NRS-304 Pharmacology II Chapter 9
A female client is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the client that she will need to take the capsule A) on an empty stomach. B) immediately after she eats. C) with or without food. D) with food.
A) on an empty stomach.
A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following? A) primary and secondary B) first and second generation C) primary and tertiary D) antibacterial and antifungal
A) primary and secondary
A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction? A) "Take the medication with a full glass of water to prevent the mouth from becoming dry during therapy." B) "Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur." C) "Make sure to limit your protein intake, as increased protein delays absorption of the medication." D)"Avoid excessive caffeine intake because this could increase the side effects of the medication."
B) "Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."
A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day? A) 4 B) 8 C) 2 D) 6
B) 8
Prior to administration of fluoroquinolones, which laboratory test should be obtained? A) Renal function B) Culture and sensitivity C) Complete blood counts D)
B) Culture and sensitivity
The nurse is reviewing the medical record of a client taking rifampin and Lanoxin (digoxin). The nurse understands that these medications may interact in what way? A) Increased effectiveness of rifampin B) Decreased serum levels of digoxin C) Increased serum levels of digoxin D) Decreased effectiveness of rifampin
B) Decreased serum levels of digoxin
In which condition present in the client should macrolides be used with caution? A) Hypertension B) Diabetes mellitus C) Liver dysfunction D) Glaucoma
C) Liver dysfunction
While administering aminoglycosides to clients, the nurse must be aware of what toxicities that can result from their use? (Select all that apply.) A) Hepatotoxicity B) Neurotoxicity C) Nephrotoxicity D) Ototoxicity E) Cardiotoxicity
C) Nephrotoxicity D) Ototoxicity
A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse should first ensure that the client has not recently eaten what type of foods? A) Any high-fat foods B) Acidic foods C) Leafy green vegetables D) Dairy products
D) Dairy products
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic? A) Decreased elimination B) Increased elimination C) Increased absorption D) Decreased absorption
D) Decreased absorption
The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug? A) Headache and dizziness B) Superinfections and phlebitis C) Lethargy and paresthesias D) Diarrhea and nausea
D) Diarrhea and nausea
A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of: A) alcohol. B) nicotine. C) fats in her diet. D) oral contraceptives.
D) oral contraceptives.
A client has been prescribed oxacillin after the prescriber reviewed the results of culture and sensitivity testing. The nurse should explain what unique benefit of this medication? A) It is effective against many pathogens that have developed resistance to penicillins B) It can be administered by an intramuscular depot route, requiring only a one-time dose C) It has not appreciable adverse effects on the gastrointestinal system D) It does not require monitoring in an intensive care or critical care setting
A) It is effective against many pathogens that have developed resistance to penicillins
A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis. Which adverse effect will result in discontinuation of the medication? A) Jaundice B) Weight gain C) Fever D)
A) Jaundice
A client has been prescribed lomefloxacin (Maxaquin) for a respiratory infection. What must the nurse closely monitor for in this client? A) Photosensitivity B) Hemolytic anemia C) Signs of increased intracranial pressure D) Psychosis
A) Photosensitivity
The nurse is teaching a client about his prescription for a macrolide antibiotic. What should the nurse teach the client to report? A) Recurring symptoms of infection B) Missed doses C) Increased urinary output D) Lessening of symptoms of infection
A) Recurring symptoms of infection
The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician? A) Vaginal itching and discharge B) Swelling and itching of the throat C) Nausea D) Abdominal pain
A) Vaginal itching and discharge
A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply. A) increase in respiratory rate B) sudden increase in temperature C) pulse rate within usual parameters D) decrease in blood pressure E) regular urine output
A) increase in respiratory rate B) sudden increase in temperature D) decrease in blood pressure
The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug? A) Lethargy and paresthesias B) Diarrhea and nausea C) Superinfections and phlebitis D) Headache and dizziness
B) Diarrhea and nausea
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction? A) Fatigue B) Photosensitivity C) Muscle cramping D)Weakness
B) Photosensitivity
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply.The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client. Which interventions should the nurse provide to decrease the risk for nephrotoxicity and ototoxicity? Select all that apply. A) Obtain peak level before administering next dose of drug, and report level above 2 mcg/mL. B) Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated. C) Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. D) Draw the trough level 30 to 60 minutes after drug is administered, and report level above 10 to 12 mcg/mL. E) Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy.
B) Provide the client with 2 to 3 L of noncaffeinated oral fluids daily, unless contraindicated. C) Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy. E) Obtain baseline assessment of cranial nerve eight and periodic measurements during therapy.
After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms? A) fungicidal B) bactericidal C) fungistatic D) bacteriostatic
B) bactericidal
When describing the action of sulfonamides to a client, the nurse integrates understanding of the drug's action with effects exerted due to which mechanism? A) disruption of bacterial cell wall synthesis B) inhibition of the activity of folic acid in bacterial cell metabolism C) inhibition of bacterial RNA-dependent protein synthesis D) inhibition of DNA-gyrase
B) inhibition of the activity of folic acid in bacterial cell metabolism
A client has been treated with ofloxacin multiple times for an ear infection. The nurse instructs the client to report signs of local adverse reactions. What would this include? (Select all that apply.) A) difficulty breathing B) itching C) nausea D) ear irritation E) burning
B) itching D) ear irritation E) burning
What event triggers the development of a superinfection? A) bone marrow suppression triggered by antibiotic treatment B) proliferation of antibiotic-resistant microorganisms C)unforeseen interactions between the antibiotic and other prescribed medications D) complete establishment of the infection prior to initiation of antibiotic therapy
B) proliferation of antibiotic-resistant microorganisms
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's bestresponse? A) "The antibiotics are only effective against some types of bacteria." B) "The antibiotics are only effective in killing off some of the bacteria in the body." C) "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." D) "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control."
C) "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic? A) Increased absorption B) Decreased elimination C) Decreased absorption D) Increased elimination
C) Decreased absorption
Compared with penicillins, cephalosporins more appropriate for treating infection by what type of microorganism? A) Viruses B) Gram-positive bacteria C) Gram-negative bacteria D) Fungi
C) Gram-negative bacteria
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? A) It inhibits protein synthesis. B) It causes mutations. C) It inhibits cell wall synthesis. D) It lowers the pH of cellular contents.
C) It inhibits cell wall synthesis.
How does rifampin achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms? A) It is metabolized in the liver. B) It binds to acetylcholine. C) It inhibits synthesis of RNA. D) It causes phagocytosis.
C) It inhibits synthesis of RNA.
A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject? A) The fact that nonadherence will necessitate the use of antiretrovirals B) The need to match drug dosages carefully to signs and symptoms C) The need to consistently take the prescribed drugs in order to cure TB D) The fact that nonadherence to treatment exacerbates the risks of adverse effects
C) The need to consistently take the prescribed drugs in order to cure TB
A 49-year-old client is diagnosed with TB. The client has a history of alcoholism but has been sober for 3 months now. The client has been prescribed INH. What should the nurse ensure is obtained before initiating the therapy? A) baseline serum glucose levels B) baseline renal function values C) baseline liver function test values D) baseline bone mass determination
C) baseline liver function test values
What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? A) subcutaneous (SQ) B) intramuscular (IM) C) oral (PO) D) intravenous (IV)
C) oral (PO)
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamides will most likely be prescribed? A) demeclocycline B) tetracycline C) trimethoprim-sulfamethoxazole D) doxycycline
C) trimethoprim-sulfamethoxazole
A client is diagnosed with an infectious process that is sensitive to penicillin. The client is allergic to penicillin, so the health care provider orders a drug with a similar antibacterial spectrum. The nurse anticipates that the provider will order what antibiotic? A) Dicloxacillin B) Vancomycin C) Streptomycin D) Erythromycin
D) Erythromycin
A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely? A) Audiometric studies B) Urine culture C) Pulmonary function studies D) Liver function studies
D) Liver function studies
A client is started on sulfamethoxazole-trimethoprim for a urinary infection. What adverse effect should the nurse assess with this client? A) Bone marrow depression B) Congestive heart failure C) Liver toxicity D) Renal damage
D) Renal damage
When describing how tetracyclines treat infection, the nurse would incorporate which information into the description? A) inhibiting bacterial DNA gyrase B) depolarizing the bacterial cell wall C) inhibiting bacterial cell wall synthesis D) inhibiting bacterial protein synthesis
D) inhibiting bacterial protein synthesis
The nurse is justified in suspecting that a client who recently completed a course of ceftaroline may have been treated for what health problem? A) encephalitis B) endocarditis C) chlamydial infection D) methicillin-resistant Staphylococcus aureus (MRSA) infection
D) methicillin-resistant Staphylococcus aureus (MRSA) infection