Pharmacology PREP U Exam 4

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 fact that nonadherence to treatment exacerbates the risks of adverse effects the need to consistently take the prescribed drugs in order to cure TB the need to match drug dosages carefully to signs and symptoms the fact that nonadherence will necessitate the use of antiretrovirals

the need to consistently take the prescribed drugs in order to cure TB Consistent adherence to treatment is imperative to ensure successful treatment of TB. Nonadherence leads to resistance and unsuccessful treatment, not increased adverse effects. Nonadherence has no relationship with matching dosage with signs and symptoms. Antivirals are ineffective against TB.

A client is prescribed ciprofloxacin. Which statement by the nurse is correct regarding the adverse effects of the medication? "Adverse effects include nausea, vomiting, and tendinitis or tendon rupture." "Adverse effects include difficulty with blood pressure regulation and sunburns." "Adverse effects include increased respiratory rate and gastrointestinal distress." "Adverse effects include irritability and difficulty hearing."

"Adverse effects include nausea, vomiting, and tendinitis or tendon rupture." Ciprofloxacin is a fluoroquinolone, and has adverse effects including nausea, vomiting, and abdominal discomfort. The U.S. Food and Drug Administration alerted health professions to the disabling risk of tendinitis and tendon rupture. Ciprofloxacin does not affect blood pressure, respiratory rate, or irritability.

A 23-year-old client is prescribed zidovudine for treatment of human immunodeficiency virus (HIV). Which statement indicates that the client has understood the client teaching regarding the action of this medication? "Zidovudine inactivates the virus and prevents recurrence of the disease." "Zidovudine therapy may result in the development of resistant strains." "Zidovudine slows the progression of the disease but does not cure it." "Zidovudine prevents the occurrence of opportunistic infections."

"Zidovudine slows the progression of the disease but does not cure it." Zidovudine slows the progression of the disease but does not cure the disease. Zidovudine does not inactivate the virus, result in resistant strains, or prevent the occurrence of opportunistic infections.

The nurse is providing care for a diverse group of clients. Which client should the nurse monitor most closely for signs and symptoms of a fungal infection? A client who is receiving combination therapy for acquired immunodeficiency syndrome (AIDS) A client with breast cancer who is post-operative day two following a mastectomy A client with chronic renal failure who has peritoneal dialysis three times per week An older adult client with osteoporosis who is taking a bispohosphonate

A client who is receiving combination therapy for acquired immunodeficiency syndrome (AIDS) Clients who are immunosuppressed, such as those who have AIDS, are at particular risk for fungal infections. Many older adults also have high risks, but the risk among clients with AIDS is known to be particularly high. Post-operative clients and those with renal failure are not particularly high-risk.

A patient 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 there is no dog behind the chair. What is the most important question the nurse should ask the daughter? A)"Does you father have health care insurance for psychiatry?" B)"Has your father been fearful of dogs in the past?" C)"Has your father consumed alcoholic beverages on a regular basis?" D)"What type of foods or spices has your father consumed today?"

ANS: "Has your father consumed alcoholic beverages on a regular basis?" Explanation: Delirium tremens, the most serious form of alcohol withdrawal, is characterized by confusion, disorientation, delusions, visual hallucinations, and other signs of acute psychosis.

What statement indicates the patient needs more teaching about administering sumatriptan subcutaneously? A)"I will not drive after I take the medication." B)"I will not take more than two injections in 24 hours." C)"I can give the medication in my arm or leg." D)"I can take this medication safely when pregnant."

ANS: "I can take this medication safely when pregnant." Explanation: The medication should not be taken if pregnant. All other statements are correct.

The nurse is caring for a client receiving antiviral medications to treat HIV. What laboratory study should the nurse monitor most closely to determine the effectiveness of the medications? A)CD4 count B)CBC with differential C)P24 antigen test D)Liver function studies

ANS: CD4 count Explanation: HIV attacks the helper T cells (CD4 cells) within the immune system. Monitoring T cell count would indicate how effective the drug is at controlling the virus. CBC with differential does not include a T cell count. P24 antigen tests confirm the presence of the virus but do not indicate the severity of the disease; it is either positive or negative. Liver function studies are not indicated unless liver function is damaged by the disease.

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? A)Diarrhea and nausea B)Headache and dizziness C)Lethargy and paresthesias D)Super infections and phlebitis

ANS: Diarrhea and nausea Explanation: The most common adverse effects associated with ceftriaxone, a cephalosporin, include those affecting the GI tract, such as nausea, vomiting, diarrhea, abdominal pain, and flatulence. Headache, dizziness, lethargy, and paresthesias can occur as well as super infections and phlebitis (with IV administration), but these are not the most common.

A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? A)Dietary habits B)Work environment C)Typical daily fluid intake D)Ethnicity

ANS: Dietary habits Explanation: The nurse must consider the patient's dietary habits because foods high in purines increase uric acid concentrations in the blood, making a gouty attack more likely. Assessing the patient's work environment, fluid intake, and ethnicity are not as important as assessing his dietary habits.

When teaching clients about the effect of nicotine on the cardiovascular system, the nurse should include what information? A)It increases catecholamines to increase heart rate. B)It diminishes the blood's ability to clot. C)It increases myocardial contractility of the heart. D)It increases high-density lipoproteins.

ANS: It increases catecholamines to increase heart rate. Explanation: Nicotine increases catecholamines, resulting in an increase of heart rate and blood pressure. Nicotine increases platelet adhesiveness and aggregation to increase, not decrease, clotting. Nicotine decreases myocardial contractility. Nicotine decreases good cholesterol, which is the high-density lipoprotein.

The nurse is administering penicillin to a client who has strep throat. Which of the following statements accurately describe the action of penicillin? A)It is effective against gram-positive organisms B)It is not effective against gram-negative organisms C)It has many side effects, especially in large doses D)It is metabolized in the liver

ANS: It is effective against gram-positive organisms Explanation: Penicillin is most effective against gram-positive organisms, such as streptococci, staphylococci, and pneumococci. It is also active against some gram-negative organisms, such as gonococci and meningococci, and against the organisms that cause syphilis. It is relatively free of side effects, even in larger doses, and is excreted rapidly in the urine.

Ms. Harbor received parenteral opioid analgesics during labor and delivery of her first child. The nurse observes that the neonate is experiencing respiratory depression. What is the drug of choice in this case? A)Magnesium sulfate B)Terbutaline C)Morphine sulfate D)Naloxone

ANS: Naloxone Explanation: Parenteral opioid analgesics (e.g., IV or IM meperidine, morphine, or fentanyl) are commonly used to control pain during labor and delivery. They may prolong labor and cause sedation and respiratory depression in the mother and neonate. Meperidine may cause less neonatal depression than other opioid analgesics. Butorphanol is also widely used. If neonatal respiratory depression occurs, it can be reversed by naloxone (Narcan). Reference:

A male client develops a wound infection, and the health care provider orders once-daily intravenous multiple-dose regimens of aminoglycosides. What kinds of monitoring does the nurse expect the provider to order? A)Peak and trough serum levels B)A complete blood count every 48 hours C)A serum albumin determination every 48 hours D)Measurement of electrolytes every 48 hours

ANS: Peak and trough serum levels Explanation: Multiple-dose regimens (conventional dosing) of aminoglycosides must be carefully monitored with evaluation of peak and trough serum levels. Once-daily regimens are monitored with random level (12-hour) serum evaluation.

A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of A)methamphetamine. B)cocaine. C)marijuana. D)nicotine.

ANS: marijuana. Explanation: The major ingredient of Marinol is 9-tetrahydrocannabinol (THC), the active ingredient in marijuana.

A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions should a nurse perform when preparing penicillin in parenteral form? A)Extract penicillin from vial and then reconstitute. B)Save excess antibiotic after reconstitution for later use. C)Use any available diluent for reconstitution. D)Shake the vial well to distribute the drug evenly.

ANS: Shake the vial well to distribute the drug evenly. Explanation: When preparing a parenteral form of penicillin, the nurse should shake the vial thoroughly before withdrawing the drug to ensure its even distribution in the solution. Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial. Excess antibiotic after reconstitution should never be saved, as the drug loses its potency when stored. Reconstitution should be done only with the diluent prescribed on the manufacturer's label.

An older adult client has been diagnosed with candidiasis and prescribed fluconazole. What aspect of the client's health status should warrant close monitoring by the nurse? A)The client has atrial fibrillation and takes warfarin daily B)The client has hypothyroidism and takes levothyroxine daily C)The client adheres strictly to a vegetarian diet D)The client has a low body mass index

ANS: The client has atrial fibrillation and takes warfarin daily Explanation: Fluconazole causes increased levels of warfarin which may constitute a risk for hemorrhage. The client' use of levothyroxine is not problematic, nor is the fact that the client is a vegetarian and has a low body mass index.

What client should not receive a nonsteroidal anti-inflammatory medication as ordered for migraine relief? A)The client with a gastric ulcer B)The client who drinks 10 cups of coffee a day C)The client who has arthritis D)The client who takes one aspirin per day for the prevention of heart disease

ANS: The client with a gastric ulcer Explanation: The client with a gastric ulcer may have severe stomach upset and bleeding from the administration of an NSAID. The other clients are not at risk for taking these medications.

An older adult client with a creatinine level of 4.0 mg/dL (353.60 µmol/L) and a diagnosis of herpes simplex is prescribed acyclovir. When preparing to administer this medication parenterally, what would the nurse expect in regard to medication dosage? A)The dose is smaller due to the herpes simplex. B)The dose is smaller based on the client's kidney function. C)The dose is higher if treating genital herpes. D)The dose is higher if the creatinine is above 4.0 mg/dL (353.60 µmol/L).

ANS: The dose is smaller based on the client's kidney function. Explanation: Oral and IV acyclovir are excreted in the urine, and the dose should be decreased in clients who are older or have renal impairment. The dose is not smaller when treating herpes simplex, nor is the dose higher in treating genital herpes. The dose should be lower if the creatinine level is above 4.0 mg/dL (353.60 µmol/L).

A family expresses concern when a family member withdrawing from alcohol is given lorazepam (Ativan). What information should be given to the family about the medication? A)The medication promotes a sense of wellbeing during the client's difficult withdrawal period B)The medication is given for a short time to help the client complete the withdrawal process C)The medication will help the client forget about the physical sensations that accompany alcohol withdrawal D)The medication helps in the treatment of coexisting diseases, such as cardiac problems and hypertension

ANS: The medication is given for a short time to help the client complete the withdrawal process Explanation: Lorazepam is a short-acting benzodiazepine that may be given for 1 week to help the client in alcohol withdrawal. However, there's some debate over its use due to a potential risk for cross-addiction. The medication isn't given to help forget the experience; it lessens the symptoms of withdrawal. It isn't used to treat coexisting cardiovascular problems or promote a sense of well-being.

A patient on your unit has bacterial colitis and is being treated with oral vancomycin. Why is vancomycin given orally, rather than intravenously, in the treatment of bacterial colitis? A)Fewer pathogens are resistant to the oral version of the drug than to the IV version. B)The oral version of the drug acts within the bowel lumen. C)The oral version of the drug is easier to administer. D)The oral version of the drug limits the release of histamines.

ANS: The oral version of the drug acts within the bowel lumen. Explanation: For bacterial colitis, vancomycin is given orally because it is not absorbed from the GI tract and acts within the bowel lumen.

The client who has been on long-term sulfonamide therapy begins begins to demonstrate symptoms associated with side affects of the therapy. The nurse knows that these symptoms are related to which complication associated with sulfonamide therapy? A)Hypokalemia B)Hypotension C)Thrombocytopenia D)Hyperglycemia

ANS: Thrombocytopenia Explanation: Hypotension, hypokalemia, and hyperglycemia are not adverse effects of sulfonamide therapy. Thrombocytopenia is a complication manifested by easy bruising and unusual bleeding after trauma to the skin or mucous membranes.

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: A)are ineffective in clients who are allergic to penicillins. B)can cause kidney damage in clients who are allergic to penicillins. C)are derived from penicillin. D)can cause allergic reactions in clients who are allergic to penicillins.

ANS: can cause allergic reactions in clients who are allergic to penicillins. Explanation: Clients who are allergic to penicillins may also be allergic to cephalosporins. Although this cross-allergenicity (allergy to a drug of another class with similar chemical structure) is rare, cephalosporins are not typically administered to clients who have had life-threatening allergic reactions to a penicillin.

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? A)interfering with DNA synthesis in the B)bacterial cell C)interfering with protein synthesis D)disrupting the bacterial cell wall blocking ribosomal reading of mRNA

ANS: interfering with DNA synthesis in the bacterial cell Explanation: The fluoroquinolones exert their bactericidal effect by interfering with the synthesis of bacterial DNA by not allowing the cell to reproduce. The tetracyclines are bacteriostatic and exert their effect by inhibiting bacterial protein synthesis. Penicillins act to disrupt the bacterial cell wall. The aminoglycosides exert their bactericidal effect by blocking the ribosome from reading the mRNA, a step in protein synthesis necessary for bacterial multiplication.

What medication would the nurse anticipate being prescribed for a client diagnosed with trichomoniasis? A)clindamycin B)metronidazole C)rifaximin D)penicillin

ANS: metronidazole Explanation: Metronidazole is effective against anaerobic bacteria, including gram-negative bacilli such as Bacteroides, gram-positive bacilli such as Clostridia, and some gram-positive cocci. It is also effective against protozoa that cause amebiasis, giardiasis, and trichomoniasis. None of the other options would effectively manage this infection.

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example? A)metronidazole B)ciprofloxacin C)levofloxacin D)gemifloxacin

ANS: metronidazole Explanation: Metronidazole is not an example of a fluoroquinolone. Ciprofloxacin is an example of a fluoroquinolone. Levofloxacin is an example of a fluoroquinolone. Gemifloxacin is an example of a fluoroquinolone.

The nurse is providing care for a client physically dependent on an opioid. How is physical dependence best characterized? A)psychological adaptation that results in unpleasant symptoms when the drug is stopped B)physiologic adaptation that results in unpleasant symptoms when the drug is stopped C)psychological adaptation that results in feelings of satisfaction and pleasure D)physiologic adaptation requiring increased dosages of medication

ANS: physiologic adaptation that results in unpleasant symptoms when the drug is stopped Explanation: Physical dependence involves physiologic adaptation to chronic use of a drug so that unpleasant symptoms occur when the drug is stopped, when its action is antagonized by another drug, or when its dosage is decreased. Attempts to avoid withdrawal symptoms reinforce psychological dependence and promote continuing drug use and relapses to drug-taking behavior. Tolerance is often an element of drug dependence in which increasing doses are required.

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? A)polydipsia B)tachycardia C)skin rash or itching D)dizziness

ANS: skin rash or itching Explanation: Clients taking sulfonamides should be instructed to contact the prescriber if they experience skin rash or itching. These symptoms may indicate a sulfonamide-induced allergic reaction and the need to change or stop the drug.

What is a priority nursing assessment of a client prescribed oral sumatriptan? A)Vital signs B)Urinary output C)Head to toe assessment D)Glasgow coma scale

ANS: vital signs Explanation: After administration of sumatriptan, the nurse should assess for adverse effects. These include increased blood pressure as well as chest pain, shock, dizziness and vertigo. Urine output and head to toe assessment are not warranted. The Glasgow comas scale is used to determine best neurological function and not migraine pain.

A nurse is caring for a hospitalized client with a urinary tract infection (UTI). The nurse is preparing to administer nitrofurantoin, which is a bacteriostatic antibiotic. Which statement best differentiates bacteriostatic and bactericidal medications? Bacteriostatic medications destroy bacteria. Bactericidal medications preserve bacteria growth. Bactericidal medications improve the destruction of bacteria. Bacteriostatic medications slow or retard the multiplication of bacteria.

Bacteriostatic medications slow or retard the multiplication of bacteria. Bacteriostatic medications slow or retard the multiplication of bacteria and bactericidal destroys bacteria. Bactericidal medications do not improve the destruction of bacteria.

A client is diagnosed with bacterial pneumonia. Pending culture results, what would the nurse expect the health care provider to order? Broad-spectrum antibiotics Short-term oral antibiotic therapy Short-term IV antibiotic therapy Long-term oral antibiotic therapy

Broad-spectrum antibiotics Bacterial pneumonia is usually treated with a broad-spectrum antibiotic until culture and susceptibility reports become available.

Culture and sensitivity testing of a client's urine sample reveals a bacterium that is susceptible to cephalosporins. What medication would be most likely for the nurse to administer? Cefaclor Imipenem-cilastin Neomycin Ciprofloxacin

Cefaclor Cefaclor is an example of a cephalosporin. Imipenem-cilastin is an example of a carbapenem. Neomycin is an example of an aminoglycoside. Ciprofloxacin is an example of a fluoroquinolone.

A non-nucleoside reverse transcriptase inhibitor has direct effects on the HIV virus activities within the cell. What drug is a non-nucleoside reverse transcriptase inhibitor? Econazole nitrate Oxaliplatin Olanzapine Efavirenz

Efavirenz The non-nucleoside reverse transcriptase inhibitors available today include delavirdine, efavirenz, and nevirapine. Econazole nitrate is an antifungal cream, Olanzapine is an atypical antipsychotic, and Eloxatin is an antineoplastic agent.

A client with a fungal infection has been prescribed ketoconazole 250 mg PO daily. The client reports nausea and anorexia the day after starting the medication. What is the nurse's best action? Encourage the client to try eating small, frequent meals rather than three larger meals Have the client withhold the next scheduled dose and come be assessed by the provider Collaborate with the care provider to obtain a prescription for ondansetron Educate the client about the fact that this adverse effect usually resolves within 72 hours TAKE A PRACTICE QUIZ

Encourage the client to try eating small, frequent meals rather than three larger meals Clients who experience GI effects of antifungals may benefit from smaller, more frequent meals. There is no clear need to have the client discontinue or withhold the medication, though the nurse should follow up with the client. Changes in diet should normally be trialed before seeking prescription antiemetics. There is no guarantee that adverse effects will resolve spontaneously.

A client has an upper respiratory infection and is allergic to penicillin. What medication does the nurse expect will be ordered? Cephalosporin Ampicillin Erythromycin Ancef

Erythromycin A macrolide can be given safely to a client who is allergic to penicillin. Ampicillin, Ancef, and cephalosporins cannot be given because of the risk of cross-sensitivity.

The patient receiving IV acyclovir should be monitored for which adverse reaction? Increased BUN and creatinine levels Decrease in white blood cell count Decrease in platelet count Decrease in magnesium level

Increased BUN and creatinine levels The only laboratory test that is specific to renal function is the BUN and creatinine levels. IV acyclovir may be nephrotoxic. Acyclovir nephrotoxicity appears to result from crystallization of the drug in the nephron, which can lead to renal tubular obstruction.

A male client is placed on an IV regimen of aztreonam. The nurse would expect the health care provider to order which laboratory test? CBC Hematocrit Serum albumin Liver function

Liver function Aztreonam, imipenem, meropenem, and ertapenem may cause abnormalities in liver function test results (i.e., elevated alanine and aspartate aminotransferases [ALT and AST] and alkaline phosphatase), but hepatitis and jaundice rarely occur.

The nurse at a long-term care facility is admitting a new resident who is an older adult. The resident's current medication regimen includes nystatin 1,000,000 units PO t.i.d. The nurse should recognize the need to prioritize what aspect of this resident's care? Mouth care Encouraging fluid intake Protective isolation

Mouth care Nystatin PO is normally prescribed for oral candidiasis. Fluid intake would not have an immediate effect on the resident's health problem and there is no indication for protective isolation. There is no reason to believe the client has a fungal scalp infection.

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first? Using combination therapy Obtaining sensitivity testing Checking client allergies Evaluating the bactericidal effects

Obtaining sensitivity testing Performing sensitivity testing on cultured microbes is important to evaluate the bacteria and determine which drugs are capable of controlling the particular organism. Once the sensitivity testing is completed, then the decision for the drug can be made. Combination therapy is used when appropriate after culture and when sensitivity testing has been completed. Checking client allergies also would be done after sensitivity testing but before administering the drug. The bactericidal effects of a drug may or may not play a role in the selection of the drug.

An elderly female client is admitted to the medical floor with pustules on her body that travel along the nerve route in her legs and arms. The health care provider prescribes the drug acyclovir (Zovirax). What disease is this client demonstrating? Herpes simplex Shingles Influenza CMV

Shingles The client has herpes zoster virus (shingles). CMV is a virus with symptoms that include malaise, fever, pneumonia, and superinfection. Herpes simplex causes oral, ocular, or facial infections. The influenza virus is commonly called the "flu" and is an acute respiratory illness.

When administering the fusion protein inhibitor enfuvirtide, the nurse should include which technique to assure the medication's continued effectiveness? Have the client gargle with normal saline immediately after taking the drug. Flush the client's central venous catheter with 100 Unit/mL heparin prior to administration. Inject the drug into the client's ventrogluteal site using the Z-track method. Regularly rotate the subcutaneous injection sites that are used.

Regularly rotate the subcutaneous injection sites that are used. The nurse injects enfuvirtide subcutaneously into the upper arm, abdomen, or anterior thigh. Rotation of injection sites and assessment of the sites for reactions are necessary. The suggestions that the medication should be administered intravenously, orally, or intramuscularly are all incorrect.

A patient with TB is undergoing initial therapy in the treatment. The nurse has to administer three or more drugs in combination to the patient. The patient wishes to know the reason for administering a combination of drugs. Which of the following explanations does the nurse offer related to the combination of medications? Prevents the incidence of liver dysfunction. Slows down bacterial resistance. Slows body's resistance to medication. Prevents further spreading of TB.

Slows down bacterial resistance. The nurse should inform the patient that administering two to three drugs in combination slows down the development of bacterial resistance in the body. Administering a combination of drugs will not specifically prevent the incidence of liver dysfunction. Using drugs in combination does not slow down the body's resistance to medication, though it does reduce the development of bacterial resistance. Prophylactic treatment helps in preventing the TB from spreading further.

A female patient with giardiasis is taking oral metronidazole. After 3 weeks of therapy, she comes to the clinic for a checkup. Which would be the most important nursing action? Test a stool specimen. Tell the patient to stop taking the drug if her urine is discolored. Test for visual acuity. Monitor for thrombophlebitis.

Test a stool specimen. It would be most important for the nurse to test three stool specimens several days apart. Stool test results are good indicators of the success of metronidazole therapy. Discolored urine is a common adverse effect; the patient should not stop taking the drug. The nurse should also monitor for thrombophlebitis when metronidazole is administered intravenously. When the patient is on prolonged metronidazole therapy, the nurse may need to test visual acuity and recommend dental checkups.

A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV infections. Which would the nurse include as the primary reason? More than one drug is needed to ensure sensitivity to the different forms of the virus. The use of multiple drugs allows attack on the virus at different points in its life cycle. One drug helps to control the virus, while the other drugs help to alleviate the adverse effects. Using several drugs at once helps to improve the client's immune response.

The use of multiple drugs allows attack on the virus at different points in its life cycle. HIV mutates over time, presenting a slightly different configuration with each new generation. Thus, multiple drugs are used to attack the virus at various points in the life cycle to achieve the maximum effectiveness with the least amount of toxicity. Sensitivity is not an issue. The virus needs to enter the cell to cause infection. Adverse effects are numerous with anti-HIV drugs and the use of combination therapy can increase the client's risk for these adverse effects, including further depression of the immune response.

Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture? To identify the organism causing the infection To determine the severity of the infection To identify the drugs that might be effective in treatment To determine the body's response to the infection

To identify the organism causing the infection Culture identifies the infection's causative organism. Susceptibility tests determine which drugs are likely to be effective against the organism.

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

alcohol Alcohol increases the risk of hepatotoxicity even if alcohol use is stopped during isoniazid therapy. There is no therapeutic reason for clients taking isoniazid to avoid sunlight, dairy products, or purines.

A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse should first ensure that the client has not recently eaten what type of foods? dairy products leafy green vegetables any high-fat foods acidic foods

dairy products The combination of tetracycline with metallic ions such as aluminum, calcium, iron, or magnesium inhibits tetracycline absorption. It is important not to take tetracycline with dairy products, antacids, or iron supplements. None of other foods present significant amounts of metallic ions.

What adverse effect would most likely necessitate discontinuing treatment with isoniazid? persistant nausea jaundice pruritus alopecia

jaundice Jaundice is a clear indication of hepatotoxicity and would most likely warrant discontinuing treatment with isoniazid. Nausea would not likely prompt and change in treatment. Pruritus may be associated with liver damage but may also have other potential causes. Alopecia does not typically accompany isoniazid therapy.

The nurse recognizes that what drug classification increases the risk of ototoxicity and nephrotoxicity when prescribed with gentamicin? loop diuretics benzodiazepines proton pump inhibitors tricyclic antidepressants

loop diuretics Loop diuretics given simultaneously with gentamicin increase the risk of nephrotoxicity by decreasing fluid volume, thereby increasing drug concentrations in serum and tissues. Loop diuretics may also contribute to ototoxicity. This risk is not associated with therapies that include both gentamicin and any of the other options.

Which medication will be administered to treat the diarrhea and abdominal distention associated with giardiasis? sulfasalazine metronidazole trimethoprim-sulfamethoxazole doxycycline

metronidazole Adults and children older than 8 years of age with symptomatic giardiasis are usually treated with oral metronidazole. The administration of sulfasalazine is used to treat ulcerative colitis. Trimethoprim-sulfamethoxazole is used to treat urinary tract infections. Doxycycline is a tetracycline agent. It is not used for giardiasis.

A client prescribed metronidazole to treat Clostridium difficile is also prescribed which medication orally to assist in restructuring the flora of the intestinal tract? spectinomycin rifaximin vancomycin quinupristin-dalfopristin

vancomycin Oral vancomycin, active only against gram-positive microorganisms, is used to treat pseudomembranous colitis caused by C. difficile. Spectinomycin, rifaximin, and quinupristin-dalfopristin are not administered to treat pseudomembranous colitis caused by C. difficile.