Pharmacology- Chapter 9
A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response? pg 96
"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."
A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which of the following statements made by the client would indicate the need for additional education? pg 98
"I will limit my fluid intake"
Which of the statements by the client identifies an understanding of psueodomembranous colitis?
"If I have blood or mucus in my stools, I will collect a sample."
The client has been taking a fluoroquinolone and now reports that he has a white patch in his mouth. What is the best response of the nurse?
"You may be experiencing an additional infection. I will discuss with your physician."
Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is mixed in a syringe for an IV pump as a solution of 250 mg/15 mL. How many mL should be in the syringe? pg 100
45
A nurse knows that when administering intravenous (IV) carbapenem, the highest priority action after administration is: pg 98
Assessing the IV site
Fluoroquinolones treat infection by which of the following effects? (Choose one) pg 96
Bactericidal
The client has been started on levofloxacin (Levaquin) for a respiratory infection. The client is now experiencing sores in his mouth. The nurse suspects this is due to what type of superinfection? pg 97
Candidiasis
The client is complaining of vaginal itching after five days of fluoroquinolone therapy. The nurse suspects which of the following?
Candidiasis
A patient has been diagnosed with a community-acquired skin infection and has been prescribed linezolid (Zyvox). Which of the following foods should not be eaten during the administration of this medication? pg 88
Cheddar cheese
A patient presents to the clinic reporting severe polyuria and dysuria. What medication would the nurse expect this patient to be prescribed?
Ciprofloxacin (Cipro) 250 mg PO BID x3 days
The client has been taking levofloxacin IV for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response?
Continue to monitor vital signs
A patient with a gram negative bacteria infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which of the following laboratory tests, if ordered, are obtained before the first dose of fluoroquinolones is administered to the patient?
Culture and sensitivity test
A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic? pg 97
Decreased absorption
The nurse should advise the client which of the following in regards to the administration of fluoroquinolones? pg 97
Do not take antacids while taking fluoroquinolones
Which type of bacteria have readily evolved and are most commonly resistant to vancomycin (Vancocin)?
Enterococci
The nurse should inspect the vein used for IV infusion how frequently? (Choose one) pg 98
Every 4 to 8 hours
A client is prescribed ciprofloxacin for an acute sinus infection. This drug belongs to what category of anti-infective medications? pg96
Flouroquinolones
The nursing student correctly identifies the class of drugs that exerts their bactericidal effect by interfering with the synthesis of bacterial DNA, thus preventing cell reproduction and leading to death of the bacteria, as which of the following groups? pg 96
Flouroquinolones
Which of the following classes of antibiotics is a direct inhibitor of DNA synthesis in bacteria? pg 96
Fluoroquinolones
The pharmacology instructor is discussing antimicrobials with the nursing class. What would the instructor tell the students is the mechanism of action of some antimicrobials? pg 91
Inhibiting cell wall synthesis
Which of the following represents the mechanism of action of fluoroquinolones? pg 96
Interference with the synthesis of bacterial DNA.
A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor? pg 96
It is important to use antibiotics cautiously and to teach the patients to complete the full course of an antibiotic prescription
Which of the following medications are associated with QT interval prolongation on electrocardiogram (ECG)? Select all that apply. pg 96-97
Levoflaxacin Moxifloxacin Ciprofloxacin Ofloxacin
The client is being started on oral ciprofloxacin (Cipro). The nurse identifies that the client is also taking corticosteroids. What is the most appropriate action of the nurse? pg 97
Notify the physician
The client has been prescribed a drug that must be taken on an empty stomach. The nurse knows that, to administer a medication on an empty stomach, it is given in which of the following ways? pg 97
One hour prior to a meal or tow hours after the meal
The client has been prescribed a drug that must be taken on an empty stomach. The nurse knows that, to administer a medication on an empty stomach, it is given in which of the following ways? pg 97
One hour prior to a meal or two hour after the meal
When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route? pg 100
Oral
A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse focuses education on which adverse reaction? pg 97
Photosensitivity
What is the most common adverse reaction to IV vancomycin? pg 95
Red man syndrome
A patient who has been receiving intravenous (IV) vancomycin begins to report neck and back pain as well as feeling hot and having chills. The nurse assesses the patient and notices that the neck is red. The patient's temperature is 102 degrees F; BP is 86/58. This patient is showing signs and symptoms of which of the following syndromes?
Red-man syndrome
A client is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach the client about the medication. What must the nurse include in the education plan? pg 98
Take precautions to prevent photosensitivity
The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred? pg 97
The client has developed a superinfection
A client is diagnosed with an infection and is ordered to receive a fluoroquinolone. Which of the following would the nurse expect upon evaluation? pg 99
The client's temperature is returning to normal.
A patient has a genitourinary infection and is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? pg 100
The fluoroquinolone is given orally.
A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? pg 97
The use of ciprofloxacin is contraindicated in pregnancy.
The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body? pg 96
They disrupt the microbial flora of the body
A patient is prescribed ciprofloxacin 500 mg po twice a day. The nurse notes that the ciprofloxacin is scheduled to be given with breakfast. The nurse correctly administers ciprofloxacin _____ pg 98
Twice daily po, 2 hours after the meals
A client who routinely takes antacids has been prescribed a oral fluoroquinolone for an infection. The nurse instructs the client to take the antibiotic at which times?
Two to four hours before, or six to eight hours after the antacid
Fluoroquinolones, such as norfloxacin (Noroxin), are commonly prescribed antibiotics given to treat which of the following?
Urinary tract infections
The nurse would expect a patient with an eye infection to be treated with which of the following eye ointments? (Select all that apply.) pg 100
ciprofloxacin norfloxacin ofloxacin
A nursing student is studying anti-infectives in pharmacology class and correctly identifies the following to be new drug classes that interfere with RNA and DNA synthesis within the bacterial cell wall. (Select all that apply.) pg 92
cyclic lipopeptides oxazolidinones
The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include to: pg 98
increase fluid intake.
Which of the following medications is contraindicated in children
levofloxacin
The nurse realizes that vancomycin is a powerful drug and can treat serious gram-positive infections that do not respond to treatment with other anti-infectives. Serious adverse effects classic for vancomycin include which of the following? (Select all that apply.)
nephrotoxicity ototoxicity
A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect? pg 98
phlebitis
Common, potentially serious, adverse effects of antibiotic drugs include:
skin rash