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Which are benefits of using a combination of two or more antibiotics? Select all that apply. Reduced risk in severe infection Reduced cost Reduced risk of superinfection Reduced resistance Reduced toxicity

Reduced risk in severe infection Reduced resistance Reduced toxicity

Which superficial mycosis is generally treated with oral antifungal agents? a. Tinea capitis b. Tinea corporis c. Tinea cruris d. Tinea pedis

a. Tinea capitis

A nurse is discussing the care of a patient with cancer with a nursing student. The patient is about to begin chemotherapy with a bifunctional alkylating agent. Which statement by the student indicates an understanding of this chemotherapeutic agent? a. "Alkylating agents are toxic to tissues that have rapidly dividing cells." b. "Bifunctional alkylating agents cannot form cross-links in DNA." c. "Resistance to alkylating agents is rare." d. "This drug needs to be given as a prolonged infusion."

a. "Alkylating agents are toxic to tissues that have rapidly dividing cells."

A patient asks a nurse about ways to minimize side effects of chemotherapy. Which response is correct? a. "Avoid contact with people who are ill." b. "Take antiemetics immediately after receiving chemotherapy." c. "Treat fevers immediately with ibuprofen." d. "Use a firm-bristled toothbrush to stimulate gums."

a. "Avoid contact with people who are ill."

A nurse is teaching a group of nursing students about cancer treatment. Which statement by a student indicates an understanding of the characteristics of cancer cells? a. "Cancer cells are characterized by unrestrained growth and division." b. "Division of cancer cells is characteristically rapid." c. "Malignant cells of solid tumors do not invade other tissues." d. "Telomerase is an enzyme produced by cancer cells that promotes metastases."

a. "Cancer cells are characterized by unrestrained growth and division."

A nurse is teaching a group of nursing students about how cytotoxic anticancer drugs affect normal cells. Which statement by a student indicates an understanding of this teaching? a. "Cytotoxic drugs lack tissue specificity." b. "Cytotoxic drugs have a high degree of selective toxicity." c. "Differences between cancer cells and normal cells are qualitative." d. "Neoplastic cells and normal tissue cells are very different."

a. "Cytotoxic drugs lack tissue specificity."

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. The nurse will expect to teach this patient about which medication? a. Acyclovir [Zovirax] b. Azithromycin [Zithromax] c. Metronidazole [Flagyl] d. Tinidazole [Tindamax]

a. Acyclovir [Zovirax]

A nurse is preparing to administer medications to a patient recently started on delavirdine [Rescriptor]. Which concurrent prescription should the nurse question before administration? a. Alprazolam [Xanax] b. Diphenhydramine [Benadryl] c. Morphine d. Penicillin

a. Alprazolam [Xanax]

A patient will begin chemotherapy with cisplatin. Which medications will the nurse expect to administer to offset this agent's side effects? a. Amifostine [Ethyol], diuretics, and antiemetics b. Antiemetics, vitamin B12, and glucocorticoids c. Dexamethasone, antiemetics, and vistonuridine d. Folic acid, gabapentin, and vitamin B12

a. Amifostine [Ethyol], diuretics, and antiemetics

A patient who is taking nelfinavir [Viracept] calls the nurse to report moderate to severe diarrhea. What will the nurse expect the provider to recommend? a. An over-the-counter antidiarrheal drug b. Immediate discontinuation of the nelfinavir c. Reducing the dose of nelfinavir by half d. Taking the nelfinavir with food to avoid side effects

a. An over-the-counter antidiarrheal drug

Amphotericin B is the drug of choice for which systemic mycosis? (Select all that apply.) a. Aspergillosis b. Candidiasis c. Dermatophytosis d. Histoplasmosis e. Mucormycosis

a. Aspergillosis d. Histoplasmosis e. Mucormycosis

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The nurse will expect the provider to order which drug? a. Azithromycin b. Doxycycline c. Erythromycin ethylsuccinate d. Sulfisoxazole

a. Azithromycin

What contributes to drug resistance to chemotherapeutic agents? (Select all that apply.) a. Cellular production of P-glycoprotein b. Creation of selection pressure by drugs c. Drug-induced cellular mutation d. Increased drug uptake by tumor cells e. Reduced target molecule sensitivity

a. Cellular production of P-glycoprotein b. Creation of selection pressure by drugs e. Reduced target molecule sensitivity

A patient is receiving intravenous vincristine [Oncovin]. The patient complains of pain at the IV insertion site. The nurse examines the site and notes an area of erythema and edema. What will the nurse do? a. Change the IV site and notify the provider of the extravasation. b. Contact the provider to suggest using a different chemotherapeutic agent. c. Obtain an order for a topical anesthetic to minimize discomfort. d. Slow the rate of infusion to reduce the patient's discomfort.

a. Change the IV site and notify the provider of the extravasation.

A nurse is preparing to administer an antibiotic to a patient with methicillin-resistant Staphylococcus aureus (MRSA). The nurse would expect the healthcare provider to order which antibiotic? a. Daptomycin [Cubicin] b. Levofloxacin [Levaquin] c. Norfloxacin [Noroxin] d. Ciprofloxacin [Cipro]

a. Daptomycin [Cubicin]

A patient with advanced cancer of the prostate begins treatment with leuprolide [Lupron Depot] injections and will receive 7.5 mg IM once per month. After the first injection, the patient experiences an increase in cancer symptoms. What will the nurse tell the patient? a. Desensitization to the drug over time will result in a decrease in these symptoms. b. The dose of leuprolide may have to be increased to 22.5 mg per month. c. These symptoms indicate a need for surgical castration to treat the cancer. d. This is a sign that the patient's cancer is getting worse.

a. Desensitization to the drug over time will result in a decrease in these symptoms.

A patient with colorectal cancer is admitted to the hospital oncology unit to receive cetuximab [Erbitux]. The nurse notes that the prescriber has not ordered any other medications. The nurse will contact the prescriber to request an order for which medication in order to minimize cetuximab's side effects? a. Diphenhydramine [Benadryl] b. Epinephrine c. Ondansetron [Zofran] d. Magnesium supplements

a. Diphenhydramine [Benadryl]

Which are guidelines for selecting chemotherapeutic agents to use in combination therapy? (Select all that apply.) a. Drugs used should have different mechanisms. b. Each drug should be delivered by different routes. c. Each drug should be effective. d. Each drug should have different dosing schedules. e. Toxicities should be minimally overlapping.

a. Drugs used should have different mechanisms c. Each drug should be effective. e. Toxicities should be minimally overlapping.

An adolescent patient comes to the clinic complaining of a burning sensation upon urination and a pus-like discharge from the penis. The nurse is correct to suspect that the patient has which disorder? a. Gonorrhea b. Herpes simplex c. Nongonococcal urethritis d. Syphilis

a. Gonorrhea

A 43-year-old patient with a strong family history of breast cancer considers taking tamoxifen [Nolvadex] for cancer prevention. Which assessment finding is a possible contraindication? a. History of deep vein thrombosis (DVT) b. History of osteoporosis c. Hyperlipidemia d. Prior hysterectomy

a. History of deep vein thrombosis (DVT)

A female patient has come to the STD clinic and has been diagnosed with a Trichomonas vaginalis infection. What education should be provided to this patient? a. Male partners should always be treated, even if they are asymptomatic. b. The applicator for the vaginal gel should be washed after each application. c. The infection is not completely eliminated with the medication. d. The medication should be taken twice daily for 2 weeks.

a. Male partners should always be treated, even if they are asymptomatic.

A nursing student asks a nurse why chemotherapeutic agents are given intermittently instead of continuously. The nurse will tell the student that intermittent dosing: a. allows normal cells to recover and repopulate. b. catches malignant cells in latent phases. c. increases cancer cell kill and speeds up treatment. d. suppresses drug resistance in tumor cells.

a. allows normal cells to recover and repopulate.

A patient who has a brain tumor will receive a nitrosourea agent. A nursing student asks why this type of drug is used for this type of cancer. The nurse will tell the student that nitrosoureas are useful because they: a. are lipophilic. b. are bifunctional alkylating agents. c. have a broad spectrum of antineoplastic characteristics. d. have delayed bone marrow suppression.

a. are lipophilic.

A patient with cancer who is receiving chemotherapy develops a fever. The patient's chest radiograph is normal. The patient's neutrophil count is 750/mm3. The nurse expects the provider to: a. begin empiric therapy with intravenous antibiotics. b. obtain cultures and wait for results before prescribing antibiotics. c. order colony-stimulating factor to minimize neutrophilia. d. reassure the patient that serious infection is unlikely.

a. begin empiric therapy with intravenous antibiotics.

A patient who has undergone surgical removal of a solid tumor has just begun chemotherapy. The patient experiences severe nausea and vomiting as well as alopecia. The nurse will expect the provider to: a. continue the chemotherapeutic agent at the same dose. b. decrease the dose of chemotherapy to minimize side effects. c. order lab tests to evaluate for the presence of residual cancer cells. d. stop the chemotherapy because the tumor has been removed.

a. continue the chemotherapeutic agent at the same dose.

A patient who has leukemia is receiving chemotherapy and develops severe anemia. The provider has ordered hospitalization and blood transfusions. The patient asks the nurse about using erythropoietin (epoetin alfa) instead. What will the nurse tell this patient? a. "Ask your provider about ordering erythropoietin instead of a transfusion." b. "Erythropoietin (epoetin alfa) can make your leukemia worse." c. "Erythropoietin is used to prolong life in patients with myeloid malignancies." d. "You will probably receive erythropoietin along with the transfusion."

b. "Erythropoietin (epoetin alfa) can make your leukemia worse."

A nurse provides teaching to a patient who will begin taking oral cyclophosphamide to treat non-Hodgkin's lymphoma. Which statement by the patient indicates an understanding about how to minimize side effects while taking this drug? a. "I don't need to worry about bone marrow suppression with this drug." b. "I should drink plenty of fluids while taking this drug." c. "I should take this drug on an empty stomach." d. "If I shampoo less often, I can prevent hair loss."

b. "I should drink plenty of fluids while taking this drug."

A nurse is teaching a group of nursing students about influenza prevention. Which statement by a student indicates understanding of the teaching? a. "I may develop a mild case of influenza if I receive the vaccine by injection." b. "I should receive the vaccine every year in October or November." c. "If I have a cold I should postpone getting the vaccine." d. "The antiviral medications are as effective as the flu vaccine for preventing the flu."

b. "I should receive the vaccine every year in October or November."

A patient will receive oral ciprofloxacin [Cipro] to treat a urinary tract infection. The nurse provides teaching for this patient. Which statement by the patient indicates a need for further teaching? a. "I may have abdominal pain and nausea, but these are usually mild." b. "I should take this medication with food or milk to improve absorption." c. "I should stop taking the medication immediately if I experience heel pain." d. "I will need to use sunscreen every time I go outdoors."

b. "I should take this medication with food or milk to improve absorption."

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The nurse will expect the provider to order which drug(s)? a. Azithromycin [Zithromax], 1 gm PO once, and doxycycline [Vibramycin], 100 mg PO twice daily for 7 days b. Ceftriaxone [Rocephin], 250 mg IM once, and azithromycin [Zithromax], 1 gm PO once c. Ceftriaxone [Rocephin], 125 mg IM once d. Doxycycline [Vibramycin], 100 mg IV twice daily for 12 days

b. Ceftriaxone [Rocephin], 250 mg IM once, and azithromycin [Zithromax], 1 gm PO once

A nursing student asks about the differences between cell-cycle phase-specific chemotherapeutic agents and those that are cell-cycle phase nonspecific. What will the nurse explain? a. Cell-cycle phase-nonspecific drugs are less toxic. b. Cell-cycle phase-specific drugs do not harm "resting" cells. c. Cell-cycle phase-specific drugs should be given at specific intervals. d. Neither type is toxic to cells in the "resting" G0 phase.

b. Cell-cycle phase-specific drugs do not harm "resting" cells.

The nurse is caring for a patient who has been receiving vinorelbine [Navelbine] for about 5 days. Which assessment finding in this patient would cause the nurse to withhold the next dose and notify the prescriber? a. Alopecia b. Dyspnea and cough c. Neutrophil count of 1200/mm3 d. Peripheral neuropathy

b. Dyspnea and cough

A patient will begin taking tamoxifen [Nolvadex] to treat breast cancer. The nurse performs a medication history and learns that the patient is taking sertraline [Zoloft] for depression. The nurse will tell the patient to contact her provider to ask about: a. increasing her dose of sertraline. b. changing from sertraline to escitalopram [Lexapro]. c. switching from sertraline to fluoxetine [Prozac]. d. decreasing her dose of tamoxifen.

b. changing from sertraline to escitalopram [Lexapro].

A patient with advanced prostate cancer will begin treatment with leuprolide [Lupron]. The provider has ordered flutamide to be given as adjunct therapy. The patient asks the nurse why both drugs are necessary. The nurse will tell the patient that: a. flutamide reduces the side effects, such as hot flushes, caused by leuprolide. b. flutamide suppresses initial tumor flare caused by leuprolide. c. leuprolide helps to reduce the toxicity of flutamide. d. the combination of both drugs increases cancer survival.

b. flutamide suppresses initial tumor flare caused by leuprolide.

The nurse would be correct to state that the purpose of angiogenesis inhibitors is to: a. kill existing cancer cells directly. b. suppress the formation of new blood vessels in tumors. c. enhance the size of collateral vessels. d. enhance red cell development in the bone marrow.

b. suppress the formation of new blood vessels in tumors.

A hospitalized patient with cancer is receiving chemotherapy and reports oral pain. Inspection of this patient's oral mucosa reveals erythema and inflammation without denudation or ulceration. The nurse understands that: a. chemotherapy will have to be stopped until healing of the oral mucosa occurs. b. the patient can use a mouthwash with a topical anesthetic to control pain. c. the patient will need an antifungal agent to treat Candida albicans. d. the patient will need systemic opioids to control discomfort.

b. the patient can use a mouthwash with a topical anesthetic to control pain.

A nursing student asks a nurse to explain the differences between amphotericin B [Abelcet] and the azoles group of antifungal agents. Which statement by the nurse is correct? a. "Amphotericin B can be given orally or intravenously." b. "Amphotericin B increases the levels of many other drugs." c. "Azoles have lower toxicity than amphotericin B." d. "Only the azoles are broad-spectrum antifungal agents."

c. "Azoles have lower toxicity than amphotericin B."

A nurse explains to a patient with cancer why it is difficult to achieve 100% cell kill to cure cancer with chemotherapy. Which statement by the patient indicates a need for further teaching? a. "It is necessary to continue giving the same dose of chemotherapeutic agents throughout therapy, even if toxicity occurs." b. "Symptoms of cancer often disappear before all malignant cells are eradicated." c. "The immune system attacks chemotherapeutic agents and renders them impotent." d. "The immune system often fails to recognize cancer cells as foreign."

c. "The immune system attacks chemotherapeutic agents and renders them impotent."

The nurse wants to evaluate a nursing student's understanding of chemotherapy. The nurse asks, "Which factor would be a major obstacle to successful chemotherapy?" What is the student's best response? a. "The patient's reluctance about the doses administered." b. "The patient's degree of nausea." c. "The toxicity of anticancer drugs to normal tissues." d. "The difficulty attaining and maintaining venous access."

c. "The toxicity of anticancer drugs to normal tissues."

A nurse is discussing vesicant chemotherapeutic agents with a nursing student. Which statement by the student indicates a need for further teaching about this type of drug? a. "Extravasation of this type of drug may result in the need for skin grafts." b. "If an IV line used for a vesicant drug infiltrates, it must be discontinued immediately." c. "These drugs may be administered orally as well as intravenously." d. "This type of drug may not be infused at a site of previous irradiation."

c. "These drugs may be administered orally as well as intravenously."

A newborn infant has been given erythromycin ophthalmic ointment as a routine postpartum medication. The infant's mother learns that she has a C. trachomatis infection and asks the nurse if her baby will need to be treated. Which response by the nurse is correct? a. "The erythromycin ointment will prevent your baby from developing conjunctivitis." b. "Without additional treatment, your baby could develop blindness." c. "Your baby will need to be treated with oral erythromycin." d. "Your baby will need to take doxycycline [Vibramycin] for 10 days."

c. "Your baby will need to be treated with oral erythromycin."

A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient? a. Azithromycin [Zithromax], 1 gm PO once, and cefoxitin, 2 gm IM once in the clinic b. Ceftriaxone [Rocephin], 250 mg IM once, with doxycycline [Vibramycin], 100 mg PO twice daily for 14 days as an outpatient c. Doxycycline [Vibramycin], 100 mg IV twice daily, and cefoxitin, 2 gm IV every 6 hours in the hospital d. Doxycycline [Vibramycin], 100 mg PO twice daily for 14 days, and metronidazole [Flagyl], 500 mg PO twice daily for 14 days in the hospital

c. Doxycycline [Vibramycin], 100 mg IV twice daily, and cefoxitin, 2 gm IV every 6 hours in the hospital

A patient with non-Hodgkin's lymphoma is about to begin chemotherapy with a massive dose of methotrexate [Rheumatrex]. The nurse will expect to administer which medication concurrently with this drug? a. Dexamethasone b. Folic acid c. Leucovorin d. Vitamin B12

c. Leucovorin

The nurse on an oncology unit prepares to administer the fourth cycle of docetaxel [Taxotere] to a patient with breast cancer. Which clinical finding would cause the nurse to withhold the dose and call the prescriber? a. Alanine transaminase (ALT) 1.2 times the upper limit b. Alkaline phosphatase 2 times the upper limit c. Neutrophil count below 1500/mm3 d. Creatinine clearance of 130 mL/min/1.73 m2

c. Neutrophil count below 1500/mm3

A nurse is preparing to administer a second infusion of trastuzumab [Herceptin] to a patient who has breast cancer. The patient tells the nurse that she experienced chills, fever, pain, and nausea after her first infusion. What will the nurse do? a. Contact the provider to request a CBC to assess for neutropenia. b. Ensure that oxygen and respiratory support measures are readily available. c. Reassure the patient that these symptoms will diminish with each infusion. d. Request an order for an electrocardiogram.

c. Reassure the patient that these symptoms will diminish with each infusion.

A patient is admitted to the hospital with fever, headache, malaise, joint pain, and enlarged lymph nodes. Blood cultures are positive for Treponema pallidum. The nurse recognizes this as which type of syphilis? a. Congenital b. Primary c. Secondary d. Tertiary

c. Secondary

These patients are receiving chemotherapy. Which patient should the nurse see first? a. The patient with lightly bleeding gums b. The patient with nausea and vomiting c. The patient with a fever of 100.3°F d. The patient with diarrhea and stomatitis

c. The patient with a fever of 100.3°F

A patient is being treated with amphotericin B [Abelcet] for a systemic fungal infection. After several weeks of therapy, the provider orders flucytosine [Ancobon] in addition to the amphotericin. The nurse understands that the rationale for this combination is that it: a. broadens the antifungal spectrum. b. improves the effectiveness of the amphotericin B. c. lowers the dose of amphotericin B and reduces toxicity. d. treats fungal central nervous system (CNS) infection.

c. lowers the dose of amphotericin B and reduces toxicity.

A pregnant female patient with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The nurse knows that the best alternative for treating this urinary tract infection is with: a. cephalexin [Keflex]. b. fosfomycin [Monurol]. c. methenamine [Hiprex]. d. nitrofurantoin [Macrodantin].

c. methenamine [Hiprex].

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. The nurse expects that the prescriber will manage these levels with: a. lovastatin [Mevacor]. b. simvastatin [Zocor]. c. modified diet and exercise. d. Pancrease.

c. modified diet and exercise.

A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: a. antiviral medications are not safe during pregnancy. b. intravenous antiviral agents will be used if an outbreak occurs. c. oral acyclovir [Zovirax] may be used during pregnancy. d. topical acyclovir [Zovirax] must be used to control outbreaks.

c. oral acyclovir [Zovirax] may be used during pregnancy.

A patient has been taking isoniazid [Nydrazid] for 4 months for latent tuberculosis. The patient reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. The nurse expects the provider to: a. discontinue the isoniazid. b. lower the isoniazid dose and add rifampin. c. order pyridoxine 100 mg per day. d. recheck the tuberculin skin test to see whether it worsens.

c. order pyridoxine 100 mg per day.

A patient presents to the emergency department with complaints of chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9°F, a pulse of 92 beats per minute, respirations of 24 breaths per minute, and a blood pressure of 119/58 mm Hg. The nurse would be correct to suspect that the patient shows signs and symptoms of: a. acute cystitis. b. urinary tract infection. c. pyelonephritis. d. prostatitis.

c. pyelonephritis.

A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a. "I need to drink extra fluids while taking this medication." b. "I need to use sunscreen when taking this drug." c. "I should call my provider if I develop a rash while taking this drug." d. "I should stop taking this drug when my symptoms are gone."

d. "I should stop taking this drug when my symptoms are gone."

A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? a. "Bacterial resistance to trimethoprim is relatively uncommon." b. "Resistance among gonococci, streptococci, and meningococci to sulfonamides is high." c. "Resistance to both agents can occur by spontaneous mutation of organisms." d. "Resistance to sulfonamides is less than resistance to trimethoprim."

d. "Resistance to sulfonamides is less than resistance to trimethoprim."

A patient with cancer has a tumor composed mostly of G0 cells. When teaching this patient about the disease, the nurse will make which statement? a. "Cells in this patient's type of tumor will proliferate rapidly." b. "Chemotherapeutic agents that are not toxic to other tissues may be used." c. "This type of tumor is especially sensitive to chemotherapy." d. "This tumor will be managed primarily with surgery."

d. "This tumor will be managed primarily with surgery."

A nurse is teaching a group of adolescent students about sexually transmitted diseases. Which statement by a student indicates understanding of infections caused by C. trachomatis? a. "C. trachomatis conjunctivitis in newborns can result in blindness." b. "The CDC recommends screening for chlamydial infections in all sexually active men." c. "Treatment for C. trachomatis should be initiated when infections are symptomatic." d. "Women with asymptomatic Chlamydia trachomatis infections can become sterile."

d. "Women with asymptomatic Chlamydia trachomatis infections can become sterile."

The nurse is preparing to administer medication to a patient receiving cyclophosphamide [Cytoxan]. To protect against the side effect of hemorrhagic cystitis, the nurse would expect to administer which drug? a. Decadron b. Diphenhydramine [Benadryl] c. Leucovorin d. Mesna [Mesnex]

d. Mesna [Mesnex]

A patient on an oncology unit has been receiving ifosfamide [Ifex] for a few days. Before administering the next dose, the nurse reviews the patient's laboratory test results. Which finding would cause the nurse to hold the dose? a. Elevated white blood cell count b. Low hemoglobin and hematocrit levels c. Low levels of ketones in the urine d. Microscopic hematuria

d. Microscopic hematuria

A patient will begin receiving vincristine [Oncovin] to treat Hodgkin's lymphoma. Which side effect(s) will the nurse tell the patient to report immediately? a. Diarrhea, nausea, and vomiting b. Hair loss c. Headaches d. Tingling of the extremities

d. Tingling of the extremities

A premenopausal woman has ER-positive breast cancer, and her prescriber has ordered tamoxifen [Nolvadex]. She asks the nurse if anastrozole [Arimidex] would work better for her. What will the nurse tell her? a. Anastrozole is more likely to cause hot flushes than tamoxifen. b. Anastrozole is more likely to promote endometrial carcinoma. c. Cancer recurrence is higher with anastrozole. d. Until she is postmenopausal, anastrozole will not be effective.

d. Until she is postmenopausal, anastrozole will not be effective.

A patient has an invasive aspergillosis infection. Which antifungal agent is the drug of choice for this infection? a. Amphotericin B b. Fluconazole [Diflucan] c. Posaconazole [Noxafil] d. Voriconazole [Vfend]

d. Voriconazole [Vfend]

After starting an antiviral protease inhibitor, a patient with HIV telephones the nurse, complaining, "I'm so hungry and thirsty all the time! I'm urinating 10 or 12 times a day." The nurse recognizes these findings to be consistent with: a. pancreatic infiltration by HIV. b. allergic reaction. c. nonadherence to the antiviral regimen. d. hyperglycemia.

d. hyperglycemia.

A patient will receive intrathecal liposomal cytarabine [DepoCyt] to treat acute myelogenous leukemia. The provider has ordered the concurrent administration of dexamethasone. The nurse understands that this is given to: a. prevent bone marrow suppression. b. prevent hair loss and stomatitis. c. reduce the incidence of pulmonary edema. d. reduce the severity of chemical arachnoiditis.

d. reduce the severity of chemical arachnoiditis.

A patient has just been diagnosed with cancer and will begin chemotherapy. The patient asks the nurse about the possibility of nausea and vomiting. The nurse will tell the patient that: a. nausea and vomiting can be avoided by having a snack before chemotherapy. b. nausea and vomiting are common side effects and will abate over time. c. nausea and vomiting are common and will be treated with antiemetics when they occur. d. the provider will order drugs to help prevent nausea and vomiting before each dose.

d. the provider will order drugs to help prevent nausea and vomiting before each dose.

A nurse is caring for a patient who takes an ACE inhibitor and an ARB medication who will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the nurse expect to monitor closely? a. Calcium b. Chloride c. Potassium d. Sodium

c. Potassium

A patient is being treated for a systemic fungal infection with amphotericin B [Abelcet] and will be discharged home from the hospital to complete every other day infusions of the medication for 6 to 8 weeks. The nurse provides discharge teaching before dismissal. Which statement by the patient indicates a need for further teaching? a. "I may experience headaches and pain in my lower back, legs, and abdomen." b. "I may need to take potassium supplements while taking this drug." c. "I should take acetaminophen and diphenhydramine before each infusion." d. "I will need to have blood drawn for serum creatinine and BUN levels every 3 to 4 days."

a. "I may experience headaches and pain in my lower back, legs, and abdomen."

A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her? a. "This agent is not effective against infections of the upper urinary tract." b. "This antiseptic agent is safe for use during pregnancy and has no drug resistance." c. "This drug is linked to many serious birth defects and is not recommended during pregnancy." d. "You will need to take this medication with meals to avoid gastric upset."

a. "This agent is not effective against infections of the upper urinary tract."

The nurse is preparing to administer amphotericin B intravenously. The nurse will expect to pretreat the patient with which medications? a. Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol] b. Aspirin, diphenhydramine [Benadryl], and meperidine [Demerol] c. Ibuprofen [Motrin], diphenhydramine [Benadryl], and meperidine [Demerol] d. Morphine sulphate [Morphine] and acetaminophen ]Tylenol]

a. Acetaminophen [Tylenol], diphenhydramine [Benadryl], and meperidine [Demerol]

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. restrict dairy products. d. switch to gemifloxacin.

a. add metronidazole [Flagyl].

A patient with high-risk factors for tuberculosis will begin therapy for latent TB with isoniazid and rifampin. The nurse learns that this patient takes oral contraceptives. The nurse will counsel this patient to discuss ____ with her provider. a. another birth control method b. reducing the rifampin dose c. reducing the isoniazid dose d. increasing the oral contraceptive dose

a. another birth control method

A patient who is taking drugs to treat HIV has tuberculosis and has been on a four-drug regimen for 3 months without improvement in symptoms. Which drug will the nurse anticipate that the provider will add to this patient's regimen? a. bedaquiline [Sirturo] b. capreomycin [Capastat Sulfate] c.ethionamide [Trecator] d.pyridoxine

a. bedaquiline [Sirturo]

A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. The nurse anticipates that the prescriber will: a. begin a 2-week course of antibiotics. b. evaluate for a structural abnormality of the urinary tract. c. initiate long-term prophylaxis with low-dose antibiotics. d. treat the patient with intravenous antibiotics.

a. begin a 2-week course of antibiotics.

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. The nurse caring for this patient understands that it is important for the provider to: a. begin antibiotic therapy after urine culture and sensitivity results are available. b. give prophylactic antibiotics for 6 weeks after the acute infection has cleared. c. initiate immediate treatment with broad-spectrum antibiotics. d. refer the patient for intravenous antibiotics and hospitalization.

a. begin antibiotic therapy after urine culture and sensitivity results are available.

A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When providing teaching for this patient, the nurse will tell the patient that it will be important to: a. drink 8 to 10 glasses of water each day. b. eat foods that are high in potassium. c. take the medication with food. d. take folic acid supplements.

a. drink 8 to 10 glasses of water each day.

A patient is taking oral ketoconazole [Nizoral] for a systemic fungal infection. The nurse reviews the medication administration record and notes that the patient is also taking omeprazole [Prilosec] for reflux disease. What action should the nurse take? a. Administer the omeprazole 1 hour before the ketoconazole. b. Administer the omeprazole at least 2 hours after the ketoconazole. c. Confer with the prescriber about a potential hazardous interaction. d. The nurse should not administer omeprazole to a patient receiving ketoconazole.

b. Administer the omeprazole at least 2 hours after the ketoconazole.

A nurse is caring for a patient who is receiving amphotericin B [Abelcet] for a systemic fungal infection. In spite of receiving diphenhydramine and acetaminophen before initiation of treatment, the patient has fever and chills with rigors. The nurse will contact the provider to discuss the addition of which drug? a. Aspirin b. Dantrolene c. Hydrocortisone d. Omeprazole

b. Dantrolene

A patient with a history of congestive heart failure and renal impairment has esophageal candidiasis. Which antifungal agent would the nurse anticipate giving to this patient? a. Amphotericin B [Abelcet] b. Fluconazole [Diflucan] c. Itraconazole [Sporanox] d. Voriconazole [Vfend]

b. Fluconazole [Diflucan]

The nurse is performing a physical assessment on a patient who is receiving treatment with abacavir, zidovudine, and lamivudine [Trizivir]. The patient complains of fatigue. Upon further assessment, the nurse finds a rash and notes that the patient has a temperature of 101.1°F. What is the nurse's best course of action? a. Tell the patient that this is an expected response to these medications and to continue the agents as prescribed. b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber. c. Have the patient continue the abacavir but discontinue the other two agents for 3 weeks. d. Instruct the patient to continue all three medications and administer an antihistamine for the symptoms.

b. Have the patient hold the medications and arrange for an immediate evaluation by the prescriber.

A nursing student is caring for a patient with community-acquired pneumonia (CAP) who also has a methicillin-resistant Staphylococcus aureus (MRSA) skin infection. The prescriber has ordered daptomycin [Cubicin]. The nurse encourages the student to approach the provider to request a different antibiotic because of which facts about daptomycin? (Select all that apply.) a. It causes significant renal impairment. b. It is approved only for bloodstream and skin infections. c. It increases the risk of serious cardiorespiratory events. d. It is more likely to produce resistant strains of bacteria. e. It is not effective against MRSA infections.

b. It is approved only for bloodstream and skin infections. c. It increases the risk of serious cardiorespiratory events.

A patient taking stavudine [Zerit] telephones the clinic and reports numbness and tingling in the hands and feet. What should the nurse tell the patient? a. The numbness is an expected side effect of the medication and will diminish once the drug is withdrawn. b. The medication will probably be stopped, and the patient should come into the clinic for further evaluation. c. The dose may be too high, and the patient should cut the tablet in half. d. The patient should take the medication on a full stomach to reduce absorption of the drug.

b. The medication will probably be stopped, and the patient should come into the clinic for further evaluation.

A patient who is taking ketoconazole tells the nurse that her periods have become irregular. What will the nurse tell her? a. This indicates that she should begin taking oral contraceptives. b. This is caused by a reversible effect on estradiol synthesis. c. This is a serious side effect that warrants discontinuation of the drug. d. This is a sign of hepatic toxicity, and the drug dose should be lowered.

b. This is caused by a reversible effect on estradiol synthesis.

A patient with hepatitis B begins treatment with adefovir [Hepsera] and asks the nurse how long the drug therapy will last. The nurse will tell the patient that the medication will need to be taken for: a. a lifetime. b. an indefinite, prolonged period of time. c. 48 weeks. d. until nephrotoxicity occurs.

b. an indefinite, prolonged period of time.

A patient comes to a clinic for tuberculosis medications 2 weeks after beginning treatment with a four-drug induction phase. The patient's sputum culture remains positive, and no drug resistance is noted. At this point, the nurse will expect the provider to: a. change the regimen to a two-drug continuation phase. b. continue the four-drug regimen and recheck the sputum in 2 weeks. c. obtain a chest radiograph and consider adding another drug to the regimen. d. question the patient about adherence to the drug regimen.

b. continue the four-drug regimen and recheck the sputum in 2 weeks.

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir [Zovirax] 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. The nurse will expect the provider to: a. extend this patient's drug therapy to twice daily for 12 months. b. give intravenous foscarnet every 8 hours for 2 to 3 weeks. c. increase the acyclovir dose to 800 mg PO 5 times daily. d. order intravenous valacyclovir [Valtrex] 1 gm PO twice daily for 10 days.

b. give intravenous foscarnet every 8 hours for 2 to 3 weeks.

An immunocompromised child is exposed to chickenpox and the provider orders valacyclovir [Valtrex] to be given orally three times daily. The nurse will contact the provider to change this order for which reason? a. Valacyclovir is not used as varicella prophylaxis. b. The dosage is too high for this indication. c. The drug may cause serious adverse effects in immunocompromised patients. d. Valacyclovir is not approved for use in children.

c. The drug may cause serious adverse effects in immunocompromised patients

A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? a. Patients with diabetes have an increased risk of an allergic reaction. b. Patients taking TMP/SMZ may need increased doses of glipizide. c. The patient should check the blood glucose level more often while taking TMP/SMZ. d. The patient should stop taking the glipizide while taking the TMP/SMZ.

c. The patient should check the blood glucose level more often while taking TMP/SMZ.

A nursing student asks a nurse why pegylated interferon alfa is used instead of regular interferon for a patient with hepatitis C. The nurse will tell the student that pegylated interferon: a. decreases the need for additional medications. b. has fewer adverse effects than interferon. c. is administered less frequently than interferon. d. may be given orally to increase ease of use.

c. is administered less frequently than interferon.

A patient who is taking didanosine [Videx] reports nausea, vomiting, and abdominal pain. What will the nurse recommend to this patient? a. "Take the drug with food to minimize these side effects." b. "Stop taking the drug immediately and resume taking it once your symptoms subside." c. "Take the medication in the evening to avoid experiencing these kinds of symptoms." d. "You will need laboratory tests to determine if these are serious effects of the drug."

d. "You will need laboratory tests to determine if these are serious effects of the drug."

A patient who has drug-sensitive tuberculosis has completed 2 months of the standard four-drug therapy and asks the nurse how long he will have to take medication. Which response by the nurse is correct? a. "As long as you remain symptomatic, you will not have to take more medication." b. "The four-drug regimen will continue for 3 more months." c. "You will have to take maintenance drugs indefinitely." d. "You will need to take only two drugs for the next 4 months."

d. "You will need to take only two drugs for the next 4 months."

A nurse reads a tuberculin skin test on a patient and notes a 6- to 7-mm area of induration. The patient is a young adult who has recently immigrated from a country with a high prevalence of tuberculosis. The patient has no other risk factors. The nurse will expect the provider to: a. begin treating this patient with a two-drug regimen of isoniazid and rifampin. b. order a chest radiograph and a sputum culture to assess for active tuberculosis. c. order a nucleic acid amplification test of the patient's sputum. d. reassure the patient that this is not considered a positive test result.

d. reassure the patient that this is not considered a positive test result.

Ketoconazole is used as an alternative to amphotericin B for less severe systemic mycosis. Which are the primary reasons for choosing ketoconazole? (Select all that apply.) a. It can be given orally. b. It can be used safely in patients with hepatic dysfunction. c. It can be given once weekly rather than daily. d. It is effective for severe, acute infections. e. It is less toxic.

a. It can be given orally. e. It is less toxic.

A patient has a systemic candidal infection, and the provider has ordered oral fluconazole [Diflucan] 400 mg on day 1 and 200 mg once daily thereafter. What will the nurse do? a. Administer the drug as ordered. b. Contact the provider to discuss cutting the dosing in half. c. Contact the provider to discuss giving 400 mg on all days. d. Contact the provider to discuss giving the drug intravenously.

a. Administer the drug as ordered.

Which antibiotics may be administered topically? (Select all that apply.) a. Bacitracin b. Daptomycin c. Ofloxacin d. Polymyxin B e. Rifampin

a. Bacitracind. d. Polymyxin B

A patient with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What will the nurse do? a. Notify the provider and request an order for a serum calcium level. b. Notify the provider of potential foscarnet overdose. c. Request an order for a creatinine clearance level. d. Request an order of IV saline to be given before the next dose.

a. Notify the provider and request an order for a serum calcium level.

A 20-year-old female patient has suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment? a. Uncomplicated lower urinary tract infection treatable with short-course therapy b. Complicated lower urinary tract infection treatable with single-dose therapy c. Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics d. Complicated upper urinary tract infection requiring parenteral antibiotics

a. Uncomplicated lower urinary tract infection treatable with short-course therapy

A hospitalized patient is being treated for tuberculosis with a drug regimen that includes pyrazinamide. The patient complains of pain in the knee and shoulder joints. The nurse will contact the provider to request an order for: a. ibuprofen. b. renal function tests. c. discontinuation of the pyrazinamide. d. measurement of uric acid levels.

a. ibuprofen.

A patient is receiving intravenous voriconazole [Vfend]. Shortly after the infusion starts, the patient tells the nurse, "Colors look different, and the light hurts my eyes." What will the nurse do? a. Observe the patient closely for the development of hallucinations. b. Reassure the patient that these effects will subside in about 30 minutes. c. Stop the infusion and notify the provider of CNS toxicity. d. Tell the patient that this is an irreversible effect of the drug.

b. Reassure the patient that these effects will subside in about 30 minutes.

A patient has a positive test for influenza type A and tells the nurse that symptoms began 5 days before being tested. The prescriber has ordered oseltamivir [Tamiflu]. The nurse will tell the patient that oseltamivir: a. may decrease symptom duration by 2 or 3 days. b. may not be effective because of the delay in starting treatment. c. may reduce the severity but not the duration of symptoms. d. will alleviate symptoms within 24 hours of the start of therapy.

b. may not be effective because of the delay in starting treatment.

A patient has a positive test for hepatitis C and is admitted to the hospital. The admission laboratory tests reveal a normal ALT, and a liver biopsy is negative for hepatic fibrosis and inflammation. The nurse will prepare this patient for: a. dual therapy with pegylated interferon alfa and ribavirin. b. no medication therapy at this time. c. pegylated interferon alfa only until ALT levels are elevated. d. triple drug therapy with pegylated interferon alfa, ribavirin, and boceprevir.

b. no medication therapy at this time.

The nurse is caring for a patient who is HIV positive and is taking zidovudine [Retrovir]. Before administering the medication, the nurse should monitor which laboratory values? a. Ketones in the urine and blood b. Serum immunoglobulin levels c. Serum lactate dehydrogenase d. Complete blood count (CBC)

d. Complete blood count (CBC)

A patient has lamivudine-resistant hepatitis B and has been taking entecavir [Baraclude] for 2 years. The patient asks the nurse why the provider has recommended taking the drug for another year. What will the nurse tell the patient? a. "Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term." b. "It is necessary to continue taking entecavir to avoid withdrawal symptoms." c. "The drug will be given until the infection is completely eradicated." d. "You will need to continue taking entecavir to prevent lactic acidosis and hepatotoxicity."

a. "Entecavir can reverse fibrosis and cirrhosis of the liver when taken long term."

A patient with chronic myeloid leukemia (CML) begins treatment with imatinib [Gleevec]. Which statement by the patient indicates understanding of this medication? a. "Resistance to this drug may develop over time." b. "The intensity of side effects is dose dependent." c. "This drug does not have significant drug interactions." d. "This drug must be given intravenously."

a. "Resistance to this drug may develop over time."

The nurse is providing education to a group of patients who are HIV positive. The nurse is discussing the various medications used to treat HIV infection. A patient asks about nevirapine [Viramune]. Which statements by the nurse most accurately reflect the facts about nevirapine? (Select all that apply.) a. "Some herbal preparations can reduce the levels of this drug." b. "This agent can damage the liver; therefore, liver function tests are needed periodically." c. "Usually no adverse effects occur when this medication is used alone." d. "The drug must be dosed five times per day at evenly spaced intervals." e. "You should call your healthcare provider immediately if you develop a rash."

a. "Some herbal preparations can reduce the levels of this drug." b. "This agent can damage the liver; therefore, liver function tests are needed periodically." e. "You should call your healthcare provider immediately if you develop a rash."

A male patient with hepatitis C will begin triple drug therapy with pegylated interferon alfa 2a [Pegasys], ribavirin [Ribasphere], and boceprevir [Victrelis]. The patient tells the nurse that his wife is pregnant. What will the nurse tell him? a. Boceprevir is contraindicated in males whose partners are pregnant. b. He should use a barrier contraceptive when having sex. c. He should use dual drug therapy with pegylated interferon alfa and ribavirin only. d. This combination drug therapy is safe for him to use.

a. Boceprevir is contraindicated in males whose partners are pregnant.

Which infections may be acquired through nonsexual transmission? (Select all that apply.) a. Chlamydia trachomatis b. Gardnerella vaginalis c. Herpes simplex d. Neisseria gonorrhea e. Treponema pallidum

a. Chlamydia trachomatis b. Gardnerella vaginalis c. Herpes simplex d. Neisseria gonorrhea e. Treponema pallidum

Which fluoroquinolone antibiotics may be administered to children? (Select all that apply.) a. Ciprofloxacin [Cipro] b. Levofloxacin [Levaquin] c. Moxifloxacin [Avelox] d. Norfloxacin [Noroxin] e. Ofloxacin

a. Ciprofloxacin [Cipro] b. Levofloxacin [Levaquin]

A patient is about to begin therapy with ethambutol. The nurse knows that, before initiating treatment with this drug, it is important to obtain which test(s)? a. Color vision and visual acuity b. Complete blood cell (CBC) count c. Hearing testing and a tympanogram d. Hepatic function tests

a. Color vision and visual acuity

A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the nurse learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What will the nurse do? a. Contact the provider to request a different antibiotic for this patient. b. Obtain frequent blood glucose determinations while giving TMP/SMZ. c. Suggest that the patient take a potassium supplement while taking TMP/SMZ. d. Tell the patient to avoid excessive fluid intake while taking TMP/SMZ.

a. Contact the provider to request a different antibiotic for this patient.

Before giving methenamine [Hiprex] to a patient, it is important for the nurse to review the patient's history for evidence of which problem? a. Elevated blood urea nitrogen and creatinine b. History of reactions to antibiotic agents c. Possibility of pregnancy d. Previous resistance to antiseptic agents

a. Elevated blood urea nitrogen and creatinine

The nurse is caring for a patient who is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine [Videx]. Which laboratory findings would most concern the nurse? a. Increased serum amylase and triglycerides and decreased serum calcium b. Decreased serum amylase and serum triglycerides and increased serum calcium c. Decreased hemoglobin and hematocrit d. Increased serum amylase, decreased triglycerides, and increased platelets

a. Increased serum amylase and triglycerides and decreased serum calcium

A patient who is being treated for HIV infection has a 5-mm area of induration after a routine TST. The patient's chest radiograph is normal, and there are no other physical findings. The nurse will expect this patient to begin treatment with which drugs? a. Isoniazid and rifabutin b. Isoniazid and rifampin c. Isoniazid and rifapentine d. Isoniazid and pyrazinamide

a. Isoniazid and rifabutin

A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will be used for this patient? a. Isoniazid, pyrazinamide, ethambutol + rifabutin b. Isoniazid, pyrazinamide, ethambutol c. Isoniazid, rifampin, pyrazinamide, ethambutol d. Isoniazid + rifabutin

a. Isoniazid, pyrazinamide, ethambutol + rifabutin

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. Instruct the patient to exercise the right foot and ankle to minimize the pain. c. Question the patient about the consumption of milk and any other dairy products. d. Request an order to increase this patient's dose of glucocorticoids.

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

A patient newly diagnosed with tuberculosis asks the nurse why oral medications must be given in the clinic. The nurse will tell the patient that medications are given in the clinic so that: a. clinic staff can observe adherence to drug regimens . b. nurses can monitor for drug toxicities. c. providers can adjust doses as needed. d. the staff can ensure that the U.S. Food and Drug Administration (FDA) regulations are met.

a. clinic staff can observe adherence to drug regimens

The nurse is caring for a patient receiving intravenous acyclovir [Zovirax]. To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: a. hydrate the patient during the infusion and for 2 hours after the infusion. b. increase the patient's intake of foods rich in vitamin C. c. monitor urinary output every 30 minutes. d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.

a. hydrate the patient during the infusion and for 2 hours after the infusion.

A patient comes to the clinic and receives valacyclovir [Valtrex] for a herpes-zoster virus. The nurse instructs the patient to take the medication: a. without regard to meals. b. without any dairy products. c. each morning. d. on an empty stomach.

a. without regard to meals.

A patient is about to begin treatment for latent tuberculosis. The patient is an alcoholic, has difficulty complying with drug regimens, and has mild liver damage. What will the nurse tell this patient? a. "You must stop drinking before adequate treatment can begin." b. "You must take isoniazid with close monitoring of hepatic function." c. "You must take rifampin daily for 4 months." d. "You will begin a regimen of isoniazid and rifampin."

b. "You must take isoniazid with close monitoring of hepatic function."

Which patient should begin treatment for tuberculosis? a. A patient with HIV and a tuberculin skin test result of a 4-mm region of induration b. A recent immigrant from a country with a high prevalence of TB with a 10-mm region of induration c. A patient with no known risk factors who has a job-related tuberculin skin test result of a 12-mm area of induration d. An intravenous drug abuser with a tuberculin skin test result of a 5-mm region of induration

b. A recent immigrant from a country with a high prevalence of TB with a 10-mm region of induration

A nursing student asks the nurse what differentiates antiestrogen drugs from aromatase inhibitors in the treatment of breast cancer. What is the correct response by the nurse? a. Antiestrogen drugs decrease the risk for thromboembolic events. b. Antiestrogen drugs increase the risk for endometrial cancer. c. Aromatase inhibitors block the production of estrogen by the ovaries. d. Aromatase inhibitors can be used for tumor cells that lack estrogen receptors.

b. Antiestrogen drugs increase the risk for endometrial cancer.

The nurse is caring for a patient in the oncology unit who was recently diagnosed with advanced renal carcinoma. The nurse prepares to administer aldesleukin [Proleukin] as part of the treatment regimen. What is the primary adverse effect of this drug? a. Hypertension b. Capillary leakage syndrome c. Hyperglycemia d. Hyperuricemia

b. Capillary leakage syndrome

A patient is receiving fluorouracil [Adrucil] as a continuous intravenous dose to treat a solid tumor. The patient reports soreness and blisters in the mouth, loose stools, and tingling of the hands and feet. What will the nurse do? a. Contact the provider to discuss bolus dosing instead of continuous dosing. b. Discontinue the medication and contact the provider to report these symptoms. c. Reassure the patient that these are expected, uncomfortable side effects. d. Request an order for dexamethasone to treat these side effects.

b. Discontinue the medication and contact the provider to report these symptoms.

The nurse is preparing to administer a first dose of ado-trastuzumab emtansine [Kadcycla] to a patient who has metastatic breast cancer. Which nursing action is correct? a. Administer a test dose with an antihistamine. b. Ensure that the patient has HER2-positive disease. c. Infuse the initial dose over 30 to 45 minutes. d. Review renal function tests.

b. Ensure that the patient has HER2-positive disease.

A patient who has urinary bladder cancer will begin receiving the chemotherapeutic agent valrubicin [Valstar]. What will the nurse do when administering this drug? a. Administer the drug intravenously using a large bore needle and tubing. b. Ensure that the tubing used to administer the drug does not contain polyvinyl chloride. c. Monitor the patient closely for a variety of systemic drug adverse effects. d. Use a normal saline or sterile water diluent to dilute the medication.

b. Ensure that the tubing used to administer the drug does not contain polyvinyl chloride.

The nurse asks a graduate nurse, "When a patient in the initial phase of HIV infection is assessed, which findings would you expect to see?" The graduate nurse would be correct to respond with which conditions? (Select all that apply.) a. Respiratory distress b. Fever c. Myalgia d. Lymphadenopathy e. Insomnia

b. Fever c. Myalgia d. Lymphadenopathy

A patient admitted to the hospital is using metronidazole [Flagyl] 0.75% gel. The nurse understands that this agent is used to treat which condition? a. Chlamydia trachomatis b. Gardnerella vaginalis c. Haemophilus ducreyi d. Trichomonas vaginalis

b. Gardnerella vaginalis

A 45-year-old patient with a family history of breast cancer is considering using tamoxifen [Nolvadex] for cancer prevention. The nurse performs a health history and learns that the woman had a child when she was 35 years old, that she has not had a hysterectomy, and that she experienced DVT when she was pregnant. What will the nurse tell the patient? a. Because of her family risk and late childbearing, this drug is a good choice for her. b. Her history of DVT outweighs any possible benefits she may have with this drug. c. Since she has not had a hysterectomy, the risk of endometrial cancer is too great. d. When she turns 50 years old, this drug will carry fewer risks for her.

b. Her history of DVT outweighs any possible benefits she may have with this drug.

The nurse is preparing to discharge a patient with HIV who will continue to take enfuvirtide [Fuzeon] at home. The nurse is providing patient education about the medication. What information about the administration of enfuvirtide is most appropriate for the patient? a. The importance of injecting the drug into two alternating sites daily b. How to reconstitute and self-administer a subcutaneous injection c. The importance of taking the drug with high doses of vitamin E d. Likely drug interactions between enfuvirtide and other antiretroviral drugs

b. How to reconstitute and self-administer a subcutaneous injection

A patient is about to begin treatment for latent tuberculosis with a short course of daily rifampin. The patient asks why rifapentine [Priftin] cannot be used, because it can be given twice weekly. What will the nurse tell this patient about rifapentine? a. It is more toxic than rifampin. b. It is not approved for treatment of latent TB. c. It is not well absorbed and thus not as effective. d. It will stain contact lenses orange.

b. It is not approved for treatment of latent TB.

A patient is receiving chemotherapy. Seven days after a dose, the patient's neutrophil count is 1000 cells/mm3. The nurse will tell this patient: a. that hospitalization is necessary to provide infection prophylaxis. b. that the provider will probably repeat the lab work in 3 to 5 days. c. to ask the provider about skipping the next dose of chemotherapy. d. to report any symptoms such as pus, abscesses, or cough.

b. that the provider will probably repeat the lab work in 3 to 5 days.

The nurse is caring for a patient who is human immunodeficiency virus (HIV) positive and is taking high doses of zidovudine [Retrovir]. The nurse is providing patient education about the adverse effects of the medication. Which statement by the patient demonstrates a need for further teaching? a. "I may experience fatigue from anemia." b. "I may be more susceptible to infection from neutropenia." c. "I may have a deficiency of vitamin B6." d. "I may have a deficiency of folic acid."

c. "I may have a deficiency of vitamin B6."

A nurse is discussing intravenous amphotericin B treatment with a nursing student who is about to care for a patient with a systemic fungal infection. Which statement by the student indicates a need for further teaching? a. "A test dose of amphotericin B may be given to assess the patient's reaction." b. "If I see any precipitate in the IV solution, I should stop the infusion immediately." c. "Infusions of amphotericin B should be administered over 1 to 2 hours." d. "The IV site should be rotated frequently to reduce the risk of phlebitis."

c. "Infusions of amphotericin B should be administered over 1 to 2 hours."

A nursing student asks a nurse about flucytosine [Ancobon]. Which statement by the nurse is correct? a. "Flucytosine has a broad antifungal spectrum." b. "Irreversible neutropenia and thrombocytopenia may occur with this drug." c. "Resistance is common with this medication." d. "Severe hepatic injury is common and limits this drug's use."

c. "Resistance is common with this medication."

A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a. "Immunosuppressed patients are folate deficient." b. "Patients who are immunosuppressed are more likely to develop resistance." c. "Sulfonamides are bacteriostatic and depend on host immunity to work." d. "Sulfonamides intensify the effects of immunosuppression."

c. "Sulfonamides are bacteriostatic and depend on host immunity to work."

A nurse provides teaching for a patient with cytomegalovirus (CMV) retinitis who will receive the ganciclovir ocular implant [Vitrasert]. Which statement by the patient indicates a need for further teaching? a. "My vision may be blurred for 2 to 4 weeks after receiving the implant." b. "Surgical placement of the implant is an outpatient procedure." c. "The implant will remain in place permanently." d. "The implant will slow progression of CMV retinitis."

c. "The implant will remain in place permanently."

A healthcare worker who is asymptomatic has a screening TST result of 10 mm of induration during a pre-employment physical. What will the nurse reading this test tell the patient? a. "This is a negative test, so you are cleared for employment." b. "You have latent TB and will need to take isoniazid for 6 to 9 months." c. "You need to have a chest radiograph and a sputum culture." d. "You will begin taking a four-drug regimen to treat tuberculosis."

c. "You need to have a chest radiograph and a sputum culture."

A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient? a. "Make sure you void after intercourse and drink extra fluids to stay well hydrated." b. "We will treat each infection as a separate infection and treat with short-course therapy." c. "You will need to take a low dose of medication for 6 months to prevent infections." d. "You will need to take antibiotics for 4 to 6 weeks each time you have an infection."

c. "You will need to take a low dose of medication for 6 months to prevent infections."

The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn't just order an antibiotic for the child's current symptoms of low-grade fever, flank pain, and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse? a. "Your child may need to be hospitalized for treatment." b. "Your child may need a urine culture before and after treatment." c. "Your child may need tests to assess for urinary tract abnormalities." d. "Your child may need additional medications, such as urinary tract antiseptics."

c. "Your child may need tests to assess for urinary tract abnormalities."

A child has ringworm of the scalp. A culture of the lesion reveals a dermatophytic infection. The nurse teaching the child's parents about how to treat this infection will include which statement? a. "Adverse effects of the medication include itching, burning, and erythema." b. "Apply the topical medication daily until at least 1 week after the rash is gone." c. "Your child will need to take this oral medication for 6 to 8 weeks." d. "You will use an antifungal shampoo to treat this infection."

c. "Your child will need to take this oral medication for 6 to 8 weeks."

A patient will begin treatment with posaconazole [Noxafil] to treat oropharyngeal candidiasis that has not responded to fluconazole. The provider has ordered 200 mg three times daily. Which action by the nurse is correct? a. Administer the drug as ordered. b. Contact the provider to discuss decreasing the dose to twice daily. c. Discuss a 400-mg twice daily drug regimen with the provider. d. Suggest to the provider that this dose may be too high for this indication.

c. Discuss a 400-mg twice daily drug regimen with the provider.

A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the two are similar products, and both contain sulfonamides. What does the nurse tell the student about silver sulfadiazine? a. It causes increased pain when the medication is applied. b. It has a broader spectrum of antimicrobial sensitivity. c. It has antibacterial effects related to release of free silver. d. It suppresses renal excretion of acid, causing acidosis.

c. It has antibacterial effects related to release of free silver.

A patient with histoplasmosis is being treated with itraconazole [Sporanox]. The nurse will teach this patient to report which symptoms? a. Gynecomastia and decreased libido b. Headache and rash c. Nausea, vomiting, and anorexia d. Visual disturbances

c. Nausea, vomiting, and anorexia

A patient will begin taking an immunosuppressant medication. The nurse learns that the patient has a history of frequent candidal infections. The nurse will expect the provider to order which drug as prophylaxis? a. Fluconazole [Diflucan] b. Ketoconazole c. Posaconazole [Noxafil] d. Voriconazole [Vfend]

c. Posaconazole [Noxafil]

A nursing student asks a nurse how cancer cells become resistant to methotrexate [Rheumatrex]. The nurse is correct to respond by saying that cancer cells acquire resistance to methotrexate by: a. reduced production of transporter that pumps methotrexate out of cells. b. reduced synthesis of dihydrofolate reductase. c. reduced uptake of methotrexate into cells. d. increased ability to convert the drug to a polyglutamated form.

c. reduced uptake of methotrexate into cells.

A patient has come to the clinic with tinea corporis, and the prescriber has ordered clotrimazole. When educating the patient about this medication, the nurse will include which statement? a. "Apply the medication over the entire body twice daily for 2 weeks." b. "Sun exposure will minimize the drug's effects." c. "This drug is effective after a single application." d. "Use the medication for at least 1 week after the symptoms have cleared."

d. "Use the medication for at least 1 week after the symptoms have cleared."

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The nurse caring for this patient knows that which treatment is most effective? a. A 14-day course of amoxicillin with clavulanic acid [Augmentin] b. A 7-day course of ciprofloxacin [Cipro] c. A single dose of fosfomycin [Monurol] d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]

d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim]

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics? a. A 5-year-old child with a fever of 100.5°F, dysuria, and bacteriuria b. A pregnant woman with bacteriuria, suprapubic pain, and fever c. A young man with dysuria, flank pain, and a previous urinary tract infection d. An older adult man with a low-grade fever, flank pain, and an indwelling catheter

d. An older adult man with a low-grade fever, flank pain, and an indwelling catheter

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will be used initially? a. Isoniazid and pyrazinamide b. Isoniazid, pyrazinamide, and ethambutol c. Rifampin, pyrazinamide, and ethambutol d. Isoniazid, rifampin, pyrazinamide, and ethambutol

d. Isoniazid, rifampin, pyrazinamide, and ethambutol

A nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin [Rifadin]. What would be an expected finding? a. Crystalluria b. Myopathy c. Peripheral neuropathy d. Red-orange-tinged urine

d. Red-orange-tinged urine

A nurse is caring for a patient who has a superficial fungal infection and notes that the provider has ordered 200 mg of ketoconazole [Nizoral] 200 mg PO once daily. Which action by the nurse is correct? a. Administer the drug as ordered. b. Contact the provider to discuss twice daily dosing. c. Discuss a 400-mg daily drug regimen with the provider. d. Request an order for a different antifungal medication.

d. Request an order for a different antifungal medication.

The nurse is caring for a patient who will begin receiving intravenous ciprofloxacin [Cipro] to treat pyelonephritis. The nurse learns that the patient has a history of myasthenia gravis. Which action by the nurse is correct? a. Administer the ciprofloxacin and monitor the patient for signs of muscle weakness. b. Ask the provider whether the ciprofloxacin can be given orally. c. Request an order for concurrent administration of metronidazole [Flagyl]. d. Suggest that the provider order a different antibiotic for this patient.

d. Suggest that the provider order a different antibiotic for this patient.

A patient starting therapy with efavirenz [Sustiva] asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the nurse provide? a. The drug must be taken within 30 minutes after a meal. b. The drug is best taken with a high-fat meal. c. The drug can be taken anytime without regard to meals. d. The drug should be taken once daily on an empty stomach.

d. The drug should be taken once daily on an empty stomach.

A patient who is taking nitrofurantoin calls the nurse to report several side effects. Which side effect of this drug causes the most concern and would require discontinuation of the medication? a. Anorexia, nausea, and vomiting b. Brown-colored urine c. Drowsiness d. Tingling of the fingers

d. Tingling of the fingers

A provider has ordered oral voriconazole [Vfend] for a patient who has a systemic fungal infection. The nurse obtains a medication history and learns that the patient takes phenobarbital for seizures. The nurse will contact the provider to discuss which possibility? a. Administering intravenous voriconazole b. Reducing the dose of phenobarbital c. Reducing the dose of voriconazole d. Using a different antifungal agent

d. Using a different antifungal agent

A nurse is caring for an African American patient who has been admitted to the unit for long-term antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would be correct to suspect that the patient has developed: a. Stevens-Johnson syndrome. b. kernicterus. c. hepatotoxicity. d. hemolytic anemia.

d. hemolytic anemia.

A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) [Bactrim] for a urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: a. birth defects. b. hypoglycemia. c. rash. d. kernicterus.

d. kernicterus.

A nurse is preparing to administer oral ofloxacin to a patient. While taking the patient's medication history, the nurse learns that the patient takes warfarin and theophylline. The correct action by the nurse is to request an order to: a. reduce the dose of ofloxacin. b. increase the dose of ofloxacin. c. increase the dose of theophylline. d. monitor coagulation levels.

d. monitor coagulation levels.

A nurse is obtaining a drug history from a patient about to receive sulfadiazine. The nurse learns that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this assessment, the nurse will expect the provider to: a. change the antibiotic to TMP/SMZ. b. increase the dose of the glipizide. c. monitor the patient's electrolytes closely. d. monitor the patient's coagulation levels.

d. monitor the patient's coagulation levels.

A patient is about to begin treatment with isoniazid. The nurse learns that the patient also takes phenytoin [Dilantin] for seizures. The nurse will contact the provider to discuss: a. increasing the phenytoin dose. b. reducing the isoniazid dose. c. monitoring isoniazid levels. d. monitoring phenytoin levels.

d. monitoring phenytoin levels.

An older male patient comes to the clinic with complaints of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The nurse would most likely suspect that the patient has: a. acute cystitis. b. urinary tract infection. c. pyelonephritis. d. prostatitis.

d. prostatitis.

A provider orders intravenous moxifloxacin [Avelox] for a patient who has sinusitis. Before administering the drug, the nurse will review this patient's chart for: a. a history of asthma. b. concurrent use of digoxin. c. concurrent use of warfarin. d. recent serum electrolyte levels.

d. recent serum electrolyte levels.

A female patient who has hepatitis C is being treated with pegylated interferon alfa and ribavirin [Ribasphere]. It will be important for the nurse to teach this patient that: a. if she gets pregnant, she should use the inhaled form of ribavirin [Virazole]. b. if she is taking oral contraceptives, she should also take a protease inhibitor. c. she should use a hormonal contraceptive to avoid pregnancy. d. she will need a monthly pregnancy test during her treatment.

d. she will need a monthly pregnancy test during her treatment.

A patient who is taking calcium supplements receives a prescription for ciprofloxacin [Cipro] for a urinary tract infection. The nurse will teach this patient to: a. consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. b. stop taking the calcium supplements while taking the ciprofloxacin. c. take the two medications together to increase the absorption of both. d. take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

d. take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin.

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 request an order for an antihistamine to treat the rash. c. Withhold the dose and notify the provider of the symptoms. d. Request an order for intravenous TMP/SMZ, because the patient is getting worse.

provider of the symptoms.