exam 3 Flashcards
The ability of an antibiotic to target pathogens without major effects on human cells is termed:
a. selective toxicity
b. selective synthesis
c. bacteriostatic action
d. opportunistic action
SELECTIVE TOXICITY
The ability of an organism to become unresponsive over time to an anti-infective is termed:
a. superinfection
b. sensitivity
c. mutation
d. acquired resistance
ACQUIRED RESISTANCE
Which location is the most difficult to reach with antibiotic therapy?
a. gastrointestinal system
b. integumentary system
c. central nervous system
d. lungs
central nervous system
A client has been on an antibiotic for two weeks for treatment of an ulcer caused by Helicobacter pylori. The client asks the nurse if the antibiotic could be causing diarrhea. What is the nurse’s most accurate response?
a. the infection has become severe
b. this might be secondary infection due to the antibiotic therapy
c. the infection has a restricted group of microorganisms
d. the organisms that caused the infection have developed immunity to the dryg
This might be a secondary infection due to the antibiotic therapy
An advantage of using a broad-specturm antibiotic is that?
a. it is effective against a large number of organisms
b. it is effective against a small number of organisms
c. it has a high potency
d. it produces a large number of side effects
it is effective against a large number of organisms
Which instruction should take priority in client teaching for nay antibiotic therapy?
a. the full course of prescribed drug therapy must be completed
b. maintain adequate food intake
c. maintain an adequate fluid intake
d. report symptoms of secondary infection, such as vaginal yeast infection
The full course of prescribed therapy must be completed
The nurse is administering the first dose of ampicillin intramuscularly to a client with a severe infection. In addition to the six rights of administration, an important priority nursing action is to:
a. monitor bowel sounds
b. teach the client about the side effects of the drug
c. encourage the client about the side effects of the drug
d. monitor the client closely for hypersensitivity with the first dose.
Monitor the client closely for hypersensitivity with the fist dose
The mother of a 4 year old calls the nurse to report her child has been having diarrhea since he began taking an antibiotic 48 hours ago. The mother asks if she should give her child an O-T-C medication for the diarrhea. What is the nurse best response?
a. wait one more day and see if the diarrhea clears
b. yes give something otc, but only one dose
c. yes, give something OTC according to dosage directions on the label
d. do not treat the diarrhea and bring the child to the office
yes, give the OTC according to the dosage directions on the label
A 16 year old client has been prescribed metronidazole for treatment of a sexually transmitted infection. this client has been seen in the clinic 4 times in the last 6 months for the same condition. the client just wants the nurse to give her the medication so that she can go home. What would be considered the priority nursing diagnosis for this client?
a. noncompliance related to therapeutic regimen
b. diarrhea related to effects of drug therapy
c. risk for infection
d. knowledge deficit related to disease process, transmission, and drug therapy
knowledge deficit related to disease process, transmission, and drug therapy
Bacterial enzymes participate in the construction of the bacterial cell wall. penicillin targets these enzymes and interfere with:
a. bacterial DNA
b. the addition of cross-links to the cell wall
c. protein synthesis
d. the channels in the cells internal structure
the addition of cross-links to the cell wall
Class of antibiotics that exert their antibacterial effect by interfering with the synthesis of the bacterial cell wall include:
a. cephalosporins
b. aminoglycosides
c. sulfonamides
d. erythromycins
cephalosporins
Penicillin’s antibacterial activity is based on its:
a. beta-lactam ring, which terminated construction of the cell wall
b. alteration of bacterial DNA in the cell wall
c. interference with cellular cytoplasm
d. interruption of bacterial protein synthesis
beta-lactam ring, which terminated construction of the cell wall
Augmentin is a combination drug containing the antibiotic amoxicilin and elavulanate which is a(n):
a. secondary antibiotic
b. beta-lactamase inhibitor to prevent the excretion of penicillin
c. anti-inflammatory to prevent allergic response
d. antiviral to prevent superinfection
beta-lactamase inhibitor to prevent the excretion of penicillin
Which generation of cephalosporin would be selected to treat complicated meningitis?
a. second
b. third
c. fourth
d. first
fourth
The nurse caring for a client with an allegory to cephalosporins would be cautious in implementing an order for an anti-infective agent from which class?
a. aminoglycosides
b. fluroquinolones
c. sulfonamides
d. penicillins
penicillins
Which client should be monitored closely for adverse effects directly related to receiving penicillin G?
a. a client who has osteromyelitis and will need IV medication for several months
b. client who has a myocardial infarction 2 days ago and now has a fever of 102
c. client who is postop from corneal transplant
d. a client who has diabetes and is on dialysis
a client who has diabetes and is on dialysis
antibacterial protein synthesis inhibitors act by?
a. disrupting the growth of the polypeptide chain
b. inhibiting synthesis of enzymes
c. promoting lysis of the cell wall
d. disrupting cell wall synthesis
inhibiting synthesis of enzymes
A client being discharged with a prescription for penicillin and probenecid asks the nurse what the probenecid is for. the nurse explains that probenecid:
a. prevents diarrhea often associated with penicillin
b. will prevent an allergic response
c. is a secondary antibiotic
d. will allow the penicillin to stay in the body longer
will allow the penicillin to stay in the body longer
Bacterial protein synthesis inhibitors have selective toxicity because:
a. susceptible strains of bacteria are affected
b. biochemical processes are the same
c. human ribosomes are larger and denser than bacterial ribosomes
d. antibacterial activity is broad-specturm
human ribosomes are larger and denser than bacterial ribosomes
The nurse is managing care for a patient prescribed tetracycline who is reporting frequent episodes of diarrhea. the nurse plans to monitor this client for:
a. Pseudomenbranous colitis
b. paralytic ileus
c. intestinal obstruction
d. impaired biliary function
Pseudomenbranous colitis
A client reports no improvement after 5 days of therapy with tetracycline. The nurse suspects drug resistance and knows that drug resistance can develop in which ways except?
a. a drug is prevented from concentrating inside the bacterial cell
b. a broad spectrum antibacterial drug is used instead of a narrow spectrum drug
c. a bacteriostatic agent is parked with a bactericidal agent
d. drug therapy is not completed for the prescribed duration of time
drug therapy is not completed for the prescribed duration of time
A pregnant client has been prescribed azithromycin for pelvic inflammatory disease (PID). The client ask the nurse why this medication was prescribed instead of erythromycin. The nurse explains that azithromycin:
a. causes less otitis media in the infant
b. is safe to take during pregnancy
c. does not cause diarrhea or abdominal pain
d. is not associated with hypersensitivity
is safe to take during pregnancy
the health care practitioner is preparing to prescribe trimethorprim-sulfamethoxazole. For which client should the nurse question an order for this medication?
a. the client who has a Shigella infection of the bowel
b. the client with p.Jiroveci pneumonia
c. the client with iron-deficiency anemia
d. the client with pernicious anemia
the client with pernicious anemia
A client has been taking nitrofurantoin for treatment of a urinary tract infection. the client calls and reports that her urine has turned brown. What is the best response by the nurse to the client’s concerns?
a. please come to the office immediately so you can be examined for a possible allergic reaction to the medication
b. are you running a fever
c please go to the emergency department immediately. the brown color indicates that you are experiencing a server adverse redaction the medication
d. this is a normal finding, don’t be concerned
this is a normal finding, don’t be concerned
A 19 year old client with symptoms of recurrent urinary tract infection states that she generally does not finish the prescription given to her for the infection. What medication is the health care practitioner most likely to prescribe for this client?
a. nitrofurantoin
b. trimethoprim-sulfamethoxazole
c. Fosfomycin (monurol)
d. ciprofloxacin
Fosfomycin (monurol)
How do fluroquinolones block bacterial DNA replication?
a. fluroquinolones inhibit the synthesis of precursor bases
b. Fluroquinolones bind to enzymes of bacterial DNA replication, blocking the relaxation and migration processes
c. Fluroquinolones inhibit topoisomerase I so that DNA cannot be repaired
d. Fluroquinolones bind with the enzymes DNA polymerase, blocking the replication of the DNA process
Fluroquinolones bind with the enzymes DNA polymerase, blocking the replication of the DNA process
During pharmacology class, a nursing professor poses the following question, “we have learned that certain medications such as Fluroquinolone, are effective because they inhhit bacterial DNA replication. why don’t these medication cause harm to nonbacterial cells in the body?” Which of the following student nurses answered the question correctly?
a. Student B;
b. Student D:
c. Student C
d. Student A.
STUDENT C!!!!!
A clients urine culture has come back showing that the infecting organism is resistant to ciprofloxacin. The client is upset, saying that this medication has worked every other time. What explanation should the nurse give to the client concerning the development of resistance?
a. there are a number of ways that an organism can become resistant to an antibacterial, sometimes one of the enzymes involved in bacterial DNA replication mutates so that the medication is no longer effective
b. you must be infected with one of the new superbugs, there aren’t many antibacterial that wil work against it
c. don’t worry the doctor will give you leveofloxacin to take instead of ciprofloxacin
d. there are a number of ways that an organism can become resistant to an antibacterial. IT probably happened because you didn’t take your medication correctly the last time you took it.
there are a number of ways that an organism can become resistant to an antibacterial, sometimes one of the enzymes involved in bacterial DNA replication mutates so that the medication is no longer effective
A client has been hospitalize for a severe UTI. cirpofloxacin IV is prescibred. Two days later the symptoms have abated, and the client is discharged with a prescription for oral ciprofloxacin. What characteristic of fluroquinolones allow for this quick discharge front the hospital?
a. FLuroquinolones given IV are very expensive. and must be switched to oral administration as soon as possible to save the client money
b. FLuroquinolones have equal serum drug levels with either IV or oral administration, which allows for smooth transition from IV to oral therapy
c. FLuroquinolones given as an IV infusion eradicate infection quickly so that the client can be discharged
d. Fluroquinolones are less toxic when given orally
FLuroquinolones have equal serum drug levels with either IV or oral administration, which allows for smooth transition from IV to oral therapy
Fluroquinolones are very effective against both gram-negative and gram-positive organism. Several of the drugs int his class have been discontinued from use. What adverse effects have caused the removal of these drugs from the market?
a. the development of dysrhythmias after administration of Fluroquinolones
b. the development of pathologic fractures after administration of Fluroquinolones
c. the development of insomnia after administration of Fluroquinolones
d. the development of sever phototoxicity after administration of Fluroquinolones
the development of dysrhythmias after administration of Fluroquinolones
CLients in a nursing home have been prescribed permethrin for head lice. The nurse will question the order for the client who has:
a. seizures
b. hypothyroidism
c. diabetes mellitus
d. an allergy to sulfites
an allergy to sulfites
An adolescent is takign isotretinoin for treatment of sever acne. The nurse has completed medication education with the mother and evaluates that addition learning is required when the mother states:
a. i will pay particular attention to her mood now
b. i will be sure she has a monthly period
c. she might complain of aches and pain
d. we will need to check her cholesterol levels
I will be sure she has a monthly period
Prior to teaching a client about the care of psoriasis, the nurse assesses the client’s knowledge of the disorder. which statement indicates that the client has a knowledge base about this illness?
a. treatment can help lessen the discomfort of my psoriasis
b. i wish there were some way other than lotions to treat my psoriasis
c. no medications are effective for treating my disorder
d. oral medications are the only medications that are effective
treatment can help lessen the discomfort of my psoriasis
A client with AIDS is suffering from a systemic fungal infection. The nurse anticipates the drug of choice for this client will be a. fluconazole b. Amphotericin B c. Nystatin D. Griseofulvin
Amphotericin B
The nurse would recognize which symptom as a sign of a serious adverse effect in a client taking Amphotericin B?
a. hypokalemia
b. leukopenia
c. hematuria
d. paresthesia
hematuria
The nurse is educating a client with tuberculosis. the client ask the nurse to estimate the duration of the tx. which responses would be correct in identifying the expected duration for pharmacological management of tuberculosis?
a. 1 month
b. 7 days
c. 14 days
d. 6-12 months
6-12 months
The nurse caring for a client with tuberculosis knows that the primary reason for lack of success in the treatment of tuberculosis is?
a. the development of resistance
b. under dosing by the provider
c. client nonadherance
d. medication errors by the nurse
client nonadherance
The client recently diagnosed with tuberculosis asks the nurse why so many different pills are required to treat the infection. The nurse bases the response on the knowledge that:
a. treatment is a trial-and error process, and it will take 14 days for the appropriate drug to be identified
b. Mycobacteria grow slowly and often develop resistance during the course of treatment
c. it is difficult for a single drug to break down the cysts that are formed by the tubercle
d. the client might have a genetic different that requires multiple dosing
Mycobacteria grow slowly and often develop resistance during the course of treatment
The nurse knows that which medication is considered the mainstay of pharmacological intervention in the client with tuberculosis and is included in all regimens?
a. isoniazid
b. pyrazinamide (PZA)
c. Rifampin
d. thambutol
isoniazid
The nurse teaches clients with acquired immune deficiency syndrome (AIDS) about the importance of taking their medications as prescribed. what does the nurse recognize as the primary factor for medication nonadherance in the AIDS population
a. the difficulty with availability of medications to that AIDS
b. the lack of understanding for the reason to take medications
c. the necessity go having to take multiple medications throughout the day
d. the unpleasant side effects associated with the medications.
the necessity go having to take multiple medications throughout the day
When discussing antiviral drug resistance with a client beginning pharmacotherpay, the nurse explains that the most of the reasons for drug resistance is certain medicines are related to:
a. the viral load
b. the lymphocyte count
c. the suppressor T cells
d. the mutations that can occur in the virus
the mutations that can occur in the virus
When the client is started on antiretroviral drugs for HIV, what important information should the nurse teach the client?
a. this drug is rapidly available all over the world for treatment
b. this type of drug will be used prior to vaccines
c. this drug all cure the disease over a period of time
d. this drug will not cure the disease, but could extend life expectancy
this drug will not cure the disease, but could extend life expectancy
Which teaching point by the nurse is correct in regard to antiviral therapy?
a. antivrial drug therapy can be challenging because of how slowly viruses become resistant to the drugs
b. they have a broad-spectrum of activity
c. it is difficult to administer adequate doses of medication to kill the virus without injuring normal cells
d. they must be given one at a time because of the possibility of sever side effects
it is difficult to administer adequate doses of medication to kill the virus without injuring normal cells
The nurse is providing the discharge teaching to a client recently diagnosed with HIV. the nurse knows the client has understood the instructions when he’s rates that a goal of HIB pharmacotherapy is not only prolong survival but also to
a. prevén HIV-related morbidity
b. restore and preserve immunologic fucntion
c. increase viral load
d. eliminate the potential for transmission from mother to child in pregnant clients who have HIV infections
restore and preserve immunologic fucntion
The nurse is teaching a client about the stander drug therapy for HIV-ADIS. Which antiviral medications does the nurse include in the teaching plan?
a. Zidovudine
b. interferon-alfa
c. Rimantadine
d. acyclovir
Zidovudine
The nurse states that the goal of HAART is
a. reduction of the plasma level of HIV to the lowest level possible
b. elimination of the virus from the lymph system
c. reduction of side effects seen with other HIV-AIDS drugs
d. elimination of the virus from the bloodstream
reduction of the plasma level of HIV to the lowest level possible
The nurse would correctly educate parents about the most common adverse effect of vaccine administration:
a. cough and runny nose
b. pain, swelling, and redness at injection sites
c. fever of 101 or greater
d. development of a full body rash
pain, swelling, and redness at injection sites
In which pregnancy category are almost all vaccines?
a. C
b. X
c. D
d. B
C
The nurse teaches nursing students that to maintain immunity, the booster for tetanus prevention should be given to adults at what intervals?
a. 5 years
b. 8 years
c. 10 years
d. 15 years
10 years
Which population should receive the Zostavax vaccine?
a. adults over 60
b. pregnant women
c. children at 15 months
d. college students
adults over 60
