pharmacology exam 2

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.)

-Avoid the use of broad-spectrum antibacterial drugs when treating trivial or viral infections. -Use narrow-spectrum agents if they are thought to be effective. -Do not use vancomycin unnecessarily.

The nurse collects the past medical history of a patient new to the clinic. The patient states he or she is allergic to penicillin. What would the nurse question next? (Select all that apply.)

-What signs and symptoms were displayed with the reaction?----How many dosages were administered before the reaction occurred? -Had the medication ever been prescribed before the time when the reaction occurred?

Selective toxicity, or the ability to affect certain proteins or enzyme systems in the infecting organism, is a much sought-after quality in an anti-infective agent. How many anti-infective agents have this quality?

0% Although anti-infective agents target foreign organisms infecting the body of a human host, they do not possess selective toxicity

What medication is only administered intravenously and is used to treat cytomegalovirus (CMV)?

Acyclovir

When administering anti-infectives to patients, the nurse is aware of the risk for what potentially fatal adverse effect?

Anaphylaxis

The nurse is teaching the patient about amoxicillin prior to discharge and includes what important teaching point?

Blackening of the tongue may occur but will subside when the drug is discontinued.

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?

Ciprofloxacin (Cipro)

The nurse is preparing to contact the physician for an antibiotic order for the patients infection. What information will the nurse be prepared to provide for the physician to choose the proper antibiotic?

Culture and sensitivity test results

The nurse is caring for a patient who is receiving a broad-spectrum anti-infective agents. The nurse would assess the patient for what common adverse effect of broad spectrum anti-infective agents?

Destruction of the normal flora One offshoot of the use of anti-infectives, especially broad-spectrum anti-infectives, is destruction of the normal flora resulting in superinfections.

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?

Disturbed sensory perception (kinesthetic) related to CNS effects

What drug would the nurse administer orally without the need to question when treating infections caused by Candida albicans?

Fluconazole Fluconazole is available for oral use and is effective in treating C. albicans.

A 21-year-old woman presents with cytomegalovirus (CMV). The LPN says, Ive never heard of CMV before. The nurse explains to the LPN that this infection is most often seen with patients diagnosed with what?

HIV

The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesnt 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?

Has she ever received tetracycline?

The nursing instructor teaches the students about selective toxicity when one of the students asks, What happens when a drug doesnt have selective toxicity? What is the instructors best response?

Healthy cells are damaged. When a drug does not display selective toxicity, healthy cells are damaged because the drug does not specifically target only the pathogen.

For what viruses might the nurse administer acyclovir? (Select all that apply.)

Herpes simplex virus Shingles Chickenpox

The nurse is caring for a 62-year-old patient who is receiving IV gentamicin. The patient complains of difficulty hearing. What should the nurse do?

Hold the dose and notify the physician immediately.

The nurse has provided patient teaching for a patient who will be discharged to home on an anti-infective. What statement made by the patient indicates the nurse needs to provide additional teaching concerning the use of anti-infectives?

I will stop taking the antibiotic as soon as I feel better.

A hospitalized patient is receiving an antiviral drug to treat cytomegalovirus. What is the nurses priority action after administering the antiviral drug?

Keep side rails up.

When discussing cephalosporins with the nursing class, the pharmacology instructor explains that this classification of drug is primarily excreted through which organ?

Kidney The cephalosporins are primarily metabolized in the liver and excreted in urine. These drugs cross the placenta and enter breast milk.

The nursing instructor is talking with the students about anti-infective medication and explains that drugs that are very selective in their actions are said to be what?

Narrow spectrum

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?

Nystatin

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?

Oseltamivir (Tamiflu)

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).

Preventing cell division Causing cell death Inhibiting cell wall synthesis

A patient is told that he or she will have to undergo extensive dental surgery. The dentist prescribes a course of antibiotic therapy before beginning the procedures and continuing for 5 days after the procedure. What is this is an example of?

Prophylaxis

A 12-year-old patient with a complicated skin infection has been admitted to the pediatric unit. The physician has ordered Ertapenem. What is the nursing priority?

Question the order by calling the physician who prescribed it. The nurse should call the physician and question the order Because this drug is not recommended for children younger than 18 years of age.

After administering an antibiotic, the nurse assesses the patient for what common, potentially serious, adverse effect?

Rash

The nurse is caring for a patient receiving IV aminoglycosides for an intractable infection in his or her leg. What would it be important for the nurse to monitor this patient for?

Renal dysfunction When patients are taking aminoglycosides, it is important they be monitored closely for any sign of renal dysfunction.

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?

Renal system

How would the nurse describe selective toxicity?

Selective toxicity is the ability of the drug to kill foreign cells without causing harm to ones own body cells.

The clinic nurse is providing health teaching to a patient who has been prescribed doxycycline. What is a priority teaching point for this patient?

Stay out of the sun.

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?

Stop using the drug immediately.

What is the priority reason for the nurse to consider questioning an order for tetracycline in a child younger than 8 years of age?

Tetracyclines can damage developing teeth and bone in children younger than 8 years of age.

A 17-year-old male patient with athletes 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?

The composition of the protective layers of the fungal cell makes the organism resistant to antibiotics.

The nurse attends a class on preventing resistance to anti-infectives and learns that the critical concept in preventing the development of resistant strains of microbes is what?

The duration of drug use

A patient asks the nurse how an anti-infective produces a therapeutic effect. What key point will the nurse explain to this patient?

The goal of anti-infectives is to interfere with normal functioning of the invading organism.

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?

Unusual bruising and bleeding Unusual bruising and bleeding can be an indication of hepatic toxicity, which should be reported immediately. Yellowing of the eyes, not redness, and tearing are also indicative of hepatic toxicity.

The nurse explains why viruses are so difficult to treat when making what statement?

Viruses are contained inside the human cell and cannot be destroyed without destroying the cell.

A patient comes to the clinic to talk with the nurse about planned overseas travel. The patient tells the nurse that he or she is planning a trip to an area of the world where malaria is common. He wants to know how to prevent contracting the disease. What should the nurse respond?

We can ask the physician for some anti-infectives for you to take prophylactically.