1042 Exam 2 - antibiotics Prep-U
The nursing instructor has been teaching about antivirals, actions and effects. The instructor realizes that a student needs further instruction when the student makes which statement?
"Antivirals are the cure for viral infections."
The client has been diagnosed with a serious infection caused by gram-negative aerobic bacilli. The client has been prescribed IV gentamicin. What statement by the client should the nurse follow up most promptly?
"I feel like I'm having trouble hearing the last little while."
The client has been prescribed a fluoroquinolone. Which statement by the client indicates additional education is needed?
"If I cover my head, I will be protected from the sun."
An adult client is being treated for genital herpes with acyclovir. Which client statement indicates a need for further health education?
"It's a relief to know that this drug will stop me from spreading the infection."
The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?
"Make sure to avoid drinking any alcohol for the next three days."
The nurse is educating a client diagnosed with a urinary tract infection about the prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The client has a history of type 2 diabetes and currently takes a sulfonylurea. Which statement made by the client establishes the need for further clarification?
"The drug will not affect the herbal supplement, ginseng that I take."
A nurse is caring for a client who is hospitalized for pneumonia. The nurse reviews the electronic health record and evaluates that the microbiology data does not support the use of the broad spectrum antibiotic. Which statement is the nurse's best response to the provider about the results?
"The microbiology data is identifying another antibiotic appropriate for the client."
The nurse is reviewing the medication instruction for the client taking acyclovir. Which statement by the client would indicate the need for additional teaching?
"This medication will maintain the symptoms and cure my disease."
It would be most important for a nurse to monitor which client for ototoxicity while on gentamicin therapy?
A 25-year-old male who has a hearing impairment
The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate?
A client with signs of infection who is awaiting the results of laboratory testing
A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in the great toes. Which laboratory values should be assessed?
ALT and AST
________ is indicated for the treatment of herpes viruses, including HSV, herpes zoster virus, Epstein-Barr virus, and CMV; it is not effective against hepatitis or RSV.
Acyclovir
A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism?
Aminoglycoside
A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?
An HIV-positive client
What would contribute to drug resistance?
Antibiotic prescription for viral illness
Which statement regarding antiviral medications is true?
Antivirals do not eliminate existing viruses from tissues.
A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?
BUN and creatinine
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?
Cefadroxil
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?
Cefadroxil is a cephalosporin.
An older adult client is treated for pneumonia with clindamycin. One week after the completion of the medication, the client develops diarrhea. What is the most probable cause of the diarrhea?
Change in normal flora
Which of the following would a nurse identify as the prototype lincosamide drug?
Clindamycin
A client is to be started on an antibiotic. Which is most important to take into consideration before beginning the antibiotic regimen?
Culture and susceptibility
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
A client is taking clindamycin for an infectious process and presents to the health care provider's office with symptoms of dehydration. The nurse understands that the client is experiencing what adverse reaction from the administration of clindamycin?
Diarrhea
The nurse is providing client teaching before discharging a client home. The client is taking ciprofloxacin. What action should the nurse encourage the client to prioritize?
Drink at least 2L of fluid per day.
A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?
Drug-resistant tuberculosis
A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?
Erythromycin
What potential adverse reaction is most likely to develop during cefazolin therapy?
Gastrointestinal upset
A client is diagnosed with latent tuberculosis infection. The nurse expects that the treatment plan will include which drug?
INH
A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?
INH, rifampin, pyrazinamide, ethambutol
A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?
Inflammation of the tongue and mouth
A female client's medical history includes type 2 diabetes, CVA, dysphasia, and chronic renal failure. She develops an infectious process. The health care provider orders erythromycin. Based on the client's medical history, why is erythromycin the drug of choice?
It is metabolized in the liver.
A female client is diagnosed with hepatitis C as well as a urinary tract infection. The organism is sensitive to tetracycline. Why is the health care provider reluctant to order tetracycline in a client with hepatic impairment?
It slows drug elimination.
A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?
Monitor for appearance of adverse reactions.
A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client?
Nausea nausea, vomiting, and diarrhea
The nurse should monitor the client for which common side effects of erythromycin therapy?
Nausea, vomiting, and diarrhea
To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?
Obtaining sensitivity testing
A group of students are reviewing material for a test on antibiotics. They demonstrate an understanding of the material when they identify what as the first antibiotic introduced for clinical use?
Penicillin
A patient diagnosed with TB is undergoing treatment. The nurse knows that which of the following preventive therapies will avoid the spreading of TB?
Prophylactic therapy
The nurse is caring for a child weighing 30 kg. The healthcare provider orders gentamicin 100 mg IV three times per day. The recommended dosage range is 6 to 7.5 mg/kg/day. What action should the nurse take?
Question the prescriber about the dosage of the medication.
What organ system is responsible for the excretion of cefotaxime sodium from the body?
Renal
During ongoing assessment of clients taking fluoroquinolones and miscellaneous anti-infectives, which adverse reaction should be reported to the health care provider immediately? Select all that apply.
Respiratory difficulty Severe diarrhea Hypersensitivity reaction A decided drop in blood pressure
A client, being 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.
A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?
Rifampin and isoniazid
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
Serum alanine transaminase, aspartate transaminase, and bilirubin
_________are well-absorbed by the GI tract and are excreted by the kidneys. _______ treat both gram-positive and negative infections.
Sulfonamides
A client who is 32 weeks pregnant has been diagnosed with a urinary tract infection. The nurse would immediately question any prescription for a sulfonamide based on what risk?
Sulfonamides can cause a life-threatening toxicity for the fetus.
A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan?
Take precautions to prevent photosensitivity.
The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?
Teeth
What would the nurse identify as the primary purpose of performing a CD4 count for a patient infected with HIV?
The CD4 count is an indication of the patient's current immunological status.
Chest radiography and sputum sample microscopy have confirmed a diagnosis of TB in a 40-year-old man who has a history of type 1 diabetes and who currently has a diabetic foot ulcer. How should the nurse account for this patient's health status when planning care during INH treatment?
The patient will require vigilant monitoring of blood glucose levels.
A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client?
These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.
The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?
Vaginal itching and discharge
Aminoglycoside antibiotics tend to collect in the eighth cranial nerve. The nurse would anticipate that which clinical manifestation may occur from the cranial nerve involvement?
Vertigo
The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects?
Vomiting and diarrhea
In the rare instance in which penicillin is considered essential, hypersensitivity can be assessed by administering:
a skin test.
The nurse is providing health education to a client prescribed isoniazid. What should the nurse instruct the client to avoid?
alcohol
The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?
antacids should not take antacids or drugs containing iron or zinc at the same time as taking a fluoroquinolone because these drugs will decrease the absorption of the fluoroquinolones.
The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins:
can cause allergic reactions in clients who are allergic to penicillins.
First- and second-generation drugs are two types of
cephalosporins
A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?
changing to a different antibiotic
A client has been diagnosed with an infection. The nurse can help to ensure the success of anti-infective treatment by:
confirming that the medication prescribed is the drug of choice for the specific microorganism.
A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client?
culture and sensitivity test
Susceptibility tests
determine which drugs are likely to be effective against the organism.
A client diagnosed with malaria has been prescribed treatment with sulfadiazine. The nurse should encourage the client to increase consumption of what dietary component?
fluids
Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:
he should wear glasses during the therapy.
While reviewing a newly admitted client's previous health records, the nurse notes that the client is currently prescribed acyclovir. The nurse should assess the client for signs and symptoms associated with what medical diagnosis?
herpes simplex virus
Directly Observed Therapy (DOT)
is used to administer drugs two to three times weekly.
peripheral nerves, mucosa of the upper respiratory tract, skin, and eyes are the parts of the body affected by
leprosy.
Abdominal pain and cramping are adverse reactions .
macrolides
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?
metronidazole
The nurse is preparing to administer vancomycin intravenously (IV) to a client. In preparation, the nurse dilutes the medication into 0.9% NaCl for what reason?
minimize the adverse reactions related to histamine release
A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
monitor the patient for bleeding gums.
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client?
oral (PO)
A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?
phlebitis
A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following?
primary and secondary Primary drugs provide the foundation for treatment. Secondary drugs are less effective and more toxic than primary drugs.
What event triggers the development of a superinfection?
proliferation of antibiotic-resistant microorganisms
The nurse has administered the first dose of a client's newly-prescribed antibiotic. What assessment finding should the nurse interpret as adverse effect that suggests a more serious concern?
rash to the face and trunk
A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the:
route Recommended parameters for ciprofloxacin are 100-500 mg b.i.d. PO for up to 6 weeks. As a result, the nurse should have the provider confirm the correct route.
A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?
skin rash or itching
A 7-year-old child has been taking tetracycline for a bacterial infection. The nurse will be sure to inform the parents that this drug could cause
staining of permanent teeth.
Clients taking antibiotics should be instructed to report
symptoms of infection that recur or develop during therapy.
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed?
trimethoprim-sulfamethoxazole
An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
vancomycin.
A nurse is reviewing the medical record of a client who is prescribed tetracycline. Which drug, if found being used by the client, would alert the nurse to the need for a decreased dosage of that drug?
warfarin
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
with a glass of water 1 hour before or 2 hours after a meal.
A client for whom antiretroviral therapy has been prescribed informs the nurse that the client is taking oral contraceptives. What should the nurse inform the client is one of the effects of combining birth control pills with antiretroviral therapy?
Decreases effectiveness of birth control pills
A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. The nurse tells the client that irregular administration of this medication could lead to what outcome?
Development of drug resistance
After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following?
"I should drink a full 8-oz glass of water when I take the medicine."
The nurse is providing health education to a client who has been diagnosed with sinusitis. The health care provider has prescribed antibiotics. What should the nurse teach the client in order to prevent antibiotic resistance?
"Make sure to take every pill, even if you're feeling better."
A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?
Assessing for renal insufficiency
A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?
Avoid the consumption of alcohol.
**Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture?
Identifies the organism causing the infection
A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that:
the microorganism causing the infection is likely known.
