PrepU CH 15-25 & 59-61

Which statement provides the rationale for the administration of lidocaine in preparation for an eye exam?

to produce a local anesthetic effect

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication?

Jaundice

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?

Jaundice

A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?

Rifampin and isoniazid

A young child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem?

"Has your child been swimming a lot lately?"

A nurse is caring for a client who is receiving a corticosteroid for arthritic pain. Which statement made by the client would raise concern about medication dosage revision?

"I recently lost my health care coverage and need to look for another job."

The client has been prescribed celecoxib for osteoarthritis. Which statement by the client indicates the need for further client education?

"I will stop taking the medication when I feel better."

The nurse instructs a client who is prescribed low-dose prednisone daily for a chronic condition. Which client statement indicates to the nurse that teaching has been effective?

"I will take the medication with a meal."

The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?

"Take it first thing in the morning."

Which of the following patients would the nurse determine has the highest risk of cumulative toxicity if prescribed colchicine?

A patient with hepatic disease

A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome?

Acetylsalicylic acid

A patient is required to be administered vancomycin for treatment of an abdominal abscess. What should the nurse ensure when monitoring the IV infusion of vancomycin in the patient when caring for him?

Administer each dose over 60 minutes

The nurse administers cefuroxime to a client at least one hour before meals, as prescribed. However, the client experiences a GI upset. Which is an appropriate nursing intervention in this case?

Administer the drug with food.

The nurse is providing client teaching before discharging a client home. The client is taking ciprofloxacin. What action should the nurse encourage the client to prioritize?

Avoid all caffeine and alcohol

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

BUN

Aspirin (ASA) is an over-the-counter drug that is found in many other drugs. What is the mechanism of action for aspirin?

Blocking the transmission of pain impulses

The use of corticosteroids in older adults may aggravate which conditions? (Select all that apply.)

Congestive heart failure Diabetes mellitus Arthritis

The eye has several structures to facilitate sight. Which structure serves as the mucous membrane lining of the eyelids?

Conjunctiva

A nursing student identifies which drug class exerts a localized anti-inflammatory effect when applied topically?

Corticosteroids

A patient received a kidney transplant and is placed on cyclosporine to reduce the risk of rejection. The patient reports having severe pain in the right toe. What will the nurse recognize as the greatest risk for this patient developing gout?

Cyclosporine decreases the renal excretion of uric acid.

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?

Decrease the drug dose.

A client has an upper respiratory infection and is allergic to penicillin. What medication does the nurse expect will be ordered?

Erythromycin

Which of the following drugs are considered to be macrolides? Choose all that apply.

Erythromycin Azithromycin (Zithromax) Clarithromycin (Biaxin)

Which of the following drugs would be classified as an aminoglycoside?

Gentamicin

Antivirals are used to treat infections caused by viruses. In particular, acyclovir is useful to treat which infection?

Herpes Zoster

A resident of a skilled nursing facility develops methicillin-resistant Staphylococcus aureus. What type of infection has this person developed?

Hospital- acquired infection

The azole antifungals are contraindicated in clients with what condition?

Increased liver enzymes

The nurse is giving discharge instructions to parents of an infant with a skin condition and knows that topical agents are used cautiously in infants for what reason?

Infant skin is more permeable

What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Inhibit prostaglandin synthesis

Your client has developed a postoperative wound infection. Cultures reveal methicillin-susceptible Staphylococcus aureus. Which of the following medications would you anticipate being ordered for your client?

Nafcillin

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?

Obtaining sensitivity testing

A client has just returned from x-ray after reporting pain in her joints. The x-rays indicate damage of the joint spaces. This is indicative of which disease process?

Osteoarthritis

A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order?

Peak and trough serum levels

A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?

Refer the client to the health care provider because the client may be experiencing resistance.

A nurse has questioned why a client's health care provider has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?

The use of broad-spectrum antibiotics can create a risk for a superinfection.

The client who has been on long-term sulfonamide therapy begins to demonstrate symptoms associated with side affects of the therapy. The nurse knows that these symptoms are related to which complication associated with sulfonamide therapy?

Thrombocytopenia

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug?

To balance urate concentration and prevent gout attacks

Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture test?

To identify the organism causing the infection

When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is aware that when compared with doses for young and middle-aged adults, these clients may require:

a lower dose.

Which are examples of infection control used in the healthcare environment? Select all that apply.

Use of cleaning agents daily for the nursing computer stations. Temperature cooler in many areas of a hospital. Routine cleaning of areas with many visitors. Hand hygiene by all healthcare providers and visitors.

The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects?

Vomiting and diarrhea

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?

Warfarin

A client has a diagnosis of otitis media and has just begun antibiotic treatment. The client reports otalgia and has asked for medication. The nurse should anticipate the administration of:

acetaminophen (Tylenol)

After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?

bactericidal

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:

can cause allergic reactions in clients who are allergic to penicillins.

What is the expected result of timolol maleate therapy?

decreased intraocular pressure (IOP)

A nurse is preparing medication information for the spouse of a client diagnosed with cerebral edema. Which medication should the nurse include in this information?

dexamethasone

A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?

potassium

The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections?

pseudomembranous colitis

People taking antimicrobial drugs should be instructed to report any problem that could indicate adverse drug effects, lack of therapeutic response, or emergence of another infection. One such problem is:

skin rash.