NUR 170- Pharmacology Test 4-with 100% verified answers-2024-2025.docx, Exams of Nursing

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NUR 170- Pharmacology Test 4-with

100% verified answers-2024-

The nurse is caring for a patient who has recurrent wound infections. The patient’s current infection is not responding to an antibiotic that has been used successfully several times in the past. The nurse understands that this is most likely due to: acquired bacterial resistance. cross-resistance. inherent bacterial resistance. transferred resistance. The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic? Administering a small test dose to determine whether hypersensitivity exists Having epinephrine available in the event of a severe hypersensitivity reaction Monitoring baseline vital signs, including temperature and blood pressure Obtaining a specimen for culture and sensitivity The nurse is teaching a patient who will be discharged home from the hospital to take amoxicillin (Amoxil) twice daily for 10 days. Which statement by the nurse is correct? "Discontinue the antibiotic when your temperature returns to normal and your symptoms have

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improved.”

“If diarrhea occurs, stop taking the drug immediately and contact your provider.” "Stop taking the drug and notify your provider if you develop a rash while taking this drug.” “You may save any unused antibiotic to use if your symptoms recur.” The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient’s chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse’s next action? Request an order for (naloxone) Narcan Ask the provider whether a cephalosporin from a different generation may be used. Contact the provider to report potential drug hypersensitivity. Notify the provider and suggest an oral cephalosporin. The nurse is preparing to give a dose of a cephalosporin medication to a patient who has been receiving the antibiotic for 2 weeks. The nurse notes ulcers on the patient’s tongue and buccal mucosa. Which action will the nurse take? Hold the drug and notify the provider. Obtain an order to culture the oral lesions. Gather emergency equipment to prepare for anaphylaxis. Report a possible superinfection side effect of the cephalosporin. Question 4

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The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for furtherteaching? “I may stop taking the medication if my symptoms clear up.” “I should eat yogurt while taking this medication.” “I should stop taking the drug and call my provider if I develop a rash.” “I will not consume alcohol while taking this medication.” A patient is receiving high doses of a cephalosporin. Which laboratory values will this patient’s nurse monitor closely? Electrolytes and minerals Blood urea nitrogen (BUN), serum creatinine, and liver function tests Serum calcium and magnesium Serum glucose and lipids The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin (Zithromax) to treat an infection. The patient is also taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug’s side/adverse effects? WBC count Question 8

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Electrolytes Liver enzymes Urinalysis The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min. The nurse notes red blotches on the patient’s face, neck, and chest and assesses a blood pressure of 120/80 mm Hg. Which action will the nurse take? Request an order for IV epinephrine to treat anaphylactic shock. Slow the infusion to 10 mg/min and observe the patient closely. Stop the infusion and obtain an order for a BUN and serum creatinine. Suspect Stevens-Johnson syndrome and notify the provider immediately. The nurse is counseling a patient who will begin taking a sulfonamide (Bactrim) drug to treat a urinary tract infection. What information will the nurse include in teaching? “Drink several quarts of water daily.” “If stomach upset occurs, take an antacid.” “Limit sun exposure to no more than 1 hour each day.” Question 9

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“Sore throat is a common, harmless side effect.” A patient who has tuberculosis asks the nurse why four drugs are used to treat this disease. The nurse will explain that multi-drug therapy is used to reduce the likelihood of disease relapse. drug hypersensitivity reactions. drug resistance. drug adverse effects. Which nursing intervention has the highest priority for the patient who is taking a cephalosporin? Wait until culture results are received before initiating antibiotic. Monitor the patient for signs and symptoms of a superinfection. Administer IV over 2 hours to prevent phlebitis. Instruct the patient to take the drug for 5 days only. A patient enters the emergency department with a draining wound. Once the patient is admitted and assessed, the priority nursing intervention is to administer the ordered antibiotics. Question 11

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teach the patient about the ordered antibiotics. culture the wound. enforce droplet isolation precautions. Which statement will the nurse include when teaching a patient about cephalosporin therapy? “Avoid ingesting buttermilk or yogurt when taking this medication.” “Stop taking the medication when you feel better.” “Immediately stop taking the medication if you develop nausea.” “Inform your health care provider if you develop mouth ulcers.” A patient is admitted to the health care facility with methicillin-resistant Staphylococcus aureus (MRSA). The nurse anticipates administration of which drug? Nafcillin (Nallpen) Vancomycin (Vancocin) Aztreonam (Azactam) Piperacillin-tazobactam (Zosyn) Question 14

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Which teaching by the nurse has highest priority for the patient taking azithromycin (Zithromax)? Instruct the patient to use sunblock and protective clothing during sun exposure. Instruct the patient to store the drug out of light and extreme heat. Inform parents that children younger than 8 years should not take the drug, to avoid tooth discoloration. Instruct the patient to report any loose stools or diarrhea. A child is ordered to receive azithromycin (Zithromax) to treat otitis media. This medication is unique because it requires a 5-day course of medication. it must be taken with an antacid. it cannot be used in patients with allergies to penicillin. it is administered via the rectum. Which statement by a patient who has received teaching on tetracycline therapy indicates that MORE teaching is indicated? “I will store the medication away from light and extreme heat.” Question 17

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“I will use an additional contraceptive technique because this drug may cause the oral contraceptive I take to be less effective.” “I will take this medication with an antacid.” “If my stomach becomes upset when taking this medication, I will take it with nondairy foods.” A patient is receiving gentamicin therapy: 100 mg intravenously at 0800, 1600, and 2400. At 0730, the nurse is informed that peak and trough levels need to be drawn. When is the best time to obtain the peak level? 0700 0900 1600 2330 When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives highest priority to teaching the patient to increase fluid intake. report signs of ringing in the ears or loss of hearing. expect the color of their urine to change to a reddish orange. take this drug with dairy products or antacids to protect the stomach. Question 19

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A patient is ordered to receive Trimethoprim and Sulfamethoxazole (Bactrim). This medication is a combination of two medications that are antagonistic. additive. synergistic. contraindicated. A patient is diagnosed with a Candida infection in the mouth. The nurse anticipates that the patient will be treated with metronidazole (Flagyl). amphotericin B (Fungizone). isoniazid (INH). nystatin (Mycostatin). When you check a patient receiving doxycycline (Vibramycin) IV 15 minutes after the drug was started, the patient tells you “I can’t swallow, my chest hurts, and I feel like something bad is going to happen.” What do you do next? Notify the prescriber. Question 23

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Stop the drug infusion. Start forcing fluids. Call the other nurse to verify your findings. Patients taking methenamine (Urex) for urinary tract infections are counseled to drink cranberry juice in order to: ensure a brisk urine flow. increase the alkalinity of the urine. decrease urinary retention.nsure a brisk urine flow. lower the pH of the urine. A patient with a urinary tract infection is complaining of pain with urination. The nurse would anticipate the patient’s receiving norfloxacin (Noroxin). ciprofloxacin (Cipro). methenamine mandelate (Mandelamine). phenazopyridine (Pyridium). Question 24

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Which antibacterial drug exerts its mechanism of action by inhibiting the synthesis of bacterial RNA and DNA? Cephalosporins Tetracyclines Fluoroquinolones Aminoglycosides Sulfasalazine (Azulfidine) is ordered for a patient. This medication is most often used to treat fungal infections. ulcerative colitis. yeast infections. skin infections. A patient is ordered to receive vancomycin (Vancocin) for a severe infection. It is most important for the nurse to assess the patient for the development of neurotoxicity hepatotoxicity Question 26

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ototoxicity cardiotoxicity A patient asks the nurse why she gets yeast infections after a course of antibiotics. The nurse explains, “The antibiotics lower your white blood cell count.” “People are poorly nourished and hydrated after an infection.” “Yeast infections happen if the antibiotic is not taken for the full course.” “Yeast infections are common when the normal body flora are disrupted.” Sulfasalazine (Azulfidine) is ordered for a patient. This medication is most often used to treat fungal infections. ulcerative colitis. yeast infections. skin infections. Question 30

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A middle-aged adult is diagnosed with tuberculosis. Which is true of treatment for this diagnosis? Treatment may take about 10 days to 2 weeks. Usually three to four agents are needed. The bacteria is usually resistant to treatment therapy. Treatment for tuberculosis is usually without side effects. When teaching a patient about isoniazid (INH) and rifampin drug therapy, which statement will the nurse include “Take isoniazid with meals.” “Double the amount of vitamin C in your diet to prevent the peripheral neuropathy associated with isoniazid therapy.” “Notify the primary health care provider immediately if your urine turns a red-orange color.” “Avoid exposure to direct sunlight.” Which drug is associated with disulfiram (Antabuse) reaction? Atovaquone (Mepron) Streptomycin Metronidazole (Flagyl) Question 33

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Amphotericin B A female patient has been diagnosed with a lower urinary tract infection caused by E. coli. The patient has been prescribed nitrofurantoin. A day later, the patient is ordered phenazopyridine hydrochloride (Pyridium). The most likely rationale for administration of this agent treatment of the bacterial infection. increase of bladder tone. relief of urinary pain and burning. increase of urinary output. A healthcare provider prescribes hydroxychloroquine sulfate for a client with lupus. Which assessment finding by the nurse would be most concerning? An increase in blood pressure Complaints of ringing in the ears An increase in heart rate Report of changes in visual acuity Question 34

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A healthcare provider orders ceftriaxone (Rocephin) for a client diagnosed with a urinary tract infection who has an allergy to penicillin. Which action by the nurse is best? Correct Answer Hold the medication and clarify the order with the prescriber. Give one half the dose of ceftriaxone (Rocephin) and assess client response. Administer an antipyretic medication along with ceftriaxone (Rocephin). Administer the ceftriaxone (Rocephin) as ordered. A client receives intravenous ciprofloxacin (Cipro) for a urinary tract infection. During the infusion, the nurse notes the site is reddened, hot, and the client voices discomfort at the insertion site. Which response by the nurse is best? Elevate the affected extremity and slow down the infusion rate. Remove the intravenous catheter and start a new IV Administer analgesia and instruct the patient to tell you if discomfort continues. Notify the physician that the patient reacted to the medication A client in the hospital receives piperacillin (Pipracil) IV. The client calls the nurse to report feeling “anxious” and is visibly short of breath. Which action should the nurse do first? Raise the head of the bed Assess the client’s vital signs. Question 37

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Stop the infusion of the medication. Check for allergies. A young woman comes into the clinic and is diagnosed with otitis media and receives a prescription for amoxicillin (Amoxil). The client is also taking oral contraceptive pills. Which statement by the client indicates teaching has been effective? " I will take the medication once daily for five days." "I understand my urine may be discolored orange while taking this medication." " I will use backup contraception this month to prevent pregnancy." "Vaginal itching will go away when the medication is completed." When doing discharge teaching for a patient who is going home on oral antibiotics what should the nurse include in the teaching? “Stop taking the antibiotics as soon as symptoms disappear to prevent antibiotic resistance.” “If symptoms do not improve when the prescription is complete call the pharmacy for a refill.” “If you develop a vaginal discharge that itches call your doctor for a different antibiotic.” “Take all the antibiotics as prescribed and do not save any for future infections.” Question 41

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A nurse is caring for a client who has been receiving ampicillin (Omnipen) for several days. Which assessment finding most concerns the nurse? The patient complains of a dry mouth. The patient has a temperature of 99.2. The patient states they have had three loose stools today. he patient states they have had no bowel movement for two days A clinic nurse is teaching a client about doxycycline (Vibramycin) that was ordered by the primary care provider. What teaching needs to be included for this client? Take the medication once a day for five days. Be sure to take each dose with food. Avoid sexual activity for the duration of treatment. Stay out of the sun as much as possible. A nurse is caring for a client whose current medication regimen includes trimethoprim/sulfamethoxazole (Bactrim). Which assessment finding shows the medication is effective? The client's surgical incision is well approximated with no exudate. The client has clear, odorless urine and denies dysuria Question 42

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The client's bowel sounds are normal, and diarrhea has resolved. The client's lungs are clear on auscultation with minimal sputum production. A nurse is assessing a 7-year-old child that has received tetracycline (Achromycin V) four times in the last two years. What action should the nurse take first? Assess the child for signs of ototoxicity Assess the child's deep tendon reflexes Carefully inspect the child's teeth Inspect the child's skin and sclerae for jaundice An elderly client, who lives alone and has occasional memory lapses, is being seen by a home health nurse and was recently prescribed azithromycin (Zithromax) for an upper respiratory infection. What makes this medication an appropriate choice for this client? The half-life of azithromycin (Zithromax) is 3 to 7 hours. Azithromycin (Zithromax) is taken once daily for five days. This medication is effective after a three-day regimen. Azithromycin (Zithromax) is associated with very few medication interactions. Question 46 Question 44

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A nurse is caring for a client with a bacterial infection receiving ceftriaxone (Rochepin). Which laboratory value should the nurse monitor most closely? Neutrophils Lymphocytes Platelets Hemoglobin The emergence of resistant strains of microbes is a serious public health problem. Health care providers can work to prevent the emergence of resistant strains by encourage the patient to stop taking the antibiotic as soon as the symptoms are resolved to prevent overexposure to the drug. encourage the use of antibiotics when the patient fell they will help. Correct Answer limit the use of antimicrobial agents to the treatment of specific pathogens know to be sensitive to the drug being used. using the most recent powerful drug available to treat an infection to ensure eradication of the microbe. Superinfections can occur when anti-infective agents destroy the normal flora of the body. Candida infections are commonly associated with antibiotic use. A patient with this type of superinfection would exhibit difficulty breathing. Question 48

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vaginal discharge or white patches in the mouth elevated blood urea nitrogen (BUN) dark lesions on the skin. Which of the following would the nurse recommend that a women with repeated vaginal yeast infections keep on hand? tolnaftate (Tinactin) coltrimazole (Lotrimin) undecylenic (Desenex) clindamycin (Cleocin) Sensitivity testing of a culture shows drugs that are capable of controlling that particular microorganism. the patient for potential allergic reactions to the drug. the offending organism an immune reaction to the infecting organism Question 49

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