Exam 3 NCLEX Questions

A nurse is administering a daily dose of tobramycin at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level? 8:00 AM 9:00 AM 11:30 AM 12:00 PM

9:00 AM

The nurse identifies rifampin as useful in the treatment of which disorders? (Select all that apply.) A. Tuberculosis Correct B. Active meningococcal infection Incorrect C. Leprosy D. Prophylaxis of meningitis caused by Haemophilus influenzae E. C. difficile infection

A, C, D

When administering an aminoglycoside to a patient with myasthenia gravis, it is most important for the nurse to assess what? Deep tendon reflexes Breath sounds Eyelid movement Muscle strength

Breath sounds

A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? Magnesium sulfate [Epsom salt] Potassium chloride [K-Dur] Sodium bicarbonate [Citrocarbonate] Calcium gluconate [Kalcinate]

Calcium gluconate [Kalcinate]

A patient who has human immunodeficiency virus (HIV) infection has a tuberculin skin test (TST) for latent tuberculosis. The nurse assesses the result 48 hours after the injection. An induration of what size indicates that the patient needs to be treated for latent tuberculosis? A. 1 mm B. 2 mm C. 3 mm D. 5 mm

D. 5 mm

A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action? A. No action is needed, because this is a temporary but expected side effect. B. Continue the antibiotic with an anti-inflammatory medication. C. Slow the running pace and walk more. D. Discontinue the medication, because severe damage can result.

D. Discontinue the medication, because severe damage can result.

A patient taking gemifloxacin develops a rash. The nurse anticipates the healthcare provider to take which action? A. No action is needed, because this is a temporary but expected side effect. Incorrect B. Continue the antibiotic with an anti-inflammatory medication. C. Cut the dose of medication in half. D. Discontinue the medication.

D. Discontinue the medication.

A patient who has an infection with Mycobacterium leprae (leprosy) has been prescribed rifampin [Rifadin]. The nurse identifies which dosing schedule as most effective for this drug? A. Two times per day B. Every other day C. Once every 2 weeks D. Once per month

D. Once per month

A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? Unsteadiness Vertigo Headache Dizziness

Headache

The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? Concentration Trough Peak Dose

Trough

When teaching a patient about tuberculosis, the nurse will include which statements? (Select all that apply.) A. "Most people infected with M. tuberculosis are asymptomatic." B. "Most people infected with M. tuberculosis harbor dormant bacteria for life if they do not receive drug therapy." C. "Treatment of tuberculosis lasts 3 months." D. "Isoniazid can cause peripheral neuropathy by depleting vitamin B12." E. "Rifampin can cause optic neuritis."

A, B

Which statements will the nurse include when teaching a patient about isoniazid therapy for the treatment of tuberculosis? (Select all that apply.) A. "Take the isoniazid on an empty stomach." B. "Notify your healthcare provider if your skin starts to turn yellow." C. "Numbness or tingling in your extremities is a normal response when taking this drug." D. "Your urine will turn reddish orange because of the effects of this drug." E. "Use of this drug is associated with vision problems."

A, B

Which statement should the nurse include when teaching a patient about rifampin [Rifadin]? A. "A harmless side effect will be a red-orange discoloration of body fluids." B. "Oral contraception is the preferred method of birth control when using rifampin." C. "Take vitamin B6 to relieve numbness and tingling in the fingers and toes." D. "Treatment length for the medication is 3 times/day for an 8-week period."

A. "A harmless side effect will be a red-orange discoloration of body fluids."

Which approach should a nurse take when administering an oral dose of levofloxacin [Levaquin]? A. Give the medication with or without food. B. Administer the drug with an oral dose of a magnesium-based antacid. C. Premedicate the patient with diphenhydramine [Benadryl]. D. Administer the drug with milk products.

A. Give the medication with or without food

Which approach should a nurse take to administer intravenous (IV) acyclovir [Zovirax] to an immunocompromised patient? A. Infuse IV fluids during administration of the dose and for 2 hours afterward. B. Administer IV acyclovir diluted in 20 mL normal saline (NS) over 10 minutes. C. Only infuse the drug if the white blood cell (WBC) count is above 2500/mm3. D. Ask the provider to change the route to subcutaneous (subQ) injection.

A. Infuse IV fluids during administration of the dose and for 2 hours afterward.

A patient is taking rifampin [Rifadin] for active tuberculosis. Which assessment does the nurse identify as an adverse effect of the drug? A. Jaundice B. Blood glucose level of 60 mg/dL C. Absent deep tendon reflexes D. Moon face

A. Jaundice

A patient who has tuberculosis is treated with isoniazid. The nurse should monitor for which symptoms, which could indicate a vitamin B6 deficiency caused by the medication? A. Numbness and tingling in the fingers and toes B. Alopecia and flaking scalp C. Dry skin and brittle nails D. Oral ulcers and tongue fissures

A. Numbness and tingling in the fingers and toes

After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant? A. The patient takes antacids on a daily basis. B. The medication was stored in a cool, dry area. C. The patient did not use sunscreen while taking the ciprofloxacin [Cipro]. D. The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.

A. The patient takes antacids on a daily basis.

To promote treatment adherence in a patient with tuberculosis, the nurse will include which interventions? (Select all that apply.) A. Use a single medication, to keep the treatment simple. B. Teach the patient about intermittent-dose therapy. C. Teach the patient about the need for long-term treatment. D. Use a signed consent form to enhance patient compliance. E. Directly watch the patient take the medication.

B, C, E

A nurse obtains a specimen from which body fluid when performing the QuantiFERON-TB Gold (QFT-G) test for latent tuberculosis? A. Saliva B. Blood C. Urine D. Sputum

B. Blood

The nurse develops a care plan for a patient in the continuation phase of treatment for active tuberculosis (TB). The care plan includes teaching about which medication regimen? A. Pyrazinamide and ethambutol B. Isoniazid and rifampin C. Ethambutol and isoniazid D. Rifampin and ethambutol

B. Isoniazid and rifampin

A nurse develops a plan of care for a patient who has an outbreak of recurrent genital herpes and is taking oral acyclovir [Zovirax]. Which outcome should be included? A. Minimal scarring from lesions B. Less frequent eruption of lesions C. Prevention of transmission to contacts D. Complete eradication of the virus

B. Less frequent eruption of lesions

A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse anticipates administration of which antibiotic if a stool sample tests positive for Clostridium difficile? A. Rifaximin [Xifaxan] B. Metronidazole [Flagyl] C. Daptomycin [Cubicin] D. Gemifloxacin [Factive]

B. Metronidazole [Flagyl]

A patient is taking daptomycin [Cubicin]. The nurse should obtain a creatine phosphokinase (CPK) level when the patient shows what? A. Increased urination and urinary urgency B. Muscle pain and weakness C. Abdominal bloating and diarrhea D. Headache and visual disturbances

B. Muscle pain and weakness

Which statements about ototoxicity and aminoglycosides does the nurse identify as true? (Select all that apply.) A. The risk of ototoxicity is related primarily to excessive peak levels. B. The first sign of impending cochlear damage is headache. C. The first sign of impending vestibular damage is headache. D. Ototoxicity is largely irreversible. E. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

C, D, E

Which statement by a patient taking ethambutol [Myambutol] indicates understanding of adverse effects of the drug? A. "I will get up slowly when sitting to prevent me from getting dizzy." B. "I'll increase the fiber and liquids in my diet to prevent constipation." C. "I'll report any problems with blurred vision or determining colors." D. "I'll immediately report any red-orange urine to my healthcare provider."

C. "I'll report any problems with blurred vision or determining colors."

The nurse notices tan lines around the arms of a female patient who is taking levofloxacin [Levaquin]. Which action should the nurse take? A. No action is needed, because this is a temporary but expected side effect. B. Continue the antibiotic with an anti-inflammatory medication. C. Advise the patient to avoid sun exposure and wear sun screen when outside. D. Discontinue the medication.

C. Advise the patient to avoid sun exposure and wear sun screen when outside.

The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients? A. Metronidazole [Flagyl] B. Rifampin [Rifadin] C. Ciprofloxacin [Cipro] D. Daptomycin [Cubicin]

C. Ciprofloxacin [Cipro]

A patient who has active TB is to start a medication regimen that includes pyrazinamide. The nurse identifies a risk for complications if the patient also has which medical condition? A. Parkinson's disease B. Rheumatoid arthritis C. Glaucoma D. Alcoholism

D. Alcoholism

Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what? Myasthenia gravis Hypertension Diabetes mellitus

Myasthenia gravis

Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery? Gentamicin Tobramycin Amikacin Neomycin

Neomycin

A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin? White blood cells (WBCs) Glucose Ketones Protein

Protein

A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? Some hearing loss may have occurred. The confusion is due to the hospital stay. A nutrition consult most likely is needed. The patient has a family history of dementia.

Some hearing loss may have occurred.