Tetracyclines, Aminoglycosides, & Others

The nurse administers ampicillin to a patient who also receives tobramycin. Which condition is likely to occur with this pharmacotherapy? 1 Vestibular dysfunction 2 Impaired renal function 3 Drug-resistant organism 4 Infusion site inflammation

2

The nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child? 1 Early onset of puberty 2 Discoloration of the teeth 3 Delay in long bone growth 4 Severe face and body acne

2

The nurse is assessing a patient who is being treated with amikacin [Amikin]. The patient has increased serum creatinine concentrations, for which loop diuretics are prescribed. What should the nurse primarily monitor in the patient? 1 Orientation 2 Hearing ability 3 Glucose concentrations 4 Serum bilirubin concentrations

2

Which patient condition would be a contraindication for the administration of clindamycin [Cleocin]? 1 Arthritis 2 Skin infection 3 Ulcerative colitis 4 Diabetes mellitus

3

A chronic alcoholic patient has developed cirrhosis of the liver. The primary healthcare provider has prescribed erythromycin [Erythrocin]. Which possible drug interaction should the nurse be aware of when administering additional drugs? 1 Delay in drug absorption 2 Development of drug toxicity 3 Shortened duration of drug actions 4 Decreased pharmacologic effects of drugs

2

A nurse is administering a daily dose of tobramycin at 10:00 AM. At which time should the nurse obtain the patient's blood sample to determine the trough level? 1 8:00 AM 2 9:00 AM 3 11:30 AM 4 12:00 noon

2

The nurse should question the prescription of tetracycline for which patient? 1 A 40-year-old patient diagnosed with rickettsiae 2 A 6-year old patient with Haemophilus influenzae 3 A 60-year-old patient with a history of hypertension 4 A 45-year-old patient with a history of diabetes mellitus

2

The patient who is receiving tobramycin develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? 1 Potassium chloride [K-Dur] 2 Calcium gluconate [Kalcinate] 3 Magnesium sulfate [Epsom salt] 4 Sodium bicarbonate [Citrocarbonate]

2

The nurse explains to a patient the need for serum blood test monitoring associated with the use of aminoglycosides. Which serum blood tests will be ordered for this patient due to the use of this medication? Select all that apply. A Creatinine B Blood glucose C Peak and trough D Blood urea nitrogen (BUN) E Creatine phophokinase test (CPK)

a, c, d

Which statements about Clostridium difficile-associated diarrhea (CDAD) with clindamycin therapy does the nurse identify as true? Select all that apply. A Leukopenia commonly occurs. B It is a potentially fatal condition. C Patients usually experience abdominal pain. D Anticholinergics are effective in treating the diarrhea. E Clindamycin therapy should be discontinued and vancomycin started.

b, c, e

A certain group of patients should not be given tetracyclines. Which patients are of most concern? Select all that apply. A Hearing impaired B Pregnant women C Mentally impaired D Breastfeeding women E Children younger than 8 years

b, d, e

The nurse is assessing a patient who has cystic fibrosis who has developed a pulmonary infection. Which inhalational medication would the nurse expect the primary healthcare provider to prescribe for this patient? 1 Neomycin 2 Amikacin [Amikin] 3 Tobramycin [Nebcin] 4 Gentamicin [Garamycin]

3

The patient is receiving tobramycin. The nurse asks the patient to choose daily meal selections to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? 1 Some hearing loss may have occurred. 2 A nutrition consult most likely is needed. 3 The confusion is due to the hospital stay. 4 The patient has a family history of dementia.

1

Which antibiotic should the nurse administer if the culture of a patient with bacterial endocarditis reveals the presence of gram-positive streptococcus? 1 Tobramycin 2 Amikacin [Amikin] 3 Clindamycin [Cleocin] 4 Gentamicin [Garamycin]

1

Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline? 1 "Use sunscreen and protective clothing when outdoors." 2 "You'll need to return to the clinic for weekly blood work." 3 "You may stop taking the pills when you begin to feel better." 4 "Take the medication with yogurt or milk so you won't have nausea."

1

The nurse has administered the morning dose of tobramycin [Nebcin] to a patient according to the prescription. In the evening, the nurse collects a blood sample from the patient and observes that the serum drug concentration is >2 mcg/mL. What should the nurse infer from this? 1 The patient is at risk of heartburn. 2 The patient is at risk of renal dysfunction. 3 The patient is at risk of nasal congestion. 4 The patient is at risk of red man syndrome.

2

Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery? 1 Amikacin 2 Neomycin 3 Gentamicin 4 Tobramycin

2

Which instruction should the nurse include in the discharge teaching for a patient receiving tetracycline? 1 "Take the medication until you feel better." 2 "Use sunscreen and protective clothing when outdoors." 3 "Keep the remainder of the medication in case of recurrence." 4 "Take the medication with food or milk to minimize gastrointestinal upset."

2

A patient is scheduled for a computed tomography (CT) scan. The nurse notifies the primary healthcare provider that the patient is receiving treatment with amikacin [Amikin]. Which instruction would the primary healthcare provider give to the nurse after completion of the CT scan? 1 Check the patient's blood glucose concentrations. 2 Check the patient's blood ammonia concentrations. 3 Check the patient's serum creatinine concentrations. 4 Check the patient's serum thyroxine concentrations.

3

The nurse is caring for a patient who is being treated for acne. The nurse anticipates that the healthcare provider is most likely to treat the patient using which medication? 1 Bacitracin 2 Polymyxin 3 Tetracycline 4 Vancomycin

3

What does the nurse identify as an adverse effect of clindamycin [Cleocin] therapy? 1 Cyanosis and gray discoloration of the skin 2 Elevated bilirubin with dark urine and jaundice 3 Frequent, loose, watery stools with mucus and blood 4 Reduction in all blood cells produced in the bone marrow

3

A patient has been ordered azithromycin [Zithromax] and asks the nurse why the medication does not have to be taken as often as other antibiotics that have previously been ordered. What is the nurse's best response? 1 "You'll need to ask your healthcare provider questions like that." 2 "I'll call the pharmacy and ask about the chemical makeup of the drug." 3 "This is a much more effective drug than what you received previously." 4 "This drug has a longer duration of action than some of the other antibiotics."

4

A patient prescribed azithromycin [Zithromax] expresses concern regarding gastrointestinal upset experienced when taking erythromycin. What should the nurse tell this patient? 1 "I will call the doctor and ask for a different antibiotic." 2 "You need this medication and will have to tolerate the nausea." 3 "I will ask the doctor for a prescription for an antiemetic for possible nausea." 4 "This drug is like erythromycin but has less severe gastrointestinal side effects."

4