Pharm 3 test urinary and hiv
Which side effect of amitriptyline HCl (Elavil) should the nurse inform a patient about to ensure safety?
Orthostatic hypotension Reason: Amitriptyline HCl (Elavil) is a tricyclic antidepressant used in the treatment of depression. Orthostatic hypotension is a common side effect of the medication which occurs because of a disruption in autonomic nervous system activity. Increased appetite and postural hypotension are the common side effects of amoxapine (Asendin), which is an atypical antidepressant. Imipramine HCl (Tofranil) is used in the treatment of enuresis and depressive disorders; therefore, an increased dose or increased intake frequency of the medication would delay micturition.
Which nonnucleoside reverse transcriptase inhibitor (NNRTI) should be taken on an empty stomach? 1.Efavirenz 2.Etravirine 3.Rilpivirine 4.Delavirdine
1.Efavirenz Efavirenz should be taken on an empty stomach. Etravirine and rilpivirine should be taken with food to enhance absorption. Delavirdine can be taken without regard to food.
he nurse is assessing a patient with human immunodeficiency virus (HIV) infection. The patient has been prescribed efavirenz (Sustiva). Which instruction given by the nurse prevents the food-medication interaction in the patient? Select all that apply. 1."Avoid bread." 2."Avoid cheese." 3."Avoid carrots." 4."Avoid legumes." 5."Avoid fried food.
Avoid cheese and fried food The absorption of efavirenz (Sustiva) increases when fatty meals are consumed, because fat increases the concentration of the medication in the blood and leads to adverse effects; therefore the nurse should suggest that the patient avoid eating fatty foods, such as meat and cheese. Bread, legumes, and carrots are nutritious and do not interact with this medication, so they should not be avoided.
Which intervention is a priority for a patient who is taking HAART? 1 Increase fluids to 2400 mL/day 2 Teach hand washing to the patient 3 Teach adherence to the medication regimen 4 Refer the patient for preventive care measures
Teach adherence to the medication regimen Although all of these interventions should be carried out, teaching adherence to the regimen is the highest priority. If the patient does not adhere to therapy, the medications will not work. This would impact patient safety, always the highest priority.
A patient with human immunodeficiency virus (HIV) infection has a chronic hepatitis B infection. Which medication should a nurse expect to be the most beneficial for the patient?
Tenofovir (Viread) is a nucleotide reverse transcriptase inhibitor (NtRTI), which hinders the synthesis of reverse transcriptase enzyme and destroys the virus that causes chronic hepatitis B and human immunodeficiency virus (HIV) infection. The nurse should expect that tenofovir (Viread) would be the most beneficial medication for the patient because it alleviates the symptoms of chronic hepatitis B and human immunodeficiency virus (HIV) infection. Rifampin (Rifadin), phenytoin (Dilantin), and carbamazepine (Carbatrol) do not have any antiviral properties and therefore are not beneficial medications for the patient. Rifampin (Rifadin) is an antitubercular medication prescribed for tuberculosis. Phenytoin (Dilantin) and carbamazepine (Carbatrol) are anticonvulsant medications commonly prescribed for seizures.
After an appointment, the patient approaches the nurse and excitedly reports that he or she is no longer taking antiretroviral medication because the "HIV is gone." How should the nurse respond? Incorrect1 The nurse should remind the patient that there is currently no cure for HIV and that the virus is not actually gone. 2 The nurse should give the patient information on diet and nutritional supplements that will support a healthy immune system. 3 The nurse should offer the patient resources on how to decrease changes of reinfection with HIV by avoiding high-risk behaviors. Correct4 The nurse should educate the patient on the importance of continuing the medication in order to maintain the undetectable viral load
The nurse should educate the patient on the importance of continuing the medication in order to maintain the undetectable viral load. Failure to adhere to antiretroviral therapy can lead to drug resistance. While it is correct that there is no cure for HIV, only offering this information does not directly address the importance of continuing the medication. Offering information on diet and nutritional supplements does not address the serious problem of the patient discontinuing the medication. Offering resources on how to avoid reinfection is incorrect, as the patient has not been cured.
The patient has been ordered treatment with darifenacin hydrobromide (Enablex) and is also undergoing treatment for glaucoma. What is the nurse's highest priority action? 1.Document the information in the chart. 2.Notify the health care provider about this information. 3.Notify the pharmacist so that the dose can be adjusted. 4. instruct the patient to monitor him- or herself for vision changes.
The nurse should notify the health care provider about this information because glaucoma is a contraindication for usage of this medication. The nurse does not have to notify the pharmacist; to suggest dosage changes the nurse must talk to the health care provider.
The nurse is caring for a patient who is undergoing treatment for bipolar disorder. The patient's caregiver informs the nurse that the patient has become extremely forgetful and is confused much of the time. Which reason does the nurse suspect for this behavior in the patient?
The patient is taking lithium citrate (Eskalith). Reason: When a patient who is diagnosed with bipolar disorder is administered lithium citrate (Eskalith), it may cause memory loss and confusion, because the medication can inhibit cognitive processing. Vilazodone (Viibryd) causes nausea and vomiting as side effects. Paroxetine HCl (Paxil) may cause sexual dysfunction in men and women. Mirtazapine (Remeron) administration leads to an increase in the levels of both norepinephrine and serotonin in the patient.
What are the side effects of tolterodine tartrate (Detrol)? Select all that apply. 1 Dyspnea 2 Blurred vision 3 Urinary incontinence 4 Brown-colored urine 5 Dizziness and confusion
Tolterodine tartrate (Detrol) is an anticholinergic drug used to treat overactive bladder disorders. It alters intraocular pressure, which may result in blurred vision. The drug stimulates the detrusor muscle, which may cause urinary incontinence. Dizziness and confusion are caused by the anticholinergic properties of the drug. Tolterodine (Detrol) causes neither dyspnea nor brown-colored urine. Dyspnea and brown-colored urine are side effects of nitrofurantoin (Macrodantin).
A patient with otitis media has developed a urinary tract infection. Which prescription does the nurse expect for this patient?
Trimethoprim-sulfamethoxazole (Bactrim) is an antibiotic that is widely used for the treatment of otitis media and urinary tract infections. Therefore, this is the drug of choice for a patient with both otitis media and urinary tract infection. Although ciprofloxacin (Cipro), nalidixic acid (NegGram), and methenamine hippurate (Hiprex) are antibiotics, these drugs are not known to be effective for the treatment of otitis media. These antibiotics are more appropriate for treating urinary tract infections.
The nurse is caring for a patient who is on antibiotic therapy for cardiac surgical prophylaxis. The nurse observes red blotching of the face, neck, and chest of the patient. Which medication is associated with this side effect of "red man" syndrome? 1.Lincomycin (Lincocin) 2.Clindamycin (Cleocin) 3.Telithromycin (Ketek) 4.Vancomycin (Vancocin)
Vancomycin (Vancocin) Reason: Vancomycin (Vancocin) is used in cardiac surgical prophylaxis when the patient is allergic to penicillin. Red blotching of the face, neck, and chest refers to "red man" syndrome or "red neck" syndrome. This condition occurs in the client due to rapid intravenous administration of vancomycin (Vancocin). Lincomycin (Lincocin) and clindamycin (Cleocin) may cause anaphylactic shock. Telithromycin (Ketek) may lead to an exacerbation of myasthenia gravis.
A patient with a history of gout is diagnosed with cystitis and is prescribed nitrofurantoin (Macrodantin). Which measure does the nurse take while administering this medication to the patient? 1 Administers the medication with milk 2 Administers the medication immediately after meals 3 Administers the medication 30 minutes before meals 4 Administers the medication in combination with probenecid (Benemid)
administer medication immediately after meals Nitrofurantoin (Macrodantin) is a urinary anti-infective drug. It should be taken immediately after meals to prevent gastrointestinal side effects. Nitrofurantoin (Macrodantin) requires a urinary pH of 5.5 for effective action. Milk makes the urine alkaline, and thus the medication should not be administered with milk. This drug may cause gastric distress if taken on an empty stomach; therefore, nitrofurantoin (Macrodantin) is not administered before meals. Renal clearance of nitrofurantoin (Macrodantin) is decreased with concomitant administration of probenecid (Benemid). This may lead to toxic effects of nitrofurantoin (Macrodantin), and thus should be avoided.
A patient suspected of having an acute urinary tract infection is admitted to the hospital. What would be the first nursing action for this patient? 1 Administer oral antibiotics. 2 Assess the patient's symptoms. 3 Administer intravenous antibiotics. 4 Take the patient's urine sample for analysis
assess the patients sx The first priority is to assess the patient's symptoms related to urinary tract infection. The nurse should also assess the patient for signs and symptoms of urinary incontinence, pain during urination, and frequency and urgency of urination. The next step is to monitor urine culture and sensitivity results to find the causative organism of the infection. Based on the culture results, specific antibiotics can be administered to the patient as prescribed by the primary health care provider. If the test results reveal that the patient has a severe infection, then specific antibiotics would be given intravenously to ensure an effective recovery.
The nurse is caring for a patient with human immunodeficiency virus (HIV) infection who has been prescribed raltegravir (Isentress). Which nursing intervention helps provide safe and effective care to the patient? 1 Administering the medication once a day 2 Reducing high-fat meals from the patient's diet 3 Administering the medication one hour before meals 4 Encouraging the patient to report side effects promptly
encourage the patient ot report side effects promptly Raltegravir (Isentress) is an integrase inhibitor, which interferes with the integrase enzyme and prevents the multiplication of human immunodeficiency virus (HIV). Headache, diarrhea, nausea, and pyrexia are the common side effects of raltegravir; therefore to provide safe and effective care to the patient, the nurse should instruct the patient to report any side effects promptly. In addition, a rash could indicate the presence of Stevens-Johnson syndrome. In order to maintain adequate therapeutic levels of medication in the blood, the nurse should administer raltegravir twice a day. The absorption of raltegravir increases with the intake of high-fat meals, so the nurse should not avoid providing high-fat meals to the patient. Raltegravir does cause gastric irritation, so the nurse administers the medication with meals.
The primary health care provider has prescribed flavoxate HCl (Urispas) to a patient with urinary incontinence. Which condition should the nurse assess before administering the medication to the patient?
narrow angle glaucoma Flavoxate HCl (Urispas) is an antispasmodic that is used for the treatment of urinary incontinence. Flavoxate HCl (Urispas) is contraindicated in patients with narrow-angle glaucoma, so the nurse should ask if the patient has this condition. Flavoxate HCl (Urispas) does not cause any allergic reactions. Allergy is a common side effect of antibiotics. Dryness of the mouth is due to the anticholinergic action of the drug. This is a common side effect associated with the drug, and can be resolved by adequate water intake and by sucking on hard sugar-free candies. Electrolyte imbalance need not be assessed in this patient, because diarrhea is not a side effect associated with Flavoxate HCl (Urispas).
For which diseases do humans use vaccines to obtain artificial active immunity? Select all that apply. 1 HIV 2 Tetanus 3 Measles 4 Influenza 5 Diphtheria 6 Distemper
tetanus, measles, influenza, Diphtheria
The nurse is caring for a patient with overactive bladder disorder and urinary tract infection. The patient has been prescribed tolterodine tartrate (Detrol), phenazopyridine HCl (Pyridium), nitrofurantoin (Macrodantin), and ciprofloxacin (Cipro). Upon reviewing the patient's case history, the nurse finds that the patient has narrow-angle glaucoma. Which drug does the nurse expect the primary health care provider to replace in the patient's drug regimen? 1 Ciprofloxacin (Cipro) 2 Tolterodine tartrate (Detrol) 3 Nitrofurantoin (Macrodantin) 4 Phenazopyridine HCl (Pyridium)
tolterodine tartrate detrol
A patient who is newly diagnosed with HIV and starting antiretroviral therapy (ART) confides in the nurse that she wishes to have a baby. How does the nurse respond? 1 "You should really think about whether the risk of infecting your child is worth it." 2 "It's good you told me, but it's rare for HIV to be transmitted from mother to child." 3 "I'm glad you told me. We will need to talk about risks and benefits of the ART options." 4 "If you keep your viral load down, you will be fine. Just keep us informed of your decision.
"I'm glad you told me. We will need to talk about risks and benefits of the ART options." Because of the risk of transmitting HIV to the fetus, the ART regimen may be different for pregnant patients. The nurse's response is supportive of the patient and lets the patient know that there will be decisions that will have to be made based on a risk assessment. The nurse should not tell the patient to think about if the risk of transmission is worth it, as this is an insensitive and unproductive response. The nurse should not falsely reassure the patient that risk of transmission is rare. Telling the patient that she "will be fine" if she keeps her viral load down is inaccurate. The risk of transmission is lower when the viral load is lower, but the nurse cannot accurately offer this reassurance to the patient.
A patient taking antiretroviral therapy (ART) for HIV. When talking with the nurse, the patient admits to impromptu overnights at a friend's house about once a week. "I don't carry my medications with me, and I never know when I'm staying there, so I've missed a few doses." How does the nurse respond?
"Let's discuss strategies for adherence. For example, you might think about carrying a small drug organizer." In evaluating a patient's adherence to ART, the nurse should help the patient develop strategies. The nurse might suggest carrying a drug organizer or storing some doses at the friend's house. It is important to help the patient determine strategies that work for him or her as an individual. Telling the patient that it is bad to miss doses and that he or she needs to try to remember to take them does not support improved adherence because it does not invite solutions for the patient's problem. Telling the patient that he or she needs to be more responsible is disrespectful of the patient and does not help the patient address the reason for missed doses. The patient should not take a double dose to make up for missed doses. The goal for ART is 95% adherence to avoid HIV replication and drug resistance.
The nursing instructor has taught the student nurses about methenamine (Hiprex). Which statements by the students indicate effective teaching? Select all that apply.
"Methenamine (Hiprex) exerts bactericidal action." "Methenamine (Hiprex) needs acidic urine for action." Methenamine (Hiprex) kills infection-causing organisms. Therefore, it exerts bactericidal action. Methenamine forms ammonia and formaldehyde in acidic urine. These metabolites exert antibiotic action. Therefore, the urine pH should be acidic for the drug to act effectively. Methenamine is not a pain reliever. Methenamine irritates the bladder rather than relaxing it. Methenamine, when taken along with sulfonamides, causes crystalluria. Therefore, these drugs should not be taken together.
A patient on antibiotic therapy needs trough levels drawn. Which is the most appropriate time for the nurse to draw the trough level? 1. 10 minutes before administration of the intravenous antibiotic 2.30 minutes after beginning administration of the intravenous antibiotic 3.60 minutes after completion of the intravenous antibiotic infusion 4. 90 minutes after the intravenous antibiotic is scheduled to be administered
1. 10 minutes before administration of the intravenous antibiotic reason: Trough levels are drawn just before infusion. Peak serum drug levels should be drawn 30 to 60 minutes after the medication is infused. The nurse should document the time drug administration is started and completed and the exact time a peak and/or trough level is drawn.
Which actions are associated with safe administration of tricyclic antidepressants (TCAs)? Select all that apply. 1. Administer at night to reduce the risk of sedation and risk for falls. 2. Taper dose to reduce withdrawal symptoms when discontinuing. 3.Avoid foods containing tyramine such as aged cheese and nuts. 4. Avoid central nervous system (CNS) stimulants or sympathomimetics. 5. Avoid sausage, chocolate, bananas, raisins, and yogurt
1. Administer at night to reduce the risk of sedation and risk for falls. 2. Taper dose to reduce withdrawal symptoms when discontinuing. Reason: TCAs are administered at night to minimize problems caused by their sedative action. When discontinuing a TCA, dosage is reduced gradually to minimize withdrawal symptoms such as nausea, vomiting, anxiety, and akathisia. Foods containing tyramine can interact with monoamine oxidase inhibitors (MAOIs), not TCAs, causing a hypertensive crisis. Additionally, MAOIs can interact with CNS stimulants and sympathomimetics causing a hypertensive crisis.
A registered nurse is evaluating a student nurse who is performing routine assessments of a patient with signs of bipolar affective disorder. The patient belongs to a different culture and is having difficulty communicating with the nurse. Which action by the registered nurse is appropriate to ensure the patient's well-being? 1. Obtaining an interpreter to complete the assessment 2.Asking family members for help understanding the patient's condition 3.Emphasizing the importance of follow-up visits to the primary health care provider 4.Requesting that the primary health care provider perform the necessary assessments
1. Obtaining an interpreter to complete the assessment Reason: Because the patient speaks a different language and is having trouble communicating, the nurse should obtain an interpreter to assist in performing thorough assessments. Relying on family members is not sufficient, because they may not provide accurate or complete information. The nurse should educate the patient regarding the importance of follow-up visits to the primary health care provider. However, it is essential to understand the patient's condition first. The primary health care provider may be consulted, but an interpreter might be necessary to communicate with the patient.
The nurse is assessing a patient with acquired immunodeficiency syndrome (AIDS) who is on atazanavir (Reyataz) therapy. After reviewing the laboratory reports, the nurse suspects that the patient is experiencing an adverse effect. Which findings in the patient's laboratory reports support the nurse's assumption? 1.Increased glucose levels 2.Decreased bilirubin levels 3.Increased thyroxine levels 4.Increased lipoprotein levels
1.Increased glucose levels Hyperglycemia and diabetes mellitus are common adverse effects of atazanavir (Reyataz). An increase in glucose levels indicates that the patient has hyperglycemia and is at risk for diabetes mellitus; therefore the nurse should suspect that an increase in the glucose levels likely suggests that the patient is experiencing an adverse effect of the medication. Increased lipoprotein levels indicate that patient has hyperlipidemia. Hyperlipidemia is not the adverse effect of atazanavir because it does not alter the lipid levels. Because atazanavir (Reyataz) increases bilirubin levels and causes jaundice, any decrease in bilirubin levels would not indicate that the patient has had an adverse effect from the medication. Atazanavir (Reyataz) does not cause hyperthyroidism.
What is a side effect associated with phenazopyridine HCl (Pyridium)? 1.Drowsiness 2.Reddish-orange urine 3.Skin rash on exposure to sunlight 4.Pain and burning sensation of the urethra
2. Reddish orange urine Phenazopyridine HCl (Pyridium) is an azo dye that works as a urinary analgesic to relieve pain and burning on urination. It is excreted in the urine, making the urine reddish-orange in color. Phenazopyridine HCl does not have a sedative effect; therefore, it does not cause drowsiness. Phenazopyridine HCl, being an analgesic, does not cause pain or a burning sensation of the urinary tract. Unlike quinolone drugs, phenazopyridine HCl does not cause any photosensitive reactions.
Which antiretroviral medication is suitable for administration through the subcutaneous route? 1.Tipranavir (Aptivus) 2.Enfuvirtide (Fuzeon) 3.Maraviroc (Selzentry) 4.Raltegravir (Isentress)
2.Enfuvirtide (Fuzeon) Enfuvirtide (Fuzeon) is the only antiretroviral medication that is available to be administered by the subcutaneous route. Tipranavir (Aptivus), maraviroc (Selzentry), and raltegravir (Isentress) are available only in oral form and cannot be administered subcutaneously.
A student nurse is giving examples of different types of depression. Which scenario is an example of reactive depression? 1.The patient has constant mood swings. 2.The patient is sad after the death of a parent. 3.The patient has lost all interest in going to work. 4.The patient shows no interest toward taking care of family
2.The patient is sad after the death of a parent. reason: Depression triggered by the loss of a loved one is an example of reactive depression. Mood swings may indicate bipolar affective disorder. Loss of interest in work and home are examples of major depression.
The nurse is caring for a patient who has human immunodeficiency virus (HIV) infection. While assessing the patient, the nurse observes dark blue lesions on the patient's skin. What should the nurse infer from this finding in the patient? 1.The patient has lymphoma. 2.The patient has leishmaniasis. 3.The patient has Kaposi sarcoma. 4.The patient has squamous cell carcinoma.
3.The patient has Kaposi sarcoma. Dark blue lesions on the skin are associated with the medical condition known as Kaposi sarcoma; therefore the nurse should infer that the patient has this condition. The occurrence of skin diseases is very common in a patient who has human immunodeficiency virus (HIV) infection because of decreased immunity. Lymphoma refers to enlarged lymph nodes and indicates lymphocytes tumors in a patient. Leishmaniasis is a protozoan disease that causes ulcers on the skin. Squamous cell carcinoma manifests as red nodules on the skin of a patient.
While assessing a patient with fever, the nurse finds that the patient has symptoms of lymphadenopathy and pharyngitis. The patient's medical history shows that the patient underwent a blood transfusion 12 weeks ago. What does the nurse infer from this finding? 1.The patient may have wasting syndrome. 2.The patient may have transient, flulike illness. 3.The patient may have a primary HIV infection. 4. the patient may have Stevens-Johnson syndrome.
3.The patient may have a primary HIV infection. A patient who has recently been infected with human immunodeficiency virus (HIV) would have symptoms such as fever, fatigue, headache, lymphadenopathy, and pharyngitis. The patient experiences these symptoms 2 to 12 weeks after exposure to HIV. Because of the patient's history of a blood transfusion 12 weeks prior coupled with the patient's current symptoms of fever, lymphadenopathy, and pharyngitis, the nurse should infer that the patient has primary HIV infection. Transient flulike illness is manifested by fever, fatigue, pharyngitis, and headache; therefore the nurse should confirm the presence of HIV infection. Wasting syndrome results in both loss of weight and appetite and occurs when the CD4 cell count is less than 100 cells/mL. Stevens-Johnson syndrome is a major side effect of antiretroviral therapy, which presents with fever and disruption of integument.
Which class of drugs is commonly prescribed with antibiotics for urinary tract infections? 1.Antimuscarinic 2.Urinary stimulants 3.Urinary analgesics 4.Urinary antispasmodics
3.Urinary analgesics Urinary tract infections are characterized by pain and a burning sensation during urination. Urinary analgesics relieve this pain, which is caused by the infection. The antibiotic kills the microorganisms responsible for the infection. Therefore, urinary analgesics are generally administered with antibiotics to treat urinary tract infections. Antimuscarinic agents are used to control overactive bladder. Urinary stimulants are used to treat bladder dysfunction. Urinary antispasmodics are used to treat urinary incontinence.
Which condition is referred to as pyelonephritis? 1.Inflammation of the vagina 2.Inflammation of the urethra 3.Inflammation of the bladder 4.Inflammation of the kidney(s)
4.Inflammation of the kidney(s) Pyelonephritis is inflammation of the kidney(s). Vaginitis is inflammation of the vagina. Urethritis is inflammation of the urethra. Cystitis is inflammation of the bladder.
What does the nurse know is true of dimethyl sulfoxide used to treat cystitis? 1.It may cause contact lens discoloration. 2.It may cause a headache, dry mouth, and nausea. 3.The patient should take the medication in the morning. 4.It may cause bladder discomfort and spasms
4.It may cause bladder discomfort and spasms Dimethyl sulfoxide is a urinary analgesic that is administered for cystitis and can cause bladder discomfort and spasms. The dye in phenazopyridine can cause contact lens discoloration. A headache, dry mouth, and nausea are some of the side effects of urinary antispasmodics. Dimethyl sulfoxide does not have to be administered in the morning.Test- Taking Tip: Start by reading each of the answer options carefully. Usually at least one of them will be clearly wrong. Eliminate this one from consideration. Now you have reduced the number of response choices by one and improved the odds. Continue to analyze the options. If you can eliminate one more choice in a four-option question, you have reduced the odds to 50/50. While you are eliminating the wrong choices, recall often occurs. One of the options may serve as a trigger that causes you to remember what a few seconds ago had seemed completely forgotten.
The primary health care provider has prescribed trimethoprim-sulfamethoxazole (Bactrim) for a patient. What does the nurse infer about the reason for prescribing this drug to the patient? 1.The patient has urinary incontinence. 2.The patient has pain during urination. 3.The patient has overactive bladder disorder. 4.The patient has chronic urinary tract infection.
4.The patient has chronic urinary tract infection. Trimethoprim-sulfamethoxazole (Bactrim) is a combination of trimethoprim and sulfonamide antibiotics and is used to treat chronic urinary tract infections. Urinary antispasmodics, such as oxybutynin (Ditropan) and flavoxate (Urispas), are used to treat urinary incontinence and urgency. Phenazopyridine hydrochloride (Pyridium) is a urinary analgesic that is used for relieving pain and burning during urination. Antimuscarinic drugs, such as tolterodine tartrate (Detrol), are used for the treatment of overactive bladder disorder. Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.
The nurse is caring for a patient who is taking oxybutynin (Ditropan). The nurse recognizes that the patient is most likely experiencing which condition? A. Overactive bladder B. Pain upon urination C. Difficulty urinating D. Nighttime urination
A. Overactive bladder Rationale: Oxybutynin (Ditropan) is used to treat overactive bladder. It does not treat pain, difficulty urinating, or nighttime urination.
The nursing instructor is teaching student nurses about acute cystitis. Which statement(s) by the student nurse indicate(s) effective learning? Select all that apply.
Acute cystitis is an inflammatory condition of the bladder caused by bacteria. The urethra is short in females, providing easy access for bacteria, which can result in acute cystitis. Various gram-positive and gram-negative bacteria cause acute cystitis; Escherichia coli is most common among them. Acute cystitis is a localized infection characterized by pain upon urination. It is a lower urinary tract infection, not an upper urinary tract infection. High fever and chills are symptoms of acute pyelonephritis, not acute cystitis.
A patient who is on ampicillin (Principen) therapy developed a mild rash and hives after 2 days. Which drug would the primary health care provider prescribe to treat this condition?
Antihistamines Reason: Rashes and hives indicate that the patient has had a mild allergic reaction. Mild allergic reactions are treated with antihistamines. Nystatin is used for the treatment of fungal infection in the mouth, which is a superinfection, occurring with the use of broad-spectrum antibiotics. Epinephrine and bronchodilators are used for the treatment of anaphylactic reactions such as vascular collapse, bronchospasm, or shortness of breath.
A 22-year-old female patient is prescribed amoxicillin. Which is the most important intervention for this patient?
Assess if the patient is on oral contraceptives. Reason: This medication may decrease the effectiveness of oral contraceptives. The nurse needs to assess whether or not the patient is on oral contraceptives and whether or not the patient is sexually active. The other interventions are not priorities. Long-term use of antibiotics can cause blood dyscrasias, but a baseline assessment is not indicated.
Which therapeutic response does the nurse expect to find in the patient with a neurogenic bladder who is being treated with bethanechol chloride?
Bethanechol chloride is a urinary stimulant used to stimulate micturition. Urinary antiseptics and antiinfectives prevent bacterial growth and infection in the kidneys and bladder. Antimuscarinics and anticholinergics are used to treat incontinence. Urinary antispasmodics are prescribed to decrease bladder spasms.
The nurse notes lithium (Eskalith) on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with?
Bipolar disorder Lithium is an antimanic drug used to treat manic episodes associated with bipolar disorder.
The nurse is caring for a patient who has been diagnosed with seasonal affective disorder. Which medication should the nurse expect a primary health care provider to prescribe to the patient? 1. Amoxapine (Asendin) 2. Trazodone HCl (Desyrel) 3. Maprotiline HCl (Ludiomil) 4. Bupropion HCl (Wellbutrin)
Bupropion HCl (wellbutrin) Reason: Seasonal affective disorder is a psychotic disorder in which the patient experiences symptoms of depression only in a particular season. Bupropion HCl (Wellbutrin) treats seasonal affective disorder by inhibiting the reuptake of norepinephrine and dopamine by the uptake pumps into presynaptic neurons, thus increasing the concentration of these neurotransmitters that are essential in the regulation of motivation and mood. Amoxapine (Asendin) is used to treat patients diagnosed with depression along with anxiety. Trazodone HCl (Desyrel) and maprotiline HCl (Ludiomil) are used to treat depression.
A patient is receiving highly active antiretroviral therapy (HAART). Which outcome indicates a therapeutic response to the medication therapy? 1 CD4 T-cell increase 2 Decreased T-cell reactivity 3 Elevation of HIV RNA levels 4 Increased immune system functioning
CD4 T cell increase The expected outcome of HAART is a suppression of HIV RNA levels and CD4 T-cell increases in patients. Elevated HIV RNA levels, decreased T-cell reactivity, and increased immune system functioning are not indicative of a therapeutic response to medication therapy.
Which are common side effects of antimuscarinic/anticholinergic medications? Select all that apply. 1 Bradycardia 2 Dry mouth 3 Dizziness 4 Diarrhea 5 Blurred vision
Common side effects of antimuscarinic/anticholinergic medications include dry mouth, dizziness, and blurred vision. The symptoms are a result of the inhibition of the parasympathetic nerve impulses. Antimuscarinic/anticholinergic medications cause tachycardia and constipation, not bradycardia and diarrhea.
While assessing a patient with human immunodeficiency virus (HIV) infection, the nurse finds that the patient has blurred vision, dry cough, chest pain, dementia, and fever. What should the nurse infer from these findings?
Cytomegalovirus infection is a virus that infects the entire body and most commonly causes blurred vision, but also has pneumonia-like symptoms, including dry cough, chest pain, dementia, and fever. Kaposi sarcoma is associated with the presence of dark blue lesions on various parts of the body. Cryptosporidiosis is a protozoal infection caused by Cryptosporidium, which presents with lower abdominal cramping; nonbloody, watery diarrhea; nausea; and vomiting. The symptoms of toxoplasmosis encephalitis are headache, confusion, motor weakness, and fever.
Which medication is useful for treating urinary spasms?
Darifenacin hydrobromide (Enablex) is the drug of choice for the treatment of urinary tract spasms, because it acts by blocking muscarinic receptors. Ciprofloxacin (Cipro) is a urinary antiseptic, which is used to treat urinary tract infections. Bethanechol Cl (Urecholine) is a urinary stimulant, which is used for the treatment of overactive bladder. Phenazopyridine HCl (Pyridium) is a urinary analgesic, and is used to treat pain experienced during micturition.
The nurse is caring for a patient with a urinary tract infection who is prescribed a 3-day course of nitrofurantoin (Macrodantin). What finding in the patient may indicate a risk for drug toxicity? 1 Decreased urinary output 2 Decreased red blood cell count 3 Decreased blood creatinine level 4 Decreased blood urea nitrogen level
Decreased urinary output Nitrofurantoin (Macrodantin) is a urinary anti-infective medication. Nitrofurantoin (Macrodantin) is excreted in the urine. Therefore, a decrease in urinary output indicates a decreased drug clearance, resulting in accumulation of the drug in the body.This can lead to drug toxicity. A decreased red blood cell count indicates anemia, which would not cause drug toxicity. Increased blood creatinine and blood urea nitrogen levels indicate impaired renal function, which may increase the risk of drug toxicity. However, decreased levels do not indicate toxicity.
The nurse is caring for a patient with human immunodeficiency virus (HIV) infection who is on didanosine (Videx) therapy. Which medication administration times would promote optimal absorption of the medication? Select all that apply.
Didanosine (Videx) should be taken 120 minutes after meals or 30 minutes before meals because this medication has a low absorption rate when food is present in the stomach. This intervention also helps ensure the maximum therapeutic effect of the medication. Administering the medication 30 or 60 minutes after meals may not result in effective absorption of the medication because of the presence of food in the stomach. Administering the medication 10 minutes before meals is not suitable because the medication may interact with food, resulting in delayed absorption.
Which symptoms are associated with acute cystitis? Select all that apply. 1.Dysuria 2.Nocturia 3.Urinary frequency 4.Urinary retention 5.Urinary urgency
Dysuria, Nocturia, Frequency, urgency Symptoms associated with acute cystitis include dysuria, nocturia, urinary frequency, and urinary urgency. Urinary retention can be caused by a variety of medications or medical conditions, but it is not a symptom of acute cystitis.
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase inhibitor (MAOI)? 1. Participating in a bowling league 2. Sunbathing at the pool 3. Eating aged cheese 4. Smoking a low-nicotine cigarette
Eating aged cheese Reason: Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in patients taking MAOIs.
The nurse observes that a patient who has human immunodeficiency virus (HIV) infection shows disinterest in the teaching sessions. While communicating with the nurse, the patient says, "I've been getting horrible nightmares and feeling dizzy lately." Which medication does the nurse expect to be the cause of these symptoms in the patient?
Efavirenz (Stocrin) efavirenz may cross the blood-brain barrier and have adverse effects on the central nervous system. These effects may include lack of concentration, nightmares, and dizziness; therefore a nurse should expect this medication to be the cause of the patient's symptoms. The administration of etravirine (Intelence) may cause side effects such as peripheral neuropathy and Stevens-Johnson syndrome. The administration of nevirapine (Viramune) causes side effects that include severe rashes and hepatotoxicity. The possible side effects of delavirdine (Rescriptor) include skin rashes and headache.
Which organism causes cystitis 1.Escherichia coli 2.Aspergillus niger 3.Staphylococcus aureus 4.Streptococcus pneumonia
Escherichia colican causes acute cystitis. Aspergillus niger causes ear infections. Staphylococcus aureus and Streptococcus pneumonia cause respiratory tract infections.
A patient is taking zidovudine (AZT). According to the nurse, which symptom is not likely to be the result of an adverse drug effect?
Excessive sleepiness is not a direct side effect of zidovudine (AZT). Some of the serious adverse effects of zidovudine (AZT) include bone marrow suppression, hepatotoxicity, lactic acidosis, and hypersensitivity reactions. Because of the bone marrow suppression, the patient is susceptible to joint pain. Lactic acidosis can lead to nausea and weakness.
The primary health care provider has prescribed fosfomycin tromethamine (Monurol) to a patient for the treatment of a urinary tract infection. What would the nurse anticipate as the reason for prescribing this drug? The patient is pregnant. 2 The patient is under 10 years of age. 3 The patient has requested a 3-day course drug. Correct4 The patient is at risk for nonadherence to a drug regimen
Fosfomycin tromethamine (Monurol) is a single-dose treatment that is effective for urinary tract infections. Because this drug is available as a single dose, the drug would be most suitable for a patient who is at risk for nonadherence to a drug regimen. Fosfomycin tromethamine (Monurol) is a pregnancy Category B drug. Therefore, the drug may be safely administered in pregnant women. However, there are other antibiotics that are more effective and equally safe for administration during pregnancy. Fosfomycin tromethamine (Monurol) is not safe for administration in children. It is only available in an adult dose. Fosfomycin tromethamine (Monurol) is a single-dose treatment. Nitrofurantoin (Macrodantin) and fluoroquinolones are prescribed for a 3-day course regimen.
Which side effect reported by the patient who is on an antibiotic therapy would be of high priority and require prompt notification to the primary health care provider? 1. "I have difficulty in breathing." 2. "I have trouble with digestion." 3. "I have giddiness upon standing." 4. "I have pain in the upper abdomen."
I have difficulty in breathing Reason: Respiratory distress is a serious side effect of antibiotic therapy due to anaphylaxis. It requires immediate intervention and prompt notification to the primary health care provider. Indigestion may also occur due to antibiotic therapy, but it may not require immediate intervention. Giddiness may also occur with antibiotic therapy, but it is not as important as that of an anaphylactic reaction. Abdominal pain can be treated based on its severity, but it is not of high priority and may not require immediate intervention.
A patient suffering from chronic anxiety is prescribed tranylcypromine sulfate (Parnate). On assessment, the nurse finds that the patient often uses the herb St. John's wort. What course of action should the nurse take to prevent fatal complications?
Instruct the patient to stop using St. John's wort. Using the herb St. John's wort along with monoamine oxidase inhibiters (MAOIs) such as tranylcypromine sulfate (Parnate) might lead to a hypertensive crisis. The nurse should instruct the patient to stop using the herb. The nurse should not stop administering the medication unless indicated by the primary health care provider. Tyramine-rich food items and sympathomimetic drugs can also cause a hypertensive crisis when taken along with MAOIs.
A primary health care provider prescribes methenamine (Hiprex) to a patient with a urinary tract infection. What advice does the nurse give the patient about taking this drug?
Methenamine (Hiprex) is a commonly prescribed drug for the treatment of urinary tract infections. Methenamine (Hiprex) acts effectively only when the urine pH is less than 5.5. Milk alkalizes urine, which would decrease the effectiveness of the drug. Therefore, a patient taking methenamine (Hiprex) is advised to avoid milk. The patient is advised to take methenamine (Hiprex) on a full stomach to decrease gastrointestinal side effects. Plums acidify urine and increase the bactericidal effect of the drug; therefore, the patient should eat plenty of plums while taking this medication. Methenamine (Hiprex) does not stain teeth; therefore, the patient need not rinse his or her mouth after taking this drug.
Which antiprotozoal drug is effective for the treatment of trichomoniasis? 1. Iodoquinol (Diquinol) 2. Atovaquone (Mepron) 3. Metronidazole (Flagyl) 4. Pentamidine (NebuPent)
Metronidazole (Flagyl) Reason: Metronidazole (Flagyl) is the antiprotozoal drug that is effective for the treatment of trichomoniasis. Iodoquinol is effective for the treatment of amebiasis. Atovaquone (Mepron) is effective for the treatment of pneumocystosis. Pentamidine (NebuPent) is effective for the treatment of pneumocystosis.
The nurse is caring for a patient with a urinary tract infection who is on nitrofurantoin (Macrodantin) therapy. Which interventions should the nurse perform to ensure drug safety in the patient? Select all that apply.
Nitrofurantoin (Macrodantin) is a urinary anti-infective medication. This drug is excreted in urine; therefore, the nurse should regularly monitor the patient's urinary output. If the urine output is low, the drug may accumulate in the body, leading to toxicity. The drug causes gastrointestinal irritation and should be taken with food. The desirable pH for action of nitrofurantoin (Macrodantin) is 5.5. Therefore, urine pH levels should be checked before administering the drug to ensure maximum effectiveness. Crystalluria is a side effect of methenamine (Hiprex). Photosensitivity is a side effect of nalidixic acid (NegGram), not nitrofurantoin (Macrodantin); therefore, the nurse would not need to ask the patient to avoid exposure to sunlight.
A patient complains of abdominal discomfort while taking nitrofurantoin. What will the nurse teach the patient?
Nitrofurantoin is usually taken with food to decrease gastrointestinal distress. Antacids decrease the absorption of this medication. Taking the medication on an empty stomach will not help the gastric pain. Discontinuing the medication is not recommended for this side effect.
A patient who is being treated for a neuromuscular disease has been ordered telithromycin (Ketek). What is the nurse's highest priority action? 1.Notify the health care provider. 2.Administer the first dose promptly. 3.Notify the pharmacy. 4.Administer the medication with food
Notify the HCP Reason: Use of telithromycin (Ketek) can worsen symptoms of myasthenia gravis. The health care provider should be notified so that the patient with a neuromuscular disease can be assessed and this disease ruled out. There would be no need to notify the pharmacy, and the medication does not have to be administered with food. The nurse should not administer the first dose of the medication without completing a thorough patient assessment.
The patient has been ordered a regimen to treat a urinary tract infection and notifies the nurse that the patient's urine has turned an orange color. The nurse recognizes that the patient is most likely being treated with which drug? 1 Ciprofloxacin (Cipro) 2 Bethanechol Cl (Urecholine) 3 Phenazopyridine HCl (Pyridium) 4 Darifenacin hydrobromide (Enablex)
Phenazopyridine HCl (Pyridium)
Which medication would be beneficial for a patient experiencing pain and a burning sensation during urination? 1 Methenamine (Hiprex) 2 Flavoxate HCl (Urispas) 3 Bethanechol (Urecholine) 4 Phenazopyridine HCl (Pyridium)
Phenazopyridine HCl (Pyridium) is ananalgesic that can alleviate the pain and burning associated with urinary tract infection. Because the medication is excreted in the urine, the urine becomes reddish-orange in color. Flavoxate HCl (Urispas) is used for the treatment of urinary tract spasms. Methenamine (Hiprex) is an antibiotic that treats the infection, but does not relieve pain. Bethanechol (Urecholine) increases the bladder tone and stimulates urination.
A patient is complaining of urinary pain after being diagnosed with a urinary tract infection the previous day. What is the nurse's best action? 1.Administer ordered trimethoprim (Trimpex). 2.Administer ordered bethanechol (Urecholine). 3.Administer ordered phenazopyridine hydrochloride (Pyridium). 4.Administer ordered acetaminophen (Tylenol) and a warm bath.
Phenazopyridine hydrochloride (Pyridium) is a urinary analgesic prescribed to relieve the pain associated with urinary tract infections. The other drug options are anti-infective agents and antispasmodic drugs that are not effective against urinary tract pain or infections. Having the patient take a warm bath will not address the pain.
Which condition(s) should be evaluated in a patient who is newly diagnosed with human immunodeficiency virus (HIV) infection prior to receiving retroviral therapy? Select all that apply.
Pregnancy statusGenotypic-resistance testingPotential medication-to-medication interactions Certain parameters should be checked before initiating antiretroviral (ART) therapy for a patient to ensure safety. The nurse should evaluate the pregnancy status of the patient because some antiretroviral medications are contraindicated during pregnancy. Genotypic-resistance testing helps identify mutations in the genes that may reduce the therapeutic effectiveness of certain medications. Potential medication-to-medication interactions are of main concern to prevent the adverse effects caused by medication interactions; therefore a nurse should obtain a list of all prescribed and over-the-counter medications. A nurse checks the viral load while diagnosing the disease or condition, but not while initiating therapy. Antiretroviral medications do not alter thyroid functioning; therefore a nurse should not anticipate thyroid functioning tests being needed for the patient.
The nurse is assessing a patient with HIV. The nurse notes that the patient is taking rifabutin. What does the nurse know about this patient's status? 1 The patient is pregnant. 2 The patient has tuberculosis. 3 The patient is treatment-naïve. 4 The patient has Kaposi sarcoma.
Pt has tb All HIV-infected patients diagnosed with active tuberculosis (TB) are prescribed TB therapy. Rifabutin is a drug in the TB regimen. Rifabutin is not prescribed to patients who do not have TB. The nurse therefore knows that the patient has TB. Being prescribed rifabutin is not an indicator of a patient being pregnant, treatment-naïve, or having Kaposi sarcoma.
A patient reports flank pain and painful urination. On assessment, the nurse finds that the patient has a high fever. What does the nurse infer about the patient's condition? 1 The patient has cystitis. 2 The patient has urethritis. 3 The patient has prostatitis. 4 The patient has pyelonephritis.
Pyelonephritis is an upper urinary tract infection. The symptoms of pyelonephritis include high fever, chills, flank pain, painful urination, and pus in the urine. Therefore, the patient most likely has pyelonephritis. Cystitis, urethritis, and prostatitis are lower urinary tract infections. The symptoms of lower urinary tract infections include painful urination, increased urinary frequency, and urgency.
What are the side effects of ritonavir (Norvir)? Select all that apply.
Ritonavir (Norvir) is a protease inhibitor and has central nervous system-depressant action; therefore a patient who is taking ritonavir (Norvir) may have side effects such as asthenia, GI intolerance, and paresthesias, as the medication affects the central nervous system. Unlike indinavir (Crixivan), ritonavir impairs hair growth and does not cause alopecia. Pancreatitis is not a side effect of ritonavir (Norvir) because the drug does not cause inflammation of pancreas.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs) are popular treatments for depression. Which side effects does the nurse know are atypical of these antidepressants? Select all that apply. 1.Sedation 2. Hypotension 3. Anticholinergic effects 4. Sexual dysfunction 5. Serotonin syndrome
Sedation hypotension anticholinergic effects Reason: SSRIs and SNRIs are preferred treatments for depression as they have fewer side effects than other classifications of antidepressants. Sedation, hypotension, and anticholinergic effects are uncommon with SSRIs and SNRIs. Sexual dysfunction and serotonin syndrome are both potential side effects of SSRIs and SNRIs.
What describes the ability of immune system cells to recognize self versus nonself? 1.Self-tolerance 2.Self-resilience 3.Self-harmony 4.Self-recognition
Self-tolerance is the ability of immune system cells to recognize self versus nonself. Self-resilience, self-harmony, and self-recognition are not terms used to describe this ability.
What are the modes of transmission of human immunodeficiency virus (HIV) infection? Select all that apply. 1.Mosquito bite 2.Sexual contact 3.Casual contact 4.Mother to fetus 5.Blood transfusion
Sex, mother to fetus, and blood transfusion Human immunodeficiency virus (HIV) infection is transmitted through sexual contact, from mother to fetus, and through a blood transfusion. During sexual contact, the virus transmission takes place from the genital secretions of the infected person to the healthy person. HIV also spreads through direct blood contact. The virus transmits through maternal-fetal blood circulation and by blood transfusion. HIV does not spread through casual contact, such as hugging the infected person. Carriers, such as mosquitoes, do not transmit HIV.