Chapter 6
A client is being treated for a urinary tract infection with trimethoprimsulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? A. assessing for the prescence of asthma B. assessing for hypertension C. assessing for diabetes mellitus D. assessing for renal insufficiency
D
The nurse is caring for a client who is taking methotrexate for rheumatoid arthritis and will be taking a sulfonamide for a urinary tract infection. What lab results will be most important for the nurse to monitor? A. liver B. kidney C. electrolytes D. complete blood count
D
The nurse is caring for a client with a urinary tract infection caused by E coli and expects the health care provider to order which sulfonamide? A. sulfadiazine B. sulfasalazine C. sulfisoxazole D. trimethoprim (TMP) and sulfamethoxazole (SMZ)
D
The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction? A. fear of an allergic reaction B. fear of inability to swallow C. fear of diarrhea D. fear of incontinence
D
A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component? A. fluids B. proteins C. calories D. vitamin D
A
A client has bene on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide? A. 10 lb weight loss B. loose stools for the last two days C. unable to eat spicy foods D. decreased appetite
A
A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection? A. culture and sensitivity B. white blood cell count C. tissue biospy D. x-ray
A
A client is given sulfasalzaine to treat ulcerative colitis. The client begins to complain of flu-like symptoms including fever, cough, headache, and muscle aches and pains. The nurse notices red wheals on the client's face and neck. The nurse suspects which adverse effect? A. Stevens-Johnson syndrome (SJS) B. toxic epidermal necrolysis (TEN) C. anaphylactic reaction D. aplastic anemia
A
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? A. trimethoprim-sulfamethoxazole B. doxycycline C. penicillin D. tetracycline
A
A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective? A. "I will apply it in a very thin layer over the areas." B. "If I feel some stinging, I should call the health care provider." C. "I need to fan the area while the wound is open." D. "I must avoid cleaning the wound before I apply the drug."
A
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 types of medication? A. bacteriostatic B. bacteriocidal C. bacteriostationary D. bacteriophage
A
Drugs that destroy bacteria are known as which type of drug? A. bacteriocidal B. bacteriostatic C. bacteriostationary D. bacteriophage
A
The nurse is applying silver sulfadiazine (Silvadene) to a client's burn when the client states, "Every time you put that on me in burns." What is the nurse's best response? A. "I'm sorry that it hurts, but many clients report a burning sensation when this medication is applied." B. "I will contact the health care provider and ask that the medication be discontinued." C. "I will ask the health care provider if I can apply mafenide (Sulfamylon) instead." D. "You want it to burn because then you that it is working."
A
The nurse is caring for a client who has developed leukopenia a result of long term sulfonamide therapy. What is the most important nursing intervention in light of this client's condition? A. all individuals in contact with the client must perform frequent hand hygiene B. do not administer any intamuscular medications C. encourage the client to use a soft toothbursh D. handle the client's extremities with care to prevent injuryy
A
The nurse is caring for the following clients is aware that sulfonamides should be used cautiously in which client? A. the client with asthma B. the client with a knee replacement C. the client with an appendectomy D. the client with Bell's palsy
A
The nurse is preparing to adminsiter a sulfonamide to a client when the client states, "I woke up this morning with a lot of sores in my mouth." What is the nurse's next best action? A. "I'm going to contact your health care provider before I administer your medication." B. " I wouldn't worry about it. It should get better in the next day or two." C. "You have most likely developed these sores due to the stress of infection." D. "Take this dose of medication and I'll notify your health care provider."
A
The nursing instructor is teaching about anti-infectives and informs students that viruses have been difficult to treat in the past. He indicates the reason for this to be which of the following? A. viruses have the ability to change because they use DNA and RNA of other cells B. viruses cause superinfections that make treatment more difficult C. viruses have a typical cell structure that is hard to treat D. viruses do not host cells to grow and divide
A
The primary health care provider has prescribed mafenide for a client with second-degree burns. The nurse would be alert for which effect as the most frequent adverse reaction associated with the topical application of mafenide on the affected area? A. burning sensation during application B. skin turning yellow C. Stevens-Johnson syndrome D. orange coloration of urine
A
When describing the action of sulfonamides to a client, the nurse integrates understanding of the drug's action with effects exerted due to which mechanism? A. inhibition of the activity of folic acid in bacterial cell metabolism B. disruption of bacterial cell wall synthesis C. inhibition of DNA-gyrase D. inhibition of bacterial RNA-dependent protein synthesis
A
The nurse understands that some clients should not take sulfonamides. These include which clients? Select all that apply. A. clients with a hypersensitivity sulfonamides B. women who are lactating C. teenagers D. children younger than 2 months E. school-aged children
A, B, D
A client has been admitted for treatment of a burn on the left arm. Which sulfonamides are most likely to be prescribed to treat this condition? Select all that apply. A. Mafenide (Sulfamylon) B. Trimethoprim (TMP) and sulfamethoxazole (SMZ) (Bactrim) C. silver sulfadiazine (Silvadene) D. Sulfasalazine (Azulfidine) E. Sulfisoxazole (Azo Gantrisin)
A, C
When teaching a client about taking a sulfonamide, the nurse should include various types of hypersensitivity reactions that can occur. Which do these include? Select all that apply. A. urticaria B. skin discoloration C. pruritis D. generalizd skin eruptions E. stevens-Johnson syndrome
A, C, D, E
A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client? A. liver toxicity B. renal damage C. bone marrow depression D. congestive heart failure
B
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
A male client with diabetes who controls his disease with an oral agent and diet has been hospitalized with a urinary tract infection. The physician has ordered sulfasalazine 500 mg QID. What should the nurse closely monitor for in this client? A. hyperglycemic reaction B. hypoglycemic reaction C. increased potassium level D. decreased potassium level
B
A professional female cyclist has been prescribed SMZ-TMP for chronic urethritis. She has informed the nurse that she has a cross-country race in 2 days. Which would be an appropriate response by the nurse? A. "I don't see any harm in participating in the race if you feel want to." B. "It would not be a good idea to be outside while taking this medication because of possible photosensitivity occuring." C. "You really don't need to participate in the race. It may aggravate the infection." D. "If you participate in the race you may be at risk further progression of infection to the kidneys."
B
Mr. Laird is a 49-year old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regumen involves the daily application of silver sulfadiazine to his wound. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? A. apply a layer of sulver sulfadiazine that is sufficiently thick to cover exposed nerve endings B. cleanse the wound of debris prior to applying the silver sulfadiazine C. apply a thin layer of the drugs to Mr. Laird's wound bed using clean technique D. perform through wound care immediately using a clean dry gauze
B
The nures is assisting in the admission of a client with a suspected urinary tract infection and anoral temperature of 100.9 degrees farenheit. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine 500 mg PO four times daily; and force fluids to 3L/day. Which order will the nurse complete first? A. provide client with eight ounces of fluid B. obtain urine for culture and sensitivity C. administer acetaminophen for temperature D. administer sulfasalazine
B
The nurse if aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system? A. splenic B. renal C. hepatic D. pancreatic
B
The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction? A. hyperglycemia B. hypoglycemia C. increased burning D. elevated temperature
B
The nurse is teaching the client who has just been placed on sulfasalazine about its potential adverse reactions. One common reaction the nurse should definietly include in teaching is which? A. may cause clay-colored stools and diarrhea B. may cause the skin and urine to tuen orange-yellow C. may cause the eyes to water and become irritated D. may cause facial pigmentation changes that will fade after therapy
B
The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action? A. all intestinal bacteria are destroyed by the medication B. inflammation is decreased because of interaction with intestinal bacteria C. bacteria causing ulcerative colitis are killed off D. it causes intestinal bacteria to replicate and repopulate
B
The nurse knows that the normal recommended time to administer a sulfonamide to a client is at which time? A. at bedtime to decrease stomach upset B. 1 hour before or 2 hours after meals C. anytime with a sip of water D. during meals with a large glass of water
B
The nurse understands that the most frequent adverse reaction seen with the topical application of a sulfonamide is which of the following? A. rash B. burning sensation or pain C. itching D. edema
B
The nursing student learning about anti-infective therapy demonstrates understanding when she defines which as "bacterial resistance"? A. ability to destroy the bacteria B. ability of bacteria to inactivate or destroy the antibiotic C. ability to slow the multiplication of the bacteria D. ability to retard the mulitplication of the bacteria
B
The nursing student studying pharmacology identifies correctly which classes of drugs to be the first to effectively treat infections? A. penicillins B. sulfonamides C. cephalosporins D. macrolides
B
Which statement by a client taking a sulfonamide requires further instruction? A. "I will be sure to drink a full glass of water every time I take my medicine." B. "I will make sure to use extra sunscreen when I go to the tanning booth." C. "I will take all of my medicine even if my symptoms go away." D. " I will take my medicine with my meals like it says on the prescription bottle."
B
The nurse is caring for a client who is on suldonamide therapy and monitors the client for which common side effects? Select all that apply. A. anemia B. nausea C. diarrhea D. low platelets E. photosensitivity
B, C, E
A nurse is caring for a client with crystalluria. When caring for the client, which intervention would the nurse include in the plan of care to prevent more stones from forming? A. ensure care while moving client to avoid bruising B. change the client's diet to a soft diet or a liquid diet C. instruct the client to increase fluid intake to 2000 mL D. instruct client to drink cranberry juice regularly
C
A nurse is monitoring a client on sulfanomide therapy. Which finding would lead the nurse to suspect that the client is developing thrombocytopenia? A. fever B. cough C. unusual bleeding D. sore throat
C
A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug? A. polydipsia B. tachycardia C. skin rash or itching D. dizziness
C
Some clients stop taking their prescribed sulfonamide once symptoms disappear. What should the nurse tell the client when first teaching about this medication to prevent the early discontinuation of the drug? A. since you like to be outdoors, you can stop taking it once symptoms are gone B. discontinuing the medication early can save you money C. failure to complete a course of therapy may result in a recurrence of the infection D. if you stop taking it when symptoms are gone you will have medication for the next time
C
The client has completed a course of sulfonamide therapy and the nurse knows that continued inspection of the skin is required for how long after the end of treatment? A. three days B. one week C. two weeks D. one month
C
The client who has been on long-term sulfonamide therapy begins to demonstrate symptoms associated with side affects of the therapy. The nurse knows that these symptoms are related to which complication associated with sulfonamide therapy? A. hypokalemia B. hypotension C. thrombocytopenia D. hyperglycemia
C
The nurse instructs on sulfonamide therapy to drink a full glass of water when taking the medication and to also drink at least 8 large glasses of water each day until the therapy is finished. The nurse is trying to prevent which complication assoiated with sulfonamide therapy? A. dehydration B. anuria C. crystalluria D. proteinuria
C
The nurse is admitting a client with a urinary tract infection who has been prescribed sulfadiazine. What information obtained in the admission process would cause the nurse to contact the health care provider immediately? A. The client is allergic to cephalosporins. B. The client doesn't like cranberry juice. C. The client is currently taking warfarin (Coumadin). D. The client had a hip replacement less than six months ago.
C
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? A. stomatitis B. gastritis C. ulcerative colitis D. crystalluria
C
The nurse is caring for four clients on a medical floor. For which client would the nurse suspect the health care providier might order a sulfonamide? A. A 65-year old woman admitted with a urinary tract infection and history of chronic renal failure B. A 26-year old man with an ear infection and a history of bronchial asthma C. A 35-year old woman with a urinary tract infection and a history of ulcerative colitis D. A 48-year old man with pneumonia and a history of liver disease
C
Which category of antimicrobial agents is used chiefly because of low cost and effectiveness in treating bacterial infections? A. cephalosporins B. aminoglycosides C. sulfonamides D. macrolides
C
