Quizlet Cumulative Questions
1. A client is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the client which instruction? a. Do not skip doses. b. Take the drugs t.i.d. with food. c. Take an antacid with the drugs to decrease GI distress. d. Take rifampin initially, and then begin isoniazid after 2 months.
A
1. Sulfasalazine (Azulfidine) has been ordered for a client. The nurse knows that this drug is most effective against which organisms? a. Escherichia coli and Clostridium b. Neisseria gonorrhoeae and H. Influenzae c. Pseudomonas aeruginosa and Helicobacter pylori d. Enterococcus faecium and Staphylococcus aureus
A
2. A client is taking sulfasalazine (Azulfidine). What should the nurse teach the client to do? a. Drink at least 10 glasses of fluid per day. b. Monitor blood glucose carefully to avoid hyperglycemia. c. Avoid operating a motor vehicle as this drug may cause drowsiness. d. Take this drug with an antacid to decrease the risk of gastrointestinal distress.
A
3. The nurse enters a client's room to find that his heart rate is 120, his BP is 70/50, and he is flushed. Vancomycin (Vancocin) is running IVPB. The nurse interprets this as a severe adverse effect of "red man syndrome." What should the nurse do? a. Stop the infusion and call the laboratory. b. Reduce the infusion to 10 mg/min. c. Encourage the client to drink more oral fluids up to 2 L/day. d. Report to health care provider the onset of Stevens-Johnson syndrome.
A
3. The nurse teaches the client taking amphotericin B to report which signs and symptoms to the health care provider? a. Blindness b. Loss of hearing c. Nephrotoxicity d. Stevens-Johnson syndrome
A
4. A client with a history of malaria, presently being treated with chloroquine, is admitted to the hospital. What should the nurse advise the client to do? a. Get frequent hearing checks. b. Take antimalarials before meals. c. Get frequent testing of stool specimens. d. Check heart rate before taking drug to ensure 60 or above.
A
4. The nurse is administering tetracycline (Vibramycin) to a client. Which would be appropriate teaching? a. Take sunscreen precautions when at the beach. b. Take an antacid or milk with the drug to prevent severe GI distress. c. Obtain frequent hearing tests for early detection of hearing loss. d. Obtain frequent eye checkups for early detection of retinal damage.
A
5. A client has developed vaginal candidiasis. The nurse knows that which medication is appropriate treatment for this condition? a. terconazole (Terazol-3) b. haloprogin (Halotex) c. terbinafine (Lamisil) d. tolnaftate (Aftate)
A
4. A client is taking cefoperazone (Cefobid). The nurse anticipates which appropriate nursing intervention(s) for this medication? (Select all that apply.) a. Monitoring renal function studies b. Monitoring liver function studies c. Infusing IV medication over 30 minutes d. Monitoring client for mouth ulcers e. Advising client to take medication with food
A B C D
7. A client is prescribed cephradine (Velosef). The nurse should follow which nursing implication(s)? (Select all that apply.) a. Report seizures to the health care provider. b. Advise client to eat yogurt to prevent a superinfection. c. Monitor client for an allergic reaction especially after first and second dose. d. Advise client to take medication on an empty stomach even if GI distress occurs. e. Culture infected area prior to first dose of medication.
A B C E
6. Penicillin G (Pentids) has been prescribed for a client. Which nursing intervention(s) should the nurse include for this client? (Select all that apply.) a. Collect C & S prior to first dose. b. Monitor client for mouth ulcers. c. Instruct client to limit fluid intake to 1000 mL/day. d. Have epinephrine on hand for a potential severe allergic reaction.
A B D
A client is being treated for tuberculosis. Which medications are used to treat this condition? (Select all that apply.) a. Streptomycin sulfate b. Amoxicillin (Amoxil) c. Ethambutol (Myambutol) d. Gentamicin (Garamycin) e. Rifabutin (Mycobutin) f. Ethionamide (Trecator-SC) g. Pyrazinamide
A, C, E, F, G
Which diseases are caused by herpes viruses? (Select all that apply.) a. Chicken pox b. Hepatitis c. Influenza d. Mononucleosis e. Shingles
A, D, E
6. The nurse is teaching the client about trimethoprim-sulfamethoxazole (Bactrim). Which directives should be included in the teaching? (Select all that apply.) a. Report any bruising or bleeding immediately. b. Report any diarrhea or bloody stools promptly. c. Report any fever, rash, or sore throat promptly. d. Avoid unprotected exposure to sunlight. e. Report thirst and polyuria immediately.
A,B,C,D
7. The nurse acknowledges which nursing intervention(s) for the client taking ciprofloxacin (Cipro)? (Select all that apply.) a. Obtain culture prior to drug administration. b. Tell the client to avoid taking Cipro with antacids. c. Monitor the client for hearing loss. d. Encourage fluids to prevent crystalluria. e. Infuse IV Cipro over 60 minutes. f. Monitor blood glucose, as Cipro can decrease effects of oral hypoglycemic.
A,B,C,D,E
6. What should the nurse include when teaching a client about gentamicin (Garamycin)? (Select all that apply.) a. Client should report any hearing loss. b. Client must use sunscreen. c. IV gentamicin will be given over 20 minutes. d. Client will be monitored for mouth ulcers and vaginitis. e. Peak levels will be drawn 30 minutes prior to IV dose. f. Client should increase fluid intake.
A,B,D,F,
6. The nurse is caring for a client taking nitrofurantoin (Macrodantin). Which are appropriate nursing interventions for this client? (Select all that apply.) a. Monitor urinary output and urine specific gravity. b. Monitor the client for peripheral neuropathy. c. Advise the client to wear protective clothing to prevent photosensitivity. d. Warn the client to avoid excess exposure to sunlight. e. Inform the client that urine may turn a harmless brown color.
A,B,E,
1. A client is taking azithromycin (Zithromax). The nurse should apply which interventions? (Select all that apply.) a. Monitor periodic liver function tests. b. Dilute with 50 mL for IV administration. c. Tell the client to report any hearing loss. d. Instruct the client to report evidence of superinfection. e. Teach the client to take oral drug 1 hour a.c. or 2 hours p.c. f. Avoid antacids from 2 hours prior to 2 hours after azithromycin administration.
A,C,D,E,F
6. A client has been diagnosed with tuberculosis and is to begin the antitubercular medications isoniazid, rifampin, and ethambutol. What should the nurse do? (Select all that apply.) a. Encourage periodic eye examinations. b. Instruct client to take medications with meals. c. Suggest that client take antacids with medications to prevent GI distress. d. Advise client to report numbness and tingling of hands or feet. e. Alert client that body fluids may develop a red-orange color. f. Teach client to avoid direct sunlight and to use sunblock.
A,D,E,F
6. Acyclovir (Zovirax) has been ordered for a client with genital herpes. Which nursing interventions are appropriate for this client? (Select all that apply.) a. Monitor BUN and creatinine. b. Monitor client's BP for hypertension. c. Administer IV acyclovir over 30 minutes. d. Advise client to maintain adequate fluid intake. e. Teach client to perform oral hygiene several times a day. f. Monitor client's CBC, especially WBC, platelets, hemoglobin, and hematocrit.
A,D,E,F
1. For the client who is crushing nitrofurantoin (Macrodantin) tablets, what should the nurse teach the client to do? a. Expect the urine to turn blue. b. Keep the urine acidic by drinking milk. c. Rinse the mouth after oral nitrofurantoin to avoid teeth staining.
c
2. A client taking isoniazid is worried about the side effects/adverse reactions. The nurse realizes that which is a common adverse reaction of isoniazid? a. Ototoxicity b. Hepatotoxicity c. Nephrotoxicity d. Optic nerve toxicity
B
5. A client is taking a sulfonamide for an acute urinary tract infection. Which medication does the nurse realize is a short-acting sulfonamide? a. sulfasalazine (Azulfidine) b. sulfadiazine (Microsulfon) c. sulfamethoxazole (Gantanol) d. co-trimoxazole/TMP-SMZ (Bactrim)
B
5. The client is taking tolterodine tartrate (Detrol). The nurse should teach the client to report which condition? a. Alkaline urine b. Urinary retention c. Excessive tearing d. Reddish orange urine
B
1. A client is diagnosed with HSV-3. The nurse understands that this illness is better known by which name? a. Chicken pox b. Hepatitis B c. Shingles in an adult d. Cytomegalovirus
C
3. The nurse is teaching a client about sulfadiazine (Microsulfon). Which directive should the nurse include in the teaching? a. Avoid caffeine during sulfonamide treatment. b. Administer in 50 mL of fluid over 30 minutes. c. Avoid sulfonamides during the third trimester of pregnancy.
C
4. A client with a diagnosis of intestinal amebiasis develops severe nausea, vomiting, fever, facial flushing, slurred speech, tachycardia, hypotension, and palpitations. A beginning assessment reveals that the client has just had several alcoholic beverages. The nurse should obtain a drug history for which drug? a. bacitracin (Baci-IM) b. fluconazole (Diflucan) c. metronidazole (Flagyl) d. ethambutol (Myambutol)
C
2. The client complains about a burning sensation and pain when urinating. The nurse knows that which is an appropriate urinary analgesic? a. tolterodine (Detrol) b. oxybutynin (Ditropan) c. bethanechol (Urecholine) d. phenazopyridine (Pyridium)
D
2. The nurse closely monitors the client taking lincosamides for which serious adverse effect? a. Seizures b. Ototoxicity c. Hepatotoxicity d. Pseudomembranous colitis
D
2. Zanamivir (Relenza) is ordered for a client. The nurse knows that this drug is intended for which purpose? a. Treatment of HSV-2 b. Oral administration for treatment of HSV-1 c. Treatment of varicella-zoster viruses d. Administration within 48 hours of onset of symptoms to be effective
D
3. A client is taking the urinary antiseptic methenamine mandelate (Mandelamine) for a UTI. The nurse realizes that this drug should not be given concurrently with which other drug to avoid potential crystalluria? a. ertapenem (Invanz) b. ciprofloxacin (Cipro) c. nalidixic acid (NegGram) d. trimethoprim-sulfamethoxazole (Bactrim)
D
3. A client who is taking acyclovir asks the nurse about the drug. Which instruction should the nurse include in client teaching? a. Restrict fluids to prevent complications. b. Monitor blood pressure for hypertension. c. Stevens-Johnson syndrome is an adverse effect. d. Importance of frequent CBC, BUN, and creatinine tests.
D
4. A client is ordered to take trimethoprim-sulfamethoxazole (Bactrim). The nurse knows to expect which common adverse reaction? a. Bronchospasm b. Dysrhythmias c. Pseudomembranous colitis d. Stevens-Johnson syndrome
D
5. A client is taking levofloxacin (Levaquin). The nurse knows that which is true regarding this drug? a. Administered IV only b. May cause hypertension c. Classified as an aminoglycoside d. Adverse reaction includes dysrhythmias
D
5. A client is taking thiabendazole. What does the nurse realize about this drug? a. The drug is given for 7 days. b. The drug should be avoided if the client has renal disease. c. Family members should be checked for the same disease. d. Proper hygiene must be taught to avoid the spread of disease.
D
A patient has been prescribed Amoxicillin (Amoxil). What does the nurse know is true about this medication? a. It has a normal adult dose of 2 grams q6h. b. It has a common side effect of hypotension. c. It has an intramuscular administration route. d. It is used to treat respiratory infections.
D. It is used to treat respiratory infections.
A child is diagnosed with pinworms. Which anthelmintic drug will the provider order for this child? a. Bithionol (Bitin) b. Diethylcarbamazine (Hetrazan) c. Mebendazole (Vermox) d. Praziquantel (Biltricide)
c. Mebendazole (Vermox)
The nurse is teaching a nursing student about the antifungal drug amphotericin B. Which statement by the student indicates a need for further teaching? a. "Amphotericin B may be given intravenously or by mouth." b. "Patients who take this drug should have potassium and magnesium levels assessed." c. "Patients with renal disease should not take amphotericin B." d. "This drug is used for severe systemic infections."
a. "Amphotericin B may be given intravenously or by mouth."
The nurse is counseling a patient who will begin taking a sulfonamide drug to treat a urinary tract infection. What information will the nurse include in teaching? a. "Drink several quarts of water daily." b. "If stomach upset occurs, take an antacid." c. "Limit sun exposure to no more than 1 hour each day." d. "Sore throat is a common, harmless side effect."
a. "Drink several quarts of water daily"
The nurse provides home care instructions for a patient who will take a high dose of azithromycin after discharge from the hospital. Which statement by the patient indicates understanding of the teaching? a. "I may take antacids 2 hours before taking this drug." b. "I should take acetaminophen for fever or mild pain." c. "I should expect diarrhea to be a common, mild side effect." d. "I should avoid dairy products while taking this drug."
a. "I may take antacids 2 hours before taking this drug."
2. Amoxicillin (Amoxil) is prescribed for a client who has a respiratory infection. The nurse is teaching the client about this medication and realizes that more teaching is needed when the client makes which statement? a. "I should not take my medication with food." b. "I will take my entire prescription of medication." c. "I should report to the physician any genital itching." d. "I should report to the health care provider any excess bleeding."
a. "I should not take my medication with food."
The nurse is teaching a patient about rifampin. Which statement by the patient indicates understanding of the teaching? a. "I should not wear soft contact lenses while taking rifampin." b. "I will need regular eye examinations while taking this drug." c. "I will report orange urine to my provider immediately." d. "I understand that renal toxicity is a common adverse effect."
a. "I should not wear soft contact lenses while taking rifampin."
A child who weighs 10 kg will begin taking oral trimethoprim-sulfamethoxazole (TMP-SMX). The liquid preparation contains 40 mg of TMP and 200 mg of SMX per 5 mL. The nurse determines that the child's dose should be 8 mg of TMP and 40 mg of SMX/kg/day divided into two doses. Which order for this child is correct? a. 5 mL PO BID b. 5 mL PO daily c. 10 mL PO BID d. 10 mL PO daily
a. 5 mL PO BID
A patient is preparing to travel to a country with prevalent malaria. To prevent contracting the disease, the provider has ordered chloroquine HCl (Aralen). The nurse will instruct the patient to take this drug according to which schedule? a. 500 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel b. 1000 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel c. 500 mg once followed by 500 mg per dose in 6 hours, 24 hours, and 48 hours d. 1000 mg once followed by 500 mg per dose in 6 hours, 24 hours, and 48 hours
a. 500 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel
A young adult female who is taking metronidazole (Flagyl) to treat trichomoniasis calls the nurse to report severe headache, flushing, palpitations, cramping, and nausea. What will the nurse do next? a. Ask about alcohol consumption. b. Reassure her that these are harmless side effects. c. Tell her that this signals a worsening of her infection. d. Tell her to go to the emergency department immediately.
a. Ask about alcohol consumption.
The client has been ordered Cefazolin. The nurse anticipates an increase in the client's _____ from this medication? a. BUN and serum creatinine b. serum potassium c. serum calcium d. serum white blood cells
a. BUN and serum creatinine
The nurse is caring for a patient who is receiving a high dose of tetracycline (Sumycin). Which laboratory values will the nurse expect to monitor while caring for this patient? a. Blood urea nitrogen (BUN) and creatinine levels b. Complete blood counts c. Electrolytes d. Liver enzyme levels
a. Blood urea nitrogen (BUN) and creatinine levels
Most beta-lactam antibiotics are excreted through the kidneys. The nurse should assess the client's renal function by monitoring which levels? a. Blood urea nitrogen and serum creatinine b. Creatinine phosphokinase and alkaline phosphatase c. White blood cell count and red blood cell count d. Hemoglobin and hematocrit
a. Blood urea nitrogen and serum creatinine
A patient taking trimethoprim-sulfamethoxazole (TMP-SMX) to treat a urinary tract infection complains of a sore throat. The nurse will contact the provider to request an order for which laboratory test(s)? a. Complete blood count with differential b. Throat culture c. Urinalysis d. Coagulation studies
a. Complete blood count with differential
The nurse receives the following order for a patient who is diagnosed with herpes zoster virus: PO acyclovir (Zovirax) 400 mg TID for 7 to 10 days. The nurse will contact the provider to clarify which part of the order? a. Dose and frequency b. Frequency and duration c. Drug and dose d. Drug and duration
a. Dose and frequency
A patient who has travelled to an area with prevalent malaria has chills, fever, and diaphoresis. The nurse recognizes this as which phase of malarial infection? a. Erythrocytic phase b. Incubation phase c. Prodromal phase d. Tissue phase
a. Erythrocytic phase
The nurse is caring for a patient who is diagnosed with a urinary tract infection. The patient reports always having difficulty remembering to take medications. Which drug will the nurse expect the provider to select when treating this patient? a. Fosfomycin tromethamine (Monurol) b. Nalidixic acid (NegGram) c. Nitrofurantoin (Macrodantin) d. Trimethoprim-sulfamethoxazole (Bactrim)
a. Fosfomycin tromethamine (Monurol)
The nurse is preparing to give trimethoprim-sulfamethoxazole (TMP-SMX) to a patient and notes a petechial rash on the patient's extremities. The nurse will perform which action? a. Hold the dose and notify the provider. b. Request an order for a blood glucose level. c. Request an order for a BUN and creatinine level. d. Request an order for diphenhydramine, Benadryl.
a. Hold the dose and notify the provider
The nurse is preparing to administer methenamine (Hiprex) to a patient who has pyelonephritis. Which action will the nurse perform? a. Increase fluid intake to 2000 mL per day. b. Monitor the patient's urine for dark brown color. c. Order alkaline foods 3 times daily. d. Request an order for a sulfonamide antibiotic.
a. Increase fluid intake to 2000 mL per day.
The nurse is caring for an infant who has respiratory syncytial virus (RSV) and who will receive ribavirin. The nurse expects to administer this drug by which route? a. Inhalation b. Intramuscular c. Intravenous d. Oral
a. Inhalation
The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the nurse that the provider plans to order a prophylactic antitubercular drug for family members and asks which drug will be ordered. The nurse will expect the provider to order which drug? a. Isoniazid (INH) b. Pyrazinamide c. Rifampin (Rifadin) d. Streptomycin
a. Isoniazid (INH)
A client is ordered to receive a cephalosporin to treat a bacterial infection. Regarding monitoring of the client, the highest priority action on the part of the nurse includes assessing the client for which side effects? a. Nausea, vomiting, and diarrhea b. Photophobia and phototoxicity c. Pain with urination and blood in the urine d. High fevers and sweating
a. Nausea, vomiting, and diarrhea
A client with otitis media is ordered to receive amoxicillin (Amoxil). The client discloses to the nurse that she is allergic to penicillin. What is the highest priority action on the part of the nurse? a. Notify the healthcare provider that the client is allergic to penicillin. b. Encourage the client to take the dose under close monitoring. c. Administer half of the amoxicillin dose under supervision. d. Report the amoxicillin order to the supervisor.
a. Notify the healthcare provider that the client is allergic to penicillin.
A nurse is ordered to draw blood levels for a person receiving an antibiotic. The nurse is aware that peaks and troughs of serum antibiotic levels are monitored for drugs with a: a. narrow therapeutic index. b. large therapeutic index. c. long half-life. d. short half-life.
a. narrow therapeutic index.
The nurse is teaching a parent about administering nitrofurantoin suspension to a 5-year-old child. Which instruction will the nurse include in the patient teaching? a. "Give the medication on an empty stomach." b. "Have the child rinse the mouth after taking the drug." c. "Limit the child's fluid intake to concentrate the urine." d. "Report brownish-colored urine to the child's provider."
b. "Have the child rinse the mouth after taking the drug."
A patient is diagnosed with histoplasmosis and will begin taking ketoconazole. What information will the nurse include when teaching this patient about this medication? a. "Take the medicine twice daily." b. "Take the medication with food." c. "You may consume small amounts of alcohol." d. "You will not need lab tests while taking this drug."
b. "Take the medication with food."
A nurse whose last flu vaccine was 1 year prior is exposed to the influenza A virus. The occupational health nurse will administer which medication? a. Acyclovir (Zovirax) b. Amantadine HCl (Symmetrel) c. Influenza vaccine d. Oseltamivir phosphate (Tamiflu)
b. Amantadine HCl (Symmetrel)
A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication, the nurse will review which laboratory values in the patient's medical record? a. Complete blood count (CBC) with differential white cell count b. Blood urea nitrogen (BUN) and creatinine c. Potassium and magnesium levels d. Serum fasting glucose
b. Blood urea nitrogen (BUN) and creatinine
The patient has been ordered treatment with rimantadine (Flumadine). The patient has renal impairment. The nurse anticipates what change to the dose of medication? a. Increased b. Decreased c. Unchanged d. Held
b. Decreased
The client has been ordered treatment with Cefaclor as well as erythromycin. The nurse anticipates what effect from the interaction of the medications? a. Increased action of the Cefaclor b. Decreased action of the Cefaclor c. Anaphylactic reaction to the Cefaclor d. Toxic action of the Cefaclor
b. Decreased action of the Cefaclor
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in phase I of treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse anticipate the provider will order to replace the isoniazid? a. Ciprofloxacin (Cipro) b. Ethambutol (Myambutol) c. Kanamycin d. Streptomycin sulfate
b. Ethambutol (Myambutol)
The nurse receives an order to administer a purine nucleoside antiviral medication. The nurse understands that this medication treats which type of virus? a. Hepatitis virus b. Herpes virus c. HIV d. Influenza virus
b. Herpes virus
The nurse is preparing to administer an intravenous polymyxin antibiotic. The patient reports dizziness along with numbness and tingling of the hands and feet. The nurse will perform which action? a. Administer the drug since these are harmless side effects. b. Hold the drug and notify the provider of these adverse reactions. c. Obtain an order for an oral form of this medication. d. Request an order for serum electrolytes.
b. Hold the drug and notify the provider of these adverse reactions.
Which topical antifungal medication is used to treat vaginal candidiasis? a. Haloprogin (Halotex) b. Miconazole (Monistat) c. Oxiconazole (Oxistat) d. Terbenafine HCl (Lamisil)
b. Miconazole (Monistat)
Which side effects are common to most urinary antiseptics? a. Dyspnea and chest pain b. Nausea and vomiting c. Peripheral neuritis d. Visual disturbances
b. Nausea and vomiting
The nurse is preparing to administer methenamine (Hiprex) to a patient who is diagnosed with a urinary tract infection. The nurse reviews the patient's chart and notes a urinary pH of 6.0. Which action will the nurse take? a. Administer the drug as ordered. b. Obtain an order for 8 ounces of cranberry juice 3 times daily. c. Request an order for an increased dose. d. Restrict fluids to concentrate the patient's urine.
b. Obtain an order for 8 ounces of cranberry juice 3 times daily.
A male patient reports urinary urgency and pain with burning on urination. The nurse understands that this patient will be treated for which condition? a. Cystitis b. Prostatitis c. Pyelonephritis d. Urethritis
b. Prostatitis
A patient who is taking metronidazole (Flagyl) reports reddish-brown urine. Which action will the nurse take? a. Obtain an order for BUN and creatinine levels. b. Reassure the patient that this is a harmless effect. c. Request an order for a urinalysis. d. Test her urine for occult blood.
b. Reassure the patient that this is a harmless effect.
The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min. The nurse notes red blotches on the patient's face, neck, and chest and assesses a blood pressure of 80/55 mm Hg. Which action will the nurse take? a. Request an order for IV epinephrine to treat anaphylactic shock. b. Slow the infusion to 10 mg/min and observe the patient closely. c. Stop the infusion and obtain an order for a BUN and serum creatinine. d. Suspect Stevens-Johnson syndrome and notify the provider immediately.
b. Slow the infusion to 10 mg/min and observe the patient closely.
Which is a characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infection? a. Sulfonamides are bactericidal. b. Sulfonamides are derived from biologic substances. c. Sulfonamides have antifungal and antiviral properties. d. Sulfonamides increase bacterial synthesis of folic acid
b. Sulfonamides are derived from biologic substances
When antibacterials are prescribed for the treatment of an infection and a culture is ordered, what should happen next? a. The initial dose of the antibiotic should be given before the culture is taken. b. The culture should be taken before the initial dose of the antibiotic is given. c. The culture should be taken any time after the antibiotic therapy begins. d. The culture may be taken at any time before or during antibiotic therapy.
b. The culture should be taken before the initial dose of the antibiotic is given.
A patient who has chronic liver disease reports contact with a person who has tuberculosis (TB). The nurse will counsel this patient to contact the provider to discuss a. a chest x-ray. b. a TB skin test. c. liver function tests (LFTs). d. prophylactic antitubercular drugs.
b. a TB skin test.
Drug concentration is important for the eradication of bacterial infection. It is desired to keep the drug dose: a. below minimum effective concentration. b. above minimum effective concentration. c. below minimum toxic level. d. above minimum toxic level.
b. above minimum effective concentration.
A client who reports an allergy to penicillin is ordered to receive cephalexin (Keflex). The correct action for the nurse is to: a. administer the medication as ordered with additional fluids. b. administer the medication and carefully observe for allergic reaction. c. call the physician to change the order because of the allergy history. d. administer another antibiotic after consulting the pharmacist.
b. administer the medication and carefully observe for allergic reaction.
A patient who will begin taking trimethoprim-sulfamethoxazole TMP-SMX asks the nurse why the combination drug is necessary. The nurse will explain that the combination is used to a. broaden the antibacterial spectrum. b. decrease bacterial resistance. c. improve the taste. d. minimize toxic effects.
b. decrease bacterial resistance
The nurse caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The nurse will contact the provider to a. discuss giving a smaller dose of penicillin. b. discuss using erythromycin (E-mycin) instead of penicillin. c. request an order for diphenhydramine (Benadryl). d. suggest that the patient receive cefuroxime (Ceftin).
b. discuss using erythromycin (E-mycin) instead of penicillin.
The nurse is preparing to administer bethanechol chloride (Urecholine) to a patient. The nurse understands that this drug acts to a. block parasympathetic nerve impulses. b. increase the tone of the urinary detrusor muscle. c. relax smooth muscles in the urinary tract. d. relieve urinary pain and burning.
b. increase the tone of the urinary detrusor muscle.
A patient who has completed the first phase of a three-drug regimen for tuberculosis has a positive sputum acid-bacilli test. The nurse will tell the patient that a. drug resistance has probably occurred. b. it may be another month before this test is negative. c. the provider will change the pyrazinamide to ethambutol. d. there may be a need to remain in the first phase of therapy for several weeks.
b. it may be another month before this test is negative.
A patient who is taking acyclovir (Zovirax) to treat an oral HSV-1 infection asks the nurse why oral care is so important. The nurse will tell the patient that meticulous oral care helps to a. minimize transmission of disease. b. prevent gingival hyperplasia. c. reduce viral resistance to the drug. d. shorten the duration of drug therapy.
b. prevent gingival hyperplasia
A patient is taking chloroquine (Aralen) to treat acute malaria. Which statement by the patient indicates understanding of this medication? a. "I should abstain from alcohol while taking this medication." b. "I should report urine output less than 1000 mL/day." c. "I should report visual changes immediately." d. "I should take this drug on an empty stomach."
c. "I should report visual changes immediately."
The nurse provides teaching for a patient who will begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. Which statement by the patient indicates understanding of the teaching? a. "If I experience gastrointestinal upset, I may take an antacid." b. "I should notify my provider immediately if my urine is brown." c. "I should take the drug with food and increase my fluid intake." d. "Tingling of my fingers is a harmless side effect of this drug."
c. "I should take the drug with food and increase my fluid intake."
The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin) to treat pneumonia. The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC) antacids to treat occasional heartburn. The patient reports frequent arthritis pain and takes acetaminophen when needed. Which statement by the nurse is correct when teaching this patient? a. "You may take antacids with levofloxacin to decrease gastrointestinal upset." b. "You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain." c. "You should monitor your serum glucose more closely while taking levofloxacin." d. "You should take levofloxacin on an empty stomach to improve absorption."
c. "You should monitor your serum glucose more closely while taking levofloxacin."
The nurse is caring for a patient who is receiving sulfadiazine. The nurse knows that this patient's daily fluid intake should be at least which amount? a. 1000 mL/day b. 1200 mL/day c. 2000 mL/day d. 2400 mL/day
c. 2000 mL/day
A patient is diagnosed with influenza and will begin taking a neuraminidase inhibitor. The nurse knows that this drug is effective when taken within how many hours of onset of flu symptoms? a. 12 hours b. 24 hours c. 48 hours d. 72 hours
c. 48 hours
The nurse is preparing to give a dose of oral clindamycin (Cleocin) to a patient who is being treated for a skin infection caused by Staphylococcus aureus. The patient has had several doses of the medication and reports having nausea. Which action will the nurse take next? a. Administer the next dose when the patient has an empty stomach. b. Hold the next dose and contact the patient's provider. c. Instruct the patient to take the next dose with a full glass of water. d. Request an order for an antacid to give along with the next dose.
c. Instruct the patient to take the next dose with a full glass of water.
The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action? a. Add ethambutol (Myambutol). b. Change the streptomycin to clarithromycin. c. Change the streptomycin to kanamycin. d. Order renal function tests.
c. Change the streptomycin to kanamycin.
The nurse is caring for a patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX). The nurse learns that the patient takes an angiotension-converting enzyme (ACE) inhibitor. To monitor for drug interactions, the nurse will request an order for which laboratory test(s)? a. A complete blood count b. BUN and creatinine c. Electrolytes d. Glucose
c. Electrolytes
A female patient who is allergic to penicillin will begin taking an antibiotic to treat a lower respiratory tract infection. The patient tells the nurse that she almost always develops a vaginal yeast infection when she takes antibiotics and that she will take fluconazole (Diflucan) with the antibiotic being prescribed. Which macrolide order would the nurse question for this patient? a. Azithromycin (Zithromax) b. Clarithromycin (Biaxin) c. Erythromycin (E-Mycin) d. Fidaxomicin (Dificid)
c. Erythromycin (E-Mycin)
A patient is diagnosed with mycoplasma pneumonia. Which antibiotic will the nurse expect the provider to order to treat this infection? a. Azithromycin (Zithromax) b. Clarithromycin (Biaxin) c. Erythromycin (E-Mycin) d. Fidaxomicin (Dificid)
c. Erythromycin (E-Mycin)
The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question? a. Azithromycin (Zithromax) 500 mg IV in 500 mL fluid b. Azithromycin (Zithromax) 500 mg PO once daily c. Erythromycin 300 mg IM QID d. Erythromycin 300 mg PO QID
c. Erythromycin 300 mg IM QID
The nurse assumes care for a patient who is experiencing urinary tract spasms and is ordered to receive flavoxate HCl (Urispas). When reviewing this patient's history, which condition would cause the nurse to notify the provider? a. Chronic obstructive pulmonary disorder b. Diabetes c. Glaucoma d. Hypotension
c. Glaucoma
A patient is diagnosed with tinea capitis. The provider will order which systemic antifungal medication for this patient? a. Anidulafungin (Eraxis) b. Fluconazole (Diflucan) c. Griseofulvin (Fulvicin) d. Ketoconazole (Nizoral)
c. Griseofulvin (Fulvicin)
The nurse is preparing to administer trimethoprim-sulfamethoxazole (TMP-SMX) to a patient who is being treated for a urinary tract infection. The nurse learns that the patient has type 2 diabetes mellitus and takes a sulfonylurea oral antidiabetic drug. The nurse will monitor this patient closely for which effect? a. Headaches b. Hypertension c. Hypoglycemia d. Superinfection
c. Hypoglycemia
The nurse is teaching a patient who will receive acyclovir for a herpes virus infection. What information will the nurse include when teaching this patient? a. Blood cell counts should be monitored closely. b. Dizziness and confusion are harmless side effects. c. Increase fluid intake while taking this medication. d. Side effects are rare with this medication.
c. Increase fluid intake while taking this medication.
1. A client is receiving amoxicillin (Amoxil). The nurse knows that the action of this drug is by which process? a. Inhibition of protein synthesis b. Alteration of membrane permeability c. Inhibition of bacterial cell-wall synthesis d. Alteration of synthesis of bacterial ribonucleic acid
c. Inhibition of bacterial cell-wall synthesis
A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question? a. Verify that the client is not allergic to penicillin. b. Obtain culture before administering the first dose of medication. c. Instruct client to discontinue penicillin when temperature is normal. d. Encourage the client to increase fluid intake.
c. Instruct client to discontinue penicillin when temperature is normal.
The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin to treat an infection. The patient is also taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug's side effects? a. Complete blood counts b. Electrolytes c. Liver enzymes d. Urinalysis
c. Liver enzymes
A client has been receiving a cephalosporin for 20 days to treat a severe bacterial infection. The client complains of mouth pain, and the nurse assesses white patches in the client's mouth. What is the highest priority action on the part of the nurse? a. Provide mouth care with glycerin swabs. b. Encourage the client to drink more fluids. c. Notify the physician and describe symptoms. d. Administer analgesia for the mouth pain.
c. Notify the physician and describe symptoms.
A patient who has AIDS is at risk to contract aspergillosis. The nurse will anticipate that which antifungal medication will be ordered prophylactically for this patient? a. Metronidazole (Flagyl) b. Micafungin (Mycamine) c. Posaconazole (Noxafil) d. Voriconazole (Vfend)
c. Posaconazole (Noxafil)
A 25-year-old female patient reports urinary frequency with pain on urination, flank pain, fever, and chills. The nurse recognizes these symptoms as characteristic of which condition? a. Cystitis b. Dysuria c. Pyelonephritis d. Urethritis
c. Pyelonephritis
A female patient who is taking trimethoprim-sulfamethoxazole TMP-SMZ Bactrim, Septra to treat a urinary tract infection reports vaginal itching and discharge. The nurse will perform which action? a. Ask the patient if she might be pregnant. b. Reassure the patient that this is a normal side effect. c. Report a possible super infection to the provider. d. Suspect that the patient is having a hematologic reaction.
c. Report a possible super infection to the provider.
The nurse is reviewing a patient's chart prior to administering gentamycin (Garamycin) and notes that the last serum peak drug level was 9 mcg/mL and the last trough level was 2 mcg/mL. What action will the nurse take? a. Administer the next dose as ordered. b. Obtain repeat peak and trough levels before giving the next dose. c. Report possible drug toxicity to the patient's provider. d. Report a decreased drug therapeutic level to the patient's provider.
c. Report possible drug toxicity to the patient's provider.
The nurse is preparing to administer clarithromycin to a patient. When performing a medication history, the nurse learns that the patient takes warfarin to treat atrial fibrillation. The nurse will perform which action? a. Ask the provider if azithromycin may be used instead of clarithromycin. b. Obtain an order for continuous cardiovascular monitoring. c. Request an order for periodic serum warfarin levels. d. Withhold the clarithromycin and notify the provider.
c. Request an order for periodic serum warfarin levels.
A patient calls the clinic in November to report a temperature of 103° F, headache, a nonproductive cough, and muscle aches. The patient reports feeling well earlier that day. The nurse will schedule the patient to see the provider and will expect the provider to order which medication? a. Amantadine HCl (Symmetrel) b. Influenza vaccine c. Rimantadine HCl (Flumadine) d. An over-the-counter drug for symptomatic treatment
c. Rimantadine HCl (Flumadine)
A patient who is taking trimethoprim-sulfamethoxazole (TMP-SMX) calls to report developing an all-over rash. The nurse will instruct the patient to perform which action? a. Increase fluid intake. b. Take diphenhydramine. c. Stop taking TMP-SMX immediately. d. Continue taking the medication.
c. Stop taking TMP-SMX immediately
A patient will take an anthelmintic medication and asks the nurse about side effects. The nurse will tell the patient that anthelmintic drugs a. can cause hepatic toxicity. b. cause orthostatic hypotension. c. commonly have gastrointestinal (GI) side effects. d. have many serious adverse reactions.
c. commonly have gastrointestinal (GI) side effects.
A patient who has tuberculosis asks the nurse why three drugs are used to treat this disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of a. disease relapse. b. drug hypersensitivity reactions. c. drug resistance. d. drug adverse effects.
c. drug resistance.
The client has been ordered treatment with Amoxil. The client reports to the nurse that she has developed symptoms of vaginitis. The highest priority action on the part of the nurse is to recognize this as: a. an expected side effect of the medication. b. a life-threatening reaction to the drug. c. evidence of development of a superinfection. d. evidence of an anaphylactic reaction.
c. evidence of development of a superinfection.
The nurse is caring for a patient who is ordered to receive PO trimethoprim-sulfamethoxazole (TMP-SMX) 160/800 QID to treat a urinary tract infection caused by E. coli. The nurse will contact the provider to clarify the correct a. dose. b. drug. c. frequency d. route
c. frequency
With continuous use of antibiotics, antibiotic resistance result because: a. bacteria are producing fewer mutations. b. the immune system has enhanced ability to fight infection. c. mutant bacteria are surviving antibiotic use. d. fewer new antibiotics have been produced.
c. mutant bacteria are surviving antibiotic use.
The nurse is caring for a 70-kg patient who is receiving gentamicin (Garamycin) 85 mg 4 times daily. The patient reports experiencing ringing in the ears. The nurse will contact the provider to discuss a. decreasing the dose to 50 mg QID. b. giving the dose 3 times daily. c. obtaining a serum drug level. d. ordering a hearing test.
c. obtaining a serum drug level.
The nurse is caring for a patient who will begin taking doxycycline to treat an infection. The nurse should plan to give this medication a. 1 hour before or 2 hours after a meal. b. with an antacid to minimize GI irritation. c. with food to improve absorption. d. with small sips of water.
c. with food to improve absorption.
4. A client is receiving solifenacin succinate (VESIcare). The nurse knows that this drug is used to treat which condition? a. Chronic cystitis b. Urinary tract spasms c. Urinary tract infection d. Overactive bladder
d
The nurse is teaching a patient who is receiving chloroquine (Aralen) for malaria prophylaxis. Which statement by the patient indicates a need for further teaching? a. "I may experience hair discoloration while taking this drug." b. "I should not take this drug with lemon juice." c. "I should use sunscreen while taking this drug." d. "If I have gastrointestinal upset, I should take an antacid."
d. "If I have gastrointestinal upset, I should take an antacid."
A patient who has oral candidiasis will begin using nystatin suspension to treat the infection. What information will the nurse include when teaching this patient? a. "Coat the buccal mucosa with the drug and then rinse your mouth." b. "Gargle with the nystatin and then spit it out without swallowing." c. "Mix the suspension with 4 ounces of water and then drink it." d. "Swish the liquid in your mouth and then swallow after a few minutes."
d. "Swish the liquid in your mouth and then swallow after a few minutes."
A patient who has pain with urination associated with cystitis will be discharged home with a prescription for phenazopyridine (Pyridium). What instruction will the nurse include when teaching the patient about this drug? a. "Do not take this drug concurrently with an antibiotic." b. "Report reddish-brown urine to the provider immediately." c. "This drug has antiseptic and analgesic properties." d. "The drug provides symptomatic relief of pain."
d. "The drug provides symptomatic relief of pain."
A child is being treated for pinworms, and the parent asks the nurse how to prevent spreading this to other family members. What will the nurse tell the parent? a. "Give your child baths every day." b. "Obtain a daily stool specimen from your child." c. "Wash your child's clothing in hot water." d. "Your child should wash hands well after using the toilet."
d. "Your child should wash hands well after using the toilet."
Which person should be treated with prophylactic antitubercular medication? a. A child who attends the same school with a child who has tuberculosis b. A nurse who is working in a hospital c. An individual who is HIV-positive with a negative TB skin test d. A patient who has close contact with someone who has tuberculosis
d. A patient who has close contact with someone who has tuberculosis
The nurse is caring for a hospitalized patient who has symptoms characteristic of pyelonephritis. Before administering the first dose of the intravenous antibiotic, the nurse will ensure that which action is performed? a. An antipyretic is administered. b. A dose of oral antibiotic is given. c. A urinary analgesic is given. d. A urine culture is obtained.
d. A urine culture is obtained.
The client has been ordered treatment with Wycillin. The nurse notes that the solution is milky in color. What is the highest priority action on the part of the nurse? a. Call the pharmacist and report the milky color. b. Add normal saline to dilute the medication. c. Call the physician and report the milky appearance. d. Administer the medication as ordered by the physician.
d. Administer the medication as ordered by the physician.
A client's medication warrants peak and trough levels to be drawn. The nurse is aware that if the peak level of the drug is too high, what could occur? a. Mild side effects b. Inadequate drug action c. Slow onset of drug action d. Drug toxicity
d. Drug toxicity
A patient who takes an oral sulfonylurea medication will begin taking fluconazole (Diflucan). The nurse will expect to monitor which lab values in this patient? a. Blood urea nitrogen (BUN) and creatinine b. Electrolytes c. Fluconazole levels d. Glucose
d. Glucose
3. A client is prescribed dicloxacillin (Dynapen). The nurse plans to monitor the client for which side effect/adverse reaction? a. Seizures b. Renal failure c. Hypertension d. Hemolytic anemia
d. Hemolytic anemia
The nurse is preparing to administer intravenous gentamicin to an infant through an intermittent needle. The nurse notes that the infant has not had a wet diaper for several hours. The nurse will perform which action? a. Administer the medication and give the infant extra oral fluids. b. Contact the provider to request adding intravenous fluids when giving the medication. c. Give the medication and obtain a serum peak drug level 45 minutes after the dose. d. Hold the dose and contact the provider to request a serum trough drug level.
d. Hold the dose and contact the provider to request a serum trough drug level.
The nurse is preparing to administer a phenazopyridine HCl (Pyridium) dose to a patient who has diabetes. The nurse notes that the patient has a positive Clinitest. What will the nurse do next? a. Encourage the patient to increase oral fluid intake. b. Hold the dose until the patient's Clinitest is negative. c. Notify the provider of the patient's hyperglycemia. d. Request an order for serum blood glucose.
d. Request an order for serum blood glucose.
A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction? a. Wear a Medic Alert bracelet that indicates the allergy. b. Avoid all penicillin-type drugs. c. Inform all healthcare providers of the allergy. d. Restrict fluids when taking the antibiotic.
d. Restrict fluids when taking the antibiotic.
The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin. Which is an important nursing action? a. Administer each antibiotic to infuse over 15 to 20 minutes. b. Order serum peak and trough levels of ampicillin. c. Prepare the schedule so that the drugs are given at the same time. d. Set up separate tubing sets for each drug labeled with the drug name and date.
d. Set up separate tubing sets for each drug labeled with the drug name and date.
A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports tingling of the fingers and toes. The nurse will recommend discussing which treatment with the provider? a. Adding pyrazinamide b. Changing to ethambutol c. Increasing oral fluid intake d. Taking pyridoxine (B6)
d. Taking pyridoxine (B6)
The nurse is caring for a 7-year-old patient who will receive oral antibiotics. Which antibiotic order will the nurse question for this patient? a. Azithromycin (Zithromax) b. Clarithromycin (Biaxin) c. Clindamycin (Cleocin) d. Tetracycline (Sumycin)
d. Tetracycline (Sumycin)
An older woman has urgent urinary incontinence related to an overactive bladder. Which medication does the nurse expect the provider to order? a. Dimethylsulfoxide (DMSO) b. Flavoxate (Urispas) c. Phenazopyridine HCl (Pyridium) d. Tolterodine tartrate (Detrol)
d. Tolterodine tartrate (Detrol)
A patient will begin taking a urinary antimuscarinic medication. Which symptom should the patient report immediately? a. Dry mouth b. Fatigue c. Increased heart rate d. Urinary retention
d. Urinary retention
A female patient will receive doxycycline to treat a sexually transmitted illness (STI). What information will the nurse include when teaching this patient about this medication? a. Nausea and vomiting are uncommon adverse effects. b. The drug may cause possible teratogenic effects. c. Increase intake of dairy products with each dose of this medication. d. Use a backup method of contraception if taking oral contraceptives.
d. Use a backup method of contraception if taking oral contraceptives.
The client has been ordered to be treated with amoxicillin. The highest priority instruction that the nurse should give the client related to diet while on the medication is to avoid: a. green leafy vegetables. b. beef and other red meat. c. coffee, tea, and colas. d. acidic fruits and juices.
d. acidic fruits and juices.
The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX) and learns that the patient takes warfarin (Coumadin). The nurse will request an order for a. a decreased dose of TMP-SMX. b. a different antibiotic. c. an increased dose of warfarin. d. coagulation studies.
d. coagulation studies