Antimicrobials II

Ms. Jones is admitted to the hospital with the diagnosis of rule-out tuberculosis. She is placed in isolation. The diagnosis is confirmed 72 hours after admission, based on sputum cultures and chest x-ray findings. She has been prescribed three different drugs for the treatment of TB. You are completing the discharge teaching with Ms. Jones. Which statement by her indicates that she understand the drug therapy? o "I will only be taking one medication at home for the next 6 months." o "I will need to take the medication daily for up to 2 years." o "The physician will stop the medication in 1 or 2 months." o "I will contact the physician to renew the prescription every month."

"I will need to take the medication daily for up to 2 years."

Contraindication for using sulfonamide are: a. Anaphylactic allergy to any sulfonamide b. Anemia due to folate deficiency c. Headache, dizziness, cramps d. Pregnancy, lactation, infant under two months e. Pregnancy, lactation, infants under one month

(A)Anaphylactic allergy to any sulfonamide, (B) Anemia due to folate deficiency, and (D)Pregnancy, lactation, infant under two months a. Sulfonamides can cause serious hypersensitivity reactions. Folate deficiency is a contraindication because sulfonamides prevent the synthesis of folic acid. Pregnancy, lactation and infants under two months are contraindicated due to the risk of birth defects, kernicterus and rash in the infant.

A patient has just been diagnosed with a fungal infection, the nurse knows that the priority action is to A. Draw appropriate labs for a culture and sensitivity testing B. Provide patient education on potential adverse effects of drug C. Initiate therapy using a broad spectrum antibiotic D. Place patient on droplet contact isolation precaution

A

. Justin is a 25-year-old male who has been diagnosed with herpes simplex virus. The nurse knows Justin requires further teaching when he states: (SELECT ALL THAT APPLY) A. This drug has no adverse effects B. This drug will cure me. C. I cannot infect anyone while on this drug D. This drug is for my symptoms.

A, B, C

A nurse is about to begin an infusion of ciprofloxacin on a client, what should the nurse do before the infusion begins? Select All that Apply A.Set the infusion for one hour B.Tell the patient this drug has no known side effects C. Assess patient allergies D. Determine if the patient has a history of Myasthina Gravis

A, C, D

Oseltamivir (Tamiflu) (reconstituted as a liquid) is to be prescribed for a child with H1Ni influenza. Which of the following should be included in your education to the parents? (Mark all that apply) A. Shake the suspension prior to administering each dose B. Administer the solution mixed with apple juice to encourage the child to drink the whole dose C. Report any behavioral changes to the prescriber D. Take the full course of therapy for 5 days

A,C,D

A nurse is caring for a 40 year-old patient who is on IV acyclovir (Zovirax) for a severe outbreak of herpes zoster. What monitoring is priority for this nurse? A. Cardiac B. ALT and AST C. BUN and creatinine D. Blood glucose

A. Cardiac

A client with a urinary tract infection is receiving ciprofloxacin by the intravenous route. The nurse appropriately administers the medication by performing which action? a. Infusing slowly over 60 minutes. b. Infusing in a light-protective bag. c. Infusing only through a central line. d. Infusing rapidly as a direct IV push medication

Answer: A. Rationale: Ciprofloxacin is prescribed for treatment of mild, moderate, severe, and complicated infections of the urinary tract, lower respiratory tract, and skin and skin structure. A single dose is administered slowly over 60 minutes to minimize discomfort and vein irritation. Ciprofloxacin is not light-sensitive, may be infused through a peripheral IV access, and is not given by IV push.

Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would indicate a possible toxic effect related to this medication? a. Pallor b. Drowsiness c. Bradycardia d. Restlessness

Answer: D. Rationale: toxicity (overdose) of oxybutynin produces central nervous system excitation, such as nervousness, restlessness, hallucinations, and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdosage.

A client is to begin a 6 month course of therapy with Isoniazid (INH). A nurse places to teach the client to: a. use alcohol in small amounts only b. report yellow eyes or skin immediately c. increase intake of Swiss or aged cheeses d. Avoid vitamin supplements during therapy

B

A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to: A. Use alcohol in small amounts only. B. Report yellow eyes or skin immediately. C. Increase intake of Swiss or aged cheeses. D. Avoid vitamin supplements during therapy

B

A client with tuberculosis is being started on antitu berculosis therapy with Isoniazid (INH). Before giving the client the first does, a nurse ensures that which of the following baseline studies has been co mpleted? a. Electrolyte levels b. liver enzyme levels c. serum creatinine levels d. coagulation times

B

A nurse is assessing a 60 year old patient who is about to receive Vancomycin, an antifnfective therapy. Which problem would be of most concern to the nurse ? A. Endocrine disease B. Hepatic disease C. Cardiac disease D. Pulmonary disease

B

A nurse is assessing a 60 year old patient who is about to receive anti-fungal drug therapy. Which problem would be of most concern A. Endocrine disease B Hepatic disease C.Cardiac disease D. Pulmonary disease

B

A patient diagnosed with genital herpes is prescribed acyclovir (Zovirax). While educating the patient on the drug, which statement made by the patient indicates a need for further teaching? A. "While I am taking this drug, I can still spread the disease to my partner." B. "I will wait for my lesions to crust over before taking this drug." C. "I will take this drug with a glass of water and drink more throughout the day." D. "I will notify my provider if I notice a change in the frequency I urinate."

B. "I will wait for my lesions to crust over before taking this drug."

A client has been prescribed nitrofurantoin (Macrodantin) for treatment of a lower urinary tract infection. Which of the following instructions should the nurse include when teaching the client how to take this medication? Select all that apply. A. "Take the medication on an empty stomach." B. "Your urine may become brown in color." C. "Increase your fluid intake." D. "Take the medication until your symptoms subside." E. "Take the medication with an antacid to decrease gastrointestinal distress."

B. "Your urine may become brown in color." C. "Increase your fluid intake."

A client is receiving Pyridium (phenazopyridine hydrochloride) for a urinary tract infection. The client should be taught that the medication may: A. Cause diarrhea B. Change the color of her urine C. Cause mental confusion D. Cause changes in taste

B. Change the color of her urine

A patient is prescribed zanamivir for their flu-like symptoms. The patient asks, "How do I take the medication." As a nurse, what is your response for prescribed zanamivir? A. Oral B. Inhaled C. Subcutaneous D. IV

B. Inhaled

A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to: A. Use alcohol in small amounts only. B. Report yellow eyes or skin immediately. C. Increase intake of Swiss or aged cheeses. D. Avoid vitamin supplements during therapy.

B. Report yellow eyes or skin immediately.

Which of the following nursing diagnoses might occur when administering large parenteral doses of amphotericin B and vancomycin? a. Decreased cardiac output b. Ineffective airway clearance c. Ineffective breathing pattern d. Fluid volume excess

Both of these drugs are nephrotoxic, so fluid volume excess may happen due to renal problems

. Isoniazid is used to treat: A. Active tuberculosis B. Latent tuberculosis C. Both A and B D. None of the above

C

A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication: A. Should always be taken with food or antacids B. Should be double-dosed if one dose is for-gotten C. Causes orange discoloration of sweat, tears, urine, and feces D. May be discontinued independently if symptoms are gone in 3 months

C

A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication: A. Should always be taken with food or antacids to increase absorption B. Should be double-dosed if one dose is forgotten C. May cause orange discoloration of sweat, tears, urine, and feces D. May be discontinued independently if symptoms are gone within 5 months

C

A patient arrives to a clinic complaining of a cough, congestion, a fever, runny nose, and chills. The patient states that they have been experiencing these symptoms for two days. Which medication will the prescribe most likely recommend? A.Ciprofloxacin B. Fluconazole C. Oseltamivir D. Phenazopyridine

C

A patient is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole (Bactrim). What assessment should the nurse make prior to the administration of the medication? a. Hypertension b. Diabetes mellitus c. Renal insufficiency Asthma

C

A patient is to receive IV rifampin. To safely admini ster this medication, the nurse should: a. premedicate the patient with IV diazepam b. administer IVP over 30 seconds c. infuse IV over 2 hr d. administer IVP over 2 to 3 minutes

C

The nurse is caring for a patient who has started med ication therapy that includes rifampin. The nurse instructs the patient to exp ect which side effects of this medication? a. bilious urine b. yellow sclera c. orange secretions d. clay-colored stools

C

Which of the following statements, made by a patient who has been prescribed SMZ-TMP, would indicate understanding of the treatment therapy? a. For the drug to be effective, I will drink at least a quart of cranberry juice a day. b. I will return to the clinic after 3 days for another urine culture c. I will take the medication for 10 days even if m y symptoms improve in a few days. d. I will limit drinking alcohol to just on the weekends w hen someone else can drive me home.

C

You are administering IV erythromycin, a macrolide, to your patient to treat bacterial endocarditis. The patient reports burning during the infusion. Your most appropriate initial action is to a. document that the patient is allergic to erythromycin b. apply a warm compress to the vein c. slow the rate of the infusion d. remove the IV from the patient

C

Your 66-year-old patient is a homeless alcoholic who comes to the clinic with a report of dysuria and hematuria. The patient receives a diagnosis of pyelonephritis and is prescribed a course of SMZ-TMP. Because of this patient's health status history, which of the following lab tests would be appropriate before initiating therapy? a. Renal function and arterial blood gas b. Folate level and complete blood count (CBC) c. Hepatic enzymes and folate level Arterial blood gas and hepatic enzymes

C

A client has been diagnosed with a systemic fungal infection. The physician has prescribed amphotericin B (Fungizone). The nurse will include which of the following in her client education. A. "Drug therapy will be for a very short time, probably 2-4 weeks." B. "Carefully inspect all intramuscular injection sites for bruising." C. "Notify the physician should you come down with symptoms of increased weight gain or vertigo." D. "Stop the medication if you're feeling better."

C. "Notify the physician should you come down with symptoms of increased weight gain or vertigo."

1. Sulfamethoxazole- Trimethoprim (SMZ-TMP) is prescribed for a patient. A nurse should instruct the patient to report which symptom if it developed during the course of this medication therapy? A. Nausea B. Diarrhea C. Headache D. Sore throat

D: Notify the health care provider if sore throat, fever, and pallor occur. The other options do not require health care provider notification

A patient receiving a topical antifungal complains of blisters in the perineum. Which is/are possible explanations for this? a. Fungal infection is not healing b. Patient is allergic to the drug c. Both A and B d. None of the above

Development of rash, especially if accompanied by blisters and irritation signify worsening of condition and development of hypersensitivity reaction.

Your patient is being discharged with a prescription of fluconazole. Which of the following OTC medications should the patient be advised against taking while on fluconazole? o Tylenol o Nasal decongestants o Ibuprofen o Multivitamin

Ibuprofen

A nurse is administering amphotericin B to a patient with a systemic fungal infection. Which drug(s) would they avoid administering concurrently? Methotrexate Sumatriptan Gentamycin Lorazepam Sertraline

Methotrexate, gentamycin (both carry risk of nephrotoxicity)

The nurse is caring for a client who has been taking a sulfonamide and should monitor for signs and symptoms of which adverse effects of the medications? Select all that apply. 1. Ototoxicity 2. Palpitations 3. Nephrotoxicity 4. Bone marrow suppression 5. Gastrointestinal effects 6. Increase white blood cell count

Rationale: Adverse effects of sulfonamides include nephrotoxicity, bone marrow suppression, GI effects hepatotoxicity, dermatological effects, and some neurological symptoms, including headache, dizziness, vertigo, ataxia, repression and seizures. Options, 1, 2, an 6 are unrelated to these medications.

Phenazopyridine (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse should provide the client with which information regarding this medication? 1. Take the medication at bedtime. 2. Take the medication before meals. 3. Discontinue the medication if a headache occurs. 4. A reddish orange discoloration of the urine may occur.

Rationale: The nurse should instruct the client that a reddish orange discoloration of urine may occur. The nurse also should instruct the client that this discoloration can stain fabric. The medication should be taken after meals to reduce the possibility of gastrointestinal upset. A headache is an occasional side effect of the medication and does not warrant discontinuation of the medication.

Mrs. Jones, age 35, has sought care because of complaints of urinary frequency, dysuria, and inability to empty her bladder completely, which she has experienced for the last 6 months. The physician diagnoses her with chronic urethritis and prescribes sulfonamide, which has led to crystalluria. Which medication can be added to her current medication therapy? o Methenamine o Long-acting sulfonamide o Sulfisoxazole o Phenazopyridine

Sulfisoxazole

Anna is going to administer SMZ-TMP to Ms. Marks, a 35-year-old woman with cystitis. She is reviewing the mechanism of action prior to administration. What is the process in which SMZ displaces PABA, thereby resulting in the inhibition of formation of new bacteria? o Synthesis of G6PD o Synthesis of dihydrofolic acid o Destruction of G6PD Destruction of dihydrofolic acid

Synthesis of dihydrofolic acid

Which of the following patient statements indicates understanding of teaching? o I can stop taking Tamiflu when my symptoms resolve o I do not need to get a yearly influenza vaccine because I can take Tamiflu if I get influenza o Tamiflu works best when started within 24 hours of symptom onset o I must take Tamiflu on an empty stomach

Tamiflu works best when started within 24 hours of symptom onset

. When teaching the client with a urinary tract infection about taking phenazopyridine hydrochloride (Pyridium), the nurse should tell the client to expect: a. Bright orange-red urine b. Incontinence c. Constipation d. Slight drowsiness

The client should be told that phenazopyridine hydrochloride (Pyridium) turns the urine a bright orange-red, which may stain underwear. It can be frightening for a client to see orange-red urine without having been forewarned. Other common adverse effects associated with phenazopyridine include headaches, gastrointestinal disturbances, and rash. Phenazopyridine does not cause incontinence, constipation, or drowsiness.

1. Mr. Green has been prescribed INH therapy for the treatment of latent tuberculosis. He also has a history of hypertension. As the nurse caring for the patient, you are providing instructions about dietary restrictions. You inform him that he should not eat cheese, dairy products, bananas, or any foods or drinks containing caffeine. What is the best explanation you can give Mr. Green about the effects of eating these foods while on INH? o These foods can cause the medication to be toxic to your liver. o These foods cause the medication to be less effective. o These foods can cause an unsafe increase in blood pressure. o These foods may cause a disturbance in your balance.

These foods can cause an unsafe increase in blood pressure.

A patient taking fluconazole calls the providers office complaining of nausea and vomiting since starting this prescription. What would you tell this patient? o Stop taking the medication immediately and come into the providers office o Try taking the medication with food o Advise patient ask for a lower dose of the medication o Tell the patient that this is an expected effect and will continue until he finishes the course of treatment

Try taking the medication with food

The patient complains of the following symptoms: cough, low-grade fever, anorexia, and night sweats. As well, he states that he has been coughing up blood at times. What disease does this patient most likely have? o Pneumonitis interstitial infection o Tuberculosis o Kaposi sarcoma o Pneumonia caused by influenza

Tuberculosis

2. Which of the following comments by a patient taking oral acyclovir for herpes simplex infection requires additional teaching? o I will look into statewide programs to help me pay for acyclovir o I will remain well hydrated while taking acyclovir o I will only take acyclovir when I have active herpes lesions to prevent drug resistance o When I take acyclovir I will no longer be at risk for transmitting the infection to my partner

When I take acyclovir I will no longer be at risk for transmitting the infection to my partner

A potential adverse effect to the infant who receives SMZ-TMP from breast-feeding is: a. Kernicterus b. Hepatitis c. Pancreatitis d. Aplastic anemia

A

Although clindamycin is reserved for serious infections, topical clindamycin is useful in the treatment of a. hives b. Stevens-Johnson syndrome c. acne vulgaris d. pruritus

C

The nurse caring for a patient with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? a. "I must take the medication exactly as prescribed" b. "Once I start the medication, I will no longer be contagious" c. "I will not get any colds or infections while taking this medication" d. "This medication has minimal side effects and I can return to normal activities"

(A). "I must take the medication exactly as prescribed" a. Antiviral medications for influenza must be taken exactly as prescribed. These medications do not prevent the spread of influenza and clients are usually contagious for up to 2 days after the initiation of antiviral medications. Secondary bacterial infections may occur despite antiviral treatment. Side effects occur with these medications and may necessitate a change in activities, especially when driving or operating machinery if dizziness occurs.

The nurse is caring for a client with systemic candidiasis who is receiving amphotericin B intravenously (IV). The nurse should perform which action during administration of the medication to monitor for an adverse effect? a. Monitor Urinary Output b. Check peripheral pulses c. Monitor for hypothermia d. Check the neurological status

(A). Monitor urinary output a. Amphotericin B is an antifungal medication and can cause toxicity, which during administration can produce symptoms such as chills, fever, headache, vomiting, and impaired renal function. The medication is also irritating to the IV site, commonly causing thrombophlebitis. The nurse administering this medication watches for signs of the problems. Option B, C, & D are not specifically related to the administration of this medication.

How should sulfonamides be monitored? a. White blood cell count and febrile status b. Baseline serum creatinine and blood urea nitrogen if renal impairment is suspected c. Urinalysis during therapy in patients with renal dysfunction d. Hepatic tests e. All of the above

(A)White blood cell count and febrile status (B) Baseline serum creatinine and blood urea nitrogen if renal impairment is suspected (C)Urinalysis during therapy in patients with renal dysfunction WBC count needs to be monitored because bone marrow suppression can occur with the use of sulfonamides. Serum creatinine, BUN and urinalysis need to be monitored because renal dysfunction could lead to impaired excretion of the drug, causing toxicity.

The nurse cares for a patient on the medical/surgical unit. The patient rings the call bell and exclaims, "My urine has been orange today! What medication is doing this to me?" Which of the following medications, if noted in the patient's chart, would explain this side effect? Select all that apply: a. INH (Isoniazid). b. Pyridium. c. Rifampin. d. Bleomycin. e. Pantoprazole.

(B) Pyridium and (C) rifampin. a. These two medications can cause orange urine. Bleomycin can turn urine blue/green. INH and Pantoprazole do not affect urine color.

A 68-year-old man is in the hospital because of a prostatectomy performed 4 days before. He is wearing a urinary catheter and is currently treated with a combination of broad spectrum antibiotics. The patient has being suffering from chronic renal insufficiency for the past two years. Two recent urinalysis show many budding yeasts and cultures were positive for Candida albicans. Which of the following drugs would be appropriate for a systemic antifungal treatment of this patient? a. Amphotericin B b. Fluconazole c. Piperacillin d. Metronidazole e. Griseofulvin

(B). Fluconazole a. The patient is suffering from candiduria, a condition often related to the placement of an indwelling urinary catheter, especially if the patient is taking broad spectrum antibiotics, like in the present case. Eradication of candida in the urine includes the removal of the catheter and an antifungal treatment. Treatment options include amphotericin B or fluconazole. However, in the present patient, amphotericin B, which directly damages renal tubules, is contraindicated because of chronic renal dysfunction. A) (see explanation above) C, D) These agents are not antifungal drugs. E) This antifungal drug is not effective against Candida albicans.

Which of the following statements best explain the mechanism of antifungal action of amphotericin B? a. Inhibition of topoisomerase II b. Impairment of the normal permeability of fungal cell membrane c. Inhibition of reverse transcriptase d. Blockade of fungal mitosis e. Inhibition of fungal cytochrome P450 enzymes

(B). Impairment of the normal permeability of fungal cell membrane a. Answer: B Amphotericin B binds to fungal cell membrane and causes the formation of artificial pores through which ions and small molecules are lost. This causes the death of the fungal cell. A) This would be the mechanism of action of quinolones. C) This would be the mechanism of action of several antiviral drugs. D) This would be the mechanism of action of griseofulvin. E) This would be the mechanism of action of azoles.

The nurse is preparing to administer the fourth dose of vancomycin IVPB to a client with infective endocarditis. Which intervention does the nurse anticipate? a. Administering PRN antiemetic prior to the infusion b. Administering via an infusion pump over at least 30 minutes c. Drawing a trough level just prior to the administration of the vancomycin d. Starting a new IV line before administration

(C) Drawing a trough level just prior to the administration of the vancomycin a. Vancomycin is a very potent antibiotic that can cause nephrotoxicity and ototoxicity. Measuring for serum concentrations is a way to monitor for risk of nephrotoxicity as well as for therapeutic response. Trough serum vancomycin concentrations are the most accurate and practical method for monitoring efficacy. A trough should be obtained just prior (about 15-30 minutes) to administration of the next dose.

A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir? a. Limit the client's activity b. Encourage a high-CHO diet c. Utilize an incentive spirometer to improve repiratory function Encourage fluids

(D) Encourage Fluids a. Clients taking Acyclovir should be encouraged to drink plenty of fluids because renal impairment can occur. Limiting activity is not necessary. nor is eating a high-carbohydrate diet. Use of an incentive spirometer is not specific to clients taking Acyclovir; therefore. answers A. B. and C are incorrect.

A nurse is caring for a client with a diagnosis of meningitis who is receiving amphotericin B (Fungizone) intravenously. Which of the following would indicate to the nurse that the client is experiencing an adverse effect related to the medication? A. Nausea B. Decreased urinary output C. Muscle weakness D. Confusion

(sign of a renal problem - nephrotoxicity is a risk with ampho B)

Teaching for a patient receiving a prescription for ciprofloxacin (Cipro) should include: a. report unusual heel, lower leg or calf pain or difficulty walking b. avoid taking the medicine with milk products and antacids c. limit Vit. C, both dietary and oral vitamin forms d. Take pill with an antihistamine to avoid side effects

** Ciprofloxacin may be taken with food or meals but when taken with dairy, ferrous sulfate or antacids can affect absorption and should not be consumed at with the medication. Ciprofloxacin has a black box warning for risk of tendonitis and tendon rupture. Any unusual pain, especially in the heel, lower leg or calf, or difficulty walking should be reported to the provider.

An older adult client diagnosed with stress incontinence is prescribed the medication oxybutynin (Ditropan). Which side effects does the nurse tell the client to expect? Select all that apply. a. Dry mouth b. Increased blood pressure c. Increased intraocular pressure d. Constipation e. Reddish-orange urine

** Oxybutynin is an anticholinergic/antispasmodic. Anticholinergic side effects include dry mouth, urinary retention, constipation, and risk for increased intraocular pressure. Increased blood pressure may result with alpha-adrenergic agonists and beta blockers, which may be prescribed for urinary incontinence. Phenazopyridine, a bladder analgesic causes the urine to be a reddish-orange color.

Fluconazole (Diflucan) can be administered to a client with: a. Pneumococcal Meningitis a. Oral Thrush b. Cryptococcal Meningitis c. Pneumococcal Pneumonia

**A and D are incorrect because pneumococcal meningitis and pneumonia are not caused by fungal infections. B would be treated with a more mild antifungal.

A student nurse administering acyclovir was asked by the clinical instructor how the drug works. The student nurse would be correct by stating that this drug works in which way? a. Unknown; but it is believed to be shedding the protein coat of the virus b. It competes with the viral receptors found in the host cells c. It takes away the necessary substances needed by viruses to form DNA chains d. Trapping the viruses and disintegrating them directly

**Agents for CMV and herpes viruses are known to compete with the substrates needed by viruses for this process leading to formation of shorter and noneffective DNA chains. Option A is the mechanism of action of agents for influenza and respiratory viruses

. A client has been prescribed nitrofurantoin (Macrodantin) for treatment of a lower urinary tract infection. Which of the following instructions should the nurse include when teaching the client how to take this medication? Select all that apply. a. "Take the medication on an empty stomach." b. "Your urine may become brown in color." c. "Increase your fluid intake." d. "Take the medication until your symptoms subside." e. "Take the medication with an antacid to decrease gastrointestinal distress."

**Clients should be instructed to take the medication with meals and to increase their fluid intake to minimize gastrointestinal distress. The urine may become brown in color. The client should be instructed to take the full prescription and not to stop taking the drug because symptoms have subsided. The medication should not be taken with antacids as this may interfere with the drug's absorption.

A patient with type 2 diabetes mellitus is started on co-trimoxazole (TMP-SMZ). Which nursing intervention is a priority for this patient? a. Assess blood sugar b. Monitor platelet count c. Assess hemoglobin and hematocrit. d. Take blood pressure every 4 hours.

**Cotrimoxazole increases the hypoglycemic response when taken with sulfonylureas (oral hypoglycemic agents).

When providing health promotion teaching at a senior citizen center, the nurse would include information about which medication used to decrease the duration of influenz A and B? a. Oseltamivir (Tamiflu) b. Ganciclovir (Cyotvene) c. Enfuvirtide (Fuzeon) d. Indaniavir (Crixivan)

**Oseltamivir (Tamiflu) and zanamivir (Relenza) are active against influenza virus types A and B and have been shown to reduce the duration of influenza infection by several days

Which of the following can help prevent an infusion related reaction from IV administration of amphotericin B? (select all that apply) o Administering a test dose first o Give diphenhydramine and acetaminophen before starting therapy o Give dantrolene and meperidine before starting therapy o Use an infusion pump and administer over 2-4 hours o Administer right after giving a blood transfusion

-Administering a test dose first o Give diphenhydramine and acetaminophen before starting therapy -Use an infusion pump and administer over 2-4 hours

Fluoroquinolones such as ciprofloxacin may cause which of the following serious side effects? Possible Answers: a. Sudden tendon rupture b. Seizures c. Irreversible peripheral neuropathy d. Liver failure e. All of these

1. a. Explanation:Fluoroquinolones (the most commonly prescribed of which is ciprofloxacin) carry a risk of all of the following adverse effects: sudden tendon rupture or tendonitis, hepatotoxicity or liver failure, seizures, and permanent peripheral neuropathy. Other adverse effects include Clostridium difficileassociated diarrhea, bone marrow suppression, Steven-Johnson's Syndrome, tremors, and psychosis. The majority of these adverse effects are seen in higher numbers in children and the elderly.

Acyclovir has been ordered for a patient with genital herpes. Which nursing intervention is appropriate? A. Assess patient for unusual behavior B. Monitor patient's BP for hypertension C. Advise patient to maintain adequate fluid intake D. Administer IV acyclovir over 30 minutes

10. C: Patients must remain well hydrated while taking acyclovir to avoid nephrotoxicity. IV acyclovir needs to be administered over 60 minutes.

Because linezolid is a weak MAO inhibitor, patients should avoid foods high in what content? A. Tyramine B. Dairy C. Phorphorous Sodium

A

Fluconzaole is used to treat all of the following EXCEPT: A. Influenza B. Candidiasis C. Fungal infections D. Candiduria

A

Jeremy is a 20-year-old male who has been ordered acyclovir for his herpes. The nurse should NOT: A. Withhold fluids for 8 hours to prevent nephrotoxicity B. Infuse acyclovir over at least 1 hour C. Encourage hydration during and 2 hours after infusion D. Rotate IV injection sites

A

Which statement would be correct for a patient regarding the administration of an antifungal medication? A. Instruct the patient to complete the entire drug therapy even if a dose is missed. B. Instruct the patient to take a forgotten dose as soon as it is remembered, even if it is time for the next dose. C. Instruct the patient to take frequent meals of fat and protein when GI distress occurs. D. Advise that for persistent headache, unrelieved by acetaminophen, the patient should increase the dosage of acetaminophen.

A

Your client is being treated for streptococcal pharyngitis and is NPO. Her health care provider has ordered Penicillin G to be given IM. She wants to know why she cannot take her medications via an oral route. Your best response is: a. Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV. b. Penicillin G is inactivated by gastric acid, therefore it is only given IM. c. Penicillin G is no longer used for this problem. d. Penecillin G can be given orally but requires higher doses.

A

A nurse is about to give a client with a lower UTI nitrofurantoin. What should the nurse instruct the client to report to the health care provider? Weakness and numbness of the extremities Nausea Dark yellow or brown urine Constipation

A Weakness and numbness of the extremities describe peripheral neuropathy

The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribed and the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? A. "I must take the medication exactly as prescribed." B. "Once I start the medication, I will no longer be contagious." C. "I will not get any colds or infections while taking this medication." D. "This medication has minimal side effects and I can return to normal activities."

A. "I must take the medication exactly as prescribed."

Use of which of the following would alert the nurse to the possibility of a drug-drug interaction for a patient receiving ketoconazole? a. Dofetilide b. Digoxin c. Lovastatin d. Pimozide

B

A nurse is assessing a patient with a diagnosis of hepati tis A at the clinic. Which of the following is the most likely route o f transmission for this patient? a. Sexual contact with an infected partner. b. Contaminated food c. Blood transfusion. d. Illegal drug use

B

The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction should be included in the list? a. Advise that sunscreen is not needed. b. Drink 8 to 10 glasses of water per day. c. If the urine turns dark brown, call the healthcare provider immediately. d. Decrease the dosage when symptoms are improving to prevent an allergic response.

Answer: B. Rationale: Each dose of TMP-SMZ should be administered with a full glass of water, and the client should maintain a high fluid intake to avoid crystalluria. The medication is more soluble in alkaline urine. The client should not be instructed to taper or discontinue the dose. CLients should be advised to use sunscreen sunce the skin becomes sensitive to the sun. Some forms of the medication cause the urine to turn dark brown or red. This does not indicate the need to notify the HCP.

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation? a. Urine is clear amber. b. Urination is not painful. c. Urge incontinence is not present. d. A reddish-orange discoloration of the urine is not present.

Answer: B. Rationale: Phenazopyridine is a urinary analgesic. It is effective when it eliminates pain and burning with urination. It does not eliminate the bacteria causing the infection, so it would not make the urine clear amber. It does not treat urge incontinence. It will cause the client to have reddish-orange discoloration of urine but this is a side effect of the medication, not the desired effect.

The nurse has been caring for a client who has been taking a sulfonamide and should monitor for signs and symptoms of which adverse effects of the medication? Select all that apply. a. Ototoxicity b. Palpitations c. Nephrotoxicity d. Bone marrow suppression e. GI effects f. Increased white blood cell count

Answer: C, D, E. Rationale: Adverse effects of sulfonamides include nephrotoxicity, bone marrow suppression, GI effects, hepatotoxicity, dermatological effects and some neurological symptoms, including headache, dizziness, vertigo, ataxia, depression, and seizures. Options A, B, and F are unrelated to these medications.

Fluconazole (Diflucan) can be administered to a client with: a. A. Pneumococcal meningitis b. B. Oral thrush c. C. Cryptococcal meningitis d. D. Pneumococcal pneumonia

Answer: C. Rationale: Fluconazole (Diflucan) is a drug given for the treatment of cryptococcal meningitis. A and D are incorrect because pneumococcal meningitis and pneumonia are not caused by fungal infections. Oral thrush is treated with a more mild antifungal, such as nystatin.

Which of the following statements is true when educating clients about penicillin therapy? a. The client must take the medication at evenly spaced intervals. b. The client may save leftover medication for a future illness. c. If signs of an allergic reaction, continue the medication and notify physician. d. Clients taking oral contraceptives must be cautioned to use an alternate form of birth control while being treated with penicillin.

Answer: D. Penicillin will reduce the effectiveness of birth control pills.

Corinne is experiencing diarrhea after consuming her prescribed antibiotics for the whole week. This is because: a. The drugs render food indigestible. b. Gastric flora is disturbed. c. Fluid is added into the intestine. d. Normal intestinal bacteria are destroyed.

Answer: D. Rationale: The destruction of normal intestinal flora causes diarrhea. In choice A, a drug that rendered food indigestible could not be given because it would cause severe malnutrition. Choice B is incorrect because there is no gastric flora. Choice C is incorrect because there is no way to add fluid into the intestine.

Which of the following nursing diagnoses might occur when administering large parenteral doses of amphotericin B with vancomycin (Vancocin)? a. Decreased cardiac output b. Ineffective airway clearance c. Ineffective breathing pattern d. Fluid volume excess

Answer: D. Rationale: These two drugs are both nephrotoxic, so this nursing diagnosis may result from renal problems

A patient is to receive a dose of Clotrimazole, an antifungal, to treat her vaginal candidiasis. The nurse knows the patient education was successful when the patient states A. " I will take this pill three times a day for 1 week with grapefruit juice." B. " I will remain in recumbent position for at least 10-15 minutes after insertion of suppository." C. " I will stop taking this medication when I have a relief of symptoms." D. " I should continue to take this medication if I experience a rash and pain, as this is an expected outcome of this medication."

B

A patient is to receive a dose of Clotrimazole, an antifungal, to treat her vaginal candidiasis. The nurse knows the patient education was successful when the patient states A." I will take this pill three times a day for 1 week with grapefruit juice." B. " I will remain in recumbent position for at least 10-15 minutes after insertion of suppository." C. " I will stop taking this medication when I have a relief of symptoms." D. " I should continue to take this medication if I experience a rash and pain, as this is an expected outcome of this medication."

B

A patient was recently prescribed phenazopyridine. They call the clinic and inform the nurse that their skin and white around their eyes has a yellow tinge. The nurse should instruct the patient to do the following: A. Ignore it, this is an expected adverse reaction B. Stop the drug immediately and come to the clinic to be checked C. Reduce the dose by half D. Skip the next dose

B

An adult patient comes into the clinic during flu season where you are working complaining of general malaise, runny nose, sore throat, feelings of fatigue, and denies having any fever. The patient states, "I have not been feeling well and would like something that can help me get over this illness." What would the nurse anticipate for this patient? A. Determine if symptoms began within 48 hours and obtain MD prescription for oseltamivir (Tamiflu) for the patient B. Tell the patient that they are exhibiting symptoms of a cold and explain that antibiotics or antivirals are not prescribed for the cold C. Determine if symptoms began longer than 48 hours ago and obtain MD prescription for zanamivir (Relenz) D. Obtain vaccination records and give an oseltamivir (Tamiflu) prescription to the patient if they have not been vaccinated, explaining that now they don't have to get the flu vaccine if they complete this course of medication

B

Discharge teaching by the nurse for a client receiving tetracycline should include what instruction? A. "Take the medication until you feel better." B. "Use sunscreen and protective clothing when outdoors." C. "Keep the remainder of the medication in case of recurrence." D. "Take the medication with food or milk to minimize GI upset."

B

INH treatment is associated with the development of peripheral neuropathies. Which of the following interventions would the nurse teach the client to help prevent this complication? A. Adhere to a low cholesterol diet B. Supplement the diet with pyridoxine (vitamin B6) C. Get extra rest D. Avoid excessive sun exposure

B

Jill, a 65 year old female, has been prescribed sulfamethoxazole-trimethoprim (SMZ-TMP) for her urinary tract infection (UTI). The nurse knows to include which of the following in her patient teaching? A. Avoid exposure to sunlight when taking this drug B. Take this drug on an empty stomach with a full glass of water C. Take this drug with grapefruit juice to increase its effectiveness D. Blood in your urine is an expected side effect

B

Ms. Kim, age 54, is taking penicillin for an upper respiratory infection. She calls the office after 2 days of therapy, complaining of nausea and abdominal pain. Which would be the best instruction to give Ms. Kim? a. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. b. These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. c. Continue to take the medication as prescribed; these are expected side effects from the medication. d. Stop the medication and the physician will order you a different antibiotic.

B

Rifampin is often used with other drugs to treat tuberculosis because: A. Rifampin alone may result in hypersensitivity B. Rifampin alone may lead to bacterial resistance C. Rifampin alone may increase the chance of adverse effects D. Rifampin is not used for tuberculosis

B

The health care professional has recommended sulfonamide therapy for a patient. While obtaining the patient's medical history, the nurse discovers that the patient is taking oral anticoagulants. Which of the following are the possible effects of combining sulfonamide therapy with oral anticoagulants? A. Sulfonamide therapy is rendered ineffective B. Increased action of the anticoagulant C. Patient may develop leucopenia D. Increased risk of an anaphylactic shock

B

The nurse is educating an 82-year-old client regarding amphotericin B. The nurse knows the client understands when he states that he could develop which adverse effect? A. Pancreatitis B. Damage to his kidneys C. Liver necrosis D. Diabetes

B

To minimize the potential for peripheral neuropathy, INH may be given in combination with a. Rifampin (Rifadin) b. Pyridoxine (Vitamin B6) c. Spectinomycin d. Ethambutol (Myambutol)

B

Which of the following drugs is used as fungal prophyl axis in immunocompromised patients? a. amphotericin B b. fluconazole (Diflucan) c. nystatin (Mycostatin) d. ketoconazole (Nizoral)

B

Which of the following viruses is unaffected by acyclovir (Zovirax)? a. Herpes b. HIV c. Cytomegalovirus d. Epstein-Barr

B

Your patient has been taking triple antimicrobial therapy for active TB for the past 3 months. The patient comes to the clinic today and states, "My soft contact lenses have turned red." Which of the following medications may have caused this problem? a. INH b. Rifampin (Rifadin) c. Ethambutol (Myambutol) Spectinomycin

B

The nurse is reviewing the medication instruction for the patient taking acyclovir. Which of the following would indicate the need for additional teaching? A. I need to contact my physician if the lesions turns red. B. I need to take this medication until I am cured. C. I must complete the full course of drug therapy even if lesions resolve. D. I only need to take this medication when active lesions are present.

B: Acyclovir does not cure the viral infection; it only decreases the symptoms and severity of the disease

A client has been prescribed sulfamethoxazole-trimethoprim. What is the nurse's primary intervention for this client? A. Instruct the patient to take the medication for 14 days. B. Instruct the patient to increase fluids in the diet. C. Ensure the patient eats something when taking the medication. D. Assess the patient's urine before and after treatment.

B: Increased fluid intake is highly recommended to avoid complications such as crystallization in the urine. The course of therapy is not always 14 days; the patient does not have to take the drug on a full stomach; and the drug is not prescribed only for UTI's.

Debra, a 70 year old female, has been taking Rifampin for 3 months to treat her tuberculosis. She tells the nurse she has been noticing orange urine. The nurse would likely respond by saying: A. You are probably dehydrated. You should drink more water. B. Orange urine means the drug has worked and you no longer need to take it. C. Orange urine, saliva, sweat, and tears are an expected side effect of rifampin D. That is not a good sign. I will notify the doctor.

C

Ms. Tom, age 24, is prescribed cefazolin for a sinus infection. After administration of the first dose of the medication, Ms. Tom complains of itching. Your nursing assessment reveals a rash over her torso; also, you note that she has a history of allergic reaction to penicillin. What would explain your findings? a. Ms. Tom should be watched carefully during the next dose of the medication to ensure her symptoms do not become more severe. b. Ms. Tom is having an anaphylactic reaction and needs to be transferred to the ICU. c. Ms. Tom is experiencing an allergic reaction caused by a cross-sensitivity reaction. Ms. Tom is experiencing a side effect from the medication

C

Patients receiving IV amphotericin B (Fungizone) have the greatest risk for the development of: a. Blurred vision b. Arachnoiditis c. Nephrotoxicity d. Hypertension

C

A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient? a. Monitoring blood creatinine levels. b. Monitoring fluid intake. c. Testing for increased glucose levels. d. Testing for occult blood.

D

A client enters the emergency department with suspected influenza. What is most important to determine before starting the client on Oseltamivir phosphate (Tamiflu)? a. Allergies to antibiotics b. Over-the-counter medications taken in the last 48 hours c. History of anaphylactic reactions d. Length of time since onset of symptoms

D

A client is ordered to take trimethoprim-sulfamethoxazole (Bactrim). The nurse knows to expect which common adverse reaction? A. Pseudomembranous colitis B. Dysrhythmias C. Bronchospasm D. Stevens-Johnson syndrome

D

A client who is taking acyclovir (Zovirax) asks the nurse about the drug. Which instructions 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

A client with AIDS is taking Acyclovir. Which nursing int ervention is most critical during the administration of the drug acyclovir? a. Limit the client's activity b. Encourage a high-carbohydrate diet c. Utilize an incentive spirometer to improve respiratory f unction d. Encourage fluids

D

A client with TB is starting antituberculosis therapy with isoniazid. Before giving the first dose, the nurse ensures that which of the following baseline studies has been completed? A. Electrolyte levels B. Blood glucose levels C. Serum creatinine levels D. Liver enzyme levels

D

A male patient is taking digoxin, SSRIs, and aspirin as part of his daily drug regimen. A patient with this drug history who is also receiving linezolid would be at risk for what serious complication? A. Diabetes type 2 B. Congestive heart failure C. Renal failure D. Serotonin syndrome

D

A patient has been prescribed acyclovir to treat herpes simplex virus (HSV). Which statement indicates that the patient has understood the teaching? A. " I can continue to have sexual intercourse as long as I am taking this medication". B. "Once my symptoms began to subside, I can skip a dose to reduce the adverse effects". C. "I don't have to worry about staying hydrated while on this medication". D. "I will wear gloves while applying the topical cream on my skin".

D

Jim is an immunocompromised patient who has been prescribed amphotericin B to treat his severe systemic fungal infection. The nurse knows to: A. Obtain baseline liver and kidney function tests prior to administration B. Monitor for infusion reactions up after starting infusion C. Pre-medicate patient before administration D. All of the above

D

Lucy is prescribed nitrofurantoin to treat her urinary tract infection (UTI). The nurse knows which of the following is NOT true regarding nitrofurantoin? A. Not effective systemically B. Urine may have a brownish appearance C. Contraindicated in patients with renal dysfunction D. Safe for pregnant women

D

The most serious adverse effect of fluconazole is: A. GI upset B. Vomiting and diarrhea C. Alopecia D. Stevens-Johnson syndrome

D

Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy? A. Nausea B. Diarrhea C. Headache D. Sore throat

D

Which of the following is highest priority when teaching a client about antituberculin medications? A. Get adequate rest when taking the medications B. Eat a well-balanced diet C. Avoid exposure to crowds D. Take all the medications as prescribed

D

Which of the following is true regarding phenazopyridine? a. It has many drug-drug interactions b. It inhibits protein synthesis c. It is administered in a single dose d. It may cause urine to turn orange or red

D

You are administering the first dose of amphotericin B for a systemic fungal infection. Before beginning the infusion, you should: a. Administer a test dose b. Assess vital signs c. Administer an antipyretic, such as acetaminophen d. All of the above e. None of the above

D

You are caring for a patient that has been diagnose d with Aspergillosis. The physician prescribed amphotericin B to be infused over 3 hours. During the infusion, your patient experiences wheezing, nausea, and drop of blood pressure. What should you do? a. decrease the rate of infusion b. increase the rate of infusion c. change the IV site to a peripheral line with a smaller vein d. stop the infusion and notify the physician immediately as you know the patient is experiencing signs of an infusion reaction

D

You are caring for a patient who is receiving amphotericin B. Which of the following medications could you administer concomitantly to promote patient comfort? A. Beta-adrenergic blockers B. Sedatives C. Diuretics Antipyretics

D

Your patient is hospitalized with a serious infection and is receiving IV clindamycin. This patient should be monitoredfor which of the following symptoms? a. rash b. facial rigidity c. respiratory depression d. blood-tinged diarrhea

D

Your patient is receiving IV acyclovir (Zovirax). To safely administer this drug, you should administer it: a. Over 20 minutes and keep the patient NPO b. Over 20 minutes and keep the patient well hydrated c. Over 60 minutes and keep the patient NPO d. Over 60 minutes and keep the patient well hydrated

D

10. The nurse is caring for the client receiving Amphotericin B. Which of the following indicates that the client has experienced toxicity to this drug? A. Changes in vision B. Nausea C. Urinary frequency D. Changes in skin color

D. Changes in skin color

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. Stevens-Johnson syndrome

When administering fluconazole (Diflucan) to a client, the nurse should: A. Have the client chew the tablet. B. Instruct the client to double the dose the next day if one dose is missed. C. Encourage the client to increase fluid intake to a minimum of eight glasses of water a day to prevent crystal in the urine. D. Assess for nausea, vomiting, abdominal pain, or diarrhea.

D: Flucanzole can cause GI effects

A nurse is infusing IV amphotericin B to a client who has a system fungal infection. The nurse should monitor the client for which of the following adverse effects of this medication? 1. Hypoglycemia 2. Constipation 3. Fever 4. Hyperkalemia

Rationale: Amphotericin B can cause fever, chills and nausea during the infusion. Pretreatment with diphenhydramine and acetaminophen can reduce these effects.

The nurse is caring for a client with a diagnosis of influenza who first began to experience symptoms yesterday. Antiviral therapy is prescribe an the nurse provides instructions to the client about the therapy. Which statement by the client indicates an understanding of the instructions? 1. I must take the medication exactly as prescribed. 2. Once I start the medication, I will no longer be contagious. 3. I will not get any colds or infections while taking this medication. 4. This medication has minimal side effects and I can return to normal activities.

Rationale: Antiviral medications for influenza must be taken exactly as prescribed. These medications do not prevent the spread of influenza and clients are usually contagious for up to 2 days after the initiation of antiviral medications. Secondary bacterial infections may occur despite antiviral treatment. Side effects occur with these medications and may necessitate a change in activities especially when driving or operating machinery if dizziness occurs.

Trimethoprim-sulfamethoxazole (TMP-SMZ; Bactrim) is prescribed for a client. The nurse should instruct the client to report which symptom if it develops during the course of this medication therapy? 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat

Rationale: Clients taking trimethoprim (TMP)-sulfamethoxazole (SMZ) should be informed about early signs/ symptoms of blood disorders that can occur from this medication. These include sore throat, fever, and pallor, and the client should be instructed to notify the health care provider (HCP) if these occur. The other options do not require HCP notification.

A nurse is administering IV amphotericin B to a client who has a system fungal infection. The nurse should monitor which of the following laboratory values? (select all that apply ) 1. Serum albumin 2. Serum amylase 3. Serum potassium 4. Hematocrit 5. Serum creatinine

Rationale: Hypokalemia is a serious adverse effect of amphotericin B; therefore the nurse should monitor serum potassium values for hypokalemia. Amphotericin B can also cause bone marrow suppression. The nurse should then monitor CBC and platelet count periodically. Lastly it can also cause nephrotoxicity, so the nurse should monitor kidney function (with serum creatinine, BUN, and creatinine clearance)

. Nitrofurantoin (Macrodantin) is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse should make which interpretation about the client's complaints? 1. The client may have contracted the flu. 2. The client is experiencing anaphylaxis. 3. The client is experiencing expected effects of the medication. 4. The client is experiencing a pulmonary reaction requiring cessation of the medication.

Rationale: Nitrofurantoin can induce two kinds of pulmonary reactions: acute and subacute. Acute reactions, which are most common, manifest with dyspnea, chest pain, chills, fever, cough, and alveolar infiltrates. These symptoms resolve 2 to 4 days after discontinuing the medication. Acute pulmonary responses are thought to be hypersensitivity reactions. Subacute reactions are rare and occur during prolonged treatment. Symptoms (e.g., dyspnea, cough, malaise) usually regress over weeks to months following nitrofurantoin withdrawal. However, in some clients, permanent lung damage may occur. The remaining options are incorrect interpretations.

A nurse is teaching a female client who has severe UTI about ciprofloxacin, Which of the following information about adverse reactions should the nurse include? (Select all that apply) 1. Observe for pain and swelling of the Achilles Tendon 2. Watch for a vaginal yeast infection 3. Expect excessive nighttime perspiration 4. Inspect the mouth for cottage cheese-like lesions 5. Take the medication with a dairy product

Rationale: Pain and swelling of the Achilles tendon indicate an adverse effect of ciprofloxacin to report to the provider. A vaginal yeast infection is an overgrowth of candida albicans, which commonly occurs when taking ciprofloxacin. Cottage cheese like- lesions in the mouth indicate an overgrowth of candida albicans, a common adverse effect when taking ciprofloxacin

A Nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? 1. Administer a concentrated solution 2. Infuse the medication over 60 mins. 3. Infuse the solution through the primary IV fluid tubing 4. Choose a small peripheral vein for administration

Rationale: The nurse should administer ciprofloxacin IV for over 60 minutes to minimize irritation of the vein.

Oxybutynin chloride is prescribe for a client with urge incontinence. Which sign would indicate a possible toxic effect relate to this medication? 1. Pallor 2. Drowsiness 3. Braycaria 4. Restlessness

Rationale: Toxicity (overosage) of oxybutynin produces central nervous system excitation , such as nervousness, restlessness, hallucinations and irritability. Other signs of toxicity include hypotension or hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a frequent side effect of the medication but does not indicate overdose.