Pharm unit 4 review questions
A patient asks the nurse if he or she should use a topical antifungal. The nurse is aware that the most important contraindication to topical antifungals is what? A) Hepatic impairment B) Renal impairment C) Congestive heart failure D) Known allergy to any of the antifungal drugs
D
A client is prescribed salmeterol. The nurse would expect this drug to be administered by which route?
Inhalation
A nurse is administering levalbuterol to a client. The nurse would administer this drug by which route?
Inhalation
How do inhaled corticosteroid agents assist in the treatment of asthma?
Inhaled corticosteroid agents will reduce airway inflammation.
A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy? a. A cancer client B. An obese 45-year-old man C. An HIV-positive client D. A new mother who is nursing
c
A nurse would note that a patient had a good understanding of his antimalarial drug regimen if the patient reported, A. "I keep these pills with me at all times while I'm away and take them only when I have been bitten by a mosquito." B. "I will need to start these pills now and then continue to take them every day for the rest of my life." C. "I'll start the pills before my trip, keep taking them during the trip, and for a period of time after I'm home." D. "I start taking these pills as soon as I arrive at my vacation destination, but before I get off the plane."
c
A patient is not getting a response to the antihistamine that was prescribed. Appropriate action might include A. switching to a decongestant. B. stopping the drug and increasing fluids. C. trying a different antihistamine. D. switching to a corticosteroid.
c
A patient receiving a fluoroquinolone should be cautioned to anticipate A. increased salivation. B. constipation. C. photosensitivity. D. cough.
c
A. "I have to wear black socks and must be careful not to change them very often because it could pull more skin off of my feet." B. "I need to apply a thick layer of the antifungal cream between my toes, making sure that all of the lesions are full of cream." C. "I should wear white socks and keep my feet clean and dry. I shouldn't use the antifungal cream in areas where I have open lesions." D. "After I apply the cream to my feet, I should cover my feet in plastic wrap for several hours to make sure the drug is absorbed."
c
After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following? A. "I only need to take one pill every day for this medicine to work." B. "I need to take the medicine with a meal so I don't get an upset stomach." C. "I should drink a full 8-oz glass of water when I take the medicine." D. "I might have some bloody diarrhea after using this medicine."
c
Nasal decongestants would be contraindicated for which client? a client with a history of coronary artery disease a client with a history of diet-controlled diabetes mellitus a client with a pulse rate of 58 beats per minute a client with a history of controlled hypertension
a client with a history of coronary artery disease
Which client would be at risk of developing an infection? Select all that apply. A. a client with an impaired immune system B. a client who performs daily hygiene care C. a client experiencing diarrhea chronically D. an elderly client who has one chronic disease E. a client who takes nutritional supplements -
a client with an impaired immune system a client experiencing diarrhea chronically an elderly client who has one chronic disease
What type of cough is best treated with dextromethorphan? a dry, nonproductive cough a cough that is associated with an allergy to ragweed a cough that occurs when the client is exposed to airborne irritants an occasional, productive cough
a dry, nonproductive cough
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. bacteriophage B. bacteriostationary C. bacteriostatic D. bacteriocidal
c
After a group of students is taught about protozoal infections, which infection, if stated by the group as caused by an insect bite, would indicate the need for additional teaching? A. Malaria B. Trypanosomiasis C. Leishmaniasis D. Giardiasis
d
After assessing a patient the nurse would question an order for amphotericin B to prevent the possibility of serious nephrotoxicity if the patient was also receiving which of the following? A. digoxin B. oral anticoagulants C. phenytoin D. corticosteroids
d
After reviewing information about the drugs used to treat herpes virus and CMV infections, a group of students demonstrate understanding about these drugs when they identify which of the following as being available only for intravenous administration? A. Acyclovir B. Famciclovir C. Ganciclovir D. Foscarnet
d
Giardiasis is the most common intestinal parasite seen in the United States, and it A. does not respond to drug therapy. B. can invade the liver and cause death. C. is seen only in areas with no sanitation. D. is associated with rotten egg-smelling stool, diarrhea, and mucus-filled stool.
d
Herpes viruses cause a broad range of conditions but have not been identified as the causative agent in A. cold sores. B. shingles. C. genital infections. D. leprosy.
d
The nurse is caring for a client receiving amphotericin B. Which condition should the nurse assess for in this client? A. nausea 30 minutes after administered orally B. swelling at the subcutaneous injection site C. bruising at the intramuscular injection site D. phlebitis
d
A pharmacology student is learning about amphotericin B. This drug can be administered via which route? A. IV B. IM C. SQ D. IF
A. IV
The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug will the nurse anticipate receiving an order for to treat this child? A) Amphotericin B (Fungizone) B) Fluconazole (Diflucan) C) Griseofulvin (Fulvicin) D) Ketoconazole (Nizoral)
B
The nurse admits a patient for treatment of cytomegalovirus (CMV). The patient has been ordered foscarnet (Foscavir), 40 mg/kg q8-12h given over 2 hours. By what route would the nurse administer this drug? A) Sub q B) IV C) IM D) PO
B
The nurse is caring for a patient of Greek descent who plans to travel to an area of the world in which malaria is endemic. What should this patient be tested for before administering antimalarial medications? A) Tay-Sachs' disease B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency C) Plasmodium D) Penicillin allergy
B
The nurse is caring for a pregnant woman diagnosed with HIV on prenatal drug screening. What medication would the nurse expect to administer to reduce the risk of maternal to fetal transmission of the virus? A) Lamivudine (Epivir) B) Zidovudine (Retrovir) C) Stavudine (Zerit XR) D) Tenofovir (Viread)
B
A nurse is caring for a 29-year-old man who is being treated for meningitis. He is receiving flucytosine (5-FC). Which will the nurse monitor weekly? A. Blood glucose B. Visual acuity C. Hematologic status D. Blood pressure
c
To help liquefy cold-related secretions, the nurse should encourage the client to implement which measure? reducing salt intake deep breathing and exercises gargling with normal saline increasing fluid intake
increase fluid intake
In which condition present in the client should macrolides be used with caution? A. Glaucoma B. Liver dysfunction C. Diabetes mellitus D. Hypertension -
liver dysfunction
Which nursing action is most important in achieving successful antimicrobial therapy with vancomycin? A. Provide maximum physical comfort to the client. B. Monitor serum drug level. C. Taper down the drug dosage gradually. D. Promote adequate intake of fluids and nutrients. -
monitor serum drug level
A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for? A. Photosensitivity B. Abdominal pain C. Cramping D. Blood dyscrasias -
photosensitivity
A patient who has received a heart transplant is taking cyclosporine. The patient is found to have a systemic Aspergillus infection. What drug would the nurse question if ordered for this patient? A) Terbinafine B) Posaconazole C) Itraconazole D) Ketoconazole
D
A patient with malaria is taking primaquine. What would indicate to the nurse caring for this patient that the patient has cinchonism? A) Diarrhea B) Abdominal cramping C) Tan, frothy stool D) Vertigo
D
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? A. oral (PO) B. intravenous (IV) C. subcutaneous (SQ) D. intramuscular (IM) -
PO
The client with asthma has been ordered an inhaler and the nurse is teaching how to prevent Candida infections. Which would the nurse include in the instructions?
Rinse mouth with water after each use.
A female client presents to the emergency department with acutely deteriorating asthma. Her husband tells the nurse that his wife takes salmeterol. He then tells the nurse that he gave her three extra puffs when she became ill. What statement is correct in this situation?
Salmeterol is contraindicated based on his wife's condition.
The nurse is providing care for a newborn who has received an instillation of surfactin. What assessment data indicates the infant is experiencing adequate oxygen perfusion? Select all that apply.
Skin is pink over entire body Skin warm to the touch
A client has been prescribed a inhaled steroid for the treatment of asthma. What information should the nurse include when providing medication education to the client? Select all that apply.
The medication is not intended to treat an acute asthma attack Abruptly stopping any previously prescribed systemic steroid could cause an adrenal insufficiency Rebound nasal congestion is a adverse effect of this form of medication Promptly report a fever or any other indication of infection to your health provider
In which of the following patients is the use of cidofovir contraindicated? A. Patients with history of epilepsy B. Patients with renal impairment C. Patients with low blood cell counts D. Patients with cardiac disease
b
Locally active antiviral agents can be used to treat A. HIV infection. B. warts. C. RSV. D. CMV systemic infections.
b
The nurse instructs the patient to use care when applying topical antifungal agents to prevent systemic absorption because A. the fungus is only on the surface. B. these drugs are too toxic to be given systemically. C. absorption would prevent drug effectiveness. D. these drugs can cause serious local burning and pain.
b
The nurse is caring for a client who is HIV positive. What laboratory test is used to determine this client's ability to fight against viral infections? A. BUN B. CD4 C. RBCs D. AST
b
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? A. Headache and dizziness B. Diarrhea and nausea C. Lethargy and paresthesias D. Superinfections and phlebitis
b
The nurse is providing care for a diverse group of clients. Which client should the nurse monitor most closely for signs and symptoms of a fungal infection? A. An older adult client with osteoporosis who is taking a bispohosphonate B. A client who is receiving combination therapy for acquired immunodeficiency syndrome (AIDS) C. A client with chronic renal failure who has peritoneal dialysis three times per week D. A client with breast cancer who is post-operative day two following a mastectomy
b
The penicillins A. are bacteriostatic. B. are bactericidal, interfering with bacteria cell walls. C. are effective only if given intravenously. D. do not produce cross-sensitivity within their class.
b
Virus infections have proved difficult to treat because they A. have a protein coat. B. inject themselves into human cells to survive and to reproduce. C. are bits of RNA or DNA. D. easily resist drug therapy.
b
What statement made by the patient indicates to the nurse that the patient does not understand the transmission of HIV? A. "I may transmit the virus to someone if I have unprotected sex." B. "As long as I am taking the HAART therapy, I cannot transmit the virus to anyone else." C. "If I have unprotected sex with someone with HIV, I may be re-infected with another strain." D. "I should not breast feed because I can transmit the virus to the baby this way."
b
What would be most important for the nurse to monitor in a client receiving amphotericin B? A. coagulation studies B. complete blood count C. bowel sounds D. respiratory status
b
When describing the development of malaria caused by the Plasmodium protozoan the instructor would explain that the organism depends on A. a snail to act as intermediary in the life cycle of the protozoan. B. a mosquito and a red blood cell for maturation. C. a human liver cell for cell division and reproduction. D. stagnant water for maturation.
b
Which antifungal agent is available for systemic and topical use? A. Voriconazole B. Ketoconazole C. Clotrimazole D. Butoconazole
b
Which of the following drugs would be classified as an aminoglycoside? a. Cefaclor B. Gentamicin C. Levofloxacin D. Clarithromycin
b
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection? a. Respiratory difficulty B. Nephrotoxicity C. Increased bleeding D. Nausea
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
Which statement regarding antiviral medications is true? A. Antivirals present relatively low risk for toxicity. B. Antivirals do not eliminate existing viruses from tissues. C. Once antivirals are used, protection lasts for 3 weeks after the last dose. D. Most antivirals temporarily increase viral replication.
b
The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age? A. Penicillins B. Cephalosporins C. Aminoglycosides D. Tetracyclines
d
The nurse is caring for a child with respiratory syncytial virus (RSV). Which drug should the nurse expect the pediatrician to order? A. Oseltamivir B. Zanamivir C. Rimantadine D. Ribavirin
d
The nurse is conducting discharge teaching to the caregiver of a 6-month-old child diagnosed with acute otitis media prescribed amoxicillin and alternating acetaminophen and ibuprofen for fever. Which statement by the caregiver establishes a need for additional teaching by the nurse? A. "I should see an improvement in my baby in 24 hours from the time the drugs are started." B. "Sudden development of a rash, shortness of breath, or wheezing should be reported immediately." C. "The entire course of the amoxicillin should be taken as directed on the bottle and completed." D. "If the fever increases after alternating acetaminophen and ibuprofen, baby aspirin may be used."
d
The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration? a. Nausea B. Thrombocytopenia C. Pain during administration D. Phlebitis
d
To prevent viral infections, what precaution should the general public take? A. Wear masks. B. Use intermittent hand hygiene. C. Wear personal protective equipment. D. Become vaccinated against prevalent virus infections.
d
What organ system is responsible for the excretion of cefotaxime sodium from the body? a. gastrointestinal B. hepatic C. respiratory D. renal
d
What potential adverse reaction is most likely to develop during cefazolin therapy? a. dry skin and pruritus B. orthostatic hypotension C. drowsiness D. gastrointestinal upset
d
When administering the fusion protein inhibitor enfuvirtide, the nurse should include which technique to assure the medication's continued effectiveness? A. Have the client gargle with normal saline immediately after taking the drug. B. Flush the client's central venous catheter with 100 Unit/mL heparin prior to administration. C. Inject the drug into the client's ventrogluteal site using the Z-track method. d.Regularly rotate the subcutaneous injection sites that are used.
d
A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse 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 -
dairy products
A client asks the nurse how long to use oxymetazoline (Afrin) nasal spray for nasal congestion. What is the nurse's best response? "Consult with your primary care provider." "Use the medication until your symptoms are completely relieved." "Over-the-counter medications are safe for long-term use." "Afrin can be used as long as nasal burning and stinging do not occur."
"Consult with your primary care provider."
A client, taking metronidazole for the past 4 days, reports to the nurse that the most recent dose caused the client to feel "flushed, sweaty, and sick in the stomach." What assessment is most likely to address the cause of this phenomenon? A. "Do you know if you've ever had an allergic reaction to penicillin?" B. "Did you drink any alcoholic beverages around the time of taking the drug?" C. "Did you take this dose on an empty stomach?" D. "Are you taking any over-the-counter antihistamines?" -
"Did you drink any alcoholic beverages around the time of taking the drug?"
The nurse has finished teaching a 15-year-old client how to use an inhaler to treat asthma. What statement by the client suggests an understanding of the teaching?
"I need to shake the inhaler well before taking the medication."
A nurse is preparing a presentation for a local elementary school parent group about over-the-counter cold medications and their use in children. Which would be most appropriate to include? (Select all that apply.) Using household measuring devices for dosage measurements Avoidance of use in children under age 2 Importance of reading the label for ingredients and dosage Need to follow the directions for how often to give the drug Using adult formulation with smaller doses
-Need to follow the directions for how often to give the drug -Avoidance of use in children under age 2 -Importance of reading the label for ingredients and dosage
A client is receiving ipratropium as maintenance therapy for chronic obstructive pulmonary disease. The nurse would caution the client that up to how many inhalations may be used in 24 hours if needed?
12
After administering an antibiotic, the nurse assesses the patient for what common, potentially serious, adverse effect? A) Rash B) Pain C) Constipation D) Hypopnea
A
Which antifungal would the nurse explain works by inhibiting glucan synthesis A) Flucytosine B) Terbinafine C) Micafungin D) Ketoconazole
C
A client is given theophylline to treat acute asthma symptoms. Which food should the client avoid?
Chocolate
Ms. Thompson, age 45, is being seen in the physician's office today for complaints of a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan? Dextromethorphan works on the receptors in the throat to prevent a cough. Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan works by relaxing the smooth muscles in the bronchioles. Dextromethorphan works by inhibiting allergen response.
Dextromethorphan works in the medulla to suppress the cough reflex. Dextromethorphan is related chemically to the opiate agonists and can suppress coughing as effectively as narcotics. Cough suppression occurs by several mechanisms, but mainly the drug directly affects the cough center in the medulla. Therapeutic doses do not affect ciliary activity
The first step in treating obstructive pulmonary disorders involves medication therapy.
False
While reviewing a client's history, an allergy to which of the following would alert the nurse to a possible problem with the use of ipratropium?
Peanuts
A gerontological nurse has encouraged a group of caregivers who work with older adults to avoid administering first-generation H1 receptor antagonists to their clients. The nurse's cautionary message is an acknowledgment of what possible nursing diagnosis? Risk for infection related to adverse effects of antihistamines Risk for deficient fluid volume related to diuresis Risk for falls related to sedation Risk for impaired skin integrity related to urticaria
Risk for falls related to sedation
The nurse is evaluating the education of a client that uses albuterol for an acute asthma attack. The nurse knows that the lesson has been effective when the client states that albuterol is which of the following types of medication?
SABA
Cromolyn should not be used during an acute asthmatic attack.
True
Children younger than the age of 12 years should not receive indinavir. A. False B. True
b
The nurse's assessment should prioritize what system when caring for a client who has just been admitted for an overdose of pseudoephedrine? renal cardiovascular gastrointestinal neurological
cardiovascular
Before administering a mucolytic drug to a client with an upper respiratory infection, which would the nurse need to assess? Degree of dyspnea Evidence of productive cough Therapeutic effectiveness Frequency of coughing
degree of dyspnea
A male client presents to the health care provider's office with reports of inability to breathe freely. When the nurse reviews his use of over-the-counter medications, it is discovered that the client routinely uses nasal spray three times a day for 1 year. The nurse knows that what may be causing this client's continuous nasal congestion? Rebound nasal swelling Damage of the nasal concha Chronic nasal polyps Burning of the nares secondary to chronic use of nasal sprays
rebound nasal swelling
When the use of antihistamines result in dryness of the mouth, the nurse should recommend which to relieve the dryness? Select all that apply. Suck on sugarless hard candy. Offer ice chips. Take frequent sips of water. Administer intravenous fluid bolus. Use a dehumidifier in the home.
• Offer ice chips. • Take frequent sips of water. • Suck on sugarless hard candy
By what route would the nurse administer amphotericin B? A) Intravenously B) Intramuscularly C) Orally D) Topically
A
During treatment of amebiasis with chloroquine (Aralen Phosphate), the nurse assesses the patient for what adverse effects? A) Diarrhea B) Weight gain C) Hypertension D) Seizures
A
The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?
15 min prior to exercising
Antibiotics that are used together to increase their effectiveness and limit the associated adverse effects are said to be A. broad spectrum. B. synergistic. C. bactericidal. D. anaerobic.
b
Chronic obstructive pulmonary disease (COPD) encompasses which of the following? Select all that apply:
Asthma Chronic bronchitis
A neonate is receiving beractant. The nurse understands that this agent is administered by which route?
Intratracheal
A history of an allergy to which would be a contraindication to the use of anticholinergics? (Select all that apply
Soy and peanuts
Cipro, a widely used antibiotic, is an example of A. a penicillin. B. a fluoroquinolone. C. an aminoglycoside. D. a macrolide antibiotic.
b
HIV selectively enters which of the following cells? A. B clones B. Helper T cells C. Suppressor T cells D. Cytotoxic T cells
b
A client has expressed frustration stating, "I've been taking an over-the-counter (OTC) decongestant for several days and it still hasn't really cured my cold." What teaching point should the nurse convey to the client? "Sometimes a decongestant can sometimes mask the effects of your cold, essentially prolonging it." "It usually takes between 8 and 10 days for a decongestant to cure affect cold symptoms." "Most people find that cold medications are essentially ineffective." "Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."
"Drugs like this can often relieve some of the symptoms of a cold, but they won't cure it."
The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask? A. "Has she ever received tetracycline?" B. "Has she ever received gentamicin?" C. "Has she ever received ampicillin?" D. "Has she ever received cephalexin?" -
"Has she ever received tetracycline?"
The nurse is educating an older adult client diagnosed with rhinosinusitis in an outpatient clinic about the prescribed topical oxymetazoline. The client has a history of hypertension and coronary artery disease. Which statement made by the client establishes the need for further clarification? "I will rinse the spray tip off after each use." "I will blow my nose before using the nasal spray." "I can take over-the-counter pseudoephedrine, too." "The drug is used no longer than 3 days."
"I can take over-the-counter pseudoephedrine, too."
The nurse is educating an adult client diagnosed with a nonproductive cough about the prescribed dextromethorphan. Which statement made by the client establishes the need for further clarification? "If I raise mucous, I will stop taking the drug and call my prescriber." "I will not eat or drink for 30 minutes after taking a dose." "I will dilute the drug syrup with an equal amount of water." "The drug should only be taken as directed on the package."
"I will dilute the drug syrup with an equal amount of water."
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." -
"I will make sure to use extra sunscreen when I go to the tanning booth."
The nurse is teaching a client newly diagnosed with asthma about triggers. Which statement by the client indicates the client understands the teaching plan?
"I will use my air conditioner."
After teaching a client who is receiving an antitussive about the drug, which statement indicates the need for additional teaching? "I'll keep the room warm and toasty." "I can use some lozenges for comfort." "I need to increase the amount of fluids I drink." "I'll get a humidifier for my bedroom."
"I'll keep the room warm and toasty." Explanation: Measures to assist with cough control when using antitussives include cool temperatures, humidification, lozenges, and increased fluids.
Which client statement suggests a need for additional education on the second-generation antihistamine prescribed for the client? "I'm really hoping that these pills will cure my allergies before summer starts." "I know these can be a bit expensive, but hopefully it will be worth it for me." "I'll check with my health care provider to make sure that the diet supplements I'm taking are okay to take at the same time as these pills." "It's handy that I don't necessarily have to take these pills at bedtime."
"I'm really hoping that these pills will cure my allergies before summer starts." not cure
What statement made by a client suggests a need for further teaching on the risk factors associated with drug allergies? "All drugs have the potential to cause an allergic reaction." "Virtually any drug may induce an immunologic response in a susceptible person." "The additives that are in drugs can also cause allergic reactions." "If you didn't have allergies as a child, you won't develop allergies later in life."
"If you didn't have allergies as a child, you won't develop allergies later in life."
Which statement made by a nurse providing care to a newborn prescribed surfactin therapy indicates a need for additional instructions to ensure the medication's effectiveness?
"The baby requires suctioning every 1 hour for 4 hours after the instillation of surfactant."
The nurse admits a client with septicemia (infection in the bloodstream). The client denies any allergies and the provider has ordered cefuroxime based on blood culture and sensitivity testing. The client states, "I'd prefer vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response? A. "Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work." B. "There are some resistant infections that require vancomycin so you are right to prefer a stronger antibiotic." C. "I appreciate your concern but you can certainly rest assured that the health care provider ordered the right medication for your needs." D. "You can't believe anything you read on the Internet because most of it is just someone's opinion and not fact." -
"Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work."
After teaching a group of parents about the use of over-the-counter cough and cold products with their children, which statement indicates the need for additional teaching? "We can use the adult brand, but we just have to decrease the amount." "We can use over-the-counter products for our 5-year-old but not for our 18-monthold." "We need to read the label carefully to see how often and how much to give." "We should use the cup that comes with the drug to measure it out."
"We can use the adult brand, but we just have to decrease the amount." Parents should use the children's, pediatric, or infant formulations of the drug. Over-the-counter cough and cold preparations should not be used in children under the age of 2 years. The parents need to read the label carefully to determine the dosage and frequency, and they need to use the device that comes with the drug to ensure a proper dosage
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?
"When I am short of breath, I will increase the use of my fluticasone."
The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse? A. "You are allergic to the medication. Stop taking it immediately." B. "That is the medication working. Continue to take as directed." C. "You are experiencing an adverse affect of the medication. Those symptoms will decrease over time." D. "You may be experiencing an additional infection. I will discuss this with your health care provider." -
"You may be experiencing an additional infection. I will discuss this with your health care provider."
A male college student has presented to the campus medical clinic reporting cold symptoms that he has been experiencing for the past 2 weeks. He tells the nurse that he has been taking OTC decongestants twice daily since the onset of the cold. What teaching point should the nurse provide to this student? "Over-the-counter decongestants don't normally work; you'll likely need to get a prescription for something more effective." "You can probably expect to get relief within the next few days or a week at the longest." "You might find yourself more congested than ever as your body compensates for your use of these drugs." "It's best to take small doses of decongestants several times daily rather than two larger doses each day."
"You might find yourself more congested than ever as your body compensates for your use of these drugs."
The pediatric nurse is caring for a 9-year-old client who has been diagnosed with amebiasis. The client weighs 82.5 lbs. and has been prescribed metronidazole 40 mg/kg/day in three divided doses for 10 days. How many 250-mg tablets should the nurse administer for each dose? A. 0.5 B. 1 C. 2 D. 4 -
2
The health care provider suggests that a client use guaifenesin to help his cough. The nurse instructs the client to call the health care provider if he continues to have a productive cough after which amount of time? 1 week 2 weeks 3 weeks 5 days
1 week
In assessing a patient a viral cause might be suspected if the patient was diagnosed with A. tuberculosis. B. leprosy. C. the common cold. D. gonorrhea.
c
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? A. 10 lb weight loss B. Loose stools for the last two days C. Unable to eat spicy foods D. Decreased appetite -
10 lb weight loss
The nurse assesses the serum theophylline of a client. Which finding would the nurse identify as being therapeutic?
15 mcg/mL
How does the nurse adapt the plan of care when caring for an older adult receiving an antiprotozoal agent? A) Patients should be monitored more closely for toxic adverse effects. B) The drug dosage should be lowered for all older adults. C) Antiprotozoal agents should not be administered to older adults. D) Female patients of appropriate age should be advised to use barrier contraceptives.
A
A client who is experiencing anaphylaxis with severe wheezing receives a dose of epinephrine intravenously. The nurse would expect the drug to exert it full effects within which time frame?
20 minutes
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? A. 180 mg B. 225 mg C. 36 mg D. 600 mg -
225 mg
A patient receives dextromethorphan. The nurse would expect this drug to begin acting within which time frame? 25 to 30 minutes 10 to 15 minutes 20 to 25 minutes 15 to 20 minutes
25 to 30 minutes
A patient has been prescribed an antimalarial as prophylaxis for the disease. What assessment finding would the nurse recognize as indicating the patient has a common adverse effect? A) Dyspepsia B) Hematemesis C) Tarry stool D) Tachycardia
A
A patient receives guaifenesin. The nurse would expect the drug to begin acting within which time frame? 60 minutes 45 minutes 15 minutes 30 minutes
30 minutes
A patient is prescribed mefloquine (Lariam) for malaria prophylaxis. When should the nurse instruct mefloquine be started? A) 1 week prior to entering an endemic area B) 1 to 2 days prior to entering an endemic area C) On arrival to an endemic area D) When mosquitoes are present
A
A patient with AIDS is taking an antiviral agent. What comment by the patient would indicate that the teaching plan was effective? A) "I feel like I do when I have the flu." B) "I will continue to take the over-the-counter medication for my allergies." C) "Excessive fatigue and a severe headache are common adverse effects of my medication." D) "This drug will cure AIDS."
A
A patient with giardiasis is being treated with metronidazole. What comment by the patient would indicate that the nurse needs to provide further teaching? A) "I can continue to work delivering pizza because the disease is not contagious." B) "I will not lose my hair during drug therapy." C) "I know I will experience diarrhea during this time." D) "I shouldn't experience irregular menstrual periods."
A
An immunocompromised 3-year-old has been exposed to avian flu. The patient is brought to the clinic and the mother reports that the patient has had "flu-like symptoms" for the past 12 hours. What medication would you expect the physician to order for this patient? A) Oseltamivir (Tamiflu) B) Amantadine (Symmetrel) C) Ribavirin (Rebetron) D) Zanamivir (Relenza)
A
A 21-year-old woman presents with cytomegalovirus (CMV). The LPN says, "I've never heard of CMV before." The nurse explains to the LPN that this infection is most often seen with patients diagnosed with what? A) HIV B) Influenza C) Autoimmune disorder D) Hepatitis B
A
A 91-year-old man is being treated for Pneumocystis carinii pneumonia with pentamidine (NebuPent). What should the nurse measure when assessing this patient for adverse effects of the medication? A) Liver function tests B) Serum potassium C) Daily blood pressure D) Blood urea nitrogen (BUN) and creatinine
A
A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose? A) Ciprofloxacin (Cipro) B) Gemifloxacin (Factive) C) Norfloxacin (Noroxin) D) Sparfloxacin (Zagam)
A
The clinic nurse is providing health teaching to a patient who has been prescribed doxycycline (Doxycin). What is a priority teaching point for this patient? A) Stay out of the sun. B) Avoid sexual activity. C) Take an antacid with the drug if nausea occurs. D) Chew the tablets completely before swallowing.
A
The clinic nurse provides teaching for a patient prescribed pyrimethamine (Daraprim) to prevent malaria and instructs on the need to notify the prescriber immediately if what signs and symptoms occur? A) Diarrhea, fatigue, weight loss, and anemia B) Irritation, rash, or inflammation C) Headache, nausea, or constipation D) Anorexia, nausea, or vomiting
A
The mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her child needs an antibiotic. What is the priority rationale the nurse should give the mother? A) It is better absorbed. B) It is less costly. C) It has a less frequent dosing schedule. D) It tastes better in oral form.
A
The mother of a 6-month-old infant comes to the clinic. The mother is diagnosed with a protozoal infection. What would be a priority for the nurse to assess for? A) Whether she is breast-feeding B) Whether she has a support network C) Whether she has money to pay for the medication D) Whether she eats a protein-rich diet
A
The nurse administers nystatin (Mycostatin) to a patient with thrush (oral candidiasis). How does the medication work in the body? A) Changes membrane permeability B) Prevents reproduction of fungal cells C) Fungistatic D) Inhibits glucan synthesis
A
The nurse admits a patient diagnosed with diabetes who has been undergoing fertility treatment in the hopes of becoming pregnant but is not pregnant at this time. The patient has a life-threatening fungal infection and requires systemic antifungal therapy. What medication would be contraindicated in this patient? A) Ketoconazole B) Fluconazole C) Posaconazole D) Itraconazole
A
The nurse explains why viruses are so difficult to treat when making what statement? A) Viruses are contained inside the human cell and cannot be destroyed without destroying the cell. B) Release of interferons by the host cell makes the virus replicate more quickly allowing the virus to spread. C) Drugs exist to treat all viral infections but they carry serious adverse effects and the benefit often does not outweigh the risk. D) Individual antiviral drugs are often effective in treating many different viruses because one virus in a category behaves like others in the same category.
A
The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question would the nurse ask? A) "Has she ever received tetracycline?" B) "Has she ever received gentamicin?" C) "Has she ever received ampicillin?" D) "Has she ever received cephalexin?"
A
The nurse is caring for a 62-year-old patient who is receiving IV gentamicin (Garamycin). The patient complains of difficulty hearing. What should the nurse do? A) Hold the dose and notify the physician immediately. B) Administer the dose and speak in a louder voice when talking to the patient. C) Administer the dose and report this information to the oncoming nurse. D) Administer the dose and document the finding in the nurse's notes.
A
The nurse is caring for a female patient whose tests confirm she is 10 weeks pregnant and has contracted tuberculosis. The health care provider orders a combination of antimycobacterials. What combination of drugs would the nurse identify as safest for this pregnant patient? A) Isoniazid, ethambutol, and rifampin B) Rifabutin, streptomycin, and rifampin C) Capreomycin, cycloserine, and ethionamide D) Dapsone, ethambutol, and cycloserine
A
The nurse is caring for a patient who is prescribed cidofovir, IV. What other medication will the nurse administer with cidofovir? A) Probenecid B) Paroxetine hydrochloride C) Penciclovir D) Prostigmin
A
The nurse is caring for a patient who is receiving an aminoglycoside. What would be a priority assessment on this patient? A) Respiratory function B) Vision C) Cardiac function D) Liver function
A
The nurse is caring for a patient with a gram-positive infection. What antibiotic would be most effective in treating this infection? A) Cefaclor (Ceclor) B) Cefoxitin (generic) C) Cefotaxime (Claforan) D) Cefazolin (Zolicef)
A
The nurse is planning care for an AIDS patient admitted with chronic severe diarrhea secondary to adverse effects of the antiviral drugs prescribed. What would be the most appropriate goal for this patient? A) Patient will show improved nutritional status evidenced by weight gain. B) Alleviation or reduction of signs and symptoms of AIDS. C) Patient will be able to demonstrate the effectiveness of the teaching plan. D) Patient will state that comfort and safety measures are effective and show compliance with the regimen.
A
The nurse is reading the patient's medical record and discovers the patient has a mycosis and interprets this as meaning what? A) An infection caused by a fungus B) A fungus normally found on mucous membranes C) A systemic fungal infection D) A fungal infection with a secondary bacterial infection
A
The nurse is reviewing the patient's medications and sees fluconazole has been ordered. The nurse will question this order when finding the patient is taking what other medication? A) Digoxin B) Humulin insulin C) Acetaminophen D) Hydrochlorothiazide
A
The nurse is teaching the patient about a newly prescribed systemic antifungal drug. What sign or symptom will the nurse instruct the patient to report to the provider immediately? A) Unusual bruising and bleeding B) Constipation or diarrhea C) Red and dry eyes D) Increased appetite with weight gain
A
The nurse is teaching the patient about amoxicillin prior to discharge and includes what important teaching point? A) Blackening of the tongue may occur but will subside when the drug is discontinued. B) Even if it seems like the infection is not improving, the drug is still working. C) Yeast infections are unlikely to occur with this medication because it is narrow spectrum. D) Appearance of a rash is common and does not indicate an allergic reaction.
A
The nurse is writing a plan of care for a patient receiving antimalarial drug therapy. What nursing diagnosis would be appropriate for this patient if common adverse effects were indicated? A) Disturbed sensory perception (visual) related to central nervous system effects B) Imbalanced nutrition: more than body requirements C) Constipation D) Ineffective breathing pattern
A
The nurse provides discharge teaching for a patient who will receive a prescription for cefaclor (Ceclor). What important information will the nurse provide this patient? A) Avoid alcohol until 72 hours after stopping this medication. B) Genital itching will go away after the drug is discontinued. C) Monitor for yellowing of the skin or eyes and call the doctor if it occurs. D) Avoid grapefruit juice when taking this medication to prevent adverse effects.
A
The nurse teaches the patient to administer butoconazole (Gynazole) for vaginal candidal infection. What instructions will the nurse supply? A) "Fill the applicator with the medication and insert it into the vagina at bedtime." B) "Apply the medication to the perineal area twice a day and wear white cotton underwear." C) "Soak in a sitz bath twice daily and insert the medication into the vagina after the bath." D) "Take one tablet by mouth and be sure to follow the medication with a full glass of water."
A
The nurse, learning about malaria, discovers that the transmission of malaria occurs when what is injected into the human body by the infected mosquito? A) Sporozoites B) Gametocytes C) Schizonts D) Merozoites
A
The patient is admitted for IV administration of antifungal medication with the plan to discharge the patient on oral medication in a few days. What medication would the nurse be able to administer both IV and orally? A) Fluconazole B) Itraconazole C) Posaconazole D) Terbinafine
A
The patient is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the patient would indicate the need to consult the health care provider before administering the ordered medication? A) Takes furosemide (Lasix), a potent diuretic, daily B) Had prostate surgery 3 months ago C) History of hypothyroidism D) Allergic to peanuts and peanut products
A
The patient, newly diagnosed with African sleeping sickness, asked what caused the disease. What is the nurse's best response? A) Trypanosoma brucei gambiense B) Giardia lamblia C) Promastigote D) Trypanosoma cruzi
A
What drug administered by the nurse belongs to the group of Carbapenems? A) Primaxin B) Gemifloxacin C) Demeclocycline D) Cefuroxime
A
A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?
A 65-year-old male with asthma
The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate? A. A client with signs of infection who is awaiting the results of laboratory testing B. A client with pneumonia who has a confirmed allergy to penicillins C. A client who is being treated for a urinary tract infection for the third time this year D. A client with an infected surgical wound -
A client with signs of infection who is awaiting the results of laboratory testing
A nurse administers an antitussive agent cautiously to a client with asthma for which reason? The client may experience increased sedation. A loss of respiratory reserve can occur. The drug can lead to addiction. The airway needs to be maintained.
A loss of respiratory reserve can occur.
A male client presents to the emergency department in bronchospasm. He has a history of smoking two packs per day for 20 years and is prescribed phenytoin to control a seizure disorder that developed after a head injury 3 years ago. Based on the client's history, what would the nurse expect the health care provider to order?
A modified dose of aminophylline
Naturally occurring substances that are released in the body in response to viral invasion are called A. antibodies. B. immunoglobulins. C. interferons. D. interleukins.
c
Some antiviral agents are given locally to treat local viral infections. How do these medications work? (Select all that apply.) A) Interfere with viral metabolic processes B) Interfere with viral cellular replication C) Interfere with host metabolic processes D) Interfere with viral transcription E) Increase antibody production
A,B
The nurse is caring for a patient who is taking adefovir to treat hepatitis B. The nurse would hold the medication and notify the health care provider if assessing the signs and symptoms of what? (Select all that apply.) A) Lactic acidosis B) Hepatotoxicity C) Headache D) Nausea E) Asthenia
A,B
A nursing student asks the pharmacology instructor for ways to minimize the emergence of drug-resistant microbial agents. What would be an appropriate response by the instructor? (Select all that apply.) A) Avoid the use of broad-spectrum antibacterial drugs when treating trivial or viral infections. B) Use narrow-spectrum agents if they are thought to be effective. C) Do not use vancomycin unnecessarily. D) Prescribe antibiotics when the patient believes they are warranted. E) Start the antibiotics, do culture and sensitivity tests, and provide patient education.
A,B,C
For what viruses might the nurse administer acyclovir (Zovirax)? (Select all that apply.) A) Herpes simplex virus B) Shingles C) Chickenpox D) HIV E) Cytomegalovirus (CMV)
A,B,C
The nurse explains that the drugs metronidazole (Flagyl) or tinidazole (Tindamax) can be administered to treat what protozoan infections? (Select all that apply.) A) Trichomoniasis B) Giardiasis C) Amebiasis D) Pneumocystis carinii pneumonia E) Cryptosporidium parvum
A,B,C
The nurse is caring for a patient diagnosed with amebiasis caused by Entamoeba histolytica that resulted in the patient having amebic dysentery. What questions might the nurse ask in an attempt to discover how the patient came in contact with the organism? (Select all that apply.) A) "Have you traveled outside the country recently?" B) "Have you been swimming in a lake or pond recently?" C) "Have you been eating fresh fruits or vegetables without washing them first?" D) "Have you been bitten by a mosquito?" E) "Have you had unprotected sex recently?"
A,B,C
The nurse is caring for a patient whose condition has continued to decline on other antiviral medications and is now prescribed nevirapine (Viramune). What other medications will the nurse assess for to avoid a drug-drug interaction with this new prescription? (Select all that apply.) A) Oral contraceptives B) Protease inhibitors C) St. John's wort D) Ergot derivatives E) Antiarrhythmics
A,B,C
The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students about the mechanism of action of antimicrobials? (Select all that apply). A) Preventing cell division B) Causing cell death C) Inhibiting cell wall synthesis D) Causing leakage of cell wall allowing fluid to leak in E) Inhibiting synthesis of ribonucleic acid (RNA)
A,B,C
When caring for a 92-year-old patient, the nurse would anticipate the need for what interventions related to administration of any antifungal medications? (Select all that apply.) A) Dose reduction B) Frequent monitoring C) Frequent testing of liver function D) Shorter course of treatment E) Continuous cardiorespiratory monitoring
A,B,C
When the nurse cares for a patient receiving an antibiotic, what instructions will the nurse provide no matter what medication is prescribed? (Select all that apply.) A) Drink plenty of fluids to avoid kidney damage. B) Take all medications as prescribed until all of the medication is gone. C) Report difficulty breathing, severe headache, or changes in urine output. D) Take antibiotic with food to avoid gastrointestinal (GI) upset. E) Take safety precautions such as changing position slowly.
A,B,C
What factors would the nurse indicate as contributing to an increase in diagnosed fungal infections? (Select all that apply.) A) Acquired immunodeficiency syndrome (AIDS)-related complex B) Increased prevalence of cancer C) Rise in birth rates across the country D) Greater number of older adults E) Increased use of immunosuppressants
A,D,E
A parent has informed the nurse that she has been applying an OTC antifungal to her infant's buttocks and perineal region for a rash. What question related to safety should the nurse ask the parent? A. "Are there any open wounds on the areas where you're putting the ointment?" B. "Did you take any antifungal medications while you were pregnant?" C. "Did you explore any herbal or alternative remedies before starting to use this ointment?" D. "Does your infant have any food allergies that you're aware of yet?"
A. "Are there any open wounds on the areas where you're putting the ointment?"
A parent has informed the nurse that she has been applying an OTC antifungal to her infant's buttocks and perineal region. What question related to safety should the nurse ask the parent? A. "Are there any open wounds on the areas where you're putting the ointment?" B. "Did you take any antifungal medications while you were pregnant?" C. "Did you explore any herbal or alternative remedies before starting to use this ointment?" D. "Does your infant have any food allergies that you're aware of yet?"
A. "Are there any open wounds on the areas where you're putting the ointment?"
A client has been diagnosed with a fungal infection and been prescribed a topical antifungal medication. What assessment question should the nurse ask when addressing the possible etiology of the fungal infection? A. "Have you been prescribed any antibiotics in the recent past?" B. "Have you received any vaccinations in the past few weeks?" C. "When was the last time you visited a hospital or clinic?" D. "Were you prone to acne when you were younger?"
A. "Have you been prescribed any antibiotics in the recent past?"
The nurse is working with a client with a cutaneous fungal infection. The client was prescribed a topical antifungal ointment. The client tells the nurse, "I went ahead and bought a steroid ointment at the drugstore because I read it might help with my skin infection." What is the nurse's best response? A. "It's best to check with your health care provider before applying any of the steroid ointment." B. "Actually, that ointment would probably make your infection worse, not better." C. "You can't safely take any over-the-counter drugs while you're taking a prescription drug." D. "Any ointment that you're able to buy without a prescription likely isn't going to help much."
A. "It's best to check with your health care provider before applying any of the steroid ointment."
A client is receiving gentian violet as topical treatment for a fungal infection. What instruction should the nurse include in the teaching plan? A. "This medication can stain your skin and clothing." B. "Take this medicine with good to minimize upset stomach." C. "Cover the area with plastic wrap to seal it off." D. "Apply a thin layer of the medicine to any open areas on your skin."
A. "This medication can stain your skin and clothing."
A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? (ATI Pharm Chapter 22) A. "remove the prior dose before applying a new dose" B. "rub the ointment directly into your skin until it is no longer visible" C. "Cover the applied ointment with a clean gauze pad" D. "Apply the ointment to the same skin area each time"
A. "remove the prior dose before applying a new dose"
A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? (ATI Pharm Chapter 17) A. "rinse your mouth after each use of this medication" B. "limit fluid intake while taking this medication" C. "increase your intake of vitamin B12 while taking this medication." D. "you can take the medication as needed"
A. "rinse your mouth after each use of this medication"
The nurse is caring for a client who has a systemic infection and who has been prescribed griseofulvin. After administering a dose at 0900, the nurse should expect the drug levels to peak at what time? A. 1300 hours B. 1000 hours C. 1500 hours D. 1700 hours
A. 1300 hours
The nurse is caring for several clients who have fungal infections. Which client should the nurse prioritize for informing the provider? A. A client receiving amphotericin B whose torso appears jaundiced B. A client with candidiasis who has been prescribed nystatin and who requires education C. A client who has a dose of miconazole vaginal suppository due in 15 minutes D. A client who reports the new onset of a rash where terbinafine is being applied
A. A client receiving amphotericin B whose torso appears jaundiced
The nurse is caring for a client diagnosed with a life-threatening systemic fungal infection that is not responding to treatment with an azole. What medication should the nurse anticipate the provider may order next? A. Amphotericin B B. Nystatin C. Butenafine D. Terbinafine
A. Amphotericin B
A client asks, "What is the difference between antitussive medications and expectorants?" What information should the nurse's response be based upon? A. Antitussives suppress coughing while expectorants loosen bronchial secretions. B. Antitussives liquefy bronchial secretions while expectorants assist in the expectoration of those secretions. C. Both drug types loosen bronchial secretions for ease of removal. D. Antitussives kill cold viruses while expectorants liquefy bronchial secretions.
A. Antitussives suppress coughing, and expectorants loosen bronchial secretions.
1. A nurse reviewing a client's medication history notes an allergy to sulfonamides. This allergy is a contraindication for taking which of the following medications? (Select all that apply.) A. Hydrochlorothiazide B. Metoprolol C. Acetaminophen D. Glipizide E. Furosemide
A. CORRECT: A sulfonamide allergy is a contraindication for taking hydrochlorothiazide. Hypersensitivity, including Stevens‑Johnson syndrome, can result from taking hydrochlorothiazide and a sulfonamide concurrently. D. CORRECT: A sulfonamide allergy is a contraindication for taking some oral antidiabetes medications, including glipizide and glyburide. Hypersensitivity, including Stevens‑Johnson syndrome, can result from taking glipizide and a sulfonamide concurrently. E. CORRECT: A sulfonamide allergy is a contraindication for taking loop diuretics, such as furosemide. Hypersensitivity, including Stevens‑Johnson syndrome, can result from
2. A nurse is caring for a client who takes several antiretroviral medications, including the NRTI zidovudine, to treat HIV infection. The nurse should monitor for which of the following adverse effects of zidovudine? (Select all that apply.) A. Fatigue B. Blurred vision C. Ataxia D. Hyperventilation E. Vomiting
A. CORRECT: Fatigue is a manifestation of anemia, an adverse effect of zidovudine. Neutropenia can also occur, causing a high risk for infection. D. CORRECT: Hyperventilation is a finding that can occur if the client develops lactic acidosis, a serious adverse effect of zidovudine. E. CORRECT: Vomiting and other GI effects are adverse effects of zidovudine.
3. A nurse is teaching a female client who has a severe UTI about ciprofloxacin. Which of the following information about adverse reactions should the nurse include? (Select all that apply.) A. Observe for pain and swelling of the Achilles tendon. B. Watch for a vaginal yeast infection. C. Expect excessive nighttime perspiration. D. Inspect the mouth for cottage cheese‑like lesions. E. Take the medication with a dairy product.
A. CORRECT: Pain and swelling of the Achilles tendon indicate an adverse effect of ciprofloxacin to report to the provider. B. CORRECT: A vaginal yeast infection is an overgrowth of Candida albicans, which commonly occurs when taking ciprofloxacin. D. CORRECT: Cottage cheese‑like lesions in the mouth indicate an overgrowth of Candida albicans, a common adverse effect when taking ciprofloxacin.
4. A nurse is caring for a client who has subacute bacterial endocarditis and is receiving several antibiotics, including streptomycin IM. For which of the following manifestations should the nurse monitor as an adverse effect of this medication? A. Extremity paresthesias B. Urinary retention C. Severe constipation D. Complex partial seizures
A. CORRECT: Paresthesias of the hands and feet are a common adverse effect of streptomycin. This medication treats infections in combination with other antibiotics or to treat severe infections when other antibiotics failed.
3. A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory infection. For which of the following manifestations should the nurse monitor as an adverse effect of this medication? (Select all that apply.) A. Pruritus B. Hematuria C. Muscle weakness D. Difficulty swallowing E. Vertigo
A. CORRECT: Paresthesias of the hands and feet, urticaria, rash, and pruritus are indications of a hypersensitivity reaction that can occur in clients taking gentamicin. B. CORRECT: Hematuria is an indication of acute kidney toxicity due to gentamicin. C. CORRECT: Muscle weakness and respiratory depression can occur in clients taking gentamicin as a result of neuromuscular blockade. E. CORRECT: Vertigo, ataxia, and hearing loss are indications of ototoxicity that can occur in clients taking gentamicin.
A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the clients history that can interact with ranolazine? (Select all that apply) (ATI Pharm Chapter 22) A. Digoxin B. Simvastatin C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch
A. Digoxin B. Simvastatin C. Verapamil
A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select all that apply.) (ATI Pharm Chapter 18) A. Dry Mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation
A. Dry Mouth D. Drowsiness E. Urinary hesitation
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
What antifungal medication has the same mechanism of action as amphotericin B but is used only in the topical treatment of candidiasis? A. nystatin B. terbinafine C. fluconazole D. griseofulvin
A. nystatin
Which statement would be correct for a client regarding the administration of an antifungal medication? A. Instruct the client to complete the entire drug therapy even if a dose is missed. B. Instruct the client to take frequent meals of fat and protein when GI distress occurs. C. Instruct the client to take a forgotten dose as soon as it is remembered, even if it is time for the next dose. D. Advise that for persistent headache, unrelieved by acetaminophen, the client should increase the dosage of acetaminophen.
A. Instruct the client to complete the entire drug therapy even if a dose is missed.
What is the action of amphotericin B when prescribed for a fungal infection of the urinary tract? A. It binds to ergosterol resulting in changes in the cell membrane. B. It binds to an enzyme required for synthesis of ergosterol. C. It disrupts the fungal cell walls rather than the cell membrane. D. It inhibits glucan synthetase required for glucan synthesis.
A. It binds to ergosterol resulting in changes in the cell membrane.
A client has been prescribed pyrimethamine 25 mg PO weekly for antimalarial prophylaxis. When reviewing the client's health history, the nurse reads that the client has type 2 diabetes that is controlled with gliclazide, a sulfonamide. What is the nurse's best action? A. Monitor the client's complete blood count results closely. B. Encourage the client to check blood glucose levels more frequently than usual. C. Monitor the client for signs and symptoms of decreased renal function. D. Confirm with the care provider that the antimalarial treatment will be effective. -
A. Monitor the client's complete blood count results closely.
What serious adverse effect is most associated with amphotericin B? A. Nephrotoxicity B. Hypovolemia C. Cardiogenic shock D. Septic shock
A. Nephrotoxicity
An 80-year-old woman is receiving treatment with oral fluconazole for a fungal infection Following yesterday's and today's dose, she reports an upset stomach to the charge nurse. How should the nurse at the facility best respond to the woman's report? A. Provide food along with the fluconazole when administering it in the future. B. Stop administering the fluconazole and inform the client's physician. C. Arrange for the client to receive intravenous fluconazole on an outpatient basis. D. Assess the client for signs and symptoms of an infusion reaction.
A. Provide food along with the fluconazole when administering it in the future.
A nurse us teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? (ATI Pharm Chapter 22) A. Remove the patch each evening B. Cut each patch in half if angina attacks are under control C. Take off the nitroglycerin patch for 30 minutes if a headache occurs D. Apply a new patch every 48 hr
A. Remove the patch each evening
A client with a systemic fungal infection has been prescribed ketoconazole 350 mg PO daily. What assessment should the nurse prioritize before administration? A. Review of liver enzyme levels B. Assessment of cranial nerve function C. Review of blood urea nitrogen and creatinine levels D. Review of potassium, sodium and chloride levels
A. Review of liver enzyme levels
A client has been prescribed sulconazole for the treatment of tinea pedis. When nursing diagnosis should the nurse identify when planning this client's care? A. Risk for impaired skin integrity related to local irritation B. Impaired urinary elimination related to nephrotoxicity C. Risk for injury related to central nervous system depression D. Imbalanced nutrition: Less than body requirements related to liver damage
A. Risk for impaired skin integrity related to local irritation
The primary health care provider prescribes flucytosine to treat a systemic fungal infection. The nurse would administer this drug by which route? A. oral B. IV C. IM D. topical
A. oral
A client with topical mycosis was prescribed oxiconazole for topical administration and has been using the medication for 10 days. The client now reports an open wound on the same region. What is the nurse's best action? A. Tell the client not to administer the medication and to come be assessed by the provider B. Document the statement and ask the client to mention this in the next scheduled appointment with the provider C. Encourage the client to apply an over-the-counter barrier cream before the next application of the medication D. Tell the client to apply a bandage over the wound to prevent secondary infection
A. Tell the client not to administer the medication and to come be assessed by the provider
A client tells the nurse that she has taken several doses of over-the-counter fluconazole to treat a "yeast infection." When assessing the client's risk for drug toxicity, what aspect of the client's health status should the nurse prioritize? A. The client client has decreased renal function following recent pyelonephritis B. The client has type 2 diabetes and takes oral hypoglycemics C. The client has lost over 30 lbs. in the past four months through diet and exercise D. The client experienced a transfusion reaction to packed red blood cells several years ago
A. The client client has decreased renal function following recent pyelonephritis
A client is being treated for histoplasmosis with amphotericin B. The nurse has completed a comprehensive assessment of the client and should report what assessment finding? A. The client's urine output is 75 mL over six hours B. The client reports a frontal headache C. The client reports a lack of appetite and refused breakfast D. The client had an episode of diarrhea overnight
A. The client's urine output is 75 mL over six hours
The client is diagnosed with a Candida infection of the mouth. How will the nurse document this finding? A. Thrush B. Ringworm C. Dermatophytes D. Tinea cruris
A. Thrush
The client is receiving ketoconazole. The nurse should be concerned about a drug-drug interaction on the basis of what other co-morbidity? A. Type 2 diabetes B. Chronic pain C. Venous ulcers D. Pencillin allergy
A. Type 2 diabetes
The client is receiving ketoconazole. The nurse should be concerned about a drug-drug interaction on the basis of what other comorbidity? A. Type 2 diabetes B. Chronic pain C. Venous ulcers D. Pencillin allergy
A. Type 2 diabetes
A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?(ATI Pharm Chapter 17) A. Weight gain B. Nervousness C. Bradycardia D. Constipation
A. Weight gain
The nurse is caring for a client who has a fungal infection and who has been prescribed fluconazole . The nurse should understand that the medication will eradicate the fungus by: A. blocking the activity of a sterol in the fungal wall. B. inhibiting the cytochrome P2D6 enzyme system. C. inhibiting the synthesis of ergosterol to prevent cell wall formation. D. inhibiting the synthesis of glucans.
A. blocking the activity of a sterol in the fungal wall.
Caspofungin has been prescribed for a client diagnosed with invasive aspergillosis. The nurse should teach the client to promptly report what symptom associated with an adverse reaction? A. cardiac distress B. diaphoresis C. dry mouth D. muscle pain
A. cardiac distress
Guidelines for the use of topical antifungals in children are frequently the same as those for adults. However, safety and dosage recommendations have not been established for most oral and IV antifungals in the pediatric population. Which antifungal drug is suitable for pediatric use? A. fluconazole B. caspofungin C. voriconazole D. metropolol
A. fluconazole
A client is receiving amphotericin B. The nurse would assess the client closely for which adverse reaction? A. renal impairment B. intensive weight loss C. skin discoloration D. CNS disorders
A. renal impairment
A client has been prescribed a topical antifungal ointment to treat a fungal infection between her breasts. When providing education about this medication, the nurse should encourage the client to: A. wash and dry the affected area before applying the ointment. B. ensure the affected area is not exposed to sunlight during treatment. C. avoid the use of soap on the affected area until treatment is complete. D. apply the ointment a maximum of every two hours.
A. wash and dry the affected area before applying the ointment.
A nurse is caring for a stroke victim in the intensive care unit. The nurse notices a cold sore and requests medication. Docosanol (Abreva) is ordered. Before applying the medication, the nurse would first? A) Clean the area to be treated and then pat it dry. B) Assess the area for open lesions or abrasions. C) Put gloves on to protect herself. D) Prepare applicator for drug administration.
B
The client states that he/she once needed medication to liquefy secretions in the respiratory tract. However, the client cannot recall the name of the medication but states that the medication is added to a nebulizer. The nurse suspects the client is taking which medication? prednisone acetylcysteine guaifenesin pseudoephedrine
Acetylcysteine Mucolytics are administered by inhalation to liquefy mucus in the respiratory tract. Solutions of mucolytic drugs may be nebulized into a face mask or mouthpiece or instilled directly into the respiratory tract through a tracheostomy. Sodium chloride solution and acetylcysteine (Mucomyst) are the only agents recommended for use as mucolytics
A child prescribed an inhaled corticosteroid agent to decrease respiratory inflammation is now receiving high doses of the drug after only 2 days of treatment. What adverse reaction is the client at risk for developing?
Adrenal insufficency
Tom, age 42, is prescribed ipratropium bromide as an anticholinergic agent for treating asthma. The nurse caring for Tom needs to develop a plan of care. What must be included in the plan? Select all that apply.
Advise the patient to avoid using ipratropium if allergic to soybeans, legumes, or soya lecithin. Remind the patient that ipratropium must be taken daily, despite the absence of symptoms of asthma.
A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)
Airway inflammation Damaged airway mucosa
A male client presents with symptoms of bronchospasm that occurred during a birthday party for his grandson. What medication would the nurse expect the health care provider to give the client?
Albuterol
During the summer, a female client experiences increased periods of acute symptoms of her asthma. The health care provider increases the dose frequency of which of her medications?
Albuterol
The parents of a 7-year-old client who has been diagnosed with allergic asthma are being taught about their son's medication regimen. The nurse is teaching about the appropriate use of a "rescue drug" for acute exacerbations. What drug should the nurse suggests the parents to use in these situations?
Albuterol
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Albuterol causes relaxation of the bronchial smooth muscles.
The client has been diagnosed with asthma and is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?
Albuterol first, wait five minutes and then follow with flunisolide
A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug? A. vancomycin B. warfarin C. atorvastatin D. losartan
B
A charge nurse is preparing information for the unit nurses on the effectiveness of antimicrobial therapy for clients who have bacterial infections. Which of the following client conditions should the charge nurse include in the information? SELECT ALL THAT APPLY. A. A client who has meningitis. B. A client who has a pacemaker. C. A client who has endocarditis. D. A client who has pneumonia. E. A client who has pyelonephritis.
Answer: A, B, C The client with meningitis may have difficulty responding to antimicrobial therapy because of the blood-brain barrier. The client with a pacemaker may have difficulty responding to antimicrobial therapy because of colonization of microorganisms around the pacemaker and the inability of phagocytic cells to destroy the microorganisms. The client who has endocarditis may have difficulty responding to antimicrobial therapy because the antibiotic may be unable to penetrate the vegetative thrombus that develops on the injured endocardium.
A charge nurse is teaching a group of nurses about the importance of prophylactic antimicrobial therapy. Which of the following information should the charge nurse include in the teaching? SELECT ALL THAT APPLY. A. Administer prophylactic antimicrobial therapy to the client who suspects exposure to a sexually transmitted infection. B. Administer prophylactic antimicrobial therapy to the client who is having orthopedic surgery. C. Instruct a client about the need for prophylactic antimicrobial therapy before dental work if he has a prosthetic heart valve. D. Consult the provider for prophylactic antimicrobial therapy if the client has recurrent UTIs. E. Instruct a client to obtain prophylactic antimicrobial therapy immediately when he has an upper respiratory infection.
Answer: A, B, C, D For E: upper respiratory infections may be viral in nature. Antibiotic resistance can happen when antimicrobials are used inappropriately.
A nurse is caring for a group of clients who are receiving antimicrobial therapy. Which of the following clients should the nurse plan to monitor for manifestations of antibiotic toxicity? A. Adolescent client who has a sinus infection. B. Older adult client who has prostatitis. C. New mother who has mastitis. D. Middle adult client who has a urinary tract infection.
Answer: B An older adult client with prostatitis who is receiving antibiotics is at risk for toxicity because of the age-related reduction in drug metabolism and excretion.
A nurse is implementing a plan of care for a client who has an infected wound of the arm. Which of the following actions should the nurse perform first? A. Administer antibiotic medication. B. Obtain a culture of the wound. C. Review WBC laboratory findings. D. Apply a dressing to the wound.
Answer: B When using the urgent vs nonurgent approach to care, the nurse's priority action is to obtain a culture of the wound before initiating antibiotic therapy.
A nurse is reviewing a client's laboratory findings to identify the antibiotic that may be prescribed by the provider to treat the client's UTI. Which of the following tests of the client's urine would provide this information? A. Gram stain B. Culture C. Sensitivity D. Specific gravity
Answer: C A sensitivity test identifies the most effective antibiotic to be used to treat a specific microorganism.
Acetylcysteine may be used as a mucolytic agent. What is an additional indication for the drug? Antidote for acetaminophen poisoning Treatment of bronchospasm Treatment of peptic ulcer disease Conversion of cardiac dysrhythmias
Antidote for acetaminophen poisoning Oral acetylcysteine is widely used in the treatment of acetaminophen overdosage.
A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is: Antihistamines are recommended for extended use, as long as you monitor for adverse effects. Antihistamines are not recommended for this issue; only antibiotics are useful. Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough. Antihistamines are not used for this issue.
Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.
An adult client has asked the nurse to recommend an OTC cold remedy. Before making a recommendation, the nurse should implement which intervention? Consult with a pharmacist or pharmacy technician. Ensure that the client has tried some of the more common herbal and natural remedies. Assess the client's understanding of the epidemiology of the common cold and upper respiratory infections. Assess the client for health problems that may contraindicate the use of a particular remedy.
Assess the client for health problems that may contraindicate the use of a particular remedy.
A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?
Asthma
A client recently began taking theophylline for treatment of asthma. Which changes in the client's lifestyle would suggest that the client understands proper use of the drug and management of the disease?
Avoiding caffine
A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis would be most appropriate for this patient? A) Acute pain related to gastrointestinal (GI) effects of the drug B) Deficient knowledge regarding drug therapy C) Imbalance nutrition: less than body requirements related to multiple GI effects of the drug D) Constipation
B
A 78-year-old woman, 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) The half-life of the drug is 3 to 7 hours. B) It is taken only once a day. C) It has very few adverse effects. D) It can be given without consideration to drug-drug interactions.
B
A nurse practitioner is teaching a health class in the local high school. The NP informs the class about hepatitis B. What occupation does the NP inform the class is at the greatest risk for contracting hepatitis B? A) Policemen B) Health care workers C) Educators D) Fire fighters
B
A patient has been diagnosed with trichomoniasis. Before beginning tinidazole (Tindamax) therapy, what should the nurse question the patient about? A) Working conditions B) Use of alcohol C) Recent visit to a beach or desert D) Possibly having AIDS
B
A patient presents at the emergency department complaining of sudden onset of high fever and swelling and reddening of the limbs. Assessment shows severe hypotension. The nurse taking the patient's history notes that the patient has recently returned to the United States from the African continent. The patient is admitted to the intensive care unit (ICU) suspected of having malaria caused by what protozoan? A) Plasmodium ovale B) Plasmodium falciparum C) Plasmodium vivax D) Plasmodium malariae
B
During a lecture on intestinal parasites, the students learn that what is the most commonly diagnosed intestinal parasite infection in the United States? A) Amebiasis B) Giardiasis C) Leishmaniasis D) Trichomoniasis
B
Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should receive patient teaching from the nurse, which includes instructions to receive what regularly? A) Cardiovascular studies B) Eye exams C) Immunizations D) Pulmonary studies
B
The nurse is caring for a patient receiving an antimycobacterial who reports dizziness, headache, and drowsiness. What is the priority nursing diagnosis? A) Imbalanced nutrition: less than body requirements B) Disturbed sensory perception (kinesthetic) related to central nervous system (CNS) effects of the drug C) Acute pain related to gastrointestinal (GI) effects of the drug D) Deficient knowledge regarding drug therapy
B
The nurse is preparing to contact the physician for an antibiotic order for the patient's infection. What information will the nurse be prepared to provide for the physician to choose the proper antibiotic? A) First day of infection symptoms B) Culture and sensitivity test results C) The patient's intake and output for past 2 days D) Results of complete blood count with differential
B
The nurse is providing patient teaching before discharging a patient home. The patient is taking ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent crystalluria caused by ciprofloxacin (Cipro)? A) Eliminate red meat and seafood from the diet. B) Encourage at least 2 liters of fluid per day. C) Avoid caffeine and alcohol. D) Spend time in the sun each day to optimize vitamin D levels.
B
The nurse works on a renal transplant unit and receives an order for posaconazole (Noxafil) for the patient which the nurse interprets to mean the patient has what infection? A) Blastomycosis B) Aspergillus C) Mucormycosis D) Coccidioidomycosis
B
The nurse, working in a pediatric clinic, admits a patient who will be traveling to a country where malaria is endemic. What is the safest treatment for this child? A) No prophylaxis is administered because of the severity of adverse effects. B) Call the Centers for Disease Control and Prevention (CDC) or local health department for the safest possible treatment. C) Administer extremely small doses of chloroquine. D) Any antimalarials in appropriate dosages can be administered.
B
The patient is having an acute malarial attack with chills and fever. The nurse knows chills and fever are caused by what? A) Formation of sporozoites into the system B) Rupture of red blood cells due to invasion of merozoites C) Invasion of the tsetse fly into the central nervous system D) Release of amastigotes into the blood vessels
B
The patient, a physician returning from a trip to the tropics, is prescribed chloroquine and asks the nurse how it works. What is the nurse's best response? A) Blocks the plasmodium's ability to synthesize ribonucleic acid B) Changes the metabolic pathways necessary for the reproduction of the plasmodium C) Interrupts the cell wall preventing entry of nutrients into the plasmodium D) It is alkaline and decreases the ability of the parasite to synthesize deoxyribonucleic acid (DNA).
B
What classification of medication will the nurse administer concurrently with amphotericin B (Fungizone) to help minimize the adverse reactions to this medication? A) Sedatives B) Antipyretics C) Beta-adrenergic blockers D) Diuretics
B
What drug used to treat influenza A should not be used by nursing mothers? A) Ribavirin (Rebetron) B) Rimantadine (Flumadine) C) Valganciclovir (Valcyte) D) Acyclovir (Zovirax)
B
What is the priority teaching point to be provided by the nurse to a patient being treated for trichomoniasis to prevent reinfection? A) "Meats should be fully cooked before eaten." B) "Sexual partners should be treated." C) "Wash hands before eating." D) "Purify all drinking water when camping."
B
What medication is only administered intravenously and is used to treat cytomegalovirus (CMV)? A) Cidofovir (Vistide) B) Foscarnet (Foscavir) C) Valacyclovir (Valtrex) D) Valganciclovir (Valcyte)
B
What severe reaction would the nurse assess for if it were necessary to administer trimethoprim/sulfamethoxazole (TMP/SMX) to an older adult? A) Diarrhea B) Bone marrow depression C) Vomiting D) Decreased gastrointestinal (GI) motility
B
When caring for a patient with a secondary immunodeficiency disease following kidney transplantation being treated for candidemia the nurse can anticipate receiving an order for what medication? A) Amphotericin B B) Anidulafungin C) Flucytosine D) Butoconazole
B
The nurse admits a patient suspected of having a fungal infection. What action will the nurse need to take before a systemic antifungal can be prescribed? (Select all that apply.) A) Initiate IV therapy. B) Assess history of liver or kidney disease. C) Obtain a culture of the fungus. D) Request the patient sign a consent form. E) Assess history of lymphatic disease.
B,C
The school nurse is preparing a lecture on hepatitis B for a health class in high school. What is an important teaching point for the nurse to include about the transmission of hepatitis B? (Select all that apply.) A) Hepatitis B is transmitted through the bite of an insect. B) Hepatitis B is transmitted through sexual contact. C) Hepatitis B is transmitted through blood-to-blood contact. D) Hepatitis B is transmitted from the mother to her unborn baby. E) Hepatitis B is transmitted through nonsexual household contact.
B,C,D
A client is prescribed metronidazole for the treatment of trichomoniasis. What is the most important information for the nurse to teach the client about proper administration of this medication? A. "Increase your fluid intake while taking this medication." B. "Do not drink alcohol while taking this medication." C. "Take the medication with meals if you have GI irritation." D. "Suck on sugar-free hard candy if you have a dry mouth." -
B. "Do not drink alcohol while taking this medication."
The client has just begun taking metronidazole and calls the clinic to report that her urine has turned very dark. What is the nurse's best response to this client? A. "Please come to the clinic as soon as possible for a urinalysis." B. "This is an expected side effect. Your urine color will return to normal after you stop taking this drug." C. "Go immediately to the emergency department because the medication is causing bleeding from your bladder." D. "If you drink more fluid, your urine will get light in color again." -
B. "This is an expected side effect. Your urine color will return to normal after you stop taking this drug."
A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? (ATI Pharm Chapter 17) A. "you can take this medication to abort an acute asthma attack" B. "Tremors are an adverse effect of this medication" C. "prolonged use of this medication can cause hyperglycemia" D. "this medication can slow skeletal growth rate"
B. "Tremors are an adverse effect of this medication"
A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, "What is my next step if i take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? (ATI Pharm Chapter 22) A. "take two more sublingual tablets at the same time" B. "call the emergency response team" C. "take a sustained-released nitroglycerin capsule" D. Wait another 5 minutes then take a second sublingual tablet "
B. "call the emergency response team"
A nurse is teaching the family of a child with cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions? (ATI Pharm Chapter 18) A. "expect this medication to suppress cough" B. "expect this medication to smell like rotten eggs" C. "expect this medication to cause euphoria" D. "expect this medication to turn your urine orange"
B. "expect this medication to smell like rotten eggs"
A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? (ATI Pharm Chapter 18) A. "I should use the spray every 4 hours while i am awake" B. "it can take as long as 3 weeks before the medication takes maximum effect" C. "this medication can also be used to treat motion sickness" D. I can use this medication when my nasal passage are blocked"
B. "it can take as long as 3 weeks before the medication takes maximum effect"
A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. which of the following instructions should the nurse include in the teaching? (ATI Pharm Chapter 17) A. Take the albuterol at the same time each day B. Administer the albuterol inhaler prior to using the beclomethasone inhaler C. Use beclomethasone if experiencing an acute episode D. Avoid shaking the beclomethasone before use
B. Administer the albuterol inhaler prior to using the beclomethasone inhaler
4. A nurse is caring for a client who has a new prescription for enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the adverse reactions of this medication? (Select all that apply.) A. Bleeding B. Pneumonia C. Cerebral edema D. Localized erythema E. Hypotension
B. CORRECT: Bacterial pneumonia with fever, cough, and difficulty breathing are manifestations of an adverse reaction to enfuvirtide. The nurse should assess breath sounds regularly. D. CORRECT: Enfuvirtide is administered subcutaneously. Injection‑site reactions, such as pain, redness, itching, and bruising, are common. E. CORRECT: A systemic allergic reaction can occur when taking enfuvirtide. Manifestations of hypersensitivity include rash, hypotension, fever, and chills.
1. A nurse is teaching a client about taking tetracycline to treat a GI infection due to Helicobacter pylori. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I will take this medication with 8 ounces of milk." B. "I will let my doctor know if I start having diarrhea." C. "I can stop taking this medication when I feel completely well." D. "I can take this medication just before bedtime."
B. CORRECT: Diarrhea can indicate that the client is developing a suprainfection, which can be very serious. The client should notify the provider if diarrhea occurs.
5. A nurse is teaching a client who has active tuberculosis about his treatment regimen. The client asks why he must take four different medications. Which of the following responses should the nurse make? A. "Four medications decrease the risk for a severe allergic reaction." B. "Four medications reduce the chance that the bacteria will become resistant." C. "Four medications reduce the risk for adverse reactions" D. "Four medications decrease the chance of having a positive tuberculin skin test."
B. CORRECT: If the client took only one medication to treat active tuberculosis, resistance to the medication would occur quickly. Taking three or four medications decreases the possibility of resistance.
2. A nurse in an outpatient facility is preparing to administer nafcillin (Unipen) IM to an adult client who has an infection. Which of the following actions should the nurse plan to take? (Select all that apply.) A. Select a 25-gauge, ½-inch needle for the injection. B. Administer the medication deeply into the ventrogluteal muscle. C. Ask the client about allergy to penicillin before administering the medication. D. Monitor the client for 30 min following the injection. E. Tell the client to expect a temporary rash to occur following the injection.
B. CORRECT: It is important to administer nafcillin IM into a deep muscle mass, such as the ventrogluteal site. C. CORRECT: It is important to ask the client about allergy to penicillin or other antibiotics before administering nafcillin. In general, a documented allergy to another penicillin or to a cephalosporin is a contraindication for administering nafcillin. D. CORRECT: When administering a parenteral penicillin or other antibiotic, it is important to monitor the client for 30 min for an allergic reaction.
1. A nurse is caring for a client who has diabetes mellitus, pulmonary tuberculosis, and a new prescription for isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH? A. Ascorbic acid B. Pyridoxine C. Folic acid D. Cyanocobalamin
B. CORRECT: Pyridoxine is frequently prescribed along with INH to prevent peripheral neuropathy for clients who have increased risk factors, such as diabetes mellitus or alcohol use disorder.
5. A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? A. Administer a concentrated solution. B. Infuse the medication over 60 min. C. Infuse the solution through the primary IV fluid's tubing. D. Choose a small peripheral vein for administration.
B. CORRECT: The nurse should administer ciprofloxacin IV over 60 min to minimize irritation of the vein.
2. A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to infuse. When should the nurse plan to obtain a blood sample for a peak serum level of gentamicin? A. 1000 B. 1030 C. 1100 D. 1130
B. CORRECT: The nurse should obtain the blood specimen for the peak serum level at 1030, 30 min after the end of the IV infusion. For the trough level, the nurse should collect the blood sample just before starting the infusion.
A client develops itching and burning of the vaginal vault while taking an anti-infective to treat strep throat. What fungal agent has caused the burning and itching? A. Cryptococcus neoformans B. Candida albicans C. Aspergillus D. Dermatophytes
B. Candida albicans
A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.) (ATI Pharm Chapter 25) A. Hypertension B. Coffee-ground emesis C. Tinnitus D. Paresthesias of the extremities E. Nausea
B. Coffee-ground emesis C. Tinnitus E. Nausea
A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions should the nurse plan to take? (ATI Pharm Chapter 25) A. Administer IM enoxaparin along with the alteplase dose B. Hold direct pressure on the puncture sites for up to 30 min C. Administer aminocaproic acid IV prior to alteplase infusion D. Prepare to administer alteplase within 8 hr of the manifestation onset
B. Hold direct pressure on the puncture sites for up to 30 min
A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40mg/0.4 mL to an adult client following hip arthroplasty. which of the following actions should the nurse plan to take? (ATI Pharm Chapter 25) A. Expel the air bubble from the prefilled syringe before injecting B. Insert the needle completely into the client's tissues C. Administer the injection in the client's thigh D. Aspirate carefully after inserting the needle into the client's skin
B. Insert the needle completely into the client's tissues
A nurse is caring for a client who states she has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following adverse effects of this medication? (ATI Pharm Chapter 18) A. Sedation B. Nasal congestion C. Productive cough D. Constipation
B. Nasal congestion
What is one method that the nurse can teach community members to prevent many parasitic infections? A. Avoidance of campgrounds B. Personal and public hygiene practices C. Avoidance of specific vacation spots D. Avoidance of nonbottled water -
B. Personal and public hygiene practices
A 43-year-old man is traveling to an area where malaria is endemic and is being treated prophylactically. The nurse will explain which regimens of chloroquine prescribed by the health care provider? A. Taking the medication for a total of 1 week before and for 2 weeks after the trip B. Taking the medication for 2 weeks before the trip and for 4 to 6 weeks after the trip C. Taking the medication for 2 weeks before the trip and continue for 2 months after the trip D. Taking the medication for 4 to 6 weeks before the trip and continue for 2 weeks after the trip -
B. Taking the medication for 2 weeks before the trip and for 4 to 6 weeks after the trip
A client is receiving chloroquine for a diagnosis of extraintestinal amebiasis. The nurse should provide information on which medication that is likely to be administered with chloroquine? A. iodoquinol B. metronidazole C. metyrosine D. carbamazepine -
B. metronidazole
Which of the following would a nurse identify as a surfactant?
Beractant
A nurse is caring for a patient who has been prescribed a nasal decongestant. Which of the following factors should the nurse assess before administering the drug? Vision Auditory tests Blood pressure Motor coordination
Blood pressure As a pre-administration assessment before giving a nasal decongestant, the nurse should assess the patient's blood pressure, pulse, and respiratory rates. Assessments for disturbed coordination, blurred vision, or auditory tests may be done as an ongoing assessment to check for signs of adverse effects
A 15-year-old patient is immunocompromised because of the adverse effects of chemotherapy. He or she has developed severe migraine headaches and is being treated with ergot. What drug would be contraindicated in this patient? A) Caspofungin B) Ketoconazole C) Posaconazole D) Terbinafine
C
A 17-year-old male patient with athlete's foot is extremely upset that he cannot get rid of it. He calls the clinic and asks the nurse whether the doctor can give him an antibiotic to "cure the infection." What should the nurse include in the explanation of treatment for fungal infections? A) "Fungi differ from bacteria in that the fungus has flexible cell walls that allow for free transfer into and out of the cell." B) "Protective layers contain sterols, which change the membrane permeability." C) "The composition of the protective layers of the fungal cell makes the organism resistant to antibiotics." D) "Fungi cell walls contain Candida, which makes the cells rigid.
C
A 25-year-old female patient presents at the clinic with fever, chills, and achy joints. The patient is diagnosed with influenza A, and ribavirin is prescribed. What should the nurse include in patient teaching about this medication? A) Advise women of childbearing age to remain on oral contraceptives for at least 1 month after finishing this medication. B) Advise women of childbearing age that this drug is also an abortifacient. C) Advise women of childbearing age to use barrier contraceptives. D) Advise women of childbearing age that this drug is safe for the fetus.
C
A 28-year-old woman is planning to be part of a mission team going to Central Africa. She will take mefloquine (Lariam) once a week, beginning 1 week before traveling to Africa until 4 weeks after leaving Africa. What precaution will the nurse teach this patient is needed? A) "Avoid excessive weight gain." B) "Have regular cancer screening." C) "Use contraceptives to avoid pregnancy." D) "Stop the medication if diabetes is diagnosed."
C
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 5 days. What would be important for the nurse to educate this patient about? A) Analgesics B) Antihistamines C) Contraceptives D) Decongestants
C
A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician has ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an oral suspension of 90 mg/5 mL. How many mL will the nurse administer? A) 5 mL B) 10 mL C) 15 mL D) 20 mL
C
A hospitalized patient is receiving an antiviral drug to treat cytomegalovirus. What is the nurse's priority action after administering the antiviral drug? A) Monitor vital signs every hour. B) Decrease fluid intake. C) Keep side rails up. D) Encourage the patient to ambulate 10 minutes after each dose.
C
A nurse is caring for a patient with HIV. What lab tests would the nurse monitor when a protease inhibitor has been ordered for this patient? A) A fasting blood sugar and 2-hour postprandial blood sugar B) Urine specific gravity and urine pH C) Serum alanine aminotransferase and bilirubin D) Arterial blood gases and O2 saturation
C
A patient comes to the clinic and is diagnosed with a vaginal fungal infection. The nurse provides patient information for self-administration of a vaginal antifungal medication. What will the nurse include in the instructions? A) "Insert low into the opening of the vagina." B) "Discontinue use during menstruation." C) "Remain recumbent for at least 15 minutes after insertion." D) "Rub the cream into the vaginal wall after insertion."
C
A patient comes to the clinic with a herpes outbreak. The nurse notes from the patient's chart that the patient is just beginning a course of antibiotics prescribed by another physician in the clinic. What classification of antibiotic should not be taken with an antiviral medication used to treat herpes? A) Penicillin B) Beta-Lactam C) Aminoglycoside D) Macrolide
C
A patient has just been diagnosed with HIV. When developing the teaching plan, what information would the nurse share with this patient related to use of alternative or complementary therapies? A) "Complementary therapies such as acupuncture or herbal therapy are dangerous to patients with HIV and you are discouraged from exploring these types of therapy." B) "Researchers have not looked at the benefits of alternative therapy for patients with HIV, so it is suggested you avoid these therapies until research data are available." C) "Alternative therapies have benefits and risks. Are there any types of alternative or complementary therapies that you follow or are there any herbs or supplements that you take?" D) "You do not take herbs or practice some type of alternative medicine such as acupuncture, massage therapy, hypnosis, or diet therapy, do you?"
C
A patient who has a tinea infection calls the clinic and complains of intense local burning and irritation with use of a topical antifungal drug. Even before asking the patient, the nurse suspects he or she is applying what medication? A) Butoconazole (Gynazole I) B) Ciclopirox (Loprox) C) Econazole (Spectazole) D) Haloprogin (Halotex)
C
A patient who is using a topical antifungal agent to treat mycosis calls the clinic to report a severe rash that is accompanied by blisters. What will the nurse instruct the patient to do? A) "Continue the drug as the prescription indicates." B) "Scrub the rash with soap and water." C) "Stop using the drug immediately." D) "Decrease the amount of the medication used."
C
A patient with a gram-negative infection is being treated with an aminoglycoside. What system should the nurse expect to monitor closely while the patient is taking this medication? A) Respiratory system B) Ophthalmic system C) Renal system D) Musculoskeletal system
C
A patient with high cholesterol is taking lovastatin (Mevacor). What drug would the nurse question if it was ordered for this patient? A) Nifedipine (Procardia) B) Ciprofloxacin (Cipro) C) Itraconazole (Sporanox) D) Oxazepam (Serax)
C
A patient with renal impairment and HIV has had a medication change. What drug would be considered the drug of choice for this patient? A) Atazanivir (Reyataz) B) Lopinavir (Kaletra) C) Nelfinavir (Viracept) D) Ritonavir (Norvir)
C
How does the nurse teach the patient to take chloroquine (Aralen Phosphate)? A) On an empty stomach B) With 8 ounces of water C) With meals D) With orange juice followed by 8 ounces of water
C
Pyrimethamine (Daraprim) has been ordered for the patient as prophylactic treatment of malaria. The nurse recognizes the action of this drug prevents relapse of the disease by acting on what? A) Changing the metabolic pathways for reproduction B) Disrupting the mitochondria of the plasmodium C) Blocking the use of folic acid D) Increasing the acidity of plasmodial food vacuoles
C
The emergency room nurse admits a patient suspected of having giardiasis. What symptoms would the nurse expect the patient to present with? A) Voluminous soft unformed stool B) Frothy voluminous pale stool C) Pale and mucous-filled stool D) Frothy tan stool
C
The nurse admits a patient diagnosed with a systemic fungal infection and is ordered IV fluconazole. When developing the plan of care for this patient, the nurse would use what nursing diagnosis related to this medication? A) Chronic pain related to the gastrointestinal (GI) system, central nervous system (CNS), and local effects of drug B) Risk for altered perfusion secondary to system cardiovascular effects of drug C) Disturbed sensory perception (kinesthetic) related to CNS effects D) Monitor IV sites to ensure that phlebitis or infiltration does not occur.
C
The nurse is assessing a patient admitted with AIDS who is taking a nonnucleoside reverse transcriptase inhibitor. What nursing diagnosis is most likely to be appropriate for this patient? A) Risk for injury related to central nervous system (CNS) effects of the drug B) Excess fluid volume related to renal failure C) Imbalanced nutrition: Less than body requirements, related to gastrointestinal (GI) effects of the drugs D) Ineffective health maintenance related to spiritual distress
C
The nurse is assessing the patient's medication history and learns the patient received a prescription for voriconazole from one provider and a prescription for an ergot alkaloid from another provider. The nurse realizes this patient is at risk for, and needs to be assessed for, what condition? A) Liver toxicity B) Central nervous system (CNS) depression C) Ergotism D) Renal toxicity
C
The nurse is caring for a child weighing 30 kg. The physician orders gentamicin (Garamycin) 100 mg tid for the patient. The recommended dosage range is 6 to 7.5 mg/kg/day. What action should the nurse take? A) Administer the medication and assess hearing frequently. B) Question the physician about the frequency of administration. C) Question the physician about the dosage of the medication. D) Administer the medication and assess renal function frequently.
C
The nurse is caring for a patient hospitalized with hepatitis B. The family comes to visit and a family member asks the nurse if it is safe to visit. What is the nurse's best response? A) "You seem fearful. Why do you think you are at risk?" B) "Don't worry, you will not contract the disease from the patient." C) "There is no risk unless you come in contact with blood and body fluids." D) "The patient should be isolated and have limited visitation."
C
The nurse is caring for a patient who is taking antimalarial medications. The nurse teaches the patient about the medication and explains the need to report what signs and symptoms immediately because of its association with a serious adverse effect? A) Loss of appetite B) Loss of hair C) Loss of vision D) Loss of sensation
C
The nurse is caring for a patient who just returned from a trip to South America and was infected by the protozoan Trypanosoma cruzi. What will the nurse assess for in this patient? A) Serious lesions in the skin B) Sleeping sickness C) Severe cardiomyopathy D) Yellowish green vaginal discharge
C
The nurse is caring for an asymptomatic preschool-aged child who has cystic fibrosis and has been exposed to influenza A before receiving the appropriate immunization. What antiviral medication might the nurse administer to this child? A) Rimantadine (Flumadine) B) Zanamivir (Relenza) C) Oseltamivir (Tamiflu) D) Amantadine (Symmetrel)
C
The nurse is providing discharge teaching for a patient going home on the medication entecavir (Baraclude). What is the priority teaching point for this patient? A) Take the whole course of the medication as prescribed. B) Take this medication with grapefruit juice. C) Do not stop taking this medication or allow the prescription to run out. D) The patient will take this medication for the rest of his life.
C
The nurse is providing discharge teaching to a patient who is being sent home on oral tetracycline (Sumycin). What instructions should the nurse include? A) Take the medication only once a day. B) Check pulse rate and hold the drug if lower than 60 beats per minute (bpm). C) Take the drug on an empty stomach. D) Take the medication with 2 ounces of water.
C
The nurse provides teaching about amphotericin B (Fungizone) for an 82-year-old patient. The nurse evaluates the patient understood teaching when he says he could develop what condition? A) Diabetes B) Liver necrosis C) Kidney damage D) Pancreatitis
C
What is the priority reason for the nurse to consider questioning an order for tetracycline in a child younger than 8 years of age? A) Children younger than 8 years of age cannot take tetracyclines. B) Weight-bearing joints have been impaired in young animals given the drugs. C) Tetracyclines can damage developing teeth and bone in children younger than 8 years of age. D) Liver and kidney function may be damaged when it is given to children under 8 years of age.
C
What liver function test is a sensitive indicator of injury to liver cells and useful in detecting acute liver disease such as hepatitis? A) Clotting factors B) SGGT C) Serum aminotransferases D) Alkaline phosphatase
C
What statement, if made by the nurse, would be correct? A) "Malaria can live without a host and be contracted from drinking standing water." B) "Any mosquito can carry the plasmodium that transmits malaria." C) "A major problem with controlling malaria is the mosquito that is resistant to insecticide." D) "Widespread efforts at mosquito control have never been helpful."
C
What statements made by the 36-year-old patient leads the nurse to believe that he or she has understood the teaching regarding metronidazole (Flagyl)? A) "I will refrain from operating heavy machinery while I am taking this medication." B) "I will avoid foods high in vitamin C." C) "I will not drink alcohol while I am taking this medication." D) "I will contact my physician if I have a cold."
C
When administering a topical antifungal via the vaginal route, what action would the nurse take? A) Place the patient in left lateral Sims' position. B) Applied using sterile technique C) Administered high into the vagina. D) Insert a tampon after insertion.
C
When discussing cephalosporins with the nursing class, the pharmacology instructor explains that this classification of drug is primarily excreted through which organ? A) Lung B) Liver C) Kidney D) Skin
C
A client is being treated with amphotericin B. Which statement indicates that the client has understood the client teaching? A. "The medication may cause diabetes." B. "The medication will cause liver necrosis." C. "The medication may cause kidney damage." D. "The medication will cause pancreatitis."
C. "The medication may cause kidney damage."
1. A nurse is caring for a client in an acute care setting who was admitted with a cerebral spinal fluid (CSF) infection caused by a highly gram-negative bacteria. Which of the following cephalosporin IV antibiotics should the nurse expect to be effective in treating this infection? A. Cefaclor (Ceclor) B. Cefazolin (Ancef) C. Cefepime (Maxipime) D. Cephalexin (Keflex)
C. CORRECT Rationale: Cefepime, a fourth-generation cephalosporin, is more likely to be effective against this infection than the other medications, which are from the first or second generation. Medications from each progressive generation of cephalosporin are more effective against gram-negative bacteria, more resistant to being destroyed by beta-lactamase, and more able to penetrate the CSF.
2. A nurse is infusing IV amphotericin B to a client who has a systemic fungal infection. The nurse should monitor the client for which of the following adverse effects of this medication? A. Hypoglycemia B. Constipation C. Fever D. Hyperkalemia
C. CORRECT: Amphotericin B can cause fever, chills, and nausea during the infusion. Pretreatment with diphenhydramine and acetaminophen can reduce these effects.
4. A nurse is teaching a client who is beginning a course of metronidazole to treat an infection. For which of the following adverse effects should the nurse instruct the client to stop taking metronidazole and notify the provider? A. Metallic taste B. Nausea C. Ataxia D. Dark‑colored urine
C. CORRECT: Ataxia, tremors, paresthesias of the extremities, and seizures are manifestations of CNS toxicity. The client should stop taking the medication and notify the provider if any of these effects occur.
3. A nurse is preparing to administer cefotaxime (Claforan) IV to a client who has a severe infection and has been receiving cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication and should be reported to the provider? A. Diaphoresis B. Epistaxis C. Diarrhea D. Alopecia
C. CORRECT: Diarrhea is caused by cefotaxime and other cephalosporins and should be reported to the provider. Severe diarrhea may indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening.
3. A nurse is administering IV amphotericin B to a client who has a systemic fungal infection. The nurse should monitor which of the following laboratory values? (Select all that apply.) A. Serum calcium B. Serum amylase C. Serum potassium D. Hematocrit E. Serum creatinine
C. CORRECT: Hypokalemia is a serious adverse effect of amphotericin B. The nurse should monitor serum potassium values for hypokalemia. D. CORRECT: Amphotericin B can cause bone marrow suppression. The nurse should monitor CBC and platelet count periodically. E. CORRECT: Amphotericin B can cause nephrotoxicity. The nurse should monitor kidney function (with serum creatinine, BUN, and creatinine clearance).
4. A nurse is taking a medication history for a hospitalized client who is to receive imipenem-cilastatin IV to treat an infection. Which of the following medications taken by the client places the client at risk for medication interaction? A. Regular insulin (Humulin R) B. Furosemide (Lasix) C. Valproic acid (Depakote) D. Ferrous sulfate (Feosol)
C. CORRECT: Imipenem-cilastatin decreases blood levels of valproic acid, an anti seizure medication, putting the client at risk for increased seizure activity. Combination of these two medications should be avoided. If they must be taken concurrently, the nurse should monitor the client for seizures.
1. A nurse is teaching a client who has a new prescription for combination oral NRTIs (abacavir, lamivudine, and zidovudine) for treatment of HIV. Which of the following statements should the nurse include? A. "These medications work by blocking HIV entry into cells." B. "These medications work by weakening the cell wall of the HIV virus." C. "These medications work by inhibiting enzymes to prevent HIV replication." D. "These medications work by preventing protein synthesis within the HIV cell."
C. CORRECT: The NRTI antiretroviral medications this client takes work by inhibiting the enzyme reverse transcriptase and preventing HIV replication.
5. A nurse is administering IV acyclovir to a client who has varicella. Which of the following actions should the nurse take? A. Administer a stool softener. B. Decrease fluid intake following infusion. C. Infuse acyclovir over 1 hr. D. Monitor for a for hypotension
C. CORRECT: The nurse should administer IV acyclovir slowly, over at least 1 hr, to prevent nephrotoxicity.
6. A nurse is teaching a client who is beginning highly active antiretroviral therapy (HAART) for HIV infection about ways to prevent medication resistance. Which of the following information should the nurse teach the client about resistance? A. Taking low dosages of antiretroviral medication minimizes resistance. B. Taking one antiretroviral medication at a time minimizes resistance. C. Taking medication at the same times daily without missing doses minimizes resistance. D. Changing the medication regimen when adverse effects occur minimizes resistance.
C. CORRECT: The nurse should emphasize the importance of taking each dose of medication exactly as prescribed. Missing even a few doses of antiretroviral medication can promote medication resistance, which can cause treatment failure.
5. A nurse is caring for a client who is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should the nurse expect to administer specifically to suppress normal flora in the GI tract? A. Kanamycin B. Gentamicin C. Neomycin D. Tobramycin
C. CORRECT: The nurse should expect to administer neomycin, an aminoglycoside antibiotic, orally prior to GI surgery to rid the large intestine of normal flora.
4. A nurse is planning discharge teaching for a female client who has a new prescription for trimethoprim‑sulfamethoxazole. Which of the following information should the nurse include? A. Take the medication even if pregnant. B. Maintain a fluid restriction while taking it. C. Take it on an empty stomach. D. Stop taking it when manifestations subside.
C. CORRECT: The nurse should inform the client that she may take the medication with or without food.
Which statement best reflects the use of antimalarial agents for treatment of the protozoan? A. Typically, a single drug is sufficient to destroy the sporozoites in the early stages. B. Quinine is considered the current mainstay of treatment for malaria. C. Combination therapy is used to attack the parasite at various life cycle stages. D. The development of resistant strains of the parasite against antimalarial agents is rare. -
C. Combination therapy is used to attack the parasite at various life cycle stages.
A client has been diagnosed with an amebiasis infection, and the primary health care provider has prescribed metronidazole. The client is also taking warfarin for blood clotting. Which is a possible interaction associated with taking metronidazole with warfarin? A. Increases absorption of metronidazole B. Increases metabolism of metronidazole C. Increases the risk of bleeding D. Increases the risk of heart attack -
C. Increases the risk of bleeding
A client receiving which agent should be instructed to avoid alcohol consumption? A. Pentamidine B. Atovaquone C. Metronidazole D. Nitazoxanide -
C. Metronidazole
A nurse is caring for a client who has arterial fibrillation and a new prescription for dabigatran to prevent development go thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran? (ATI Pharm Chapter 25) A. Vitamin K1 B. Protamine C. Omeprazole D. Probenecid
C. Omeprazole
A nurse is caring for a hospitalized client who is receiving IV heparin for a deep-vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? (ATI Pharm Chapter 25) A. Vitamin K1 B. Atropine C. Protamine D. Calcium gluconate
C. Protamine
A nurse is teaching a client who has a new prescription for dextromethorphan to suppress cough. the nurse should instruct the client to monitor for which of the following adverse effects of this medication? (ATI Pharm Chapter 18) A. Diarrhea B. Anxiety C. Sedation D. Palpations
C. Sedation
A client has been placed on amphotericin B. The nurse caring for this client should administer this medication: A. intramuscularly. B. orally. C. intravenously. D. subcutaneously.
C. intravenously.
A patient taking nevirapine (Viramune) as part of combination therapy for treatment of HIV took 200 mg/daily PO for 14 days. The patient is now taking 200 mg PO bid. How many mg of the medication is the patient taking daily? A) 100 mg B) 200 mg C) 300 mg D) 400 mg
D
When providing health education to an adult who is taking an over-the-counter (OTC) combination cold and cough remedy, the nurse should encourage the client to implement what intervention to best assure medication safety? Start with a low dose and gradually increase it until symptoms are relieved. Withhold the medication until a prescription is obtained from a care provider. Carefully read the label and adhere to the guidelines for use. Administer the medication with an additional dose of acetaminophen to potentiate therapeutic effects.
Carefully read the label and adhere to the guidelines for use.
The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply:
Check blood pressure. Check pulse. Check respiratory rate
A nurse would expect to increase the dosage of theophylline if the client has a current history of which of the following?
Cigarette smoking
How should the nurse adapt the plan of care when caring for an older adult receiving an antiprotozoal agent? A. Clients should be monitored more closely for toxic adverse effects. B. The drug dosage should be lowered for all older adults. C. Antiprotozoal agents should not be administered to older adults. D. Female clients of appropriate age should be advised to use barrier contraceptives to prevent genitourinary infections. -
Clients should be monitored more closely for toxic adverse effects.
Which agent acts directly on the medullary cough center? Ephedrine Benzonatate Codeine Tetrahydrozoline
Codeine- Medulla (antitussive) benxonatate also antitussive but works directly on respiratory tract
A client prescribed antiasthmatic drugs should be encouraged to avoid excessive intake of what beverage?
Coffee
A nurse is providing discharge planning for a 45-year-old woman who has a prescription for oral albuterol. The nurse will question the patient about her intake of which of the following?
Coffee
Infections caused by protozoa are relatively rare in the United States, but with people moving throughout the world in increasing numbers, it is not unusual to find a person who returns home from travel with a fully developed protozoal infection. Which of the following areas are where protozoa infections are most prevalent? Select all that apply. A. Columbia B. Canada C. Thailand D. Egypt E. Ireland -
Columbia Thailand Egypt
A client is started on trimethoprim and sulfamethoxazole for a urinary tract infection. The client reports nausea, anorexia, and abdominal pain. What intervention does the nurse discuss with the client? A. Drink frequent sips of water. B. Consume the medication with food. C. Call the prescriber for pain medication. D. Avoid driving and performing tasks that require alertness. -
Consume the medication with food
The nurse is reviewing a client's morning blood work and notes a theophylline level of 22.2 mcg/mL (123.21 µmol/L). What action should the nurse take?
Contact the care provider and inform him or her that the client has toxic theophylline levels.
A patient has been prescribed ribavirin for influenza A. The patient is experiencing nausea, vomiting, and diarrhea. What would the nurse be sure to include in the patient teaching about this medication? A) Do not take with anticholinergic medications. B) Do not take with acetaminophen or aspirin. C) Do not take with antiarrhythmics. D) Do not take with antacids.
D
A patient newly diagnosed with HIV is receiving patient teaching from the clinic nurse about antiviral medications. What would the nurse tell the patient needs to be reported to a health care provider? A) Dizziness B) Constipation C) Vomiting D) Rash
D
A group of students are reviewing the various drugs that affect inflammation. The students demonstrate understanding when they identify which agent as a mast cell stabilizer?
Cromolyn
A 12-year-old patient with a complicated skin infection has been admitted to the pediatric unit. The physician has ordered Ertapenem (Invanz). What is the nursing priority? A) Transcribe the order to the medication administration record (MAR). B) Perform hand hygiene before preparing the medication. C) Assess the patient's renal and hepatic functions. D) Question the order by calling the physician who prescribed it.
D
A 22-year-old female is diagnosed with mycobacterial tuberculosis. The physician orders rifampin (Rifadin) 600 mg PO daily. What should the nurse question the patient about? A) Her diet B) Sun exposure C) Type of exercise she does D) Use of contact lenses
D
A nonnucleoside reverse transcriptase inhibitor has direct effects on the HIV virus activities within the cell. What drug is a nonnucleoside reverse transcriptase inhibitor? A) Econazole nitrate (Spectazole) B) Oxaliplatin (Eloxatin) C) Olanzapine (Zyprexa) D) Efavirenz (Sustiva)
D
A patient, recently returned from a vacation in the tropics, is diagnosed with leishmaniasis. The patient asks the nurse how he or shes got this disease. What is the nurse's best response? A) "You got this disease from a mosquito bite." B) "You got this disease from unsanitary drinking water." C) "You got this disease from eating unsanitary food." D) "You got this disease from the bites of sand flies."
D
A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor? A) Taking drugs not prescribed for the particular illness tends to maximize risks and minimize benefits. B) Never use antibiotics in combination with other prescriptions or in combination with other antibiotics. C) Maximize antibiotic drug therapy by administering the full dose when the patient has a fever. D) Use antibiotics cautiously and teach patients to complete the full course of an antibiotic prescription.
D
An 85-year-old man who is a resident in an extended-care facility has athlete's foot. After applying an antifungal cream, what is the nurse's next action? A) Wipe away excess medication from the affected area. B) Wrap a sterile kling dressing around both feet. C) Elevate the feet for 30 minutes. D) Apply clean dry socks.
D
An intensive care unit nurse is caring for a patient taking kanamycin. What is the nurse's priority action? A) Giving the drug for no longer than 7 days B) Assessing liver function daily C) Contacting the ordering physician D) Monitoring renal function daily
D
How would the nurse describe selective toxicity? A) Selective toxicity interferes with a biochemical reaction common to many different organisms. B) Selective toxicity will decrease invading bacteria by interfering with the pathogens' ability to reproduce. C) Selective toxicity will eliminate bacteria by interrupting protein synthesis and damaging the pathogen's cell wall. D) Selective toxicity is the ability of the drug to kill foreign cells without causing harm to one's own body cells.
D
The nurse admitted a 25-year-old woman to the unit. What would be the most important thing for the nurse to assess before administering ketoconazole? A) Complete blood count (CBC) and blood glucose B) Eating and sleeping habits C) Height and weight D) Renal and hepatic function
D
The nurse is caring for a patient receiving an oral fungicide to treat a systemic fungal infection. What intervention would the nurse include in the plan of care? A) Maintain complete bed rest. B) Assess for cyanosis every 4 hours. C) Administer medication 1 hour before meals. D) Monitor nutritional status.
D
The nurse is caring for a patient who is being treated with quinine (Qualaquin) for drug-resistant malaria. The nurse will monitor the patient for cinchonism that will present with what manifestations? A) Diarrhea, nausea, and fever B) Yellowing of the sclera and skin C) Tremors and ataxia D) Vomiting, tinnitus, and vertigo
D
The nurse is caring for a patient with acquired immunodeficiency syndrome (AIDS) who has been diagnosed with Pneumocystis jiroveci pneumonia. The patient is taking multiple oral agents to treat AIDS. What would be the drug of choice for this patient? A) Nitazoxanide (Alinia) B) Chloroquine C) Metronidazole D) Pentamidine
D
The nurse is caring for a patient with hepatitis B. The patient is taking adefovir (Hepsera). Which medication would the nurse question if it were ordered? A) Cimetidine (Tagament) B) Diltiazem (Cardizem) C) Diphenhydramine (Benadryl) D) Telbivudine (Tyzeka)
D
What antifungal would be appropriate for the nurse to administer to treat a patient with an oropharyngeal candidiasis? A) Itraconazole B) Fluconazole C) Posaconazole D) Clotrimazole
D
What antimalarial medication is used as a radical cure of Plasmodium vivax malaria? A) Chloroquine B) Mefloquine C) Pyrimethamine D) Primaquine
D
What drug would the nurse administer orally without the need to question when treating infections caused by Candida albicans? A) Amphotericin B (Abelcet) B) Tolnaftate (Tinactin) C) Griseofulvin (Fulvicin) D) Fluconazole (Diflucan)
D
What drug would the nurse administer to treat chronic hepatitis C in children and adults who relapse after interferon-alfa therapy? A) Zanamivir (Relenza) B) Acyclovir (Zovirax) C) Cidofovir (Vistide) D) Ribavirin (Virazole)
D
What drug would the nurse recognize as contraindicated for pediatric use? A) Fluconazole B) Terbinafine C) Griseofulvin D) Flucytosine
D
What medication could the nurse administer in a single dose for effective treatment of the patient's vaginal candidal infection? A) Caspofungin (Cancidas) B) Terbinafine (Lamisil) C) Ketoconazole (Nizoral) D) Tioconazole (Monistat-1)
D
What medication would the nurse question if ordered for a pediatric patient? A) Amikacin B) Cefazolin C) Streptomycin D) Levofloxacin
D
While calculating the drug dose of antiviral medications for children who have AIDS a pediatric nurse uses what? A) The viral complications B) The child's age C) The severity of the virus D) The child's weight
D
What effect is associated with a first-generation H1 receptor antagonist? It raises the seizure threshold by impairing vitamin D. It depletes norepinephrine and serotonin. It catalyzes the enzymatic oxidation of uric acid. It decreases capillary permeability.
It decreases capillary permeability.
A client is receiving flucytosine. The nurse is reviewing the client's serum drug level. Which serum drug level would lead the nurse to suspect that the client is developing toxicity? A. 22 mcg/mL B. 45 mcg/mL C. 88 mcg/mL D. 110 mcg/mL
D. 110 mcg/mL
3. A nurse is caring for a client who is taking ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication? A. Increased TSH level B. Decreased ALT level C. Hypoglycemia D. Hyperlipidemia
D. CORRECT: Hyperlipidemia with increased cholesterol and triglyceride levels can occur as an adverse effect of ritonavir.
The azole antifungals are contraindicated in clients with what condition? A. Hypovolemia B. Pancreatitis C. HIV D. Increased liver enzymes
D. Increased liver enzymes
A nurse us caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? (ATI Pharm Chapter 22) A. Furosemide B. Captopril C. Ranolazine D. Metoprolol
D. Metoprolol
Which of the following effects would result from the action of montelukast?
Decreased eosinophil migration
A client calls the clinic and reports symptoms of a cold. The client is most concerned because the cold symptoms are preventing him from sleeping. The nurse would inform the client that what medication relieves cold symptoms and aids sleep? Phenergan Diphenhydramine Epinephrine Antihistamine
Diphenhydramine
A nurse is describing the action of a prescribed antihistamine to a client. The nurse is describing which medication, by explaining that the drug elicits its antihistamine effects by nonselectively binding to central and peripheral H1 receptors? Loratadine Diphenhydramine Fexofenadine Cetirizine
Diphenhydramine all other are 2nd generation antihistamines
A 76-year-old client has been prescribed an oral antihistamine. What adverse effect presents a priority safety concern for older adult clients? Drowsiness Nonproductive cough Dry mouth Nasal burning
Drowsiness
A client is admitted to the emergency department with inspiratory stridor and air hunger. When anticipating treatment, the nurse will prepare which medication for administration?
Epinephrine
After teaching a group of students about leukotriene receptor antagonists, the instructor determines a need for additional teaching when the students identify which agent as an example?
Fluticasone
An 8-year-old client reports shortness of breath, cough, and chest tightness when participating in gym class. The client is diagnosed with exercise-induced asthma. What inhaled drug therapy is the health care provider most likely to prescribe?
Formoterol (Foradil), a highly selective beta-2 agonist
A group of nursing students are reviewing information about expectorants. The students demonstrate understanding when they identify which medication as an example? Acetylcysteine Benzonatate Guaifenesin Dextromethorphan
Guaifenesin
A female client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client? Aspirin Codeine Guaifenesin Dextromethophan
Guaifenesin Expectorants, such as guaifenesin, are agents given orally to liquefy respiratory secretions and allow for easier removal. Dextromethorphan and codeine are antitussives used to suppress coughing
A nurse is providing education to a 56-year-old man who is admitted to the emergency department with an acute asthma attack. The nurse's initial assessment reveals that the patient has a history of pneumonia, drinks large quantities of coffee, and eats a high-calorie diet. Albuterol is prescribed for him. The important consideration when the nurse is preparing a teaching plan will be that the patient
Has a high coffee intake
A nurse is required to educate a patient prescribed albuterol on the adverse effects associated with the drug. Which of the following symptoms, if experienced, should the nurse instruct the patient to report to the health care provider?
Headache and flushing
When teaching a patient to use a dry powder inhaler, which of the following is true? Select all that apply:
Hold breath for 10 seconds. Inhale quickly.
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?
I'll keep taking my medications until I'm not experiencing any more symptoms."
5. A nurse is preparing to administer ceftriaxone (Rocephin) 0.5 g IM to a client in a long-term care facility. Available is ceftriaxone diluted to 350 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth.)
If there is 350 mg/mL and the prescribed amount is 0.5 g (500 mg), it makes sense to give 1.4 mL. The nurse should administer ceftriaxone injection 1.4 mL IM.
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?
Increased serum theophylline
The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?
Ineffective breathing pattern
Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic? A. Inhibition of synthesis of bacterial proteins B. Inhibition of synthesis of DNA only C. Inhibition of mitochondrial reproduction D. Inhibition of cell wall osmosis -
Inhibition of synthesis of bacterial proteins
A client, diagnosed with Trichomonas vaginalis, is being treated with metronidazole orally. What instruction is most important for the nurse to provide this client to minimize the spread of this infection? A. Instruct her on safe sex. B. Instruct her to drink red wine. C. Instruct her to take two tablets if a dose is missed. D. Instruct her to have her partner treated. -
Instruct her to have her partner treated.
Which agents would the nurse identify as selectively and competitively blocking the receptors for the production of two substances that are components of SRSA?
Leukotriene receptor antagonists
When teaching a client about his prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death?
Long-acting beta-2 agonists
A male client is prescribed montelukast and uses it successfully to manage his asthma. He develops hepatitis C. What would the nurse expect the health care provider to do?
Maintain the same dose of the montelukast
What information about antibiotic therapy should the nurse include in a client's medication education? A. Bacteria can remain in the body for up to 48 to 72 hours after the completion of antibiotic therapy. B. Maintenance of normal bacterial flora is essential to health during the therapy. C. The healthy human body hosts dozens of minor infections at any given time. D. An aseptic internal environment only exists in young adults. -
Maintenance of normal bacterial flora is essential to health during the therapy.
Which medication is used to treat acute airflow obstruction?
Metaproterenol
A female client calls the pediatrician's office for a suggestion regarding the best over-the-counter cough and cold medicine for her 6-month-old child. The pediatrician advises against the medication for what reason? The medication is contraindicated for viral infections. The medication is not effective for croup. Misuse could result in overdose. The medication is contraindicated for the child's symptoms.
Misuse could result in overdose. Several OTC cough and cold medicines for use in infants have been recalled voluntarily due to concerns about possible misuse that could result in overdoses.
A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions? Expectorant Antihistamine Mucolytic Centrally acting antitussive Peripherally acting antitussive
Mucolytic
After teaching a group of students about zafirlukast, the students demonstrate understanding when they identify which as possible adverse effects? (Select all that apply.)
Myalgia Dizziness Vomiting
Which would contraindicate the use of a topical nasal decongestant? Glaucoma Hypertension Diabetes Nasal ulceration
Nasal ulceration all others are cautionary
The nurse should monitor the client for which common side effects of erythromycin therapy? A. Headache and fever B. Urticaria and opthalmic drainage C. Nausea, vomiting, and diarrhea D. Shortness of breath and sore throat -
Nausea, vomiting, diarrhea
The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?
Nervousness
A client with COPD takes theophylline. The nurse identifies that the client is still experiencing severe dyspnea. Upon review of labs, the theophylline level remains nontherapeutic. The nurse evaluates the client for which of the following drugs that may cause decreased theophylline levels?
Nicotine
A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.)
Pollutants Allergens Exercise
A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects? Phenylephrine Pseudoephedrine Ephedrine Epinephrine
Pseudoephedrine
The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring? A. Gray syndrome B. Red man syndrome C. Serotonin syndrome D. Cushing's syndrome -
Red man syndrome
A client has been taking vancomycin 750 mg PO q6h for the past four days to treat Clostridium difficile-related diarrhea. The nurse learns that the client's 24-hour urine output was 550 mL yesterday and that is has been 125 mL over the past 12 hours. What is the nurse's best action? A. Report the findings promptly to the client's care provider. B. Encourage oral fluid intake and monitor closely. C. Recognize and document the expected adverse effects of vancomycin. D. Ask about the client's pre-illness levels of urine output. -
Report the findings promptly to the client's care provider.
A male client is diagnosed with chronic bronchitis. What would the nurse expect to be one of his physical reports? Rhinitis Rhinorrhea Retention of secretions Chronic nasal swelling
Retention of secretions
What home remedies are effective for mouth dryness and cough? (Select all that apply.) Administration of over-the-counter antihistamine Sucking on hard candy or throat lozenges Humidification of the environment Swishing the mouth with astringent mouthwash. Adequate fluid intake
Sucking on hard candy or throat lozenges Humidification of the environment Adequate fluid intake
A group of students demonstrate understanding of topical decongestants, identifying them as: Parasympathomimetics Sympathomimetics Parasympatholytics Sympatholytics
Sympathomimetic
The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the health care provider before administering the ordered medication? A. Takes high-dose furosemide (Lasix) daily B. Had prostate surgery 3 months ago C. History of hypothyroidism D. Allergy to peanuts and peanut products -
Take high-dose furosemide (Lasix) daily
A 62-year-old client has been prescribed an antihistamine to alleviate vasomotor rhinitis. The client reports gastric irritation after taking the tablet. Which instructions should the nurse provide to help alleviate the client's condition? Take the tablet with food. Take an antacid before the tablet. Take the tablet one hour before food. Drink ample water before taking the tablet.
Take the tablet with food
After teaching a group of students about topical nasal steroid decongestants, the instructor determines the need for additional teaching when the students identify which as an example? Fluticasone Triamcinolone Tetrahydrozoline Flunisolide
Tetrahydrozoline- topical nasal decongestant
The nurse is providing care for an older adult who has a urinary tract infection. What aspect of this client's current health status should the nurse focus on when ensuring safe and effective antibiotic therapy? A. The client has a history of cirrhosis. B. The client has type 2 diabetes controlled with diet. C. The client uses bronchodilators for the treatment of asthma. D. The client had a hip fracture 8 months ago. -
The client has a history of cirrhosis
What assessment finding would signal the nurse to the possibility that the client's infusion of vancomycin is running too quickly? A. The client is flushed and has a visible skin rash. B. The client's apical heart rate is irregular. C. The client is reporting nausea. D. The client reports pain at the intravenous access site. -
The client is flushed and has a visible skin rash.
A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis. He has been prescribed theophylline by his family provider. What effect will the client's smoking status have on the therapeutic use of theophylline?
The client may require higher doses of theophylline than a nonsmoker
A hospital client's medication administration record specifies concurrent doses of nebulized ipratropium and albuterol at 08:00 and 20:00. When administering these drugs, the nurse should base the intervention on which fact?
The two drugs can be mixed in the nebulizer immediately before administration.
The nursing instructor is discussing the use of nasal decongestants and shares what reason for their effectiveness? They treat multiple symptoms in a cost-effective manner. They come into direct contact with nasal mucosa. They are absorbed systemically. Their effects last for 48 to 72 hours.
They come into direct contact with nasal mucosa.
A client is asking how fluoroquinolones work. What is the nurse's best response? A. They inhibit the growth of the bacteria. B. They disrupt the cell membrane of the bacteria. C. They interfere with the DNA of the bacteria. D. They promote WBC development from the bone marrow. -
They interfere with the DNA of the bacteria.
A 21-year-old patient reports a mild stinging sensation on using a nasal spray containing a nasal decongestant. Which information should the nurse provide the patient? Consult the physician immediately. Dose of the medication needs reduction. Medication needs to be stopped immediately. This sensation usually disappears with continued use.
This sensation usually disappears with continued use.
A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which can be an adverse effect of the drug? A. Yellow-gray-brown discoloration of the teeth B. Toxic effects to the developing fetus C. Increase in the blood pressure D. Bacterial overgrowth of nonsusceptible organisms -
Toxic effects to the developing fetus
A premenopausal woman has been bothered with recurrent urinary tract infections. What antibiotic after sexual intercourse would assist in preventing the recurrence of infection? A. Amoxicillin (Amoxil) B. Trimethoprim-sulfamethoxazole (Bactrim) C. Pyridium (phenazopyridine hydrochloride) D. Anaspaz (hyoscyamine sulfate) -
Trimethoprim-sulfamethoxazole (Bactrim)
Ketoconazole is available in oral form, a shampoo, and a cream. False True
True
Leukotriene receptor antagonists are administered orally.
True
True/False: Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.
True; add pneumonia
Fluoroquinolones, such as norfloxacin (Noroxin), are commonly prescribed antibiotics given to treat which of the following? A. Yeast infections B. Respiratory infections C. Severe skin infections D. Urinary tract infections -
Urinary tract infections
When developing the teaching plan for a client receiving an antihistamine, which would the nurse include? (Select all that apply.) Using sugarless candies or lozenges to combat dry mouth Advising the client to avoid alcohol consumption Encouraging the client to engage in usual activities such as driving Stopping the drug after 3 days if no relief is obtained
Using sugarless candies or lozenges to combat dry mouth Advising the client to avoid alcohol consumption
When describing the action of decongestants, a nurse integrates knowledge of this class of drugs, identifying which mechanism? Nonselectively binding to central and peripheral H1 receptors Vasoconstriction of small blood vessels of the nasal membranes Selectively binding to peripheral H1 receptors Anesthetizing stretch receptors in the respiratory passages
Vasoconstriction of small blood vessels of the nasal membranes
A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as; a. superinfection. B. allergy. C. allergic reaction. D. skin rash. E. analphylactic reaction.
a
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 renal insufficiency B. assessing for the presence of asthma C. assessing for hypertension D. assessing for diabetes mellitus
a
A client is being treated with saquinavir for AIDS. The client history includes a BMI of 37.98%, hyperlipidemia, and sleep apnea. Based on the client history, why would caution be used when the client is started on saquinavir? A. There are potential adverse effects associated with hyperlipidemia. B. Saquinavir has a possible association with cardiovascular events. C. It may cause an exacerbation requiring a dosage change. D. The drug is largely metabolized by the liver.
a
A client is diagnosed with cytomegalovirus infection and is to receive foscarnet. The nurse would expect to administer this drug by which route? A. Intravenous B. Topical C. Oral D. Intramuscular
a
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? a. Serum BUN and creatinine levels B. Coagulation studies C. Complete blood count D. Signs of disulfiram-like reaction
a
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? A. Liver function studies B. Audiometric studies C. Pulmonary function studies D. Urine culture
a
A client is taking rifampin (Rifadin) for active TB. The nurse should stress that what may be caused by the use of this drug? a. body fluids such as urine, saliva, tears, and sputum may become discolored. B. the drug usually causes cardiac arrhythmias. C. facial flushing may appear but will go away once therapy is concluded. D. the drug frequently causes seizure activity.
a
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? a. changing to a different antibiotic B. changing to parenteral administration of rifaximin C. supplementing the antibiotic with vitamin K D. increasing the dose of rifaximin
a
A client with HIV is frustrated by the size and complexity of the current medication regimen. What should the nurse teach the client about combination therapy for the treatment of HIV? A. Use of combination therapy attacks the virus at different stages of the life cycle. B. One drug combats the virus while the others are prescribed to diminish the adverse effects. C. Use of multiple drugs ensures sensitivity to various viral forms. D. The client's immune response is enhanced with multiple drugs.
a
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 A. route. B. choice of drug. C. frequency. D. dose.
a
A client with a fungal infection has been prescribed a miconazole vaginal suppository. What education should the nurse provide about safe and effective administration? A. "If possible, lie down for 10 or 15 minutes after inserting the medication." B. "Take showers rather than baths until you've finished the course of medication." C. "Insert the medication into your lower vagina so that it's distributed evenly." D. "You can douche up to once per day to help distribute the medication."
a
A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to A. complete the entire course of drug therapy. B. take the drug only in safe and secure home settings. C. reduce the dosage of ciprofloxacin gradually. D. take the drug through subcutaneous injection if it tastes bad.
a
A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV infections. Which would the nurse include as the primary reason? A. The use of multiple drugs allows attack on the virus at different points in its life cycle. B. More than one drug is needed to ensure sensitivity to the different forms of the virus. C. One drug helps to control the virus, while the other drugs help to alleviate the adverse effects. D. Using several drugs at once helps to improve the client's immune response.
a
A nurse is preparing a presentation for a local community group after media reports about cases of avian influenza in the surrounding region. When explaining the treatment options for avian flu, the nurse should reference what drug? A. Oseltamivir B. Ribavirin C. Zanamivir D. Rimantadine
a
A nurse is preparing to administer IV acyclovir to a client diagnosed with a herpes simplex viral infection. The health care provider has ordered 5 mg/kg every 8h. The client weighs 60 kg. How much medication will the nurse administer per dose? A. 300 mg B. 600 mg C. 1200 mg D. 900 mg
a
A patient with AIDS is being prepared for discharge. The nurse caring for the patient with AIDS knows the patient receives Agenerase. What dietary counseling will the nurse provide based upon the patient's medication regimen? A. Avoid high-fat meals while taking this medication B. Limit sodium intake to 2 grams per day. C. Limit fluid intake to 2 liters a day D. Avoid meals high in protein while taking this medication
a
A patient with a throat infection has been recommended penicillin therapy by the primary health care provider. Before administering the first dose of penicillin to the patient, which interventions should the nurse perform as part of the pre-administration assessment? a. Obtain patient's general health history. B. Evaluate the patient's lifestyle and diet. C. Perform renal and hepatic function tests. D. Inspect patient's stools.
a
A patient with chronic hepatitis B (HBV) infection is scheduled to begin a new treatment regimen that will include adefovir dipivoxil (Hepsera). What assessments should be prioritized before the initiation of this drug treatment? A. Liver function testing and HIV testing B. Pulmonary function testing and echocardiogram C. Cardiac stress test and blood cultures D. Complete blood count and prothrombin time (PT)
a
A person with hypertension and known heart disease has frequent bronchospasms and asthma attacks that are most responsive to sympathomimetic drugs. This patient might be best treated with A. an inhaled sympathomimetic to decrease systemic effects. B. a xanthine. C. no sympathomimetics because they would be contraindicated. D. an anticholinergic.
a
After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement? a. "I need to wear protective clothing when I'm out in the sun." B. "I will take the drug with an antacid to prevent an upset stomach." C. "I should limit the amount of fluids that I drink." D. "I should chew gum and chocolate if my mouth gets sore."
a
An aminoglycoside antibiotic might be the drug of choice in treating A. serious infections caused by susceptible strains of gram-negative bacteria. B. otitis media in an infant. C. cystitis in a woman who is 4 months pregnant. D. suspected pneumonia before the culture results are available.
a
Antihistamines should be used very cautiously in patients with A. a history of arrhythmias or prolonged QT intervals. B. COPD or bronchitis. C. asthma or seasonal rhinitis. D. angioedema or low blood pressure.
a
How will a client's newly prescribed fluconazole be affected by long-term prescribed calcium channel blocker therapy? A. It will increase the effect of the fluconazole. B. It will increase the chance of fluconazole-related adverse effects. C. It will increase the risk of blood dyscrasias. D. It will render the fluconazole ineffective.
a
In which clients are the use of cidofovir contraindicated? A. clients with renal impairment B. clients with low blood cell counts C. clients with history of epilepsy D. clients with cardiac disease
a
Nursing interventions for the patient receiving antiviral drugs for the treatment of HIV probably would include A. monitoring renal and hepatic function periodically during therapy. B. administering the drugs just once a day to increase drug effectiveness. C. encouraging the patient to avoid eating if GI upset is severe. D. stopping the drugs and notifying the prescriber if severe rash occurs.
a
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins A. can cause allergic reactions in clients who are allergic to penicillins. B. can cause kidney damage in clients who are allergic to penicillins. C. are derived from penicillin. D. are ineffective in clients who are allergic to penicillins.
a
The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring? a. Red man syndrome B. Gray syndrome C. Cushing's syndrome D. Serotonin syndrome
a
The nurse is reviewing the medication instruction for the client taking acyclovir. Which statement by the client would indicate the need for additional teaching? A. "This medication will maintain the symptoms and cure my disease." B. "I need to complete the full course of therapy as prescribed." C. "I need to report any rash or itching while taking the medication." D. "I need to contact my health care provider if the lesion turns red."
a
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? a. antacids B. antidiabetic agents C. oral contraceptives D. antihypertensives
a
There are many antiviral medications on the market. What is the clinical reason for this? A. Each medication is only effective against a small number of specific viral infections. B. The client can help in the decision of which medication based on his or her insurance plan's coverage. C. Each medication is effective against a large number of viral infections. D. It gives the provider many choices as to which medication can be prescribed.
a
Treatment of obstructive pulmonary disorders is aimed at A. opening the conducting airways or decreasing the effects of inflammation. B. blocking the autonomic reflexes that alter respirations. C. blocking the effects of the immune and inflammatory systems. D. altering the respiratory membrane to increase the flow of oxygen and carbon dioxide.
a
Trypanosomiasis may assume which of the following two different forms? A. African sleeping sickness and Chagas' disease B. Elephantiasis and malaria C. Dysentery and African sleeping sickness D. Malaria and Chagas' disease
a
What antibiotic is contraindicated for the treatment of intermittent colitis? A. clindamycin B. doxycycline C. telithromycin D. erythromycin
a
What can the nurse do to maximize a patient's adherence to the medication regimen? A. As an advocate of the patient, discuss benefits and risks of antiretroviral therapy as well as administration. B. Teach that patients who do not take the medication could have poor outcomes. C. Inform patients to research other options to antiretroviral therapy. D. Inform patients that they have to be compliant with the approved treatment regimen to receive care.
a
What describes how amphotericin B harms host cells? A. The drug disrupts the sterols in the cell membrane. B. The mechanism of action is that the drug binds to the fungal cell. C. The drug increases cell permeability in the host cells. D. The drug leads to the destruction of target cells within the host.
a
What event triggers the development of a superinfection? a. proliferation of antibiotic-resistant microorganisms B. the infection is well established before antibiotic treatment begins C. bone marrow suppression triggered by antibiotic treatment D. unforeseen interactions between the antibiotic and other prescribed medications
a
Which would be considered a penicillinase-resistant antibiotic? A. Ticarcillin B. Amoxicillin C. Carbenicillin D. Nafcillin
a
Common adverse effects associated with the use of topical nasal steroids would include which of the following? A. Local burning and stinging B. Dryness of the mucosa C. Headache D. Constipation and urinary retention E. Fungal infections F. Osteonecrosis
a, b, c, e
In general, all patients receiving antibiotics should receive teaching that includes which of the following points? A. The need to complete the full course of drug therapy B. The possibility of oral contraceptive failure C. When to take the drug related to food and other drugs D. The need for assessment of blood tests E. Advisability of saving any leftover medication for future use F. How to detect superinfections and what to do if they occur
a, b, c, f
Additional nursing interventions for clients receiving antihistamines probably would include which of the following? A. Using a humidifier B. Advising the client to suck sugarless lozenges to help relieve the dry mouth C. Limiting fluid intake to decrease swelling D. Providing safety measures to prevent falls or injury E. Encouraging pushing fluids, if allowed F. Leaving bowls of water around the house to increase humidity
a, b, d, e, f
An antihistamine would be the drug of choice for treating which of the following? A. Itchy eyes B. Irritating cough C. Nasal congestion D. Runny nose E. Idiopathic urticaria F. Thick, tenacious secretions
a, c, d, e
A child with repeated asthma attacks may be treated with which of the following drugs? A. A leukotriene receptor antagonist B. A beta-blocker C. An inhaled corticosteroid D. An inhaled beta-agonist E. A surfactant F. A mast cell stabilizer
a, c, d, f
The nurse would include which of the following in a teaching plan for a patient who is receiving an oral antifungal drug? A. It is important that you complete the full course of your drug therapy. B. You can share this drug with other family members if they develop the same symptoms. C. If you feel drowsy or dizzy, you should avoid driving or operating dangerous machinery. D. If GI upset occurs, avoid eating and drinking so you don't vomit and lose the drug. E. Use over-the-counter drugs to counteract any adverse effects like headache, fever, or rash. F. Notify your health care provider if you experience yellowing of the skin or eyes, dark urine or light-colored stools, or fever and chills.
a, c, f
When explaining to a client the reasoning behind using combination therapy in the treatment of HIV the nurse would include which of the following points? A. The virus can remain dormant within the T cell for a very long time; it can mutate while in the T cell. B. Adverse effects of many of the drugs used to treat this virus include immunosuppression, so the disease could become worse. C. The drugs are cheaper if used in combination. D. The virus slowly mutates with each generation. E. Attacking the virus at many points in its life cycle has been shown to be most effective. F. Research has shown that using only one type of drug that targeted only one point in the virus life cycle led to more mutations and more difficulty in controlling the disease.
a, d, e, f
When administering a systemic antifungal, the nurse would include which of the following in the patient's plan of care? A. Ensuring that a culture of the affected area had been done. B. Having the patient swallow the troche used for oral Candida infections. C. Ensuring that the patient stays flat for at least 1 hour if receiving a vaginal suppository. D. Monitoring the IV site to prevent phlebitis. E. Keeping the patient NPO (nothing by mouth) if GI upset occurs to prevent vomiting. F. Providing antipyretics if fever occurs with IV antifungals.
a, d, f
2. Appropriate nursing diagnoses related to the drug therapy for a patient receiving combination antiviral therapy for the treatment of HIV infection would include the following: A. Disturbed sensory perception (kinesthetic) related to the CNS effects of the drugs. B. Imbalanced nutrition: More than body requirements related to appetite stimulation. C. Heart failure related to cardiac effects of the drugs. D. Adrenal insufficiency related to endocrine effects of the drugs. E. Acute pain related to GI, CNS, or dermatological effects of the drugs. F. Deficient knowledge regarding drug therapy.
a, e, f
When focusing on the lifestyle of the patient with HIV, what are important teaching considerations? (Select all that apply.) A. Take drug therapy as prescribed. B. Advise the patient about the adverse effect of granulocytopenia. C. Transmission can occur while on medication. D. No blood test will need to be done while on therapy.
a,b,c
Incidence of fungal infections has increased with the rising number of people who are immunocompromised. What groups are considered to have a compromised immune system? (Select all that apply.) A. Clients with acquired immune deficiency syndrome (AIDS) and AIDS-related complex (ARC) B. Clients taking immunosuppressant drugs C. Middle-class citizens D. The elderly E. Clients who have undergone transplantation surgery or cancer treatment
a,b,d,e
If a fetus or young infant receives a sulfonamide by placental transfer, in breast milk, or by direct administration, the drug displaces bilirubin from binding sites on albumin. As a result, what may the fetus experience? a. Hyperbilirubinemia B. Hyperkalemia C. Kernicterus D. Hypernatremia
a,c
Fluconazole is the prototype for antifungals. Which are characteristics of fluconazole? (Select all that apply.) A. Binds to sterols in the fungal cell membrane B. Inhibits the growth of tumor cells and enhances the immune response C. Treatment of malignant melanoma D. Metabolized in the liver and excreted in the urine E. Treatment of oropharyngeal, esophageal, and vaginal candidiasis
a,d,e
A client who has recently had a transplant is worried about contracting CMV (cytomegalovirus). The treatment of choice to prevent this infection is which? Select all that apply. A. valganciclovir B. acyclovir C. adefovir D. amantadine E. ganciclovir
a,e
What are classified as anti-infectives? (Select all that apply.) A. antihelmintics B. antifungals C. antiprotozoals D. anticonvulsants E. antimetabolites -
antihelmintics antifungals antiprotozoals
A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion? antianginals antipyretics antihistamines antimicrobials
antihistamine
Which of the following would a nurse identify as being classified as a macrolide? A. Azithromycin B. Gentamicin C. Doxycycline D. Cephalexin -
azithromycin
A 58-year-old with HIV is starting treatment with Combivir. He currently has a CD4+ cell count of less than 200 cells/mL and a viral load greater than 45,000 copies/mL. The nurse treating the client knows that what is a sign of effective drug therapy? A. Decreased CD4+ cell counts B. Increased CD4+ cell counts C. Decreased creatinine clearance D. Increased red blood cell count
b
A client asks how tetracycline works on acne. What is the nurse's best response? A. "Tetracycline changes the chemical structure of your skin so it's less hospitable to bacteria." B. "Tetracycline interferes with the growth of the bacteria causing the pimples." C. "Tetracycline interferes with components of bacterial protein synthesis." D. "Tetracycline reduces the number of bacteria in the blood running through your skin."
b
A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? a. To prevent adverse reactions B. To prevent resistance C. To decrease allergic response of medications D. To decrease length of drug therapy
b
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? A. "The antibiotics are only effective against some types of bacteria." B. "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." C. "The antibiotics are only effective in killing off some of the bacteria in the body." D. "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control."
b
A client has been treated with abacavir for the past 6 weeks. The client contacts the physician's office with reports of diarrhea, abdominal pain, sore throat, cough, and shortness of breath. Which is the appropriate action to take for this situation? A. Discontinue the therapy and then reintroduce it. B. Discontinue the therapy. C. Reduce the dose. D. Administer the drug at bedtime.
b
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication? a. weight gain B. jaundice C. fever D. arthralgia
b
A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client? a. Stop the medication and the health care provider will order you a different antibiotic. B. These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. C. Continue to take the medication as prescribed; these are expected side effects from the medication. D. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction.
b
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic? a. The client has a history of not adhering to treatment B. The client has chronic renal failure C. The client has type 2 diabetes, controlled with oral antihyperglycemics D. The client has a known latex allergy
b
A nurse is caring for a client hospitalized with AIDS. The family comes to visit and a family member asks the nurse about safety when visiting a client with AIDS. What is the best response for addressing the family member's fears? A. "The client should be isolated and have limited visitation." B. "AIDS is commonly transmitted by contact with blood and body fluids." C. "Don't worry, you will not contract the disease from the client." D. "Why do you think you are at risk?"
b
A nurse is caring for a client who is taking acyclovir. What is likely to be a priority nursing diagnoses for this client? A. Disturbed Body Image related to adverse drug effects B. Imbalanced Nutrition; Less than body requirements related to drug adverse effects C. Imbalanced Nutrition; More than body requirements related to drug adverse effects D. Disturbed Sleep Pattern related to adverse drug effects
b
A nurse is caring for a patient, who has been prescribed the antiviral drug amantadine. Which of the following adverse reactions specific to amantadine should the nurse monitor for? A. anorexia and dyspnea B. hypotension and insomnia C. asthenia and abdominal pain D. fever and dizziness
b
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 delay metabolism of the drug. B. Antacids decrease the absorption of the drug. C. Antacids can exacerbate nausea and reflux. D. Antacids cause a dangerous rise in gastric pH.
b
A nurse, reviewing a newly admitted client's previous health records, notes that the client is currently prescribed acyclovir. The nurse should assess the client for signs and symptoms associated with what medical diagnosis? A. hepatitis A B. herpes simplex virus C. human immunodeficiency virus (HIV) D. hepatitis B
b
A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient? A. Monotherapy protease inhibitor therapy B. Combination antiretroviral therapy C. Didanosine therapy once daily D. Zidovudine therapy once daily
b
A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient? A. Monotherapy protease inhibitor therapy B. Combination antiretroviral therapy C. Zidovudine therapy once daily D. Didanosine therapy once daily
b
A patient taking an OTC cold medication and an OTC allergy medicine is found to be taking double doses of pseudoephedrine. As a result, the patient might exhibit A. ear pain and eye redness. B. restlessness and palpitations. C. sinus pressure and ear pain. D. an irritating cough and nasal drainage.
b
A patient traveling to an area of the world where malaria is known to be endemic should be taught to A. avoid drinking the water. B. begin prophylactic antimalarial therapy before traveling and continue it through the visit and for 2 to 3 weeks after the visit. C. take a supply of antimalarial drugs in case he or she gets a mosquito bite. D. begin prophylactic antimalarial therapy 2 weeks before traveling and stop the drugs on arriving at the destination.
b
A patient with a fungal infection asks the nurse why she cannot take antibiotics. The nurse explains that the reason for this is that a fungus is resistant to antibiotics because A. a fungal cell wall has fewer but more selective protective layers. B. the composition of the fungal cell wall is highly rigid and protective. C. a fungus does not reproduce by the usual methods of cell division. D. antibiotics are developed to affect only bacterial cell walls.
b
A patient with many adverse reactions to drugs is tried on an inhaled steroid for treatment of bronchospasm. For the first 3 days the patient does not notice any improvement. You should A. switch the patient to a xanthine. B. encourage the patient to continue the drug for 2 to 3 weeks. C. switch the patient to a sympathomimetic. D. try the patient on surfactant.
b
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? a. Fatigue B. Photosensitivity C. Weakness D. Muscle cramping
b
After teaching a group of students about topical fungal infections the instructor determines that the students need additional instruction when they identify which of the following as an example? A. athlete's foot B. Rocky Mountain spotted fever C. jock itch D. vaginal yeast infections
b
An immigrant and his wife are both HIV positive. The physician prescribes antiretroviral medications. However, the client, tell the nurse he is concerned about his ability to afford the treatment. What advice can the nurse provide to the client to help begin the treatment? A. The client should consider a second opinion from another medical expert B. The client can approach social agencies and pharmaceutical companies that provide antiretroviral drugs on compassionate grounds C. The client can choose an alternative, less expensive medication and later shift to taking antiretroviral medications D. It is not the responsibility of the nurse to advise clients on the financial aspect of a treatment
b
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? A. Ciprofloxacin is safe to use in pregnancy and the client may use to same dose and route as a nonpregnant client. B. The use of ciprofloxacin is contraindicated in pregnancy. C. It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. D. The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client. -
b The use of ciprofloxacin is contraindicated in pregnancy.
Clients who are using inhalers require careful teaching about which of the following? A. Avoiding food 1 hour before and 2 hours after dosing B. Storage of the drug C. Administration techniques to promote therapeutic effects and avoid adverse effects D. Lying flat for as long as 2 hours after dosing E. Timing of administration F. The difference between rescue treatment and prophylaxis
b, c, e, f
A young woman is found to have a soft-tissue infection that is most responsive to tetracycline. Your teaching plan for this woman should include which of the following points? A. Tetracycline can cause gray baby syndrome. B. Do not use this drug if you are pregnant because it can cause tooth and bone defects in the fetus. C. Tetracycline can cause severe acne. D. You should use a second form of contraception if you are using oral contraceptives because tetracycline can make them ineffective. E. This drug should be taken in the middle of a meal to decrease GI upset. F. You may experience a vaginal yeast infection as a result of this drug therapy.
b, d, f
When administering caspofungin intravenously (IV), the nurse should implement what intervention? Select all that apply. A. Administer it slowly, diluted in at least 250 mL of IV fluid. Administer it as a bolus over a 5-minute period. B. The medication should be allowed to warm to room temperature prior to administration. C. Prepare reconstituted medication in at least 250 mL of normal saline IV fluid. D. Dilute it in dextrose prior to administration. E. Administer it as a constant infusion over 60 minutes.
b,c
Antifungal drugs are available that do not fit into either the azole or echinocandin groups. Which fall into the other group? Select all that apply. A. terbinafine (Lamisil) B. griseofulvin (generic) C. flucytosine (Ancobon) D. nystatin (Mycostatin) E. amphotericin B (Abelcet)
b,c,d,e
What medications are classified as echinocandin antifungals? (Select all that apply.) A. Voriconazole (Vfend) B. Micafungin (Mycamine) C. Anidulafungin (Eraxis) D. Terbinafine (Lamisil) E. Caspofungin (Cancidas)
b,c,e
Which of the following are examples of fluoroquinolones? Select all that apply. A. Spectinomycin (Trobicin) B. Levofloxacin (Levaquin) C. Amoxicillin (Amoxil) D. Ciprofloxacin (Cipro) E. Cephalexin (Keflex)
b,d
A nurse is preparing to administer a fluoroquinolone. Which infections are treated with fluoroquinolones? Select all that apply. a. upper respiratory infections B. urinary tract infections C. ear infections D. skin infections E. sexually transmitted disease
b,d,e
A client is experiencing allergy symptoms after being exposed to environmental dust. This reaction involves the action of histamine, which is released by what cells? basophils lymphocytes platelets CD4 T cells
basophils and mast cells
What is the most common first-line therapy for relief of an acute asthma attack?
beta2-adrenergic agonist
Which assessment finding should prompt the nurse to suspect that the resident is experiencing an anticholinergic effect of diphenhydramine? urticaria wheezing on expiration blurry vision tinnitus
blurry vision
A 23-year-old client is prescribed zidovudine for treatment of human immunodeficiency virus (HIV). Which statement indicates that the client has understood the client teaching regarding the action of this medication? A. "Zidovudine inactivates the virus and prevents recurrence of the disease." B. "Zidovudine therapy may result in the development of resistant strains." C. "Zidovudine slows the progression of the disease but does not cure it." D. "Zidovudine prevents the occurrence of opportunistic infections."
c
A 45-year-old client is prescribed acyclovir for the treatment of genital herpes. Which is an expected outcome for this client? A. The client will no longer be able to transmit the infection to others. B. The client will be cured of the viral infection. C. The client will experience fewer recurrences. D. The client will experience recurrences but milder symptoms.
c
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug a. intravenously with the assistance of a home health nurse. B. with a sip of water 1 hour before mealtime. C. with a glass of water 1 hour before or 2 hours after a meal. D. immediately before or with a meal.
c
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day? a. 2 B. 6 C. 8 D. 4
c
A client has presented to the campus medical clinic reporting vaginal itching and burning accompanied by yellowish discharge. The client is diagnosed with trichomoniasis and prescribed metronidazole 250 mg PO t.i.d. What health education should the nurse provide? A. Avoid sunlight, or wear effective sunscreen, during treatment. B. Avoid grapefruit juice until at least 48 hours after treatment is complete. C. Avoid drinking alcohol until treatment is complete. D. Limit intake of high-potassium foods while taking metronidazole.
c
A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism? a. GABA analog B. aminopenicillin C. aminoglycoside D. antifungal
c
A client is receiving tenofovir as part of a therapy regimen for HIV infection. The nurse should provide what teaching related to what the client may experience? A. "There's a high likelihood of severe hypersensitivity reactions, so take your temperature regularly." B. "Avoid high carbohydrate foods, since your body might have difficulty digesting them." C. "It's possible you might have changes in body fat distribution." D. "Occasional pockets of mucus in your stool are expected at the beginning of treatment."
c
A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client? a. Bone marrow depression B. Congestive heart failure C. Renal damage D. Liver toxicity
c
A client is undergoing treatment with amphotericin B. The client feels like a medication reaction is taking place about 1 hour into the infusion and reports fevers and chills. The nurse should A. inform the client that the client is allergic to amphotericin B and stop the infusion. B. tell the client that this is a common reaction and the client does not need any treatment. C. inform the client that this is a common reaction. Obtain orders to treat the client's fever and provide comfort measures for the chills. D. speak with the health care provider, as the client should not take any more amphotericin B without provider approval.
c
A client with active AIDS is infected with a retrovirus. This virus is better known as which? A. CMV B. DSV C. HIV D. HSV
c
A client's previous medical history includes mycosis. What conclusion should the nurse draw from this fact? A. The client had an infection involving an overgrowth of opportunistic organisms B. The client has an underlying immune disorder that caused a fungal infection C. The client has had a disease that was caused by a fungus D. The client had a superficial infection of the skin related to fungal invasion
c
A nurse is administering a drug that blocks the protease enzyme so new viral particles cannot mature. Which category of drugs is the nurse most likely administering? A. integrase inhibitors B. reverse transcriptase inhibitors C. protease inhibitors D. entry inhibitors
c
A nurse is caring for a client who asks why she has been prescribed posaconazole following kidney transplantation. The nurse responds that posaconazole is used as prophylaxis to prevent A. blastomycosis. B. coccidioidomycosis. C. Aspergillus infection. D. mucormycosis.
c
A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to A. eat light meals every day. B. decrease the drug dosage if initial symptoms of nephrotoxicity appear. C. stay well hydrated by drinking at least eight 8-oz glasses of water daily. D. take the tablets on an empty stomach.
c
Amebiasis or amebic dysentery A. is seen only in Third World countries. B. is caused by a protozoan that enters the body through an insect bite. C. is caused by a protozoan that can enter the body in the cyst stage in water or food. D. usually has no signs and symptoms.
c
An adult client is being treated for genital herpes with acyclovir. Which client statement indicates a need for further health education? A. "I know that this medication doesn't guarantee the infection won't return." B. "I was happy to learn that there aren't that many side effects of this drug." C. "It's a relief to know that this drug will stop me from spreading the infection." D. "I'm glad that there something I can take that will help to heal my lesions."
c
Anidulafungin is prescribed to treat what form of fungal infection? A. aspergillosis B. histoplasmosis C. candidiasis D. tinea infection
c
Antiretroviral drugs have different mechanisms of action. Which action below is NOT a common antiretrovirial mechanism? A. Blocking the protease enzyme sot that new viral particles cannot mature. B. Entry inhibitors, which prevent the attachment or fusion of HVI to a host cell for initial entry into the cell. C. Exit facilitators which remove the HIV from the cell D. Reverse transcriptase inhibitors, which block the reverse transcriptase enzyme so the HIV material cannot change into new DNA in the new cell, preventing new copies from being created.
c
Antitussives are useful in blocking the cough reflex and preserving the energy associated with prolonged, nonproductive coughing. Antitussives are best used with A. postoperative patients. B. asthma patients. C. patients with a dry, irritating cough. D. COPD patients who tire easily.
c
Drugs that destroy bacteria are known as which type of drug? a. bacteriostationary B. bacteriophage C. bacteriocidal D. bacteriostatic
c
Gram-negative bacteria A. are mostly found in the respiratory tract. B. are mostly associated with soft tissue infections. C. are mostly found in the GI and GU tracts. D. accept a positive stain when tested.
c
Nursing students are studying antiviral drug therapy in a pharmacology class. A student asks the instructor to explain why multi-drug regimens are used to treat HIV infections. The instructor responds that drug combinations are often prescribed because they A. decrease the length of illness. B. increase compliance. C. are more effective than single-drug therapy. D. decrease the risk of opportunistic infection.
c
Pneumocystis jiroveci pneumonia is A. an endemic protozoan found in the human respiratory system. B. responsive to inhaled pentamidine. C. an opportunistic bacterial infection. D. frequently associated with children in day care settings.
c
Respiratory distress syndrome occurs in A. babies with frequent colds. B. babies with genetic allergies. C. premature and low-birth-weight babies. D. babies stressed during the pregnancy.
c
The fluoroquinolones A. are found freely in nature. B. are associated with severe adverse reactions. C. are widely used to treat gram-positive infections. D. are broad-spectrum antibiotics with few associated adverse effects.
c
The goal of antibiotic therapy is A. to eradicate all bacteria from the system. B. to suppress resistant strains of bacteria. C. to reduce the number of invading bacteria so that the immune system can deal with the infection. D. to stop the drug as soon as the patient feels better.
c
The nurse is caring for a 3-year-old with HIV. The nurse knows that, when administering antiviral drug therapy in young children with HIV, dosage calculations are typically based on A. the client's body surface area. B. the severity of the client's condition. C. the client's weight. D. dosage recommendations for adults.
c
The nurse is caring for a client receiving antiviral medications to treat HIV. What laboratory study should the nurse monitor most closely to determine the effectiveness of the medications? A. Liver function studies B. P24 antigen test C. CD4 count D. CBC with differential
c
The nurse is caring for a client whose fungal infection is being treated with ketoconazole. What change in the client's health status should the nurse prioritize when updating the provider on the client's condition? A. The client vomited 30 minutes after the most recent scheduled dose of ketoconazole B. The client's temperature is 99.5°F (37.5°C) C. The client's aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels are elevated D. The client's sodium level is 136 mEq/L (136 mmol/L) and potassium is 5.0 mEq/L (5.0 mmol/L)
c
The nurse is caring for a patient who has HIV and is taking saquinavir therapy. What should the nurse include in the dietary education for this patient? A. The patient is not restricted to a specific diet while taking this medication. B. The patient should limit proteins while taking this medication. C. The patient should not take this medication with grapefruit or pomegranate juice. D. The patient should limit carbohydrates when taking this medication.
c
The nurse is describing fungi that cause infections of the skin and mucous membranes, appropriately calling these which of the following? A. mycoses B. meningeal fungi C. dermatophytes D. worms
c
The nurse should monitor the client for which common side effects of erythromycin therapy? a. Urticaria and opthalmic drainage B. Headache and fever C. Nausea, vomiting, and diarrhea D. Shortness of breath and sore throat
c
The nurse understands that which is the highest priority when teaching about antitubercular medications? a. Staying hydrated B. Monitoring sputum C. Taking medications as prescribed D. Eating a well balanced diet
c
The xanthines A. block the sympathetic nervous system. B. stimulate the sympathetic nervous system. C. directly affect the smooth muscles of the respiratory tract. D. act in the CNS to cause bronchodilation.
c
When administering a systemic antifungal agent, the nurse incorporates understanding that all systemic antifungal drugs function to A. break apart the fungus nucleus. B. interfere with fungus DNA production. C. alter cell permeability of the fungus, leading to cell death. D. prevent the fungus from absorbing needed nutrients.
c
When providing care to a client with a viral infection, the nurse knows that ribavirin (Virazole) for inhalation is used to treat which virus? A. AIDS B. HIV C. RSV D. RVS
c
Which of the following is not a caution for the use of cephalosporins? A. Allergy to penicillin B. Renal failure C. Allergy to aspirin D. Concurrent treatment with aminoglycosides
c
Which of the following would be an important teaching point for the patient receiving an agent to treat herpes virus or CMV? A. Stop taking the drug as soon as the lesions have disappeared. B. Sexual intercourse is fine—as long as you are taking the drug, you are not contagious. C. Drink plenty of fluids to decrease the drug's toxic effects on the kidneys. D. There are few if any associated GI adverse effects.
c
Which of the following would the nurse recommend that a woman with repeated vaginal yeast infections keep on hand? A. tolnaftate B. butenafine C. clotrimazole D. naftifine
c
Your patient has been maintained on theophylline for many years and has recently taken up smoking. The theophylline levels in this patient would be expected to A. rise because nicotine prevents the breakdown of theophylline. B. stay the same because smoking has no effect on theophylline. C. fall because nicotine stimulates liver metabolism of theophylline. D. rapidly reach toxic levels.
c
A mother calls in concerned that her son, a college freshman, has been diagnosed with giardiasis. The nurse would respond to the mother's concerns by telling her which of the following? A. You should have your son come home immediately so that he can be treated appropriately. B. This is a very rare disorder; it is not usually seen in this country. C. This is the most common protozoal infection seen in this country and is usually transmitted through food or water. D. This infection can be treated with oral drugs, and he should be able to get the drugs where his infection was diagnosed. E. This is an infection that has to be treated quickly with IV medications. F. Encourage your son to get the medicine and to try very hard to eat nutritious food.
c, d, f
A client's fungal infection will be treated with amphotericin B. The nurse should question the prescription if what route of administration is specified? A. intravenous (IV) B. oral C. topical D. subcutaneous
d
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? a. Red blood cells and white blood cells B. Sodium and potassium C. Amylase and lipase D. BUN and creatinine
d
The client's theophylline levels are increased when the lab results are added to the electronic health record. The nurse questions the client about his intake of which?
coffee
A client, having an allergic reaction to mold, describes chest tightness and difficulty breathing. Which body effect is occurring? contraction of smooth muscle in the bronchi suppression of the vagus nerve endings producing tachycardia decreased permeability of the veins and capillaries decreased secretion of the mucous glands
contraction of smooth muscle in the bronchi
A client has endocarditis and is taking gentamicin. The nurse will be sure to monitor the client's A. potassium level. B. creatinine clearance. C. serum albumin level. D. prothrombin time. -
creatinine clearance.
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? A. Asking the client if she has had an allergic reaction to a penicillin B. Measuring the client's blood pressure C. Asking the client if she is allergic to sulfonamides D. Asking the client if she is pregnant
d
A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse should prioritize assessments of which of the following? A. Respiratory function B. Cardiac function C. Neurologic function D. Renal function
d
A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient? a. Monitoring fluid intake. B. Testing for occult blood. C. Testing for increased glucose levels. D. Monitoring blood creatinine levels.
d
A HIV-positive patient is being treated with didanosine as part of the antiretroviral therapy. Which of the following symptoms should the nurse monitor for and immediately report to the care provider? A. Headache B. Taste alteration C. Excoriation D. Peripheral neuropathy
d
A bacteriostatic substance is one that A. directly kills any bacteria it comes in contact with. B. directly kills any bacteria that are sensitive to the substance. C. prevents the growth of any bacteria. D. prevents the growth of specific bacteria that are sensitive to the substance.
d
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform? a. Assess the child for allergies to salicylates. B. Assess whether the child has ever had tuberculosis skin test. C. Assess the child's immunization status. D. Assess the child for allergies to penicillins.
d
A client diagnosed with tuberculosis (TB) has 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 to speed up the course of treatment." B. "Multiple drugs are prescribed because the final testing results for TB can take up to 3 months." C. "Multiple drugs are used because health care providers aren't sure which drug will kill a particular TB strain." D. "The use of multiple drugs prevents the development of drug-resistant TB."
d
A client is being treated for a fungal infection with IV amphotericin B. In order to prevent drug discomfort, the nurse should consistently monitor the client's levels of which component? A. calcium B. leukocytes C. hemoglobin D. sodium
d
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication? A. weight gain B. arthralgia C. fever D. jaundice
d
A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client? a. "Call your health care provider if you experience headache or dizziness." B. "You might experience some nausea or stomach upset." C. "The drug can cause an allergic reaction." D. "Your urine or sweat may become orange in color."
d
A client with amebiasis is to receive metronidazole. The client also takes warfarin for atrial fibrillation. The nurse would instruct the client to immediately report which symptom? A. Abdominal cramps B. Paresthesias C. Ataxia D. Increased bleeding
d
A client's health care provider is considering the addition of efavirenz to the client's drug regimen for the treatment of recently diagnosed HIV. Which aspects of the client's medical history should prompt the nurse to question the use of this drug? A. The client's body mass index at the time of diagnosis was 27 (overweight). B. The client has a diagnosis of type 2 diabetes and did not consistently monitor blood glucose levels prior to diagnosis with HIV. C. The client experienced an adverse reaction to an influenza immunization several years ago. D. The client has hepatitis C and a history of heavy alcohol use.
d
A client, being treated for a fungal infection, reports being nauseating and requests that the dose be decreased or medication changed. Which statement should form the basis of the nurse's response to the client's request? A. Antifungal drugs are relatively inexpensive. B. There are several other drugs available that are just as effective. C. The drugs that are effective are given intravenously and generally cause medical complications. D. Antifungal drugs that are effective for this disease without being excessively toxic to human cells are limited.
d
A nurse is caring for a client who is receiving amphotericin B. Which medication could the nurse administer concomitantly to promote client comfort? A. sedatives B. diuretics C. beta-adrenergic blockers D. antipyretics
d
A nursing student is reading a journal article about highly active antiretroviral therapy (HAART). The nurse would expect to find which condition as being treated with this therapy? A. herpes simplex virus (HSV) B. rotavirus C. cytomegalovirus (CMV) D. human immunodeficiency virus (HIV)
d
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? A. Take the drug along with a meal. B. Take the drug immediately after meals. C. Take the drug along with milk or fruit juice. D. Take the drug on an empty stomach.
d
A patient who is receiving a combination drug to treat malaria asks the nurse why. The nurse responds to the patient based on the understanding that combination drugs are A. associated with a much lower degree of toxicity when used in combination. B. absorbed more completely when administered and taken together. C. more effective in preventing mosquitoes from biting the individual. D. effective at various stages in the life cycle of the protozoan.
d
A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections? a. Monitor signs of liver dysfunction weekly. B. Monitor patient's vital signs each morning. C. Administer streptomycin to promote nutrition. D. Rotate injection sites for frequent parenteral injections.
d
A patient with sinus pressure and pain related to seasonal rhinitis would benefit from taking A. an antitussive. B. an expectorant. C. a mucolytic. D. a decongestant.
d
An adult client, recently diagnosed with a tinea infection, has begun treatment with griseofulvin. During a scheduled clinic visit, the client states to the nurse, "I'm pretty good at reading my body's signals, so I make sure to take a bit extra when I think my infection is getting worse." This client's statement is suggestive of what nursing diagnosis? A. disturbed thought processes related to appropriate use of griseofulvin B. ineffective coping related to self-medication C. effective therapeutic regimen management related to symptom identification D. deficient knowledge related to correct use of griseofulvin
d
An older adult client has been diagnosed with candidiasis and prescribed fluconazole. What aspect of the client's health status should warrant close monitoring by the nurse? A. The client adheres strictly to a vegetarian diet B. The client has hypothyroidism and takes levothyroxine daily C. The client has a low body mass index D. The client has atrial fibrillation and takes warfarin daily
d
Dornase alfa (Pulmozyme), because of its mechanism of action, is reserved for use in A. clearing secretions before diagnostic tests. B. facilitating the removal of secretions postoperatively. C. protecting the liver from acetaminophen toxicity. D. relieving the buildup of secretions in cystic fibrosis.
d
For which clients would treatment with acyclovir be most clearly indicated? A. A 2-month-old infant brought to the emergency department with signs of respiratory syncytial virus (RSV) B. A 44-year-old intravenous drug user who has been diagnosed with hepatitis C virus (HCV) C. A man who contracted hepatitis A virus (HAV) while on a tropical vacation D. A 77-year-old whose recent debilitating pain has been attributed to a herpes zoster infection
d
Leukotriene receptor antagonists act to block production of a component of slow-reacting substance of anaphylaxis. They are most beneficial in treating A. seasonal rhinitis. B. pneumonia. C. COPD. D. asthma.
d
Lung surfactants used therapeutically are A. injected into a developed muscle. B. instilled via a nasogastric tube. C. injected into the umbilical artery. D. instilled into an endotracheal tube properly placed in the baby's lungs.
d
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? a. Cephalosporin B. Tetracycline C. Vancomycin D. Penicillin
d
Patients with seasonal rhinitis experience irritation and inflammation of the nasal passages and passages of the upper airways. Treatment for these patients might include A. systemic corticosteroids. B. mucolytic agents. C. an expectorant. D. topical nasal steroids.
d
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9 degrees ferenheit. The health care provider has written the following orders; acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first? a. Provide client with eight ounces of fluid. B. Administer acetaminophen for temperature. C. Administer sulfasalazine (Azulfidine). D. Obtain urine for culture and sensitivity.
d
A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs? A. Increased risk of bleeding B. Increased action of neuromuscular-blocking drugs C. Increased profound respiratory depression D. Decreased absorption of tetracycline -
decreased absorption of tetracycline
A female client administers diphenhydramine to her 9-year-old male child, who experiences seasonal allergies, before his first baseball game. What may the child experience if he has a paradoxical effect to the medication? Poor reflexes Exacerbation of allergic symptoms Decreased mental alertness Hyperactivity
decreased mental alertness
What intervention should be included in the care plan of a client experiencing excessive respiratory tract secretions? deep breathing and coughing exercises administration of guaifenesin supplemental oxygen by nasal prongs administration of pseudoephedrine
deep breathing and coughing exercises With excessive respiratory tract secretions, mechanical measures (e.g., coughing, deep breathing, ambulation, chest physiotherapy, forcing fluids) are more likely to be effective than expectorant drug therapy. Research studies do not support guaifenesin's overall effectiveness, and many authorities do not recommend its use. Pseudoephedrine is not an expectorant, and supplemental oxygen will not loosen secretions.
A client prescribed codeine for a persistent, debilitating cough tells the nurse, "I was sure that codeine was a narcotic that people take for pain." The nurse should cite what mechanism of action when describing this use of codeine? vasodilation of the alveolar capillaries stimulation of the reticular activating system (RAS) desensitization of the cough receptors in the sinuses and trachea depression of the cough center in the medulla oblongata
depression of the cough center in the medulla oblongata
A client diagnosed with asthma is being prescribed a leukotriene receptor antagonist as part of their mediation therapy. The nurse should encourage the client to report incidence of what events as possible adverse effects of the new medication? Select all that apply.
diarrhea headache fever muscle aches
An adult client has reported experiencing a dry mouth and urinary retention after several nights of taking an over-the-counter (OTC) sleep aid. The nurse should suspect that this medication contains what antihistamine? promethazine diphenhydramine loratadine olopatadine
diphenhydramine
What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction? diphenhydramine cetirizine epinephrine clemastine
diphenhydramine
A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply. A. drop in blood pressure B. increase in respiratory rate C. sudden increase in temperature D. regular urine output E. pulse rate within usual parameters -
drop in blood pressure increase in RR sudden increase in temperature
A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered? A. acamprosate calcium B. atazanavir C. erythromycin D. flumazenil -
erythromycin
Which medication is the drug of choice for Legionnaires disease? A. erythromycin B. loxapine hydrochloride C. meclizine D. pravastatin -
erythromycin
The pharmacology instructor is discussing the adverse effects of diphenhydramine. Which is not one of these effects? Dry mouth Excessive salivation Blurred vision Drowsiness
excessive salivation
What is considered a possible trigger for an asthma attack? Select all that apply.
exercise allergens pollutants cigarette smoke
What is the chemical mediator released in immune and inflammatory response to allergic reactions? mast cells norepinephrine histamine epinephrine
histamine
Adrenergics are a category of bronchodilators used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). In what conditions is cautious use of these drugs recommended? Select all that apply.
hypertension seizure disorders diabetes mellitus
A client is admitted to the unit. The nurse knows that the client is at high risk for infection. What factors predispose the client to infection? (Mark all that apply.) A. Impaired blood supply B. Hypertension C. Suppression of immune system D. Advanced age E. Decreased amalyse levels -
impaired blood supply suppression of immune system advanced age
Which nursing diagnosis would provide the clearest indication for the administration of inhaled acetylcysteine? impaired tissue perfusion risk for infection ineffective breathing pattern ineffective airway clearance
ineffective airway clearance Acetylcysteine reduces the viscosity of mucous secretions with the ultimate goal of allowing the client to establish and maintain a clear airway. This drug does not directly influence the pattern of breathing
When describing how tetracyclines treat infection, the nurse would incorporate which information into the description? A. inhibiting bacterial protein synthesis B. inhibiting bacterial cell wall synthesis C. inhibiting bacterial DNA gyrase D. depolarizing the bacterial cell wall -
inhibiting bacterial protein synthesis
Acetylcysteine (Mucomyst) is primarily administered by which route when being used to thin secretion? (Select all that apply.) Instilled into a tracheostomy Rectally Inhalation Orally Parenterally
instilled into a tracheostomy inhalation
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. The half-life of the drug is 3 to 7 hours. B. It is taken only once a day. C. It has very few adverse effects. D. It can be given without consideration to drug-drug- interactions. -
it is taken only once a day
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? A. metronidazole B. ciprofloxacin C. levofloxacin D. gemifloxacin -
metronidazole
Aminoglycosides fight infection by interfering with what process within the causative bacterium? A. Protein synthesis B. DNA synthesis C. Cell wall synthesis D. Drainage -
protein synthesis
A nurse is caring for a client who is receiving IV aminoglycosides for an intractable infection in one leg. What would it be important for the nurse to monitor for? A. Visual disturbances B. Liver dysfunction C. Serum glucose levels D. Renal dysfunction -
renal dysfunction
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 -
skin rash or itching
A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that A. the microorganism causing the infection is likely known. B. the client likely has compromised immune function. C. broad spectrum antibiotics were likely administered without success. D. the care team wished to reduce the client's risk of adverse effects. -
the microorganism causing the infection is likely known.
Expectorants elicit their effect by which mechanism? Breaking down thick mucus in the lower lungs Thinning respiratory secretions Depressing the cough center in the brain Anesthetizing stretch receptors in the respiratory passages
thin respiratory secretions
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed? A. trimethoprim-sulfamethoxazole B. tetracycline C. doxycycline D. demeclocycline -
trimethoprim-sulfamethoxazole
A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic. True False -
true
According to the National Asthma Education and Prevention Program (NAEPP) Expert Panel Guidelines, a client prescribed a short-acting beta2 agonist may take this medication how often during an acute exacerbation of asthmatic symptoms?
up to three treatments at 20-minute intervals
A patient has been diagnosed with trichomoniasis. Before the client begins tinidazole therapy, the nurse should learn about the client's A. working conditions. B. use of alcohol. C. recent visit to a beach or desert. D. possibly having AIDS. -
use of alcohol
