PHARMACOLOGY CH 15 (PREP U)
A client has been diagnosed with an infection. The nurse can help to ensure the success of anti-infective treatment by: A)confirming that the medication prescribed is the drug of choice for the specific microorganism. B)teaching the client that significant adverse effects are expected, and must be endured during treatment. C)administering antihistamines, as ordered, to prevent the development of adverse effects. D) monitoring the client closely for signs of arrhythmias or cardiac ischemia.
A
A client with an inflammatory disease has been prescribed indomethacin. The nurse is aware of the risk for drug-induced nephrotoxicity and should prioritize what intervention? A) Encouraging the client to increase fluid intake B) Educating the client about sodium limitation C) Administering the medication with meals whenever possible D) Monitoring closely for hematuria
A
A drug that does not actually cause the death of a cell but does interfere with its ability to reproduce is said to be: A) bacteriostatic. B) drug resistant C) broad spectrum. D) bactericidal.
A
Administration of what type of antibiotic by the nurse would be most likely to cause a superinfection? A) broad spectrum B) narrow spectrum C) bactericidal D) bacteriostatic
A
For what client would a broad-spectrum antibiotic be most appropriate? A) A client who has symptoms of infection but whose culture and sensitivity results are not yet available B) A client who has an oral temperature of 100.2° F (37.9° C) but no other signs or symptoms of infection C) A client whose urinary tract infection has been attributed to Escherichia coli D) A client with a respiratory infection who is 84 years old
A
The hospital nurse is caring for a group of adult clients. For which client should the nurse most likely administer prophylactic anti-infectives? A) A client with colorectal cancer who is pre-operative for a bowel resection B) A client with diabetic nephropathy who has recently begun dialysis C) A client who has hyperkalemia and who is receiving sodium polystyrene A) client who is undergoing cardiac rehabilitation following a myocardial infarction
A
The nurse administering an anti-infective agent recognizes that the drug will destroy some human cells as well as pathogens because of the absence of: A) selective toxicity. B) virulence. C) resistance. D) antigens.
A
The nurse admits a client with septicemia (infection in the bloodstream). The client denies any allergies and the provider has ordered cefuroxime based on blood culture and sensitivity testing. The client states, "I'd prefer vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response? A) "Vancomycin is a powerful drug with many adverse effects and it is generally reserved for when no other drug will work." B) "There are some resistant infections that require vancomycin so you are right to prefer a stronger antibiotic." C) "I appreciate your concern but you can certainly rest assured that the health care provider ordered the right medication for your needs." D)"You can't believe anything you read on the Internet because most of it is just someone's opinion and not fact."
A
The nurse has educated a client about the risk for kidney damage that accompanies the client's anti-infective regimen. What should the nurse recommend to the client in order to reduce the risk of renal damage? A) Increase intake of fluids. B) Temporarily adopt a low-residue diet. C) Take the medication with water. D) Avoid taking the medication right before bedtime.
A
The nurse in the emergency department is obtaining the health history of a new client. When asked about allergies, the client states, "I'm allergic to aspirin." What is the nurse's best response? A) "What happened the last time you took aspirin?" B) "Is your care provider aware of this?" C) "When was the last time you took aspirin?" D) "Are you able to take drugs like Tylenol and Advil?"
A
The nurse is administering an anti-infective medication that is known to lack total selective toxicity. What consequence should the nurse anticipate? A) Some healthy cells will be damaged. B) All pathogens in the body will be destroyed. C) The microbe's enzyme production will be slowed D) Bacterial DNA will mutate
A
The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate? A) A client with signs of infection who is awaiting the results of laboratory testing B) A client with pneumonia who has a confirmed allergy to penicillins C) A client who is being treated for a urinary tract infection for the third time this year D) A client with an infected surgical wound
A
When reviewing the medication orders, a nurse notes that combination therapy with two anti-infective agents has been ordered. What is the nurse's best interpretation of this order? A) The client has an infection that may be caused by more than one organism. B) The client has an infection that is a result of antibiotic resistance. C) The risk of anaphylaxis precludes the use of one antibiotic in higher doses. D) Treatment with a single antibiotic has proven unsuccessful.
A
You are working as a nurse educator in the hospital setting. Part of your responsibility includes developing a plan to prevent antibiotic resistance. What is the most important part of your plan? A) surveillance of staff performing invasive procedures B) An education campaign that focuses on handwashing between patients C) Conducting a poster presentation in the cafeteria of the types of isolation used at your facility D) Providing a flyer to all staff members about the importance of preventing antibiotic resistance
A
Which client would be at risk of developing an infection? Select all that apply. A) a client with an impaired immune system B) a client who performs daily hygiene care C) a client experiencing diarrhea chronically D) an elderly client who has one chronic disease E) a client who takes nutritional supplements
A, C, D
A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead? A) Decreased absorption of the drug B) Development of drug resistance C) Increased rate of elimination of the drug D) Increased chances of serious adverse eventS
B
A female client comes to the clinic reporting vaginal discharge with itching. When obtaining the client's medication history, what would the nurse consider as significant? A) inhaled bronchodilator for asthma B) broad spectrum anti-infective for recent infection C) oral contraceptive use D) daily multivitamin supplement
B
Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is: A) the number of effective drugs available for serious or antibiotic-resistant infections. B) the host's ability to defend itself against the would-be invaders. C) continuous antimicrobial treatment of infections. D) infections that tend to recur and involve simple organisms.
B
To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first? A) Using combination therapy B) Obtaining sensitivity testing C) Checking client allergies D) Evaluating the bactericidal effects
B
What information about antibiotic therapy should the nurse should include in a client's medication education? A) Bacteria can remain in the body for up to 48 to 72 hours after the completion of antibiotic therapy. B) Maintenance of normal bacterial flora is essential to health during the therapy. C) The healthy human body hosts dozens of minor infections at any given time. D) An aseptic internal environment only exists in young adults.
B
What would contribute to drug resistance? A) High dosage to eradicate the organism B) Antibiotic prescription for viral illness C) Around-the-clock scheduling D) Prescribed duration of therapy
B
Which cells participate in this effort to control tissue injury associated with the second stage of the inflammation process? A) B cells B)neutrophils C)monocytes D) natural killer cells
B
You are speaking to a group of clients in a public meeting. They ask you to explain the difference between community-acquired infections and nosocomial infections. Your best response is: a)There is no difference between the infection types, they are simply categorized as community-acquired or nosocomial. b) Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. c) Usually, nosocomial infections are less severe and easier to treat. Community-acquired infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired. d)Only drug-resistant strains of staphylococci, Pseudomonas, and Proteus are categorized as nosocomial infections.
B
An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with A) ciprofloxacin. B) clindamycin. C) vancomycin. D) an antistaphylococcic penicillin.
C
Inappropriate use of antibiotics does all of the following except increase: A) adverse drug effects. B) health care costs. C) the number of available effective drugs for serious or antibiotic-resistant infections. D) infections with drug-resistant microorganisms.
C
What intervention is necessary for the nurse to perform prior to initiating prescribed antibiotic therapy? A) increasing the client's fluid intake B) educating the client about adverse effects C) obtaining a specimen for culture and sensitivity D) administer an antidiarrheal to prevent gastrointestinal (GI) upset
C
When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is aware that when compared with doses for young and middle-aged adults, these clients may require: A) a higher dose. B) the same dose. C)a lower dose. D) the same dose but less frequent.
C
When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include? A) The drug is effective against many different organisms. B)The drug is highly aggressive in killing the pathogen. C) The drug is selective in its action on organisms. D) The drug is effective in interfering with the cell's reproduction.
C
A client asks the nurse how an anti-infective produces a therapeutic effect. What should be included in the nurse's teaching plan? A) Drugs used to treat infections date back to the 17th century. B) Fluoroquinolones interfere with the growth and development of cells. C) Selective toxicity determines the appropriate drug dosage needed. D) Penicillin interferes with biosynthesis of the bacteria cell wall.
D
Like many other classes of drugs, anti-infective drugs can have a variety of adverse effects. What is the most common, potentially serious, adverse effect of antimicrobial drugs? A) Skin rash B) Pain C) Constipation D) Toxic effects on the kidney
D
