NR293 Pharmacology Exam 1

Penicillin

-common for allergic reactions interactions: NSAIDS, oral contraceptives, warfarin Deactivates aminoglycosides Augmentin = amoxicillin and clavulanate Includes: penicillin, cephalosporins, macrolides, carbapenems, and monobactams

b. lipid solubility

A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes? a. protein-binding ability b. lipid solubility c. hepatic metabolism d. slow dissolution

B. decreased hemoglobin

A nurse is collecting data from a client who has AIDS And is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider? A. nausea and vomiting B. decreased hemoglobin C. decreased appetite D. anxiety

B. grapefruit juice

A nurse is reinforcing teaching with a client who has atrial fibrillation and a new prescription for amiodarone. Which of the following items should the nurse instruct the client to avoid while taking this medication? A. green leafy vegetables B. grapefruit juice C. garlic D. salt substitutes

B. Levothyroxine 75 mcg PO q AM before breakfast EC = enteric coated, XR = extended release, SL = sublingually

A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? A. Aspirin EC 80 mg PO daily B. Levothyroxine 75 mcg PO q AM before breakfast C. Metformin XR 500 mg PO daily D. Nitroglycerin 0.3 mg SL PRN chest pain, can repeat q 5 min for 2 additional doses.

Superinfection

C-diff or yeast infections result of taking antibiotic

Cephalosporins

Cephalexin - four generations increasing reach to CSF, effectiveness on gram-negatives cross-sensitivity to penicillins caution w/ renal impairment may cause alcohol sensitivity take oral meds with food, liquids in refrigerator

Aminoglycosides

Includes Gentamicin Disrupt protein synthesis

Vancomycin

PO or IV use Inhibits cell wall synthesis treats c-diff and MRSA Ototoxicity is complication Associated w/ red man syndrome PEAK IS 20-40 MCG TROUGH IS 5-15 MCG

Red man syndrome

Rashes, flushing, tachycardia, and hypotension If occurs, slow administration of medication associated w/ vancomycin

Tetracycline

Risk of tooth discoloration Not recommended for under 8 years old used for topical application of acne associated with calcium loss

Extravasation

Stop the flow of medication but leave the catheter in. When chemo drug leaks outside of vessel into surrounding tissue.

Definitive therapy

antibiotic therapy tailored to treat organism identified with cultures

Gentamicin

risk for ototoxicity and nephrotoxicity can cause hearing loss in infants report hematuria, cloudy urine, tinnitus, headache, vertigo, hearing loss PEAK 5-10 MCG TROUGH 0.5-2 MCG TOXICITY @ 12+ MCG

B. Aspirin

A nurse is collecting data from a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. nitroglycerin B. Aspirin C. Morphine D. Metoprolol

a. photosensitivity

A nurse is reinforcing teaching with a client who has a new prescription for doxycycline. The nurse should reinforce with the client the need to monitor for which of the following adverse effects of this medication? a. photosensitivity b. constipation c. ototoxicity d. blurry vision

b. cephalosporins

A nurse is reviewing the medical history of a client who has a respiratory infection. The nurse notes the client has a severe penicillin allergy. which of the following class of antibiotics is also contraindicated for this client? a. carbapenems b. cephalosporins c. aminoglycosides d. fluoroquinolones

c. paresthesias

The nurse is assessing a client who has been taking linezolid to treat a staphylococcus aureus infection. Which of the following findings should the nurse report to the provider? A. nausea b. headaches c. paresthesias d. insomnia

d. alterations in gastrointestinal flora

a nurse in a provider's office is collecting data from a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. the nurse should recognize that these manifestations occur secondary to which of the following adverse effects? a. development of gastric ulcers b. development of milk intolerance c. allergic reactions to the medication d. alterations in gastrointestinal flora

Rifampin

used in treatment of TB Body secretions become orange/brown

d. administer epinephrine subcutaneously

A nurse administered an antibiotic 10 min ago to a client who is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse perform first? A. give oral corticosteroids B. administer dopamine c. give diphenhydramine IV d. administer epinephrine subcutaneously

d. administer epinephrine subcutaneously

A nurse administered an antibiotic 10 minutes ago to a client who is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse take first? a. give oral corticosteroids b. administer dopamine c. give diphenhydramine IV d. administer epinephrine subcutaneously

A. collect data from the client to determine the client's condition

A nurse discovers that a client received an incorrect dosage of a morning medication. Which of the following actions should the nurse take first? A. collect data from the client to determine the client's condition B. report the incident to the nursing supervisor C. complete and file a facility incident report D. notify the client's provider of the incident

A. tuberculosis

A nurse in a community health clinic is collecting data from a new client who has prescriptions for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. tuberculosis B. hypertension C. diabetes D. cirrhosis

A. the excretion of the medication is reduced

A nurse in a long-term care facility is administering medications to a group of older clients. Which of the following factors of pharmacokinetics should the nurse consider when caring for this age group? A. the excretion of the medication is reduced B. the percentage of medication absorbed is increased C. the liver metabolizes the medication more quickly. D. the rate at which the liver metabolizes medication declines with age.

D. alterations in the gastrointestinal flora

A nurse in a provider's office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects? A. development of gastric ulcers B. development of milk intolerance C. allergic reactions to the medication D. alterations in the gastrointestinal flora

C. black cohosh

A nurse in a provider's office is assessing a client who reports taking a dietary supplement to reduce hot flashes related to menopause. Which of the following supplements should the nurse expect the client to report taking? A. flaxseed B. ginkgo biloba C. black cohosh D. St. John's wort

b. you are less likely to have an upset stomach with this pill because of the coating on the tablet.

A nurse is administering an enteric-coated tablet to a client and explaining the pharmaceutical preparation. Which is correct? a. the coated tablet dissolves better in your stomach and intestines. b. you are less likely to have an upset stomach with this pill because of the coating on the tablet. c. the coating on the tablet improves the absorption of the medication d. the coating on the tablet allows a gradual release of the medication

C. an extended-release capsule was crushed before being given.

A nurse is administering medications to 4 clients. Which of the following situations requires the completion of an incident report? A. a beta blocker was held for an apical heart rate of 50/min. B. a client vomited immediately after receiving his oral medications. C. an extended-release capsule was crushed before being given. D. a client who is anemia refused a blood transfusion.

B. proteinuria this is a manifestation of nephrotoxicity. The nurse should monitor for oliguria and hematuria.

A nurse is assessing a client who is receiving IV gentamicin 3 times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication? A. hypoglycemia B. proteinuria C. nasal congestion D. visual disturbances

a. seizures can occur with this medication

A nurse is assisting with preparing discharge teaching for a client who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of information should the nurse include? a. seizures can occur with this medication b. you should observe for manifestations of bleeding. c. check your hands and feet for sensory dysfunction. d. this medication can increase the risk of ototoxicity.

A. to reduce toxicity risk

A nurse is assisting with the administration of an IV injection to a client. For which of the following reasons should the nurse inject the medication slowly? A. to reduce toxicity risk B. to improve the absorption pattern C. to prevent medication dilution D. to protect against embolism

B. Intravenous

A nurse is assisting with the care of a client who is postoperative. The client reports a pain level of 8 on a scale of 0 to 10 and has a prescription for meperidine. Which of the following routes of administration will deliver the medication with the shortest time of onset? A. oral B. Intravenous C. intramuscular d. subcutaneous

C. check the client's apical pulse

A nurse is caring for a client and realizes after administering the 0900 medications that she gave digoxin 0.25 mg PO to the client instead of the prescribed dose of digoxin 0.125 mg PO. Which of the following actions should the nurse take first? A. notify the provider B. contact the nursing supervisor C. check the client's apical pulse D. complete an incident report

b. furosemide

A nurse is caring for a client taking streptomycin. Which of the following medications should the nurse identify as increasing the risk of developing ototoxicity when taken with streptomycin? a. cefoxitin b. furosemide c. naproxen d. amphotericin b

a. I have noticed my urine is orange in color.

A nurse is caring for a client who has TB and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of the medication? a. I have noticed my urine is orange in color. b. I sleep more than I used to. c. My tongue and mouth are sore. d. My voice seems hoarse.

B. superinfection

A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? A. allergic response B. superinfection C. renal toxicity D. hepatotoxicity

b. aspartate aminotransferase (AST)

A nurse is caring for a client who has a positive tuberculin skin test and a new prescription for isoniazid. Which for of the following lab values should the nurse monitor? A. thyroid stimulating hormone b. aspartate aminotransferase (AST) c. potassium d. sodium

c. baseline BUN and creatinine

A nurse is caring for a client who has a pseudomonas infection and a new prescription for ticarcillin-clavulanate. Which of the following should the nurse collect before administering this medication? a. indications of superinfeciton b. peak and trough medication levels c. baseline BUN and creatinine d. history of allergy to aminoglycoside antibiotics

b. metronidazole

A nurse is caring for a client who has developed mild C-diff infection following antibiotic therapy. After discontinuing the current antibiotic, the nurse should expect the provider to prescribe which of the following medications? a. vancomycin b. metronidazole c. clindamycin d. ciprofloxacin

C. Data Collection

A nurse is caring for a client who has multiple medication allergies. During which of the following steps of the nursing process should the nurse identify the client's allergies? A. Planning B. Evaluation C. Data Collection D. Implementation

C. hypercalcemia

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? A. hyperkalemia B. hypermagnesemia C. hypercalcemia D. hypernatremia

A. red-ringed urine

A nurse is caring for a client who has tuberculosis and is taking rifampin. The nurse should monitor the client for which of the following findings as an adverse effect of rifampin? A. red-ringed urine b. tinnitus c. blurred vision d. dry mouth

C. hydromorphone Hydromorphone is an opioid antagonist. It is used for the treatment of moderate to severe pain management in clients who have cancer.

A nurse is caring for a client who is experiencing severe cancer pain. Which of the following medications should the nurse expect the provider to prescribe? A. buprenorphine B. tramadol C. hydromorphone D. oxycodone

a. make sure the medication infuses slowly

A nurse is caring for a client who is receiving a continuous IV infusion of erythromycin lactobionate to treat a Bordetella pertussis infection. Which of the following actions should the nurse perform to minimize the risk of thrombophlebitis? a. make sure the medication infuses slowly b. stop the infusion after the client has received half the dosage. c. make sure the solution is not dilute d. request a prescription for intermittent dosing

B. Epistaxis Cefotetan is an antibiotic that affects vitamin K levels, which can result in bleeding and epistaxis. It is a second generation cephalosporin.

A nurse is caring for a client who is receiving cefotetan 1 g via intermittent IV bolus every 12 hours to treat a postoperative infection. Which of the following manifestations should the nurse monitor for as an adverse effect of the medication? A. disorientation B. epistaxis C. constipation D. jaundice

A. decreased platelet aggregation

A nurse is caring for a client who takes Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement? A. decreased platelet aggregation b. prevention of migraine headaches c. increase risk of DVT d. lowered cholesterol and triglyceride levels

A. within 15 minutes prior to the next medication dose

A nurse is caring for a client who takes gentamicin IM and has a prescription to obtain a blood sample to measure a trough level. At which of the following times should the nurse draw the blood sample? A. within 15 minutes prior to the next medication dose B. 3 hours prior to administering a dose. C. Within 15 minutes following the next medication dose D. 2 hours after administering a dose.

B. vancomycin

A nurse is caring fora client who has developed MRSA in a surgical incision. Which of the following medications should the nurse expect the provider to prescribe? A. ceftriaxone B. vancomycin C. ketoconazole D. ciprofloxacin

B. check the client for pruritis

A nurse is checking a client who is receiving an IV infusion of telavancin for streptococcus pyogenes. Which of the following actions should the nurse perform? A. check to see if the client's urine is blue. B. check the client for pruritis C. check for hypertension D. check for numbness in the limbs

a. red man syndrome

A nurse is collecting data from a client who has a C-diff infection and is receiving vancomycin via intermittent IV bolus over 60 minutes. The nurse should document the absence of which of the following conditions as a positive response to this slowed administration rate? a. red man syndrome b. thrombophlebitis c. renal failure d. ototoxicity

C. Visual disturbances Common signs of digoxin toxicity include nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances

A nurse is collecting data from a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? A. Suppression of dysrhythmias B. Increase in AV conduction C. Visual disturbances D. weight gain

d. loss of red/green color discrimination

A nurse is collecting data from a client who has tuberculosis and a prescription for ethambutol. The nurse should inform the client he is likely to develop which of the following alterations as an adverse effect of this medication? a. mottling of the extremities. b. orange-red urine and bodily secretions. c. yellowing of the sclera d. loss of red/green color discrimination

B. Garlic

A nurse is collecting data preoperatively from a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? A. Soy B. Garlic C. Black cohosh D. Green tea

A. report persistent diarrhea to the provider can cause superinfection of the bowel because it destroys some sensitive flora in the GI system

A nurse is educating a client with urethritis who has a new prescription for oral erythromycin. Which of the following statements should the nurse include in the teaching? A. report persistent diarrhea to the provider B. take this medication with a full glass of milk C. some people who take erythromycin experience vision loss D. Antacids will reduce the extent of absorption of this medication.

C. obtain a list of the client's current medications, including those that are over-the-counter.

A nurse is performing a reconciliation of a client's medications. Which of the following actions should the nurse take first? A. review the medications the client is taking at home and compare the list with the medications the client is taking in the facility. B. compare any new medication prescriptions with the client's current list of medications C. obtain a list of the client's current medications, including those that are over-the-counter. D. provide the current and accurate medication list to all of the client's health care providers.

a. 1 hour after administering the IM injection

A nurse is planning care for a client who is receiving gentamicin IM and has a new prescription to obtain gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample to evaluate the gentamicin peak? a. 1 hour after administering the IM injection b. Just before administering the IM injection c. 12 hours after the last IM injection d. 30 minutes after administering the IM injection

D. liver enzymes

A nurse is planning care for a client who took an overdose of acetaminophen. Which of the following laboratory values should the nurse plan to monitor for adverse effects of the overdose? A. hematocrit B. high-density lipoproteins (HDL) C. pancreatic enzymes D. liver enzymes

D. penicillins

A nurse is preparing an in-service session for medical-surgical staff on infections and antibiotic use. Which of the following antibiotics should the nurse identify as having the highest rate of severe allergic reactions? A. trimethoprim B. erythromycin C. sulfonamides D. penicillins

50

A nurse is preparing to administer 150 units/hr of regular insulin to a client. Regular insulin is available at 1,500 units in 0.9% sodium chloride 500 mL. The nurse should set the IV pump to deliver how many mL/hr?

5 mL

A nurse is preparing to administer albuterol syrup 0.1 mg/kg/day to a school-aged child who weights 44 pounds. The amount available is albuterol syrup 2 mg/5 mL. How many mL should the nurse administer? (Round your answer to the nearest tenth. Use a leading zero if applicable but do not use a trailing zero.)

5

A nurse is preparing to administer amoxicillin liquid suspension 250 mg PO every 8 hours to an older client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose?

c. pull the pinna of the client's ear upward and outward.

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take? a. place the client leaning forward in a chair. b. hold the medication dropper 1 in from the client's ear canal. c. pull the pinna of the client's ear upward and outward. d. have the client remain still for 30 seconds after the medication is administered.

10

A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. The amount avialble is codein oral solution 15 mg/5 mL. How many mL should the nurse plan to administer per dose?

21

A nurse is preparing to administer desmopressin 0.1 mcg/kg in 0.9% sodium chloride 50 mL IV over 30 min to a client who weights 154 lb. How many mcg of medication should the client receive?

50

A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to an older client over 8 hr. The nurse should set the IV pump to deliver how many mL/hr?

14

A nurse is preparing to administer dextrose 5% in water 1,000 mL infused over 12 hours. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to delivery how many gtt/min?

0.8 mL

A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hours. Heparin 10,000 units/1 mL is available. How many mL should the nurse administer per dose?

21

A nurse is preparing to administer lactated Ringer's 1,000 mL IV infused over 8 hr. The drop factor of the manual tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

29

A nurse is preparing to administer lactated Ringer's 700 mL IV infused over 24 hours to a pediatric client. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

C. QID

A nurse is preparing to administer medication to a client. Which of the following abbreviations indicates the greatest frequency of medication administration? A. BID B. TID C. QID D. Q8h

c. weight

A nurse is preparing to administer medication to a preschooler. The nurse should use which of the following measurements to calculate the medication dosage for this client? A. body mass index B. height c. weight d. rule of 9s

A. Aspirin EC 325 mg per NG tube daily

A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? A. Aspirin EC 325 mg per NG tube daily B. Atorvastatin 40 mg per NG tube daily C. Propranolol 20 mg per NG tube daily D. Sulcralfate 2 g oral suspension per NG tube BID

A. compare the provider's initial prescription with the medication administration record.

A nurse is preparing to administer medications to a group of clients. Which of the following actions should the nurse take to verify the right medication is administered? A. compare the provider's initial prescription with the medication administration record. B. ask each client to list the medications he or she is currently taking while in the facility. C. for unmarked medication containers, check the client's MAR 3 times while preparing the medication. D. have a second nurse verify the MAR at the client's bedside.

B. 1 1/2 inch

A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication? A. 1/2 inch B. 1 1/2 inch C. 2 1/2 inch D. 3 inch

A. seizures can occur with this medication.

A nurse is providing discharge teaching to a client who has a bacterial infection about adverse effects of imipenem to report to the provider. Which of the following pieces of information should the nurse include? A. seizures can occur with this medication. B. you should observe for manifestations of bleeding. C. check your hands and feet for sensory dysfunction D. this medication can increase the risk of ototoxicity.

D. decreased visual acuity

A nurse is providing teaching to a client with tuberculosis who has prescriptions for rifampin and ethambutol. Which of the following findings is an adverse effect of these medications that the client should report to the provider? A. red-orange discoloration of urine B. unexpected weight gain C. ringing in the ears D. decreased visual acuity

B. increased susceptibility to infection

A nurse is reinforcing teaching about immunosuppressive medications to a client who had kidney transplant surgery. Which of the following adverse effects of these medications should the nurse include in the teaching? A. increased urinary output B. increased susceptibility to infection c. increased hair loss d. increased risk for autoimmune disorders

B. limit your consumption of dairy products while taking this medicine.

A nurse is reinforcing teaching with a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching? A. take this medication on a full stomach. B. limit your consumption of dairy products while taking this medicine. C. take the medication with your regular iron supplement. D. take antacids if you have an upset stomach from using tetracycline.

B. stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and St. John's wort together puts the client at risk for serotonin syndrome.

A nurse is reinforcing teaching with a client who has a new prescription for sertraline. The client asks the nurse if he should containue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. take the medication and herbal supplement together. B. stop taking the herbal supplement while taking the medication. C. take the herbal supplement and the medication at least 2 hours apart. D. take an antacid with both the herbal supplement and the medication.

c. wear protecting clothing while in the sun

A nurse is reinforcing teaching with a client who has a prescription for doxycyline for treatment of a H. pylori infection. What should she include? a. take this medication with meals to decrease GI upset b. continue this medication if you become pregnant c. wear protecting clothing while in the sun d. expect to have severe diarrhea while taking this medication.

d. I should notify my provider immediately if my urine turns orange.

A nurse is reinforcing teaching with a client who has a urinary tract infection and new prescriptions for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching? a. if phenazopyridine upsets my stomach, I can take it with meals. b. Phenazopyridine will relieve my discomfort, but ciprofloxacin will get ride of the infection. c. I need to drink 2 liters of fluid per day while I am taking ciprofloxacin. d. I should notify my provider immediately if my urine turns orange.

a. hypertension

A nurse is reinforcing teaching with a client who has chemotherapy-induced anemia and a prescription for epoetin alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of epoetin alpha? a. hypertension b. leukocytosis c. bone pain d. neutropenia

B. Your provider will monitor your liver function while you are taking this medication.

A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for isoniazid. Which of the following instructions should the nurse include? A. You'll need to take this medication for the rest of your life to prevent recurrence. B. Your provider will monitor your liver function while you are taking this medication. C. Limit your alcohol intake to 2 drinks per day. D. You should take this medication with a meal to increase absorption.

A. red-orange discoloration of urine

A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for rifampin. The nurse should identify which of the following findings as a harmless and expected adverse effect of rifampin? A. red-orange discoloration of urine B. increased ecchymosis C. yellow appearance of the sclerae D. lack of energy

a. report persistent diarrhea to the provider.

A nurse is reinforcing teaching with a client who has urethritis and a new prescription for oral erythromycin. Which of the following statements should the nurse include in the teaching? a. report persistent diarrhea to the provider. b. take this medication with a full glass of milk. c. some people who take erythromycin experience vision loss. d. antacids will reduce the extent of absorption of this medication.

c. serum creatinine 2.5 mg/dL Vancomycin is nephrotoxic and can result in renal failure, which is indicated by elevated levels of creatinie above the expected reference range of 0.5 to 1.3 mg/dL. .

A nurse is reviewing lab results fora client who has C-diff infection and is receiving vancomycin. Which of the following results should the nurse report to he provider before administering the next dose? A. hematocrit 46% B. serum glucose 110 mg/dL c. serum creatinine 2.5 mg/dL d. serum potassium 4.8 mEq/L

B. Creatinine clearance 35 mL/min

A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the risk for reduced clearance of the medication? A. Alanine aminotransferase (ALT) 60 international units. B. Creatinine clearance 35 mL/min C. HbA1c 5% D. BMI 31

B. tell the client that the medication seems to be appropriate. This peak level is within the expected reference range of 5 to 10 mcg/mL.

A nurse is reviewing the laboratory report for a client who is taking tobramycin and notes that the peak blood level is 9.3 mcg/mL. Which of the following actions should the nurse take? A. administer half of the prescribed dosage at the client's next scheduled dose. B. tell the client that the medication seems to be appropriate. C. advise the client to drink more water throughout the day. D. Ask if the client has been experiencing any peripheral neuropathy.

c. hepatic toxicity

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The nurse should recognize that these findings are potential indications of which of the following conditions? a. renal dysfunction b. myelotoxicity c. hepatic toxicity d. cardiac dysrhythmia

D. Continue to administer the medication as prescribed. This peak level is within the expected reference range of 5 to 10 mcg/mL.

A nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medication's peak level is 7 mcg/mL. Which of the following actions should the nurse take? A. administer half of the prescribed dosage at the client's next scheduled dose. B. tell the client that the medication seems to be effective. C. advise the client to drink more water throughout the day. D. Continue to administer the medication as prescribed.

B. chronic use of salicylates

A nurse is reviewing the medical record of a client who might have hearing loss. Which of the following data from the client's medical record should the nurse identify as a risk factor for hearing loss? A. frequent use of steroids B. chronic use of salicylates C. intermittent use of antacids D. habitual use of laxatives

A. swallow this medication whole

A nurse is teaching a client about a new prescription for extended-release oxycodone for pain management. Which of the following statements should the nurse include in the teaching? A. swallow this medication whole B. take this medication before meals and at bedtime C. constipation decreases with continued use. D. avoid taking other supplemental analgesics with this medication.

B. the first immunization for DTaP in the series is given at 2 mos.

A nurse is teaching the guardian of an infant about the diptheria, tetanus, and pertusis (DTaP) vaccine. Which of the following pieces of information should the nurse include in the teaching? A. Routine immunization for DTap consists of 3 injections B. the first immunization for DTaP in the series is given at 2 mos. C. DTaP immunization has been replaced with DTP D. this immunization is administered subcutaneously.

Quinolones/Ciprofloxacin

Treats anthrax Black box warning for tendon rupture Older adults risk for renal failure, increased risk of tendonitis/rupture with concurrent glucocorticoid therapy

Amphotericin B

anti-fungal. HIGHLY TOXIC - infusin rxns (fever and chills) - nephrotoxicity - hypokalemia - hepatoxicity - gynecomasita - C/I with aminoglycosides (just like PCN) Expected reactions: often pre-medicated serious interaction w/ alcohol i.e. fluconozale, nystatin

Zidovudine/Retrovir

hard on bone marrow susceptible to opportunistic infections may cause aplastic anemia

C. laryngeal edema this can indicate an allergic reaction, possibly anaphylaxis

nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly. Which of the following findings should the nurse plan to evaluate first? A. pain at the injection site B. prolonged motor dysfunction C. laryngeal edema D. temperature of 99.7 F

Empiric therapy

treatment before specific culture info has been obtained.

Prophylactic therapy

treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma