chapter 9 pharm

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? 2 8 6 4

8

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? Tobramycin Neomycin Kanamycin Gentamicin

Gentamicin

Common, potentially serious, adverse effects of antibiotic drugs include: Hypopnea Pain Constipation Skin rash

Skin rash

Which statement by a client taking a sulfonamide requires further instruction? "I will take all of my medicine even if my symptoms go away." "I will make sure to use extra sunscreen when I go to the tanning booth." "I will take my medicine with my meals like it says on the prescription bottle." "I will be sure to drink a full glass of water every time I take my medicine."

"I will make sure to use extra sunscreen when I go to the tanning booth."

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? "Remember to have your required blood work drawn in 48 hours." "Make sure to avoid drinking any alcohol for the next three days." "You might develop a mild fever when you finish your antibiotics, but that doesn't mean your infection has returned." "It's possible that your urine might be pink-tinged for the next little while, but that's expected and it will resolve."

"Make sure to avoid drinking any alcohol for the next three days."

The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse? "You are experiencing an adverse affect of the medication. Those symptoms will decrease over time." "You are allergic to the medication. Stop taking it immediately." "You may be experiencing an additional infection. I will discuss this with your health care provider." "That is the medication working. Continue to take as directed."

"You may be experiencing an additional infection. I will discuss this with your health care provider."

A client is receiving gentamicin to treat meningitis. The health care provider has ordered a peak serum level be drawn in association with the 07:00 dose, which will finish infusing at 07:30. When should the peak serum level be drawn? 09:00 10:00 08:00 12:00

08:00

A client 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 Urine culture and sensitivity Hematocrit and hemoglobin Complete blood count (CBC) with differential

ALT and AST

A client has been diagnosed with an infected postoperative wound, and cultures reveal methicillin-resistant Staphylococcus aureus (MRSA). The client is currently receiving intravenous cefazolin because in vitro testing indicates susceptibility. When considering the effectiveness of this client's treatment, what is the nurse's best action? Monitor the client closely for signs of hepatotoxicity. Administer the medication as prescribed and monitor for expected outcomes. Contact the health care provider because the medication should be changed to the oral route. Contact the health care provider because the medication is not known to be clinically effective.

Administer the medication as prescribed and monitor for expected outcomes.

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? Take prescribed Ethambutol with food. Double the dose if earlier dose is missed. Take prescribed Pyrazinamide without regard to food. Avoid the consumption of alcohol.

Avoid the consumption of alcohol.

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? Serotonin syndrome Red man syndrome Gray syndrome Cushing's syndrome

Red man syndrome

A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted? Headache Renal disease Aplastic anemia Abdominal cramp

Renal disease

Cephalosporins should be used cautiously in clients with which of the following? Select all that apply. Known penicillin allergy Renal disease Bleeding disorder Hepatic impairment Diabetes

Renal disease Hepatic impairment Bleeding disorder Known penicillin allergy

The health care provider orders an aminoglycoside for a ventilator-dependent client who is admitted to the critical care unit. The client's current diagnoses include respiratory arrest, type 2 diabetes, hepatitis C, and chronic obstructive pulmonary disease. Which statement indicates the risk of using this class of medication in this client? Risk for hepatic impairment is significant, because the drug is metabolized in the liver. Risk for hepatic impairment is not significant, because the drug is excreted through the kidneys. Risk for hepatic impairment is significant because of a higher risk for toxicity. Risk for hypertensive crisis is increased.

Risk for hepatic impairment is not significant, because the drug is excreted through the

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? Increase in serum theophylline level Increase in serum levels Respiratory depression Risk of toxicity

Risk of toxicity

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels Red blood count, white blood count, and differential Fasting blood sugar and 2-hour postprandial blood sugar Serum alanine transaminase, aspartate transaminase, and bilirubin

Serum alanine transaminase, aspartate transaminase, and bilirubin

The nurse understands that which is the highest priority when teaching about antitubercular medications? Staying hydrated Taking medications as prescribed Eating a well balanced diet Monitoring sputum

Taking medications as prescribed

What assessment finding may be attributable to an adverse effect of erythromycin? The client was incontinent of urine during the night. The client is uncharacteristically euphoric. The client slept poorly due to a dry cough. The client's systolic blood pressure is approximately 20 mm Hg below the norm.

The client is uncharacteristically euphoric.

When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions? The need to increase fluid intake for the duration of treatment The need to take the medication on an empty stomach The fact that the drug should be discontinued once symptoms subside The fact that a mild rash frequently follows the first few doses

The need to take the medication on an empty stomach

A client is prescribed rifampin. What information should the nurse include in the client's medication education? It has an increased serum half-life, so it is more effective than rifabutin. When taking it with warfarin, an increased anticoagulant effect occurs. The urine, tears, sweat, and other body fluids will be a discolored red-orange. It decreases hepatic enzymes and decreases metabolism of drug

The urine, tears, sweat, and other body fluids will be a discolored red-orange

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. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. Stop the medication and the health care provider will order you a different antibiotic. Continue to take the medication as prescribed; these are expected side effects from the medication.

These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.

A client asks why three medications are prescribed to treat his tuberculosis. The nurse informs the client of which reasons? To decrease allergic response of medications To prevent adverse reactions To prevent resistance To decrease length of drug therap

To prevent resistance

Which of the following are examples of a secondary infection? Select all that apply. C. difficile colitis Vaginal candidiasis Otitis media Oral candidiasis Endocarditis SUBMIT ANSWER

Vaginal candidiasis Oral candidiasis C. difficile colitis

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? Abdominal pain Vaginal itching and discharge Nausea Swelling and itching of the throat

Vaginal itching and discharge

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 Headache and dizziness Phlebitis Superinfections

Vomiting and diarrhea

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

Aminoglycosides are contraindicated for all of the following clients EXCEPT: Clients with acute renal failure. Clients with drug-resistant TB. Clients with multiple sclerosis. Clients with myasthenia gravis.

Clients with drug-resistant TB.

A nurse is caring for a 35-year-old male taking telithromycin. For what type of infection is this client being treated? Bacterial colitis Community-acquired pneumonia Streptococcal meningitis Streptococcal sinusitis

Community-acquired pneumonia

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? Increased elimination Increased absorption Decreased absorption Decreased elimination

Decreased absorption

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? Administer oral diphenhydramine to the client during the infusion. Slow down the rate so that the infusion takes place over 2 hours. Discontinue the infusion and inform the health care provider promptly. Administer an STAT dose of acetylcysteine.

Discontinue the infusion and inform the health care provider promptly.

When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element? direct sunlight unpasteurized dairy products alcohol foods containing purines

alcohol

Tuberculosis typically affects the lungs but can also involve other parts of the body. Which of the following can be affected by the disease? Kidneys GI/GU tract Lymph nodes All the above

all the above

A 10-year-old client is diagnosed with acute otitis media. What does the nurse anticipate the health care provider will prescribe? amoxicillin ciprofloxacin ibuprofen neomycin-polymyxin B

amoxicillin

A client is diagnosed with an infectious process that is sensitive to penicillin. The client is allergic to penicillin, so the health care provider orders a drug with a similar antibacterial spectrum. The nurse anticipates that the provider will order what antibiotic? Erythromycin Dicloxacillin Vancomycin Streptomycin

Erythromycin

The nurse is caring for a client diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe? Meclizine Loxapine hydrochloride Erythromycin Pravastatin

Erythromycin

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? antidiabetic agents antacids oral contraceptives antihypertensives

anatcids

A 20-year-old female is being treated with rifampin and INH. The nurse is teaching the client about birth control recommendations while on these medications. What method would the nurse recommend? The use of condoms Oral contraceptives and condoms concurrently Depo-Provera injections Any of the above

any of the above

An 80-year-old client is diagnosed with latent tuberculosis infection. What is a risk for the elderly population when being treated with INH? Hypovolemia Hypoxemia Renal failure Hepatotoxicity

Hepatotoxicity

The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction? Hyperglycemia Elevated temperature Increased bruising Hypoglycemia

Hypoglycemia

Sulfonamides are bacteriostatic against a wide range of gram-positive and gram-negative bacteria, but they are becoming less useful for what reason? Intermittent resistance Increasing resistance Decreased resistance Increased susceptibility

Increasing resistance

Daptomycin belongs to the lipopeptide class of antibiotics that kills gram-positive bacteria. What is the mechanism of action for this antibiotic? Inhibition of cell wall osmosis Inhibition of synthesis of bacterial proteins Inhibition of mitochondrial reproduction Inhibition of synthesis of DNA only

Inhibition of synthesis of bacterial proteins

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? Propranolol and sotalol Carbamazepine and phenytoin Dextroamphetamine and doxapram Isoniazid and rifampin

Isoniazid and rifampin

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? Dextroamphetamine and doxapram Isoniazid and rifampin Propranolol and sotalol Carbamazepine and phenytoin

Isoniazid and rifampin

A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice? It is excreted into the GI tract. It is excreted into the bloodstream. It is metabolized in the liver. It is metabolized in the kidneys.

It is metabolized in the liver.

After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example? Ertapenem Doripenem Imipenem-cilastatin Cefuroxime

cefuroxime

When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline? leukocyte count of 11.6/mm3 (high) potassium of 3.4 mEq/L (3.40 mmol/L) (low) creatinine of 2.8 mg/dL (247.52 µmol/L) (high) hemoglobin of 10.5 g/dL (105.00 g/L) (low)

creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

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. increase in respiratory rate drop in blood pressure sudden increase in temperature regular urine output pulse rate within usual parameters

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 TB Vancomycin-resistant Staphylococcus aureus Methicillin-resistant Staphylococcus aureus Human immunodeficiency virus

drug- resistant TB

A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component? proteins fluids vitamin D calories

fluids

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-positive infections viral infections gram-negative infections fungal infections

gram-negative infections

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 protein synthesis interfering with DNA synthesis in the bacterial cell blocking ribosomal reading of mRNA disrupting the bacterial cell wall

interfering with DNA synthesis in the bacterial cell

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? chloramphenicol linezolid quinupristin-dalfopristin clindamycin

linezolid

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 Excessive tearing Hypotension Chest pain

nausea

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? a persistent cough since starting the medication a slight decrease in his blood glucose levels numbness and tingling in his feet changes in his bowel elimination pattern

numbness and tingling in his feet

What event triggers the development of a superinfection? unforeseen interactions between the antibiotic and other prescribed medications proliferation of antibiotic-resistant microorganisms the infection is well established before antibiotic treatment begins bone marrow suppression triggered by antibiotic treatment

proliferation of antibiotic-resistant microorganisms

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? intestinal function lung function renal function cardiac function

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: choice of drug. frequency. dose. route

route.

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 tachycardia polydipsia dizziness

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 orange-tinged urine. deep muscle pain. staining of permanent teeth. sleep deprivation.

staining of permanent teeth.

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? Take the drug immediately after meals. Take the drug along with milk or fruit juice. Take the drug on an empty stomach. Take the drug along with a meal.

take the drug on an empty stomach

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? vancomycin warfarin losartan atorvastatin

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 vaginal discharge hydration status oral mucosa

weight

In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences: increased appetite. leg pain. pale urine. yellowing of the eyes or skin.

yellowing of the eyes or skin.