Pharm Exam 3 Prep U (Version 2)

Major defense mechanisms of the human body include all of the following EXCEPT

● Increased platelet cells.

Which drugs would be the safest to prescribe a client with a high risk for bleeding? Select all that apply.

• ● acetaminophen • COX-2 inhibitors

The client is taking NSAIDs for pain. The nurse explains to the client that NSAIDs act by which actions?

● Inhibiting the synthesis of prostaglandins

A client is to receive penicillin. The nurse understands that this drug achieves its effect by which action?

● Interfering with the pathogen cell wall

Successful treatment with bacteriostatic antibiotics depends upon what factor?

● adequate duration of drug therapy.

The client has been prescribed celecoxib for osteoarthritis. Which statement by the client indicates the need for further client education?

● "I will stop taking the medication when I feel better."

The client states that he knows many people who take acetaminophen, and asks the nurse what it is used for. What is the best response by the nurse?

● "It is an aspirin substitute for pain and fever."

The nurse is caring for a diverse group of clients on a hospital medical unit. What client is most likely to experiencing a superinfection?

● an older adult client with Clostridium difficile-associated diarrhea

A nurse is aware that a client prescribed meloxicam is most likely being treated for what health problem?

● arthritis

How should a nurse best explain the presence of the inflammation process?

● as an attempt by the body to remove the damaging agent and repair the damaged tissue

A nurse is presenting an educational event for a group of new parents. A participant has asked about the safe use of acetaminophen in children. What should the nurse teach the parents?

"Check the label of over-the-counter medications carefully to see if they include acetaminophen."

A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?

"Do not take any NSAIDs."

Which statement by the client indicates a clear understanding of the primary adverse effect of aspirin therapy?

"I ask my health care provider to check for blood in my stool on a regular basis."

After teaching a client about the prescribed NSAID therapy, the nurse determines that the teaching was successful when the client states which comment?

"I should take the drug with food and milk."

A nurse is performing discharge teaching for a client who is prescribed ibuprofen. After teaching the client about the possible cardiovascular effects of the drug, the nurse determines that additional teaching is needed when the client states which comment?

"My blood pressure won't change."

Your client asks about the difference between viruses and bacterial infection. When explaining about the origin of viruses, you would include

: ● They are officially classified according to their structure but are more commonly described according to origin and the disorders or symptoms they produce.

You are speaking to a group of clients in a public meeting. They ask you to explain the difference between community-acquired infections and nosocomial infections. Your best response is

: ● Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.

A drug that does not actually cause the death of a cell but does interfere with its ability to reproduce is said to be

: ● bacteriostatic.

A client is febrile and is suspected of having a respiratory infection. A sputum culture has been collected and the results of sensitivity testing are expected within 48 hours. The nurse should anticipate that the client may

: ● be immediately prescribed a broad-spectrum antibiotic.

A client has been diagnosed with an infection. The nurse can help to ensure the success of anti-infective treatment by

: ● confirming that the medication prescribed is the drug of choice for the specific microorganism.

The nurse administering an anti-infective agent recognizes that the drug will destroy some human cells as well as pathogens because of the absence of

: ● selective toxicity.

A client has been diagnosed with osteomyelitis and has been prescribed clindamycin, a narrow spectrum antibiotic. When planning this client's care, the nurse should understand that

: ● the microorganism causing the infection is likely known.

A home care nurse is seeing a 66-year-old female who has just been released from the hospital after being treated for rotator cuff repair. The nurse knows that it is important to assess the client's knowledge of which area?

Adverse effects of NSAIDs

The nurse is preparing discharge teaching for a client with unstable angina. Which medication will the nurse include in this teaching?

Aspirin

A patient with arthritis is on nonsteroidal anti-inflammatory drug (NSAID) therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?

Better mobility

A 78-year-old male client calls the clinic and reports severe pain and swelling in his right great toe. The client states that the pain is worse at night and has been present for at least 2 weeks. The nurse understands that this client has what type of inflammatory disorder?

GOUT

A nurse is preparing to teach a client about the adverse effects of the prescribed NSAID therapy. Which system would the nurse include as being involved?

Gastrointestinal

A 15-year-old client is brought to the emergency department after the parents discovered the client has taken 15 gm of acetaminophen over the past 24 hours for back pain. Which assessment finding should the nurse prioritize?

Hypotension

What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Inhibit prostaglandin synthesis

A 64-year-old client has been prescribed ibuprofen for osteoarthritis. Which adverse reaction should the client report with the use of ibuprofen?

Tarry stool

The nurse would question the health care provider who prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for which client?

The client diagnosed with peptic ulcers

An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin?

The patient has a history of peptic ulcer disease.

While providing client teaching relative to inflammatory disorders, the nurse would explain the presence of inflammation as

an attempt by the body to remove the damaging agent and repair the damaged tissue.

A client diagnosed with gout reports having no symptoms of the disease and asks why allopurinol was prescribed. How will the nurse best respond?

● "It is used to prevent or treat hyperuricemia, which occurs with gout."

A client with mild low back pain has been advised to take acetaminophen. The nurse teaching the client about this medication would include that excessive intake of acetaminophen may result in which?

liver damage

A nurse has admitted a 10-year-old to the short-stay unit. The child reports chronic headaches, and his mother states that she gives the child acetaminophen at least twice a day. What will the nurse evaluate?

● Hepatic function

What conditions are salicylates are effective in managing? (Select all that apply.)

• Pain • Fever • Inflammation

The development of gout has three distinct phases. Place in order each phase of the development of gout.

• ● Acute gouty arthritis • ● Intercritical gout • ● Chronic tophaceous gout

A nurse is caring for a client who is hospitalized for pneumonia. The nurse reviews the electronic health record and evaluates that the microbiology data does not support the use of the broad spectrum antibiotic. Which statement is the nurse's best response to the provider about the results?

● "The microbiology data is identifying another antibiotic appropriate for the client."

The nurse admits a client with septicemia (infection in the bloodstream). The client denies any allergies, and the doctor has ordered cefuroxime based on blood culture and sensitivity testing. The client states, "I'd prefer vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response?

● "Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work."

A client asks a nurse why the health care provider has prescribed two anti-infective agents. Which response by the nurse would be most appropriate?

● "Your infection, like many infections, is caused by more than one organism."

Patients are often given a daily dose of aspirin for prophylaxis of myocardial infarction (MI), transient ischemic attacks (TIA), and cerebrovascular accident (CVA). What is the recommended daily dose for this purpose?

● 81-325 mg

The hospital nurse is caring for a diverse group of clients and is reviewing each client's medication regimen. Which client is most likely to benefit from combination therapy?

● A client being treated for acquired immunodeficiency syndrome (AIDS)

Which client is at highest risk for developing hepatotoxicity related to the use of acetaminophen?

● A male 30 years of age who drinks four beers per day

For what client would the use of prophylactic anti-infective be most appropriate?

● A pre-surgical client who has an artificial heart valve

What is an important nursing action for the administration of colchicine to the patient in the acute care setting?

● Administer the medication with a full glass of water at evenly spaced intervals throughout the day.

Mr. Conn, age 65, is taking probenecid for treatment of chronic gouty arthritis. When providing patient and family education, what should a nurse advise the patient to do if he misses a dose and it is almost time for the next dose?

● Advise the patient to take only the second dose and ignore the missed dose.

You are working as a nurse educator in the hospital setting. Part of your responsibility includes developing a plan to prevent antibiotic resistance. What is the most important part of your plan?

● An education campaign that focuses on handwashing between patients

A nurse is preparing to present information about ibuprofen at a community health promotion conference. Which actions will the nurse illustrate during the presentation? Select all that apply.

● Anti-inflammatory • ● Analgesic • ● Antipyretic

What would contribute to drug resistance?

● Antibiotic prescription for viral illness

Which drug is used to decrease the risk of myocardial infarction in patients with unstable angina or previous myocardial infarction?

● Aspirin

A client is in the surgical intensive care unit after having a coronary bypass grafting approximately 6 hours ago. What medication will the nurse be expected to administer at this time?

● Aspirin 625 mg

The nurse is preparing to administer a new anti-infective to a client. The nurse should prioritize what assessment?

● Assessment for allergic reaction

The nurse teaches the client to do which of the following prior to surgery?

● Avoid salicylates.

A client is diagnosed with bacterial pneumonia. Pending culture results, what would the nurse expect the health care provider to order?

● Broad-spectrum antibiotics

A nurse is preparing a discharge teaching for a client who is to continue taking NSAIDs at home. Which important point should the nurse prioritize in the teaching?

● Call your health care provider if you have no relief after 2 weeks.

A nurse is preparing a presentation for a local community group about over-the-counter analgesics, including NSAIDs. Which possible reaction would the nurse integrate into the presentation as a serious risk with this class of drugs?

● Cardiovascular thrombosis

The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take?

● Celecoxib

A nurse is asked to explain the difference between community-acquired infections and hospital-acquired infections. What response best describes the difference?

● Community-acquired infections are usually less severe and easier to treat since hospital-acquired infections often involve drug-resistant microorganisms.

A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. The nurse tells the client that irregular administration of this medication could lead to what outcome?

● Development of drug resistance

Assessment of a newly admitted patient reveals the characteristic signs and symptoms of cellulitis on the back of the hand. A swab of the patient's wound was ordered upon admission, but the results of culture and sensitivity (C&S) testing are not yet available. What strategy will most likely be adopted to treat this patient's infection?

● Empiric antimicrobial therapy will be implemented until laboratory results are available.

A client with an inflammatory disease has been prescribed indomethacin. The nurse is aware of the risk for drug-induced nephrotoxicity and should prioritize what intervention?

● Encouraging the client to increase fluid intake

Which of the following is the most important nursing action to help prevent antimicrobial resistance in health care settings?

● Good hand-washing between each patient contact

A client has been prescribed an aminoglycoside. In order to prevent accumulation of the drug, what should the nurse encourage the client to do?

● Increase fluid intake.

A nurse practitioner is teaching a group of nurses about actions that have the potential to prevent antibiotic resistance. What teaching point should the nurse practitioner include?

● It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.

The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug?

● It will directly cause the death of pathogenic cells.

The pharmacology instructor is discussing ways to decrease the incidence and severity of adverse effects among children taking anti-infective agents. What would the instructor mention is one way to do this in children?

● Keep clients well hydrated.

What information about antibiotic therapy should the nurse include in a client's medication education?

● Maintenance of normal bacterial flora is essential to health during the therapy.

What information should be provided to a client diagnosed with an acetylsalicylic acid allergy?

● Nonaspirin form of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided.

It is the duty of all health care providers to prevent antibiotic resistance. As a nurse, how can you play an active role in preventing antibiotic resistance? (Select all that apply.)

● Obtain culture specimens prior to administration of antibiotic therapy. • ● Use proper isolation procedures. • ● Report culture results to the health care provider.

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?

● Obtaining sensitivity testing

A client has just returned from x-ray after reporting pain in her joints. The x-rays indicate damage of the joint spaces. This is indicative of which disease process?

● Osteoarthritis

A client asks the nurse how an anti-infective produces a therapeutic effect. What should be included in the nurse's teaching plan?

● Penicillin interferes with biosynthesis of the bacteria cell wall.

A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. What should be included in the nurse's teaching?

● Penicillin interferes with synthesis of the bacteria cell wall.

After teaching a group of students about resistance, the instructor determines that the students need additional teaching when they identify what as a way that microorganisms develop resistance?

● Production of a chemical to act as an agonist

A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action?

● Refer the client to the health care provider because the client may be experiencing resistance.

An 11-year-old client is having a cavity filled in the left mandibular first molar. The health care provider has prescribed aspirin for pain relief after the procedure. The nurse discovers upon assessment that the child is suffering from a flulike illness. The nurse contacts the health care provider about the prescribed medication for pain. What is the risk if aspirin is administered to this client?

● Reye syndrome

The nurse is administering an anti-infective medication that is known to lack total selective toxicity. What consequence should the nurse anticipate?

● Some healthy cells will be damaged.

A 65-year-old man who just had a heart attack is placed on aspirin, 81 mg daily. The nurse is explaining the purpose of this medication to the client and his wife. What would be the nurses best explanation?

● The aspirin is being prescribed because it reduces your risk of a second heart attack.

The nurse is assessing a client who has recently been given the first dose of a new anti-infective. What finding should lead the nurse to suspect that the client is experiencing a hypersensitivity reaction?

● The client has a facial and trunk rash.

When reviewing the medication orders, a nurse notes that combination therapy with two anti-infective agents has been ordered. What is the nurse's best interpretation of this order?

● The client has an infection that may be caused by more than one organism.

When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include?

● The drug is selective in its action on organisms.

A client with a urinary tract infection has been prescribed Bactrim, a medication that is a combination of sulfamethoxazole and trimethoprim. What is the most likely rationale for the use of a combination antibiotic?

● The drugs' combined effect exceeds the sum of their individual effects.

A nurse has questioned why a client's health care provider has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?

● The use of broad-spectrum antibiotics can create a risk for a superinfection.

Like many other classes of drugs, anti-infective drugs can have a variety of adverse effects. What is the most common, potentially serious, adverse effect of antimicrobial drugs?

● Toxic effects on the kidney

Which are examples of infection control used in the healthcare environment? Select all that apply.

● Use of cleaning agents daily for the nursing computer stations. ● Temperature cooler in many areas of a hospital. ● Routine cleaning of areas with many visitors. ● Hand hygiene by all healthcare providers and visitors.

The client has a history of gastrointestinal bleeding. What would be the best response by the nurse when the health care provider prescribes Indocin as treatment for rheumatoid arthritis?

● Withhold the medication and notify the provider.

A parent has brought a 6-year-old child to the clinic. The child has a fever of 102.8°F (39.3°C) and is subsequently diagnosed with the flu. What medication best balances risks and benefits for treating this client's fever?

● acetaminophen

The nurse is caring for a child who weighs 30 kg. The physician orders gentamicin t.i.d. The recommended dosage range is 6 to 7.5 mg/kg/day. What should the nurse explain is the importance of giving a dosage within this recommended range? Select all that apply.

● avoiding toxic effects ● protecting other clients ● reducing the risk of drug-resistant organisms • ● eradicating the bacteria promptly

When assessing a client who is to receive celecoxib, a history of which disease process or condition would be important to assess?

● cardiac disease

A client with an infection has been prescribed metronidazole, a bactericidal antibiotic. What should the nurse determine is the therapeutic effect of the medication?

● death of the microbial cells

A client who is receiving anti-infective therapy is experiencing gastrointestinal toxicity. What would the nurse expect to assess?

● diarrhea

What is a mechanism of action found in some antimicrobial drugs?

● inhibition of bacterial cell wall synthesis

The nurse is assessing a 10-year-old child who has been experiencing chronic headaches. The child's parent reports the administration of acetaminophen three to four times a day for the past several weeks. What assessment should the nurse prioritize?

● liver enzymes

An adult client is brought to the emergency department after deliberately overdosing on acetaminophen. The care team should prioritize interventions based on the client's risk for which adverse reaction?

● liver failure

The nurse administers a drug to treat Chlamydia trachomatis. The nurse is aware that this drug has no effect on any other bacteria. How should the nurse describe this characteristic of the drug?

● narrow spectrum

A 70-year-old woman on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. The client states that in the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to which?

● peptic ulcer disease or gastritis.

What occurs when the normal flora is destroyed by the use of anti-infectives?

● superinfection

Inappropriate use of antibiotics does all of the following except increase

● the number of available effective drugs for serious or antibiotic-resistant infections.

A client is scheduled for outpatient surgery for a toenail removal. When performing the preoperative teaching with the client, the nurse would instruct the client to avoid taking any salicylates for at least how many days before the surgery?

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