PHARMACOLOGY EXAM 3 Flashcards
Which adverse response to isoniazid (INH) in a client with tuberculosis would cause the nurse to determine that prompt intervention is needed?
A. Orange feces
B. Yellow sclera
C. Temperature of 96.8°F (36°C)
D. Weight gain of 5 pounds (2.3 kilograms)
Yellow sclera
Which purpose would the nurse identify as the reason for prescribing vitamin B 6 when a chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B 6 and isoniazid (INH)?
A. To improve the nutritional status of the client
B. To enhance the tuberculostatic effect of INH
C. To accelerate the destruction of dormant tubercular bacilli
D. To counteract the peripheral neuritis that INH may cause
To counteract the peripheral neuritis that INH may cause
Which explanation would the nurse provide to a client with tuberculosis who asks why vitamin B 6 (pyridoxine) is given with isoniazid?
A. “It will improve your immunologic defenses.”
B. “The tuberculostatic effect of isoniazid is enhanced.”
C. “Isoniazid interferes with the synthesis of this vitamin.”
D. “Destruction of the tuberculosis organisms is accelerated.”
“Isoniazid interferes with the synthesis of this vitamin.”
A health care provider has prescribed isoniazid for a client. Which instruction will the nurse give the client about this medication?
A. Prolonged use can cause dark, concentrated urine.
B. The medication is best absorbed when taken on an empty stomach.
C. Take the medication with aluminum hydroxide to minimize gastrointestinal (GI) upset.
D. Drinking alcohol daily can cause medication-induced hepatitis.
Drinking alcohol daily can cause medication-induced hepatitis
When caring for a client on isoniazid therapy for tuberculosis, the nurse would focus on which diagnostic testing for this client?
A. Creatinine
B. Hearing tests
C. Electrocardiogram
D. Liver function tests
Liver function tests
A client diagnosed with tuberculosis is taking isoniazid. To prevent a food and medication interaction, the nurse will advise the client to avoid which food item?
A. Hot dogs
B. Red wine
C. Sour cream
D. Grapefruit juice
Red wine
Isoniazid (INH) is prescribed as a prophylactic measure for a client whose spouse has active tuberculosis (TB). Which statements made by the client indicate that there is a need for further teaching? Select all that apply. One, some, or all responses may be correct.
A. ‘I plan to start taking vitamin B 6 with breakfast.’
B. ‘I’ll still be taking this medication 6 months from now.’
C. ‘I sometimes allow our children to sleep in our bed at night.’
D. ‘I know I also have tuberculosis because the skin test was positive.’
E. ‘I plan to attend a wine tasting event this evening.’
‘I sometimes allow our children to sleep in our bed at night.’
‘I know I also have tuberculosis because the skin test was positive.’
‘I plan to attend a wine tasting event this evening.’
Pyridoxine (vitamin B 6) and isoniazid (INH) are prescribed as part of the medication protocol for a client with tuberculosis. Which response indicates that vitamin B 6 is effective?
A. Weight gain
B. Improvement of stomatitis
C. Absence of paresthesias
D. Absence of night sweats
Absence of paresthesias
The chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B 6 and isoniazid (INH). Which would the nurse identify as the reason for prescribing vitamin B 6?
A. To improve the nutritional status of the client
B. To enhance the tuberculostatic effect of INH
C. To accelerate the destruction of dormant tubercular bacilli
D. To counteract the peripheral neuritis that INH may cause
To counteract the peripheral neuritis that INH may cause
A parent of three young children has contracted tuberculosis. Which medication would the nurse anticipate being prescribed for members of the family who have been exposed?
A. Isoniazid
B. Multiple-puncture test
C. Bacille Calmette-Guérin
D. Tuberculin purified protein derivative
Isoniazid
The nurse is caring for a client who is receiving isoniazid for tuberculosis (TB). Which assessment finding would indicate the client is having a possible adverse response to this medication?
A. Yellowing of the sclera
B. Tinnitus and decreased hearing
C. Headache and sore throat
D. Urinary frequency
Yellowing of the sclera
A client who is taking isoniazid for tuberculosis asks the nurse about the possible side effects of this medication. The nurse informs the client to report which side effect of this medication to the primary health care provider (HCP)?
A. Extremity tingling and numbness
B. Confusion and light-headedness
C. Double vision and visual halos
D. Photosensitivity and photophobia
Extremity tingling and numbness
Which action would the nurse take when administering tetracycline?
A. Administer the medication with meals or a snack.
B. Provide orange or other citrus fruit juice with the medication.
C. Administer the medication at least an hour before ingestion of milk products.
D. Offer antacids 30 minutes after administration if gastrointestinal side effects
Administer the medication at least an hour before ingestion of milk products.
Which effect has resulted in the avoidance of tetracycline use in children under 8 years old?
A. Birth defects
B. Allergic responses
C. Severe nausea and vomiting
D. Permanent tooth discoloration
Permanent tooth discoloration
How would the nurse reply when a client prescribed a tetracycline class medication asks why milk and antacids should be avoided before and after dosing?
A. ‘Taking these together can lead to kidney impairment.’
B. ‘The pairing of these substances leads to tooth staining.’
C. ‘Severe diarrhea can occur when taking these substances together.’
D. ‘This can lead to decreased absorption of the medication you need.’
‘This can lead to decreased absorption of the medication you need.’
A pregnant client with an infection tells the nurse that she has taken tetracycline for infections in the past and prefers to take it now. Which response would the nurse give regarding the avoidance of tetracycline administration during pregnancy?
A. ‘It affects breast-feeding adversely.’
B. ‘Tetracycline causes fetal allergies.’
C. ‘It alters the development of fetal teeth buds.’
D. ‘It increases fetal tolerance to the medication.’
‘It alters the development of fetal teeth buds.’
A mother complains that her child’s teeth have become yellow in color. The nurse understands that with prolonged use, which medication may be responsible?
A. Tetracycline
B. Promethazine
C. Chloramphenicol
D. Fluoroquinolones
Tetracycline
A child is prescribed tetracycline. The nurse understands which possible medication-related reaction is associated with this medication?
A. Kernicterus
B. Gray syndrome
C. Reye syndrome
D. Staining of teeth
Staining of teeth
Which information would the nurse provide to a client diagnosed with chlamydia and prescribed doxycycline? Select all that apply. One, some, or all responses may be correct.
A. Report worsening symptoms.
B. Refrain from sexual relations.
C. Use barrier protection devices.
D. Contact partners to be tested.
E. Take the entire course of antibiotics.
Report worsening symptoms.
Refrain from sexual relations.
Use barrier protection devices.
Contact partners to be tested.
Take the entire course of antibiotics.
The nurse is preparing to administer doxycycline to a client to treat syphilis. Which lab results should the nurse review before administering this medication?
A . Pregnancy test
B. Hematocrit
C. Sodium level
D. Arterial blood gas
Pregnancy test
The nurse is providing medication teaching for a client who has been prescribed tetracycline. The client regularly takes calcium supplements to prevent osteoporosis. Which statement is appropriate for the nurse to make?
A. Take your calcium two hours before you take the antibiotic
B. You can take the calcium with the antibiotic to decrease an upset stomach
C. Try taking the antibiotic and calcium with orange juice
D. It is best to take the antibiotic and calcium on an empty stomach
Take your calcium two hours before you take the antibiotic
The nurse in the urgent-care clinic is reviewing discharge instructions with a client who is prescribed doxycycline. Which statement by the client indicates understanding of the instructions?
A. “I will not wear my contact lenses while taking this medication.”
B. “I will carry glucose tablets with me in case I experience low blood sugar.”
C. “I will take this medication with an antacid to prevent an upset stomach.”
D. “I will apply sunscreen when outside to prevent a sunburn.”
“I will apply sunscreen when outside to prevent a sunburn.”
The health care provider has prescribed tetracycline for a 28-year-old female client with severe acne. When teaching the client about this medication, which information is important for the nurse to include?
A. It may cause staining of the teeth.
B. It may decrease the effectiveness of oral contraceptives.
C. It should be taken with food or milk.
D. It may cause hearing loss
It may decrease the effectiveness of oral contraceptives.
The nurse is educating an older adult client about newly prescribed levofloxacin for the treatment of pneumonia. The nurse should teach the client that which side effect is a priority for the client to report to the provider?
A . Joint tenderness
B. Diarrhea
C. Dizziness
D. Difficulty sleeping
Joint tenderness
The nurse is reviewing discharge instructions with a client who has been prescribed ciprofloxacin following a minor burn injury. Which statement by the client requires additional teaching?
A. “I will protect my skin from the sun with sunscreen and clothing.”
B. “I will not take ciprofloxacin prior to sun exposure.”
C. “After healing, I should have no scarring from this burn.”
D. “I can take ibuprofen for the pain related to this burn.”
“I will not take ciprofloxacin prior to sun exposure.”
The nurse teaches a teenage client about the administration of levofloxacin to treat a sinus infection. The nurse concludes the teaching is effective when the client makes which statement?
A. ‘I should take the medication at mealtime.’
B. ‘I should take the medication just before a meal.’
C. ‘I should take the medication 1 hour before a meal.’
D. ‘I should take the medication 30 minutes after a meal.’
‘I should take the medication 1 hour before a meal.’
Levofloxacin is prescribed for a woman who has been experiencing urinary frequency and burning for the past 24 hours. The nurse concludes the teaching has been effective when the client states she will make which change in her routine?
A. Limit her fluid intake.
B. Strain her urine for calculi.
C. Monitor her urine output.
D. Take mineral supplements 2 hours before or after levofloxacin
Take mineral supplements 2 hours before or after levofloxacin
A 5-year-old child is given fluoroquinolones. Which potential adverse effect unique to pediatric clients would the nurse anticipate?
A. Tendon rupture
B. Cartilage erosion
C. Staining of developing teeth
D. Central nervous system toxicity
Tendon rupture
Which action will the nurse take after stopping the antibiotic infusion of a client who becomes restless and flushed, and begins to wheeze during the administration of an antibiotic?
A. Check the client’s temperature.
B. Take the client’s blood pressure.
C. Obtain the client’s pulse oximetry.
D. Assess the client’s respiratory status.
Assess the client’s respiratory status.
Which explanation would the nurse include when teaching a client scheduled for a bowel resection about the purpose of preoperative antibiotics?
A. “They prevent incisional infection.”
B. “Antibiotics prevent postoperative pneumonia.”
C. “These medications limit the risk of a urinary tract infection.”
D. “They are given to eliminate bacteria from the gastrointestinal (GI) tract.”
“They are given to eliminate bacteria from the gastrointestinal (GI) tract.”
A client with advanced cancer of the bladder is scheduled for a cystectomy and ileal conduit. Which intervention would the nurse anticipate the health care provider will prescribe to prepare the client for surgery?
A. Intravesical chemotherapy
B. Instillation of a urinary antiseptic
C. Administration of an antibiotic
D. Placement of an indwelling catheter
Administration of an antibiotic
A client with burns develops a wound infection. The nurse plans to teach the client that local wound infections are primarily treated with which antibiotic formulation?
A. Oral
B. Topical
C. Intravenous
D. Intramuscular
Topical
Which issue related to antibiotic use is an increased risk for the older adult?
A. Allergy
B. Toxicity
C. Resistance
D. Superinfection
Toxicity
Which client would benefit most from the administration of prophylactic antibiotics? Select all that apply. One, some, or all responses may be correct.
A. Chickenpox infection
B. Fever of unknown origin
C. Preoperative hip replacement
D. Congenital bicuspid aortic valve
E. Current chemotherapy treatment
Preoperative hip replacement
Congenital bicuspid aortic valve
Current chemotherapy treatment
The nurse is preparing to administer an intravenous piggyback antibiotic that has been newly prescribed. Shortly after initiation, the client becomes restless and flushed and begins to wheeze. After stopping the infusion, which priority action will the nurse take?
A. Notify the primary health care provider immediately about the client’s condition.
B. Take the client’s blood pressure.
C. Obtain the client’s pulse oximetry.
D. Assess the client’s respiratory status
Assess the client’s respiratory status
An infant is prescribed an antibiotic after cardiac surgery. Which instruction would the nurse emphasize to the parents regarding administration of the medication?
A. Give the antibiotic between feedings.
B. Ensure that the antibiotic is administered as prescribed.
C. Shake the bottle thoroughly before giving the antibiotic.
D. Keep the antibiotic in the refrigerator after the bottle has been opened
Ensure that the antibiotic is administered as prescribed.
A client being discharged home is prescribed an antibiotic with a dosage three times higher than it was administered when the client was in the hospital (IV route). Which route of administration should the nurse anticipate will be prescribed for the greatest first-pass effect?
A. Oral.
B. Sublingual.
C. Intravenous.
D. Subcutaneous.
Oral.
The nurse is assessing a client who is receiving antibiotic therapy for an infection. Which finding should indicate to the nurse that the client may be experiencing an allergic reaction to a medication?
A. Xerostomia
B. Hypertension
C. Pruritus
D. Lymphadenopathy
Pruritus
The nurse is caring for a client with sepsis receiving broad-spectrum antibiotics. Which finding might indicate to the nurse the need for a dosage adjustment?
A. Elevated creatinine level
B. Elevated heart rate
C. Decreased white blood cell count
D. Decreased platelet count
Elevated creatinine level
The nurse in an ambulatory clinic is speaking with the parents of a 2-year-old child diagnosed with acute otitis media. Which information is most important for the nurse to include in the instructions to the parents?
A. The child may be given acetaminophen or ibuprofen drops for pain.
B. The child must complete the entire course of the prescribed antibiotic.
C. The child should return to the clinic to evaluate effectiveness of the treatment.
D. The child may be given a decongestant to relieve pressure on the tympanic membrane.
The child must complete the entire course of the prescribed antibiotic.
The nurse in an urgent care clinic is preparing discharge instructions for the parents of a 15-month-old child with a first episode of otitis media. Which information is the priority to include?
A. Explain that the child should complete the full 10 days of antibiotics
B. Describe the tympanocentesis most likely needed to clear the infection
C. Offer information on recommended immunizations around the child’s second birthday
D. Provide a written handout describing the care of myringotomy tubes
Explain that the child should complete the full 10 days of antibiotics
A nurse is assessing a 9-year-old child after several days of treatment for a documented strep throat. Which statement is incorrect and suggests that further teaching is needed?
A. “Sometimes I take my medicine with fruit juice.”
B. “Sometimes I take the pills in the morning and other times at night.”
C. “I am feeling much better than I did last week.”
D. “My mother makes me take my medicine right after school.”
“Sometimes I take the pills in the morning and other times at night.”
Which of the following instructions is most important for the nurse to include when discharging a client with an infection caused by staphylococcus?
A. Schedule follow-up blood cultures
B. Monitor for signs of recurrent infection
C. Visit the provider in a few weeks
D. Complete the full course of the antibiotic
Complete the full course of the antibiotic
Which statement indicates that a female client who is receiving rifampin for tuberculosis understands the teaching? Select all that apply. One, some, or all responses may be correct.
A. “This medication may be hard on my liver, so I must avoid alcoholic drinks while taking it.”
B. “This medication may reduce the effectiveness of the oral contraceptive I am taking.”
C. “I cannot take an antacid within 2 hours before taking my medicine.”
D. “My health care provider must be called immediately if my eyes and skin become yellow.”
“This medication may be hard on my liver, so I must avoid alcoholic drinks while taking it.”
“This medication may reduce the effectiveness of the oral contraceptive I am taking.”
“My health care provider must be called immediately if my eyes and skin become yellow.”
Which class is contraindicated in clients who take rifampin?
A. Loop diuretics
B. Oral contraceptives
C. Proton pump inhibitor
D. Intermediate-acting insulin
Oral contraceptives
A client who takes rifampin tells the nurse, ‘My urine looks orange.’ Which action would the nurse take?
A. Explain that this is expected.
B. Check the liver enzymes.
C. Ask the provider to order a urinalysis.
D. Ask what foods were eaten.
Explain that this is expected.
A client with tuberculosis is started on rifampin. The nurse evaluates that the teaching about rifampin is effective when the client makes which statement?
A. ‘I need to drink a lot of fluid while I take this medication.’
B. ‘My sweat will turn orange from this medication.’
C. ‘I should have my hearing tested while I take this medication.’
D. ‘Most people who take this medication develop a rash.’
‘My sweat will turn orange from this medication.’
A client is diagnosed with pulmonary tuberculosis, and the health care provider prescribes a combination of rifampin and isoniazid. The nurse evaluates that the teaching regarding the medications is effective when the client reports which action as most important?
A. ‘Report any changes in vision.’
B. ‘Take the medicine with my meals.’
C. ‘Call my doctor if my urine or tears turn red-orange.’
D. ‘Continue taking the medicine even after I feel better.’
‘Continue taking the medicine even after I feel better.’
Which statement by the client indicates to the nurse a need for further teaching on rifampin therapy?
A. ‘I can expect my skin to turn yellow.’
B. ‘I can expect my sweat to change color.’
C. ‘I can expect my urine to turn red-orange.’
D. ‘I can expect my contact lenses to stain orange.’
‘I can expect my skin to turn yellow.’
Clients who take rifampin should not take medications from which class?
A. Loop diuretics
B. Oral contraceptives
C. Proton pump inhibitor
D. Intermediate-acting insulin
Oral contraceptives
A client is prescribed rifampin after being exposed to active tuberculosis. Which finding would the nurse immediately report to the health care provider? Select all that apply. One, some, or all responses may be correct.
A. Reddish-orange color urine
B. Yellow-colored teeth stains
C. Orange-colored sweat and tears
D. Small, red, pinpoint areas on the arms
E. Numbness, tingling, and burning of extremities
Small, red, pinpoint areas on the arms
The nurse is assessing a client who is taking rifampin for the treatment of tuberculosis. Which finding reported by the client should the nurse immediately report to the healthcare provider?
A. Blurred vision
B. Orange-tinged tears
C. Dark amber urine
D. Diarrhea
Dark amber urine
A client diagnosed with tuberculosis is prescribed rifampin and isoniazid. Which information should the nurse include when reinforcing information about these medications?
A. “You can take the medication with food.”
B. “You may experience an increase in appetite.”
C. “You may notice an orange-red color to your urine.”
D. “You may have occasional problems sleeping.”
“You may notice an orange-red color to your urine.”
A client begins treatment with rifampin for suspected pulmonary tuberculosis. Which information should the nurse include when teaching the client about this drug?
A. “It is important to stay upright for 30 minutes after taking this drug.”
B. “Check your radial pulse before taking the drug.”
C. “Avoid prolonged exposure to the sun while taking this drug.”
D. “You may notice an orange-red color to your urine.”
“You may notice an orange-red color to your urine.”
Which response will be given by a nurse caring for a client with chronic hepatitis B who asks “Are there any medications to help me get rid of this problem?”?
A. “Sedatives can be given to help you relax.”
B. “We can give you immune serum globulin.”
C. “Vitamin supplements are frequently helpful and hasten recovery.”
D. “There are medications to help reduce viral load and liver inflammation.”
“There are medications to help reduce viral load and liver inflammation.”
The nurse is preparing to administer the next dose of prescribed vancomycin to the client being treated for sepsis. Which of the following laboratory results would be the priority for the nurse to review?
A. Peak serum drug level
B. Serum potassium level
C. Serum creatinine level
D. White blood cell count
Serum creatinine level
The nurse is caring for a client with osteomyelitis who is receiving IV infusion of prescribed vancomycin. Which statement by the client would be a priority for the nurse to report to the healthcare provider?
A. I fell some burning at the catheter site
B. I feel a little nauseous
C. I have a ringing in my ears
D. I have a headache
I have a ringing in my ears
The nurse is caring for a client who is prescribed erythromycin 500 mg orally every six hours for the treatment of pneumonia. The nurse should monitor the client for which common side effect?
A. Esophagitis
B. Tendon rupture
C. Orange-red discoloration of urine
D. Nausea and vomiting
Nausea and vomiting
Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply.One, some, or all responses may be correct.
A. Creatinine
B. Trough level
C. Hearing ability
D. Intravenous site
E. Blood urea nitrogen
Creatinine
Trough level
Hearing ability
Intravenous site
Blood urea nitrogen
Which reason will the nurse explain is the purpose for neomycin being prescribed to a client with cirrhosis?
A. Prevents an infection
B. Limits abdominal distention
C. Minimizes intestinal edema
D. Reduces the blood ammonia level
Reduces the blood ammonia level
Which action would the nurse take when a client develops a maculopapular rash on the upper extremities and audible wheezing during the admistinration of intravenous vancomycin?
A. Stop the infusion.
B. Decrease the flow rate.
C. Reassess in 15 minutes.
D. Notify the health care provider.
Stop the infusion.
Neomycin is prescribed preoperatively for a client with colon cancer. The client asks why this is necessary. Which response would the nurse provide?
A. ‘It kills cancer cells that may be missed during surgery.’
B. ‘This medication is helpful in decreasing the inflammatory response associated with surgical procedures.’
C. ‘It kills intestinal bacteria to decrease the risk for infection.’
D. ‘This medication alters the body flora to prevent the occurrence of superinfections.’
‘It kills intestinal bacteria to decrease the risk for infection.’
A client with pulmonary tuberculosis develops tinnitus and vertigo. Which antitubercular medication would the nurse suspect is causing these symptoms?
A. Isoniazid
B. Rifampin
C. Streptomycin
D. Ethambutol
Streptomycin
A client with tuberculosis takes combination therapy with isoniazid, rifampin, pyrazinamide, and streptomycin. The client says, ‘I’ve never had to take so much medication for an infection before.’ How would the nurse respond?
A. ‘The bacteria causing this infection are difficult to destroy.’
B. ‘Streptomycin prevents the side effects of the other medications.’
C. ‘You only need to take the medications for a couple of weeks.’
D. ‘Aggressive therapy is needed because the infection is well advanced.’
‘The bacteria causing this infection are difficult to destroy.’
A client with an infection is receiving vancomycin. Which laboratory blood test result would the nurse report?
A. Hematocrit: 45%
B. Calcium: 9.0 mg/dL (2.25 mmol/L)
C. White blood cells (WBC): 10,000 mm 3 (10 × 10 9/L)
D. Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)
Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)
A client with a history of tuberculosis reports difficulty hearing. Which medication would the nurse consider is causing this response?
A. Streptomycin
B. Pyrazinamide
C. Isoniazid
D. Ethambutol
Streptomycin
A client receiving intravenous vancomycin reports ringing in both ears. Which initial action would the nurse take?
A. Notify the primary health care provider.
B. Consult an audiologist.
C. Stop the infusion.
D. Document the finding and continue to monitor the client.
Stop the infusion.
The nurse is caring for a client who is receiving intermittent intravenous piggyback (IVPG) doses of vancomycin every 12 hours. The primary health care provider prescribes trough levels of the antibiotic. The nurse schedules the blood sample to be obtained at which time?
A. Just before the medication is administered
B. Between 30 and 60 minutes after the infusion is completed
C. Six hours after the dose is completely infused
D. In the morning before the client eats breakfast
Just before the medication is administered
After receiving streptomycin sulfate for 2 weeks as part of the medical regimen for tuberculosis, the client reports feeling dizzy and having some hearing loss. Which part of the body is the medication affecting?
A. Pyramidal tracts
B. Cerebellar tissue
C. Peripheral motor end plates
D. Eighth cranial nerve’s vestibular branch
Eighth cranial nerve’s vestibular branch
Which action would the nurse take to avoid red man syndrome when preparing to administer a vancomycin infusion?
A. Infuse slowly.
B. Change the intravenous (IV) site.
C. Reduce the dosage.
D. Administer vitamin K.
Infuse slowly.
The clinic nurse is planning care for a client with chlamydia. Which treatment would the nurse anticipate implementing?
A. Administration of 250 mg of acyclovir orally in a single dose
B. Administration of 1 g of azithromycin orally in a single dose
C. Administration of 250 mg of ceftriaxone intramuscularly in a single dose
D. Administration of 2.4 million units of benzathine penicillin G intramuscularly in a single dose
Administration of 1 g of azithromycin orally in a single dose
Use of which medication would the nurse identify as a potential risk for hearing impairment in a child?
A. Amoxicillin
B. Gentamicin
C. Clindamycin
D. Ciprofloxacin
Gentamicin
The nurse teaches an adolescent about the side effects of azithromycin. The nurse determines the teaching has been understood when the adolescent identifies which problem as the most common side effect of this medication?
A. Tinnitus
B. Diarrhea
C. Dizziness
D. Headache
Diarrhea
Which assessment would the nurse perform before administering a dose of vancomycin to a client? Select all that apply. One, some, or all responses may be correct.
A. Creatinine
B. Trough level
C. Hearing ability
D. Intravenous site
E. Blood urea nitrogen
Creatinine
Trough level
Hearing ability
Intravenous site
Blood urea nitrogen
The nurse is caring for a client who has been prescribed vancomycin intravenous infusion for the treatment of methicillin-resistant staphylococcus aureus. Which of the following laboratory values should be immediately reported to the healthcare provider?
A. Vancomycin trough of 15 mcg/dl
B. Blood urea nitrogen level of 18 mg/dl
C. Creatinine level of 1.1 mg d/l
D. White blood cell count of 11,500 per microliter
Vancomycin trough of 15 mcg/dl
The home health nurse is teaching a female client about self-administering vancomycin. Which statement by the client demonstrates understanding of the teaching?
A. I need to call my provider if my urine changes
B. Muscle tingling and weakness is an expected side effect of this medication
C. Ringing in the ears is common when taking vancomycin
D. I should avoid eating food with active cultures in it
I need to call my provider if my urine changes
An older adult client is to receive intravenous (IV) gentamicin for urosepsis. Before administering the medication, for which finding should the nurse notify the health care provider (HCP)?
A. The client has a history of acid reflux disease.
B. The client has a history of retinopathy.
C. The client has a history of chronic kidney disease.
D. The client has a history of urinary retention.
The client has a history of chronic kidney disease.
A hospitalized infant is receiving gentamicin. While monitoring for drug toxicity, the nurse should focus on which laboratory result?
A. Platelet counts
B. Serum creatinine
C. Thyroxin levels
D. Growth hormone levels
Serum creatinine
The nurse receives an order to administer intravenous gentamicin to a client. For which finding should the nurse contact the health care provider to clarify the order?
A. Low serum albumin
B. Low serum blood urea nitrogen
C. High gastric pH
D. High serum creatinine
High serum creatinine
The health care provider prescribes peak and trough levels after initiation of intravenous antibiotic therapy. The client asks why these blood tests are necessary. Which reason would the nurse provide?
A. ‘They determine if the dosage of the medication is adequate.’
B. ‘They detect if you are having an allergic reaction to the medication.’
C. ‘The tests permit blood culture specimens to be obtained when the medication is at its lowest level.’
D. ‘These allow comparison of your fever to changes in the antibiotic level.’
‘They determine if the dosage of the medication is adequate.’
When the nurse is administering a course of aminoglycoside treatment to a client with Klebsiella infection, which adverse effects prompt the nurse to hold treatment and contact the health care provider? Select all that apply. One, some, or all responses may be correct.
A. Vertigo
B. Tinnitus
C. Dizziness
D. Heartburn
E. Persistent headache
Vertigo
Tinnitus
Dizziness
Persistent headache
Which condition would the nurse monitor for in the client on aminoglycoside therapy and skeletal muscle relaxants?
A. Stroke
B. Respiratory arrest
C. Myocardial infarction
D. Abdominal discomfort
Respiratory arrest
When would the nurse have the laboratory obtain a blood sample to determine the peak level of an antibiotic administered by intravenous piggyback (IVPB)?
A. Halfway between two doses of the medication
B. Between 30 and 60 minutes after a dose
C. Immediately before the medication is administered
D. Anytime it is convenient for the client and the laboratory
Between 30 and 60 minutes after a dose
A peak and trough level is prescribed for a client receiving antibiotic therapy. When should the nurse should obtain the trough level?
A. Sixty minutes after the antibiotic dose is administered.
B. Immediately before the next antibiotic dose is given.
C. Upon completion of the prescribed antibiotic regime.
D. An hour before the next antibiotic dose is given.
Immediately before the next antibiotic dose is given.
Which therapy is indicated for a client admitted to the hospital after general paresis develops as a complication of syphilis?
A. Penicillin therapy
B. Major tranquilizers
C. Behavior modification
D. Electroconvulsive therapy
Penicillin therapy
Which statement by a client prescribed ampicillin indicates that teaching by the nurse was effective?
A. “I will miss eating grapefruit.”
B. “I must increase my fluid intake.”
C. “I can stop taking this medication any time.”
D. “I should take this medication just after eating.”
“I must increase my fluid intake.”
Which rationale will the nurse give for the need to take penicillin G and probenecid for syphilis?
A. “Each medication attacks the organism during different stages of cell multiplication.”
B. “The penicillin treats the syphilis, and the probenecid relieves the severe urethritis.”
C. “Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods.”
D. “Probenecid decreases the potential for an allergic reaction to penicillin, which treats the syphilis.”
“Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods.”
The nurse is preparing a client for discharge from the emergency department. Which client statement provides evidence that the client understands medication teaching for high-dose ampicillin?
A. ‘I should take this medication with meals.’
B. ‘This medicine may cause constipation.’
C. ‘I must avoid dairy products while taking this medicine.’
D. ‘I must increase my intake of fluids while taking this medication.’
‘I must increase my intake of fluids while taking this medication.’
Which statement by a client prescribed ampicillin 250 mg by mouth every 6 hours indicates to the nurse that teaching has been effective?
A. “I should drink a glass of milk with each pill.”
B. “I should drink at least six glasses of water every day.”
C. “The medicine should be taken with meals and at bedtime.”
D. “The medicine should be taken 1 hour before or 2 hours after meals.”
“The medicine should be taken 1 hour before or 2 hours after meals.”
A client has an anaphylactic reaction after receiving intravenous penicillin. Which would the nurse conclude is the cause of this reaction?
A. An acquired atopic sensitization occurred.
B. There was passive immunity to the penicillin allergen.
C. Antibodies to penicillin developed after a previous exposure.
D. Genes encoded for allergies cause a reaction on an initial penicillin exposure.
Antibodies to penicillin developed after a previous exposure.
Which information would the nurse include in the teaching plan on ampicillin?
A. ‘Take the ampicillin with meals.’
B. ‘Store the ampicillin in a light-resistant container.’
C. ‘Notify the health care provider if diarrhea develops.’
D. ‘Continue the medication until a negative culture is obtained.’
‘Notify the health care provider if diarrhea develops.’
The nurse provides teaching about ampicillin. Which client statement indicates that additional teaching is needed?
A. ‘I should take this on an empty stomach with a full glass of water.’
B. ‘This medicine will work best if I space the time out evenly.’
C. ‘I can stop this medication after I am symptom-free for 48 hours.’
D. ‘If I get worse, I will notify my primary health care provider.’
‘I can stop this medication after I am symptom-free for 48 hours.’
Which assessment findings during the administration of intravenous penicillin prompt the nurse to stop the infusion? Select all that apply. One, some, or all responses may be correct.
A. Hives
B. Itching
C. Nausea
D. Skin rash
E. Shortness of breath
Hives
Itching
Skin rash
Shortness of breath
When a female client with a new infant is prescribed amoxicillin for a urinary tract infection, which instruction would the nurse include when teaching about the use of this medication?
A. ‘Take this medication on an empty stomach.’
B. ‘Report signs of allergic reaction such as skin rash or itching.’
C. ‘Stop taking the medication as soon as you void without burning.’
D. ‘Breast-feeding should stop until you have finished with this medication.’
‘Report signs of allergic reaction such as skin rash or itching.’
Which substance history of a severe allergic reaction results in avoidance of the cephalosporins such as cefazolin, cefditoren, cefotetan, and ceftriaxone? Select all that apply. One, some, or all responses may be correct.
A. Milk
B. Aspirin
C. Calcium
D. Penicillin
E. Strawberries
Milk
Aspirin
Calcium
Penicillin
Which medication is considered first-line therapy for an infant with congenital syphilis?
A. Vidarabine
B. Pyrimethamine
C. Intravenous (IV) penicillin
D. Trimethoprim-sulfamethoxazole
Intravenous (IV) penicillin
A client is prescribed ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs?
A. Rash.
B. Nausea.
C. Headache.
D. Dizziness.
Rash
While taking a medical history, the client states, “I am allergic to penicillin.” What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history?
A. Aminoglycosides.
B. Cephalosporins.
C. Sulfonamides.
D. Tetracyclines.
Cephalosporins
The nurse is monitoring a client who received a first dose of intravenous ampicillin. Which finding should indicate to the nurse that the client may be experiencing an allergic reaction?
A. Abdominal pain
B. Increase in blood pressure
C. Hypotensive bowel sounds
D. Hives on the extremities
Hives on the extremities
The nurse is providing education to the parent of a pediatric client receiving amoxicillin clavulanate suspension. Which of the following statements is appropriate?
A. Use the measuring device provided by the pharmacy
B. You should take this medication on an empty stomach
C. Avoid shaking the medication before opening
D. Take the medication with a glass of juice
Use the measuring device provided by the pharmacy
A nurse is administering an intravenous piggyback infusion of penicillin. Which client statement would require the nurse’s immediate attention?
A. “I am itching all over.”
B. “I have soreness and aching in my muscles.”
C. “I have cramping in my stomach.”
D. “I have a burning sensation when I urinate.”
“I am itching all over.”
A 2 year-old child is being treated with amoxicillin suspension, 200 milligrams per dose, for acute otitis media. The child weighs 33 lb (15 kg) and the daily dose range is 20 to 40 mg/kg of body weight, in three divided doses every eight hours. Using principles of safe drug administration, what should a nurse do next?
A. Recognize that antibiotics are over-prescribed
B. Call the health care provider to clarify the dose
C. Hold the medication because the dosage is too low
D. Give the medication as ordered
Give the medication as ordered
The nurse is preparing to administer ceftriaxone to a client. Which of the following findings from the client’s medical record should cause the nurse to question this prescription?
A. White blood cells in the urine
B. History of hypertension
C. Allergy to cephalexin
D. Current tobacco smoker
Allergy to cephalexin
At 6 weeks’ gestation a client is found to have gonorrhea. For which medication would the nurse anticipate preparing a teaching plan?
A. Ceftriaxone
B. Levofloxacin
C. Sulfasalazine
D. Trimethoprim/sulfamethoxazole
Ceftriaxone
Which fact about ceftriaxone medication therapy will the nurse emphasize when teaching a client diagnosed with gonorrhea?
A. Cures the infection
B. Prevents complications
C. Controls its transmission
D. Reverses pathologic changes
Cures the infection
During an assessment the client mentions taking cefotetan and drinking a few cocktails at dinner. Which symptoms might be explained by this medication–alcohol interaction? Select all that apply. One, some, or all responses may be correct.
A. Pruritus
B. Diaphoresis
C. Hypotension
D. Hypertension
E. Stomach cramps
F. Chest pain
Pruritus
Diaphoresis
Hypotension
Stomach cramps
A nurse receives a prescription to administer intravenous cefepime to a client with a bacterial infection. The client has a history of lung cancer and is on a continuous cisplatin infusion. How will the nurse administer the prescribed medication?
A. Piggyback the cefepime onto the cisplatin infusion
B. Wait for the cisplatin infusion to finish before administering cefepime
C. Infuse the cefepime via IV push at the proximal port
D. Initiate a new intravenous line for the cefepime infusion
Initiate a new intravenous line for the cefepime infusion
A child with pinworms is prescribed mebendazole. Which expected response to the medication would the nurse teach the parents watch for?
A. Blood
B. Constipation
C. Yellow stools
D. Passage of worms
Passage of worms
The nurse is caring for a pregnant client who has contracted a trichomonal protozoan infection. For which oral medication would the nurse anticipate preparing to provide education?
A. Penicillin G
B. Acyclovir
C. Nystatin
D. Metronidazole
Metronidazole
A client with giardiasis is taking metronidazole (Flagyl) 2 grams PO. Which information should the nurse include in the client’s instruction?
A. Notify the clinic of any changes in the color of urine.
B. Encourage the use of over-the-counter cough/cold syrup when a cough/cold develops.
C. Stop the medication after the diarrhea resolves.
D. Take the medication with food.
Take the medication with food.
Which instruction) should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis? (Select all that apply.)
A. Increase fluid intake, especially cranberry juice.
B. Do not abruptly discontinue the medication; taper use.
C. Check blood pressure daily to detect hypertension.
D. Avoid drinking alcohol while taking this medication.
E. Use condoms until treatment is completed.
F. Ensure that all sexual partners are treated at the same time.
Increase fluid intake, especially cranberry juice.
Avoid drinking alcohol while taking this medication.
Use condoms until treatment is completed.
Ensure that all sexual partners are treated at the same time.
The nurse is teaching the client with bacterial vaginosis who has been prescribed metronidazole tablets. What statement is appropriate?
A. You may continue to experience symptoms after you stop the medication
B. You should avoid drinking alcohol while taking this medication
C. Call your healthcare provider if you experience diarrhea
D. Your sexual partner will need to be treated as well
You should avoid drinking alcohol while taking this medication
The nurse is educating a client prescribed metronidazole. Which of the following findings should the nurse include in the education as reportable to the healthcare provider?
A. Pinpoint red spots on the skin
B. Nausea after beginning the medication
C. Metallic taste
D. Occasional diarrhea
Pinpoint red spots on the skin
Which explanation would the nurse provide to a client with gastric ulcer disease who asks the nurse why the health care provider has prescribed metronidazole?
A. To augment the immune response
B. To potentiate the effect of antacids
C. To treat Helicobacter pylori infection
D. To reduce hydrochloric acid secretion
To treat Helicobacter pylori infection
Which education would the nurse provide the parents of an infant receiving the first diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) at 2 months of age?
A. Give the baby aspirin if there is pain.
B. Call the clinic if marked drowsiness occurs.
C. Apply ice to the injection site if there is swelling.
D. Provide heat at the injection site if redness occurs.
Call the clinic if marked drowsiness occurs.
Which health history would the nurse consider a contraindication to administering the second diphtheria/tetanus/pertussis (DTaP) immunization to a 4-month-old infant?
A. Allergy to eggs
B. Lactose intolerance
C. Infectious dermatitis
D. High fever after the first dose
High fever after the first dose
The nurse is planning to administer a series of vaccines to a 4-year-old child including the DTap, IPV, MMR, and VAR. Before administering the vaccines, what information should the nurse be aware of? Select all that apply.
A. Either the deltoid muscle of the arm or anterolateral thigh muscle can be used
B. A 20 gauge needle is used to administer the varicella (VAR) vaccine intramuscularly (IM)
C. A 5/8 inch needle length is often used for subcutaneous (SubQ) injections
D. The vaccines contain the preservative thimerosal
E. Multiple immunizations should be administered a minimum of 1 inch apart
F. The vaccines all contain weakened live viruses
Either the deltoid muscle of the arm or anterolateral thigh muscle can be used
A 5/8 inch needle length is often used for subcutaneous (SubQ) injections
Multiple immunizations should be administered a minimum of 1 inch apart
Which vaccine is contraindicated for a child undergoing chemotherapy?
A. Influenza (Hib)
B. Hepatitis B (Hep B)
C. Measles, mumps, rubella (MMR)
D. Diphtheria, tetanus, acellular pertussis (DTaP)
Measles, mumps, rubella (MMR)
Which education would the nurse provide parents about the side effects of the Haemophilus influenzae (Hib) vaccine?
A. Lethargy
B. Urticaria
C. Generalized rash
D. Low-grade fever
Low-grade fever
A 6-month-old infant is to receive scheduled immunizations. The parents ask why two influenza vaccines are given: Haemophilus influenzae type B (Hib) and pneumococcal conjugate vaccine (PCV). Which response by the nurse is appropriate?
A. ‘PCV prevents influenza.’
B. ‘Hib is given to prevent pneumonia.’
C. ‘Hib and PCV prevent different bacterial diseases.’
D. ‘They are given together to protect against viral and bacterial diseases.’
‘Hib and PCV prevent different bacterial diseases.’
The nurse is teaching parents about the side effects of immunization vaccines. Which expected side effect associated with the Haemophilus influenzae (Hib) vaccine would the nurse include in the teaching?
A. Urticaria
B. Lethargy
C. Low-grade fever
D. Generalized rash
Low-grade fever
Which parent education would the nurse give about why the MMR vaccine is administered at 12 to 15 months of age?
A. There is an increased risk of side effects in infants.
B. Maternal antibodies provide immunity for about 1 year.
C. It interferes with the effectiveness of vaccines given during infancy.
D. There are rare instances of these infections occurring during the first year of life.
Maternal antibodies provide immunity for about 1 year.
Which vaccine is used to prevent human papilloma virus infection?
A. Varivax
B. RotaTeq
C. Gardasil
D. Hepatitis A vaccine
Gardasil
Which action would the nurse take when a client arrives for an influenza vaccination and reports a low-grade fever with a cough?
A. Administer aspirin with the vaccine.
B. Check the temperature and current history.
C. Hold the vaccine and notify the health care provider.
D. Reschedule administration of the vaccine for the next month.
Check the temperature and current history.
The parent of a newborn asks the nurse why, except for hepatitis B vaccine, the immunization schedule does not start until the infant is 2 months old. Which response would the nurse provide?
A. ‘A newborn’s spleen can’t produce efficient antibodies.’
B. ‘Infants younger than 2 months are rarely exposed to infectious disease.’
C. ‘The immunization will attack the infant’s immature immune system and cause the disease.’
D. ‘Maternal antibodies interfere with the development of active antibodies by the infant when immunized.’
‘Maternal antibodies interfere with the development of active antibodies by the infant when immunized.’
Which immunizations would the nurse determine are safe for a child who is receiving prednisone? Select all that apply. One, some, or all responses may be correct.
A. Rubeola
B. Pertussis
C. Varicella
D. Inactivated poliovirus
E. Tetanus immune globulin
Pertussis
Inactivated poliovirus
Tetanus immune globulin
Which are the characteristics of reactions associated with immunizations for a 2-month-old infant?
A. Local or systemic and usually mild
B. Often serious, possibly requiring hospitalization
C. Sometimes causing ulceration at the injection site
D. May be responsible for permanent neurological damage
Local or systemic and usually mild
A teenager with a deep laceration of his leg does not remember the date of the last tetanus immunization received. The nurse explains that tetanus immunoglobulin and tetanus toxoid are required. Which explanation underlies the nurse’s statement?
A. Neither medication is effective alone.
B. Both eliminate the need for additional medications.
C. Antibodies provide protection, whereas the toxoid stimulates a response.
D. Tetanus toxoid minimizes the risks related to the tetanus immunoglobulin.
Antibodies provide protection, whereas the toxoid stimulates a response.
There is an order to administer an intramuscular influenza vaccine to an adult client. What actions should the nurse take before administration of the injection? Select all that apply.
A. Ask if the client ever had an adverse reaction to the flu vaccine
B. Have the client sign the vaccination consent form
C. Check the expiration date on the vaccination bottle
D. Provide the client with the a vaccine information statement
E. Record the site and time of injection
F. Record the client’s reaction to the injection
Ask if the client ever had an adverse reaction to the flu vaccine
Have the client sign the vaccination consent form
Check the expiration date on the vaccination bottle
Provide the client with the a vaccine information statement
Which information will the nurse include when teaching about tetanus immune globulin prescribed to a client with a puncture wound?
A. “It will take about a week to become effective.”
B. “Immune globulin provides lifelong passive immunity.”
C. “It provides immediate, passive, short-term immunity.”
D. “Immune globulins stimulate the production of antibodies.”
“It provides immediate, passive, short-term immunity.”
Tetanus immune globulin is prescribed after a client steps on a rusty nail. Which action would the nurse associate with this medication?
A. Provides antibodies
B. Stimulates plasma cells
C. Produces active immunity
D. Facilitates long-lasting immunity
Provides antibodies
A client has a prescription for nitrofurantoin 50 mg orally every evening to manage recurrent urinary tract infections. Which instruction would the nurse give to the client?
A. ‘Increase your intake of fluids.’
B. ‘Strain your urine for crystals and stones.’
C. ‘Stop taking the medication if your urinary output increases.’
D. ‘This may turn your urine green.’
‘Increase your intake of fluids.’
