The nurse is caring for a patient who begins to complain of shortness of breath. Upon further assessment, the nurse notes 3+ pitting edema bilaterally in the lower extremities. Which medication taken by the patient would most concern the nurse with regard to these findings?
patient is vulnerable to opportunistic infections, especially if there were an indication of the HIV conversion to acquired immunodeficiency syndrome (AIDS). Which of the following findings would most concern the nurse?
Very low helper T lymphocyte count
A patient comes to the emergency department after having been exposed to a foreign antigen. The nurse anticipates that which antibody class was fist to respond?
IgM---first to increase
Which of the following patients may receive the measles, mumps and rubella (MMR) vaccine without caution?
Child being treated for mild febrile illness
Which of the following describes the etiology of the thrush?
A patient has just received a prescription for a 10-day course penicillin for the treatment of strep throat. What patient education is essential for the nurse to provide?
The entire course of the drug must be taken to prevent the recurrence of infection and potential resistance.
The nurse is reviewing laboratory test results for a patient who is about to begin taking piperacillin. An abnormal elevation in which laboratory values would cause the nurse to notify the prescriber immediately?
BUN and Creatnine
Penicillin works by
Weakening the bacterial cell wall, which then ruptures and dies.
A newly admitted patient is going to be started on a course of antibiotic therapy with penicillin.The nurse understands that, while taking the patient’s health history, a priority assessment is questioning the patient about
any previous allergy to penicillin
A patient tells the nurse during the health history that the last time she received penicillin, she experienced anaphylaxis.Which of the following medications should the nurse advise the patient to avoid?
The nurse is caring for a patient taking vancomycin (Vancocin).Upon assessment of the patient, the nurse finds that he is experiencing flushing, rash, pruritus, and urticaria.His vital signs are:P-120, BP-192/97, T-98.9 degrees F, and R-20.
An allergic reaction
A patient with an abdominal infection has been prescribed oral clarithromycin (Cleocin). The nurse, who is providing patient education about the drug, should teach the patient to report
A patient who works as a landscaper is preparing to be discharged home.He has been instructed to take tetracycline (Sumycin) as an outpatient.Which of the following should be included in the discharge teaching for this patient?
“Use sunscreen and protective clothing when outdoors”
The nurse is caring for a patient receiving gentamicin (Garamycin) intravenously (IV).What statement by the patient would most concern the nurse?“I am experiencing
A nurse is caring for a patient with an infection that is being treated with an aminoglycoside.Which of the following findings would most concern the nurse?
For which diagnosis would the nurse administer a sulfonamide?
Urinary tract infection
With which class of drugs would the nurse be most likely to see Steven’s-Johnson syndrome?
The patient states that the only medication she is taking is trimethoprim/sulamethoxazole (Bactrim).Which statement made by the patient would most concern the nurse?
I am allergic to sulfa.
The nurse is performing a physical assessment on a patient with tuberculosis who takes rifampin (Rifadin).Which of the following would be an expected finding?
The nurse describes a typical course of therapy to a patient newly diagnosed with active tuberculosis. Which description is the most accurate?
The entire course should take 6 months; the first 2 months with four drugs, and the last 4 months with two drugs.”
A patient with AIDS has been diagnosed with active tuberculosis. The nurse would not expect the addition of which drug to the patients medication regimen?
When assessing a patient for adverse reactions to the combination of isoniazid and rifampin (rifadin), the nurse would monitor which laboratory results?
Liver function tests (LFTs)
The nurse is preparing to administer an antibiotic to a patient with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). The nurse would expect the health care provider to order which of the following antibiotics?
A patient develops antibiotic-induced diarrhea related to Clostridium difficile infection and continues to have diarrhea 2 days after the antibiotic was discontinued. The nurse would expect the prescriber to order ?
A patient complains of mouth sores. Upon assessment, the nurse notes white,patchy spots and redness of the tongue and throat. The nurse expects the prescriber to order?
The nurse is providing education to a patient with recurrent herpes simplex genitalis. The nurse should make sure to advise the patient that?
patient will need to use condoms even when no lesions are evident
The nurse is providing patient education for a patient who is to start taking interferon. The nurse should instruct the patient that the most common adverse effect is?
flulike syndrome----Interferon A/E—flu like
After receiving a first time dose of the inactivated influenza vaccine an adult patient telephones the nurse and complains of lethargy and a fever of 101 that has lasted for 6 hours. Select the nurse’s best action?
Advise the patient to take acetaminophen and rest
After starting an antiviral protease inhibitor, a patient with HIV telephones the nurse, complaining “I’m so hungry and thirsty all the time! I’m urinating 10 or 12 times a day.” The nurse recognizes these finding to be consistent with?
A 19- year-old patient begins to cry when she learns that she has genital herpes. The patient tearfully asks about the treatment. The nurse explains that treatment includes a drug that suppresses transmission, which is?
The nurse is working at a sexually transmitted disease clinic. A patient has been diagnosed with an STD and will be treated with penicillin G. The nurse understands that penicillin G is the drug of choice in the treatment of
The nurse asks the graduate nurse which disinfectant would be used to cleanse the respiratory and anesthetic equipment and why
Glutaraldehyde: because it is lethal to all microorganisms
The wound care nurse teaching the class asks, “which agent would be most appropriate for cleansing open wounds and loosening debris?”
½ hydrogen peroxide and ½ saline
The nurse asks, “Which of the following would be a major impediment to successful chemotherapy?”
The toxicity of anticancer drugs to normal tissues
patient who has been receiving chemotherapy as an outpatient. The nurse notes that the patients gums and nose are bleeding. Laboratory test results confirm severe thrombocytopenia. The nurse should expect the prescriber to order
The nurse would correctly identify the major dose limiting toxicity of cyclophosphamide (Cytoxan) as
Bone marrow suppression
The nurse would correctly describe the method of action of cell cycle specific anticancer agents as toxic only to cells
That are passing through a particular phase of the cell cycle.
To monitor the patient for bleomycin (Blenoxane) toxicity, the nurse will want to keep a close watch primarily on
pulmonary function studies
The patient asks the nurse about other beneficial actions of this agent, the nurse should explain that tamoxifen reduces:
low-density lipoprotein cholesterol
The nurse would be correct to state that the purpose of angiogenesis inhibitors is to
suppress the formation of new blood vessels in tumors
While reviewing antibodies, the nurse states, “antibodies are also known as
In which of the following scenarios would the nurse consider antibiotic therapy tot be prophylactic?
Patient with an artificial heart valve who is scheduled for hernia repair.
All of the following statements about the differences between the first and fourth generation cephalosporin’s are correct EXCEPT?
First generation agents have increased resistance to beta lactamases
The patient is taking gentamicin (Garamycin) for the infection. What areas should be the focus of the nurses assessment?
Sense of hearing
Itraconazole (Sporaox) is used as an alternative to amphotericin B for less severe systemic mycosis. The primary reason for choosing itraconazole is which of the following?
Itraconazole can be given orally.
The nurse asks a graduate nurse, when a patient in the initial phase of HIV infection is assessed which findings would you NOT expect to see?
Which of the following drugs is administered orally to treat persistent infection of the toenails?
Cardiotoxicity occurs with cytotoxic anticancer drugs classified as:
After receiving inactivated influenza vaccine, an adult patient telephones a nurse and complains of lethargy and fever of 101 degrees F that has lasted for 6 hrs.Select he nurse’s best action:
Advise the pat to take acetaminophen and rest
Amphotericin B and nysatin are antifungal agents whose mechanisms of action involve binding to the membrane sterols and destroying the integrity of the cell membrane.Which of the following reasons explains why the two drugs are specific for fungi?
The main sterol in fungi cell membranes is Egosterol
Which of the following classes of cephlosporins would reach the highest concentration in the cerebular spinal fluid and be most active against gram negative microorganisms?
Often a major process by which resistance has developed to penicillin is that bacteria have developed.
An enzyme that metabolizes penicillin
To help minimize side effects in cancer patients receiving interferon- alfa therapy the nurse should:
Dr. Taylor’s eldest granddaughter was born in which month?
Chemotherapy will be most effective for a neoplastic tumor if the malignancy is:
Patients who will be taking a tetracycline antibiotic should be adequately informed about which one of the following interactions?
Milk and cheese products result in decrease levels of tetracycline.
Cell cycle specific and cell cycle non-specific agents are frequently combined to treat cancer patients.The rationale for such a combination is based upon all of the following advantage EXCEPT?
The two drugs together antagonizes the actions of each on normal cells only
The patient has been treated with cisplatin for 3 months. In addition to managing nausea and vomiting, the nurse should also monitor the patient for the following adverse effect?
Cushing ‘s syndrome
Aminoglycosides acts on microorganisms by
inhibiting protein synthesis
A patient with shingles who is being treated with topical antiviral therapy using acyclovir should be warned about which of the following side effects?
Transient burning when applied
A patient is receiving Amphotericin B for a systemic fungal infection. The nurse should constantly monitor the patient for the development of
Female patients taking ciprofloxacin should be monitored for signs of the development of
Vaginal Yeast Infections
A patient treated with trimethoprim develops hematologic toxicity. The nurse would expect to administer which agent to counteract this effect
The nurse manages care for a patient with HIV/AIDS who has taken protease inhibitors for 8 months. The patient is now diagnosed with active TB. The addition of rifamprin as part of the new antituberculosis regimen is
Contradicted because the rifamprin will decreases the effects of the protease inhibitors
When patients are taking sparfloxacin, the nurse should monitor
The administration of gentamicin with general anesthetics increase the risk of
The preferred dosing schedule for the majority of patients on amino glycosides is:
The purposes of administratering probenecid with cefotaxime (Claforam) is to:
delay the renal excretion of the Cefotaxime
Antibodies are manufactured by
A patient is receiving methenamine for their treatment of a chronic UTI.Which agent when used concurrently can create risk for crystallia?
The term “selective toxicity” relates to drugs ability to:
kill or injure a target organism without causing injury to the host
How do penicillin V and G differ?
penicillin V can be administered orally
Darbepoetin alfa (Aranesp) has an advantage over Erythropoietin in that:
can be administered less frequently
A colony-stimulating factor used to stimulate the production of Neutorphils, Eosoniphils, Monocytes and Macrophages is:
What is the function of macrophages in the body?
A nurse should instruct a patient taking cyclosporine that toxic levels may be reached if the drug is administered with:
A priority assessment of a patient beginning antibiotic treatment therapy includes questioning the patient about:
A patient being treated with an oral cephalosporin complains of nausea.The nurse should give which instruction?
take the drug with food
A pregnant adolescent asks a nurse whether it would be appropriate to obtain a prescription for tetracycline to clear up her acne.The nurse’s best response would be:
a tetracycline drug could be harmful to the baby’s teeth
When ototoxicity from on aminoglycocide is beginning, the first sign of impending cochlear damage is:
The principle indication for the uses of sulfonamides is:
A patient is being treated for active TB.The patient asks, “Why do I have to take so many drugs?”What is the best nurse response?
multiple agents prevent the emergence of resistant organisms
A nurse manages the care of a patient on rifampin for leprosy.The patient telephones reporting, “My urine and saliva have looked an orange-red color for the past two days.”The best nurse response is which of the following:
this is a normal effect of the drug and not harmful
Cytotoxic drugs are not the drugs of first choice for immunosuppression because they.
are toxic to all proliferating cells
Cytotoxic drugs injure the digestive track primarily because:
they destroy the rapidly growing epithelial lining of the GI track
The administration of gentamicin with general anesthetics increases the risk of:
Which side effect should the nurse discuss with patients receiving filgrastim?
the purpose of administering probenecid with cefotaxime (Claforan) is to:
delay the renal excretion of the cefotaxime.
Ciprofloxacin, a widely used antibiotic, is an example of which class of antibiotic?
How is orlistat different from most drugs for weight lossTerm
It reduces fat absorption in the intestines.
Which chemotherapy agent permits safe administration of high doses of methotrexate by allowing normal cells to produce thymidylate?
A patient who has end-stage renal failure and has been admitted to the hospital for severe anemia may receive which of the followingdrugs (in addition toblood transfusion) to stimulate red blood cell production?
Erythropoietin (Epoetin alfa)
A patient treated with trimethoprim develops hematologic toxicity. The nurse would expect to administer which agent to counteract this effect?
A patient is receiving amphotericin B for a systemic fungal infection. The nurse should constantly monitor the patient for the development of?
Pt comes to (ED) with fever, cough, malaise, and weakness. Forty-eight hours later, the symptoms have become progressively worse, and they progress to severe respiratory distress, septicemia, and hemorrhagic meningitis. The nurse recognizes these signs and symptoms as
A patient is receiving intravenous vancomycin (Vancocin).A unique complication of rapid IV infusion of vancomycin is
red man syndrome
The nurse is caring for a patient with Pseudomonas infection and has just administered amikacin (Amikin).That is the advantage of this aminoglycoside over the other aminoglycosides?
It is the most resistant to bacteria.
Parents bring their child to the clinic because they suspect the child has pinworms.What education is most important for the nurse to provide to the parents.
everyone in the family should be treated
A patient who has been taking nalidixic acid (NegGram) for a urinary tract infection is now diagnosed with a respiratory infection.The patient asks, “Will the nalidixiz acid I’m taking cover both infections?” Select the nurse’s best response:
“The drug you’re taking has no action outside the urinary tract.You will be an additional antibiotic for the respiratory tract infection.
Which one of the following antiseptics may be safely used to cleanse the skin?
The nurse would correctly identify the major dose-limiting toxicity of cyclophosphamide
-bone marrow suppression
How is a definitive diagnosis of tuberculosis made?
Microscopic examination of sputum
The nurse would correctly describe the method of action of cell-cycle specific anticancer agents as toxic only to cells
that are passing through a particular phase of the cell cycle
The nurse is comparing the side effects of anastrozole (Arimidex) and tamoxifen (Nolvadex).What is the advantage of anastrozole of tamoxifen?
It causes fewer hot flushes
A prescriber orders melarsoprol (Arsobal) for a patient with trypanosomiasis.Which agency would the nurse contact to obtain the medication?
Centers for Disease Control and Prevention
For which one of the following patients undergoing treatment for an ongoing attack of malaria would mefloquine (Lariam) be contradicted?
Patients with epilepsy
The nurse is teaching a class on malaria to a Peace Corps group preparing to go to Africa.Which of the following statements is correct information that the nurse would have given the class?
Chloroquine (Aralen) is the drug of choice for the treatment of Plasmodiumvivax.”
When a patient is given griseofulvin, which dietary instruction should be given?
Taking the drug with a fatty meal can enhance absorption
The nurse at a public health clinic is caring for an older teen patient.The patient has been diagnosed with pediculosis pubis.The nurse should expect the condition to be treated with
How does codeine produce the antitussive effect?
Through elevation of the cough threshold
A nurse would expect to see all the following problems in a patient undergoing chemotherapy EXCEPT
The nurse is caring for a patient who has been taking doxorubicin (Adriamycin).To reduce the risk of cardiotoxicity in this patient, the nurse whould ensure that the patient also has an order for
Trichomonas vaginalis with metronidazole (Flagyl). What info should the nurse provide that would be most important?
The nurse would be correct to state that the purpose of angiogenesis inhibitors is to
Suppress the formation of new blood vessels in tumors.
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