TB
A patient is to receive medication through a feeding tube. The order reads, "Give amoxicillin 250 mg per feeding tube every 8 hours." When reconstituted, the concentration of the medication is 125 mg/5 mL. How many milliliters will the nurse give per dose?
10 mL
The order reads: "give Vancomycin 1250 mg in 250ml NS IVPB, every 12 hours. Infuse over 90 minutes." The nurse will set the infusion pump to what setting for mL/hour?
167 mL/hr
The patient has new orders for pyrazinamide, 30 mg/kg/day. The patient weighs 132 lb. How many milligrams will the patient receive per day? Is this dosage safe?
1800 mg; yes, the maximum dose is 2g (2000 mg)
The order reads, "Give colistimethate (Coly-Mycin) 2.5 mg/kg/day IVPB. Infuse over 5 minutes." The patient weighs 165 pounds. How many milligrams will the patient receive per dose? (Record answer using one decimal place.)
187.5 mg
The order for a 1-year-old child reads, "Give amantadine (Symmetrel) 4.4 mg/kg/day in 2 divided doses." The child weighs 22 lb. How many milligrams will the child receive per dose?
22 mg
A patient is to receive 2 million units of penicillin G potassium per day, every 6 hours in IV piggyback doses. The medication is available in vials of 1 million units/50 mL, and each dose needs to be mixed in 50 mL of D5W. How many milliliters will the nurse draw up for each IV piggyback dose?
25 mL per dose. Each dose will contain 500,000 units (every 6 hours will be 4 doses per day; divide 2 million units per day by 4 to get 500,000 units per dose)
The patient is to receive isoniazid (INH) 0.3 g daily. The medication is available as 100-mg tablets. How many tablets will the nurse administer per dose?
3 tablets
A 6-year-old child is to receive albuterol (Proventil) 0.2 mg/kg PO two times a day. The child weighs 40 lb. How many milligrams will the child receive per dose? (Record answer using one decimal place.)
3.6 mg
A patient will be taking oral neomycin before having bowel surgery. The order reads, "Give 1 g per hour for 4 doses PO." The patient cannot swallow pills, so an oral solution has been ordered. The solution is 125 mg/5 mL. How many milliliters will the nurse give for each 1-g dose?
40 mL
The order for a child read: give cefoxitin (mefoxin) 160 mg/kg/day IVPB, divided into doses given every 6 hours. The child weighs 55 pounds. How much will the patient receive each day? For each dose?
4000 mg/day; 1000 mg/dose
The nurse is preparing to administer The Elixir form of Theophylline to a patient who has a peg tube. The dose is 240 milligrams daily and the medication is available in a concentration of 80 mg/15 mL. How many milliliters of medication will the nurse give per dose?
45 mL
The order reads, "Give acyclovir, 0.25 g IVPB now." The medication comes in a vial that contains 1000 mg. The label reads, "Add 20 mL of diluent for a solution that contains 50 mg/mL." The medication will be added to 100 mL D5W for IV piggyback infusion. How many milliliters of reconstituted medication will the nurse add to the 100-mL bag for infusion?
5 mL
The order reads: give Nystatin (Mycostatin) suspension 500,000 units by mouth (Swish and swallow) 4 times a day for one week. The medication is available in a suspension of a 100,000 units per ml. How many milliliters will the nurse give per dose?
5 mL
The order reads, "Give amphotericin B (Fungizone) 20 mg in 300 mL D5W over 6 hours." The nurse will set the infusion pump to what rate?
50 mL/hr
The order for isoniazid: reads give 5 mg/kg PO daily. The patient weighs 275 pounds. What is the amount per dose? Is it a safe dose?
625 mg/dose; no, maximum dose is 300 mg
A patient is to receive voriconazole (Vfend) as follows: 6 mg/kg q12h 3 2 doses, then change to 4 mg/kg q12h. The patient weighs 242 lb. How much will the patient receive for each 6-mg/kg dose? The 4-mg/kg dose?
660 mg; 440 mg
The order for a patient who has a severe case of shingles is for acyclovir (zovirax) 10 mg/kg IV every 8 hours for 7 Days. The patient weighs 165 pounds. How much is each dose?
750 mg per dose
A newly admitted patient reports a penicillin allergy. The prescriber has ordered a second generation cephalosporin as part of the therapy. Which nursing action is appropriate? A. Call the prescriber to clarify the order because of the patient's allergy. B. Give the medication and monitor for adverse effects C. Ask the pharmacy to change the order to a first generation cephalosporin D. Administer the drug with a non-steroidal anti-inflammatory drug to reduce adverse effects
A
A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation? A. A beta Agonist such as Albuterol B. A leukotriene receptor antagonist such as montelukast C. A corticosteroid such as fluticasone D. An anticholinergic such as ipratropium
A
After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 bets/min. the nurse knows that this reaction is an A.Expected adverse effect of the medication B. allergic reaction to the medication C. indication that he has received an overdose of the medication D. idiosyncratic reaction to the medication
A
Bedaquiline (sirturo)is prescribed for a patient and the nurse is providing instructions to the patient about the medication. Which statement by the patient indicates a correct understanding of the instructions? A. I will take this with food B. I need to take this one hour before breakfast C. I can stop this drug if the side effects bother me D. It's okay to have a glass of wine while taking this drug
A
The nurse is counseling a woman who is beginning antitubercular therapy with Rifampin. This patient also takes an oral contraceptive. Which statement by the nurse is most accurate regarding potential drug interactions? A. You will need to switch to another form of birth control while you are taking the Rifampin B. Your birth control pills will remain effective while you are taking the Rifampin C. You will need to take a stronger dose of birth control pills while you are on the right fanfin D. You will need to abstain from sexual intercourse while on the Rifampin to avoid pregnancy
A
When administering Vancomycin the nurse knows that which of these is the most important to assess before giving a medication? A. Renal function B. WBC count C. liver function D. Platelet count
A
When the nurse is teaching a patient who is taking acyclovir for genital herpes which statement by the nurse is accurate? A. This drug will help the lesions to dry and crust over B. Acyclovir will eradicate the herpes virus C. This drug will prevent the spread of this virus to others D. Be sure to give this drug to your partner too
A
When monitoring a patient who is receiving caspofungin the nurse will look for which serious adverse effects? Select all that apply. A. Blood dyscrasias B. Hypotension C. Pulmonary infiltrates D. Tinnitus E. Hepatotoxicity
A B E
The nurse is teaching a patient about the inhaler Advair (salmeterol/fluticasone). Which statement by the patient indicates a correct understanding of this medication? (Select all that apply.) A. I will rinse my mouth with water after each dose. B. I need to use this inhaler whenever I feel short of breath, but not less than 4 hours between doses C. This medication is taken twice a day every 12 hours D. I can take this inhaler if I get short of breath while exercising E. I will call my doctor if I notice white patches inside my mouth
A C E
The nurse is reviewing the orders for wound care which include use of an antiseptic. Which statements best describe the use of antiseptics? (Select all that apply.) A. Antiseptics are appropriate for use on living tissue B. Antiseptic work by sterilizing the surface of the wound C. Antiseptics are applied to non-living objects to kill microorganisms D. The patient's allergies must be assessed before using the antiseptic E. Antiseptics are used to inhibit the growth of microorganisms on the wound surface
A D E
Explain the concept of "trough" levels during aminoglycoside therapy and the way in which renal function is monitored.
A blood sample of measurement of "trough" level is drawn at least 8 to 12 hours after completion of dose administration. The therapeutic goal is a trough level at or below 1 mcg/mL, then the patient is at greater risk for otoxicity and nephrotoxicity. Trough levels are normally monitored initially and then once every 5 to 7 days until the drug therapy is discontinued. The patient's serum creatinine level will also be measured at least every 3 days as an index of renal function, and drug dosages will be adjusted as needed for any changes in renal function.
Why would an eye examination be performed before instituting antitubercular therapy?
A thorough eye examination may be called for before therapy is initiated because ethambutol can cause a decrease in visual acuity resulting from optic neuritis, which is also a contraindication to the use of ethambutol. In addition, isoniazid may cause optic neuritis and visual disturbances.
A patient has a new prescription for a Combivent (ipratropium bromide/albuterol sulfate) metered-dose inhaler. The patient is to take two puffs, four times a day. The inhaler contains 200 "puffs." In how many days should the patient replace the inhaler?
After 25 days (* puffs per day, divided into 200 doses)
A patient has been receiving an aminophylline (xanthine derivative) infusion for 24 hours. The nurse will assess for which adverse effect when assessing the patient during the infusion? A. CNS depression B. Sinus tachycardia C. Increased appetite D. Temporary urinary retention
B
A patient has been receiving therapy with the aminoglycoside Tobramycin and the nurse notes that the patient's latest trough drug level is 3 mcg/ml. This drug is given daily and the next dose is to be administered now. Based on the trough drug level what is the nurses priority action? A. Administer the drug as ordered B. Hold the drug and notify the prescriber C. Call the laboratory to have the test repeated and verified D. Hold this dose but administer the next dose a scheduled
B
A patient is scheduled for colorectal surgery tomorrow. He does not have sepsis, his WBC count is normal, he has no fever and he is otherwise in good health. However, there is an order to administer an antibiotic on call before he goes to surgery. The nurse knows that the rationale for this antibiotic order is to A. Provide empiric therapy B. Provide prophylactic therapy C. Treat for a superinfection D. Reduce the number of resistant organisms
B
After the patient takes a dose of inhaled corticosteroid, such as fluticasone (flovent) what is the most important action the patient needs to do next? A. Hold the breath for 60 seconds B. Rinse out the mouth with water C. Follow the corticosteroid with a bronchodilator inhaler if ordered D. Repeat the dose in 15 minutes if the patient feels short of breath
B
During antitubercular therapy with isoniazid a patient received another prescription for pyridoxine. Which statement by the nurse best explains the rationale for the second medication? A. This vitamin will help to improve your energy levels B. This vitamin helps to prevent neurologic adverse effects C. This vitamin Works to protect your heart from toxic effects D. This vitamin helps to reduce gastrointestinal adverse effects
B
The nurse is assessing a patient who is about to receive antifungal drug therapy. Which problem would be of most concern? A. Endocrine disease b. Hepatic disease C. Cardiac disease D. Pulmonary disease
B
The nurse is reviewing the orders for a patient who has been admitted for treatment of pneumonia. The antibiotic orders include an order for doxycycline. However when the patient is asked about his allergies he lists doxycycline as one of his allergies. What is the nurses priority action at this time? A. Call the prescriber to clarify the order because of the patient's allergy b. Ask the patient to explain what happened when he had the allergic reaction C. Ask the pharmacy to order a different antibiotic D. Administer the drug with an antihistamine to reduce adverse effects
B
When teaching a patient who is taking Nystatin lozenges for oral candidiasis which instruction by the nurse is correct? A. To the lozenge carefully before swallowing B. Dissolve lozenge slowly and completely in your mouth C. Dissolve the lozenge until it's half the original size and then swallow it D. These lozenges needs to be swallowed whole with a glass of water
B
The nurse is reviewing the drugs ordered for a patient. A drug interaction occurs between penicillins and which drugs? (Select all that apply.) a. Alcohol b. Oral contraceptives c. Digoxin d. Nonsteroidal antiinflammatory drugs e. Warfarin f. Anticonvulsants
B D E
The nurse is reviewing the use of multidrug therapy for HIV with a patient. Which statements are correct regarding the reason for using multiple drugs to treat HIV? (Select all that apply.) A. The combination of drugs has fewer associated toxicities B. The use of multiple drugs is more effective against resistant strains of HIV C. Effective treatment results and reduced T-cell counts D. The goal of this treatment is to reduce the viral load E. This type of therapy reduces the incidence of opportunistic infections
B D E
The nurse is monitoring for liver toxicity in a patient who has been receiving long-term isoniazid therapy. Manifestations of liver toxicity include: (select all that apply.) A. Orange discoloration of Sweat and Tears B. Darkened urine C. Dizziness D. Fatigue E. Visual disturbances F. Jaundice
B D F
A patient has been admitted for treatment of an infected leg ulcer and will be started on intravenous linezolid. The nurse is reviewing the list of the patient's current medications. Which type of medication, if listed, would be of most concern if taken with the linezolid? A. Beta blocker B. Oral anticoagulant C. Selective serotonin reuptake inhibitor antidepressant D. Thyroid replacement hormone
C
A patient who is taking a xanthine derivatives for chronic bronchitis asks the nurse, "I miss my morning coffee. I can't wait to go home and have some." What is the nurses best response? A. I know how you feel. I miss my coffee too. B. I can get some coffee for you. I'll be right back C. It's important not to take coffee or other caffeinated products with this medication as it may cause an increase heart rate as well as other problems. D. You've been on this medicine for a few days. I can call your prescriber to ask whether you can have some coffee.
C
A teenage patient is taking a tetracycline drug as part of treatment for severe acne. When the nurse teaches this patient about drug-related precautions which is the most important information to convey? A. When the acne clears up the medication may be discontinued B. This medication needs to be taken with antiacids to reduce GI upset C. The patient needs to use sunscreen or avoid exposure some because this drug may cause photosensitivity D. The teeth should be observed closely four signs of mottling or other color changes
C
A woman has been taking an antibiotic for a UTI cause the nurse practitioner to complain of severe vaginal itching. She has also noticed a thick whitish vaginal discharge. The nurse practitioner suspects that A. This is an expected response to antibiotic therapy B. The UTI has become worse instead of better C. A superinfection has developed D. The UTI is resistant to the antibiotic
C
After giving an injection to a patient with HIV infection the nurse accidentally receives a needle stick from a too full needle disposal box. Recommendation for occupational HIV exposure may include the use of which drugs? A. Didanosine B. Lamivudine and enfuvirtide C. Emtricitabine and tenofovir D. Acyclovir
C
After surgery for organ transplantation a patient is receiving ganciclovir he does not have a viral infection. Which statement best explains the rationale for this medication therapy? A. Ganciclovir is used to prevent potential exposure to the HIV virus B. This medication is given prophylactically to prevent influenza A infection C. Ganciclovir is given to prevent CMV infection D. The drug works synergistically with antibiotics to prevent superinfection
C
During a teaching session for a patient who will be receiving a new prescription for the LTRA Montelukast (Singulair) the nurse will tell the patient that the drug has which therapeutic effect? A. Improve the respiratory drive B. Loosens and removes thickened secretions C. Reduces inflammation in the airway D. Stimulates immediate bronchodilation
C
During an infusion of amphotericin B the nurse knows that which administration technique may be used to minimize infusion-related adverse effects? A. Forcing of fluid during the infusion B. Infusing a medication quickly C. If using the medication over a longer period of time D. Stopping infusion for 2 hours after half of the bag has Infuse and then resuming one hour later
C
The nurse is teaching a patient who is starting antitubercular therapy with Rifampin. Which adverse effects with the nurse expect to see? A. Headache and neck pain B. Gynecomastiac. C. Reddish brown urine D. numbness or tingling of extremities
C
The nurse notes in the patient's medication history that the patient is taking sofosbuvir (solvald) with ribavirin. Based on this finding the nurse interprets that the patient has which disorder? A. Cytomegalovirus B. Genital herpes C. Chronic hepatitis C D. Respiratory syncytial virus infection
C
When giving intravenous quinolones the nurse needs to keep in mind that these drugs may have serious interactions with which drugs? A. Selective serotonin reuptake inhibitor antidepressants B. Nonsteroidal anti-inflammatory drugs C. Oral anticoagulants D. Antihypertensives
C
While monitoring a patient who is receiving intravenous amphotericin B the nurse expects to see which adverse effects? A. Hypertension B. Bradycardia c. Fever and chills D. Diarrhea and stomach cramps
C
The nurse is administering an intravenous aminoglycoside to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate? (Select all that apply.) A. Report a trough drug level of 0.8 mcg/ml and hold the drug B. Enforce strict fluid restriction C. Monitor serum creatinine levels D. Instruct the patient to report dizziness or a feeling of fullness in the ears E. Warn the patient that the urine may turn darker in color
C D
Mr. R., a 50-year-old banker, is scheduled for colon surgery tomorrow. The surgeon is planning to administer a prophylactic antibiotic. What drug is frequently used for this purpose, and why?
Cefoxitin (Mefoxin) is frequently used in patients undergoing abdominal surgeries because it can effectively kill intestinal bacteria, including anaerobic bacteria
A patient who has been newly diagnosed with HIV has many questions about the effectiveness of drug therapy. After a teaching session which statement by the patient Flex a need for more education? A. I will be monitored for side effects and improvements while I'm taking this medicine B. These drugs do not eliminate the HIV but hopefully the amount of virus in my body will be reduced C. There is no cure for HIV D. These drugs will eventually eliminate the virus from my body
D
During patient education regarding an oral macrolide such as erythromycin the nurse will include which information? A. If GI upset occurs the drug will have to be stopped B. The drug needs to be taken with an antacid to avoid GI problems C. The patient needs to take each dose with a sip of water D. The patient may take the drug with a small snack to reduce GI irritation
D
During therapy with an intravenous aminoglycoside, the patient calls the nurse and says, I'm hearing some odd sounds, like ringing in my ears. What is the nurses priority action at this time? A. Reassure the patient that these are expected adverse effects B. Reduce the rate of intravenous infusion C. Increase the rate of intravenous infusion D. Stop the infusion immediately
D
During treatment with zidovudine the nurse needs to monitor for which potential adverse effects? A. Retinitis B. Deep vein thromboses C. Kaposi's sarcoma D. Bone marrow suppression
D
The nurse notes in a patient's medication history that the patient is taking terbinafine (Lamisil) based on this finding the nurse interprets that the patient has which disorder?
D
When administering antifungal drug therapy the nurse knows that an issue that contributes to many of the drug interactions with antifungals is the patient's A. History Of cardiac disease B. History of gallbladder surgery C. Ethnic background D. Cytochrome P - 450 enzyme system
D
When counseling a patient who has been newly diagnosed with TB, the nurse will make sure that the patient realizes that he or she is contagious A. During All Phases of the illness B. Anytime up to 18 months after therapy begins C. During the postictal phase of TB D. During the initial period of the illness and its diagnosis
D
While assessing a woman who is receiving quinolone therapy for pneumonia, the nurse notices that the patient has a history of heart problems. The nurse will monitor for which potential cardiac defect of quinolone therapy? A. Bradycardia B. Dysrhythmias C. Tachycardia D. Prolonged QT interval
D
While monitoring a patient the nurse knows that a therapeutic response to antitubercular drugs would be? A. The patient states that he or she is feeling much better B. The patient's Laboratory test results show a lower white blood cell count C. The patient reports a decrease coughs and night sweats D. There is a decrease in symptoms along with improved chest x-ray and sputum culture results
D
A patient is receiving imipenem/cilastatin (Primaxin) and asks the nurse, "Why does that medicine bag have two names listed? Am I receiving two drugs?" What is the best explanation for the patient?
Imipenem-cilastatin (Primaxin) does contain two drugs, but one of the drugs (cilastatin) works to prevent the antibiotic (imipenem) from being destroyed by bacterial enzymes that can make the antibiotic ineffective.
Nitrofurantoin (Macrodantin) has been ordered for a patient who has a severe urinary tract infection caused by Escherichia coli. Explain why this drug is used for this type of infection.
Nitrofurantoin is used primarily to treat urinary tract infections because it is really excreted and concentrates in the time.
Sylvia has come to the clinic today complaining of nausea, palpitations, and anxiety. She says that her heart feels "as if it's going to fly out of my chest." Physical examination confirms an increased heart rate. Sylvia's records indicate that she has asthma for which she uses an albuterol inhaler. When asked about the inhaler, she states that she uses it "whenever I feel short of breath." What is causing Sylvia's complaints?
Sylvia is exhibiting dose-related adverse effects of the albuterol. If Sylvia is now using the albuterol more frequently as a rescue inhaler, the health care provider will need to review and adjust her medication regimen.
Angie has a severe infection and is receiving an aminoglycoside once a day. She says, "They tell me I have a terrible infection. Why am I not getting the antibiotic more than once a day? I don't understand!" What will the nurse tell her?
The current practice is once-a-day aminoglycoside dosing. The nurse can tell her that studies have shown that once-daily dosing provides a sufficient plasma drug concentration to kill bacteria and has either an equal or lower risk of toxicity compared with multiple daily dosing. Hopefully, this type of dosing will be safer and more effective for her.
Tom, a 70-year-old retiree who smoked for 40 years, has been diagnosed with chronic obstructive pulmonary disease (COPD); the treatment regimen prescribed includes theophylline (Theo-Dur). After a few weeks, Tom tells the nurse that he is experiencing nausea and "bad heartburn at night." The laboratory studies show the level of theophylline in his blood to be 30 mcg/mL. What condition might Tom be experiencing, and how can it be corrected?
Tom is exhibiting some side effects of theophylline therapy, and the level in his blood is too high (the common therapeutic range for theophylline is a blood level of 10 to 20 mcg/dL). It is likely that the dosage will be decreased.
Amy is 12 weeks into her pregnancy when she discovers that she is HIV positive. Amy is very upset and says, "I won't live long enough to have this baby. We're both going to die." Is it possible to treat Amy, the fetus, or both? Explain your answer.
Yes, Zidovudine, one of the few anti-human immunodeficency virus (HIV) drugs known to prolong patient survival, can be used for maternal and fetal treatment. During the pregnancy, Amy can receive the oral form of the drug. During labor, she can receive the drug intravenously. Drug therapy for the infant can begin within 12 hours of delivery and continue for 6 weeks.
Greg has been taking amiodarone (Cordarone) for a heart rhythm problem. He has developed an infection from an open wound, and the sensitivity report indicates that levofloxacin (Levaquin) is the best choice to fight this infection. Are there any concerns?
Yes. In patients who receive amiodarone therapy, dangerous cardiac dysrhythmias are more likely to occur when quinolone are taken. Hopefully, another drug besides levofloxacin has shown effectiveness against the bacteria that is causing his infection.
A patient has been admitted to the unit with a stage IV pressure ulcer. After 2 days, the wound culture results come back positive for methicillin-resistant Staphylococcus aureus (MRSA). The nurse knows that the drug of choice for the treatment of MRSA infection is which drug? a. Vancomycin (Vancocin) b. Gentamicin (Garamycin) c. Ciprofloxacin (Cipro) d. Colistimethate (Coly-Mycin)
a
A patient is experiencing status asthmaticus. The nurse will prepare to administer which drug first? a. Epinephrine b. Methylprednisolone (Solu-Medrol) c. Cromolyn (Intal) d. Montelukast (Singulair)
a
A patient who has asthma may be prescribed which type of inhaled drug for its antiinflammatory effects? a. Corticosteroid b. Anticholinergic c. Xanthine derivative d. Beta adrenergic
a
A patient will be receiving long-term isoniazid (INH) therapy. What laboratory tests are most important for the nurse to monitor during therapy? a. Liver enzyme levels b. Hematocrit and hemoglobin level c. Creatinine level d. Platelet count
a
A term for fungal infection of the mouth
a
The method of action of antiviral agents is identified by which statement? a. Inhibiting the virus's ability to replicate b. Interfering with receptor site activity c. Interrupting the viral cell wall membrane d. Destroying the nucleus of the cell.
a
The nurse is administering an antifungal drug to a patient who has a severe systemic fungal infection. Which drug is most appropriate for this patient? a. Amphotericin B (Fungizone) b. Fluconazole (Diflucan) c. Griseofulvin d. Flucytosine
a
The nurse is explaining antitubercular therapy to a patient. The patient asks, "Why do I have to take so many different medications?" What is the nurse's best response? a. "It helps to prevent the tuberculosis from becoming resistant to the drugs." b. "It makes sure that the disease is cured." c. "These medications will reduce symptoms immediately." d. "You will have fewer side effects."
a
The nurse would correctly identify the method of action of ethambutol (Myambutol) as which of the following? a. Inhibiting protein synthesis. b. inhibiting mycobacterial ATP synthase c. Altering cell wall synthesis d. Its method of action is unknown.
a
When reviewing the health history of a patient who is to receive foscarnet (Foscavir), the nurse knows that which condition would be a contraindication to its use? a. Renal failure b. CMV retinitis c. Asthma d. Immunosuppression
a
Which intervention is important for the nurse to perform before beginning antibiotic therapy? a. Obtain a specimen for culture and sensitivity. b. Give with an antacid to reduce gastrointestinal (GI) upset. c. Monitor for adverse effects. d. Restrict oral fluids.
a
A patient calls the clinic nurse to ask for oseltamivir (Tamiflu) "because I was exposed to the flu over the weekend at a family reunion." The nurse knows that Tamiflu is indicated for which condition? (Select all that apply.) a. Prevention of infection after exposure to influenza virus types A and B b. Reduction of the duration of influenza in adults c. Treatment of topical herpes simplex virus infections d. Reduction of the severity of shingles symptoms e. Treatment of lower respiratory tract infections caused by respiratory syncytial virus
a b
A patient is to receive a new prescription for an ipratropium (Atrovent) inhaler. The nurse will assess for which potential contraindications? (Select all that apply.) a. Allergy to soy lecithin b. Allergy to peanuts c. Allergy to iodine products d. Hypertension e. Seizure disorders
a b
A patient who is receiving vancomycin (Vancocin) therapy needs to notify the nurse immediately if which effects are noted? (Select all that apply.) a. Ringing in the ears b. Dizziness c. Hearing loss d. Flushing of the face e. Nausea
a b c
Patients who are in the initial period of treatment for tuberculosis need to be taught to perform which procedures? (Select all that apply.) a. Wash their hands and cover their mouths when coughing or sneezing to reduce the spread of tuberculosis. b. Throw away dirty tissues in the proper receptacle. c. Be sure to get adequate rest, nutrition, and relaxation. d. Skip medication doses occasionally if gastric distress occurs. e. Avoid all visitors until symptoms improve.
a b c
During an infusion of amphotericin B, the nurse monitors for which adverse effects? (Select all that apply.) a. Nausea b. Fever c. Malaise d. Constipation e. Chills f. Hypertension
a b c e
7. After an infusion of colistimethate (Coly-Mycin), the nurse will report to the prescriber if the patient complains of which adverse effects? (Select all that apply.) a. Numbness b. Vertigo c. Upset stomach d. Insomnia e. Dizziness
a b e
The nurse is reviewing the medication list of a patient who has been newly diagnosed with tuberculosis and will be taking rifampin (Rifadin). Which class of drugs, if taken with rifampin, may cause increased metabolism? (Select all that apply.) a. Beta blockers b. Proton pump inhibitors c. Selective serotonin reuptake inhibitors d. Oral anticoagulants e. Oral antidiabetic drugs
a d e
The nurse is administering a new order for amphotericin B (Fungizone) and reviews the patient's current medications. Which medications, if also ordered, may cause an interaction with the amphotericin B? (Select all that apply.) a. Digoxin (Lanoxin), a cardiac glycoside b. Metoprolol (Lopressor), a beta blocker c. Warfarin (Coumadin), an oral anticoagulant d. Levothyroxine (Synthroid), a hormone replacement e. Hydrochlorothiazide, a thiazide diuretic
a e
Bailey, a 53-year-old teacher, has shingles. a. What drug will the nurse expect the physician to prescribe? b. Several months later, Bailey calls the office to say that her symptoms have returned. What action will the nurse expect to be taken now?
a. Acyclovir (Zovirax) is indicated for herpes zoster (shingles). b. Bailey will be treated with acyclovir again; it is the drug of choice for treatment of both initial and recurrent episodes of shingles.
The physician is planning intravenous amphotericin B (Fungizone) therapy for James. a. What guidelines will the nurse follow in administering the drug? b. What adverse effects will the nurse expect James to experience? c. Should the nurse stop the infusion if those effects occur? Explain your answer.
a. Amphotericin B needs to be diluted according to the manufacturer's guidelines and administered using an infusion pump. The nurse must not use solutions that are cloudy or that have visible precipitates. Before administration, the nurse will check for an order to premedicate the patient with an antiemetic, antihistamine, antipyretic, or corticosteroid to prevent or minimize infusion-related reactions. b. The nurse will monitor closely for expected adverse effects such as cardiac dysrhythmias, visual disturbances, paresthesias (numbness or tingling of the hands or feet), respiratory difficulty, pain, fever, chills, and nausea. c. No, unless a severe reaction occurs (e.g. exacerbation of adverse effects or a decline in vital signs). To decrease the severity of expected adverse effects, the patient may be pretreated with an antipyretic (e.g., acetaminophen), antihistamines, and antiemetics.
Mr. K. has cryptococcal meningitis, and the physician has prescribed fluconazole (Diflucan). a. Why did the physician choose this drug rather than one of the other -azole antifungals? b. The results of Mr. K.'s cerebrospinal fluid culture eventually come back negative. When he hears the good news, he says, "Great! I'm tired of taking this medicine." What will be the nurse's response?
a. Fluconazole (Diflucan), unlike itraconazole and other azoles, can pass into the cerebrospinal fluid (CSF), which makes it useful in the treatment of cryptococcal meningitis. b. Unfortunately, Mr. K will need remain on the medication (at a reduced dosage) for 10 to 12 weeks after the negative results on his CSF culture.
Diane, a 33-year-old proofreader, has been prescribed prophylactic isoniazid (INH) treatment. a. What laboratory studies should be performed before the start of therapy? Why? b. After Diane has taken isoniazid for 2 months, the physician significantly reduces her dosage of the drug. Why might that be?
a. Liver function studies should be performed because isoniazid can cause hepatic impairment. In addition, an eye examination is important because the drug may cause visual disturbances. b. Diane may be a slow acetylator. Acetylation, the process by which isoniazid is metabolized in the liver, requires certain enzymes to break down the isoniazid. In slow acetylators, who have a genetic deficiency of these enzymes, isoniazid accumulates. The dosage of isoniazid may need to be adjusted downward in these patients.
An infant has thrush. The nurse expects to administer which drug for the treatment of thrush? a. Amphotericin B (Fungizone) b. Fluconazole (Diflucan) c. Nystatin (Mycostatin) d. Miconazole (Monistat)
c
One of the older antifungal drugs that acts by preventing susceptible fungi from reproducing
c
Ms. I. is undergoing antitubercular therapy that includes streptomycin and rifampin. a. How is streptomycin administered? b. Ms. I. takes an oral contraceptive. Is that a concern given Ms. I.'s antitubercular therapy? Explain your answer.
a. Streptomycin is administered intramuscularly, deep into a large muscle mass, and the sites are rotated. b. Although it may not be a concern in terms of Ms. I's streptomycin therapy, oral contraceptives become ineffective when given with rifampin. If rifampin is part of her therapy, Ms. I should switch to another form of birth control.
A patient is being prepared for colon surgery and will be receiving neomycin tablets during the day before surgery. He asks the nurse why he needs to take this medicine before he even has surgery. What is the nurse's best response? a. "This medicine helps to clear out your bowels before surgery." b. "It helps to reduce the number of bacteria in your intestines before surgery." c. "It is given to sterilize your bowel before surgery." d. "It is given to prevent an infection after surgery."
b
A patient will be receiving a one-dose treatment for vaginal candidiasis. The nurse expects to administer which drug? a. Ketoconazole (Nizoral) b. Fluconazole (Diflucan) c. Griseofulvin d. Terbinafine (Lamisil)
b
Multicellular fungi characterized by long, branching filaments called hyphae, which entwine to form a mycelium
b
The nurse is preparing to administer the aerosol form of ribavirin. Which condition is a contraindication to the drug? a. Asthma b. Pregnancy c. Hypertension d. Type 2 diabetes
b
The nurse should include which information in the teaching plan for a patient who is taking isoniazid (INH)? a. Urine and saliva may be reddish-orange. b. Pyridoxine (vitamin B6) may be needed to prevent neurotoxicity. c. Injection sites should be rotated daily. d. The medication should be taken with an antacid to reduce gastric distress.
b
The nurse will instruct a patient who is receiving a tetracycline antibiotic to take it using which guideline? a. It needs to be taken with milk. b. It needs to be taken with 8 oz of water. c. It needs to be taken 30 minutes before iron preparations are taken. d. An antacid should also be taken to decrease GI discomfort.
b
The nurse would be correct in identifying which of the follow levels as representative of a therapeutic level of theophylline? a. 0 to 5 mcg/mL b. 5 to 15 mcg/mL c. 15 to 25 mcg/mL d. 25 mcg/mL or greater
b
Which drug acts by blocking leukotrienes, thus reducing inflammation in the lungs? a. Cromolyn (Intal) b. Montelukast (Singulair) c. Theophylline (Elixophyllin) d. Albuterol (Proventil)
b
Which of the following patient factors would most concern the nurse in a patient who is taking theophylline? a. The patient has increased fluid intake. b. The patient smokes a pack of cigarettes a day. c. The patient has bradycardia. d. The patient complains of sleepiness.
b
Which statement accurately describes the method of action of penicillin? a. Interrupts bacterial protein synthesis b. Inhibition of bacterial cell wall synthesis c. Interruption of bacterial DNA replication d. Increased bacterial cell wall permeability.
b
8. The nurse is reviewing the list of medications for a patient who will be starting antibiotic therapy with an aminoglycoside. Which medication, if present, may present a potential interaction with the aminoglycoside? (Select all that apply.) a. Metoprolol (Lopressor), a beta blocker b. Furosemide (Lasix), a loop diuretic c. Warfarin (Coumadin), an oral anticoagulant d. Vancomycin (Vancocin), an antibiotic e. Levothyroxine (Synthroid), a thyroid hormone
b c d
During a class on health care-associated infections, the nurse shares several facts about these infections. Which statements about health care-associated infections are true? (Select all that apply.) a. They are contracted in the home or community. b. They are contracted in a hospital or institution. c. They are more difficult to treat. d. The organisms that cause these infections are more virulent. e. The infection is incubating at the time of admission.
b c d
The nurse is teaching a group of patients about the use of bronchodilators. It is important to remind them that using bronchodilators too frequently may cause which adverse effects? (Select all that apply.) a. Blurred vision b. Increased heart rate c. Decreased heart rate d. Nausea e. Nervousness f. Tremors
b d e f
A common adverse effect that occurs when vancomycin (Vancocin) is infused too quickly is which of the following? a. Bone marrow suppression b. Tubular necrosis c. Red man's syndrome d. Colitis
c
A patient is to receive antibiotic therapy with a cephalosporin. When assessing the patient's drug history, the nurse recognizes that an allergy to which drug class may be a possible contraindication to cephalosporin therapy? a. Cardiac glycosides b. Thiazide diuretics c. Penicillins d. Macrolides
c
A patient newly diagnosed with tuberculosis asks the nurse how long he will need to take "all this medicine." The nurse replies that drug therapy for active tuberculosis may need to last how long? a. 6 months b. 12 months c. 24 months d. A lifetime
c
Single-celled fungi that reproduce by budding
j
The nurse knows the use of tetracyclines is limited in children due to the occurrence of which side effect? a. Stunting of the growth plate b. Threat of sunburn c. Discoloration of teeth d. Pseudomembranous colitis.
c
The nurse would correctly identify the method of action of isoniazid (INH) as which of the following? a. Inhibiting protein synthesis. b. Inhibiting mycobacterial ATP synthase c. Altering cell wall synthesis d. Its method of action is unknown.
c
When a patient is taking parenteral xanthine derivatives such as aminophylline, the nurse should monitor for which adverse effect? a. Decreased respirations b. Hypotension c. Tachycardia d. Hypoglycemia
c
When patients are receiving aminoglycosides, the nurse must monitor for tinnitus and dizziness, which may indicate which problem? a. Cardiotoxicity b. Hepatotoxicity c. Ototoxicity d. Nephrotoxicity
c
When reviewing the use of amantadine (Symmetrel), the nurse expects that the drug would be used most appropriately in which patient? a. A 29-year-old man who tests positive for HIV b. A 22-year-old woman who is in her eighth month of pregnancy and tests positive for HIV c. A heart transplant patient who has influenza A d. Older adult patients who require prophylaxis for influenza B
c
Which statement accurately describes the method of action of quinolones? a. Interrupts bacterial protein synthesis b. Inhibition of bacterial cell wall synthesis c. Interruption of bacterial DNA replication d. Increased bacterial cell wall permeability.
c
A patient calls the gynecologic clinic because she has begun to menstruate while taking vaginal cream for a vaginal infection. She asks the nurse, "What should I do about taking this vaginal medicine right now?" Which is the nurse's best response? a. "You need to stop the medication until the menstrual flow has stopped." b. "Just take the medication at night only." c. "You should stop the medication for 3 days and then start it again." d. "It's okay to continue to take the medication."
d
An infection caused by fungi
d
For patients taking a leukotriene receptor antagonist, the nurse should include which information in the patient teaching? a. If a dose is missed, the patient may take a double dose to maintain blood levels. b. The patient should gargle or rinse the mouth after using the inhaler. c. The medication should be taken at the first sign of bronchospasm. d. Improvement should be seen within a week of use.
d
In an effort to prevent the complications associated with intravenous infusion of antifungal drugs such as amphotericin B, the nurse will administer them over which time frame? a. 30 minutes b. 60 minutes c. 1 to 2 hours d. 2 to 6 hours
d
The nurse is administering acyclovir (Zovirax) and recalls that it is considered the drug of choice for treatment of which viral infection? a. Cytomegalovirus (CMV) b. Human immunodeficiency virus (HIV) c. Respiratory syncytial virus (RSV) d. Varicella-zoster virus (VZV)
d
Viral infections and viruses are more difficult to eradicate than bacteria for which reason? a. Viruses replicate at a faster rate. b. Viruses grow as an attachment to host cells and must first be removed from the cell wall. c. Viruses require folic acid synthesis. d. Viruses replicate only inside host cells and medications must enter the cell.
d
When administering ganciclovir (Cytovene), the nurse keeps in mind that the main dose-limiting toxicity for this drug is which condition? a. Renal failure b. Gastrointestinal disturbances c. Peripheral neuropathy d. Bone marrow suppression
d
When asked about drug allergies, a patient says, "I can't take sulfa drugs because I'm allergic to them." Which question will the nurse ask next? a. "Do you have any other drug allergies?" b. "Who prescribed that drug for you?" c. "How long ago did this happen?" d. "What happened when you took the sulfa drug?"
d
Which statement accurately describes the action of antiseptics? a. They are used to kill organisms on nonliving objects. b. They are used to kill organisms on living tissue. c. They are used to sterilize equipment. d. They are used to inhibit the growth of organisms on living tissue.
d
One of the major chemical groups of antifungal drugs; includes amphotericin B and nystatin
e
A very large, diverse group of eukaryotic, thallus-forming microorganisms that requires an external carbon source
f
Another of the major groups of antifungal drugs; includes ketoconazole
g
The drug of choice for many severe, systemic fungal infections; also, the oldest antifungal drug
h
An antifungal drug commonly used to treat candidal diaper rash
i
