Ch 9
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response?
"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?
"Are you pregnant?"
The physician is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the physician ask this client before confirming this order?
"Are you pregnant?"
A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction to give the client about dietary restrictions?
"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."
A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?
"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."
A 5-year-old child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question is most likely to address the etiology of this health problem?
"Has he been swimming a lot in the last little while?"
A 5-year-old child has been brought to the clinic with signs and symptoms that are consistent with otitis externa. What assessment question should the nurse ask to address the etiology of this health problem?
"Has he been swimming a lot in the last little while?"
After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement?
"I need to wear protective clothing when I'm out in the sun."
After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following?
"I should drink a full 8-oz glass of water when I take the medicine."
A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective?
"I will apply it in a very thin layer over the area."
A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which of the following statements made by the client would indicate the need for additional education?
"I will limit my fluid intake."
Which statement by a client taking a sulfonamide requires further instruction?
"I will make sure to use extra sunscreen when I go to the tanning booth."
A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?
"I will only drink enough water to swallow the drug."
The clinic nurse is responsible for teaching a client about a new prescription for doxycycline. The nurse should increase which instruction in the teaching?
"Limit your exposure to the sun."
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?
"Make sure to avoid drinking any alcohol for the next three days."
The nurse is educating a client newly diagnosed with necrotizing otitis externa of the left ear about the prescribed ciprofloxacin IVPB. Which statement made by the client establishes the need for further clarification?
"Once the symptoms decrease, otic drops will be used to treat the infection."
A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?
"Some medications are contraindicated in pregnancy, and ofloxacin is one of these medications."
A student nurse needs further explanation about tuberculosis (TB) when making the following statement:
"TB can be cured by antitubercular drugs."
A client has been prescribed daptomycin for treatment of an infection. What instruction is most important for the nurse to tell this client?
"Tell the physician immediately if you develop any muscle pain."
A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?
"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."
A 15-year-old female patient is receiving tetracycline for the treatment of severe acne. When providing patient education to this patient, the nurse includes which of the following points for the patient?
"When taking tetracycline, wear extra sun block."
The nurse is giving discharge instructions to a woman who has been prescribed tetracycline and also uses oral contraceptives. What is the most important instruction the nurse will give to this client?
"You should use alternative means of contraception while you are taking tetracycline."
A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications the client will have to take and how long to take them. What is an appropriate response by the nurse?
"You will have multidrug therapy for 6 to 24 months."
A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?
"You will have multidrug therapy for 6 to 24 months."
A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?
"Your urine or sweat may become orange in color."
A patient is to receive rifampin. Which of the following would be most important for the nurse to include in the teaching plan for this patient?
"Your urine or sweat may become orange in color."
Which of the following are examples of fluoroquinolones? Select all that apply.
-Ciprofloxacin (Cipro) -Levofloxacin (Levaquin)
A client is being given a prescription for ciprofloxacin (Cipro) to treat a urinary tract infection. The nurse should warn the client about which of the following common adverse reactions? (Select all that apply.)
-Headache -Nausea -Dizziness
Which of the following are teaching points the nurse can use to increase client compliance in tubercular drug treatment programs? Select all that apply.
-Reinforce that short-term treatment is ineffective. -Arrange for direct observation therapy with the client and family. -Review the drug therapy regimen, including the prescribed drug, doses, and frequency of administration. -Instruct client about possible adverse reactions and the need to notify prescriber should any occur
A client has been on sulfonamide therapy for the last six weeks. What client report may cause the health care provider to discontinue the sulfonamide?
10 lb weight loss
A nurse is explaining standard treatment for tuberculosis to a client. The nurse would describe the treatment as occurring in how many phases?
2
A client is prescribed isoniazid and rifampin for the treatment of active tuberculosis (TB). The client's medication education should stress that initial symptom improvement is likely to take how long?
2 to 3 weeks
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is to mixed yielding 250 mg/15 mL. How many mL should be drawn up in the syringe?
45
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is mixed in a syringe for an IV pump as a solution of 250 mg/15 mL. How many mL should be in the syringe?
45mL
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day?
8
Extreme caution would be necessary with the use of gentamicin in which client?
A client who has chronic renal failure secondary to diabetes mellitus
A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?
A cross-sensitivity reaction.
Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?
A defective cell wall
What are nursing diagnoses that may be made during administration of antitubercular drugs? Select all that apply.
Acute pain Imbalanced nutrition Risk of ineffective therapeutic regimen management
The proper administration of a sulfonamide includes which of the following? Select all that apply.
Administration in an upright (sitting) position Administration on an empty stomach Increased fluid intake
The client calls the clinic to report the he is experiencing a throbbing headache and his face is flushed. The client received cefotetan as an IV antibiotic prior to a minor surgical procedure the day before, and returned home that same day. What has this client consumed that has caused this reaction?
Alcohol
A nurse is discussing targeted testing for latent tuberculosis infection (LTBI) with a group of nursing students. The nurse mentions that testing should be focused on groups considered to be at high risk for infection. Which group is considered high risk?
All the above
Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease?
All the above
A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?
Aminoglycoside
A patient is diagnosed with the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism?
Aminoglycosides
A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?
An HIV-positive client
A client has been prescribed ciprofloxacin after being diagnosed with a sinus infection. What medication should the client avoid taking concurrently with ciprofloxacin?
Antacids
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction?
Antacids decrease the absorption of the drug.
What are sulfonamides classified as?
Antibacterial
A 25-year-old female patient who presents at the clinic with vaginal discharge and discomfort is diagnosed with chlamydia. The nurse knows that the drug of choice to treat this infection is doxycycline. What would be a priority assessment for this patient before beginning the medication?
Asking the patient if she is pregnant
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform?
Assess the child for allergies to penicillins
A child has been diagnosed with acute otitis media. Before the child begins antibiotic treatment, what assessment should the nurse perform?
Assess the child for allergies to penicillins.
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?
Assessing for renal insufficiency
If a nurse needs to administer otic preparations in both of the patient's ears, how long should the nurse wait to place drops in the second ear? (Choose one)
At least 5 minutes
A patient has been prescribed doxycycline (Vibramycin). Which of the following teaching instructions is important with this medication?
Avoid sun exposure
A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?
BUN and creatinine
The ability of bacteria to produce substances that inactivate or destroy the antibiotic is known as which of the following?
Bacterial resistance
Natural penicillins exert what types of effects on microorganisms?
Bactericidal
Natural penicillins exert what types of effects on microorganisms? (Choose one)
Bactericidal
Drugs that slow or retard the multiplication of bacteria are known as which of the following?
Bacteriostatic
How do aminoglycosides elicit their bactericidal effects? Select all that apply.
Block a step in bacterial protein synthesis. Disrupt the functional ability of the bacterial cell wall. Block bacterial RNA synthesis.
A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?
By administering the drug in separate IV bags
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?
Cefadroxil
Which of the following drugs would be classified as a third-generation cephalosporin?
Ceftazidime
After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?
Cefuroxime
Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect?
Cell wall synthesis
A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods?
Cheese, dairy products, and bananas
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?
Confirm the client's allergy status
An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?
Confirm the client's allergy status.
Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the health care provider to order?
Culture and sensitivity
Before the selection of an aminoglycoside to treat a client's wound infection, what would the nurse expect the physician to order?
Culture and sensitivity
A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?
Culture tests
A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?
Decrease the drug dose
A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do?
Decrease the drug dose.
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic?
Decreased absorption
A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?
Decreased absorption of tetracycline
An 87-year-old resident of a long-term care facility has been prescribed oral clindamycin for the treatment of an infected pressure ulcer. The care providers at the facility should be instructed to monitor the resident closely for what potential adverse effect of clindamycin?
Diarrhea
The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug?
Diarrhea and nausea
Which of the following symptoms may indicate optic neuritis resulting from the use of ethambutol?
Difficulty differentiating between red and green
Which of the following are common adverse reactions to rifampin that the nurse should share with the client? Select all that apply.
Discoloration of body fluids Vertigo Nausea Rash
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child?
Discoloration of the teeth
A nurse is caring for a 6-year old child with a severe case of typhoid fever. The patient was mistakenly administered tetracycline, which can cause adverse reactions. Which of the following could be a permanent effect in the child?
Discoloration of the teeth
A client is receiving ciprofloxacin for a urinary tract infection. This drug is administered IV. During the infusion, the nurse notes fluid leaking into the tissue around the IV site. What is the best response of the nurse?
Discontinue the IV.
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event?
Discontinue the infusion and inform the health care provider promptly.
A client treated for a respiratory infection is being treated with levofloxacin. The client reports diarrhea, abdominal cramping, and a fever. What is the action of the nurse?
Discontinue the levofloxacin.
The nurse should advise the client which of the following in regards to the administration of fluoroquinolones?
Do not take antacids while taking fluoroquinolones
Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?
Drink a full glass of water when taking a dose of the drug
Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?
Drink a full glass of water when taking a dose of the drug.
The nursing student is studying how tuberculosis (TB) is contracted. The nurse correclty identifies the mode of transmission to be which of the following?
Droplets
A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?
Drug-resistant tuberculosis
A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?
Drug-resistant tuberculosis
What is true regarding the initial phase of tuberculosis therapy? Select all that apply.
Drugs are used to kill the rapidly multiplying M. tuberculosis. Drugs are used to prevent drug resistance. The initial phase lasts approximately two months.
A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?
Erythromycin
A client is diagnosed with an infectious process that is sensitive to penicillin. The client is allergic to penicillin, so the physician orders a drug with a similar antibacterial spectrum. The nurse anticipates that the physician will order what antibiotic?
Erythromycin
The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe?
Erythromycin
Because of their low risk of toxicity, aminoglycocides are replacing many of the other antibiotics today.
False
A patient is administered a third-generation cephalosporin. Which of the following organisms are cephalosporins most effective in treating?
Gram-negative
Aminoglycosides are used primarily in the treatment on what type of infection? (Choose one)
Gram-negative infections
Your client is currently taking aminoglycosides. You know that this type of medication is used in all of the following microorganisms, EXCEPT:
Gram-positive cocci.
The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?
Has the child taken tetracycline for treatment?
The nurse is caring for a 62-year-old who has orders to receive gentamicin . The client reports difficulty hearing. What should the nurse do?
Hold the dose and notify the health care provider immediately.
A client is diagnosed with latent tuberculosis infection. The nurse expects that the treatment plan will include which drug?
INH
A patient has just been diagnosed with tuberculosis (TB). The nurse can expect to start the patient on which of the following drugs for the initial phase of treatment?
INH, rifampin, pyrazinamide, ethambutol
Which of the drug-specific nursing diagnoses may be used in the administration of a penicillin? Select all that apply.
Impaired comfort Impaired skin integrity Diarrhea Risk of ineffective respiratory function
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which of the following?
Increase fluid intake.
The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action?
Inflammation is decreased because of interaction with intestinal bacteria.
A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?
Inflammation of the tongue and mouth
The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials?
Inhibiting cell wall synthesis
A client is diagnosed with community-acquired pneumonia, and the physician orders telithromycin. What is the mechanism of action for this antibiotic?
Inhibition of microbial protein synthesis
Which of the following represents the mechanism of action of fluoroquinolones?
Interference with the synthesis of bacterial DNA.
A client being treated for tuberculosis is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis?
Isoniazid and rifampin
Your client is 32 weeks pregnant. She has just been diagnosed with a urinary tract infection. You know that tetracycline is contraindicated for her because
It can cause a life-threatening toxicity for the fetus.
A nurse teaching the patient with tuberculosis (TB) should include the following information about ethambutol:
It can cause optic neuritis.
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?
It inhibits cell wall synthesis.
A patient with septicemia is administered cefotaxime sodium (Claforan). How is this medication excreted?
It is excreted by the kidneys.
A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor?
It is important to use antibiotics cautiously and to teach clients to complete the full course of an antibiotic prescription.
A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The physician orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice?
It is metabolized in the liver.
What is the rationale for not administering tetracycline to children under the age of 8 years?
It will interfere with enamel development.
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication?
Jaundice
A patient is administered isoniazid (INH) for latent tuberculosis. Which of the following factors will result in discontinuation of the medication?
Jaundice
When discussing cephalosporins with the nursing class, the pharmacology instructor explains that this classification of drug is primarily excreted through which organ?
Kidney
What is a contraindication to use of a fluoroquinolone?
Lactation
An elderly patient comes to the clinic and informs the nurse that he feels as if his ear is clogged. He states that he frequently has to have his ears irrigated to get out the wax. He asks the nurse what causes this wax build-up. What is the nurse's best response?
Modified sweat glands in the ear canal
A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?
Monitor for appearance of adverse reactions.
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?
Monitoring blood creatinine levels.
A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?
Nausea
The nurse is administering erythromycin to a patient. For what common side effects should the nurse monitor the patient?
Nausea, vomiting, and diarrhea
The nurse should monitor the client for which common side effects of erythromycin therapy?
Nausea, vomiting, and diarrhea
Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?
Nephrotoxicity
While administering aminoglycosides to clients, the nurse must be aware of what toxicities that can result from their use? (Select all that apply.)
Nephrotoxicity Ototoxicity Neurotoxicity
A male client has been diagnosed with otitis externa. He also has a history of a perforated ear drum. What topical otic preparation does the nurse anticipate the physician ordering for this client?
Ofloxacin otic
When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?
Ototoxicity and nephrotoxicity
A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use?
Penicillin
Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?
Penicillin
Your client has been diagnosed with streptococcal pharyngitis. Which of the following would you anticipate being ordered?
Penicillin G
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
Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.
Cephalosporins are structurally and chemically related to which classes of antibiotics?
Penicillins
The nurse is preparing to administer nafcillin intravenously (IV) to a client. What is the most common reaction related to this method of administration?
Phlebitis
A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for?
Photosensitivity
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse focuses education on which adverse reaction?
Photosensitivity
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction?
Photosensitivity
The nurse should advise clients that which of the following are adverse reactions that may occur with the administration of tetracyclines? Select all that apply.
Photosensitivity Diarrhea Stomatitis
What drug belongs to the group of carbapenems?
Primaxin
The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?
Red man syndrome
The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?
Renal
A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client?
Renal damage
A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option?
Rifampin
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?
Rifampin and isoniazid
A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions?
Risk of toxicity
A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?
Rotate injection sites for frequent parenteral injections.
A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?
Serum BUN and creatinine levels
A nurse is caring for a patient who has a serious infection. The patient is being treated with combination therapy of a cefazolin and an aminoglycoside. The nurse will be sure to monitor which of the following?
Serum BUN and creatinine levels
Common, potentially serious, adverse effects of antibiotic drugs include:
Skin rash
The nurse understands that which of the following is the highest priority when teaching about antitubercular medications?
Taking medications as prescribed
The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?
Teeth
The nurse is caring for a 6 year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?
Tetracyclines
The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?
Tetracyclines
Which of the following is true in regards to the oral administration of tetracyclines? (Choose one)
Tetracyclines should be administered with a full glass of water.
Which statement is true in regard to the oral administration of tetracyclines?
Tetracyclines should be administered with a full glass of water.
Which statement is true in regards to the oral administration of tetracyclines?
Tetracyclines should be administered with a full glass of water.
A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately?
The client has a new onset of jaundice and edema
A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic?
The client has chronic renal failure
The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?
The client has developed a superinfection.
A nurse is caring for a patient with HIV who is suspected to also have tuberculosis (TB). Which of the following is true about patients with HIV and TB?
The skin test may not show a reaction even though the disease is present.
A client is prescribed rifampin. What information should the nurse include in the client's medication education?
The urine, tears, sweat, and other body fluids will be a discolored red-orange.
A patient is administered rifampin (Rifadin). Which of the following factors should the patient be taught?
The urine, tears, sweat, and other body fluids will be a discolored red-orange.
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
The use of ciprofloxacin is contraindicated in pregnancy.
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?
The use of ciprofloxacin is contraindicated in pregnancy.
A client with a diagnosis of human immunodeficiency virus (HIV) has just been diagnosed with Mycobacterium avium complex (MAC) disease. The nurse should anticipate including what information when educating the client regarding the prescribed therapy? Select all that apply.
There is a once-daily dose of clarithromycin. A 600-mg dose of azithromycin will be prescribed. The therapy may include a prescription for rifabutin.
The nurse is caring for a client taking sulfonamides. The nurse observes sloughing of the skin and mucous membranes. The nurse suspects which hypersensitivity reaction?
Toxic epidermal necrolysis
A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic.
True
Medical treatment for tuberculosis (TB) consists of a combination of drugs to get the best results. This statement is:
True
A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples?
Urinary tract infections
Fluoroquinolones, such as norfloxacin (Noroxin), are commonly prescribed antibiotics given to treat which of the following?
Urinary tract infections
The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client?
Use a type of barrier birth control while you are taking this antibiotic.
The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?
Vaginal itching and discharge
An aminoglycoside antibiotic might be the drug of choice in treating a. serious infections caused by susceptible strains of Gram-negative bacteria. b. otitis media in an infant. c. cystitis in a woman who is 4 months pregnant. d. suspected pneumonia before the culture results are available.
a. serious infections caused by susceptible strains of Gram-negative bacteria.
A disulfiram-like reaction may occur if which substance is consumed within 72 hours after administration of certain cephalosporins?
alcohol
A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?
aminoglycoside
A homeless client presented at a street clinic with reports of hemoptysis and subsequently tested positive for TB. Which characteristics of the client's present circumstances would preclude treatment with INH?
an alcoholic who has hepatitis C (HCV)
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?
antacids
Sulfonamides are classified as which type of medication?
antibacterial
Cipro, a widely used antibiotic, is an example of a. a penicillin. b. a fluoroquinolone. c. an aminoglycoside. d. a macrolide antibiotic.
b. a fluoroquinolone
The penicillins a. are bacteriostatic. b. are bactericidal, interfering with bacteria cell walls. c. are effective only if given intravenously. d. do not produce cross-sensitivity within their class.
b. are bactericidal, interfering with bacteria cell walls
Antibiotics that are used together to increase their effectiveness and limit the associated adverse effects are said to be a. broad spectrum. b. synergistic. c. bactericidal. d. anaerobic.
b. synergistic
Gram-negative
bacteria that accept a negative stain and are frequently associated with infections of the genitourinary or gastrointestinal (GI) tract
Aerobic
bacteria that depend on oxygen for survival
Anaerobic
bacteria that survive without oxygen, which are often seen when blood flow is cut off to an area of the body
Gram-positive
bacteria that take a positive stain and are frequently associated with infections of the respiratory tract and soft tissues
Gram-negative bacteria a. are mostly found in the respiratory tract. b. are mostly associated with soft tissue infections. c. are mostly found in the GI and GU tracts. d. accept a positive stain when tested.
c. are mostly found in the GI and GU tracts.
The fluoroquinolones a. are found freely in nature. b. are associated with severe adverse reactions. c. are widely used to treat Gram-positive infections. d. are broad-spectrum antibiotics with few associated adverse effects.
c. are widely used to treat Gram-positive infections.
A patient receiving a fluoroquinolone should be cautioned to anticipate a. increased salivation. b. constipation. c. photosensitivity. d. cough.
c. photosensitivity
Which drug is a first-generation cephalosporin used as a surgical prophylaxis?
cefazolin
A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection?
culture and sensitivity (C&S)
A bacteriostatic substance is one that a. directly kills any bacteria it comes in contact with. b. directly kills any bacteria that are sensitive to the substance. c. prevents the growth of any bacteria. d. prevents the growth of specific bacteria that are sensitive to the substance.
d. prevents the growth of specific bacteria that are sensitive to the substance.
A patient has been admitted to the intensive care unit with signs and symptoms of sepsis and preliminary results of the patient's initial blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). This finding is an indication for treatment with
daptomycin.
A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.
drop in blood pressure increase in respiratory rate sudden increase in temperature
A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?
drug-resistant tuberculosis
Synergistic
drugs that work together to increase drug effectiveness
A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?
erythromycin
A client reports having had a "bad reaction" the last time receiving penicillin. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug?
erythromycin
Which medication is the drug of choice for Legionnaires disease?
erythromycin
When fluoroquinolones are administered intravenously, the nurse would check the needle site and area around the needle site for extravasation at which frequency?
every hour
When administering a secondary drug to a patient with tuberculosis (TB), the nurse is treating which type of TB?
extrapulmonary TB
The nurse understands that tuberculosis (TB) can affect other organs of the body. The term used for TB outside the lungs called which?
extrapulmonary.
What potential adverse reaction is most likely to develop during cefazolin therapy?
gastrointestinal upset
After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication?
gram-negative infections
Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:
he should wear glasses during the therapy.
What fetal risk exists if tetracycline is taken during pregnancy? Select all that apply.
hyperbilirubinemia impaired tooth development impaired bone development
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include which?
increase fluid intake.
A nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which action would the instructor most likely include?
interfering with DNA synthesis in the bacterial cell
A client is prescribed cefazolin for a sinus infection. After administration of the first dose of the medication, the client reports itching. The nursing assessment reveals a rash over the client's torso; the client has a history of allergic reaction to penicillin. The client:
is experiencing an allergic reaction caused by a cross-sensitivity reaction.
A nurse is administering an antitubercular drug that exhibits bactericidal activity. The nurse is most likely administering which drug?
isoniazid
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication?
jaundice
A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?
jaundice
What adverse effect would most likely necessitate discontinuing treatment with isoniazid?
jaundice
The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease is which?
leprosy.
The client has developed a pressure area on her hip that has become infected. If the wound culture reveals vancomycin-resistant enterococci (VRE), which medication will the nurse expect to be prescribed?
linezolid
A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?
numbness and tingling in his feet
A 35-year-old man is being treated with isoniazid (INH) for exposure to TB. He has the following medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his physician right away?
numbness and tingling in his feet
A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how?
on an empty stomach.
A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?
optic neuritis
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?
oral (PO)
A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:
oral contraceptives
A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:
oral contraceptives.
Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics?
penicillins
A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?
phlebitis
A client comes to the clinic for a follow-up visit. The nurse notes a sunburn-like appearance to the client's skin. The client's history reveals the use of ciprofloxacin. The nurse interprets which adverse effect regarding this finding?
photosensitivity
What event triggers the development of a superinfection?
proliferation of antibiotic-resistant microorganisms
When a client fails to improve appreciably after 4 weeks of treatment with first-line drugs, what adjuvant first-line antitubercular drug will be considered for inclusion in the existing medication regimen?
pyrazinamide
A critical care nurse is caring for a client taking aminoglycosides. The dosage may need to be adjusted if the nurse finds monitored changes in what system?
renal function
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:
route.
Sulfasalazine (Azulfidine) is contraindicated in people who are allergic to:
salicylates.
A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?
skin rash or itching
A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the physician if the client experiences what adverse effect associated with the drug?
skin rash or itching
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause
staining of permanent teeth.
A patient has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the patient to look for side effects from the prolonged use of the antibiotic and informs the patient that this is known as which of the following?
superinfection
A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence?
superinfection following the eradication of normal oral flora
A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as:
superinfection.
Tetracyclines should not be used in children younger than 8 years of age because of their effects on:
teeth and bones.
A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed?
tetracycline
A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?
the need to consistently take the prescribed drugs in order to cure TB
Which of the following should be included in the nurse's pre-administration assessment prior to a client receiving a penicillin? Select all that apply.
• Allergy history • Medical history • Medication history • Current symptoms
The physician has prescribed ciprofloxacin. For which patient would you contact the physician to clarify the order because the medication is contraindicated? (Select all that apply.)
• Children younger than 18 • Pregnant and lactating mothers
The nurse is preparing to administer linezolid (Zyvox) to a client and knows that it is being used in the treatment of which disorders? (Select all that apply.)
• Vancomycin-resistant Enterococcus faecium (VREF) • Methicillin-resistant S. aureus (MRSA) • Health care-acquired pneumonia • Skin structure infections
Which of the following are important points for the nurse to remember when administering an otic preparation to a client? Select all that apply:
• Warm the otic preparation prior to administration. • Straighten the ear canal. • Never insert the dropper tip into the ear canal. • Insert a piece of cotton loosely into the ear canal to prevent the drug from flowing out
A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply.
• drop in blood pressure • increase in respiratory rate • sudden increase in temperature
A patient newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the patient that sometimes treatment fails and why this happens. Which of the following are reasons for treatment failure? (Select all that apply.)
• inadequate initial drug treatment • noncompliance with the therapeutic regimen
A nurse is preparing to administer a fluoroquinolone. Which infections are treated with fluoroquinolones? Select all that apply.
• skin infections • urinary tract infections • sexually transmitted disease
A client diagnosed with tuberculosis (TB) has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?
"The use of multiple drugs prevents the development of drug-resistant TB."
A client diagnosed with tuberculosis (TB) has begun multidrug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?
"The use of multiple drugs prevents the development of drug-resistant TB."
A middle-aged woman with a complex social and medical history has begun multidrug treatment for TB. Which of the nurse's following assessment questions is most therapeutic?
"What kinds of routines would work best for you to make sure that you don't miss any doses of your rifampin?"
A client is caring for an 8-year-old child who weighs 30 kg. The physician orders gentamicin IM for the client. The recommended dosage range is 2-2.5 mg/kg q8h. What is the maximum amount of gentamicin the client will receive in a day?
225 mg
A client has been prescribed 2 tablets of 150 mg isoniazid every day. The available drug is in the form of a 100-mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each time.
3
A patient has been prescribed 2 tablets of 150 mg isoniazid every day. The available drug is in the form of a 100 mg tablet. To meet the recommended dose, the nurse will administer _______ tablets each time.
3
The health care provider has ordered penicillin V for a client. What should the nurse instruct the client to take with the medication?
A full glass of water
The physician has ordered penicillin V for a patient. What should the nurse instruct to take with the medication?
A full glass of water
A patient receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in the great toes. Which laboratory values should be assessed?
ALT and AST
A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and peripheral neuropathy. Which laboratory values should be assessed?
ALT/AST and creatinine
A nurse works in a community setting and follows patients who have TB. Which of the following patients would likely require the most follow-up from rifampin therapy?
An HIV-positive patient
In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply.
An increase in sensitivity of gram-negative microorganisms. A decrease in the sensitivity of gram-positive microorganisms.
A client has been prescribed doxycycline. Which teaching instruction is a priority with this medication?
Avoid sun exposure.
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?
Avoid the consumption of alcohol.
Which of the following would a nurse identify as being classified as a macrolide?
Azithromycin
Drugs that destroy the bacteria are known as which of the following? (Choose one)
Bacteriocidal
A 9-year-old client has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the client's admission orders and notes that IV demeclocycline has been prescribed. After beginning this treatment, the nurse should confirm the results of what laboratory test?
Blood urea nitrogen (BUN)
A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The physician orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs?
By administering the drug in separate IV bags
Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component of bacterial development do these drugs affect?
Cell wall synthesis
What symptoms should lead the nurse to suspect that a client receiving a cefuroxime ingested alcohol during treatment? Select all that apply.
Chest pain Throbbing headache Dyspnea
A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI?
Chlamydia
A client diagnosed with human immunodeficiency virus (HIV) has been infected with Mycobacterium avium complex (MAC) from an indoor pool. Which medication is the recommended treatment for this infection? Select all that apply.
Clarithromycin Rifabutin Rifampin
After 3 weeks of drug therapy for TB, a client is not showing reduction of symptoms. Repeated lab work shows positive cultures. What issues should the nurse consider? (Select all that apply.)
Client noncompliance Drug resistance
A nurse is caring for a 35-year-old male taking telithromycin. For what type of infection is this client being treated?
Community-acquired pneumonia
The client has been taking levofloxacin IV for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response?
Continue to monitor vital signs.
A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The physician orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the physician to do?
Decrease the drug dose.
A patient is admitted to the emergency room with a diagnosis of Legionnaire's disease and is placed on isolation. Which of the following medications is the drug of choice for Legionnaire's disease?
Erythromycin (Ery-Tab)
Tuberculosis (TB) affects only the lungs. True or false?
False
The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?
Fear of incontinence
The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?
Fear of incontinence.
A school-age child has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?
Frequent swimming and water sports while the child was on vacation
What potential adverse reaction is most likely to develop during cefazolin therapy?
Gastrointestinal upset
After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class?
Gentamicin
Which of the following drugs would be classified as an aminoglycoside?
Gentamicin
Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic?
Inhibition of synthesis of bacterial proteins
Culture and sensitivity testing reveals that a client's infection will respond to treatment with kanamycin. What routes of administration are available to the care team for kanamycin? Select all that apply.
Intramuscular Intravenous
Which of the following antitubercular drugs are used during the continuation treatment phase of tuberculosis? Select all that apply:
Isoniazid Rifampin
The nursing student read about a disease called Hansen's disease, which is caused by the bacterium Mycobacterium leprae and is treated with many of the same drugs as are used for TB. The student learned that another name for Hansen's disease is what?
Leprosy
Which of the following are examples of fluoroquinolones? Select all that apply.
Levofloxacin (Levaquin) Ciprofloxacin (Cipro)
In which condition present in the client should macrolides be used with caution?
Liver dysfunction
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely?
Liver function studies
A client in the critical care unit is receiving aminoglycosides for an infectious process. What does the nurse need to monitor?
Liver function tests
A major concern among public health authorities is an increase in drug-resistant TB infections. Traditionally, this has been attributed to patient lack of adherence to medication regimen. New evidence indicates that:
Many drug-resistant infections are new infections, especially in those who are immunosuppressed.
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply.
Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated.
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9 degrees ferenheit. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?
Obtain urine for culture and sensitivity.
The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9°F. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?
Obtain urine for culture and sensitivity.
The nurse is assisting in the admission of a client with a suspected urinary tract infection. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?
Obtain urine for culture and sensitivity.
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:
Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.
Cephalosporins are structurally and chemically related to which classes of antibiotics? (Choose one)
Penicillins
A nurse is caring for a client who the physician suspects may be infected with an antibiotic-resistant pathogen. What course of action is best used to determine whether this type of pathogen is present?
Perform culture and susceptibility tests.
The health care provider suspects a client may be infected with an antibiotic-resistant pathogen. The nurse caring for this client knows that what course of action is best used to determine whether this type of pathogen is present?
Perform culture and susceptibility tests.
A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client?
Renal damage
The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize?
Renal function
The client has been prescribed levofloxacin. The nurse knows that the client should be taught to do which when taking this medication?
Swallow the pill whole.
A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?
Take precautions to prevent photosensitivity.
A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?
The need to consistently take the prescribed drugs in order to cure TB
An older adult client has a feeding tube in place to manage dysphagia. After developing an infected pressure ulcer, ciprofloxacin suspension has been prescribed via feeding tube. How should the nurse follow-up this prescription?
The nurse should liaise with the health care provider to provide an alternative route of administration.
Choice of a beta-lactam antibacterial depends on which factors? (Select all that apply.)
The organism causing the infection Severity of the infection Other coexisting illnesses
A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client?
These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.
A client has been prescribed INH therapy for the treatment of latent tuberculosis. The client has a history of hypertension. The nurse teaches the client not to eat dairy products, bananas, or consume caffeine. What is the best explanation the nurse can give the client?
These foods can cause an unsafe increase in blood pressure.
The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?
They disrupt the microbial flora of the body.
The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body?
They disrupt the normal flora of the body.
A client asks the purpose for using three medications in combination to treat his tuberculosis. The nurse informs the client that multiple medications are given for which of the following reasons?
To prevent resistance
The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects?
Vomiting and diarrhea
Prior to the administration of antitubercular medications, the nurse anticipates which of the following studies to be completed? Select all that apply.
X-ray Culture and sensitivity Complete blood count Positive sputum culture
Extreme caution would be necessary with the use of gentamicin in which client?
a client who has chronic renal failure secondary to diabetes mellitus
In general, all patients receiving antibiotics should receive teaching that includes which of the following points? a. The need to complete the full course of drug therapy b. The possibility of oral contraceptive failure c. When to take the drug related to food and other drugs d. The need for assessment of blood tests e. Advisability of saving any leftover medication for future use f. How to detect superinfections and what to do if they occur
a. The need to complete the full course of drug therapy c. When to take the drug related to food and other drugs f. How to detect superinfections and what to do if they occur
A client has a diagnosis of otitis media and has just begun antibiotic treatment. The client reports otalgia and has asked for medication. The nurse should anticipate the administration of:
acetaminophen (Tylenol).
When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?
alcohol
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?
assessing for renal insufficiency
A young woman is found to have a soft-tissue infection that is most responsive to tetracycline. Your teaching plan for this woman should include which of the following points? a. Tetracycline can cause gray baby syndrome. b. Do not use this drug if you are pregnant because it can cause tooth and bone defects in the fetus. c. Tetracycline can cause severe acne. d. You should use a second form of contraception if you are using oral contraceptives because tetracycline can make them ineffective. e. This drug should be taken in the middle of a meal to decrease GI upset. f. You may experience a vaginal yeast infection as a result of this drug therapy.
b. Do not use this drug if you are pregnant because it can cause tooth and bone defects in the fetus f. You may experience a vaginal yeast infection as a result of this drug therapy
After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms?
bactericidal
Drugs that destroy bacteria are known as which type of drug?
bactericidal
After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which types of medication?
bacteriostatic
A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy?
baseline liver function test values
A 9-year-old client has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the client's admission orders and notes that IV demeclocycline has been prescribed. After beginning this treatment, the nurse should confirm the results of what laboratory test?
blood urea nitrogen (BUN)
A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that
body fluids such as urine, saliva, tears, and sputum may become discolored.
Which of the following is not a caution for the use of cephalosporins? a. Allergy to penicillin b. Renal failure c. Allergy to aspirin d. Concurrent treatment with aminoglycosides
c. Allergy to aspirin
The goal of antibiotic therapy is a. to eradicate all bacteria from the system. b. to suppress resistant strains of bacteria. c. to reduce the number of invading bacteria so that the immune system can deal with the infection. d. to stop the drug as soon as the patient feels better.
c. to reduce the number of invading bacteria so that the immune system can deal with the infection.
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:
can cause allergic reactions in clients who are allergic to penicillins.
A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?
changing to a different antibiotic
Antibiotic
chemical that is able to inhibit the growth of specific bacteria or cause the death of susceptible bacteria
A nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. The health care provider is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?
cirrhosis of the liver
A nurse is caring for a 52-year-old client who has been diagnosed with a latent tuberculosis infection. The physician is considering ordering isoniazid (INH). The preexistence of what condition would require cautious use of INH in this client?
cirrhosis of the liver
When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline?
creatinine of 2.8 mg/dL (247.52 µmol/L) (high)
A child has just returned home from a family vacation on a tropical island and is now reporting worsening tenderness in the right ear. The client is subsequently diagnosed with otitis externa. What causative factor of this infection should the nurse suspect?
frequent swimming and water sports while the child was on vacation
A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?
frequent swimming and water sports while the child was on vacation
The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem?
methicillin-resistant Staphylococcus aureus (MRSA) infection
A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug?
warfarin
A teenager is admitted to a health care facility for a fungal infection. It has been determined that the infection was present for a long time, but there was no treatment undertaken. The teenager now has a systemic fungal infection for which flucytosine is prescribed. Which would be most important for the nurse to assess before beginning therapy?
weight
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
with a glass of water 1 hour before or 2 hours after a meal.
