evolve INFECTION

A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take? Reduce the infusion rate. Administer diphenhydramine [Benadryl]. Change the IV tubing. Check the patency of the IV.

A

Question 10 of 10 The nurse identifies which drug as a short-acting tetracycline? Tetracycline (generic) Declomycin Vibramycin Minocin

A

Question 10 of 10 Which outcome would a nurse establish for a patient with trichomoniasis who is receiving metronidazole [Flagyl]? Decrease in yellow-green, odorous vaginal discharge Absence of painful urination and watery discharge Improvement in pain in the back of the testicles Resolution of genital and perianal warts

A

Question 4 of 10 A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid [Zyvox]. Which laboratory result indicates that the patient is having an adverse effect? White blood cell (WBC) count of 1200 units/L Hemoglobin (Hgb) level of 18 g/dL Potassium level of 3.0 mEq/dL Glucose level of 200 mg/dL

A

Question 4 of 10 A patient who has syphilis is to start treatment. It is most important for the nurse to ask the patient about allergies to which antibiotic? Penicillin G Tetracycline Azithromycin [Zithromax] Cefoxitin [Mefoxin]

A

Question 4 of 10 Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what? Myasthenia gravis Asthma Hypertension Diabetes mellitus

A

Question 5 of 11 Which approach should a nurse take to administer intravenous (IV) acyclovir [Zovirax] to an immunocompromised patient? Infuse IV fluids during administration of the dose and for 2 hours afterward. Administer IV acyclovir diluted in 20 mL normal saline (NS) over 10 minutes. Only infuse the drug if the white blood cell (WBC) count is above 2500/mm3. Ask the provider to change the route to subcutaneous (subQ) injection.

A

Question 6 of 10 The nurse notes that a patient's medication list includes ceftriaxone. The patient reports a history of sexually transmitted infection but cannot recall the name of the infection. The nurse is aware that ceftriaxone is the preferred medication for treating which sexually transmitted infection? Gonorrhea Trichomonas Chlamydia trachomatis Bacterial vaginosis

A

Question 7 of 10 A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? Some hearing loss may have occurred. The confusion is due to the hospital stay. A nutrition consult most likely is needed. The patient has a family history of dementia.

A

Question 8 of 10 A nurse is administering an oral dose of itraconazole [Sporanox] to a patient at 10:00 AM. The nurse should administer a prescribed dose of famotidine [Pepcid] at which time? 9:00 AM 10:00 AM 10:30 AM 11:00 AM

A

Question 9 of 11 A nurse is preparing to administer ganciclovir [Cytovene] to a patient for treatment of Cytomegalovirus (CMV) pneumonitis. Which laboratory result should the nurse recognize as a contraindication to use of this drug? Neutrophil count below 500/mm3 Platelet count of 350,000/mm3 Serum calcium level of 9.5 mg/dL Reduced forced vital capacity (FVC)

A

When ceftriaxone is administered intravenously, it is most important for the nurse to avoid mixing it with what? Ringer's lactate Normal saline Sterile water D5 0.45% NS

A

Question 1 of 10 A nurse instills 1% silver nitrate topically into the eyes of a neonate on delivery to prevent conjunctivitis caused by what? Select all that apply. Chlamydia spp. Gonorrhea Syphilis Bacterial vaginosis Herpes simplex type 2

A,B

Question 7 of 10 The nurse is aware that which treatments are used in nonpregnant women to treat bacterial vaginosis? Select all that apply. Oral metronidazole Vaginal metronidazole Penicillin G Tetracycline Azithromycin [Zithromax]

A,B

Question 6 of 10 The nurse should include which instructions when teaching a patient about tigecycline therapy? Select all that apply. "Use sunscreen when you are outside." "If you have diarrhea more than five times a day, notify your healthcare provider." "Avoid using this drug if you are pregnant." "Stop taking the drug if you experience nausea." "Stop taking the drug if you experience vomiting."

A,B,C

Which statements about vancomycin [Vancocin] does the nurse identify as true? Select all that apply. Vancomycin is the most widely used antibiotic in U.S. hospitals. Vancomycin is effective in the treatment of Clostridium difficile infection. Vancomycin is effective in the treatment of MRSA infections. Patients who are allergic to penicillin are also allergic to vancomycin. The major toxicity of vancomycin therapy is liver failure.

A,B,C

Question 10 of 11 A nurse administering flu vaccines at an annual clinic should recognize that which individuals should be vaccinated, as recommended by the Advisory Committee on Immunization Practices (ACIP)? Select all that apply. Women who will be pregnant during flu season All children 6 months and older and older adults Those who report severe allergy to chicken eggs Those who have a history of Guillain-Barré syndrome Those 6 months to 18 years old receiving aspirin therapy

A,B,E

Question 7 of 10 The nurse identifies terbinafine [Lamisil] as useful for treating which conditions? Select all that apply. Onychomycosis Tinea corporis Oropharyngeal candidiasis Vulvovaginal candidiasis Tinea pedis

A,B,EA

Which instructions will the nurse include when teaching a patient about cephalosporin therapy? Select all that apply. "Notify your healthcare provider if you develop diarrhea." "Take aspirin if you develop a headache." "Notify your healthcare provider if you develop a rash." "Cephalosporins may not be taken with food." "Do not take cephalosporins if you have lactose intolerance."

A,C

Question 11 of 11 When teaching a patient about therapy with famciclovir, which statement(s) does the nurse include? Select all that apply. Famciclovir is generally well tolerated. Famciclovir is safe to use during pregnancy. Famciclovir is administered intravenously. Famiciclovir is used in the treatment of acute herpes zoster. Famiciclovir is contraindicated in the treatment of herpes simplex genitalis.

A,D,E

Question 1 of 10 The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? Concentration Trough Peak Dose

B

Question 2 of 10 What does the nurse identify as an adverse effect of clindamycin [Cleocin] therapy? Cyanosis and gray discoloration of the skin Frequent loose, watery stools with mucus and blood Reduction in all blood cells produced in the bone marrow Elevated bilirubin, with dark urine and jaundice

B

Question 3 of 10 A nurse is administering a daily dose of tobramycin at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level? 0800 0900 1130 1200

B

Question 3 of 10 A nurse knows that which condition is a potential long-term complication in a patient with pelvic inflammatory disease (PID)? Bacterial endocarditis Infertility Cervical cancer Renal tubular necrosis

B

Question 5 of 10 When administering an aminoglycoside to a patient with myasthenia gravis, it is most important for the nurse to assess what? Deep tendon reflexes Breath sounds Eyelid movement Muscle strength

B

Question 7 of 10 Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline? "You may stop taking the pills when you begin to feel better." "Use sunscreen and protective clothing when outdoors." "You'll have to come back to the clinic for weekly blood work." "Take the medication with yogurt or milk so you won't have nausea."

B

Question 7 of 11 A nurse develops a plan of care for a patient who has an outbreak of recurrent genital herpes and is taking oral acyclovir [Zovirax]. Which outcome should be included? Minimal scarring from lesions Less frequent eruption of lesions Prevention of transmission to contacts Complete eradication of the virus

B

Question 9 of 10 A nurse planning care for a patient who is receiving nystatin [Mycostatin] should establish which outcome on the care plan? Relief of nasal congestion Decrease in mouth pain Productive cough Absence of urticaria

B

Question 9 of 10 Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin [Ery-Tab] therapy? Heart rate of 52 beats per minute Prolonged QT interval Jugular vein distention Grade III diastolic murmur

B

Question 9 of 10 Which finding does the nurse expect when assessing a male patient with secondary syphilis? Heart valve and aortic damage Skin lesions and flulike symptoms Red, protruding, painless sore on the penis Thin, watery urethral discharge

B

Question 1 of 10 Which statements about CDAD associated with clindamycin therapy does the nurse identify as true? Select all that apply. Leukopenia commonly occurs. It is a potentially fatal condition. Patients usually experience abdominal pain. Anticholinergics are effective in treating the diarrhea. Clindamycin therapy should be discontinued and vancomycin started.

B,C,E

A patient is receiving vancomycin [Vancocin]. The nurse identifies what as the most common toxic effect of vancomycin therapy? Ototoxicity Hepatotoxicity Renal toxicity Cardiac toxicity

C

A patient who is receiving ceftriaxone has all of these medications ordered. The nurse monitors the patient for an adverse effect related to an interaction with which medication? Regular insulin Ampicillin [Polycillin] Naproxen [Naprosyn] Bisacodyl [Dulcolax]

C

Before administering a cephalosporin to a patient, it is most important for the nurse to assess the patient for an allergy history to what? Soy products Peanuts Penicillins Opioids

C

Question 1 of 11 What is the priority instruction a nurse gives to a male patient who is scheduled to receive ribavirin [Rebetol] combined with peg-interferon-alfa-2a for treatment of hepatitis C? "Combining these two medications will greatly increase response rates." "An antidepressant can be prescribed to alleviate symptoms of depression." "If you are sexually active, use two reliable forms of birth control to prevent pregnancy." "It is very important that you have blood counts checked every 2 weeks."

C

Question 2 of 10 It is most important for the nurse to assess a patient taking itraconazole [Sporanox] for the development of what? Hair loss Skin rash Pedal edema Joint pain

C

Question 2 of 10 Which is the most common bacterial sexually transmitted disease (STD) in the United States, for which the Centers for Disease Control and Prevention (CDC) has recommended annual screening in certain populations? Gonorrhea Trichomonas infection Chlamydia trachomatis infection Bacterial vaginosis

C

Question 3 of 10 A patient is scheduled to receive intravenous amphotericin B. Which medication should a nurse administer as pretreatment before the infusion? 10 units of regular insulin intravenously 20 mg famotidine [Pepcid] in 50 mL of 5% dextrose 50 mg of diphenhydramine [Benadryl] and 650 mg of acetaminophen 1 g of calcium gluconate in 100 mL of normal saline

C

Question 4 of 10 When providing teaching for a patient starting flucytosine [Ancobon] therapy, the nurse identifies what as the priority concern? "You will have weekly blood draws to monitor your liver function." "Another very strong medication may be needed in addition to this one." "You'll need to report any symptoms of bruising, fever, and fatigue." "The dose is 10 pills, so take a few at a time over a 15-minute interval."

C

Question 4 of 11 A nurse should recognize that for maximum therapeutic effects against the influenza virus, oseltamivir [Tamiflu] should be taken when? Two days or more after symptom onset When lung crackles are present Within 12 hours of symptom onset Only when fever is above 102°F

C

Question 6 of 11 The nurse identifies which medication as the drug of choice for most infections caused by herpes simplex viruses and varicella-zoster virus? Ganiciclovir Amantadine Acyclovir Oseltamivir

C

Question 8 of 10 The nurse identifies tigecycline [Tygacil] as a derivative of what? Penicillins Cephalosporins Tetracyclines Macrolides

C

Question 8 of 11 A nurse is providing teaching to a group of patients regarding flu season in the United States. Which statement should the nurse include in the teaching? In the United States, flu season usually peaks in October or November. To ensure full protection, the best time to vaccinate is September. For people who missed the best time, vaccinating as late as April may be of help. The influenza vaccine may not be administered at the same time as the pneumococcal vaccine.

C

Question 9 of 10 A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? Unsteadiness Vertigo Headache Dizziness

C

Question 3 of 11 A patient has been diagnosed with respiratory syncytial virus. The nurse anticipates administration of which drug(s)? Select all that apply. Ganciclovir Oseltamivir Ribavirin (inhaled) Palivizumab Entecavir

C,D

Question 2 of 10 Which statements about ototoxicity and aminoglycosides does the nurse identify as true? Select all that apply. The risk of ototoxicity is related primarily to excessive peak levels. The first sign of impending cochlear damage is headache. The first sign of impending vestibular damage is headache. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

C,D,E

Question 5 of 10 The nurse is aware that which medications are used to treat genital herpes? Select all that apply. Oral metronidazole Vaginal metronidazole Acyclovir Valacyclovir Famciclovir

C,D,E

A patient who is receiving vancomycin [Vancocin] IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make? "The prescription could be changed, because vancomycin comes in two forms." "You're allergic to penicillin, and this is the only way this medication can be given." "It will cause too much loss of appetite and nausea if given in the oral form." "It is more effective by IV, because the pill form will stay in the digestive tract."

D

It is most important for the nurse to assess a patient receiving a cephalosporin for the development of which manifestation of antibiotic-associated pseudomembranous colitis (AAPMC)? Rigidity Ileus Ascites Diarrhea

D

Question 1 of 10 A nurse is teaching a patient who is scheduled to start taking itraconazole [Sporanox]. Which statement by the patient would indicate understanding of the teaching? "I'll take diphenhydramine [Benadryl] before this medication so I don't have a reaction." "It's important to remember to wear sunscreen while taking this medicine." "I'll avoid citrus foods, such as oranges and grapefruits, while taking this medication." "If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider."

D

Question 10 of 10 A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? Magnesium sulfate [Epsom salt] Potassium chloride [K-Dur] Sodium bicarbonate [Citrocarbonate] Calcium gluconate [Kalcinate]

D

Question 10 of 10 Which antifungal agent is used as a one-time oral dose to treat vaginal yeast infections? Nystatin [Mycostatin] Caspofungin [Cancidas] Voriconazole [Vfend] Fluconazole [Diflucan]

D

Question 2 of 11 A patient is receiving weekly subcutaneous injections of peg-interferon-alfa-2a [Pegasys] for chronic hepatitis C. A nurse teaches the patient that which adverse effect will diminish with continued therapy? Black, sticky, tarry stools Lower leg muscle weakness Dyspnea and wheezing Flulike symptoms

D

Question 3 of 10 A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child? Delay in long bone growth Early onset of puberty Severe face and body acne Discoloration of the teeth

D

Question 5 of 10 A patient is receiving amphotericin B. It is most important for the nurse to monitor which laboratory result? Serum pH Protein level Glucose level Creatinine level

D

Question 5 of 10 Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin [Biaxin] and warfarin [Coumadin]? Activated partial thromboplastin time (aPTT) Platelet count Erythrocyte sedimentation rate (ESR) International normalized ratio (INR)

D

Question 6 of 10 A patient is receiving amphotericin B. The nurse identifies which medication as useful in preventing adverse effects of amphotericin B? Furosemide [Lasix] Insulin Vitamin K Potassium

D

Question 6 of 10 Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery? Gentamicin Tobramycin Amikacin Neomycin

D

Question 8 of 10 A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin? White blood cells (WBCs) Glucose Ketones Protein

D

Question 8 of 10 When teaching a patient who has genital herpes about treatment with valacyclovir [Valtrex], the nurse includes which statement? "A condom needs to be worn only when symptoms of the virus are present." "Although it is costly, continuous daily medication administration will eliminate the virus." "Once the painful blisters heal, the infection has been cured and will not return." "The intensity of infection episodes is reduced when the medication is taken daily."

D