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Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? A female patient with acute pyelonephritis A male patient with acute prostatitis A female patient with recurring acute urinary tract infections A male patient with acute cystitis

A female patient with recurring acute urinary tract infections Female patients with relapses of urinary tract infection may need long-term therapy up to 6 months with trimethoprim/sulfamethoxazole

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching? A. "I can stop the medication as soon as the symptoms have disappeared." B. "I will drink more fluids to help clear up the infection." C. "I will stop the medication and contat the doctor if I develop a rash." D. "I should immediately report vaginal itching or discharge."

A. "I can stop the medication as soon as the symptoms have disappeared." Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve. The other responses are appropriate.

The patient is ordered daily divided doses of gentamycin. The patient received an intravenous dose of gentamycin at 4:00 PM. When should the nurse obtain the peak level? A. 4:30 PM B. 5:00 PM C. 5:30 PM D. 6:00 PM

A. 4:30 PM

Which statement about enfuvirtide does the nurse identify as true? A.) The drug is administered intravenously. B.) Enfuvirtide is one of the least expensive drugs used to treat HIV. C.) Enfuvirtide is reserved for treating HIV-1 infection that has become resistant to other antiretroviral agents. D.) This drug is most effective when used alone.

A.) The drug is administered intravenously. C.) Enfuvirtide is reserved for treating HIV-1 infection that has become resistant to other antiretroviral agents.

A patient is receiving amphotericin B to treat a systemic fungal infection. To prevent renal damage, it is most important for the nurse to do what? Administer the medication through a central venous access device Administer potassium supplements Administer 1000 mL of 0.9% saline Administer the medication orally

Administer 1000 mL of 0.9% saline

When caring for a 21-year-old female patient, post kidney transplantation, who is taking cyclosporine [Sandimmune] and repaglinide [Prandin], what should the nurse do? A.Administer the medication with grapefruit juice. B.Monitor the patient for hyperglycemia. C.Encourage the patient to take an oral contraceptive. D.Assess the patient for signs and symptoms of infection.

A.Administer the medication with grapefruit juice. Grapefruit juice should be avoided. Grapefruit juice alters the metabolism of cyclosporine, resulting in elevated serum levels of the drug. Cyclosporine can increase levels of repaglinide [Prandin], a drug for diabetes, and can thereby cause hypoglycemia. The blood glucose level should be monitored closely. Patients taking cyclosporine should be advised to use a mechanical form of contraception (condom, diaphragm) rather than oral contraceptives.

Which statement about allergic reactions to penicillin does the nurse identify as true? A.Anaphylactic reaction occur more frequently with penicillins than with any other drug. B. Allergy to penicillin always increases over time. C.Diphenhydramine [Benadryl] is the drug of choice for anaphylaxis due to penicillin allergy, D. Patient allergic to penicillin are also allergic to vancomycin.

A.Anaphylactic reaction occur more frequently with penicillins than with any other drug.

A patient has been receiving long-term prednisone therapy for treatment of rheumatoid arthritis. The chart indicates that the patient has developed Cushing's syndrome. When performing a physical assessment, the nurse anticipates finding all but which manifestation of Cushing's syndrome? A.Hypoglycemia B.Muscle weakness C.Glucosuria D."Buffalo hump"

A.Hypoglycemia Redistribution of fat produces a "potbelly," "moon face," and "buffalo hump."

The nurse is administering efavirenz [Sustiva] to a patient with AIDS. What will the nurse do? Offer St. John's wort with the medication to decrease depression Have the patient take the medication with ice cream or a milkshake Give the medication without regard to meals Administer the medication on an empty stomach at bedtime

Administer the medication on an empty stomach at bedtime A high-fat meal may cause increases in plasma levels by 39%. St. John's wort may cause decreased levels of efavirenz.

A patient who takes warfarin is prescribed itraconazole [Sporanox] to treat a fungal infection. The nurse will teach the patient to do what? Take the medication with famotidine [Pepcid] to reduce gastric upset Prepare for long-term intravenous administration of itraconazole Avoid taking esomeprazole [Nexium] with itraconazole therapy Double the dose of warfarin

Avoid taking esomeprazole [Nexium] with itraconazole therapy Drugs that reduce gastric acidity (for example, antacids, histamine2 [H2] antagonists, and proton pump inhibitors) can greatly reduce absorption of oral itraconazole. Accordingly, these agents should be administered at least 1 hour before itraconazole or 2 hours after. (Because proton pump inhibitors have a prolonged duration of action, patients using these drugs may have insufficient stomach acid for itraconazole absorption, regardless of when the proton pump inhibitor is given.)

Which patient would most likely need intravenous antibiotic therapy to treat a urinary tract infection? A. A patient with an uncomplicated urinary tract infection caused by Escherichia coli B. A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain C. A patient with acute cystitis who complains of dysuria, frequency, and urgency D. A patient with acute bacterial prostatitis with a mild fever, chills, and nocturia

B. A patient with pyelonephritis with symptoms of high fever, chills, and severe flank pain Severe pyelonephritis requires intravenous antibiotic therapy

A patient who sustained second- and third-degree burns has been prescribed mafenide. Which statement about mafenide does the nurse identify as true? A. Use of mafenide can cause alkalosis. B. Mafenide is painful upon application. C. A blue-green to gray discoloration of the skin occurs with mafenide therapy. D. Mafenide exerts its therapeutic effect by the release of free silver.

B. Mafenide is painful upon application. Mafenide is metabolized to a compound that can suppress renal excretion of acid, thereby causing acidosis. Silver sulfadiazine, another topical sulfonamide used for burn therapy, can cause a blue-green to gray skin discoloration, so facial application should be avoided. Mafenide does not cause this specific skin discoloration. Mafenide acts by the same mechanism as other sulfonamides. In contrast, the antibacterial effects of silver sulfadiazine are due primarily to the release of free silver, not to the sulfonamide portion of the molecule.

Before administering gentamycin, it is most important for the nurse to assess the patient for a history of what? A. Hypertension B. Myasthenia gravis C. Diabetes mellitus D. Asthma

B. Myasthenia gravis

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin. To prevent ototoxicity, it is most important for the nurse to monitor which value(s)? A. Serum creatinine and blood urea nitrogen levels B. Trough drug levels of gentamicin C. Peak drug levels of gentamicin D. Serum alanine aminotransferase [ALT] and aspartate aminotransferase [AST]

B. Trough drug levels of gentamicin The risk of ototoxicity is related primarily to persistently elevated trough drug levels rather than to excessive peak levels.

A patient has been prescribed oral ciprofloxacin [Cipro] for a skin infection. When administering the medication, it is most important for the nurse to do what? A. Monitor for a decrease in the prothrombin time (PT) if the patient is also taking warfarin [Coumadin] B. Withhold antacids and milk products for 6 hours before or 2 hours afterward C. Inform the healthcare provider if the patient has a history of asthma D. Assess the skin for Stevens-Johnson syndrome

B. Withhold antacids and milk products for 6 hours before or 2 hours afterward Ingestion of these products should occur at least 6 hours before ciprofloxacin or 2 hours afterward. Ciprofloxacin can increase the PT if the patient is also taking warfarin. Use of ciprofloxacin is contraindicated in patients with a history of myasthenia gravis. Patients taking ciprofloxacin are at risk for development of phototoxicity.

Which patient should receive prophylactic antibiotic therapy? A.A patient who is to have their teeth cleaned. B.A patient who is scheduled for a hysterectomy. C.A patient with a white blood cell count of 8000 cells/mm3. D.A patient with a high fever without an identifiable cause.

B.A patient who is scheduled for a hysterectomy. Patients who undergo a hysterectomy (and other specific surgeries) may have a decreased incidence of infection if antibiotics are administered before or during surgery. Use of prophylactic antibiotics are not indicated for the other conditions.

A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. What should the nurse do? A.Administer the cephalosporin as ordered. B.Contact the health care provider for a different antibiotic. C.Administer a test dose of cephalosporin to determine reactivity. D.Have an epinephrine dose available when administering the cephalosporin.

B.Contact the health care provider for a different antibiotic. A few patients with penicillin allergy (about 1%) display cross-sensitivity to cephalosporins. If at all possible, patients with penicillin allergy should not be treated with any member of the penicillin family. Use of cephalosporins depends on the intensity of the allergic response to penicillin; if the penicillin allergy is mild, use of cephalosporins is probably safe. However, if the allergy is severe, cephalosporins should be avoided.

A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what? A.Milk intolerance B.Skin rash, hives, or itching C.Constipation, nausea, or vomiting D.Headache, contusions, or seizures

B.Skin rash, hives, or itching Hypersensitivity reactions are common with cephalosporins. Patients should be instructed to report any signs of allergy, such as skin rash, itching, or hives.

A patient with HIV is prescribed saquinavir [Invirase]. It is most important for the nurse to monitor which laboratory value? Hemoglobin levels Platelet count Blood glucose levels Serum potassium levels

Blood glucose levels

A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? A. Instruct the patient to take the medication with milk B. Tell the patient to take an antacid with the medication. C. Give the patient food, such as crackers or toast, with the medication. D. Have the patient stop the medication immediately and contact the health care provider.

C. Give the patient food, such as crackers or toast, with the medication. Tetracyclines form insoluble chelates with calcium, iron, magnesium, aluminum, and zinc; absorption is decreased.

Which drug is a urinary tract antiseptic? A. Ciprofloxacin B. Ceftriaxone C. Nitrofurantoin D. Ceftazidime:

C. Nitrofurantoin Two urinary tract antiseptics currently are available: nitrofurantoin and methenamine. Ciprofloxacin, ceftriax-one, and ceftazidime are antimicrobials

A patient who takes warfarin has been prescribed sulfadiazine. When teaching the patient about this drug, which statement will the nurse include? A. "If you become pregnant, it is safe to take sulfadiazine." B. "You should limit your fluid intake while taking sulfadiazine." C."Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin." D."You will most likely need to have an increase in the dose of warfarin while taking sulfadiazine."

C."Avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin." Patients taking sulfadiazine should be advised to avoid prolonged exposure to sunlight, wear protective clothing, and apply a sunscreen to exposed skin.

Which information should the nurse include when teaching a patient about isoniazid (INH) therapy? A.Tubercle bacilli cannot develop resistance to isoniazid during treatment. B.Isoniazid is administered intravenously. C.An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine. D.The dose of isoniazid should be lowered if the patient is also taking phenytoin.

C.An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine. If peripheral neuropathy develops, it can be reversed by administering pyridoxine (50 to 200 mg daily).

A patient with systemic lupus erythematosus is prescribed prednisone. It is most important for the nurse to monitor the patient for what? A.Hypotension B.Elevated potassium levels C.Neck and back pain D.Hypoglycemia

C.Neck and back pain Other possible adverse effects of prednisone include hypertension, hypokalemia, and hyperglycemia.

A patient has been prescribed pharmacologic doses of glucocorticoids. It is most important for the nurse to teach the patient to do what? A.Increase intake of dietary sodium. B.Take antibiotics to prevent infection. C.Never abruptly withdraw therapy. D.Have an eye examination every year.

C.Never abruptly withdraw therapy. Abrupt withdrawal of glucocorticoids may cause adrenal insufficiency or an adrenal crisis.

After receiving an allograft liver transplant, a patient is prescribed cyclosporine [Sandimmune] oral solution. What is the most critical component of patient teaching that the nurse should stress? A.The medication will help prevent transplant rejection. B.The oral solution can be mixed with orange juice. C.The medication will be taken every day for life. D.The medication causes reversible increase of hair growth.

C.The medication will be taken every day for life.

A patient is prescribed sirolimus [Rapamune] and cyclosporine [Sandimmune] after renal transplantation. It is most important for the nurse to closely monitor which value? A.Serum creatinine B.Aspartate aminotransferase (AST) C.serum potassium D.partial thromboplastin time

C.serum creatinine

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin? A. Warfarin B. Milk products C. Digioxin D. Alcohol

D. Alcohol

Which tetracyline may be administered with meals? A. Tetracycline B. Demeclocycline C. Doxycycline D. Minocycline

D. Minocycline

A patient is prescribed vancomycin orally for antibiotic-associated pseudomembranous colitis. The nurse will monitor the patient for what? A. Leucopenia B. "Red man' syndrome C. Liver impairment D. Ototoxicity

D. Ototoxicity "Red man" syndrome occurs only with rapid intravenous administration. Thrombocytopenia is an adverse effect of vancomycin.

A prescriber states that a patient will need to receive penicillin intravenously. The nurse anticipates administering which drug? A. Penicillin V B. Procaine penicillin G C. Benzathine penicillin G D. Potassium penicillin G

D. Potassium penicillin G Owing to poor water solubility, procaine and benzathine salts must never be administered IV. Penicillin V is administered orally.

The nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamycin therapy? A. Blurred vision B. Hand tremors C. Urinary frequency D. Tinnitus

D. Tinnitus Ototoxicity can result from accumulation of the drug in the inner ear. Early signs that should be reported include tinnitus or headache. Other major adverse effects include nephrotoxicity and neuromuscular blockade.

Before administering erythromycin to a patient for an upper respiratory tract infection, it is most important for the nurse to determine if the patient is also prescribed which drug? A. Guaifenesin [Guiatuss] B. Hydrocodone and acetaminophen [Vicodin] C. Nitroglycerin [Tridil] D. Verapamil [Calan]

D. Verapamil [Calan]

A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? A. Hypotension B. Bronchospasm C. Temperature 35.5oC D. Widespread skin lesions

D. Widespread skin lesions

Which statement about the BCG vaccine is true? A.BCG is a live preparation of attenuated Mycobacterium bovid. B.BCG is routinely administered in the United States. C.BCG has no effect on tuberculin skin tests. D.BCG vaccine can be used to treat carcinoma of the bladder.

D.BCG vaccine can be used to treat carcinoma of the bladder. BCG vaccine is also used to treat carcinoma of the bladder. BCG vaccine is a freeze-dried preparation of attenuated My-cobacterium bovis (bacillus of Calmette and Guérin). In countries where TB is endemic, the World Health Organization recom-mends BCG vaccination in infancy.

Which statement by a new nurse about intravenous administration of amphotericin B indicates the nurse needs more education? -Almost all patients receiving amphotericin B experience some degree of nephrotoxicity. -Patients receiving amphotericin B should be under close supervision in a hospital. -Heparin can be used in the infusion site to prevent phlebitis associated with amphotericin B therapy. -Diphenhydramine plus acetaminophen can minimize rigors associated with amphotericin B therapy.

Diphenhydramine plus acetaminophen can minimize rigors associated with amphotericin B therapy.

A patient asks the nurse what he can do to prevent influenza. What should the nurse do? Teach the patient about antiviral medications Instruct the patient to obtain an influenza vaccination Tell the patient that frequent hand washing is effective Have the patient wear a mask when in public areas

Instruct the patient to obtain an influenza vaccination Influenza is managed by vaccination with drugs. Vaccination is the primary management strategy to prevent influenza.

A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication? Daptomycin Metronidazole Rifampin Rifaximin

Metronidazole Daptomycin has a unique mechanism and can rapidly kill virtually all clinically relevant gram-positive bacteria, including MRSA. Rifampin [Rifadin] is a broad-spectrum antibacterial agent used primarily for tuberculosis. However, the drug is also used against several nontuberculous infections. Rifampin is useful for treating asymptomatic carriers of Neisseria meningitidis. Rifaximin [Xifaxan] is an oral, non-absorbable analog of rifampin used to kill bacteria in the gut.

It is most important for the nurse to avoid administering oral ciprofloxacin to this patient with which food? Bananas Baked chicken Grapefruit juice Milk

Milk -Absorption of ciprofloxacin can be reduced by compounds that contain cations. Among these are (1) aluminum- or magnesium-containing antacids, (2) iron salts, (3) zinc salts, (4) sucralfate, (5) calcium supplements, (6) milk and other dairy products, all of which contain calcium ions. These cationic agents should be administered at least 6 hours before ciprofloxacin or 2 hours after.

A patient has been prescribed ciprofloxacin for treatment of a urinary tract infection with Escherichia coli. Before administering the drug, it is most important for the nurse to assess the patient for a history of what? Hypertension Diabetes mellitus Myasthenia gravis Seasonal allergies

Myasthenia gravis Ciprofloxacin and other fluoroquinolones can exacerbate muscle weakness in patients with myasthenia gravis.

A patient is prescribed acyclovir [Zovirax] by mouth. The nurse should assess the patient for which adverse effects associated with oral acyclovir therapy? Stomatitis and gastritis Nausea, vomiting, and diarrhea Hives, difficulty breathing, and angioedema Tinnitus and decreased hearing

Nausea, vomiting, and diarrhea Commonly reported adverse reactions to oral acyclovir therapy include nausea, vomiting, diarrhea, headache, and vertigo.

Which Which statement about oseltamivir [Tamiflu] does the nurse identify as true? Oseltamivir must be administered on an empty stomach. The drug is administered via an inhaler. Oseltamivir can be used to treat and prevent influenza. The drug is approved for use in infants 6 months of age or older.

Oseltamivir must be administered on an empty stomach. Dosing of oseltamivir can be done with or without food, although dosing with food can reduce nausea. The drug is available in capsules (30, 45, and 75 mg) and as a powder (360 mg) to be reconstituted to a 6-mg/mL oral suspension.

The patient is being discharged with continued ciprofloxacin therapy. When providing discharge teaching, the nurse should advise the patient to call the healthcare provider immediately if what develops? Pain in the heel of the foot Nausea Diarrhea Headache

Pain in the heel of the foot

Which information should the nurse include when teaching a patient about rifampin therapy? Oral contraceptives are safe to use with rifampin therapy. Contact your healthcare provider immediately if the color of your body fluids changes to reddish orange. Rifampin is safe to use in patients who have hepatic disease. Rifampin may be administered intravenously.

Rifampin may be administered intravenously. -Women taking oral contraceptives should consider a non-hormonal form of birth control while taking rifampin. Rifampin frequently imparts a red-orange color to urine, sweat, saliva, and tears; patients should be informed of this harmless effect. Permanent staining of soft contact lenses occasionally has occurred, so the patient should consult an ophthalmologist about contact lens use. Rifampin is toxic to the liver, posing a risk of jaundice and even hepatitis. Asymptomatic elevation of liver enzymes occurs in about 14% of patients. However, the incidence of overt hepatitis is less than 1%. Hepatotoxicity is most likely in alcohol abusers and patients with pre-existing liver disease. These individuals should be monitored closely for signs of liver dysfunction.