioritize educational interventions that address what nursing diagnosis? A) risk for injury related to antifungal therapy B) risk for acute confusion related to antifungal therapy C) risk for infection related to antifungal therapy D) risk for falls related to antifungal therapy
C) risk for infection related to antifungal therapy
A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinical 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence? A) a delayed (type IV) hypersensitivity reaction B) the fact that the client may have chewed the capsules prior to swallowing them C) superinfection following the eradication of normal oral flora D) a type I hypersensitivity reaction
C) superinfection following the eradication of normal oral flora
An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize? A) the need to supplement prednisone with high doses of vitamin D B) the need to avoid drinking grapefruit juice for the duration of treatment C) the importance of gradually reducing rather than abruptly stopping the drug D) the importance of matching each day's dose to the severity of symptoms
C) the importance of gradually reducing rather than abruptly stopping the drug
The nurse is educating a client newly diagnosed with a urinary tract infection about the prescribed phenazopyridine hydrochloride. Which statement made by the client establishes the need for further clarification? A) "The drug is an azo dye that acts directly on urinary tract mucosa to provide pain relief." B) "If I develop a sore throat, bleeding, or bruising, I will report the symptoms to my prescriber." C) "I will need to take the drug with food to decrease stomach upset." D) "I should report reddish-orange urine immediately to the prescriber."
D) "I should report reddish-orange urine immediately to the prescriber."
What administration instructions should the nurse provide to the parents of a 4-year-old child prescribed a neomycin-polymyxin B-hydrocortisone combination drug for otitis media in the right ear? A) "Put one drop into the right ear each morning." B) "Place two drops in the right ear each morning and then again before bedtime." C) "Put one to two drops in the right ear whenever your child reports pain in the right ear." D) "Place three drops into the right ear four times a day."
D) "Place three drops into the right ear four times a day."
A teenager asks the nurse how tetracycline will improve the acne. Which statement should the nurse provide to the client regarding the action of tetracycline? A) "Tetracycline decreases redness and swelling of the pustules." B) "Tetracycline treats the Chlamydia organism that causes acne." C) "Tetracycline is used in combination with doxycycline to treat acne." D) "Tetracycline interferes with the production of free fatty acids."
D) "Tetracycline interferes with the production of free fatty acids."
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction? A) Antacids delays metabolism of the drug. B) Antacids can exacerbate nausea and reflux. C) Antacids cause a dangerous rise in gastric pH. D) Antacids decrease the absorption of the drug
D) Antacids decrease the absorption of the drug.
A client is receiving hydrocortisone 40 mg PO daily for treatment of severe autoimmune inflammation. Which nursing intervention is the most important to implement? A) Increase dietary sodium. B) Limit dietary protein. C) Assess BUN and creatinine regularly. D) Implement infection control measures
D) Implement infection control measures.
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? A) It inhibits protein synthesis. B) It lowers the pH of cellular contents. C) It causes mutations. D) It inhibits cell wall synthesis.
D) It inhibits cell wall synthesis
When acetylsalicylic acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action? A) Inflammation is relieved. B) Core body temperature is reduced. C) Pain is relieved. D) Platelet aggregation is inhibited
D) Platelet aggregation is inhibited.
What aspect of a client's history would contraindicate imipenem-cilastatin drug therapy? A) The client has a history of type 1 diabetes mellitus. B) The client is showing signs and symptoms of fluid volume excess. C) The client's most recent creatinine level was 140 ìmol/L (high). D) The client has a documented allergy to penicillin.
D) The client has a documented allergy to penicillin.
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? A) assessing for the presence of asthma B) assessing for hypertension C) assessing for diabetes mellitus D) assessing for renal insufficiency
D) assessing for renal insufficiency
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? A) lactulose B) ketoconazole C) kanamycin D) cefadroxil
D) cefadroxil
Which drug is a first-generation cephalosporin used as a surgical prophylaxis? A) cefotetan B) cefoxitin C) ceftriaxone D) cefazolin
D) cefazolin
A woman is seen in the clinic for treatment of vaginal itching and discharge. The nurse should be prepared to provide the client with information concerning which single dose medication? A) caspofungin B) terbinafine C) ketoconazole D) fluconazole
D) fluconazole
A resident of a skilled nursing facility develops methicillin-resistant Staphylococcus aureus. What type of infection has this person developed? A) community acquired B) postoperative C) sustained infection D) hospital-acquired infection
D) hospital-acquired infection
A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to contribute to antibiotic resistance? A) increased survival rates from acute infections B) increased population density C) use of antibiotics that are ineffective against the infectious microorganism D) overuse of antibiotics
D) overuse of antibiotics