ATI: Pharmacology infection
A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to infuse. When should the nurse plan to obtain a blood sample for a peak serum level of gentamicin.
1030
A home health nurse is reviewing the medication list of an older adult client who reports falling a couple of times over the past week. Which of the following medications should the nurse suspect is contributing to the client's falls? A. Alprazolam (Xanax) B. Acetaminophen (Tylenol) C. Docusate sodium (Colace) D. Nystatin (Mycostatin)
A. Alprazolam (Xanax)
A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which if the following medications should the charge nurse include in the discussions? (select all that apply) A. LorazepamB. DiazepamC. DisulfiramD. NaltrexoneE. Acamprosate
A. LOrazepam B. Diazepam
A nurse is teaching a female client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates an understanding of the teaching? A. "I should avoid eating right before I chew a piece of nicotine gum." B. "I will need to stop using the nicotine gum after 1 year." C. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." D. "I must chew the nicotine gum quickly for about 15 minutes."
A. The client should avoid eating or drinking 15 minutes prior to and while chewing the nicotine gum
A client is about to start using gentamicin (Garamycin) cream to treat a serious skin infection. Which of the following instructions should the nurse include when talking with the client about using this preparation? A. "I'll wash the area with soap and water before I apply the cream. "B. "After I apply the cream, I will leave the area open to the air." C. "I can expect a little blurry vision while I'm using this cream." D. "I should apply the cream to large areas around the infection."
A. "I'll wash the area with soap and water before I apply the cream."
A nurse is caring for a client who is diagnosed with a urinary tract infection (UTI) and is taking ciprofloxacin (Cipro) 500 mg PO every 12 hr. Which of the following instructions should the nurse give to the client? A. "If the medicine causes an upset stomach, take an antacid at the same time." B. "Drink at least 1 to 2 quarts of fluid each day while taking Cipro." C. "Cipro may cause photophobia, so be sure to wear sunglasses outdoors." D. "Immediately report any ringing in your ears to your provider."
B. "Drink at least 1 to 2 quarts of fluid each day while taking Cipro."
A nurse is caring for a client treated with intermittent IV vancomycin (Vancocin). The client reports pain at the IV site when the nurse starts the infusion. Which of the following nursing actions is appropriate at this time? A. Notify the provider and have the medication changed. B. Assess the patency of the IV site. C. Turn down the infusion rate on the IV. D. Apply cold compresses to the site after the medication has infused.
B. Assess the patency of the IV site.
A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? A. increases the risk for seizure activity B. Provides a form of aversion therapy C. Decreases Cravings D. Results in mild HTN
C. propranolol is an adjunct medication used during withdrawal to decrease the client's craving for alcohol
A nurse is caring for a client who received an injection of penicillin G procaine (Bicillin). The client experiences dyspnea and states, "My tongue feels swollen." Which of the following should be the nurse's priority action? A. Obtain intravenous fluids for administration. B. Record the observed data in medical record. C. Deliver a dose of albuterol (Proventil) by inhalation. D. Administer epinephrine (Adrenalin) subcutaneously.
D. Administer epinephrine (Adrenalin) subcutaneously.
A nurse in the emergency department is assessing a client. The client's laboratory values are obtained, and she is now requesting an alcoholic beverage. After reviewing the client's admission laboratory results, which of the following medication prescriptions should the nurse question?Sodium 144 mEq/LPotassium 3.5 mEq/LChloride 106 mEq/LCarbon dioxide 32 mEq/LBUN 55 mg/dLGlucose 468 mg/dLCreatinine 5 mg/dL A. Oxazepam (Serax) B. Glipizide (Glucotrol )C. Regular insulin (Humulin R )D. Amphotericin B (Fungizone)
D. Amphotericin B (Fungizone)
A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription of clonidine. Which of the following actions should the nurse identify as the priority? A. Administer the clonidine on the prescribed schedule B. Provide ice chips at the client's bedside C. Educate the client on the effects of clonidine D. Obtain baseline vital signs
D. Assessment is the initial step if the nursing process. Obtaining the client's baseline VS is the priority nursing action
A nurse is caring for a client who is hospitalized with active pulmonary tuberculosis (TB) and is to be started on intavenous rifampin (Rifadin) therapy. The nurse should instruct the client that this medication might do which of the following? A. Cause constipation B. Cause stools to turn black C. Stain teeth D. Turn body secretions to a red-orange color
D. Turn body secretions to a red-orange color
A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take? Admin a concentrated solution Infuse the medication over 60 min infuse the solution through primary IV fluids tubing Choose a small peripheral vein for admin
Infuse medication over 60 min to minimize irritation of the vein
A nurse is caring for a patient who is starting a course of gentamicin IV for a serious respiratory infection. For which of the following manifestations should the nurse monitor as an AD of this medication?
Pruritus HematuriaMuscle weaknessVertigo
A nurse is teaching a female client who has a severe UTI about ciprofloxaxin. Which of the following information about AE should the nurse include? (SATA)Observe for pain and swelling of achilles tendonwatch for a vaginal yeast infectionexpect excessive nighttime perspirationinspect the mouth for cottage cheese lesionstake medication with dairy
Watch for vaginal yeast infection Observe for pain and swelling of achilles tendon Inspect mouth for cottage cheese lesions
A health care professional is caring for a patient who is about to receive gentamicin to treat a systemic infection. The health care professional should question the use of the drug for a patient who is also taking which of the following drugs? a. Furosemide b. diphenhydramine c. acetaminophen d. levothyroxine
a. furosemide Rational: Gentamicin, an aminoglycoside, and furosemide, and high-ceiling diuretic, are ototoxic drugs.
A health care professional is caring for a patient who is about to begin taking metronidazole (Flagyl) to treat an anaerobic intra-abdominal bacterial infection. The health care professional should recognize that cautious use of the drug is indicated if the patient also has which of the following? a. seizure disorder b. hearing loss c. asthma d. anemia
a. seizure disorder Rational: Metronidazole, an antiparasitic drug can cause ataxia, vertigo, and seizures. It requires cautions use with patients who have a history of seizure activity, liver or renal failure, or heart failure
A health care professional is caring for a patient who is about to begin using nystatin to treat oral Candida albicans that resulted from tetracycline therapy. Which of the following instructions should the health care professional include about using the antifungal preparation? a. swish the suspension in the mouth before swallowing it b. rinse the mouth immediately with water c. drink the suspension with a straw d. use cotton-tipped applicator to dab the mouth lesions with the suspension
a. swish the suspension in the mouth before swallowing it Rational: Tell the patient to swish the nystatin oral suspension inside the mouth for at least 2 min and then swallow it. This allows the drug to coat the inside of the mouth, where it exerts its therapeutic effect against Candida albicans lesions.
A patient who is taking ciprofloxacin to treat a respiratory tract infection contacts the health care professional to report dyspepsia. The health care professional to report dyspepsia. The health care care professional should recommend which of the following instructions? a. take an antacid at least 2 hr after taking the drug b. take the drug with a cup of coffee c. take an ion supplement with the drug d. drink 8 oz of milk with the drug
a. take an antacid at least 2 hr after taking the drug
A nurse is teaching a client who is beginning a course of metronidazole to treat an infection. For which of the following AE should the nurse instruct to the client a priority to stop taking the drug and notify provider> Metalic taste Nausea Ataxia Dark-colored urine
ataxia
A health care professional is caring for a patient who is about to begin taking cephalexin (Keflex) to treat bacterial meningitis. The health care professional should explain to the patient the need to monitor which of the following laboratory tests? a. prothrombin time b. creatinine c. aspartate aminotransferase d. potassium
b. creatinine Rational: excreted by the kidneys. The health care professional should evaluate renal function prior to and during treatment with the drug. Patients who have renal insufficiency should receive a reduced dose of the drug or another drug that does not affect renal function.
Which of the following drugs should a provider prescribe for a patient who has streptococcal pharyngitis and is allergic to penicillin? a. nafcillin b. erythromycin c. cephalexin d. amoxicillin/clavulanic acid
b. erythromycin Rational: Erythromycin, a macrolide, is an acceptable alternative to penicillin for patients who have bacterial infections and are allergic to penicillin. The drug is effective against most gram-positive bacteria, including streptococci, and some gram-negative bacteria
A patient who is taking tetracycline orally to treat a chlamydia infection contacts the health care professional to report severe blood-tinged diarrhea. Recognizing the adverse effects of tetracycline, the health care professional should suspect which of the following? a. hemorrhoids b. pseudomembranous enterocolitis c. diverticular disease d. small bowel obstruction
b. pseudomembranous enterocolitis Rational: severe diarrhea, often containing mucus and blood, can indiciate pseudomembranous colitis. Treatment includes stopping drug therapy and replacing fluids and electrolytes.
A health care professional is preparing to administer amphotericin B IV to a patient who has a systemic fungal infection. Which of the following drugs should the health care professional administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration? (Select all that apply.) a. aspirin b. hydrocortisone c. acetaminophen d. diphenhydramine e. ibuprofen
c. acetaminophen d. diphenhydramine Rational: Infusion reactions to IV amphotericin B start 1 to 2 hr after the infusion begins and subside within 4 hr. The health care professional can help prevent these effects by administering acetaminophen prior to the infusion. The health care professional can help prevent adverse reactions by administering diphenhydramine prior to the infusion.
A nurse is caring for a client who has a cerebrospinal fluid infection with gram-negative bacteria. Which of the following cephalosporin antibiotics should the nurse expect to administer IV to treat this infection?a. cefaclorb. cefazolinc. cefepimed. cephalexin
c. cefepime
A nurse is preparing to administer cefotaxime IV to a client who has a severe infection and has been receiving cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?a. diaphoresisb. epistaxisc. diarrhead. alopecia
c. diarrhea
A health care professional is caring for a patient who is about to begin gentamicin therapy to treat an infection. The health care professional should monitor the patient for which of the following? a. bowel function b. peripheral pulses c. urine output d. level of consciousness
c. urine output Rational:Gentamicin, can cause nephrotoxicity. The health care professional should monitor BUN and creatinine and for an increased output of diluted urine. It is also essential to monitor serum gentamicin levels and maintain a therapeutic range.
When administering erythromycin to a patient who has pneumococcal pneumonia, the health care professional should monitor for which of the following adverse effects of the drug? a. hypothermial b. blurred vision c. constipation d. cardiac dysrhythmias
d. cardiac dysrhythmias
A primary care provider is considering the various pharmacologic options for a patient who has a gynecologic infection and a history of alcohol use disorder. Which of the following medications can cause a reaction similar to disulfiram (Antabuse) if the patient drinks alcohol while taking it? (Select all that apply.) a. nitrofurantoin b. amoxicillin c. aztreonam d. cefotetan e. metronidazole
d. cefotetan e. metronidazole Rational: Cefotetan, can cause a reaction similar to what disulfiram causes when patients take it and also drink alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension. Metronidazole, an antiparasitic drug, can cause a reaction similar to what disulfiram causes when patients take it and also drink alcohol.
While administering IV cefotetan to a patient to treat bacterial meningitis, the health care professional finds the IV insertion site warm and reddened. Which of the following actions should the health care professional take? a. slow the cefotetan infusion b. administer diphenhydramine c. request a prescription for another antibiotic d. stop the cefotetan infusion
d. stop the cefotetan infusion Rational: The health care professional should stop the infusion, remove the IV catheter, assess for tissue damage, and treat it accordingly.
A health care professional is caring for a patient who is taking ciprofloxacin (Cipro) to treat a urinary tract infection and has rheumatoid arthritis, for which he takes prednisolone (Prelone). Recognizing the adverse effects of ciprofloxacin, the health care professional should tell the patient to report which of the following? a. tachycardia b. hair loss c. insomnia d. tendon pain
d. tedon pain Rational: Ciprofloxacin, a fluoroquinolone, can cause an Achilles tendon to rupture, especially in patients who take glucocorticoids or in older adults. The health care professional should tell the patient to report tendon pain, and stop taking the drug
A health care professional is caring for patient who takes an oral contraceptive and is about to begin rifampin therapy to treat tuberculosis. The health care professional should include which of the following instructions? a. increase the rifampin dose b. increase the oral contraceptive dose c. allow 2 hr between taking the two drugs d. use additional contraception
d. use additional contraception Rational: Rifampin, can increase the metabolism of oral contraceptives, reducing their effectiveness. Patients taking oral contraceptives and rifampin should use additional contraceptive methods to prevent an unwanted pregnancy.
A primary care provider is prescribing drug therapy for a patient whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered? a. Trimethoprim/sulfamethoxazole (Bactrim) b. Tetracycline c. cephalexin d. vancomycin
d. vancomycin Rationale: Vancomycin, a potentially toxic antibiotic, is used primarily for serious infections either in patients who are allergic to penicillin or in those whose infecting bacteria are resistant to penicillin, such as MRSA.
When administering erythromycin to a patient who has pneumococcal pneumonia, the health care professional should teach the patient the interaction for which of the following?
grapefruit juice
A health care professional is caring for a patient who is about to receive gentamicin to treat a systemic infection. Which of the following adverse effect health care professional should monitor?
nephrotoxicity ototoxicity
A nurse plans to administer ceftriaxone (Rocephin) 1 mL to an older adult client. Which of the following indicates the correct technique?A. Uses a 5/8-inch needle B. njects at a 45° angle C. Administers medication in deltoid muscleD. Locates the vastus lateralis injection site
D. Locates the vastus lateralis injection site
A provider is discharging a client who has pulmonary tuberculosis with a prescription for rifampin (Rifadin). The nurse should include which of the following information in the client's discharge teaching? A. Purified protein derivative skin test results will improve in 3 months. B. This medication can cause insomnia .C. It is best to take the medication with meals. D. Urine and other secretions will turn orange.
D. Urine and other secretions will turn orange.
