Pharm Exam 3 practice questions

Which statement should the nurse include when teaching a patient about rifampin [Rifadin]? "A harmless side effect will be a red-orange discoloration of body fluids." "Oral contraception is the preferred method of birth control when using rifampin." "Take vitamin B6 to relieve numbness and tingling in the fingers and toes." "Treatment length for the medication is 3 times per day for an 8-week period."

"A harmless side effect will be a red-orange discoloration of body fluids."

Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate [Augmentin]? "Take Augmentin once per day and only at bedtime." "Augmentin may be taken with food or meals." "Avoid taking Augmentin with grapefruit juice." "Use a minimal amount of liquid to swallow the Augmentin."

"Augmentin may be taken with food or meals."

The healthcare provider orders levofloxacin [Levaquin] 500 mg PO every day for 7 days. The available medication is levofloxacin 250-mg tablets. How many tablets should the patient take each day? 0.5 tablet 1 tablet 1.5 tablet 2 tablets

2 tablets

A patient who has human immunodeficiency virus (HIV) infection has a tuberculin skin test (TST) for latent tuberculosis. The nurse assesses the result 48 hours after the injection. An induration of what size indicates that the patient needs to be treated for latent tuberculosis? 1 mm 2 mm 3 mm 5 mm

5 mm

A patient who is receiving an aminoglycoside develops flaccid paralysis and impaired breathing. Which medication does the nurse anticipate administering? Magnesium sulfate [Epsom salt] Potassium chloride [K-Dur] Sodium bicarbonate [Citrocarbonate] Calcium gluconate [Kalcinate]

Calcium gluconate [Kalcinate]

A patient is taking rifampin [Rifadin] for active tuberculosis. Which assessment does the nurse identify as an adverse effect of the drug? Jaundice Blood glucose level of 60 mg/dL Absent deep tendon reflexes Moon face

Jaundice

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe? "Draw up the clear regular insulin first, followed by the cloudy NPH insulin." "It is not necessary to rotate the NPH insulin vial when it is mixed with regular insulin." "The order of drawing up insulin does not matter as long as the insulin is refrigerated." "Rotate subcutaneous injection sites each day among the arm, thigh, and abdomen."

"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."

Which statement by a patient taking ethambutol [Myambutol] indicates understanding of adverse effects of the drug? "I will get up slowly when sitting to prevent me from getting dizzy." "I'll increase the fiber and liquids in my diet to prevent constipation." "I'll report any problems with blurred vision or determining colors." "I'll immediately report any red-orange urine to my healthcare provider."

"I'll report any problems with blurred vision or determining colors."

Which statements will the nurse include when teaching a patient about isoniazid therapy for the treatment of tuberculosis? Select all that apply. "Take the isoniazid on an empty stomach." "Notify your healthcare provider if your skin starts to turn yellow." "Numbness or tingling in your extremities is a normal response when taking this drug." "You urine will turn reddish orange because of the effects of this drug." "Use of this drug is associated with vision problems."

"Take the isoniazid on an empty stomach." "Notify your healthcare provider if your skin starts to turn yellow."

Which instruction should the nurse give a patient who is to take bismuth subsalicylate for eradication of H. pylori? "Nausea and diarrhea are common side effects." "Do not drink alcohol while taking this medication." "The drug can cause your bowel movements to be black." "Take the medication through a straw to prevent staining of your teeth."

"The drug can cause your bowel movements to be black."

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

"Use sunscreen and protective clothing when outdoors."

The nurse should include which instructions when teaching a patient about tigecycline therapy? Select all that apply. "Use sunscreen when you are outside." "If you have diarrhea more than five times a day, notify your healthcare provider." "Avoid using this drug if you are pregnant." "Stop taking the drug if you experience nausea." "Stop taking the drug if you experience vomiting."

"Use sunscreen when you are outside." "If you have diarrhea more than five times a day, notify your healthcare provider." "Avoid using this drug if you are pregnant."

A nurse instructs a female patient with peptic ulcer disease who is to start a treatment regimen that includes ranitidine [Zantac] and bismuth subsalicylate [Pepto-Bismol]. Which statement by the patient indicates that the teaching has been effective? "While I'm taking these medications, my bowel movements could look black." "I have a medicine at home to take when I start having some loose diarrhea stools." "I'm so glad that my allergies will be helped while I'm taking these medications." "I'll include more calcium and vitamin D in my diet to prevent osteoporosis."

"While I'm taking these medications, my bowel movements could look black."

A nurse is administering a daily dose of tobramycin at 1000. At which time should the nurse obtain the patient's blood sample to determine the trough level? 0800 0900 1130 1200

0900 Trough levels determine the lowest level between doses. Blood is drawn just before the next dose is administered when a divided dose is used or 1 hour before the next dose if a single daily dose is used.

A patient is scheduled to receive intravenous amphotericin B. Which medication should a nurse administer as pretreatment before the infusion? 10 units of regular insulin intravenously 20 mg famotidine [Pepcid] in 50 mL of 5% dextrose 50 mg of diphenhydramine [Benadryl] and 650 mg of acetaminophen 1 g of calcium gluconate in 100 mL of normal saline

50 mg of diphenhydramine [Benadryl] and 650 mg of acetaminophen

A nurse is administering an oral dose of itraconazole [Sporanox] to a patient at 10:00 AM. The nurse should administer a prescribed dose of famotidine [Pepcid] at which time? 9:00 AM 10:00 AM 10:30 AM 11:00 AM

9:00 AM Medications that lower gastric acidity, such as famotidine [Pepcid], can reduce absorption of oral itraconazole [Sporanox]. should be given at least 1 hour before itraconazole or 2 hours after.

An antimicrobial medication that has selective toxicity has which characteristic? A. Ability to transfer DNA coding B. Ability to suppress bacterial resistance C. Ability to avoid injuring host cells D. Ability to act against a specific microbe

Ability to avoid injuring host cells

When caring for a patient receiving mafenide [Sulfamylon] for treatment of a severe burn, it is most important for the nurse to monitor which laboratory value? Blood glucose level Acid-base status Sodium level Peak mafenide level

Acid-base status

A patient is receiving local applications of mafenide [Sulfamylon] to burn areas. Before application, it is most important for the nurse to do what? Administer a pain medication. Obtain a set of vital signs. Auscultate the lung fields. Obtain a signed consent form.

Administer a pain medication.

A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which is the nurse's priority action? Ask the healthcare provider for a reduction in dose. Encourage the patient to increase dietary fiber. Administer the drug with an aluminum hydroxide antacid. Instruct the patient to keep an accurate stool count.

Administer the drug with an aluminum hydroxide antacid.

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

Assess the patient for allergies.

When providing patient teaching for oral sulfonamide therapy, the nurse should instruct the patient to take the sulfonamide in what way? At mealtime, when food is available With soy or nonmilk products Between meals with a full cup of water On awakening before breakfast

Between meals with a full cup of water

A nurse obtains a specimen from which body fluid when performing the QuantiFERON-TB Gold (QFT-G) test for latent tuberculosis? Saliva Blood Urine Sputum

Blood

A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication? Blood glucose control for 24 hours Mealtime coverage of blood glucose Less frequent blood glucose monitoring Peak effect achieved in 2 to 4 hours

Blood glucose control for 24 hours

When administering an aminoglycoside to a patient with myasthenia gravis, it is most important for the nurse to assess what? Deep tendon reflexes Breath sounds Eyelid movement Muscle strength

Breath sounds

Fluoroquinolones should be discontinued immediately if what happens? a. Nausea, vomiting, or diarrhea is experienced. b. Dizziness, headache, or confusion occurs. c. Tendon pain or inflammation develops. d. Theophylline is prescribed for asthma.

C. Tendon pain or inflammation develops. Rationale: Fluoroquinolones can cause tendon rupture and should be discontinued if tendon pain or inflammation develops.

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

Cardiac rhythm

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take? Take the patient's blood pressure. Give the patient's PRN dose of insulin. Check the patient's capillary blood sugar. Advise the patient to lie down with the legs elevated.

Check the patient's capillary blood sugar.

A nurse assesses a male patient who has developed gynecomastia while receiving treatment for peptic ulcers. Which medication from the patient's history should the nurse recognize as a contributing factor? Amoxicillin [Amoxil] Cimetidine [Tagamet] Metronidazole [Flagyl] Omeprazole [Prilosec]

Cimetidine [Tagamet]

The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients? Metronidazole [Flagyl] Rifampin [Rifadin] Ciprofloxacin [Cipro] Daptomycin [Cubicin]

Ciprofloxacin [Cipro]

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value? Creatinine (Cr) level of 2.1 mg/dL Hemoglobin (Hgb) level of 9.5 gm/dL Sodium (Na) level of 131 mEq/dL Platelet count of 120,000/mm3

Creatinine (Cr) level of 2.1 mg/dL

A patient is receiving amphotericin B. It is most important for the nurse to monitor which laboratory result? Serum pH Protein level Glucose level Creatinine level

Creatinine level Amphotericin B is toxic to cells of the kidneys.

Which tetracycline may be administered with meals? a. Tetracycline b. Demeclocycline c. Doxycycline d. Minocycline

D. minocycline Rationale: Tetracycline, demeclocycline, and doxycycline should be administered on an empty stomach. Minocycline can be administered with meals.

A nurse planning care for a patient who is receiving nystatin [Mycostatin] should establish which outcome on the care plan? Relief of nasal congestion Decrease in mouth pain Productive cough Absence of urticaria

Decrease in mouth pain Nystatin is an antifungal medication that is used for candidiasis of the skin, mouth, esophagus, intestine, and vagina.

A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Slow the running pace and walk more. Discontinue the medication, because severe damage can result.

Discontinue the medication, because severe damage can result. Fluoroquinolones may result in tendinitis and rupture by disrupting the extracellular matrix of cartilage.

A patient is taking nitrofurantoin [Macrodantin]. Which finding should a nurse recognize as an indication that the treatment is having an undesired effect? Hyperpigmentation of the palms Dyspnea with chills Gum irritation with bleeding Scalp tenderness and thinning hair

Dyspnea with chills

Most cases (more than 80%) of uncomplicated, community-acquired urinary tract infection (UTI) are caused by which bacteria? Klebsiella pneumoniae Escherichia coli Enterobacter spp. Pseudomonas spp.

Escherichia coli

Which manifestations does the nurse associate with the development of hemolytic anemia? Select all that apply. Urticaria Fever Pallor Jaundice Diarrhea

Fever Pallor Jaundice

A patient who has acute cystitis is receiving treatment with trimethoprim/sulfamethoxazole. Which manifestation should indicate to a nurse that the patient's condition is worsening? Incontinence Flank pain 3+ pedal edema Hyperactive bowel sounds

Flank pain

Which antifungal agent is used as a one-time oral dose to treat vaginal yeast infections? Nystatin [Mycostatin] Caspofungin [Cancidas] Voriconazole [Vfend] Fluconazole [Diflucan]

Fluconazole [Diflucan] has almost 100% bioavailability and therefore is often sufficient as a single dose to treat vaginal yeast infections.

A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. If the treatment has been effective, the patient's breath test result should reveal the absence of what? Bicarbonate H. pylori Histamine 2 Prostaglandins

H. pylori

A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? Unsteadiness Vertigo Headache Dizziness

Headache

A nurse assesses the history of a patient who has had multiple complicated UTIs for which risk factors? Select all that apply. Female gender, child-bearing age Indwelling catheter Prostate hypertrophy Fair skin tone Urinary tract stones

Indwelling catheter Prostate hypertrophy Urinary tract stones

The nurse develops a care plan for a patient in the continuation phase of treatment for active tuberculosis (TB). The care plan includes teaching about which medication regimen? Pyrazinamide and ethambutol Isoniazid and rifampin Ethambutol and isoniazid Rifampin and ethambutol

Isoniazid and rifampin

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body? It stimulates the pancreas to reabsorb glucose. It promotes the synthesis of amino acids into glucose. It stimulates the liver to convert glycogen to glucose. It promotes the passage of glucose into cells for energy.

It promotes the passage of glucose into cells for energy.

Which outcomes should a nurse establish when planning care for a patient taking methenamine [Mandelamine]? Select all that apply. Maintains a urine pH of 5.5 or lower Consumes 3000 mL of liquid daily Uses an enteric-coated formulation Avoids sulfonamide medications No elevation in liver enzymes

Maintains a urine pH of 5.5 or lower Uses an enteric-coated formulation Avoids sulfonamide medications

Instruction by the nurse regarding alcohol abstinence is essential when a patient will be discharged taking which medication? Tetracycline Metronidazole Bismuth subsalicylate Clarithromycin

Metronidazole

A patient who takes multiple antibiotics starts to experience diarrheal stools. The nurse anticipates administration of which antibiotic if a stool sample tests positive for Clostridium difficile? Rifaximin [Xifaxan] Metronidazole [Flagyl] Daptomycin [Cubicin] Gemifloxacin [Factive]

Metronidazole [Flagyl]

A patient is taking daptomycin [Cubicin]. The nurse should obtain a creatine phosphokinase (CPK) level when the patient shows what? Increased urination and urinary urgency Muscle pain and weakness Abdominal bloating and diarrhea Headache and visual disturbances

Muscle pain and weakness

A patient who is receiving ceftriaxone has all of these medications ordered. The nurse monitors the patient for an adverse effect related to an interaction with which medication? Regular insulin Ampicillin [Polycillin] Naproxen [Naprosyn] Bisacodyl [Dulcolax]

Naproxen [Naprosyn]

Which enteral aminoglycoside would the nurse expect to be ordered preoperatively for a patient having intestinal surgery? Gentamicin Tobramycin Amikacin Neomycin

Neomycin

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

Neurologic deficits

A patient who has tuberculosis is treated with isoniazid. The nurse should monitor for which symptoms, which could indicate a vitamin B6 deficiency caused by the medication? Numbness and tingling in the fingers and toes Alopecia and flaking scalp Dry skin and brittle nails Oral ulcers and tongue fissures

Numbness and tingling in the fingers and toes

When performing a skin test for penicillin allergy, the nurse will do what? Select all that apply. Inject a tiny amount of the allergen subcutaneously. Observe for a local allergic response. Have epinephrine readily available. Have respiratory support readily available. Administer diphenhydramine [Benadryl] as the first-line agent should anaphylaxis occur.

Observe for a local allergic response. Have epinephrine readily available. Have respiratory support readily available.

The nurse identifies which statements about Stevens-Johnson syndrome as true? Select all that apply. Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Short-acting sulfonamides do not induce Stevens-Johnson syndrome. Patients with Stevens-Johnson syndrome usually are hypothermic. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.

Patients with Stevens-Johnson syndrome have a mortality rate of about 25%. Toxemia is associated with Stevens-Johnson syndrome. Lesions of the mucous membranes are a characteristic of Stevens-Johnson syndrome.

It is most important for the nurse to assess a patient taking itraconazole [Sporanox] for the development of what? Hair loss Skin rash Pedal edema Joint pain

Pedal edema

Before administering a cephalosporin to a patient, it is most important for the nurse to assess the patient for an allergy history to what? Soy products Peanuts Penicillins Opioids

Penicillins

A nurse should associate which factors with the pathophysiology of peptic ulcer disease? Select all that apply. Poor submucosal gastric blood flow Presence of Zollinger-Ellison syndrome Reduced stomach production of bicarbonate Increased synthesis of prostaglandins Gastrointestinal (GI) tract colonized with Haemophilus influenzae

Poor submucosal gastric blood flow Presence of Zollinger-Ellison syndrome Reduced stomach production of bicarbonate

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

Potassium Renal injury from amphotericin B may cause severe hypokalemia.

A nurse removes a central line access device once the patient no longer requires intravenous (IV) antibiotics. This action is an example of which strategy to prevent antimicrobial resistance established by the Centers for Disease Control and Prevention (CDC)? A. Preventing transmission B. Proper diagnosis C. Preventing infection D. Prudent antibiotic use

Preventing infection

Which cardiovascular finding does the nurse identify as a possible adverse effect of erythromycin [Ery-Tab] therapy? Heart rate of 52 beats per minute Prolonged QT interval Jugular vein distention Grade III diastolic murmur

Prolonged QT interval

A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect? Inhibition of carbohydrate digestion Promotion of insulin secretion Decreased insulin resistance Inhibition of ketone formation

Promotion of insulin secretion

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

Reduce the infusion rate.

A patient who has acquired immunodeficiency syndrome (AIDS) is receiving trimethoprim/sulfamethoxazole [Bactrim]. Which response should a nurse expect if the medication is achieving the desired effect? Increase in CD4 T cells Increased appetite and weight gain Resolution of pneumonia Decrease in joint pain

Resolution of pneumonia

Which medications does the nurse identify as having antibacterial properties? A. Rifampin B. Zidovudine C. Imipenem D. Amphocetricin B E. Amantadine

Rifamin Zidovudine

A nurse should recognize that which sulfonamide, applied topically, has the greatest therapeutic benefit for burns? Sulfadiazine Trimethoprim [Primsol] Sulfacetamide [Bleph-10] Silver sulfadiazine [Silvadene]

Silver sulfadiazine [Silvadene]

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

Skin rash and lesions

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

Skin rash and loose stools

A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? Some hearing loss may have occurred. The confusion is due to the hospital stay. A nutrition consult most likely is needed. The patient has a family history of dementia.

Some hearing loss may have occurred.

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

Superinfection

A nurse assesses a patient who is taking pramlintide [Symlin] with mealtime insulin. Which finding requires immediate follow-up by the nurse? Skin rash Sweating Itching Pedal edema

Sweating

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the absence of which symptom? Vomiting Muscle cramps Tachycardia Chills

Tachycardia Beta-adrenergic blockers can mask early signs of sympathetic system responses to hypoglycemia; the most important of these is tachycardia, which is the most common adverse effect of glipizide.

To promote treatment adherence in a patient with tuberculosis, the nurse will include which interventions? Select all that apply. Use a single medication, to keep the treatment simple. Teach the patient about intermittent-dose therapy. Teach the patient about the need for long-term treatment. Use a signed consent form to enhance patient compliance. Directly watch the patient take the medication.

Teach the patient about intermittent-dose therapy. Teach the patient about the need for long-term treatment. Directly watch the patient take the medication.

The nurse identifies which drug as a short-acting tetracycline? Tetracycline (generic) Declomycin Vibramycin Minocin

Tetracycline (generic)

The nurse identifies tigecycline [Tygacil] as a derivative of what? Penicillins Cephalosporins Tetracyclines Macrolides

Tetracyclines

Which statements about ototoxicity and aminoglycosides does the nurse identify as true? Select all that apply. The risk of ototoxicity is related primarily to excessive peak levels. The first sign of impending cochlear damage is headache. The first sign of impending vestibular damage is headache. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

The first sign of impending vestibular damage is headache. Ototoxicity is largely irreversible. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity.

What is the minimum bactericidal concentration (MBC)? A. The lowest concentration of an antibiotic needed to suppress bacterial growth completely B. The lowest concentration of an antibiotic needed to reduce the number of bacterial colonies by 99.9% C. The lowest concentration of an antibiotic needed to produce effects D. The lowest dose of an antibiotic needed to eradicate bacteria

The lowest concentration of an antibiotic needed to reduce the number of bacterial colonies by 99.9%

A microbe acquires antibiotic resistance by which means? A. Development of medication resistance in the host B. Overriding of the minimum bactericidal concentration C. Incorrect dosing, which contributes to ribosome mutations D. Transfer of DNA coding to other bacteria

Transfer of DNA coding to other bacteria

The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? Concentration Trough Peak Dose

Trough

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

Vancomycin is the most widely used antibiotic in U.S. hospitals. Vancomycin is effective in the treatment of Clostridium difficile infection. Vancomycin is effective in the treatment of MRSA infections.

The nurse is aware that acute cystitis occurs most often in which patient population? Older-adult male patients Children younger than 12 years Women of child-bearing age Women older than 50 years

Women of child-bearing age

A patient is prescribed an antibiotic to treat a urinary tract infection. What statement by the patient indicates a need for further teaching? A. "I can stop the medication as soon as the symptoms have disappeared." B. "I will drink more fluids to help clear up the infection." C. "I will stop the medication and contact the doctor if I develop a rash." D. "I should immediately report vaginal itching or discharge."

a. "I can stop the medication as soon as the symptoms have disappeared." Rationale: Patients should be taught not to discontinue antibiotics prematurely, but rather to complete the entire course of therapy, even if symptoms improve or resolve. The other responses are appropriate.

Which statement about Regular insulin is correct? a. Can be used IV b. Is a cloudy solution c. It's slow acting d. Peaks at 6-12 hours

a. Can be used IV

A patient develops CDAD. Which antibiotic is recommended for treating this infection? a. Vancomycin b. Clindamycin [Cleocin] c. Chloramphenicol d. Linezolid [Zyvox]

a. Vancomycin

A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. The nurse will expect the provider to: a. add metronidazole [Flagyl]. b. increase the dose of ciprofloxacin. c. switch to gemifloxacin d. restrict dairy products.

a. add metronidazole [Flagyl].

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a. "First-generation cephalosporins have better penetration of the cerebrospinal fluid." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation." c. "Cephalosporins are assigned to generations based on their relative costs to administer." d. "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases."

b. "Cephalosporins have increased activity against gram-negative bacteria with each generation."

A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication? a. "I should not worry if I experience an acnelike rash with this medication." b. "I should not take this medication with milk or other dairy products." c."I should take an antacid, such as Tums, if I experience gastrointestinal distress." d. "I should take this antibiotic with a calcium supplement to improve absorption."

b. "I should not take this medication with milk or other dairy products."

Which of the following insulins is available in both 100units/ml and 500units/ml concentrations? a. NPH Insulin b. Regular insulin c. Insulin lispro d. Insulin glargine

b. Regular insulin

Which of the following levels of infection control requires providers to wash hands before all procedures and after direct contact with patients, wear gloves when when in contact with non-intact skin, and where a mask during any procedure that is likely to generate aerosolized secretions?' a. droplet precautions b. standard precautions c. contact precautions d. airborne precautions

b. standard precautions

A nurse is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What will the nurse do? a. Continue giving the aminoglycoside as ordered. b. Contact the provider to discuss an increased risk of aminoglycoside toxicity. c. Request an order for a different class of antibiotic. d. Suggest adding a penicillin to the patient's drug regimen.

c. Request an order for a different class of antibiotic.

Which assessment data best indicates a client with Type 1 diabetes is adhering to the medical treatment regimen? a. The client's fasting blood glucose is 100mg/dl. b. The client's urine specimen is negative for ketones. c. The client's Hb A1c is 5.8%. d. The client's glucometer reading is 120mg/dl

c. The client's Hb A1c is 5.8%.

Which of the following anti-diabetic drugs is used to treat Polycyctic Ovarian Disease (PCOS)? a. Miglitol b. Rapaglinide c. Glyburide d. Metformin

d. Metformin

The vast majority of antibiotic use in the United States is being used... a. to treat disease for household pets b. on crops c. to treat human disease d.for agricultural use on livestock

d.for agricultural use on livestock

A major adverse effect of insulin that can be life-threatening is: Hyperglycemia Hypertension Hypoglycemia Hypotension

hypoglycemia

A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin? White blood cells (WBCs) Glucose Ketones Protein

protein

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

"If I notice my skin turning yellow or feel any nausea, I'll notify my healthcare provider."

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse? "Inject this insulin with your first bite of food, because it is very fast acting." "The duration of action for this insulin is about 8 to 10 hours, so you'll need a snack." "This insulin needs to be mixed with regular insulin to enhance the effects." "To achieve tight glycemic control, this is the only type of insulin you'll need."

"Inject this insulin with your first bite of food, because it is very fast acting."

A patient who is receiving vancomycin [Vancocin] IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make? "The prescription could be changed, because vancomycin comes in two forms." "You're allergic to penicillin, and this is the only way this medication can be given." "It will cause too much loss of appetite and nausea if given in the oral form." "It is more effective by IV, because the pill form will stay in the digestive tract."

"It is more effective by IV, because the pill form will stay in the digestive tract."

A nurse should give which nonmedication instruction to a patient who has peptic ulcers? "Reduce your intake of caffeine-containing beverages, such as coffee and colas." "Take a nonsteroidal anti-inflammatory drug once a day to help with pain." "It would be better to eat five or six small meals a day instead of three larger ones." "An ulcer diet of bland foods with milk and cream products will speed healing."

"It would be better to eat five or six small meals a day instead of three larger ones."

When teaching a patient about tuberculosis, the nurse will include which statements? Select all that apply. "Most people infected with M. tuberculosis are asymptomatic." "Most people infected with M. tuberculosis harbor dormant bacteria for life if they do not receive drug therapy." "Treatment of tuberculosis lasts 3 months." "Isoniazid can cause peripheral neuropathy by depleting vitamin B12." "Rifampin can cause optic neuritis."

"Most people infected with M. tuberculosis are asymptomatic." "Most people infected with M. tuberculosis harbor dormant bacteria for life if they do not receive drug therapy."

When providing teaching for a patient starting flucytosine [Ancobon] therapy, the nurse identifies what as the priority concern? "You will have weekly blood draws to monitor your liver function." "Another very strong medication may be needed in addition to this one." "You'll need to report any symptoms of bruising, fever, and fatigue." "The dose is 10 pills, so take a few at a time over a 15-minute interval."

"You'll need to report any symptoms of bruising, fever, and fatigue." Flucytosine [Ancobon] is used for serious infections caused by Candida and Cryptococcus neoformans. Bone marrow suppression may cause fatal agranulocytosis, so symptoms of bruising, fever, and fatigue could indicate life-threatening conditions.

Which of the following administration techniques would be appropriate when giving a sucralfate [Carafate] tablet to a patient with a duodenal ulcer? Select all that apply. Crush the tablet into a fine powder before mixing it with water. Administer the tablet with sips of water 1 hour before meals. Allow the tablet to dissolve in water before administering it. Administer the tablet with an antacid for maximum benefit. Break the tablet in half so it is easier to swallow.

Administer the tablet with sips of water 1 hour before meals. Allow the tablet to dissolve in water before administering it. Break the tablet in half so it is easier to swallow.

The nurse notices tan lines around the arms of a female patient who is taking levofloxacin [Levaquin]. Which action should the nurse take? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Advise the patient to avoid sun exposure and wear sun screen when outside. Discontinue the medication.

Advise the patient to avoid sun exposure and wear sun screen when outside.

A patient who has active TB is to start a medication regimen that includes pyrazinamide. The nurse identifies a risk for complications if the patient also has which medical condition? Parkinson's disease Rheumatoid arthritis Glaucoma Alcoholism

Alcoholism

Before administering trimethoprim, it is most important for the nurse to assess the patient for a history of what? Heart failure Alcoholism Diabetes Emphysema

Alcoholism

A nurse caring for a patient who has diabetic ketoacidosis recognizes which characteristics in the patient? Select all that apply. Type 2 diabetes Altered fat metabolism leading to ketones Arterial blood pH of 7.35 to 7.45 Sudden onset, triggered by acute illness Plasma osmolality of 300 to 320 mOsm/L

Altered fat metabolism leading to ketones Sudden onset, triggered by acute illness Plasma osmolality of 300 to 320 mOsm/L

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush? a. Community Acquired infection b. Superinfection c. Nosocomial infection d. Antibiotic resistance

B. Superinfection

The nurse is reviewing laboratory values from a patient who has been prescribed gentamicin. To prevent ototoxicity, it is most important for the nurse to monitor which value(s)? a. Serum creatinine and blood urea nitrogen levels b. Trough drug levels of gentamicin c. Peak drugs levels of gentamicin d. Serum alanine aminotransferase and aspartate aminotransferase levels

B. Trough drug levels of gentamicin Rationale: To minimize ototoxicity, trough levels must be sufficiently low to reduce exposure of sensitive sensory hearing cells. The risk of ototoxicity is related primarily to persistently elevated trough drug levels rather than to excessive peak levels.

The nurse is reviewing the prescriber's orders and notes that omeprazole [Prilosec] has been ordered for a patient admitted with acute coronary syndrome (ACS). The nurse should be concerned if this medication is combined with which medication noted on the patient's record? Aspirin 81 mg daily Clopidogrel [Plavix] 75 mg daily Heparin 5000 units subQ every 12 hours Metoprolol 50 mg every 8 hours

Clopidogrel [Plavix] 75 mg daily

The nurse identifies which host factor as the most important when choosing an antimicrobial drug? A. age B. Competent immune function C. Genetic heritage D. Previous medication reactions

Competent immune function

The nurse is caring for a patient receiving intravenous gentamicin for a severe bacterial infection. Which assessment finding by the nurse indicates the patient is experiencing an adverse effect of gentamycin therapy? a. Blurred vision b. Hand tremors c. Urinary frequency d. Tinnitus

D. Tinnitus Ototoxicity can result from accumulation of the drug in the inner ear. Early signs that should be reported include tinnitus or headache. Other major adverse effects include nephrotoxicity and neuromuscular blockade.

A patient taking gemifloxacin develops a rash. The nurse anticipates the healthcare provider to take which action? No action is needed, because this is a temporary but expected side effect. Continue the antibiotic with an anti-inflammatory medication. Cut the dose of medication in half. Discontinue the medication.

Discontinue the medication.

Which test is the most widely used method for assessing drug sensitivity? A. Minimum inhibitory concentration (MIC) B. Minimum bacterial concentration (MBC) C. Broth dilution D. Disk diffusion

Disk diffusion

A nurse is planning care for a patient who has peptic ulcer disease and is taking amoxicillin [Amoxil]. The nurse is aware that the action of this medication is which of the following? Inhibition of an enzyme to block acid secretion Coating of the ulcer crater as a barrier to acid Selective blockade of parietal cell histamine2 receptors Disruption of the bacterial cell wall, causing lysis and death

Disruption of the bacterial cell wall, causing lysis and death

The nurse is working with a patient who has a UTI. Because patient adherence to a medication regimen is a concern, the nurse anticipates use of which medication? Fosfomycin Amoxicillin Cephalexin Trimethoprim

Fosfomycin

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

Frequent loose, watery stools with mucus and blood

Which approach should a nurse take when administering an oral dose of levofloxacin [Levaquin]? Give the medication with or without food. Administer the drug with an oral dose of a magnesium-based antacid. Premedicate the patient with diphenhydramine [Benadryl]. Administer the drug with milk products.

Give the medication with or without food.

The nurse identifies appropriate use of antimicrobials to prevent infection in which situations? Select all that apply: A. Cardiac surgery B. Recurrent urinary tract infections in women C. Anemia D. Treatment of fever of unknown origin E. Hysterectomy

Hysterectomy Recurrent urinary tract infections in women Cardiac surgery

A patient is to begin taking nitrofurantoin [Macrodantin]. The nurse should teach the patient that which manifestation should be the priority to report to the healthcare provider? Headache and drowsiness Brown-colored urine Nausea and vomiting Muscle weakness and tingling

Muscle weakness and tingling

Before administering an aminoglycoside, it is most important for the nurse to assess the patient for a history of what? Myasthenia gravis Asthma Hypertension Diabetes mellitus

Myasthenia gravis

A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect? Neutralized gastric acid Reduced stomach motility Increased barrier to pepsin Reduced duodenal pH

Neutralized gastric acid

A nurse should recognize that antibiotic prophylaxis is appropriate in patients with which medical conditions? Select all that apply: A. Aortic valve replacement B. Ruptured appendix C. Bronchitis D. Neutropenia E. Chickenpox

Neutropenia Aortic valve replacement

An 80-year-old patient with a history of renal insufficiency recently was started on cimetidine. Which assessment finding indicates that the patient may be experiencing an adverse effect of the medication? +3 pitting edema Pain with urination New onset of disorientation to time and place Heart rate changes from a baseline of 70 to 80 beats per minute (bpm) to 110 to 120 bpm

New onset of disorientation to time and place

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

Nosocomial infection

A nurse administers which medication to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? Omeprazole [Prilosec] Famotidine [Pepcid] Misoprostol [Cytotec] Ranitidine [Zantac]

Omeprazole [Prilosec]

A patient who has an infection with Mycobacterium leprae (leprosy) has been prescribed rifampin [Rifadin]. The nurse identifies which dosing schedule as most effective for this drug? Two times per day Every other day Once every 2 weeks Once per month

Once per month

The nurse identifies terbinafine [Lamisil] as useful for treating which conditions? Select all that apply. Onychomycosis Tinea corporis Oropharyngeal candidiasis Vulvovaginal candidiasis Tinea pedis

Onychomycosis (infection of the nails) Tinea corporis (ringworm infections) Tinea pedis (ringworm infections)

With the exception of pyelonephritis, the nurse is aware that most urinary tract infections are treated by which method? IV antibiotics at the hospital IV antibiotics in the urgent care setting IM antibiotics at the primary physicians office Oral antibiotics in the home setting

Oral antibiotics in the home setting

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

Penicillins are the safest antibiotics available. The principal adverse effect of penicillins is allergic reaction. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.

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

Phlebitis of the vein used for the antibiotic has developed.

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan? Refer the patient to a diabetes educator because the result reflects poor glycemic control. Glycemic control is adequate; no changes are needed. Hypoglycemia is a risk; teach the patient the symptoms. Instruct the patient to limit activity and weekly exercise.

Refer the patient to a diabetes educator because the result reflects poor glycemic control. The target value is 6.5% or lower.

The nurse identifies which statements about frequent urinary tract reinfections as true? Select all that apply. Reinfections are considered frequent if the individual has three or more a year. Prophylactic therapy should continue for at least 2 months. If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. Single-dose nitrofurantoin 50 mg taken 1 hour before intercourse has been found to reduce the rate of reinfection. If a symptomatic episode occurs, the standard therapy for acute cystitis should be used.

Reinfections are considered frequent if the individual has three or more a year. If reinfection is associated with sexual intercourse, the risk can be reduced by instructing the patient to void after intercourse. If a symptomatic episode occurs, the standard therapy for acute cystitis should be used.

When ceftriaxone is administered intravenously, it is most important for the nurse to avoid mixing it with what? Ringer's lactate Normal saline Sterile water D5 0.45% NS

Ringer's lactate Mixing ceftriaxone with calcium causes precipitates to form. Ringer's lactate contains calcium; therefore it should not be mixed with ceftriaxone.

The nurse reviews the patient's medication record and notes the following: sucralfate [Carafate] 1 gram orally four times daily before meals (7:30 AM, 11:30 AM, and 4:30 PM) and at bedtime (10:00 PM); phenytoin [Dilantin] 200 mg orally daily at 8 AM. Which modifications, if any, should be made to the medication regimen? The medications can be administered as ordered. The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily. The nurse should obtain a prescriber order for intravenous phenytoin to avoid a drug interaction. The nurse should administer the phenytoin with the 7:30 AM dose of sucralfate [Carafate], because this is more time efficient.

The nurse should obtain a prescriber order to administer the phenytoin at 9:30 AM daily. Sucralfate can impede the absorption of phenytoin; therefore, a period of 2 hours should separate these drugs.

After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant? The patient takes antacids on a daily basis. The medication was stored in a cool, dry area. The patient did not use sunscreen while taking the ciprofloxacin [Cipro]. The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.

The patient takes antacids on a daily basis. Antacids interfere with the absorption of quinolone antibiotics

Which are examples of the improper use of antibiotic therapy? A. Using surgical drainage as an adjunct to antibiotic therapy B. Treating a viral infection C. Basing treatment on sensitivity reports D. Treating fever in an immunodeficient patient E. Using dosing that results in a superinfection

Treating a viral infection Using dosing that results in a superinfection

The nurse identifies rifampin as useful in the treatment of which disorders? Select all that apply. Tuberculosis Active meningococcal infection Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae C. difficile infection

Tuberculosis Leprosy Prophylaxis of meningitis caused by Haemophilus influenzae

A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid [Zyvox]. Which laboratory result indicates that the patient is having an adverse effect? White blood cell (WBC) count of 1200 units/L Hemoglobin (Hgb) level of 18 g/dL Potassium level of 3.0 mEq/dL Glucose level of 200 mg/dL

White blood cell (WBC) count of 1200 units/L

A client diagnosed with Type 2 diabetes is prescribed glipizide. Which statement by the client would warrant intervention by the nurse? a. "I have to eat my diabetic diet even if I am taking this medication." b. "I will need to check my blood glucose level at least once a day." c. "I usually have one glass of wine with my evening meal." d. "I do not like to walk every day, but I will if it will help my diabetes."

c. "I usually have one glass of wine with my evening meal."

The nurse is discussing storage of insulin vials with the client. Which statement indicates the client understands the teaching concerning insulin storage? a. "I will keep my unopened vials of insulin in the refrigerator." b. "I can keep my insulin in the trunk of my car so I will have it at all times." c. "It's all right to put my unopened insulin vials in the freezer." d. "If I prefill my insulin syringes, I must use them within 1-2 days."

a. "I will keep my unopened vials of insulin in the refrigerator."

Which instructions will the nurse include when teaching a patient about cephalosporin therapy? Select all that apply. "Notify your healthcare provider if you develop diarrhea." "Take aspirin if you develop a headache." "Notify your healthcare provider if you develop a rash." "Cephalosporins may not be taken with food." "Do not take cephalosporins if you have lactose intolerance."

"Notify your healthcare provider if you develop diarrhea." "Notify your healthcare provider if you develop a rash."

The patient is ordered daily divided doses of gentamycin. The patient received an intravenous dose of gentamycin at 4:00 PM. When should the nurse obtain the peak level? a. 4:30 PM b. 5:00 PM c. 5:30 PM d. 6:00 PM

A. 4:30 PM Rationale: When using divided daily doses, draw blood samples for measuring peak levels 1 hour after IM injection and 30 minutes after completing an IV infusion. When a single daily dose is used, measuring peak levels is unnecessary. Draw samples for trough levels just before the next dose (when using divided daily doses) or 1 hour before the next dose (when using a single daily dose).

Thirty minutes after receiving an intramuscular (IM) injection of penicillin G [Pfizerpen], a patient reports itching and redness at the injection site. Which action should the nurse take first? A. Elevate the lower legs B. Place an ice pack on the site C. Make sure the patient stays calm. D. Administer subcutaneous epinephrine.

Administer subcutaneous epinephrine.

Which of the following is a benefit of using a combination of two or more antibiotics? a. Reduced resistance b. All of these are benefits c. Reduced risk of severe infection d. Reduced toxicity

B. All of these are benefits

A patient is diagnosed with C. difficile infection. The nurse anticipates administering which medication? a. Daptomycin b. Metronidazole c. Rifampin d. Rifaximin

B. Metronidazole Rationale: Metronidazole is a drug of choice for C. difficile infection. Daptomycin has a unique mechanism and can rapidly kill virtually all clinically relevant gram-positive bacteria, including MRSA. Rifampin [Rifadin] is a broad-spectrum antibacterial agent used primarily for tuberculosis. However, the drug is also used against several nontuberculous infections. Rifampin is useful for treating asymptomatic carriers of Neisseria meningitidis. Rifaximin [Xifaxan] is an oral, nonabsorbable analog of rifampin used to kill bacteria in the gut.

A nurse is assessing the effects of antimicrobial therapy in a patient with pneumonia. The nurse should establish which outcomes when planning care? Select all that apply: A. Potassium level 4mEq/dL B. Reduction of fever C. Sterile sputum cultures D. Oxygen saturation of 98% E. Elastic skin turgor

B. Reduction of fever C. Sterile sputum cultures D. Oxygen saturation of 98%

A patient is prescribed doxycycline [Vibramycin]. If the patient complains of gastric irritation, what should the nurse do? a. Instruct the patient to take the medication with milk b. Tell the patient to take an antacid with the medication c. Give the patient food, such as crackers or toast, with the medication d. Have the patient stop the medication immediately and contact the health care provider

C. Give the patient food, such as crackers or toast, with the medication Rationale: Tetracyclines form insoluble chelates with calcium, iron, magnesium, aluminum, and zinc; absorption is decreased. Tetracyclines should not be administered together with milk or antacids. Long-acting tetracyclines, such as doxycycline, may be taken with food; food does not affect absorption.

A patient who was taking sulfonamides develops Stevens-Johnson syndrome. Upon assessment, the nurse expects to find what? a. Hypotension b. Bronchospasm c. Temperature of 35.5º C d. Widespread skin lesions

D. Widespread skin lesions The most severe hypersensitivity response to sulfonamides is Stevens-Johnson syndrome, a rare reaction with a mortality rate of about 25%. Symptoms include widespread lesions of the skin and mucous membranes, combined with fever, malaise, and toxemia. Bronchospasm and hypotension, as well as tachycardia, are manifestations of anaphylactic reactions.

It is most important for the nurse to assess a patient receiving a cephalosporin for the development of which manifestation of antibiotic-associated pseudomembranous colitis (AAPMC)? Rigidity Ileus Ascites Diarrhea

Diarrhea AAPMC, which is manifested initially by diarrhea and abdominal cramping

A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline as a younger child? Delay in long bone growth Early onset of puberty Severe face and body acne Discoloration of the teeth

Discoloration of the teeth

Which laboratory result should a nurse monitor more frequently when a patient is receiving clarithromycin [Biaxin] and warfarin [Coumadin]? Activated partial thromboplastin time (aPTT) Platelet count Erythrocyte sedimentation rate (ESR) International normalized ratio (INR)

International normalized ratio (INR) Clarithromycin is a macrolide similar to erythromycin and can inhibit hepatic metabolism of medications such as warfarin and theophylline. The INR is the blood test used to evaluate warfarin ranges.

Which statements about CDAD associated with clindamycin therapy does the nurse identify as true? Select all that apply. Leukopenia commonly occurs. It is a potentially fatal condition. Patients usually experience abdominal pain. Anticholinergics are effective in treating the diarrhea. Clindamycin therapy should be discontinued and vancomycin started.

It is a potentially fatal condition. Patients usually experience abdominal pain. Clindamycin therapy should be discontinued and vancomycin started.

A patient is admitted to the hospital with a medical diagnosis of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). When taking the patient's history, a nurse recognizes which information as the most important? Plays a contact sport and is an athlete Currently resides in a long-term care facility Did not complete the last course of antibiotics Had gallbladder surgery in the previous month

Plays a contact sport and is an athlete. CA-MRSA is transmitted by skin-to-skin contact and by contact with contaminated objects, such as sports equipment and personal items. It is seen in young, healthy people without recent exposure to healthcare facilities

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

Renal toxicity

An immunocompromised patient who is receiving piperacillin/tazobactam [Zosyn] develops oozing and bleeding from the gums. Which additional data should the nurse determine? Whether the patient has a fever above 100.5°F Whether the patient reports any painful teeth The most recent platelet count The last time mouth care was given

The most recent platelet count

A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct? a. "Tetracycline can be harmful to the baby's teeth and should be avoided." b."Tetracycline may cause allergic reactions in pregnant women." c."Tetracycline will prevent asymptomatic urinary tract infections." d. "Tetracycline is safe to take during pregnancy."

a. "Tetracycline can be harmful to the baby's teeth and should be avoided."

Which statement about allergic reactions to penicillin does the nurse identify as true? a. Anaphylactic reactions occur more frequently with penicillins than with any other drug. b. Allergy to penicillin always increases over time. c. Benadryl is the drug of choice for anaphylaxis due to penicillin allergy. d. Patients allergic to penicillin are also allergic to vancomycin.

a. Anaphylactic reactions occur more frequently with penicillins than with any other drug. Rationale: Anaphylactic reactions occur more frequently with penicillins than with any other drug. Allergy to penicillin can decrease over time. Epinephrine is the drug of choice for anaphylaxis. Vancomycin, erythromycin, and clindamycin are effective and safe alternatives for patients with penicillin allergy.

A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do? a. Contact the provider and prepare to administer epinephrine. b. Withhold the next dose until symptoms subside. c. Request an order for a skin test to evaluate possible PCN allergy. d. Notify the provider if the patient develops a rash.

a. Contact the provider and prepare to administer epinephrine.

A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. What should the nurse do? a. Administer the cephalosporin as ordered. b. Contact the health care provider for a different antibiotic. c. Administer a test dose of cephalosporin to determine reactivity. d. Have an epinephrine dose available when administering the cephalosporin.

b. Contact the health care provider for a different antibiotic. Rationale: A few patients with penicillin allergy (about 1%) display cross-sensitivity to cephalosporins. If at all possible, patients with penicillin allergy should not be treated with any member of the penicillin family. Use of cephalosporins depends on the intensity of the allergic response to penicillin; if the penicillin allergy is mild, use of cephalosporins is probably safe. However, if the allergy is severe, cephalosporins should be avoided.

The nurse is preparing to administer 30 units of NPH to client. He finds that the vial of insulin looks cloudy and uneven in appearance. Which of the following is the appropriate action? a. Discard the vial of NPH and open a new one b. Shake the vial of NPH thoroughly then administer the dose c. Hold the dose and alert the prescriber d. Give the client 10 units of regular insulin

b. Shake the vial of NPH thoroughly then administer the dose

A patient with bronchitis is taking TMP/SMZ, 160/800 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103°F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? a. Administer the dose and request an order for an antipyretic medication. b. Withhold the dose and notify the provider of the symptoms. c. Withhold the dose and request an order for an antihistamine to treat the rash. d. Request an order for intravenous TMP/SMZ, because the patient is getting worse.

b. Withhold the dose and notify the provider of the symptoms.

A nurse is explaining to nursing students why a cephalosporin is used in conjunction with an aminoglycoside for a patient with an infection. Which statement by a student indicates a. "Cephalosporins reduce bacterial resistance to aminoglycosides." b. "Cephalosporins prevent neuromuscular blockade associated with aminoglycosides." c. "Cephalosporins prolong the postantibiotic effects of the aminoglycosides so doses can be decreased." d. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."

d. "Cephalosporins enhance the actions of aminoglycosides by weakening bacterial cell walls."

Which information should the nurse include when teaching a patient about rifampin therapy? a. Oral contraceptives are safe to use with rifampin therapy. b. Contact your healthcare provider immediately if the color of your body fluids changes to reddish orange. c. Rifampin is safe to use in patients who have hepatic disease. d. Rifampin may be administered intravenously.

D. Rifampin may be administered intravenously. Rationale: Rifampin may be administered intravenously. Women taking oral contraceptives should consider a nonhormonal form of birth control while taking rifampin. Rifampin frequently imparts a red-orange color to urine, sweat, saliva, and tears; patients should be informed of this harmless effect. Permanent staining of soft contact lenses occasionally has occurred, so the patient should consult an ophthalmologist about contact lens use. Rifampin is toxic to the liver, posing a risk of jaundice and even hepatitis. Asymptomatic elevation of liver enzymes occurs in about 14% of patients. However, the incidence of overt hepatitis is less than 1%. Hepatotoxicity is most likely in alcohol abusers and patients with pre-existing liver disease. These individuals should be monitored closely for signs of liver dysfunction.

Both IV ampicillin/sulbactam [Unasyn] and gentamicin are ordered for a patient. When administering these medications, the nurse will do what? Ensure that separate IV solutions are used. Use two different peripheral IV sites. Administer the gentamicin first. There are no necessary precautions.

Ensure that separate IV solutions are used. When penicillins are present in high concentrations, they interact chemically with aminoglycosides, causing inactivation of the aminoglycosides. Therefore, penicillins and aminoglycosides should not be mixed in the same IV solution.

When people wear face masks in public to reduce the spread of COVID 19 which link in the chain of infection transmission is being interrupted? a. Port of Exit AND Port of Entry b. Reservoir c. Susceptibility of victim d. Port of Entry

a. Port of Exit AND Port of Entry

A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient? a. The patient should stop taking the clindamycin now and contact the provider immediately. b. The provider may increase the clindamycin dose to treat this infection. c. The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms. d. This is a known side effect of clindamycin, and the patient should consume extra fluids.

a. The patient should stop taking the clindamycin now and contact the provider immediately.

A 65-year-old patient who receives glucocorticoids for arthritis is admitted to the hospital for treatment of a urinary tract infection. The prescriber has ordered intravenous ciprofloxacin [Cipro]. Before administering the third dose of this drug, the nurse reviews the bacterial culture report and notes that the causative organism is Escherichia coli. The bacterial sensitivity report is pending. The patient complains of right ankle pain. What will the nurse do? a. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms. b. Request an order to increase this patient's dose of glucocorticoids. c. Instruct the patient to exercise the right foot and ankle to minimize the pain. d. Question the patient about the consumption of milk and any other dairy products. .

a. Withhold the dose of ciprofloxacin and notify the provider of the patient's symptoms

The insulin produced endogenously by the pancreas has what length duration of action? a. up to 10 hours b. 1-3 hours c. 3-5 hours d. up to 24 hours

a. up to 10 hours

A patient is prescribed cefixime. The nurse should teach the patient to immediately report any signs of what? a. Milk intolerance b. Skin rash, hives, or itching c. Constipation, nausea, or vomiting d. Headache, contusions, or seizures

b. Skin rash, hives, or itching Rationale: Hypersensitivity reactions are common with cephalosporins. Patients should be instructed to report any signs of allergy, such as skin rash, itching, or hives. Cefditoren contains a milk protein and should not be prescribed for patients with a milk protein allergy. Cefoperazone and cefotetan can promote bleeding. Diarrhea associated with antibiotic-associated pseudomembranous colitis (AAPMC) is a possible side effect with cephalosporins.

Which statement about superinfections does the nurse identify as true? a. Superinfections are more common in patients treated with narrow-spectrum drugs. b. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection. c. Superinfections are caused by viruses. d. Superinfections are easy to treat.

b. Superinfection is defined as a new infection that appears. during the course of treatment for a primary infection. Rationale: Because broad-spectrum antibiotics kill off more normal flora than do narrow-spectrum drugs, superinfections are more likely in patients receiving broad-spectrum agents. Suprainfections are caused by drug-resistant microbes; these infections are often difficult to treat.

A patient has been prescribed oral ciprofloxacin [Cipro] for a skin infection. When administering the medication, it is most important for the nurse to do what? a. Monitor for a decrease in the prothrombin time (PT) if the patient is also taking warfarin [Coumadin] b. Withhold antacids and milk products for 6 hours before or 2 hours afterward c. Inform the healthcare provider if the patient has a history of asthma d. Assess the skin for Stevens-Johnson syndrome

b. Withhold antacids and milk products for 6 hours before or 2 hours afterward Rationale: Absorption of ciprofloxacin can be reduced by ingestion of antacids and milk products. Ingestion of these products should occur at least 6 hours before ciprofloxacin or 2 hours afterward. Ciprofloxacin can increase the PT if the patient is also taking warfarin. Use of ciprofloxacin is contraindicated in patients with a history of myasthenia gravis. Patients taking ciprofloxacin are at risk for development of phototoxicity.

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. Rhabdomyolosis b. red man syndrome. c. Stevens-Johnson Syndrome d. allergic reaction

b. red man syndrome

The nurse is teaching the client with newly diagnosed Type 1 diabetes about insulin therapy. Which of the following statements indicates the client needs more teaching? a. "If I have a headache or get nervous, I will drink some orange juice." b. "If I pass out at home, a family member should give me a glucagon injection." c. "Because I am taking my insulin daily I do not have to worry about my diet." d. "I will check my blood glucose with my glucometer at least once a day."

c. "Because I am taking my insulin daily I do not have to worry about my diet."

A child with otitis media has had three ear infections in the past year. The child has just completed a 10-day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not working, because it has worked in the past. What will the nurse tell the patient? a. "The bacteria have developed penicillin-binding proteins (PBPs) that have a low affinity for penicillins." b. "Amoxicillin is too narrow in spectrum." c. "The bacteria have synthesized penicillinase." d. "The bacteria have developed a three-layer cell envelope."

c. "The bacteria have synthesized penicillinase."

Which patient does the nurse identify as most likely to need treatment with trimethoprim/sulfamethoxazole [Bactrim] for a period of 6 months? a. A female patient with acute pyelonephritis b. A male patient with acute prostatitis c. A female patient with recurring acute urinary tract infections d. A male patient with acute cystitis

c. A female patient with recurring acute urinary tract infections Rationale: Female patients with relapses of urinary tract infection may need long-term therapy up to 6 months with trimethoprim/sulfamethoxazole.

Which of the following drugs acts in the small intestine to delay carbohydrate absorption? a. Rosiglitazone b. Sulfonylureas c. Acarbose d. Rapaglinide

c. Acarbose

A major adverse effect of insulin that can be life-threatening is: a. Hyperglycemia b. Hypotension c. Hypoglycemia d. Hypertension

c. Hypoglycemia

Which of the following insulins can be given once daily to provide glucose control for 24 hours? a. Insulin lispro b. Insulin aspart c. Insulin glargine d. Regular Insulin

c. Insulin glargine

A patient shows signs and symptoms of conjunctivitis (bacterial pink eye). Which aminoglycoside would the nurse expect to be ordered? a. Paromomycin [Humatin] b. Amikacin [Amikin] c. Neomycin [Neomycin] d. Kanamycin [Kantrex]

c. Neomycin [Neomycin]

A nurse is preparing to administer a dose of gentamicin to a patient who is receiving the drug 3 times daily. The nurse will monitor ____ levels. a. peak b. trough c. peak and trough d. serum levels

c. peak and trough

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: a. inter-patient variability b. antibiotic resistance c. renal disease d. liver disease

c. renal disease

A patient is diagnosed with an infection caused by Staphylococcus aureus, and the prescriber orders intravenous gentamicin and penicillin (PCN). Both drugs will be given twice daily. What will the nurse do? a. Infuse the gentamicin and the penicillin together to prevent fluid overload. b. Request an order to change the penicillin to vancomycin c. Give the gentamicin intravenously and the penicillin intramuscularly. d. Administer gentamicin, flush the line, and then give the penicillin.

d. Administer gentamicin, flush the line, and then give the penicillin.

A patient is prescribed cefazolin. It is most important for the nurse to teach the patient to avoid which substance while taking cefazolin? a. Warfarin b. Milk products c. Digitalis d. Alcohol

d. Alcohol Rationale: Cefazolin and cefotetan can cause alcohol intolerance. A serious disulfiram-like reaction may occur if alcohol is consumed. Inform patients about alcohol intolerance and warn them not to drink alcoholic beverages.

The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? a. Ensure the client is wearing a medical alert bracelet. b. Administer the dose according to the regular insulin sliding scale. c. Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. d. Make sure the client easts the food on the meal tray that is at the bedside.

d. Make sure the client easts the food on the meal tray that is at the bedside.

The nurse in the medical department is preparing to administer insulin lispro [Humalog] to a client diagnosed with Type 1 diabetes. Which intervention should the nurse implement? a. Ensure the client is wearing a medical alert bracelet. b. Assess the client for signs of hyperosmolar, hyperglycemic, non-ketotic syndrome. c. Administer the dose according to the regular insulin sliding scale. d. Make sure the client eats the food on the meal tray that is at the bedside.

d. Make sure the client eats the food on the meal tray that is at the bedside.

A patient is prescribed vancomycin orally for antibiotic- associated pseudomembranous colitis. The nurse will monitor the patient for what? a. Leukopenia b. "Red man" syndrome c. Liver impairment d. Ototoxicity

d. Ototoxicity Rationale: The most serious adverse effect of vancomycin is ototoxicity. "Red man" syndrome occurs only with rapid intravenous administration. Thrombocytopenia is an adverse effect of vancomycin.

A prescriber states that a patient will need to receive penicillin intravenously. The nurse anticipates administering which drug? a. Penicillin V b. Procaine penicillin G c. Benzathine penicillin G d. Potassium penicillin G

d. Potassium penicillin G Rationale: When high blood levels are needed rapidly, penicillin can be administered IV. However, only the potassium salt should be administered by this route. Owing to poor water solubility, procaine and benzathine salts must never be administered IV. Penicillin V is administered orally.

A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will expect the provider to order: a. ampicillin. b. penicillin G c. nafcillin.. d. amoxicillin―clavulanic acid [Augmentin].

d. amoxicillin―clavulanic acid [Augmentin].

A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to: a. give an analgesic to control headache discomfort. b. obtain a gentamicin trough before the next dose is given c. obtain renal function tests to evaluate for potential nephrotoxicity. d. discontinue the gentamicin.

d. discontinue the gentamicin

A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a. inhibit autolysins. b. inhibit host cell wall function c. disinhibit transpeptidases d. disrupt bacterial cell wall synthesis

d. disrupt bacterial cell wall synthesis

A patient who is taking doxycycline for a serious infection contacts the nurse to report anal itching. The nurse will contact the provider to discuss: a. testing the patient for a C. difficile secondary infection. b. adding an antihistamine to the patient's drug regimen. c. ordering liver function tests to test for hepatotoxicity. d. prescribing an antifungal drug to treat a superinfection.

d. prescribing an antifungal drug to treat a superinfection.