Quiz 10 Questions- 87, 88, 89, 91

Which patient with a urinary tract infection will require hospitalization and intravenous antibiotics?

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

A patient is diagnosed with a lung infection caused by P. aeruginosa. The culture and sensitivity report shows sensitivity to all aminoglycosides. The nurse knows that the rate of resistance to gentamicin is common in this hospital. The nurse will expect the provider to order which medication A. Amikacin [Amikin] B. Gentamicin C. Paromomycin D. Tobramycin

A. Amikacin [Amikin]

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:

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

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:

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

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?

Daptomycin (Cubicin)

A patient who has been taking gentamicin for 5 days reports a headache and dizziness. What will the nurse do?

Suspect ototoxicity and notify the prescriber.

A patient is receiving tobramycin three times daily. A tobramycin peak level is 4.5 and the trough is 1.2. What will the nurse do? a. Give the next dose as ordered. b. Hold the next dose and notify the provider. c. Monitor the patient for signs of nephrotoxicity. d. Tell the patient to report tinnitus.

a. Give the next dose as ordered.

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. Prostatitis b. UTI c. Acute cystitis d. Pyelonephritis

a. Prostatitis

A nurse preparing to administer intravenous gentamicin to a patient notes that the dose is half the usual dose for an adult. The nurse suspects that this is because this patient has a history of: a. renal disease b. liver disease c. interpatient variation d. antibiotic resistance

a. Renal disease

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 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 nurse is preparing to administer a dose of gentamicin to a patient who is receiving the drug 3 times daily. The nurse will monitor ____ levels. a. peak b. peak and trough c. serum drug d. Trough

b. peak and trough

A patient is receiving tobramycin 3 times daily. The provider has ordered a trough level with the 8:00 AM dose. The nurse will ensure that the level is drawn at what time? a. 4:00 AM b. 7:00 AM c. 7:45 AM d. 8:45 AM

c. 7:45 AM

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 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. kernicterus b. hypoglycemia c. birth defects d. rash

a. kernicterus

A nurse is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What will the nurse do? a. Contact the provider to discuss an increased risk of aminoglycoside toxicity. b. Continue giving the aminoglycoside as ordered. c. Request an order for a different class of antibiotic. d. Suggest adding a penicillin to the patient's drug regimen.

c. Request an order for a different class of antibiotic.

A patient who is taking gentamicin and a cephalosporin for a postoperative infection requests medication for mild postsurgical pain. The nurse will expect to administer which of the following medications? a. morphine b. ibuprofen c. aspirin d. acetaminophen

d. acetaminophen

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 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:

methenamine (Hiprex)

A patient is receiving an intraperitoneal aminoglycoside during surgery. To reverse a serious side effect of this drug, the nurse may expect to administer which agent? a. Amphotericin B b. Calcium gluconate c. Neuromuscular blocker d. Vancomycin

b. Calcium gluconate

A patient will be discharge 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. Take folic acid supplements b. Drink 8-10 glasses of water each day c. Take the medication with food d. Eat foods that are high in potassium

b. Drink 8-10 glasses of water each day

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

b. The pt should check the blood glu level more often while taking TMP/SMZ

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. drowsiness b. tingling of fingers c. anorexia, nausea, or vomiting d. brown-colored urine

b. Tingling of fingers

A patient who takes the loop diuretic ethacrynic acid is given intravenous gentamicin for an infection. After several days of treatment with gentamicin, the nurse reviews the patient's most recent laboratory results and notes a gentamicin trough of 2.1 mcg/mL and normal blood urea nitrogen (BUN) and serum creatinine levels. The nurse will question the patient about: a. urine output b. headache, dizziness, or vertigo c. presence of rash d. GI symptoms

b. headache, dizziness, or vertigo.

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:

begin a 2-week course of antibiotics.

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?

Uncomplicated lower urinary tract infection treatable with short-course therapy