module 7 practice questions

What should the nurse teach a patient who is taking a sulfonamide? A. Do not drink milk because this interferes with the drug's absorption. B. Use sunscreen and avoid prolonged exposure to sunlight. C. Decrease fluid intake when taking this medication. D. Take the medication with grapefruit juice.

B

A patient is receiving vancomycin [Vancocin]. The nurse identifies what as the most common toxic effect of vancomycin therapy? A. Ototoxicity B. Hepatotoxicity C. Renal toxicity D. Cardiac toxicity

C The most common toxic effect of vancomycin [Vancocin] therapy is renal toxicity. Although ototoxicity may occur, it is rare. The liver and heart are not affected when vancomycin is used.

Which drug is used for treating a client with severe postpartum bleeding? A. Nifedipine B. Oxytocin C. Propranolol D. Methylerogonorine

D

Which anti-tuberculosis drug can cause peripheral neuropathy? A. Isoniazid B. Pyrazinamide C. Rifampin D. ethambutol

A

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 Pyrazinamide is contraindicated in patients with both liver dysfunction and gout. It should be used with caution in patients who abuse alcohol, and liver function studies should be done every 2 weeks. It is not known to cause complications in patients who have Parkinson's disease, rheumatoid arthritis, or glaucoma.

Beta-adrenergic drug; Stimulation of beta2-adrenergic receptors on the uterine smooth muscle; Results in relaxation of the uterus, thus stopping premature contractions; "Off-label" use A. Terbutaline (Brethine) B. Magnesium sulfate IV

A

During a postpartum patient assessment, the nurse notes a boggy uterus and increased vaginal bleeding. Based on this assessment data, the nurse prepares to administer which medication? A. Oxytocin (Pitocin) B. Clomiphene (Clomid) C. Terbutaline (Brethine) D. Dinoprostone (Prostin E₂)

A

Latent TB is usually treated with which drug A. Isoniazid for 9 months B. All the first line TB drugs for 3 months C. Rifampin for 2 months D. Treatment is deferred unless the patient is symptomatic

A

A patient is receiving penicillin Which assessment should the nurse monitor as an indicator of an undesired effect? A. Cardiac rhythm B. Serum sodium level C. Lung sounds D. Red blood cell (RBC) count

A -Penicillin in high IV doses may cause hyperkalemia, which can result in dysrhythmias or cardiac arrest. Hypernatremia occurs with high IV doses of ticarcillin. Lung sounds and the RBC count are unrelated to the administration of penicillin

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 Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful. Rifampin does not cause peripheral neuropathy. It does reduce the effectiveness of oral contraceptives, so a nonhormonal form of birth control should be considered. All antitubercular agents need to be taken at least 6 to 24 months to eradicate the slow-growing mycobacterium.

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 Rifampin is toxic to the liver, which increases the patient's risk of hepatitis. Jaundice is a sign of liver dysfunction and should be monitored. Rifampin has no effect on the blood glucose level or deep tendon reflexes, nor does it cause a moon face.

A patient began taking antitubercular drugs a week ago. The nurse reviews the patient's medical record and learns that the patient has a 10-year history of consuming one standard drink of alcohol three times a week. The patient states, "In the last week, my urine turned orange and I am very worried about it." How should the nurse respond? A. Inform the patient that it is one of the side effects of the antitubercular drug rifampin. B. Recognize that the tuberculosis may have spread to the liver, and further medical consultation is required. C. Recognize that the liver may be damaged due to alcohol, and so a liver function test should be performed. D. Instruct the patient to stop taking antitubercular drugs immediately and consult the primary health care provider.

A- A nurse should be aware of some of the common side effects of antitubercular drugs like rifampin, one of which is orange discoloration of body fluids such as urine, sweat, tears, and sputum. It may also cause hepatitis. Liver damage can lead to jaundice, which usually presents as yellowish discoloration of urine and sclera. However it is highly unlikely that tuberculosis has spread to the liver. The alcohol intake of the patient is within normal limits, and so it is not correct to say that alcohol may have damaged the liver. It is also inappropriate to advise the patient to stop taking antitubercular drugs.

A 37-year-old man is admitted to the hospital after being diagnosed with tuberculosis. Before treatment is started, you inform him about the most common ways of transmitting the tubercle bacillus, as well as the medications used: isoniazid, rifampin, and pyrazinamide. What is a common side effect of rifampin therapy? SATA A. Reddish body fluids B. Jaundice C. Hyperuricemia D. Polyneuropathy E. Muscle pain

AB

The nurse identifies which statements about penicillins as true? (Select all that apply.) A. Penicillins are the safest antibiotics available. B. The principal adverse effect of penicillins is allergic reaction. C. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins. D. A patient who is allergic to penicillin is also allergic to vancomycin, erythromycin, and clindamycin. E. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.

ABE -A patient who is allergic to penicillin has a 1% chance of also being allergic to cephalosporins. Patients who are allergic to penicillin are safely able to take vancomycin, erythromycin, and clindamycin. The other three statements are true

What are the primary benefits to a patient who is receiving glucocorticoids as part of a chemotherapy regimen? (Select all that apply.) A. They promote appetite and weight gain. B. They increase long-bone rebuilding. C. They reduce cerebral edema after radiation. D. They are cytotoxic to selective cancers. E. They reduce the risk of pathogen invasion

ACD -Glucocorticoids are used in chemotherapy regimens to manage complications of the treatment. They promote appetite and weight gain, and they reduce cerebral edema after radiation therapy. They are also toxic to cancers of lymphoid origin, including leukemias and lymphomas. However, serious toxicity can occur with their use, including osteoporosis and an increased risk of infection.

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse realizes that which is a common adverse reaction of isoniazid? A. Ototoxicity B. Hepatotoxicity C. Nephrotoxicity D. Optic nerve toxicity

B

Methylergonovine is prescribed for a woman to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority nursing assessment? A. Uterine tone B. Blood pressure C. Amount of lochia D. Deep tendon reflexes

B

What is the primary use of sulfonamides? A. For respiratory tract infections B. For urinary tract infections C. For cardiac infections D. For CNS infections

B

The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what? A. Resistant infection B. Superinfection C. Nosocomial infection D. Allergic reaction

B Antibiotic therapy can destroy the normal flora of the body, which normally would inhibit the overgrowth of fungi and yeast. When the normal flora is decreased, these organisms can overgrow and cause a new infection, or superinfection.

Isoniazid (INH) and rifampin (Rifadin) have been prescribed for a client with TB. A nurse reviews the medical record of the client. Which of the following, if noted in the client's history, would require physician notification? A Heart disease B Allergy to penicillin C Hepatitis B D Rheumatic fever

C Isoniazid and rafampin are contraindicated in clients with acute liver disease or a history of hepatic injury.

The nurse should include which of the following instructions when developing a teaching plan for clients receiving INH and rifampin for treatment for TB? A Take the medication with antacids B Double the dosage if a drug dose is forgotten C Increase intake of dairy products D Limit alcohol intake

D INH and rifampin are hepatotoxic drugs. Clients should be warned to limit intake of alcohol during drug therapy. Both drugs should be taken on an empty stomach. If antacids are needed for GI distress, they should be taken 1 hour before or 2 hours after these drugs are administered. Clients should not double the dosage of these drugs because of their potential toxicity. Clients taking INH should avoid foods that are rich in tyramine, such as cheese and dairy products, or they may develop hypertension.

Which symptoms should the nurse monitor for in a client receiving Tobramycin?Select all that apply. A. Increased BUN B. Increased serum creatinine C. Ringing in the ears D. Vertigo E. Nausea F. Diarrhea

ABCD Adverse effects or toxic effects of tobramycin sulfate include nephrotoxicity as evidenced by an increased BUN and serum creatinine; irreversible ototoxicity as evidenced by ringing in teh ears and vertigo (may indicate dysfunction of the eighth cranial nerve)

A patient is receiving vancomycin (Vancocin). The nurse identifies what as the most common toxic effect of vancomycin therapy? A. Ototoxicity B. Hepatotoxicity C. Renal toxicity D. Cardiac toxicity

C

During treatment with doxorubicin (Adriamycin), the nurse must monitor closely for which potentially life-threatening adverse effect? A. Nephrotoxicity B. Peripheral neuritis C. Cardiomyopathy D. Ototoxicity

C

Patient teaching to prevent renal damage from cystalluria should include what? A. Requiring the patient to decrease fluid intake B. Requiring the patient to increase the intake of milk C. Requiring the patient to drink 8 to 10 glasses of water per day D. Requiring the patient to drink several glasses of cranberry juice a day

C

The nurse is administering methotrexate as part of treatment for a patient with rheumatoid arthritis and will monitor for which sign of bone marrow suppression? A. Edema B. Tinnitus C. Increased bleeding tendencies D. Tingling in the extremities

C

The nurse recognizes that which patient should not receive tetracycline? A. A 50-year-old after myocardial infarction B. A 40-year-old with acne C. A 40-year-old with renal failure D. A 30-year-old with diabetes

C

What information should the nurse provide to a client prescribed rifampin (Rifadin)? A. Oral contraception is the preferred method of birth control when using rifampin. B. The patient will only need to take this medication for the prescribed 14-day period. C. A nonharmful adverse effect of this medication is red-orange discoloration of urine, sweat, tears, skin, salvia, and feces. D. Peripheral neuropathy is an expected side effect, and the patient should report any numbness or tingling of the extremities

C

How can the nurse ↓ the risk of transferring a resistant infection from one patient to another? A. Use hand sanitizer once every hour during patient care. B. Move all patients with infections to another unit. C. Wear PPE when caring for patients with resistant infections. D. Administer antibiotics to all patients preventively.

C

In an effort to prevent superinfections of the GI tract such as Clostridium difficile, the nurse will instruct clients to eat which foods? A. Multigrain wheat bread B. Raw fruits and vegetables C. Cultured dairy products such as yogurt D. Low-fat meats such as chicken and pork

C

The nurse suspect that which TB drug causes blurred vision and color perception changes? A. Pyrazinamide B. ethambutol C. Rifampin D. isoniazid

B

the patient, 61 years old, is to receive doxorubicin as part of his chemotherapy protocol. Which assessment is the most important before administering the medication? A cardiac status B. Liver function C lung sounds D neurologic status

A

The patient is to receive cyclophosphamide as part of her cancer treatment. Which nursing intervention to the nurse expect to complete? A assess for signs of hematuria, urinary frequency, or dsyuria. B decreased fluids to reduce the risk of calculus formation. C hydrate the patient with IV fluids only after administration of cyclophosphamide. D medicate with an antiemetic only after the patient complaints of nausea.

A

What should the nurse suspect is happening in a hospitalized patient taking clindamycin who is experiencing profuse watery diarrhea, abdominal pain, fever, and leukocytosis? A. The patient is experiencing a suprainfection with Clostridium difficile. B. The patient is experiencing a complication related to the reason for treatment. C. The patient is experiencing normal adverse reactions to clindamycin. D. The patient is experiencing a suprainfection with Bacteroides fragilis.

A

Which of these is an example of the improper use of antibiotic therapy? A. Treating a viral infection B. Administering more than one type of antibiotic. C. Treating fever in an immunocompromised patient D. Giving an antibiotic by the IV route.

A

A client is taking sulfasalazine (Azulfidine). What should the nurse teach the client to do? A. Drink at least 10 glasses of fluid per day. B. Monitor blood glucose carefully to avoid hyperglycemia. C. Avoid operating a motor vehicle as this drug may cause drowsiness. D. Take this drug with an antacid to decrease the risk of gastrointestinal distress

A

What is the term for an infection a patient acquires while in the hospital? A. Antibiotic resistant infection B. Paradoxical infection C. Superinfection D. Nosocomial infection

D

Which hypersensitivity response to the sulfonamide is a rare reaction with a mortality rate of 25%? A. Renal syndrome B. Gray syndrome C. Stevens-Johnson syndrome D. Toxic shock syndrome

C

A client is ordered to take trimethoprim-sulfamethoxazole (Bactrim). The nurse knows to expect which common adverse reaction? A. Bronchospasm B. Dysrhythmias C. Pseudomembranous colitis D. Stevens-Johnson syndrome

D

A client who is taking acyclovir asks the nurse about the drug. Which instruction should the nurse include in client teaching? A. Restrict fluids to prevent complications. B. Monitor blood pressure for hypertension. C. Stevens-Johnson syndrome is an adverse effect. D. Importance of frequent CBC, BUN, and creatinine test

D

A client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication? A. Diarrhea B. Hair loss C. Chest pain D. Peripheral neutropathy

D

An expected side effect of Rifampin is: A. joint aches B. peripheral neuropathy C. foot cramps D. orange discoloration of body fluids

D

A client has relayed instructions from a physician regarding an allergy to a type of antibiotic therapy. The nurse would question which instruction? A. Wear a Medic Alert bracelet that indicates the allergy. B. Avoid all penicillin-type drugs. C. Inform all healthcare providers of the allergy. D. Restrict fluids when taking the antibiotic.

D -Fluids should be encouraged with antibiotic therapy, so such an order would need to be questioned.

When teaching a patient about isoniazid and rifampin drug therapy, which statement will the nurse include? A."Take isoniazid with meals." B."Double the amount of vitamin C in your diet to prevent the peripheral neuropathy associated with isoniazid therapy." C."Notify the primary health care provider immediately if your urine turns a red-orange color." D."Avoid exposure to direct sunlight."

A or D - Isoniazid is photosensitive , but can be taken with or without food. Pyridoxine is relation to Vit B 6 and peripheral neuropathy, and rifampin turning your urine orange is normal.

Which statements about vancomycin [Vancocin] does the nurse identify as true? (Select all that apply.) A. Vancomycin is the most widely used antibiotic in U.S. hospitals. B. Vancomycin is effective in the treatment of Clostridium difficileinfection. C. Vancomycin is effective in the treatment of MRSA infections. D. Patients who are allergic to penicillin are also allergic to vancomycin. E. The major toxicity of vancomycin therapy is liver failure.

ABC -Patients who are allergic to penicillin are able to take vancomycin. The major toxicity of vancomycin therapy is kidney failure. The other three statements are true.

Which of the following OTC medications should not be taken with tetracyclines? (Select all that apply.) A. Calcium supplements B. Milk products C. Magnesium-containing laxatives D. Antacids containing magnesium, aluminum, or both E. Aspirin

ABCD

A middle-aged adult is diagnosed with tuberculosis. Which is true of treatment for this diagnosis? A.Treatment may take about 10 days to 2 weeks. B.Usually two to three agents are needed. C.The bacteria is usually resistant to treatment therapy. Treatment for tuberculosis is usually without side effects

B -Single-drug therapy for TB is not effective. Usually two or three drugs are used for TB and treatment is at least 6 months.

The nurse is assessing a patient who is receiving a sulfonamide for treatment of a urinary tract infection. To monitor the patient for the most severe response to sulfonamide therapy, the nurse will assess for what? A. Diarrhea B. Skin rash and lesions . C. Hypertension D. Bleeding

B The nurse's priority is to monitor for hypersensitivity reactions. The most serious response to sulfonamide therapy is Stevens-Johnson syndrome, which manifests as symptoms of the skin and mucous membranes, lesions, fever, and malaise. In rare cases, hematologic effects occur, requiring periodic blood studies

Ototoxicity is more likely if aminoglycosides are administered with which of the following drug classes? A. Loop diuretics B. Metformin C. Vancomycin D. Cephalosporin

C

The nurse is aware that most patients receiving metronidazole are being treated for infections of the A. urinary tract. B. gastrointestinal system. C. integumentary system. D. reproductive system.

B. Metronidazole works by impairing the DNA function of susceptible bacteria. It is prescribed to treat intestinal organisms

A nurse is preparing to administer doxorubicin [Adriamycin] intravenously (IV) to a patient who has breast cancer. Which actions should the nurse take? (Select all that apply.) A. Infuse normal saline for the preceding 24 hours. B. Place the patient on a cardiac monitor. C. Tell the patient the urine turns red. D. Give a diuretic after the infusion. E. Ensure the patency of the IV site.

BCE -Doxorubicin is an antitumor antibiotic with cardiotoxic adverse effects. Cardiac activity may be assessed with a monitor, because acute dysrhythmias and electrocardiographic (ECG) changes can occur within minutes of administration. The medication imparts a harmless red color to urine. IV patency is critical, because doxorubicin is a vesicant and can cause significant local tissue injury if extravasation occurs. It is not necessary to infuse normal saline for 24 hours before administration or give a diuretic after the infusion.

The nurse assesses a patient receiving fluorouracil [Adrucil] for the adverse effect of plantar erythrodysesthesia. What are the characteristics of this syndrome? (Select all that apply.) A. Hypoglycemia B. Tingling of the palms and soles C. Swelling of the palms and soles D. Hypertension E. Blistering of the palms and soles

BCE -The adverse effects of fluorouracil [Adrucil] therapy include plantar erythrodysesthesia (hand-and-foot syndrome), which is characterized by tingling, burning, redness, flaking, swelling, and blistering of the palms and soles. Hypoglycemia and hypertension are not characteristics of the syndrome.

A client with a diagnosis of intestinal amebiasis develops severe nausea, vomiting, fever, facial flushing, slurred speech, tachycardia, hypotension, and palpitations. A beginning assessment reveals that the client has just had several alcoholic beverages. The nurse should obtain a drug history for which drug? A. bacitracin (Baci-IM) B. fluconazole (Diflucan) C. metronidazole (Flagyl) D. ethambutol (Myambutol)

C

Which drug is associated with disulfiram reaction? A. Atovaquone B. Streptomycin C. Metronidazole D. Ampheritocin B

C. metronidazole and alcohol has an adverse reaction of the disulfiram reaction, so patients taking this medication need to avoid alcohol while taking it and for 48 hours after finishing.

Ciprofloxacin belongs to what class of antibiotic? A. Beta lactams B. Macrolides C. Tetracyclines D. Fluoroquinolones

D

The nurse anticipates a prescription for vitamin supplementation for a client who is receiving isoniazid (Nydrazid) therapy. What vitamin supplement is usually prescribed with isoniazid? A. Folate B. Calcium C. Vitamin E D. Vitamin B6

D

Which adverse effect can result if tetracycline is administered to children younger than 8 years of age? A. Drug-induced neurotoxicity B. Delayed growth development C. Gastrointestinal (GI) and rectal bleeding D. Permanent discoloration of the teeth

D

The e nurse is counseling a patient who will begin taking a sulfonamide drug to treat a urinary tract infection. What information will the nurse include in teaching? A. "Drink several quarts of water daily." B."If stomach upset occurs, take an antacid." C."Limit sun exposure to no more than 1 hour each day." D."Sore throat is a common, harmless side effect."

A Patients should drink several quarts of water daily while taking sulfonamides to prevent crystalluria. Patients should not take antacids with sulfonamides. Patients should not go out into the sun. Sore throat should be reported.

Ciprofloxacin (Cipro-XR) is prescribed for a client to treat a urinary tract infection. Which point should a nurse stress when teaching the client about the medication? A. Avoid taking ciprofloxacin with milk or yogurt. B. Treat diarrhea, a side effect of ciprofloxacin, with bismuth subsalicylate (Pepto-Bismol). C. Avoid fennel because it will increase the absorption of the ciprofloxacin. D. Take dietary calcium tablets 1 hour before or 2 hours after ciprofloxacin.

A RATIONALE: Ciprofloxacin is a fluoroquinolone antibiotic. Milk or yogurt decreases its absorption and should be avoided.

Isoniazid treatment is associated with the development of peripheral neuropathies. Which of the following interventions would the nurse teach the client to help prevent this complication? A Adhere to a low cholesterol diet B Supplement the diet with pyridoxine (vitamin B6) C Get extra rest D Avoid excessive sun exposure

B INH competes with the available vitamin B6 in the body and leaves the client at risk for development of neuropathies related to vitamin deficiency. Supplemental vitamin B6 is routinely prescribed.

Which client statement indicates to the nurse that the client understands the discharge teaching for ethambutol (Myambutol)?A. "Constipation will be a problem, so I will increase the fiber in my diet." B. "Dizziness and drowsiness are common adverse effects with this drug." C. "I will need to have my vision checked periodically while I am taking this drug." D. "This medication may cause my bodily secretions to turn red-orange-brown."

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 fluids during the infusion B. infusing the med quickly C. infusing the med over a long period of time D. stopping the infusion of 2 hours after half of the bag has infused and then resuming 1 hour later

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

Before discharge, the nurse is reviewing a client's prescribed medication regimen for tuberculosis (TB). The client asks the nurse why pyridoxine (vitamin B6) has been prescribed while continuing to take isoniazid (Nydrazid) to treat TB. What is the nurse's best response? A. "Multidrug therapy is necessary to prevent the occurrence of resistant bacteria." B. "You really should not be on that drug. I will check with the health care provider." C. "Pyridoxine is another antitubercular drug that will work synergistically with the isoniazid." D. "Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid."

D

A patient who has tuberculosis (TB) is being treated with combination drug therapy. The nurse explains that combination drug therapy is essential because:Recommendations for the initial treatment of tuberculosis A. It minimizes the required dosage of each of the medications. B. It helps reduce the unpleasant side effects of the medications. C. It shortens amount of time that the treatment regimen will be needed. D. It discourages the development of resistant strains of the TB organism

D Recommendations for the initial treatment of tuberculosis (TB) include a four-drug regimen until drug susceptibility tests are available. After susceptibility is established, the regimen can be altered, but patients should still receive at least two drugs to prevent emergence of drug-resistance organisms. Dosage, side effects, and duration of the regimen are not reasons for combination drug therapy in a patient with TB.

Why are multiple drugs prescribed for TB treatment? A. to prevent drug reactions B. to prevent drug resistance C. to prevent stomach upset D. to ward off evil spirits

B

Amoxicillin (Amoxil) is prescribed for a client who has a respiratory infection. The nurse is teaching the client about this medication and realizes that more teaching is needed when the client makes which statement? A. "I should not take my medication with food." B . "I will take my entire prescription of medication." C. "I should report to the physician any genital itching." D. "I should report to the health care provider any excess bleeding."

A

The client receives tamoxifen (Nolvadex) for treatment of breast cancer. She asks the nurse why the medicine works. What is the best response by the nurse?A. "Tamoxifen (Nolvadex) works by blocking estrogen receptors on breast tissue." B. "Tamoxifen (Nolvadex) works by inhibiting the cellular mitosis of breast cancer." C. "Tamoxifen (Nolvadex) works by inhibiting the metabolism of breast cancer cells." D. "Tamoxifen (Nolvadex) works by binding to the DNA of breast cancer cells."

A

When planning care for a client receiving a sulfonamide antibiotic, it is important for the nurse to perform which intervention? A. Encourage fluid intake of 2000 to 3000 mL/day. B. Avoid direct sun exposure and tanning beds. C. Take the medication with dairy products such as milk or yogurt. D. Advise the client to report any tinnitus to the health care provider.

A

A nurse should teach a patient to observe for which side effects when taking ampicillin? A. Skin rash and loose stools B. Reddened tongue and gums C. Digit numbness and tingling D. Bruising and petechiae

A -Ampicillin's most common side effects are rash and diarrhea; both reactions occur more frequently with ampicillin than with any other penicillin. Reddened tongue and gums, digit numbness and tingling, and bruising and petechiae are not associated side effects of ampicillin.

A nurse is to administer vancomycin (Vancocin) to a client diagnosed with sepsis. The client is to have a peak and through level completed on this dose of the medication. Which action should the nurse initiate first? A. Determine if the trough level has been drawn on the client. B. Determine medication compatibilities before infusing into an existing IV line. C. Check the client culture and sensitivity report. D. Check the amount of time over which the medication dose should infuse.

A -The trough level must be drawn before medication administration. This is the first action because, if the trough level has not been drawn, it will delay administering the medication. Answers 2 and 3 are important but can be done will awaiting lab results of the trough level.

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 Dose-related peripheral neuropathy is the most common adverse effect of isoniazid. It results from a vitamin B6deficiency, which is corrected by taking oral supplements. Symptoms include numbness and tingling in the fingers and toes. Alopecia and flaking scalp, oral ulcers and tongue fissures, and dry skin and brittle nails are not adverse effects of isoniazid-induced vitamin B6 deficiency.

Which of the following antibiotics is contraindicated in pregnant women and small children due to it's tendency to irreversibly stain developing teeth? A. Tetracyclines B. Aminoglycosides C. Beta lactam antibiotics D. Fluoroquinolones

A Tetracycline antibiotics are contraindicated in pregnant women and small children due to their tendency to irreversibly stain developing teeth. They can also affect fetal bone growth and so are pregnancy category D (known incidence and risk of fetal harm).

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? A. Some hearing loss may have occurred. B. The confusion is due to the hospital stay. C. A nutrition consult most likely is needed. D. The patient has a family history of dementia

A The patient's comment suggests that the person did not hear the instructions. Aminoglycoside antibiotics can cause ototoxicity. The first sign may be tinnitus (ringing in the ears), progressing to loss of high-frequency sounds. Audiometric testing is needed to detect it. Nutrition, confusion, and a family history of dementia do not address the problem of possible hearing loss associated with aminoglycosides.

A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take? A. Reduce the infusion rate. B. Administer diphenhydramine [Benadryl]. C. Change the IV tubing. D. Check the patency of the IV.

A When vancomycin is infused too rapidly, histamine release may cause the patient to develop hypotension accompanied by flushing and warmth of the neck and face; this phenomenon is called red man syndrome.Diphenhydramine is not necessary if the infusion is administered slowly over at least 60 minutes. Changing the IV tubing would not help the symptoms. The patency of the IV needs to be checked before the administration is started.

When caring for a patient receiving amphotericin B, it is most important for the nurse to assess the patient for the development of A. hypokalemia. B. hypernatremia. C. hypocalcemia. D. hypermagnesemia.

A. Amphotericin B binds to K+ making it leak out in the renal system causing hypokalemia.

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."

AB - Numbness and tingling in the extremities is associated with the development of peripheral neuropathy and should be reported to the healthcare provider. Rifampin, not isoniazid, causes discoloration of body fluids. Ethambutol, not isoniazid, is associated with optic neuritis. The other two statements are true and can be included in patient teaching.

Which medications may be administered by the nurse for infections in a patient with a severe penicillin allergy? (Select all that apply.) A.Vancomycin B. Erythromycin C. Clindamycin D. Amoxicillin

ABC

Which is a complication of Vancomycin IV infusions? A. Steven's-Johnsons syndrome B. Red man syndrome C. Seizures D. Bradycardia

B

While a patient who is about to receive cyclophosphamide (Cytoxan) chemotherapy, the nurse will instruct the patient to watch for potential adverse effects, such as . . . A. cholinergic diarrhea. B. hemorrhagic cystitis. C. peripheral neuropathy. D. ototoxicity.

B

The Nurse knows to monitor the client receiving which antibiotic for possible signs of nephrotoxicity and/or ototoxicity? A. Ampicillin B. Gentamicin C. Ciprofloxacin D. Erythromycin

B

The nurse enters a client's room to find that his heart rate is 120, his BP is 70/50, and he is flushed. Vancomycin (Vancocin) is running IVPB. The nurse interprets this as a severe adverse effect of "red man syndrome." What should the nurse do? A. Stop the infusion and call the laboratory. B. Reduce the infusion to 10 mg/min. C. Encourage the client to drink more oral fluids up to 2 L/day. D. Report to health care provider the onset of Stevens-Johnson syndrome

B

What can the nurse teach a patient to decrease the risk of bacterial resistance? A. Take your antibiotics at mealtimes only. B. Take all of your antibiotics, even if you feel better. C. Take your antibiotics with dairy products. D. Take your antibiotics with a full glass of water.

B

A patient taking a sulfonamide is breast-feeding an infant. Which complication in the infant would the nurse associate with kernicterus? A. Hemolytic anemia B. Neurologic deficits C. Hepatocellular failure D. Ophthalmic infection

B -Kernicterus is a disorder in newborns caused by deposition of bilirubin in the brain, which leads to severe neurologic deficits and death. Sulfonamides promote kernicterus by displacing protein-bound bilirubin from the proteins, leaving newly freed bilirubin access to brain sites. Sulfonamides are not administered to infants under 2 years old, nor are they given to pregnant patients near term or nursing mothers. Hemolytic anemia, hepatocellular failure, and ophthalmic infection are not associated sulfonamide effects in infants.

Which instruction should a nurse include in the discharge teaching for a patient who is to start taking tetracycline? A. "You may stop taking the pills when you begin to feel better." B. "Use sunscreen and protective clothing when outdoors." C. "You'll have to come back to the clinic for a weekly blood work." D. "Take the medication with yogurt or milk so you won't have nausea."

B -Tetracyclines are bacteriostatic antibiotics; photosensitivity and severe sunburn are common adverse effects. A full course of antibiotics must always be taken. Blood studies are not necessary for therapeutic levels. Absorption decreases after ingestion of chelates, such as calcium and magnesium, so doses should be given 2 hours before or 2 hours after ingestion of milk products.

Before administering intravenous (IV) penicillin, the nurse should do what? A. Flush the IV site with normal saline. B. Assess the patient for allergies. C. Review the patient's intake and output record. D. Determine the latest creatinine clearance result

B -The principal adverse effect of penicillins is allergic reaction. Penicillins are contraindicated in patients with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems. IV patency is important, as is monitoring renal function, because impairment can cause penicillins to reach toxic levels; however, these are not as important as determining allergy status.

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 Acyclovir is used to treat herpes simplex infections caused by type 2 herpes simplex virus (HSV-2). For patients with recurrent herpes genitalis, oral therapy reduces the frequency with which lesions appear. It does not eradicate the virus or produce cure. Acyclovir does not prevent transmission of the virus to sexual contacts. It does not affect scarring from lesions.

What does the nurse identify as an adverse effect of clindamycin [Cleocin] therapy? A. Cyanosis and gray discoloration of the skin. B. Frequent loose, watery stools with mucus and blood. C. Reduction in all blood cells produced in the bone marrow. D. Elevated bilirubin, with dark urine and jaundice.

B Clostridium difficile-associated diarrhea (CDAD) is the most severe toxicity associated with clindamycin and is characterized by profuse, watery stools. The cause is superinfection of the bowel with C. difficile, an anaerobic gram-positive bacillus. Gray syndrome, which usually occurs in infants and those with aplastic anemia, is an adverse effect of chloramphenicol [Chloromycetin]. Hepatotoxicity is associated most closely with telithromycin [Ketek].

Before administering intravenous (IV) penicillin, the nurse should do what? A. Flush the IV site with normal saline. B. Assess the patient for allergies. C. Review the patient's intake and output record. D. Determine the latest creatinine clearance result.

B The principal adverse effect of penicillins is allergic reaction. Penicillins are contraindicated in patients with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems. IV patency is important, as is monitoring renal function, because impairment can cause penicillins to reach toxic levels; however, these are not as important as determining allergy status.

Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin [Ery-Tab] therapy? A. Heart rate of 52 beats/min B. Prolonged QT interval C. Jugular vein distention D. Grade III diastolic murmur

B When present in high levels, erythromycin can prolong the QT interval, causing a potentially fatal ventricular dysrhythmia. It should be avoided by patients taking class IA or class III antidysrhythmic medications or others that inhibit metabolism.

A patient has developed active tuberculosis and is prescribed isoniazid and rifampin. Which information will the nurse include in teaching the patient about taking this drug? (Select all that apply.) A.Isoniazid should be given 1 hour before or 2 hours after meals. B.Have periodic eye examinations as ordered by the health care provider. C.Compliance with drug regimen is essential. D.Report numbness, tingling, and burning of hands and feet. E.Warn patient that rifampin may turn body fluids a harmless green color.

BCD ..as said before isoniazid can be taken with or without food. ethambutol should have routine eye exams due to optic neuritis, compliance with TB meds is essential, INH (Isoniazid) causes peripheral neuropathy which has numbness, tingling and burning in the feet. Rifampin turns the secretions orange not green.

A patient taking oral contraceptives is being treated for a urinary tract infection with antibiotics. Which information should the nurse include as education related to the oral contraceptives? A. "Report any abdominal pain, blood in the urine, or changes in vision." B. "There is no drug interaction between oral contraceptives and antibiotics." C. "Use an alternative method of birth control for up to 1 month during and after antibiotic use." D. "Your sexual partner should use a nonprescription test kit that will detect a urinary tract infection."

C

Which information should the nurse include in discharge teaching for a client prescribed Doxycycline? A. "Keep the remainder of the medication in case of recurrence." B. "Take the medication until you have no fever and feel better." C. "Apply sunscreen or wear protective clothing when outdoors." D. "Take the medication with milk to minimize GI upset."

C

Which information should the nurse include in discharge teaching for a client prescribed doxycycline (Vibramycin)? A. "Keep the remainder of the medication in case of recurrence." B. "Take the medication until you have no fever and feel better." C. "Apply sunscreen or wear protective clothing when outdoors." D "Take the medication with milk to minimize gastrointestinal upset."

C

Which nursing outcome would be most appropriate as part of the planning for patients scheduled to receive cyclophosphamide? A patient will be free from symptoms of stomatitis B patient will maintain cardiac output C patient must show no signs of hemorrhagic cystitis D patient will show no signs of syndrome of inappropriate antidiuretic hormone secretion

C

Which of the following class of antibiotics is associated with ototoxicity and hearing loss? A. Beta-lactam antibiotics B. Quinolones C. Aminoglycosides D. Glycopeptides

C

Which term describes an infection caused when normal flora are affected by antibiotic therapy? A. Toxicity B. Hypersensitivity C. Superinfection D. Synergistic effects

C

the client is prescribed tamoxifen for the treatment of breast cancer. the nurse should advise the client to monitor for which adverse effect? A. fatigue B. cough C. vaginal discharge D. signs of dehydration

C

A client at an outpatient clinic is ordered to receive ampicillin (Omnipen) for an infection. Which nursing intervention related to penicillins would the nurse question? A. Verify that the client is not allergic to penicillin. B. Obtain culture before administering the first dose of medication. C. Instruct client to discontinue penicillin when temperature is normal. D. Encourage the client to increase fluid intake.

C -The entire course of the medication should be taken to ensure eradication of the infection and decreased resistance, even if the clients temperature has normalized.

The nurse identifies which medication as the drug of choice for most infections caused by herpes simplex viruses and varicella-zoster virus? A. Ganiciclovir B. Amantadine C. Acyclovir D. Oseltamivir

C Acyclovir is the drug of choice for most infections caused by herpes simplex viruses and varicella-zoster virus. Ganiciclovir is the drug of choice for prophylaxis and treatment of CMV infection in immunocompromised patients, including those with AIDS. Amantadine and oseltamivir are drugs of choice for the treatment and prophylaxis of influenza.

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 Ethambutol can cause optic neuritis, resulting in disturbance of color discrimination and blurred vision. Symptoms resolve when the medication is discontinued. Orthostatic hypotension, constipation, and discoloration of urine are not known adverse effects of ethambutol.

The most important information a nurse can give a patient regarding the antibiotic ampicilin are to, A. call the physician if she has breathing problems. B. Take it with meals to not cause an upset stomach. C. Take all of the medication even if your signs and symptoms disappear. D. Do not share with friends and family.

C Frequently patients do not complete the entire course of antibiotic therapy allowing the remaining bacteria to survive.

A nurse observes a red streak and palpates the vein as hard and cordlike at the intravenous (IV) site of a patient receiving cefepime [Maxipime]. Which assessment should the nurse make about the IV site? A. An allergic reaction has developed to the drug solution. B. The drug has infiltrated the extravascular tissues. C. Phlebitis of the vein used for the antibiotic has developed. D. Local infection from bacterial contamination has occurred.

C IV cephalosporins may cause thrombophlebitis. To minimize this, the injection site should be rotated and a dilute solution should be administered slowly. An allergic response would be shown as itching, redness, and swelling. Infiltration would show as a pale, cool, and puffy IV site. Infection would show as pus, tenderness, and redness.

A patient has acquired an infection while in the hospital. The nurse identifies this type of infection as what? A. Superinfection B. Suprainfection C. Nosocomial infection D. Resistant infection

C Nosocomial infections are acquired by patients while in the hospital. Superinfection and suprainfection are terms used to describe the emergence of drug resistance.

When administering gentamicin, you must be aware that which of the following drugs may increase the risk of ototoxicity and nephrotoxicity? A. Proton pump inhibitors B. Benzodiazepines C. Loop diuretics D. Sustained serotonin reuptake inhibitors (SSRIs)

C Rationale: Use caution with concurrent administration of diuretics and aminoglycosides. Diuretics may increase the risk of nephrotoxicity by decreasing fluid volume, thereby increasing drug concentrations in serum and tissues. Diuretics may also contribute to ototoxicity.

The nurse is about to administer Vancomycin to treat a bacterial infection that is methicillin resistant staphylococcus aureus (MRSA). The nurse understands that a possible complication of it is A. Reyes syndrome B. Rickets C. Red man syndrome D. Tendonitis

C Red man syndrome, Vancomycin must be administered in 1-2 hours to prevent hypotension and rash (red man syndrome).

A patient prescribed ampicillin is receiving instructions on administration. The nurse should warn the patient about which common, but non-life-threatening, side effect? A. Bronchospasm B. Constipation C. Headache D. Rash & Pruritis

D

The client receives methotrexate (Rheumatrex). The nurse assess for side effects of this drug. which side effects are a primary concern for the nurse? A. Hyperglycemia and fatigue B. Nausea and vomiting C. HTN and seizures D. Ulcerative stomatitis and diarrhea

D

A clients medication warrants peak and trough levels to be drawn. The nurse is aware that if the peak level of the drug is too high, what could occur? A. Mild side effects B. Inadequate drug action C. Slow onset of drug action D. Drug toxicity

D -High peak levels may indicate that the medication is above the toxic level.

Which manifestation should a nurse investigate first when monitoring a patient taking tamoxifen [Nolvadex]? A. Sleep disruption B. Pedal edema C. Hot flushes D. Vaginal bleeding

D -Vaginal bleeding is a symptom of endometrial cancer and should be followed up first when a patient is taking tamoxifen. Tamoxifen, a hormonal treatment for breast cancer, is classified as a selective estrogen receptor modulator (SERM). This medication causes receptor blockade in some tissues and receptor activation in others. Tamoxifen acts as an estrogen agonist at receptors in the uterus, causing proliferation of endometrial tissue that can lead to endometrial cancer. Pedal edema as a result of fluid retention, sleep disruption, and hot flushes are other adverse effects of tamoxifen's antiestrogen effects; however, they are not as important for follow-up as vaginal bleeding.

A nurse is teaching a patient who is scheduled to start taking itraconazole [Sporanox]. Which statement by the patient would indicate understanding of the teaching? A. "I'll take diphenhydramine [Benadryl] before this medication so I don't have a reaction." B. "It's important to remember to wear sunscreen while taking this medicine." C. "I'll avoid citrus foods, such as oranges and grapefruits, while taking this medication." D. "If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider."

D Itraconazole may cause liver injury, and although a causal link has not been identified, patients need to be informed about symptoms to report. These include jaundice, nausea, and right upper abdominal pain. It is not necessary to take diphenhydramine, wear sunscreen, or avoid citrus products while taking itraconazole

A patient is receiving amphotericin B. The nurse identifies which medication as useful in preventing adverse effects of amphotericin B? A. Furosemide [Lasix] B. Insulin C. Vitamin K D. Potassium

D Renal injury from amphotericin B may cause severe hypokalemia. Serum potassium levels should be monitored more frequently and potassium supplements given to correct low plasma levels. Furosemide, insulin, and vitamin K do not prevent any adverse effects of amphotericin B.

A patient is diagnosed with a Candida infection in the mouth. The nurse anticipates that the patient will be treated with A. metronidazole B. amphotericin B C. isoniazid D. nystatin

D. nystatin is the oral suspension used to treat candida (yeast) for the mouth and other places...it is available in topical formulations also.