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Chapter Review Questions 47-54
Terms in this set (42)
Which instruction should the nurse give a 21 year old female patient being treated with ampicillin?
1. Stop taking oral contraceptives because serious adverse effects could occur
2. Use oral contraceptives as prescribed because antibiotics do not interact with birth control pills
3. The antibiotic may decrease the effectiveness of oral contraceptives
4. The antibiotic when taken with oral contraceptives causes toxicity
The nurse is caring for a patient who is receiving intravenous vancomycin (Vancocin). Which symptom, if present, may indicate that the patient is experiencing drug-induced otoxicity?
1. Erythema of the earlobes and ear canal
2. Inner ear pruritus after infusion is completed
3. Tinnitus and dizziness when remaining still
4. Ocular pain with purulent drainage
The patient reports abnormal vaginal discharge after completing a prescription of cefotaxime (Colaforan). For which condition is the patient most likely exhibiting symptoms?
1. Hypersensitivity reaction
3. Pseudomembranous colitis
4. Antibiotic toxicity
The patient who has been taking cefixime (Suprax) for the past week and a half returns to the provider with reports of "explosive diarrhea, very watery, sometimes with lot of mucus" up to eight times in the last 2 days. The patient reports significant weakness. For which condition is the patient describing symptoms?
1. Antibiotic-induced peptic ulcer disease
2. Antibiotic-associated malabsorption
3. GI-associated hypersensitivity
4. Clostridium difficile- associated diarrhea
The patient who has been taking imipenum-cilastain (Primaxin) reports shortness of breath, mouth, and tongue swelling and generalized itching. For which of the following does the nurse initially assess the patient?
1. Hypersensitivity reaction
2. Blood dyscrasias
3. Beta-lactamase induction
4. Drug toxicity
The nurse is teaching a patient who recently was diagnosed with an upper respiratory infection and prescribed ampicillin. The nurse would evaluate the session as being successful if the patient states which of the following?
1. "I should take this medication on an empty stomach with a full glass of water"
2. "I can expect my tongue to become black and furry."
3. "Once I stop coughing , I should stop taking this medication"
4. "If I miss a dose, I should take two doses together to catchy up
1. While teaching the patient about taking oral tetracycline, which of the following goes the nurse advise the patient to do?
1. Consume calcium-rich products to decrease the duration of the antibacterial effect
2. Use a soft toothbrush and floss teeth gently to remove staining on teeth
3. Report any ringing in the ears or dizziness
4. Avoid direct exposure to sunlight and apply sunblock when outdoors.
The nurse determines that the patient understands the use of azithromycin (Zithromax) when the patient makes which statement?
1. "It only needs to be taken once daily because it lasts longer."
2. "It causes more nausea than most other antibiotics in this classification."
3. "It must be taken on an empty stomach."
4. "It is ineffective if taken with calcium-rich foods."
The patient is receiving amaikacin (Amikin) for a bacterial infection. Which adverse effects does the nurse include in the plan of care to monitor the patient's status?
1. Weight gain
2. Visual disturbances
3. Mental depression
4. Urinary frequency
The healthcare provider orders gentamicin (Garamycin) for a patient with a postoperative wound infection. Which laboratory result should prompt the nurse to consult with the prescriber about possible nephrotoxicity of this drug?
1. Elevated serum creatinine level
2. Decreased blood urea nitrogen (BUN) level
3. Increased white blood cell (WBC) count
4. Elevated serum iron level
The patient has received a prescription for tetracycline (Sumycin) for treatment of acne. The nurse will teach the patient to avoid taking the tetracycline concurrently _____.
Tetracycline antibiotics should not be taken concurrently with dairy products, iron-containing preparations or antacids. They should be taken 1 hour before 2 hours after the tetracycline
The patient is receiving gentamicin (Garamycin) IV for a significant infection. While the patient is receiving this drug, what assessment data will the nurse gather to monitor for adverse effects (SELECT ALL THAT APPLY).
1. Serum creatinine
2. Signs of muscle weakness
3. Liver function studies
4. Urine output
5. Hearing and balance assessments
1, 2, 4, 5
The patient is prescribed criproflaxin (Cipro) and is instructed to take each dose of medications as evenly spaced apart during the day as possible. The nurse recognizes that this instruction is essential because:
1. The medication can cause sleep pattern disturbances
2. Pathogenic bacteria have extremely rapid growth and reproduction rates
3. Superinfections may develop if a dose of the medication is missed
4. Allergic reactions are more likely to occur if a dose is missed
The patient is prescribed ofloxacin (Floxin) for treatment of acute bronchitis. The patient tells the nurse that he experienced an allergic reaction when he took ciprofloxacin (Cipro) previously. As reported by the patient, which of the following would be most indictive of an allergic reaction to the this drug group? (SELECCT ALL THAT APPLY)
2. Nausea and vomiting
3. Itching without visible rash
4. Swelling of lips or tongue
5. Nervousness or anxiety
3, 4, 5
The nurse is instructing a patient on a new prescription for ciprofloxacin (Cipro) and will include which instructions? (SELECCT ALL THAT APPLY)
1. Increase fluid intake 2-3 Liters per day
2. Avoid consuming dairy products or antiacids when you take the antibiotic
3. Limit vitamin C intake in both dietary and oral vitamin forms
4. Take the pill with an antihistamine to avoid adverse effects.
5. Coffee or tea without milk, cream, or coffee lightener is the preferred beverage for taking the antibiotic dose
A patient has been receiving levofloxacin (Levaquin) IV for septicemia for 2 weeks and will be give the drug orally at home. Which discharge instruction would be most appropriate for the nurse to give patient?
1. Report any unusual joint or tendon pain or difficulty with movement or walking
2. Take a daily multivitamin supplement with the levofloxacin
3. Exposure to direct sunlight will help increase absorption of vitamin D, which is impaired by this medication
4. Limit fluid intake to less than 1500 mL per day
A patient has been given a prescription for ciprofloxacin (Cipro). The nurse checks the patient's history because this drugs should be used cautiously, or is contraindicated, in patients with what condition?
1. A history of anxiety disorder and nervousness
2. Patients over the age of 65
3. A history of penicillin allergy
4. Patients with myasthenia gravis
Which of the most important goal of nursing care for a patient polymyxin B ointment on a laceration?
1. Promote wound healing
2. Sterilize the skin and mucous membranes
3. Prevent allergic reaction
4. Maximize pain relief
1. A patient who is receiving isoniazid (INEH) reports tingling and numbness of the fingers and toes. The nurse knows that these symptoms are most likely due to the drug's ability to:
1. Increase the sensitivity of nerve endings
2. Decrease the activity of pyridoxine (vitamin B6)
3. Acceleration the excretion of neurotransmitters
4. Enhance skin receptors for ascorbic acid (vitamin C)
1. Ethambutol (Myambutol) has been included as part of a multidrug regimen to treat a patient with active tuberculosis. Prior to starting this drug, which screening tests should the patients have? (SELECT ALL THAT APPLY)
1. Coagulation studies
2. Sputum cultures
3. Uric acid level
4. Hepatic function tests
5. Vision acuity and vison color sense screening
1. A patient is identified by ethnic background as possible slow acetylator and will be closely followed after beginning isoniazid therapy for latent tuberculosis. To ensure that this patient does not experience adverse effect related to the acetylation process, both ____ and ____ will be monitored frequently. *
serum drug level
1. A patient with HIV infection who also has a Mycobacterium avium infection is started on clarithromycin (Biaxin) and ethambutol (Myabmbutol). What appropriate teaching should the nurse give this patient?
1. You will remain contagious until drug treatment is completed
2. These drugs will be required only for a short period of time, approximately 2 -3 weeks
3. Drug therapy will be stopped if CD4 counts drop below 50 cell/mL.
4. It will be necessary to continue these drugs for a prolonged period of time to adequately treat the infection.
1. The patient is diagnosed with Mycobacterium leprae (leprosy) and is being treated with dapsone (DDS). Which nursing assessment finding would indicate that the patient is experiencing adverse effects from this therapy?
1. Discoloration of skin, cornea, and conjunctiva
2. Chronic constipation, chills, and dehydration
3. Hypoglycemia, impaired memory, and impotence
4. Memory loss, nervousness, and pruritus
1. Patients with diabetes who take isoniazid (INH) may require more frequent monitoring of blood glucose levels. What effect does isoniazid have on glucose levels?
1. It may decrease glucose levels
2. It has no known effects on glucose levels
3. It may increase glucose levels
4. It causes rapid rises and falls of glucose levels
1. A patient is admitted to the intensive care unit for systemic fungal infections. Amphotericin B has been ordered and the nurse will administer this drug slowly IV. When administered too rapidly, amphotericin B may cause what significant adverse effects? (SELECT ALL THAT APPLY)
1. Laryngeal spasms
2, 3, 4
1. A patient with AIDS has been given a prescription for oral fluconazole (Diflucan) to prevent Candida infection. Considering the patient's primary diagnosis and the order for fluconazole, what essential teaching will the nurse provide?
1. Keep a food diary and request antinausea medication if eating becomes problematic
2. Maintain regular low-impact exercise daily to avoid loss of muscle mass
3. Wear a high-filtration mask if going out in public
4. Avoid all fat-based soaps and allow the body to air-dry after bathing
1. Nystatin suspension has been ordered for treatment of thrush (oropharyngeal Candida) in a 6-week-old infant. What instructions should the caregiver receive? (SELECT ALL THAT APPLY)
1. Give the infant a small amount of water after feedings and before the drug to rinse the mouth
2. Using an applicator or syringe, distribute the solution around the mouth and tongue, allowing the infant to swallow the remainder
3. Chill the suspension in the refrigerator before giving for better taste
4. Give the suspension before feeding the infant to prevent adverse GI effects
5. Add the suspension to a bottle of formula for easier administration
1. The nursing is caring for a patient with onychomycosis (nail fungus) who is receiving oral terbinafine (Lamisil) for treatment. The patient questions the need for 3 months' worth of pills. What is the nurse's best response?
1. "The healthcare provider will evaluate the nails monthly and stop treatment earlier if warranted."
2. "It is cheaper to buy more pills at one time than on a monthly schedule"
3. "The extensive prescription avoids the need for shorter term, potentially toxic doses."
4. "Nails grow slowly and the nail beds must receive adequate length of treatment to eliminate the infection."
1. The nurse knows that pretreatment with corticosteroids, antihistamines, and a antipyretics prior to the administration of amphotericin B is given for what effect?
1. To enhance the effectiveness of amphotericin B
2. To eliminate toxic byproducts of amphotericin B
3. To reduce the severity of adverse effects associated with amphotericin B
4. To increase the half-life of amphotericin B
1. A patient with diabetes treated with oral antidiabetic medications is receiving oral fluconazole (Diflucan) for treatment of long-standing tinea cruris (jock itch). The nurse will instruct the patient to monitor blood sugar more frequently while on the drug because of what potential drug effects?
1. Fluconazole (Diflucan) antagonizes the effects of antidiabetic drugs
2. Fluconazole (Diflucan) may increase blood sugar levels
3. Fluconazole (Diflucan) may decrease blood sugar levels
4. Fluconazole (Diflucan) may enhance the effects of antidiabetic drugs
1. The patient is taking atovaquone-proguanil (Mialarone) prophylactically before traveling to a developing country and asks the nurse how long the drug will need to be taken after returning from the trip. Which response from the nurse would be correct? Atovaquone-proguanil (Mialarone) is:
1. Recommended for 7 days after returning from the malaria infested location
2. Not necessary after leaving the location
3. Suggested for 3 days after returning from the trip
4. Optional unless the patient reports symptoms of malaria
1. A patient has been started on hydroxychloroquine (Plaquenil) for prevention of malaria on an overseas trip. In addition the prevention and treatment of malaria, hydroxychloroquine is also indicated for what other conditions? (SELECT ALL THAT APPLY)
1. Systemic lupus erythematosus
2. Roundworm infections
3. Urinary tract infections
4. Rheumatoid arthritis
5. Leishmaniasis infections
1. A patient is being treated with metronidazole (Flagyl) for Giardia lamblia infection. When instructing the patient about this drug, the nurse should caution about the possibility of which adverse reaction?
1. Flatus and intestinal bloating
3. Unpleasant metallic taste
1. The patient is diagnosed with toxoplasmosis and will be treated with pyrimethamine (Daraprim). Because of significant adverse effects, what teaching should the nurse give this patient?
1. Increase intake of fiber-rich foods to prevent constipation.
2. Report unusual bruising, fatigue, and sores that do not heal, or low-grade fever
3. Increase fluid intake to 3L per day
4. Schedule eye examinations every 6 months for 2 years after taking this drug
1. A 6 year old boy is diagnosed with an Enterobius vermicularis (pinworm) infection and has been prescribed mebendazole (Vermox). What appropriate instructions should the nurse give the boy's caregiver?
1. The drug will be continued for 2 weeks and then a stool sample will be retested
2. Because the infection is not easily transmitted, it is not necessary to test or treat family members.
3. Eliminate all citrus and dairy products while this medication is taken
4. Wash all bedding and undergarments thoroughly after the medication is given
1. A nurse is monitoring a patient receiving metronidazole (Flagyl) for potential adverse effects. Which symptom, if present, would cause the nurse to discontinue the medication and notify the prescriber?
1. Ataxia and confusion
2. Nausea and diarrhea
3. Anorexia and thirst
4. Weight gain and irritability
1. Acyclovir (Zovirax) has been ordered intravenously for a patient with a herpes zoster infection to the upper torso and face. Which nursing intervention will help prevent a common adverse effect?
1. Administer the drug slowly IV over an hour, and encourage fluid intake throughout the day
2. Keep skin areas dry to prevent fungal overgrowth
3. Administer antihistamines 1 hour before giving the infusion to prevent itching
4. Assess visual activity periodically and provide for eye comfort such as lubricating eye drops
1. The patient is receiving elbasvir-grazoprevir (Zepatier) for hepatitis C virus. Which statement by the nurse is correct?
1. "Neither the topical nor the intravenous form of Zepatier will prevent the spread of hepatitis C virus."
2. "The patient will receive a 12-to 16 month course of therapy with Zepatier."
3. "Zepatier may be used in combination with ribavirin."
4. "The most common adverse effects of Zepatier are fatigue, rash, and dizziness.
1. Which assessment data would be most important for the nurse to monitor frequently in the patient receiving amantadine (Symmetrel)? (SELECT ALL THAT APPLY)
1. White blood cell and platelet counts
2. Serum creatinine and urine output
3. Mental status and level of consciousness
4. Sodium and potassium levels
5. Lung sounds and signs of peripheral edema
2, 3, 5
1. The patient has received a prescription for zanamivir (Relenza) for flu symptoms but tells the nurse, "I think I can hold off on starting this, I don't feel that bad yet." What would be the nurse's best response?
1. "That should be fine and the drug has a stable self-life so it can be saved for later infections."
2. "It can be saved for later but you will also require an additional antibiotic to treat the symptoms at that point."
3. "It can be started within 2 weeks after the onset of symptoms."
4. "To be effective, it must be started with 48 hours after onset of symptoms."
1. A patient with chronic hepatitis B has been prescribed tenofovir (Viread). The nurse will teach the patient to immediately report symptoms of what adverse and potentially life-threatening drug effect?
1. Systemic yeast infection
2. Lactic acidosis
3. Heart failure
4. Ventricular dysrhythmias
1. The patient is receiving ribavirin (Copegus) for treatment of chronic hepatitis B. Which manifestation, if present in the patient, would the nurse conclude is an adverse effect of this medication?
1. Neurologic symptoms such as headaches and dizziness
2. Respiratory symptoms such as dyspnea and congestion
3. Skin disruptions such as acne and ulcerations
4. Hematologic symptoms such as excessive fatigue or dizziness
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