Pharm Final Review
Which is a complication of vancomycin IV infusions?
Red man syndrome
The nurse should assess a client for nephrotoxicity and ototoxicity when administering which antimicrobial?
Gentamicin (Garamycin)
The nurse is reviewing the orders for wound care, which include use of an antiseptic. Which statements best describe the use of antiseptics? (Select all that apply)
-Antiseptics are appropriate for use on living tissue -The patient's allergies must be assessed before using the antiseptic -Antiseptics are used to inhibit the growth of microorganisms on the wound surface
The nurse is educating a client with a new diagnosis of open-angle glaucoma on the adverse effects of the indirect-acting miotic eye drops prescribed. What will the nurse include in the teaching as possible adverse effects? (Select all that apply)
-Blurred vision -Stinging on instilaltion -Decreased nighttime vision
The nurse is administering ophthalmic drops. Place the following administration steps in the correct order. (Select all that apply)
-Clean debris from the eye as needed -Have the patient tilt the head back and look up at the ceiling -Place drops into the conjunctival sac -Apply gentle pressure to the inner canthus/lacrimal sac for 1 minute -Close the eye gently -Remove excess medication gently from around the eyes
Bacterial resistance to antibiotics can occur with which situations? (Select all that apply)
-Clients stop taking an antibiotic when they feel better -Taking an antibiotic and an antiviral medication at the same time
The nurse is discussing with a client over-the-counter and prescription topical medications available for treatment of acne. Which drugs are used in the treatment of acne? (Select all that apply)
-Clindamycin (Cleocin) -Benzoyl peroxide (Benoxyl) -Vitamin A acid (Ascor L 500)
When providing instructions to clients on uses of antibiotics, which interactions would the nurse include in the teaching? (Select all that apply)
-Complete the entire course of therapy -Increase fluid intake up to 3000 mL/day -Wash your hands before and after preparing food -Notify the provider of any possible reactions that occur
Which adverse effects will the nurse expect in a teenage patient who is using topical tretinoin (Retin-A)? (Select all that apply)
-Crusted skin -Altered skin pigmentation -Red and edematous blisters
The nurse is administering an intravenous aminoglycoside to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate? (Select all that apply)
-Monitor serum creatinine levels -Instruct the patient to report dizziness or a feeling of fullness in the ears
Quinolones are a class of antibiotics known for several significant complications. Which are possible adverse effect with these drugs? (Select all that apply)
-Tendon rupture -Prolongation of the QT interval -Abnormal cartilage development in children
What vitamins are MOST likely to lead to toxic levels, hypervitaminosis, when administered in megadoses? (Select all that apply)
-Vitamin A -Vitamin D -Vitamin K
A patient has a prescription for topically applied 5% fluorouracil (Efudex) cream as part os treatment for basal cell carcinoma on her cheek? Which instructions will the nurse provide to the patient? (Select all that apply)
-You can use clean fingertips to apply the cream, but be sure to wash your hands afterward -You will need to stay out of the sun during therapy with this medication -Apply this medication to the affected site twice daily -You may have swelling, scaling, burning, and tenderness in the affected area
The nurse is planning care for a client prescribed once-daily IV gentamicin (Garamycin) therapy. When should the nurse schedule a trough drug level to be drawn?
12 hours after completing the antibiotic infusion
The order reads: "Give vancomycin, 1250 mg in 50 mL NS, IVPB, every 12 hours. Infuse over 90 minutes." The nurse will set the infusion pump to what setting for mL/hour?
167 mL/hour
The order for a child reads: "Give cefoxitin (Mefoxin) 160 mg/kg/day, IVPB, divided into doses given every 6 hours." The child weighs 55 lb. How much will the patient receive each day? For each dose?
4000 mg/day; 1000 mg/dose
A woman who has been taking an antibiotic for a UTI calls the nurse practitioner to complain of severe vaginal itching. She has also noticed a thick whitish vaginal discharge. The nurse practitioner suspects that
A superinfection has developed
For a client receiving an intravenous (IV) infusion of gentamicin (Garamycin), the nurse would monitor which laboratory values?
Blood urea nitrogen (BUN) and creatinine
A newly admitted patient reports a penicillin allergy. The prescriber has ordered a second-generation cephalosporin as part of the therapy. Which nursing action is appropriate?
Call the prescriber to clarify the order because of the patient's allergy
A nurse is educating a client on vitamin supplementation. The client states, "I take a lot of vitamins every day to stay healthy." Based on knowledge and understanding of vitamin supplements, what is the nurse's best response?
Can you tell me what vitamins you take and how many and how often?
Isotretinoin (Amnesteem) and tretinoin (Retin-A) are common dermatologic drugs used to treat which condition?
Acne vulgaris
What is the priority assessment data for a client prescribed antibiotic therapy?
Allergies
A patient is considering taking oral aloe supplements and asks the nurse about potential problems with the therapy. Which statement by the nurse is correct?
Aloe is used by some to treat constipation; it may cause diarrhea
A client receiving vitamin K MOST likely has which abnormal clinical finding?
Altered coagulation studies
The nurse will question the use of a fluoroquinolone antibiotic in a client already prescribed which medication?
Amiodarone (Cordarone)
A client who is prescribed the drug miconazole (Monistat), a topical antifungal, has MOST likely been diagnosed with which condition?
Candidiasis
A client is complaining of excessive earwax, leading to diminished hearing ability. The nurse will anticipate to teach the client about which medication to treat this condition?
Carbamide peroxide (Debrox)
A mother of a young child asks the nurse what over-the-counter (OTC) medication will remove earwax buildup in her child's ears. What OTC medication should the nurse suggest?
Carbamide peroxide (Debrox)
A client who is allergic to penicillin is at increased risk for an allergy to which drug?
Cefazolin sodium (Ancef)
A patient is prescribed bacitracin topical ointment. What does the nurse suspect as the possible diagnosis based on the medication prescribed?
Bacterial infection
Which information should the nurse include in discharge teaching for a client prescribed doxycycline (Vibramycin)?
Apply sunscreen or wear protective clothing when outdoors
A woman suffered a second-degree burn of the skin on her arm and hand while cooking breakfast. After examination in the urgent care center, silver sulfadiazine cream (Silvadene) is ordered for the burned area. The nurse will apply the medication using which procedure?
Applying a thin layer with a sterile, gloved hand to clean the debrided areas
A father calls because his son has head lice. He reports that he used Kwell shampoo three times, but nothing happened. He wants to know what to do now. What will the nurse advise first?
Be sure to use a nit comb to remove nits from the hair shafts
The nurse is reviewing the orders for a patient who has been admitted for treatment of pneumonia. The antibiotic orders include an order for doxycycline. However, when the patient is asked about his allergies, he lists "doxycycline" as one of his allergies. What is the nurse's priority action at this time?
Ask the patient to explain what happened when he had the allergic reaction
When performing discharge teaching for a client prescribed oral linezolid (Zyvox) to treat methicillin-resistant Staphylococcus aureus (MRSA), the nurse should emphasize which important information?
Avoid ingestion of foods containing tyramine
A child has been diagnosed with impetigo, a skin infection. The nurse anticipates that which drug will be used to treat this condition?
Bacitracin
A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heel that is red and includes necrotic tissue. However, his prothrombin time/international normalized ratio (PT/INR) values are too high to permit surgical debridement at this time. The nurse expects what which wound-care product will be used to treat the wound?
Collagenase (Santyl)
The client is prescribed opopatadine (Patanol) for treatment of allergic conjunctivitis. The nurse knows the medication works through which action?
Competes at histamine receptor sites
A child born with increased intraocular pressure is likely to be diagnosed with which type of glaucoma?
Congenital
In an effort to prevent superinfections of the GI tract such as Clostridium difficile, the nurse will instruct clients to eat which foods?
Cultured dairy products such as yogurt
When administering intravenous magnesium sulfate, the nurse will monitor for which signs and symptoms of hypermagnesemia?
Decrease in deep tendon reflexes
The nurse is educating the mother of an infant on how to instill eardrops for otitis media with a perforated eardrum. Which is an appropriate nursing outcome criterion for the mother?
Demonstrates accurate medication administration technique
When planning care for a client receiving a sulfonamide antibiotic, it is important for the nurse to perform which intervention?
Encourage fluid intake of 2000 to 3000 mL/day
The nurse is educating a client who was administered atropine sulfate solution for an eye examination. The nurse includes which information in the education?
Encourage use of sunglasses to decrease sunlight sensitivity
A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts. When the nurse sees her at a follow-up visit 2 months later, she complains that it has returned. She said she applied the medicine for 1 week and stopped because the itching stopped and the cream was messy. Which statement by the nurse is true regarding fungal infections of the skin?
Fungal infections often require prolonged therapy
A patient has been receiving therapy with the animoglycoside tobramycin, and the nurse notes that the patient's latest trough drug level is 3 mcg/mL. This drug is given daily, and the next dose is to be administered now. Based on this trough drug level, what is the nurse's priority action?
Hold the drug, and notify the prescriber
The nurse is teaching the mother of a 1-year-old client how to instill ear drops for OE. What instructions on instillation does the nurse provide to the mother?
Hold the pinna down and back
The nurse would question a health care provider's prescription for vitamin D in a client with which condition?
Hyperparathyroidism
A female patient has been taking isotretinoin (Amnesteem) for 3 months. During a follow-up appointment, which statement by the patient would be of highest concern the nurse?
I have been feeling rather down and lonely lately
Which statement by a client indicates a need for further teaching regarding proper administration of eyedrops?
I will rinse the eyedropper with tap water after each use
The nurse is providing education to a client diagnosed with otitis externa (OE). Which statement by the client indicates an understanding of the OE treatment plan?
I will use the eardrops in the ear canal to treat this condition
A patient has been taking the corticosteroid dexmethasone (Decadron) but has developed bacterial conjunctivitis and has a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?
Immunosuppression may make it more difficult to eliminate the eye infection
The nurse is evaluating the effectiveness of the otic medication used for OE. What will the nurse evaluate to determine if the goal of therapy has been met?
Improved hearing
When administering a nonsteroidal antiinflammatory drug and a penicillin drug together, the displacement of the penicillin antibiotic from the protein-binding sites will result in which effect?
Increased free drug in blood
A patient has a new prescription for an antiglaucoma eyedrop. The next day, she calls the clinic and states, "the package insert says this medication might make my blue eyes turn brown! Is this true?" The nurse realizes that the patient has a prescription for which eye medications?
Latanoprost (Xalatan), a prostaglandin agonist
A client who is prescribed metronidazole (Flagyl) for a gynecologic infection provides the nurse with a list of medications that are routinely taken. Which medication would lead the nurse to question the prescription for Flagyl?
Lithium (Eskalith)
Which mineral is essential for energy metabolism but may also be use in higher doses to treat certain seizures and preeclampsia?
Magnesium
The nurse will be giving ophthalmic drugs to a patient with glaucoma. Which drug is given intravenously to reduce intraocular pressure when other medications are not successful?
Mannitol (Osmitrol)
Parasympathomimetic ophthalmic drugs such as pilocarpine (Pilocar) reduce intraocular pressure in the treatment of glaucoma by which mechanism of action?
Miosis
The nurse is reviewing laboratory results for a patient and notes that the patient has positive results for nasal colonization by methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipated an order for which medication?
Mupirocin (Bactroban)
The nurse will anticipate application of which medication to treat a client diagnosed with impetigo?
Mupirocin (Bactroban)
Client teaching regarding the administration of vitamin C would include monitoring for which signs or symptoms that may indicate vitamin C toxicity?
Nausea and abdominal cramping
At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism?
Neisseria gonorrhoeae
The nurse is reviewing the use of ophthalmic preparations. Indications for the direct- and indirect-acting miotics include which condition?
Open-angle glaucoma
When giving intravenous quinolones, the nurse needs to keep in ming that these drugs may have serious interactions with which drugs.
Oral anticoagulants
A client is diagnosed with a perforated tympanic membrane, OE, and otitis media. What does the nurse anticipate the health care provider with prescribe?
Otic and oral antibacterials
The client's culture has grown gram-positive cocci, and the health care provider prescribes two different antibiotics, one of which is gentamicin (Garamycin). To treat this type of infection, which type of antibiotic is typically prescribed together with gentamicin (Garamycin)?
Penicillin
Which adverse effect can result if tetracycline is administered to children younger than 8 years of age?
Permanent discoloration of the teeth
Cyanocobalamin (vitamin B12) is indicated for the treatment of which condition?
Pernicious anemia
While assessing a woman who is receiving quinolone therapy for pneumonia, the nurse notices that the patient has a history of hart problems. The nurse will monitor for which potential cardiac effect of quinolone therapy?
Prolonged QT interval
A client with a known heart condition is prescribed an antibiotic before a dental procedure. What type of antibiotic therapy is this considered?
Prophylactic
A patient is scheduled for colorectal surgery tomorrow. He does not have sepsis, his WBC count is normal, he has no fever, and he is otherwise in good health. However, there is an order to administer an antibiotic on call before he goes into surgery. The nurse knows that the rationale for this antibiotic order is to
Provide prophylactic therapy
The health care provider has prescribed ciproflozacin-dexamethasone (Ciprodex) otic drops for a client with OE. The nurse knows the combination medication has both antibacterial medication and topical steroid medication. What is the purpose of the steroid in this medication?
Reduce inflammation
When administering vancomycin, the nurse knows that which of these is most important to assess before giving the medication?
Renal function
A patient has been admitted for treatment of an infected leg ulcer and will be started on intravenous linezolid. The nurse is reviewing the list of the patient's current medications. Which type of medications, if listed, would be of most concern if taken with the linezolid?
Selective serotonin reuptake inhibitor antidepressant
The preoperative nurse is ready to perform a skin prep with providone-iodine (Betadine) on a patient who is about to have abdominal surgery. Which allergies, if present, would be a contraindication to the Betadine prep?
Shellfish
When planning care for a burn client, the nurse would anticipate applying which topical medication?
Silver sulfadiazine (Sulfadine)
The nurse is administering antibiotic eyedrops for a patient for the first time. After the first drop is given. the patient states, "that eyedrop is making my eye sting! Is that normal?" Which is the best response by the nurse?
Sometimes these eyedrops may cause burning and stinging, but it should go away soon
During therapy with an intravenous aminoglycoside, the patient calls the nurse and says, "I'm hearing some off sounds, like ringing, in my ears." What is the nurse's priority action at this time?
Stop the infusion immediately
During antibiotic therapy, the nurse will assess the client for a condition that may occur because of the disruption of normal flora. The nurse knows this as what condition?
Superinfection
A patient asks about using minoxidil (Rogaine) for hair thinning. Which statement about minoxidil is accurate?
Systemic absorption may cause tachycardia, fluid retention, and weight gain
A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears product. The nurse includes which instructions in the teaching plan for these medications?
Take the Restasis first, and then wait 15 minutes before taking the artificial tears
The nurse is providing education to a client with a diagnosis of bilateral conjunctivitis (pink eye) who is prescribed sulfacetamide (Bleph-10). What information in the client history is MOST important and should be reported immediately to the health care provider?
The client is allergic to sulfa drugs
Which statement best describes health care-associated infections?
The infection was not incubating at the time of admission
The nurse is reviewing the medical record of a patient who is to receive wound care with tropical silver sulfadiazine (Silvadene). Which finding, if noted, would be a potential contraindication?
The patient is allergic to sulfonamide drugs
During patient education regarding an oral macrolide such as erythromycin, the nurse will include which information?
The patient may take the drug with a small snack to reduce GI upset
A teenage patient is taking a tetracycline drug as part of treatment for severe acne. When the nurse teaches this patient about drug-related precautions, which is the most important information to convey?
The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity
A client prescribed azithromycin (Zithromax) expresses concern regarding GI upset that was experienced when previously prescribed an erythromycin antibiotic. What is the nurse's best response.
This drug is like erythromycin with less gastrointestinal adverse effects
A teenage boy is taking tretinoin (Rentin-A). Which statement will the nurse include in the teaching plan?
This drug may cause increased redness of your skin
A client is prescribed epinephrine eye drops for treatment of chronic open-angle glaucoma. The client complains of burning with instillation of the drops. Which statement is the nurses's best response?
This is a typical adverse effect and may lessen over time
Sympathomimetic mydriatics have the potential to react with other drugs if sufficient topical absorption occurs. When given concurrently, drugs in which class may interact with the sympathomimetic mydriatics?
Thyroid hormones
A client has been prescribed clotrimazole (Lotrimin, Mycelex-G) for the treatment of jock itch. To document this diagnosis in the client's medical record, the nurse should use which fungal infection name?
Tinea cruris
A female client of childbearing age is prescribed isotretinoin (Amnesteem) for the treatment of severe recalcitrant cystic acne. Which information is MOST important for the nurse to include in the education of the client?
Use at least two forms of contraception while taking this medication
What vitamin can be synthesized by the skin when exposed to sunlight but can also be supplemented as needed?
Vitamin D
The nurse bases the plan of care regarding administration of eardrops on what knowledge?
Warming the eardrops to room temperature before administration helps reduce a vestibular-type reaction
The nurse would teach a client prescribed metronidazole (Flagyl) to avoid ingestion of which drink?
Wine
A female patient will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin?
You will have to use two contraceptive methods while on this drug
