Pharm Chapter 39 Adaptive Quizzing

A patient is being discharged after treatment for hospital-acquired pneumonia. The nurse notes linezolid in the patient's discharge summary. Which advice about linezolid would the nurse give to the patient before discharge?

"Avoid eating smoked meat or fish while taking the drug." pg. 620, 624

A nurse is teaching a group of nursing students about aminoglycosides. Which statement by the nurse regarding aminoglycosides is accurate?

"Aminoglycosides can potentiate warfarin toxicity." pg. 614-615

Which instruction would the nurse give a patient about administering topical clindamycin?

"Apply a thin layer to the affected area after it has been cleansed." pg. 624

A nurse is counseling a patient who is taking neomycin to prevent drug-induced superinfections. Which advice would the nurse provide?

"Eat yogurt." pg. 624

Which instruction would the nurse give a patient about allergic reactions to an antibacterial drug?

"Stop taking the medication immediately at the first sign of an allergic reaction." pg. 622

A primary health care provider prescribes an antacid to a patient who is taking ciprofloxacin. Which information would the nurse provide while counseling the patient?

"Take the antacid 2 hours before the drug." pg. 617

Which instruction to a patient prescribed nitrofurantoin is most important to facilitate adherence to the therapeutic regimen?

"Take the medication with meals or milk." pg. 620

A nurse is setting up an intravenous infusion pump to administer a dose of vancomycin to a patient. Which amount of time is the minimum period that the drug may be infused?

60-minutes

Which parameter would the nurse use to help prevent ototoxicity in a patient receiving gentamicin?

A trough level Baseline renal function Baseline hearing acuity

The nurse is assessing a patient with pneumonia who is prescribed amikacin. After reviewing the medication history, the nurse finds that the patient is taking anticoagulants. For which adverse drug-interaction effect would the nurse monitor in the patient?

Abnormal bleeding pg. 615

A patient with a severe urinary tract infection is prescribed amikacin and penicillin. Which administration process will the nurse be asked to implement?

Administer penicillin followed by amikacin. pg. 613-614

The laboratory reports of a patient confirm the presence of Enterobacter aerogenes infection. A nurse finds that the patient has a history of infection that was resistant to gentamicin and tobramycin. Which medication will the nurse expect the primary health care provider to prescribe to the patient?

Amikacin pg. 615

The nurse is assessing a patient who has been prescribed clindamycin for a bone infection and vecuronium for persistent pain. Which intervention would the nurse perform to ensure the patient's safety?

Assess the patient's respiratory rate. pg. 617

Which assessment would be conducted by the nurse before starting antibacterial therapy for a patient?

Baseline vital sign values Cardiac history Hypersensitivity Neurologic abnormalities

A nurse is caring for a patient with hepatic encephalopathy who is prescribed neomycin. Which laboratory reports will the nurse evaluate to ensure optimum drug activity?

Blood ammonia concentration pg. 616

Which antibiotic is the drug of choice for the treatment of anthrax?

Ciprofloxacin

Which antibiotic can be used against several anaerobic organisms?

Clindamycin pg. 618

During intravenous infusion of vancomycin, the patient has excessive sweating, flushes on the neck and head, and reports itching on the head, face, and upper trunk. Which intervention would the nurse perform in this situation?

Decrease the rate of infusion of vancomycin.

A patient who is prescribed intravenous vancomycin reports frequent ringing in the ears. Which condition would the nurse suspect?

Early vestibular damage

Which action will the nurse implement when administering colistimethate sodium via inhalation?

Ensure that emergency equipment is near the patient. pg. 619

Which microbe is included in the spectrum of antimicrobial activity for the drug amikacin?

Escherichia coli pg. 615

Which action does the nurse take if a patient who underwent heart transplantation has septicemia and is receiving quinupristin, dalfopristin, and cyclosporine?

Evaluating the serum cyclosporine level pg. 621

A patient with a methicillin-resistant Staphylococcus aureus (MRSA) infection is prescribed vancomycin. The nurse collects a blood sample from the patient before administering the second dose of the drug and finds that the serum drug concentration is 8 mcg/mL. Which change will the nurse expect in the primary health care provider's prescription?

Increase the dose of vancomycin.

In which solution would the nurse infuse quinupristin before administering it to a patient with a staphylococcal infection?

Five-percent dextrose in water (D 5W) pg. 621

Which antibiotic binds to 30S ribosomes to prevent protein synthesis in bacteria?

Gentamicin pg. 613

A primary health care provider has prescribed neomycin to a patient with hepatic encephalopathy. Which parameter would the nurse check before administering the drug to the patient?

Glomerular filtration rate (GFR) pg. 616

For which adverse effect would the nurse be alert in a patient who is taking tobramycin as an antibiotic therapy?

Hearing Loss pg. 615

The nurse is assessing a patient who is being treated with amikacin. The patient has increased serum creatinine concentrations, for which loop diuretics are prescribed. Which assessment will the nurse monitor in the patient?

Hearing ability pg. 614-615

The nurse has administered the morning dose of tobramycin to a patient according to the prescription. In the evening, the nurse collects a blood sample from the patient and observes that the serum drug concentration is greater than 2 mcg/mL. Which adverse drug effect would the nurse need to monitor for?

Hearing impairment pg. 615 The safe therapeutic serum concentration of tobramycin is less than or equal to 1 mcg/mL (which is undetectable in blood tests). Serum concentration of the drug greater than 2 mcg/mL is associated with greater risk for ototoxicity (hearing impairment), so the nurse would monitor the patient for changes in hearing or report of ringing in the ears.

A patient taking intravenous gentamicin has elevated blood urea nitrogen (BUN). Which action would the nurse take?

Hold the medication.

Which interaction is caused by administering divalent minerals such as a calcium supplement within an hour of a quinolone such as levofloxacin?

Impaired levofloxacin absorption pg. 617

The nurse administers ampicillin to a patient who also receives tobramycin. Which condition may occur with this concomitant pharmacotherapy?

Impaired renal function

A patient with asthma is prescribed prednisone. The primary health care provider has also prescribed levofloxacin for the treatment of a hospital-acquired urinary tract infection. For which drug interaction effect would the nurse monitor after administering the drugs?

Joint Pain pg. 617

A patient with a staphylococcal infection is prescribed tobramycin. About which assessment findings in the follow-up visit would the nurse immediately notify the primary health care provider? Select all that apply.

Nausea Vertigo Headache pg 615

Which aminoglycoside can be administered by the rectal route for an enterococcal infection?

Neomycin pg. 616

Which antibiotic is used in patients who have infections of the eyes, ears, or skin and for suppressing bowel flora before bowel surgery?

Neomycin pg. 616, 624

The nurse continues sending the patient's blood samples to be checked for drug concentrations for another week after the patient recovers from aminoglycoside therapy for pneumonia. Checking the serum drug concentrations after the patient's recovery is intended to prevent which adverse effect of therapy?

Nephrotoxicity pg 624

Gentamicin is administered intravenously over a period of 30 to 60 minutes to prevent which adverse effect from toxic levels?

Neuromuscular blockade

The nurse is caring for multiple patients receiving antibiotics. Which patient will the nurse assess first?

One taking amikacin with furosemide pg. 615

A patient who is scheduled for an appendectomy has been prescribed neomycin by the primary health care provider. Which nursing action is suitable in this situation?

Oral administration of neomycin before the surgery

Which patients are at the highest risk of developing tendinitis from the use of quinolones?

Patients on glucocorticoid therapy pg. 617

To prevent a serious complication of the therapy in a patient who is taking linezolid, which laboratory parameter would the nurse monitor?

Platelet count pg. 620

Which action would the nurse take if a patient receiving intravenous vancomycin complains of facial pruritus?

Program the vancomycin to infuse at a slower rate.

Which infections are treated with metronidazole? Select all that apply.

Protozoans Clostridium Bacteroides Streptococcus

Which clinical finding makes a patient a potential candidate for antibiotic therapy involving aminoglycoside?

Pseudomonas aeruginosa pneumonia pg. 612-614

Which is the adverse effect of vancomycin when it is infused too rapidly?

Red man syndrome

The nurse checks a patient's serum creatinine level before starting antibiotic therapy in order to assess which function?

Renal pg. 624

Which parameter is most important to assess before administering vancomycin to a patient?

Renal function

The primary health care provider prescribes vancomycin to a patient who has a streptococcal endocarditis infection. Which parameter will the nurse assess in the patient to ensure safe administration of the drug?

Renal function pg. 621/622

A patient on antibiotic therapy needs drug trough levels drawn. Which is the most appropriate time for the nurse to draw the trough level?

Ten minutes before administration of the intravenous antibiotic

A patient receiving amikacin is scheduled for a computed tomography (CT) scan. The primary health care provider will instruct the nurse to check the patient's concentration of which parameter after the CT scan?

Serum creatinine pg. 615

Which laboratory reports would the nurse evaluate if the patient is administered vancomycin and tobramycin?

Serum creatinine pg. 615

While reviewing the blood reports of a patient who is receiving amikacin therapy, the nurse finds that the serum drug concentration is 4 mcg/mL. Which additional laboratory reports will the nurse check to ensure the patient's safety?

Serum creatinine concentration

Which aminoglycoside can be prescribed if the culture of a patient with bacterial endocarditis reveals the presence of gram-positive cocci?

Streptomycin The aminoglycoside indicated in the treatment of endocarditis from gram-positive cocci is streptomycin. Amikacin is used in the treatment of tuberculosis caused by mycobacterium tuberculosis. Gentamicin is used in the treatment of gram-negative infections. Tobramycin is an aminoglycoside used topically for bacterial eye infections or by inhalation for pulmonary infections caused by cystic fibrosis. p. 614

The nurse is assessing a patient who has tuberculosis-associated plague. Which medication will the nurse expect the primary health care provider to prescribe?

Streptomycin pg. 614

The nurse is assessing a patient with cystic fibrosis and who has developed a pulmonary infection. Which inhalational medication would the nurse expect the primary health care provider to prescribe for this patient?

Tobramycin pg. 615