Pharm Exam 3

A client has been newly diagnosed with narcolepsy. What should the nurse include in client teaching?

"Avoid jobs that require working in shifts." Rationale: The client who is diagnosed with narcolepsy should avoid shift work. Caffeine use may or may not be indicated. The client should ideally not take naps. The client should not increase the methylphenidate dose without the input of the health care provider.

A client is living with his daughter after major surgery. He states, "I see a dog around the chair. Get rid of that dog. I hate dogs." The daughter tells the home care nurse that there is no dog behind the chair. What is the most important question the nurse should ask the daughter?

"Has your father consumed alcoholic beverages on a regular basis?" Rationale: Delirium tremens, the most serious form of alcohol withdrawal, is characterized by confusion, disorientation, delusions, visual hallucinations, and other signs of acute psychosis. The behavior is unlikely attributable to consumption of any food item, and a fear of dogs wouldn't likely explain the hallucination. While insurance will be helpful if the client requires mental health care, it is more important at this time to assess for delirium tremens and the immediate risks it presents.

An adult client diagnosed with depression several weeks ago began taking citalopram 10 days ago. The client has told the nurse of the intent to stop taking the drug, stating, "I don't feel any less depressed than I did before I started taking these pills." How should the nurse best respond to the client's statement?

"I'd encourage you to continue with the drug; it can take several weeks before it improves your mood." Rationale: Steady-state blood levels of selective serotonin reuptake inhibitors like citalopram are achieved slowly, over several weeks. The client should expect to sense an eventual improvement in mood, and it would be premature to change medications. This aspect of pharmacokinetics is more likely than a possible drug interaction. The nurse needs to educate the client, not demean feelings about the therapy.

A client scheduled for a bowel resection is to receive neomycin sulfate by mouth. The client asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the client?

"It will decrease the growth of intestinal bacteria." - Neomycin can be given before bowel surgery to suppress intestinal bacterial growth. When administered orally, it is poorly absorbed in the GI tract and so exerts local bactericide effect there.

A client's medication regimen for the treatment of anxiety has been changed from a benzodiazepine. The client asks the nurse what likely prompted the health care provider to change the medication. What is the nurse's best response?

"Long-term use of benzodiazepines can result in dependency." - Although bezodiazepines are effective anxiolytics, long-term use is associated with concerns over tolerance, dependency, withdrawal, lack of efficacy for treating the depression that often accompanies anxiety disorders, and the need for multiple daily dosing with some agents.

The nurse is providing education to the family of a client recently admitted for the treatment of a substance use disorder. How should the nurse best explain the etiology of this disorder?

"Substance abuse is multifactorial and involves genetics, personality, and culture." Rationale: Researchers have identified several factors in the predisposition to substance abuse and dependence. These factors include genetics, personality, and culture. The disorder is not, however, solely rooted in culture or wholly misunderstood. It is simplistic to understand the disorder as resulting from impaired coping and lack of willpower.

Rationale: The efficacy of methylphenidate in the management of ADHD is paradoxical and not well understood. It does not significantly affect dopamine levels or the function of the limbic system and parasympathetic nervous system.

"This is the result of neurologic factors over which you have no direct control." Rationale: Narcolepsy is a neurologic sleep disorder, not the result of mental illness or psychological problems. It is most likely due to several genetic abnormalities, but family history is not noted to be highly significant. Learning that improvement of sleeping habits is important, but it will not address embarrassment.

A client has been achieving an acceptable reduction in the positive and negative signs of schizophrenia after several weeks of treatment with clozapine. The client has asked the nurse if it is acceptable to have "a few drinks from time to time." How should the nurse best respond to the client's enquiry?

"When you're taking clozapine, it's best to avoid drinking alcohol altogether." Rationale: Alcohol increases central nervous system depression in clients taking clozapine; clients should ideally abstain from drinking alcohol. All the other options inappropriately suggest that there is a safe level.

The parents of a child on methylphenidate want to know why they need to withhold the medication during the summer months. What is the nurse's best response?

"Withholding the medication will decrease the growth suppression." Rationale: Stopping drug therapy will decrease weight loss and growth suppression. Withholding the drug will not assist in evaluating psychotherapy; it will allow for evaluation of the treatment regimen. Withholding the medication will not assist in stabilizing cardiac function or assist in better drug response.

The nurse is reviewing serum levels of a client who is taking lithium. What range does the nurse interpret as appropriate?

0.5 to 1.2 mEq/L Rationale: The therapeutic serum lithium level is 0.5 to 1.2 mEq/L. The other ranges indicate toxicity.

A 12-year-old child has been prescribed dextroamphetamine therapy, and the nurse is now reviewing the correct schedule for taking the drug. The child should most likely take the daily doses of dextroamphetamine at what times?

07:00 and 11:30 Rationale: Clients should take the first dose of dextroamphetamine on awakening or early in the day and the last dose at least 6 hours before bedtime. Twice-daily dosing is most common.

A client is receiving gentamicin to treat miningitis. 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?

08:00 - With conventional dosing, it is necessary to take gentamicin peak levels 30 minutes after the end of a 30-min IV infusion. Thus, 08:00 is the optimal peak time to assess the serum level of gentamicin.

A 13-year-old child is prescribed atomoxetine to be administered at 07:00. When will this medication reach its peak plasma level?

08:00 to 09:00 Rationale: Atomoxetine is rapidly absorbed with peak plasma levels in 1 to 2 hours. If the client takes the medication at 07:00, it will peak at 08:00 to 09:00.

The nurse is preparing to administer prescribed diazepam intravenously to a client. How soon after administration does the nurse expect to observe onset of action?

1 to 5 minutes - IV diazepam used to decrease seizure activity.

Extreme caution would be necessary with the use of gentamicin in which client?

A client who has chronic renal failure secondary to diabetes mellitus. - Gentamicin is nephrotoxic, and with impaired renal function, a reduction in dosage is essential.

Which client has the highest risk of developing ototoxicity secondary to gentamicin?

A client who has required repeated courses of gentamicin over the past several months. - Ototoxicity (auditory or vestibular) may develop after extended use of gentamicin and may not be reversible.

The nurse working with the family of a child prescribed methylphenidate should implement what strategy to address possible adverse effects?

A plan to address the child's loss of appetite Rationale: Like dextroamphetamine, methylphenidate often causes loss of appetite. Plans to address this should be in place at the beginning of therapy. Frequent blood glucose monitoring and actions to maintain bladder function are not likely necessary. Self-esteem should likely be addressed during treatment, but reduced self-esteem is not an adverse effect of methylphenidate.

A client has been prescribed both disulfiram and phenytoin. Based on the interaction of these two medications, the nurse should contact the health care provider regarding what potential adjustment to the medication therapies?

A reduced dose of phenytoin Rationale: The client will require a reduced dose of phenytoin because disulfiram interferes with the metabolism of phenytoin. The client will not require more frequent administration of disulfiram. The client will not require a larger dose of disulfiram. The client will not require increased administration of phenytoin.

A client is admitted to the emergency room with acute alcohol intoxication. The client is combative. Which medication will be administered?

A sedative Rationale: Acute intoxication with alcohol does not usually require treatment. If the client is hyperactive and combative, a sedative-type drug may be given. An ACE inhibitor is not administered for combativeness related to acute alcohol intoxication. An MAO inhibitor would be contraindicated in acute alcohol intoxication. A skeletal muscle relaxant would not be administered for acute alcohol intoxication.

A client with a history of heroin use has begun addiction treatment. The nurse had administered the client's daily dose of methadone. How does methadone therapy affect opioid addiction?

Acts as an agonist at opioid receptors and prevents withdrawal symptoms Rationale: Methadone is an agonist at specific opioid receptors in the CNS. Its action allows it to prevent symptoms of withdrawal. It does not cause unpleasant effects if the client uses opioids and does not act directly on the limbic system or reticular system.

A client has been admitted for the treatment of alcohol abuse disorder. Which client condition would cause the nurse to question a prescription for a benzodiazepine?

Acute intoxication with depressed vital signs Rationale: If the client's vital signs are depressed during acute intoxication, the use of benzodiazepines is contraindicated. Denial, previous treatment with benzodiazepines, and nicotine addiction do not contraindicate this treatment.

The nurse is preparing to administer oral chlorpromazine to a client. What action should the nurse include in administration?

Administer the drug 1 to 2 hours before bedtime. Rationale: For oral administration of chlorpromazine, the nurse should give doses 1 to 2 hours before bedtime; peak sedation occurs in about 2 hours. The drug is not given on alternating days, and there is no need to avoid dairy products. It is unnecessary for the client to hold the drug under the tongue.

The nurse is assessing a client with a suspected diagnosis of acute benzodiazepine withdrawal. What assessment findings would support that diagnosis? Select all that apply.

Agitation, Palpitations - Common signs and symptoms of withdrawal include increased anxiety, psychomotor agitation, insomnia, irritability, headache, tremor, and palpitations.

A client is prescribed disulfiram. How does this medication assist the client in refraining from ingestion of alcohol?

Allows the accumulation of acetaldehyde Rationale: Disulfiram interferes with hepatic metabolism of alcohol and allows accumulation of acetaldehyde. This accumulation of acetaldehyde produces an unpleasant reaction when disulfiram is consumed with alcohol. Disulfiram is not known to increase the levels of serotonin or acetylcholine. Disulfiram does not decrease the stimulation of the central nervous system.

A client is diagnosed with an infection attributable to the gram-negative microorganism Psuedomonas. Which anti-infective agent is most reliable in treating this microorganism?

Aminoglycoside - Aminoglycosides penetrate the cell walls of susceptible bacteria. As a result, the bacterial cell membrane becomes defective and cannot synthesize the proteins necessary for their function and replication. Aminoglycosides are used to treat infections caused by gram-negative microorganisms, such as Pseudomonas.

A client has been prescribed ciprofloxacin after being diagnosed with a sinus infection. What medication should the client avoid taking concurrently with ciprofloxacin?

Antacids - Clients should space out ciprofloxacin administration 4 to 6 hours with any of the following: antacids, multivitamins, sucralfate, or other products containing calcium, iron, or zinc. They decrease the antibiotic's effect.

A nurse is caring for an adult client who has been 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.

How should the nurse best assess the client for physical dependence on alcohol?

Assess the client for signs and symptoms of alcohol Rationale: Physical dependence involves physiologic adaptation to chronic use of a drug so that withdrawal, or unpleasant symptoms, occurs when the drug is stopped, when its action is antagonized by another drug, or when its dosage is decreased. Assessment of coping strategies, alcohol intake, and the client's feelings about drinking are relevant, but none directly addresses the possibility of physical dependence.

A 22-year-old college student allergic to penicillin to being treated with oral erythromycin for a chlamydial infection. What assessment should the nurse prioritize during this client's course of treatment to monitor for adverse reactions?

Assessment of the client's hearing.

A client is being prescribed a central nervous system stimulant. Which will have the lowest risk of abuse and dependence?

Atomoxetine Rationale: Atomoxetine is administered for ADHD and has a lower abuse and dependence capability. Dextroamphetamine, dextroamphetamine and amphetamine, and dexmethylphenidate have strong potential for abuse and dependence.

A client is admitted for assessment of inappropriately flamboyant and extroverted behavior coupled with risk-taking behaviors. The client reports having periods of major depression but has never sought help before. What mood disorder is most likely responsible for this client's behaviors?

Bipolar disorder type I Rationale: Bipolar disorder type I is characterized by episodes of major depression plus mania and occurs equally in men and women. Schizophrenia results from abnormal brain synapses and includes a wide variety of diseases. Depression is a mood disorder but does not exhibit periods of mania. Bipolar disorder type II is characterized by episodes of major depression plus hypomanic episodes and occurs more frequently in women.

A client has a history of long periods of depression interspersed with hypomanic episodes. What mood disorder is most likely responsible for these symptoms?

Bipolar disorder type II Rationale: Bipolar disorder type II is characterized by episodes of major depression plus hypomanic episodes and occurs more frequently in women. Bipolar disorder type I is characterized by episodes of major depression plus mania and occurs equally in men and women. Situation depression lasts a shorter amount of time and is related to life events. A coping disorder is not related to hypomania.

A high-school-age client, brought to the emergency department (ED) by friends after taking a "whole handful of dextroamphetamine," is now lapsing in and out of consciousness. The ED nurse should prioritize what assessment related to dextroamphetamine overdose?

Cardiac monitoring Rationale: Dextroamphetamine misuse may cause sudden death or serious cardiovascular events. It is essential to obtain a baseline electrocardiogram (ECG) and blood pressure reading. These assessments are priorities over blood glucose monitoring, respiratory assessment, and cognitive assessment.

What assessment should the nurse perform prior to administering pharmacologic treatments prescribed for a client diagnosed with cocaine-induced psychosis?

Cardiovascular assessment Rationale: Cocaine intoxication carries a high risk for cardiac dysrhythmias. Consequently, cardiovascular assessment would be a priority over lung auscultation, assessment of cranial nerve function, or assessment of blood glucose levels.

A client has been diagnosed with a community-acquired skin infection and has been prescribed linezolid. Which food should not be eaten during the period of this medication therapy?

Cheddar cheese - Because linezolid is a weak monoamine oxidase inhibitor, clients should avoid food high in tyramine content such as aged cheeses.

A client is admitted to an alcohol rehabilitation program. What medication will the client most likely be prescribed to treat alcohol withdrawal syndrome?

Chlordiazepoxide Rationale: Benzodiazepine antianxiety agents are the drugs of choice for treating alcohol withdrawal syndromes. Chlordiazepoxide is administered to clients for acute withdrawal syndrome. Neither clonidine, methyldopa, nor atenolol are benzodiazepines, and none are prescribed for acute alcohol syndrome.

The client reports taking a phenothiazine antipsychotic. What medication does the nurse suspect the client has been prescribed?

Chlorpromazine Rationale: Chlorpromazine is the prototype phenothiazine. Theophylline is a xanthine agent administered to treat some respiratory disorders. Haloperidol and thiothixene are nonphenothiazine antipsychotics.

What aspect of a client's health is most likely to cause insomnia?

Chronic pain

The health care provider prescribed an antibacterial drug to a client for the treatment of acne. What drug does the nurse expect to be prescribed?

Clindamycin - Often used to treat infections caused by B. fragiliz and can be administered topically for the treatment of acne.

A client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which symptom will be relieved most quickly with the onset of the drug regimen?

Combative behavior Rationale: Manifestations of hyperarousal, such as anxiety, hyperactivity, insomnia, aggressive, or combative behavior, are relieved more quickly. Symptoms such as hallucinations, delusions, and altered thought processes are relieved when the medication regimen is more effectively established.

A client is admitted to the hospital for the treatment of a stasis ulcer of the right leg. The client's history indicates alcohol abuse disorder with consumption of at least eight alcoholic beverages daily. What symptoms should the nurse assess the client for?

Confusion, hallucination, agitation, tremors Rationale: Delirium tremens, the most serious form of alcohol withdrawal, is characterized by confusion, disorientation, delusions, visual hallucinations, and other signs of acute psychosis. Denial, manipulation, combativeness, depression, remorse, withdrawal from reality, suspicion, mania, stubbornness, and fear are not symptoms of alcohol withdrawal.

A client reports insomnia during a routine visit. What should the nurse assess first regarding the most likely cause?

Daily intake of caffeine-containing products Rationale: The daily intake of caffeine should be assessed to determine if the intake is sufficient to disturb sleep. The amount of exercise the client engages in is important but not as critical as caffeine consumption. The family history of insomnia and sleep is not critical to assess. Amphetamines also have the potential to disrupt sleep, but caffeine use is far more prevalent.

A client who has been prescribed a selective serotonin reuptake inhibitor has begun taking St. John's wort daily. The nurse should teach the client that this combination may result in what adverse reaction?

Dangerous drug interactions Rationale: Combining St. John's wort with antidepressants can cause serious drug-to-drug interactions. These effects do not typically include worsened depression, alterations in coagulation, or dyscrasias.

The nurse is assessing a client who has just received haloperidol for an acute psychotic episode. For what therapeutic effect should the nurse initially assess following administration?

Decreased agitation and combativeness Rationale: When haloperidol is given for acute psychotic episodes, the nurse initially observes for sedation as well as decreased agitation, combativeness, and psychomotor activity. Increased insight, increased sophistication of thinking, and decreased CNS stimulation are not considered immediate priorities during an acute psychotic episode.

In addition to relieving agitation and anxiety, what is a rationale for using benzodiazepines in the treatment of a critically ill client?

Decreased cardiac workload - Antianxiety and sedative-hypnotic drugs are often useful in critically ill clients to relieve stress, anxiety, and agitation. Their calming effect decrease cardiac workload and respiratory effort.

A client admitted to the postanesthesia care unit (PACU) develops confusion and states, "I see bugs up and down the walls. They are going to get me." What do these behaviors indicate to the nurse?

Delirium Rationale: The client is likely experiencing delirium as a postoperative complication. Delusions are false beliefs that persist in the absence of reason or evidence. Schizophrenia is a variety of disorders and not a single symptom. Depression is the expression of sadness and despair.

A client has been admitted with the diagnosis of acute alcohol withdrawal. The nurse should plan care with the goal of preventing which primary sign of the disorder?

Delirium tremens Rationale: In acute alcohol withdrawal, a goal of treatment is to prevent a form of seizure called delirium tremens. Neither bradycardia nor hypotension is primary sign of acute alcohol withdrawal. Gastrointestinal bleeding results from heavy alcohol use but is not the primary sign of acute alcohol withdrawal.

A client who has been using cocaine on a regular basis has run out of the drug and is unable to obtain more. Within hours of stopping the medication, the client begins to show symptoms of cocaine withdrawal. What symptoms will the client exhibit?

Depression, drowsiness, and fatigue Rationale: Cocaine withdrawal begins within hours of stopping drug use and lasts up to several days. Symptoms include depression (which may be profound), drowsiness, fatigue, and sleep disturbance. Euphoria, hyperactivity, hyperalertness, clammy palms, diarrhea, chest pain, palpitations, and diaphoresis are not symptoms of withdrawal from cocaine abuse.

A client is prescribed risperidone for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of risperidone, what should the nurse suspect is triggering the client's reported polyuria and polydipsia?

Diabetes mellitus Rationale: The development of polyuria and polydipsia is indicative of diabetes mellitus. Risperidone has been associated with weight gain, diabetes, and dyslipidemia. Adverse effects of risperidone do not include urinary tract infection, renal calculus, or the development of hyperthyroidism.

A nurse is preparing a client's scheduled dose of oral vancomycin. This client's current illness was most likely manifested by what sign or symptoms?

Diarrhea - Oral vancomycin is useful only to treat staphylococcal enterocolitis and pseudomembranous colitis caused by C. difficle. These illnesses are characterized by diarrhea, vomiting, skin inflammation, or shortness of breath.

A nurse has noted that a newly admitted client has been taking ramelteon for the past several weeks. The nurse is justified in suspecting that this client was experiencing what problem prior to starting this drug?

Difficulty falling asleep at night Rationale: Ramelteon is use for the long-term treatment of insomnia characterized by difficulty with sleep onset. Ramelteon is not effective in managing any of the other suggested sleep-related issues

A teenage client treated with dextroamphetamine for attention deficit hyperactivity disorder (ADHD) for the last 10 years is now diagnosed with hyperthyroidism. What intervention should be implemented with this client to provide safe management of all conditions?

Discontinue the dextroamphetamine. Rationale: Dextroamphetamine, an amphetamine, is contraindicated upon the development of hyperthyroidism. The client will require a higher-calorie count, not a discontinuation of a high-calorie count. The client will not require an assessment for pulmonary edema. The client will only require a proton pump inhibitor if gastric hyperacidity occurs.

A client has been prescribed ciproflocaxin IV for the treatment of cellulitis. After initiating the infusion of the client's first 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. - Severe hypersensitivity reactions have occurred with the administration of fluoroquinoles.

The nurse is caring for a client who has been diagnosed with schizophrenia. The nurse understands that the client's condition is thought to be most likely related to an increased level of activity of what neurotransmitter?

Dopamine Rationale: Scientists have attributed schizophrenia to increased dopamine activity in the brain. The serotonergic and glutamatergic systems are also thought to play a role. Norepinephrine, acetylcholine, and adenosine are not currently thought to have major involvement in the pathophysiology of schizophrenia.

The nurse is preparing to administer chlorpromazine intramuscularly to a client. What action should the nurse implement during administration?

Encourage the client lie down for 30 to 60 minutes after the injection. Rationale: For IM administration of chlorpromazine, the nurse should have the client lie down for 30 to 60 minutes after the injection to prevent orthostatic hypotension. Massage is unnecessary, and the ventrogluteal site is used. The nurse should use a 11/2-inch (3.8-cm) needle.

The nurse is caring for a client who has been diagnosed with Legionnaires disease. What medication would the nurse expect the health care provider to prescribe?

Erythromycin - It is the prototype macrolide used to treat Legionnaires disease.

A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Clamydia trachomatis. Which medication will most likely be administered?

Erythromycin - There is no known cross-reaction between erythromycin and penicillin.

A client reports being prescribed a hypnotic for the treatment of chronic insomnia. What drug does the nurse suspect the client is taking?

Eszopiclone Rationale: Eszopiclone is the first oral nonbenzodiazepine hypnotic to receive FDA approval for long-term use (up to 12 months). Zaleplon is a nonbenzodiazepine hypnotic used for short-term treatment (7 to 10 days) of insomnia. Oral lorazepam and oxazepam are benzodiazepines prescribed for anxiety; the latter is also used in the management of alcohol withdrawal.

A client has been prescribed chloramphenicol for vancomycin-resistant enterococci. How is this medication eliminated from the body?

Excreted in the urine.

An older adult client diagnosed with generalized anxiety disorder is prescribed a benzodiazepine. The nurse caring for the client knows to include what intervention in the client's care plan?

Fall risk assessment - Adverse effects of bezodiazepines (e.g. drowsiness, dizziness) may contribute to falls and other injuries unless clients are carefully monitored and safeguarded.

The nurse is caring for a client suspected of experiencing benzodiazepine toxicity. Which medication does the nurse expect the health care provider to prescribe?

Flumazenil - Toxic effects of benzodiazepines include excessive sedation, respiratory depression, and coma. Flumazenil is a specific antidote that competes with benzodiazepines for benzodiazepine receptors and reverse toxicity.

A client is diagnosed with overdose of diazepam. What drug does the nurse anticipate being administered?

Flumazenil Rationale: Flumazenil is a specific antidote that can reverse benzodiazepine-induced sedation, coma, and respiratory depression. Disulfiram, methadone, and naloxone are not administered to reverse benzodiazepine overdose.

A client with a diagnosis of osteomyelitis will soon begin treatment with gentamicin. Which schedule is most likely to maximize efficacy and minimize nephrotoxicity?

Gentamicin 500 mg IV OD at 12:00. - The once daily administration method uses higher doses to produce high initial drug concentrations, with no repeat dosing until the serum concentration is quite low (typically 24 hrs later). The rationale for this dosing approach is a potential increase in efficacy with a reduced incidence of nephrotoxicity.

A client with schizophrenia has been taking haloperidol for the past several years. The health care team and the client have collaborated and chosen to transition the client to an atypical antipsychotic in an effort to reduce adverse effects and maximize therapeutic effects. In order to reduce the client's risk of extrapyramidal effects during the transition from haloperidol to an atypical antipsycotic, the health care team should implement which intervention?

Gradually taper the dose of haloperidol Rationale: When discontinuing haloperidol, it is essential to taper the dosage to prevent extrapyramidal symptoms. If the medication is abruptly discontinued, the client is at risk for this condition. A drug holiday would exacerbate symptoms, and ECT is not indicated. Concurrent administration of two drugs has the potential to exacerbate adverse effects.

A client is observed wandering in the hallways and talking with people who are not present. What behavior does the nurse document the client is experiencing?

Hallucinations Rationale: The client is experiencing hallucinations, sensory perceptions of people or objects that are not present in the external environment. Delusions are false beliefs that persist in the absence of reason or evidence and are also a symptom of a psychosis. Persons with paranoia believe that others are attempting to control them or do them harm. The described behaviors are not suggestive of depression, a disorder associated with depressed mood and intense sadness.

A client is experiencing psychotic behavior related to cocaine dependence. What medication can be administered to treat the psychosis?

Haloperidol Rationale: Psychosis related to cocaine dependence is treated with haloperidol. Diazepam does not treat psychosis related to cocaine dependence. Lorazepam and methadone are not administered to treat psychosis related to cocaine dependence.

A client diagnosed with peptic ulcer disease has been prescribed clarithromycin. Which organism is this medication intended to treat in this client?

Helicobacter pylori - Clarithromycin is approved to treat H. pylori infections (which are associated with peptic ulcers), Streptococcus pneumoniae, Haemophilus influenza, and Mycobacterium avium complex.

The nurse is preparing to administer gentamicin when the client suddenly mentions having experienced diminished hearing. What action should the nurse take based on this statement?

Hold the dosage, and notify the health care provider of the alteration in hearing. - Aminoglycosides accumulate in high concentrations in the inner ear, damaging sensory cells in the cochlea and vestibular apparatus. This accumulative effect increases the risk for the development of ototoxicity, causing in some cases, irreversible damage to one's hearing.

An 8-year-old client has been diagnosed with enuresis. What medication does the nurse suspect the health care provider will prescribe?

Imipramine Rationale: Imipramine is approved for treating childhood enuresis in children older than 6 years. Amitriptyline is a tricyclic antidepressant but is not used for childhood enuresis. Duloxetine and venlafaxine are serotonin-norepinephrine reuptake inhibitors used for depression.

A child is prescribed an amphetamine for attention deficit hyperactivity disorder (ADHD). Which effect provides evidence that the medication is working?

Improved grades Rationale: Amphetamines used with ADHD improve academic performance. Amphetamines often decrease sleep. Amphetamines will not result in lethargy. Amphetamines decrease appetite and do not cause polyphagia, the demonstration of excessive hunger and abnormally large intake of solids by mouth.

A client prescribed dextroamphetamine for attention deficit hyperactivity disorder (ADHD) has developed a common adverse effect of the medication since beginning therapy. Which initial intervention should the client be encouraged to implement?

Increase fiber intake. Rationale: Constipation is a common adverse effect of dextroamphetamine. A client who is experiencing constipation should be instructed to increase fiber in the diet. The client should not take a laxative before attempting to manage the problem with dietary modifications. The client should not be instructed to take diphenoxylate hydrochloride because it is an antidiarrheal agent. The client should not be given metronidazole since it is an anti-infective agent.

The etiology of anxiety involves which physiologic process?

Increased activation of the autonomic nervous system. - Clinical manifestations of anxiety include overactivity of the autonomic nervous system, such as dyspnea, palpitations, tachycardia, sweating, dry mouth, dizziness, nausea, and diarrhea.

The psychiatric nurse would recognize that venlafaxine's therapeutic effect is achieved by what means?

Increasing levels of both serotonin and norepinephrine Rationale: Venlafaxine increases the levels of serotonin and norepinephrine in the brain by preventing the reuptake of these neurotransmitters known to play an important part in mood. It does not directly affect endorphins or acetylcholine. The drug weakly inhibits dopamine reuptake.

A client is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside?

It blocked protein synthesis of the cell wall. - Aminoglyosides penetrate cell walls of susceptible bacteria and bind irreversibly to 30S ribosomes, intracellular structures that synthesize proteins.

A client has been prescribed mirtazapine. How will it decrease depression?

It blocks the presynaptic alpha2-adrenergic receptors. Rationale: Mirtazapine blocks presynaptic alpha2-adrenergic receptors (which increase the release of norepinephrine), serotonin receptors, and histamine H1 receptors. Consequently, the drug decreases anxiety, agitation, insomnia, and migraine headaches as well as depression. Mirtazapine's action on depression and migraine headaches is not related to any of the remaining options.

A child is administered a benzodiazepine. How will the child's dose differ from an adult's dose?

It will be lower. - Because of their smaller size and weight.

A client prescribed clindamycin is now reporting frequent diarrhea. How should the nurse best respond to this client?

Liaise with the client's health care provider to have the drug discontinued. - The FDA has issued a black box warning for clindamycin regarding the potential of severe and possible fatal colitis.

A client is to be started on amphetamine therapy for attention deficit hyperactivity disorder. Which medication has less physical dependence and abuse than other amphetamines?

Lisdexamfetamine Rationale: Lisdexamfetamine is approved for the treatment of ADHD. The drug reportedly delays the stimulation associated with other amphetamines and may be less prone to abuse. There is no need to change any existing occurrence of dextroamphetamine. Amphetamine, dextroamphetamine, and methamphetamine are prone to abuse.

When administering benzodiazepines, which medication should be considered the drug of first choice?

Lorazepam Rationale: Lorazepam is probably the benzodiazepine of first choice. The drug provides rapid tranquilization of clients experiencing agitation. Administered intravenously, it reduces nausea and vomiting as well as anxiety and induces procedural amnesia. Lorazepam has a slow onset of action (5 to 20 minutes) because of delayed brain penetration but an intermediate to prolonged duration.

A client taking prescribed lithium reports being placed on dietary restrictions. The nurse understands that the client's dose of lithium carbonate should be reduced for what type of diet?

Low sodium Rationale: A low-salt (sodium) diet will impair lithium excretion, so the dose of lithium should be reduced. Low-calorie, low-carbohydrate, and low-residue diets do not require decreasing the dose.

The nurse is preparing to provide education to a client who has been prescribed clozapine for schizophrenia. What is the most important aspect of client teaching?

Maintaining medication regimen Rationale: The client should be instructed to maintain the medication regimen to control symptoms of schizophrenia. Reporting signs of neuralgia is not taught because the medication does not have this effect. The medications will cause weight gain and should not be stopped in the event that weight gain develops. The use of alcohol is strictly prohibited with antipsychotic agents.

An adolescent client has been taking dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD) for the last 3 years, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy?

Measurement of height and body weight Rationale: Suppression of weight and height may occur in children taking amphetamines, and the nurse ensures that growth is monitored during drug therapy. Assessments for edema, diminished reflexes, and sensory deficits are not normally warranted.

A child diagnosed with attention deficit hyperactivity disorder (ADHD) has been prescribed methylphenidate. The child's mother tells the nurse that she does not understand why a stimulant would help since, "my child is completely overstimulated, not understimulated!" What should the nurse explain to the mother about the therapeutic use of methylphenidate?

Methylphenidate helps with the symptoms of ADHD, but the reasons for this are not well understood. Rationale: The efficacy of methylphenidate in the management of ADHD is paradoxical and not well understood. It does not significantly affect dopamine levels or the function of the limbic system and parasympathetic nervous system.

A client has developed Clostridium difficile associated with pseudomembranous colitis. Which medication is effective in the treatment of Clostridium difficile?

Metronidazole

Numerous residents of a long-term care facility have developed Clostridium difficile-associated diarrhea over the past week. The nurses at this facility would anticipate that many residents would require which medication therapy?

Metronidazole - Clinical indications for metronidazole include prevention or treatment of anaerobic bacterial infections and C. difficile infections associated with pseudomembranous colitis.

A client is scheduled to undergo a bronchoscopy for the investigation of a bronchial mass. What benzodiazepine should the clinic nurse anticipate administering for conscious sedation?

Midazolam - Frequently used for conscious sedation during invasive procedures.

What is the central nervous system stimulant of choice to treat narcolepsy?

Modafinil Rationale: Modafinil is used to treat narcolepsy. Atomoxetine is administered for attention deficit hyperactivity disorder (ADHD). Guarana is an herbal supplement high in caffeine; it is not administered for narcolepsy. Caffeine is not administered for narcolepsy.

An adult client with a diagnosis of alcoholism is to be treated with chlordiazepoxide on an in-client basis. When administering chlordiazepoxide, the nurse should implement which client-focused intervention?

Monitoring vital signs closely during intravenous (IV) administration Rationale: The nurse should take the client's vital signs regularly when giving the IV form of this drug, as well as observe and document subjective and objective reports by the client. Combative clients usually require a parenteral route of administration, and it is unnecessary to perform a full cardiac assessment before each dose. Usage should be tapered, and not stopped abruptly, to prevent rebound central nervous system stimulation.

The nurse is developing a care plan for a child diagnosed with night terrors who is prescribed diazepam. The nurse should include monitoring for development of what disorder in the care plan?

Mood disorders - Children may be more sensitive to its effects of this drug, namely mood and/or mental changes.

A client visits the occupational health office of the factory in which the client works. The client has fallen asleep on the production line and has a history of muscle weakness. This instance is not the first time the client has fallen asleep on the line. These behaviors support which medical diagnosis?

Narcolepsy Rationale: Narcolepsy is characterized by daytime sleep attacks in which the person goes to sleep at any place or at any time. Sleep apnea is episodes of apnea, temporary cessation of breathing, during sleep. Insomnia is the inability to sleep. This client is not exhibiting signs and symptoms consistent with substance abuse.

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 8 and periodic measurements during therapy. Monitor estimated creatine clearance and BUN at baseline and periodically during therapy. Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated. - Nurse would report drug levels above 10 to 12 mcg/mL. The trough is obtained before administered next dose, and nurse would report a level above 2 mcg/mL.

In light of current treatment modalities, the nurse should anticipate that the client newly diagnosed with schizophrenia will most likely be prescribed what drug?

Olanzapine Rationale: The "atypical" antipsychotics, such as olanzapine, are the drugs of choice, especially for clients who are newly diagnosed with schizophrenia. The other drugs are all "typical" (first-generation) antipsychotics.

While reviewing the medication history of an older adult client, the nurse learns that the client is taking amitriptyline 25 mg three times per day. What adverse effect should the nurse prioritize when incorporating safety measures into the care plan?

Orthostatic hypotension Rationale: Orthostatic hypotension is an adverse effect related to amitriptyline. The nurse should incorporate falls precautions into the care plan. Incontinence is not an adverse effect of amitriptyline. Urinary retention and dry mouth are adverse effects of amitriptyline but do not present the same safety risks posed by orthostatic hypotension.

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue?

Potential for abuse Rationale: A black box warning makes users of dextroamphetamine aware of the drug's high abuse potential. Black box warnings do not address the potential for renal failure, stroke, or unstable blood sugars.

A client diagnosed with insomnia is prescribed flurazepam. This medication has a a longer half-life than 24 hours. Which contributes to the long half-life of this medication and other benzodiazepines?

Presence of active metabolites - Benzodiazepines differ mainly in their plasma half-lives, production of active metabolites that also have long half-lives and tend to accumulate, especially in older adults and people with impaired liver function.

A 15-year-old client with a complex psychosocial history is being treated for inhalant abuse. When providing health education to a client being treated for inhalant abuse, the nurse should focus on which associated risks? Select all that apply.

Psychological dependence Physiologic withdrawal Organ damage Impaired brain development Rationale: Inhalants can harm the brain, liver, heart, kidneys, and lungs, and abuse of any drug during adolescence may interfere with brain development. Inhalant abuse can lead to psychological dependency and physiologic withdrawal. Inhalants produce symptoms comparable with those of acute alcohol intoxication, including initial mild euphoria followed by ataxia, confusion, and disorientation.

A psychiatric nurse is discussing the advantages of atypical antipsychotics with the parents of a teenager who has been diagnosed with schizophrenia. When comparing these drugs with the older, typical antipsychotics, what advantage should the nurse cite?

Reduced adverse effects Rationale: Atypical antipsychotics may be more effective in relieving some symptoms than typical antipsychotics, and they usually produce milder adverse effects. A major drawback is the high cost of these drugs. All antipsychotics are available for the oral route. There are several black box warnings relating to atypical antipsychotics.

The nurse is providing education to a client who has been prescribed clozapine. The nurse should emphasize the importance of what monitoring routine during teaching?

Regular complete blood counts Rationale: Clozapine is associated with life-threatening decrease in white blood cells (agranulocytosis). It is essential to monitor the complete blood count due to this risk. Weekly liver enzymes, monthly creatinine levels (kidney function), and INR monitoring (blood clotting function) are not recommended with clozapine therapy.

A client in intensive care has been prescribed both lorazepam and hydromorphone. The nurse should prioritize what assessments for the client?

Respiratory rate and oxygen saturation. - The combination of opioids and benzodiazepines creates a significant risk for CNS depression; respiratory function is consequently an important focus of assessment.

A client treated in the intensive care unit has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assessment is most appropriate to rule out contraindications for this medication therapy?

Review lab results to confirm normal liver function. - Erythromycin is seldom used in critical care settings, partly because broader-spectrum bactericidal drugs are usually needed in critically ill clients and partly because it inhibits liver metabolism and slows elimination of several other drugs.

The nurse is caring for a client who has been prescribed clozapine. What action should the nurse implement to ensure safe and effective administration?

Review the client history for evidence of seizure disorders. Rationale: Clozapine is an oral drug. A history of seizure disorders, known allergy to the drug, a history of clozapine-induced agranulocytosis or severe granulocytopenia, and CNS depression all contraindicate its use. Liquid oral chlorpromazine should be mixed with at 60 mL of fruit juice prior to administration. Intramuscular chlorpromazine is injected into the ventrogluteal muscle using a 11/2-inch (3.8-cm) needle.

The nurse is providing education to a client with diagnosed with traveler's diarrhea caused by an E. coli infection. On what drug will the nurse provide teaching?

Rifaximin

A client has been taking a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which represents the action of the medication?

SSRIs prevent serotonin from being reabsorbed. Rationale: Fluoxetine and the other SSRIs block the reabsorption of the neurotransmitter serotonin in the brain. This helps elevate mood. SSRIs do not increase serotonin synthesis or the number of binding sites. They do not influence the role of GABA.

A client has been prescribed phenelzine sulfate. When providing teaching, which food should the nurse instruct the client to avoid eating?

Salami Rationale: When taking a monoamine oxidase inhibitor, such as phenelzine, foods high in tyramine or tyrosine should be avoided. Salami, like other cured and aged meats, is high in tyramine. None of the other listed foods are problematic.

A client has been administered flumazenil because of the toxic effects of benzodiazepines. The client should be observed for acute benzodiazepine withdrawal symptoms. Which signs or symptoms is indicative of acute benzodiazepine withdrawal?

Seizures - Agitation, confusion, and seizures are all signs and symptoms of acute benzodiazepine withdrawal.

A client is admitted to the emergency department with a ketamine overdose. For what symptom of overdose should the nurse assess?

Seizures Rationale: Ketamine overdose results in seizures, polyneuropathy, increased intracranial pressure, respiratory arrest, and cardiac arrest. The client suffering from ketamine overdose will not have symptoms of metabolic acidosis, bradycardia, or pain.

A client reports feelings of gloom and the inability to perform activities of daily living. The normal function of which neurotransmitter is most likely impaired?

Serotonin Rationale: Serotonin helps regulate several behaviors that are disturbed in depression. Acetylcholine is a neurotransmitter with action in the cardiac and skeletal muscle. Acetylcholine has a limited impact in depression. Epinephrine is not associated with depression, though norepinephrine is implicated. Insulin is released by the pancreas to regulate blood sugar.

The nurse is providing education to a male client who has been prescribed fluoxetine. Which adverse effect should the nurse assess for to help ensure client adherence?

Sexual dysfunction Rationale: Fluoxetine is associated with a high incidence of sexual dysfunction, which is a major reason for noncompliance in men. Hypotension, pain or discomfort, and cardiac dysrhythmia are not associated with use of the drug.

A client admitted for the treatment of a fracture has a history of heavy alcohol use. What event should suggest the implementation of pharmacologic treatment for alcohol withdrawal?

Signs/symptoms of withdrawal are noted. Rationale: Treatment with chlordiazepoxide should begin as soon as the clinician identifies that the client is demonstrating signs and symptoms of alcohol withdrawal. It is unsafe to delay treatment of withdrawal. Care for physical injuries is implemented independently.

The nurse prepares to administer ciprofloxacin 250 mg per enteral feeding tube every 12 hours to the adult client diagnosed with pneumonia and a history of renal impairment in the critical care unit. Which measures should the nurse provide for safe and effective drug administration? Select all that apply.

Stop the enteral tube feeding for 1 hour before administering drug, and resume feeding 2 hours after providing drug. Crush the immediate release tablet, and mix with water before administering the medication via the enteral tube. Monitor serum creatinine and BUN, and report any changes from baseline to the provider.

A client is diagnosed with multidrug-resistant tuberculosis. Which aminoglycoside medication is used in 4- to 6-drug regimen?

Streptomycin - Streptomycin may be used as part of a 4- to 6-drug regimen for treatment of multidrug-resistant tuberculosis. The therapy includes four distinct drugs prescribed for a 6-month period.

The nurse is caring for a teenage client who has recently been prescribed a selective serotonin reuptake inhibitor. What assessment should the nurse prioritize?

Suicidal ideation Rationale: The FDA has issued a black box warning alerting health care providers to the increased risk of suicidal ideation in children, adolescents, and young adults 18 to 24 years of age when taking antidepressant medications. VTE, arrhythmias, and hypomania are not likely adverse effects.

The nurse providing education to a client prescribed erythromycin recognizes a need for additional instruction when the client makes which suggestion? Select all that apply.

Taking the medication with or without food. Recognizing dark urine a normal side effect. Swallowing the medication with milk. - Grapefruit juice, dairy products (!!!), and food in general interfere with the absorption of the medication. Dark urine should be reported immediately as it indicates possible renal complications.

A client has been prescribed a benzodiazepine daily for the treatment of an anxiety disorder. In order to minimize the chances of withdrawal symptoms, the nurse knows to include what precaution in client teaching?

Tapering the does of drug over a prolonged period of time. - To avoid withdrawal symptoms, it is necessary to taper bezodiazepines gradually before discontinuing them completely.

The nurse observes that a client with a long history of chlorpromazine therapy demonstrates lip smacking and appears to be chewing continually. The nurse should recognize that this client is likely experiencing what adverse effect of the medication?

Tardive dyskinesia Rationale: Tardive dyskinesia occurs as the result of long-term use of chlorpromazine. Clients may experience lip smacking, tongue protrusion, and facial grimaces and may have choreic movements of the trunk and limbs. Akathisia is a form of restlessness, and dystonias are uncoordinated movements. Neuroleptic malignant syndrome is an acute complication.

The nurse is caring for an older adult client who has been recently diagnosed with insomnia. What medication does the nurse expect the health care provider to prescribe?

Temazepam - It is the drug of choice for insomnia in older adults, those with liver disease, or those taking drugs that interfere with hepatic drug-metabolizing enzymes.

What is the postantibiotic effect of gentamicin therapy?

The ability of an antibiotic to kill bacteria even when serum concentrations are low. - Postantibiotic effect is the term used to identify that aminoglycosides continue killing organisms even at low serum concentrations.

Three days after discontinuing diazepam with medical guidance, an older adult client continues to demonstrate impaired memory and confusion. The nurse should consider what possible explanation for the client's current status?

The adverse effects of diazepines can persist for several days after stopping the drug. - Both therapeutic and adverse effects of diazepam are more likely to occur after 2 or 3 days of therapy than initially. Such effects accumulate with chronic usage and persist for several days after the drug is discontinued.

What assessment finding would signal the nurse to the possibility that the client's infusion of vancomycin is running too quickly?

The client is flushed and has a visible skin rash. - It is very important to give IV infusions slowly, over 1 to 2 hours, to avoid adverse reaction characterized by hypotension, flushing, and skin rash. This reaction sometimes called red man syndrome and is attributed to histamine release.

A young client has been prescribed an antipsychotic agent to relieve psychotic symptoms. Which goal of care is the priority?

The client will remain safe. Rationale: Safety is a priority over other goals. Goals such as participation in ADLs, health maintenance, and participation in relationships are valid, but safety is a priority.

A client diagnosed with genitourinary infection is being treated with fluoroquinolone. What is the advantage of fluoroquinolone over an aminoglycoside?

The fluoroquinolone can be can be given orally. - Newer fluorquinolones have been developed with a broader spectrum of activity that provides improved coverage of gram-positive organisms and, in one case, anaerobes. They are often given orally.

A client is prescribed ciprofloxacin. Which nursing intervention will best prevent the possible development of crystalluria?

The nurse should encourage fluid intake of 2000 mL/day. - Guidelines to decrease the incidence and severity of adverse effects include keeping clients well hydrated to decrease drug concentration in serum body tissues.

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. - Administration of the oral suspension of ciprofloxacin via feeding tubes should not occur, because the oil-based formulation tends to adhere to the feeding tube. As alternative route is necessary.

The nurse is caring for a client who is receiving gentamicin therapy. Why will the nurse monitor the results of a serum gentamicin level?

To identify whether the drug is at a therapeutic level. - Measurement of both peak and trough levels of gentamicin helps maintain therapeutic serum levels without excessive toxicity. It is neither nephrotoxic nor hepatotoxic.

The nurse is providing education to an adolescent client who has been prescribed an amphetamine for attention deficit hyperactivity disorder. How does the nurse explain the purpose of a "drug holiday"?

To minimize weight loss Rationale: Dextroamphetamine often causes loss of appetite, and the health care provider may stop the medication during the months when the child is not in school. A drug holiday, as this is called, helps decrease weight loss and growth suppression. It does not address potential electrolyte imbalances, thyroid imbalances, or the process of bone remodeling.

While reviewing a medication history, the nurse sees that a school-age client has been prescribed haloperidol. Based on this information, the nurse suspects that the client may have been diagnosed with what disease process?

Tourette's syndrome Rationale: Haloperidol is used in treating Tourette's syndrome in children. It is not used to treat muscular dystrophy, Alzheimer's disease, or myasthenia gravis.

A client reports taking a prescribed antidepressant for the treatment of insomnia. What medication does the nurse suspect the client is using?

Trazodone Rationale: Trazodone is administered more often for sedation and sleep than depression. Fluoxetine, olanzapine, and citalopram hydrobromide are not prescribed for sleep.

The nurse should focus on what aspects of care when preparing a caregiver to address the needs of a client who demonstrates psychotic behaviors? Select all that apply.

Understanding the nature of the client's mental health illness Encouraging the client to be as independent as is possible Being familiar with the available social services in the community Keeping all follow-up mental health appointments Rationale: Major recurring challenges face clients with psychosis and their caregivers in the home. Supporting efforts to stabilize positive and negative symptoms and cognitive function, take medications as prescribed, manage adverse effects, and obtain follow-up psychiatric care may require the coordinated efforts of several health and social service agencies or providers. Socialization is needed when it is appropriate and safe.

The nurse is providing education to a client who has been prescribed disulfiram therapy. What should the nurse explain will occur if the client consumes alcohol while taking the medication?

Unpleasant physical reactions Rationale: Disulfiram inhibits the enzyme aldehyde dehydrogenase to block the oxidation of alcohol. The resulting accumulation of acetaldehyde produces an unpleasant physical reaction when disulfiram is consumed with alcohol. The effects do not include hallucinations, increased CNS depression, or depressed mood, however.

A client prescribed metronidazole to treat Clostridium difficile is also prescribed which medication orally to assist in restructuring the flora of the intestinal tract?

Vancomycin - Oral vancomycin is active only against gram-positive microorganisms and is used to treat pseudomembranous colitis caused by C. difficile.

What effect will be produced from the combination of alcohol and disulfiram?

Vomiting Rationale: Disulfiram interferes with hepatic metabolism of alcohol and allows the accumulation of acetaldehyde. If alcohol is ingested during disulfiram therapy, acetaldehyde causes headaches, confusion, seizures, chest pain, flushing, palpitations, hypotension, sweating, blurred vision, nausea, vomiting, and a garlic-like aftertaste. Disulfiram will not cause hypertension, increased alertness, or oral bleeding.

A client is prescribed daptomycin to treat a gram-negative infection caused by Staphylococcus aureus. Which symptom should be reported immediately to the health care provider based on the adverse effects of daptomycin?

Weakness of the legs and arms. - Because of increased creatine kinase levels.