PHARMACOLOGY EXAM 2 PART 2
A client being treated for tuberculosis (TB) is determined to be drug resistant. Which medication no longer be effective in the treatment of the tuberculosis? A. Isoniazid (INH) and rifampin(RIF) B. Carbamazepine and phenytoin C. Destroamphetamine and doxapram D. Propranolol and sotalol
A
Which is the antidote for acetaminophen poisoning? A. Acetylcysteine B. Allopurinol C. Diclofenac sodium D. Ketorolac
A
Why is concomitant use of erythromycin and corticosteroids contraindicated? A. The client may be unable to adequately metabolize the corticosteroid B. The effect of the corticosteroid may be greatly increased. C. The client may have an increased risk of thromboembolism D. The corticosteroid may negate the effficeacy of the erythromycin
A
The nurse, providing education to a client prescribed erythromycin, recognizes a need for additional instruction when the client makes which suggestion? Select all that apply. A. Taking the medication with or without food B. Avoiding grapefruit juice while taking the medication C. Recognizing dark urine is a normal side effect D. Stomach cramping is considered an adverse effect E. Swallowing the medication with milk
A, C, D
A 4- year old was diagnosed with acute otitis media and began a course of oral amoxicillin.The parent has contacted the clinic and states tat there has been no significant improvement in the child's ear infection since beginning oral amoxicillin 3 days ago. THe nurse should consider which explanation for this phenomenon? A. The medication has been administered consistently. B. The ear infection has a viral etiology. C. The infection is caused by an antibiotic-resistant microorganism. D. The medication would be more effective if prescribed parenterally.
B
A client, who sustained a burn from a gas grill, has been prescribed a sulfonamide to prevent a burn infection. What route is preferred in the prevention of a burn infection? A. Intrathecal B. Topical C. Parenteral D. Oral
B
Which is the drug of choice for surgical prophylaxis associated with a vaginal hysterectomy? A. Cefadroxil B. Cefazolin sodium C. Cephalexin D. Cephradine
B
The nurse prepares to administer gentamicin intravenous every 8 hours to an older adult client which intervention should the nurse provide to decrease nephrotoxicity and ototoxicity? Select all that apply. A. Draw the trough level 30 to 60 minutes after drug is administered, and report level above 10 12 mcg/mL B. Obtain baseline assessments of cranial nerve eight and periodic measurements during therapy C. Monitor estimated creatinine clearance and BUN at baseline and periodically during therapy D. Obtain peak level before administering next dose of drug and report level above 2 mcg/mL. E. Provide the client with 2 to 3 L of noncaffeinated oral fluid daily, unless contraindicated
B, C, E
An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize? A. The need to supplement prednisone with high dose of vitamin D B. The need to avoid drinking grapefruit juice for the duration of treatment C. The importance of gradually reducing rather than abruptly stopping the drug D. The importance of matching each day's dose to the severity of symptoms
C
A client is being treated for a urinary tract infection trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication? A. Assessing for the presence of asthma B. Assessing for hypertension C. Assessing for diabetes mellitus D. Assessing for renal insufficiency
D
Which drug is a first- generation cephalosporin used as a surgical prophylaxis? A. Cefotetan B. Cefoxitin C. Ceftrixone D. Cefazolin
D
A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? A. Discontinue the infusion and inform the care provider promptly B. Slow down the rate so that the infusion takes place over 2 hours C. Administer oral diphenhydramine to the client during the infusion D. Administer an STAT dose of acetylcysteine
A
A client is diagnosed with a gram- negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside? A. It blocks protein synthesis of the cell wall B. It blocks the process of DNA replication C. It destroys the integrity of the cell wall structure D. It increases white blood cell viability
A
What health education should the nurse provide to a client prior to the instillation of atropine eyedrops? A. "These drops might sting a little bit, and they will make you temporarily sensitivity to light." B. "These eyedrops will make it more difficult to close your eyes, but this will pass in a few hours." C. "These drop will make your pupil temporarily constrict so that your eye can be examined more closely." D. "These drops will make your eyes very bloodshot and sensitive, but this is only temporary."
A
What is the expected results of timolol maleate therapy? A. Decreased intraocular pressure (IOP) B. Constriction of pupils C. Promotion of lacrimation D. Improved visual acuity
A
What potential adverse reaction is most likely to develop during cefazolin therapy? A. Gastrointestinal upset B. Dry skin and pruritus C. Drowsiness D. Orthostatic hypotension
A
When conducting health education for a client prescribed an oral penicillin for an infection caused by gram-negative bacilli, the nurse should emphasize which instructions? A. The need to take the medication on an empty stomach B. The fact that a mild rash frequently follows the first doses C. The need to increase fluid intake for the duration of treatment D. The fact that the drug should be discontinued once symptoms subside
A
Which medication can be applied to the lesion related to a bacterial skin infection? A. Bacitracin B. Benzoyl peroxide C. Butenafine D. Clotrimazole
A
A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of risk of Reye's syndrome? A. Acetaminophen B. Acetylsalicylic acid C. Ibuprofen D. Ascorbic acid
B
A child who has not received the chickenpox vaccine has developed the chickenpox virus. THe child has itching related to the chickenpox pustules. What herbal preparations should the nurse suggest when asked about interventions to decrease itching triggered by chickenpox pustules? A. Coal tar B. Colloidal oatmeal C. Clindamycin D. Bacitracin
B
A client diagnosed with tuberculosis (TB) and begun multi-drug therapy. The client has asked the nurse why is it necessary to take several different drugs. How should the nurse respond to the client's question? A. "Multiple drugs are used because the doctors aren't sure which drug will kill a particular TB strain." B. "The use of multiple drugs prevents the development of drug-resistant TB." C. "Multiple drugs are prescribed because the final testing results for TB can take up to 3 months." D. "Multiple drugs are used in order to speed up the course of treatment. "
B
A client is administered a third-generation cephalosporin. The broad- spectrum agents like cephalosporins are most effective in treating which types of microorganisms? A. Gram positive B. Gram negative C. Fungi D. Virus
B
A client is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is the most common is acute or chronic overdose of acetaminophen? A. Nephrotoxicity B. Hepatotoxicity C. Pulmonary insufficiency D. Pancreatitis
B
A client is allergic to acetylsalicylic acid. Which medication is contraindicated due to cross-hypersensitivity reactions? A. Acetaminophen B. Naproxen sodium C. Morphine sulfate D. Naloxone
B
A client is prescribed ibuprofen for knee pain. When the client is admitted to the hospital with abdominal pain, which assessment should the nurse prioritize? A. Assessment for diarrhea B. Assessment for occult blood C. Assessment for Hematuria D. Assessment for hemoptysis
B
A client is prescribed pencilling V orally for a strep throat. What is the mechanism of action of this medication? A. It inhibits protein synthesis B. It lowers the pH of cellular contents C. It causes mutations D. It inhibits cell wall synthesis
D
What aspect of a client's history would contraindicate imipenem- cilastatin drug therapy? A. The client has a history to type I diabetes mellitus B. The client is showing signs and symptoms of fluid volume excess C. The client's most recent creatinine levels was 140 [mol/L (high) D. The client has a documented allergy to penicillin.
D
A client is prescribed acetylsalicylic acid for fever and headache. What is the action of acetylicyle acid? A. Inhibiting prostaglandin synthesis in the central and peripheral nervous system. B. Providing selective action by inhibiting prostaglandin synthesis in the CNS C. Inhibiting the release of norepinephrine to increase blood pressure D. Suppressing the function of the hypothalamus to decrease inflammation
A
A client is taking oral amoxicillin to treat otitis media for the past 6 days. The client has told the nurse that "my ear is now back to normal" and asks about stopping the antibiotics. How could the nurse respond? A. "That's excellent that you're feeling better, but it's important to keep taking the antibiotics until they're all finished." B. "Try reducing your dose by half. If your ear infection gets worse, resume the dose you've been taking until now." C. "You should stop taking the antibiotics because if you don't, it could cause antibiotic resistance." D. "You can likely stop taking the antibiotics, but keep them on hand in case your infection returns."
A
A client with a diagnosis of breast cancer is administered a corticosteroid in addition to chemotherapy agents. What effect will the corticosteroids have on this client's course of recovery? A. The corticosteroid will decrease signs and symptoms of cancer B. The corticosteroid will alter the action of the chemotherapy agent C. The corticosteroid will decrease metastasis to distant sites D. The corticosteroid will decrease hepatic effects of the chemotherapy
A
A client, being treated in the intensive care unit, has been diagnosed with ventilator associated pneumonia. Culture and sensitivity testing of the client's sputum indicates that erythromycin is a treatment option. Which nursing assess is most appropriate to rule our contraindication for medication therapy? A. Review lab results to confirm normal liver function B. Question the client about any history of gastrointestinal upset C. Review the medical for a history of nephrotoxic signs or symptoms D. Confirm the ability to safely swallow oral medication
A
A nurse preparing to administer a client's first scheduled dose to Tetracycline should first ensure that the client has not recently eaten what type of foods? A. Dairy products B. Leafy green vegetables C. Any high-fat foods D. Acidic foods
A
An adult client has begun treatment with fluconazole. The nurse should recognize the need to likely discontinue the drug if the client develops which sign or symptom? A. Jaundice B. Weight gain C. Iron deficiency anemia D. Hematuria
A
How does adding a beta- lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media? A. It extends the spectrum of antibacterial activity of penicillin. B. It extends the spectrum of the beta-lactamase inhibitor. C. It decreases the side effects of high-dose penicillin. D. It increases the absorption of the penicillin.
A
The presence of what eye disorder would cause the nurse to question prescription of dexamethasone eyedrops? A. Fungal infection B. Nearsightedness C. Cataracts D. Bacterial conjunctivitis
A
The nurse prepares to administer amoxicillin to an adult client newly diagnosed with acute otitis media in the right ear. Which measures would the nurse provide for safe and effective drug administration? Select all that apply A. Check for possible drug interactions and report to prescriber. B. Provide divided doses around the clock 2 hours after meals. C. Report sudden onset of rash, wheezing, or shortness of breath. D. Inspect right ear with otoscope before inspections left ear using the same speculum. E. Asses for improvement of otalgia, otorrhea, and improvement of hearing.
A, C, E
The nurse prepares to administer tetracycline 500 mg PO every 6 hours to an adult client newly diagnosed with Lyme's disease. The client takes an oral contraceptive for birth control. Which measures would the nurse provide for safe effective drug administration? Select all that apply. A. Assess baseline renal and hepatic profiles, complete blood count, and human chorionic gonadotropin (HCG) B. Administer the medication with milk or food to decrease gastrointestinal side effects. C. Instruct client about the importance of using another form of contraceptive during the antibiotic usage. D. Educated importance of wearing sunscreen and protective clothing when in the sun while taking the drug. E. Report severe nausea and vomiting, diarrhea, rash, or perineal itching to the prescriber
A, C,D, E
A client is prescribed imipenem-cilastatin for the treatment of an E. coli infection. The nurse should be aware that cilastatin is combined with the imipenem for what purpose? A. To eliminate adverse effects of imipenem administration B. To inhibit the destruction of imipenem C. To potentiate the therapeutic effects of imipenem D. To allow imipenem to cross the blood-drain barrier
B
A client is to be started on an antibiotic. Which factor is most important to take into consideration before beginning the antibiotic regimen? A. Duration of symptoms B. Culture and sensitivity C. The client's hydration status D. The client's age and weight
B
A client receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in his or her great toes. Which laboratory values should be assessed? A. Hematocrit and hemoglobin B. ALT and AST C. Urine culture and sensitivity D. Complete blood count (CBC) with differential
B
A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs. " Subsequent health education by the nurse should focus on what subject? A. The fact that no adherence to treatment exacerbates the risks of adverse effects B. The need to consistently take the prescribed drugs in order to cure TB C. The need to match drug dosages carefully to signs and symptoms D. The fact that non adherence will necessitate the use of antiretrovirals
B
A client, diagnosed with a genitourinary infection, is being treated with a fluoroquinolone. What is the advantage of a fluoroquinolone over an aminoglycoside? A. The fluoroquinolone does not have adverse effects B. The fluoroquinolone can be given orally. C. The fluoroquinolone has a nearly immediate peak. D. The fluoroquinolone has a broader spectrum
B
A client, diagnosed with tuberculosis, will soon being first-line drug treatment. How will rifampin most likely be administered to this client? A. Orally, with food B. Orally, on an empty stomach C. Intramuscularly D. Intravenously, as bolus
B
A critically ill client has developed a fever of 38.9 C, and blood cultures have been drawn and sent to the laboratory or culture and sensitivity testing. Determination of the culture will give the care team what information? A. Whether the infection is antibiotic resistant B. The exact identity of the infectious microorganism C. The most likely location of the infection D. The most likely origin of the infection
B
Necrotizing otitis externa has the potential to progress to which condition? A. Meningitis B. Osteomyelitis C. Necrotizing fasciitis D. Epiglottitis
B
The client with elevated intraocular pressure (IOP) is at risk for what ocular condition? A. Cataracts B. Glaucoma C. Myopia D. Conjunctivitis
B
The nurse is preparing to administer gentamicin when the client mentions having experienced diminished heating. What action should the nurse take based on this statement? A. Administer the dosage and notify the health care provider of the alteration in hearing. B. Hold the dosage and notify the health care provider of the alteration in hearing. C. Administer the dosage and report the alteration hearing to the audiologist. D. Hold the dosage and document the finding in the nurses's notes.
B
What information should the nurse include when discussing sun protection with parents of young children? A. "Try to keep the children indoors as much as possible." B. "Apply SPF 30 sunscreen before going out in the sun." C. "Be sure that each child wears a hat at the beach." D. "Get sunscreen that blocks UVA rays especially."
B
What over-the-counter (OTC) medication is most likely to be safe and effective in the treatment of pain and fever associated with otitis media? A. Concurrent use of aspirin and ibuprofen for 3 days. B. Alternating doses of acetaminophen and ibuprofen. C. Monotherapy with aspirin until symptoms improve. D. Use of OTC antihistamine and acetaminophen.
B
Which client has the highest risk of developing ototoxicity secondary to gentamicin? A. A man who received his first dose of IV gentamicin 12 hours ago B. A man who has required repeated courses of gentamicin over the past several months C. A woman who has a Pseudomonas infection but who has a hypersensitivity to penicillins D. A woman who is immunocompromised and who is being treated with gentamicin
B
Which medication will be administered for the treatment of salicylate overdose? A. Intravenous meperidine B. Intravenous sodium bicarbonate C. Intravenous furosemide D. Inhaled acetylcysteine
B
Why is important to monitor the results of a serum gentamicin levels? A. To identify possible changes in the client's serum osmolality B. To identify whether the drug is at a therapeutic level C. To identify whether the drug is causing hepatoxicity D. To identify possible hemolysis following administration
B
A client diagnosed with a tumor of the spinal cord is prescribed a corticosteroid. What statement by the client demonstrates an accurate understanding of this treatment? A. "This drug will cause my tumor to be more susceptible to treatment." B. "This drug will decrease my chance of infection and meningitis." C. "This drug won't cure my cancer, but it may help me feel much better." D. "This drug will stop my cancer cells from growing further."
C
A client has been prescribed once-daily aminoglycoside. What is the advantage of this method of administration? A. It is associated with less hepatotoxicity B. It is significantly more cost-effective C. It reduces the risk of nephrotoxicity D. It increases adherence to treatment
C
A nurse is instructing a client on the antibiotic regimen for the treatment of pneumonia. Which statement is most important to share with the client? A. Take the medication with orange juice B. Supplement the medication with multivitamins C. Complete the entire prescription of medication D. Administer the medication with diary products
C
A young adult client's acne has responded well to treatment with Tetracycline. However, the client has now returned to the clinical 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence? A. A delayed (type IV) hypersensitivity reaction B. The fact that the client may have chewed the capsules prior to swallowing them C. Superinfection following the eradication of normal oral flora D. A type I hypersensitivity reaction
C
A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis external, what causative of this infection should the nurse focus upon? A. Immunocompromised state resulting from sleep deprivation while on vacation. B. The potential for food borne pathogens ingested while on vacation. C. Frequent swimming and water sports while the child was on vacation. D. Car trauma related to pressurization and depressurization while flying
C
An adult client with an autoimmune disorder regularly takes oral corticosteroids. The nurse knows that corticosteroids can be used in the successful treatment of inflammation but that they also create a risk for: A. Bleeding B. Leukocytosis C. Infection D. Electrolyte imbalances
C
An older adult client is assessed in the clinic for signs and symptoms of chronic bronchitis related to pneumococci. Which sulfonamide that will most likely be prescribed? A. Trimethoprim- sulfamethoxazole B. Tetracycline C. Doxycycline D. Demecloocyline
C
What eye disorder would contraindicate long-term use of ophthalmic corticosteroids? A. Conjunctivitis B. Hordeolum C. Glaucoma D. Blepharitis
C
What is the rationale for not administering tetracycline to children under the age of 8 years? A. It will not treat the infection effectively B. It will increase the risk of heart failure. C. It will interfere with enamel development D. It will increase the risk for future infections
C
What microorganism is the most likely cause of necrotizing otitis externa? A. Aspergillus B. Candida albicans C. Pseudomonas aeruginosa D. Escherchia coli
C
What ocular condition is generally treated with a prescription for ciprofloxacin eyedrops? A. Astigmatism B. Cataracts C. Conjunctivitis D. Increased intraocular pressure (IOP)
C
When administering anoles in the home setting, the home health nurse should prioritize educational intervention that address what nursing diagnosis? A. Risk for injury related to antifungal therapy B. Risk for acute confusion related to antifungal therapy C. Risk for infection related to antifungal therapy D. Risk for falls related to antifungal therapy
C
A client is receiving hydrocortisone 40 mg PO daily for treatment of severe autoimmune inflammation. Which nursing intervention is the most important to implement? A. Increase dietary sodium B. Limit dietary protein C. Assess BUN and creatinine regularly D. Implement infection control measures
D
A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity? A. Lactulose B. Ketoconazole C. Kanamycin D. Cefadroxil
D
A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic- resistant microorganisms. What factor is known to contribute to antibiotic resistance? A. Increased survival rates from acute infections B. Increased population density C. Use of antibiotics that are ineffective against the infectious microorganisms D. Overuse of antibiotics
D
A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instructions? A. Antacids delays metabolism of the drug B. Antacids can exacerbate nausea and reflux C. Antacids cause a dangerous rise in gastric pH D. Antacids decrease the absorption of the drug
D
A resident of a skilled nursing facility develops methicillin-resistant Staphylococcus aureus. What type of infection has this person developed? A. community acquired B. Postoperative C. Sustained infection D. Hospital- acquired infection
D
A teenager asks the nurse how tetracycline will improve the acne. Which statement should the nurse provide to the client regarding the action of tetracycline? A. "Tetracycline decreases redness and swelling of the pustule." B." Tetracycline treats the Chlamydia organism that causes acne." C. "Tetracycline is used in combination with doxycycline to treat acne." D. "Tetracycline interferes with the production of free fatty acids."
D
A woman is seen in the clinic for treatment of vaginal itching and discharge. The nurse should be prepared to provided the client with information concerning which single dose medication? A. Caspofungin B. Terbinafine C. Ketoconazole D. Fluconazoleb
D
The nurse is educating a client newly diagnosed with a urinary tract infection about the prescribed phenazopyridine hydrochloride. Which statement made by the client establishes the need for dither clarification? A. "The drug is an azo dye that acts directly on urinary tract mucosa to provide pain relief." B. "If I develop a sore throat, bleeding, or bruising. I will report the symptoms to my prescriber." C. "I will need to take the drug with food to decrease stomach upset." D. "I should report reddish-orange urine immediately to the prescriber."
D
What Administration instructions should the nurse provide to the parents of a 4- year old child prescribed a neomycin-polymyxin B- hydrocortisone combination drug for otitis media in the right ear? A. "Put one drop into the right ear each morning." B. "Place two drops in the right ear each morning and then again before bedtime." C. "Put one to two drops in the right ear whenever your child reports pain in the right ear." D. " Place three drops into the right ear four times a day."
D
When acetylsalicyle acid is administered in low doses, it blocks the synthesis of thromboxane A2. What physiologic effect results from this action? A. Inflammation is relieved B. Core body temperature reduced C. Pain is relieved D. Platelet aggregation is inhibited.
D
