pharm exam 4

Question 1

Nurse Dino is caring for a patient that is prescribed a tetracycline for an infection. Nurse Dino would question which medication on the MAR?

Answer 1

digoxin

Question 2

What foods decrease the absorption of Tetracyclines? Select all that apply.

Answer 2

calcium, magnesium, iron, zinc

Question 3

What is the biggest adverse effect associated with clindamycin _______?

Answer 3

c. diff

Question 4

The nurse is working on a telemetry unit and is caring for a patient taking macrolides. The nurse would anticipate which part of the heart rhythm to be abnormal?

Answer 4

Q-T interval

Question 5

Mupirocin, a bacteriostatic agent is a topical agent used to treat skin infections. List two skin infections it is used for.

Answer 5

impetigo and MRSA

Question 6

A pt. Was recently diagnosed with chlamydia. The nurse sees that the pt is currently taking a tetracycline. Based on the nurse’s knowledge of how this drug gets metabolized and excreted the nurse would anticipate what lab orders? Select all that apply. (Page 1054)

Answer 6

ALT, GFR, creatinine

Question 7

The nurse notes the patient has a tetracycline ordered on the MAR. The nurse knows the medication could be which of the following: (select all that apply)

Answer 7

Tetracycline
Demeclocycline
Doxycycline
Minocycline

Question 8

Tetracyclines are known for their ability to penetrate the CSF, treating most meningeal infections.

Answer 8

false

Question 9

The nurse understands that tetracyclines are used as a first line treatment for the following bacteria… (select all that apply)

Answer 9

H. Pylori
Mycoplasma pneumoniae
Chlamydia trachomatis
Borrelia burgdorferi

Question 10

What macrolide can be used in place of Penicillin G if the patient presents with an allergy to penicillin? (Page 1060)

Answer 10

Erythromycin

Question 11

What levels should be monitored in a patient who is receiving gentamicin for meningitis? Select all that apply. (Pg. 1065)

Answer 11

BUN, creatinine

Question 12

Penicillins and aminoglycosides can be mixed together in the same IV solution. (P.1065)

Answer 12

false

Question 13

What topical medication would we give an infant with conjunctivitis? (1063)

Answer 13

Neomycin

Question 14

Which aminoglycoside is the least susceptible to inactivation by bacterial enzymes? (pg. 1062)

Answer 14

Amikacin

Question 15

A patient comes in with a bacterial infection and the doctor wants to prescribe gentamicin, what class of medications on the EMAR would be a cause of questioning the order? (1065)

Answer 15

Neuromuscular blocking agent

Question 16

A patient is taking aminoglycosides with impaired renal function. What would be a concern for this patient? (Pg. 1064, short answer)

Answer 16

The half life of the aminoglycoside will be longer which could increase toxicity.

Question 17

Aminoglycosides are primarily used against gram-negative bacilli. (p.1062)

Answer 17

True

Question 18

A nurse is administering aminoglycosides at 0900 to patients suffering a severe infection of the abdomen. Which route of administration would ensure the drug to be absorbed effectively?(Select all that apply)(1062)

Answer 18

Intramuscular
intravenous

Question 19

Which parts of the body are most affected by aminoglycoside toxicity? (Pg.1064) Select all that apply

Answer 19

ears and kidneys

Question 20

What is the primary mechanism of action for aminoglycosides? (page 1062)

Answer 20

inhibition of protein synthesis

Question 21

(Pg 1100) Why is ciprofloxacin not a first line drug of choice?

Answer 21

Because its the only effective agent against anthrax

Question 22

(Pg 1101) In what disease is taking fluoroquinolones contraindicated?

Answer 22

Myasthenia Gravis

Question 23

Why is Diflucan prescribed with Cipro? (pg 1100)

Answer 23

To prevent oral or vaginal yeast

Question 24

Which broad spectrum is used to treat TB? (pg 1103)

Answer 24

Rifampin

Question 25

What adverse effect should geriatric patients be educated on when being prescribed fluoroquinolones? (Pg 1100)

Answer 25

Tendon Tears

Question 26

Which of the following antibiotics are examples of common Fluoroquinolones. (pg. 1100)

Answer 26

Ofloxacin Ciprofloxacin Levofloxacin

Question 27

The nurse would expect to see constipation as an adverse effect of which drug? (pg. 1102)

Answer 27

Daptomycin

Question 28

Ciproflaxcin and Levofloxacin are the only fluoroquinolones approved for use in children.

Answer 28

true

Question 29

What would we question in a patient’s diet if they are prescribed fluoroquinolones?

Answer 29

milk

Question 30

A nurse is caring for a patient who has inhaled Anthrax spores, what would the nurse expect to be ordered in the EMAR? (pg. 1100)

Answer 30

ciprofloxacin

Question 31

A nurse is on the EMAR and sees that the patient has furosemide. The nurse knows the following are adverse effects for this medication: Select all the apply (Pg 457)

Answer 31

Ototoxicity Hyponatremia Hypochloremia dehydration

Question 32

What are the three most common uses for Spironolactone? (Select all that apply)

Answer 32

Hypertension Edema Heart failure

Question 33

You have just given your patient a dose of PO furosemide (Lasix). What is the expected onset of the drug?

Answer 33

60 minutes

Question 34

True or False: Thiazide-induced hypokalemia is a special problem for patients taking digoxin

Answer 34

true

Question 35

A nurse sees that a patient is on spironolactone while staying in the hospital. The nurse knows to keep a look at what electrolyte imbalance?

Answer 35

Hyperkalemia

Question 36

A patient in the ER has a GFR lab that comes back as 10 mL/min. What type of diuretic can they not receive? pg: 459

Answer 36

Thiazides

Question 37

The nurse is caring for a patient in the Emergency Department who has acute renal failure, chronic heart failure and has not voided in two days. Which medication would the nurse be expecting to administer?

Answer 37

Furosemide

Question 38

A patient is in the hospital with increased intracranial pressure (ICP) and is prescribed mannitol. The nurse understands that the adverse effect of this medication is which of the following?

Answer 38

Edema

Question 39

Which adverse effects should the nurse be aware of when administering furosemide? Select all that apply:

Answer 39

a. Hearing loss B. Dysrhythmia C. Dizziness D. Dehydration F Oliguria

Question 40

Patient is in the hospital with moderate renal failure and has a foley catheter only putting out 100mL for 12 hours. The nurse overhears the care attendant talking to the patient. The nurse would intervene if they heard the care attendant saying _____.

Answer 40

“Your loop diuretic should kick in within the next 48 hours”

Question 41

Mr. Johnson was admitted for an Urinary Tract Infection which progressed into a systemic infection. The provider prescribed a Sulfonimide. What severe adverse reaction would you be on the lookout for? (pg.1070)

Answer 41

Steven-Johnson Syndrome

Question 42

What bacteria do Sulfonamides work best on (select all that apply)

Answer 42

E.coli Staphylococcus Aureus Enterobacter

Question 43

The patient presents with blue-green or gray skin what medication does the nurse expect to see on the EMAR? (pg. 1072, Table 92.2)

Answer 43

Silver sulfadiazine

Question 44

What is a contraindication regarding pregnant women and the use of sulfonamides? (pg. 1072)

Answer 44

Systemic sulfonamides can cause birth defects especially early on. Use of them later in pregnancy can cause the baby to experience kernicterus.

Question 45

Systemic sulfonamides can cause birth defects especially early on. Use of them later in pregnancy can cause the baby to experience kernicterus.

Answer 45

true

Question 46

A patient taking trimethoprim understands that they should notify the provider if they experience…. (SATA) pg. 1076

Answer 46

Sore throat Fever Pallor Easy bruising

Question 47

Which of the following are hypersensitivity reactions related to sulfonamides? Select all that apply. (page 1070)

Answer 47

Rash Photosensitivity Drug fever

Question 48

List three adverse effects of Trimethoprim: (Pg 1073)

Answer 48

Possible answers: Epigastric distress Nausea and vomiting Glossitis Stomatitis Hematologic effects Hyperkalemia

Question 49

The nurse understand that topical sulfonamides are indicated in treating _____& ____ (fill in the blank) pg 1069

Answer 49

a. Superficial infections of the eyes b. Suppressing bacterial colonization for burns

Question 50

Which of the following are ways that bacteria can acquire resistance to trimethoprim? Select all that apply. Pg 1073

Answer 50

a. Synthesizing increased amounts of dihydrofolate reductase c. Producing an altered dihydrofolate reductase that has a low affinity for trimethoprim e. Reducing cellular permeability to trimethoprim.