NURS6521/NURS 6521 Quiz 8 Wk 8 Final Score34 out of 35 point

NURS6521/NURS 6521 Quiz 8 Wk 8 Final Score34 out of 35 points NURS6521/NURS 6521 Quiz 8 Wk 8 Final Score34 out of 35 points NURS6521/NURS 6521 Quiz 8 Wk 8 Final Score34 out of 35 points NURS6521/NURS 6521 Quiz 8 Wk 8 Final Score34 out of 35 points QUESTION 1 1. Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent A twice a day. . B once a day. . C as needed. . D three times a . day. QUESTION 2 1. A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following? A Potassium level . B Creatinine . clearance C Serum albumin . level D Prothrombin . time QUESTION 3 1. Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? A Apply a thin layer of the drug to Mr. Laird's wound beds using clean . technique. B Apply a layer of silver sulfadiazine that is sufficiently thick to make the . wound bed invisible. C Perform thorough wound care immediately after the application of silver . sulfadiazine D Cleanse the wound of debris prior to applying the silver sulfadiazine . QUESTION 4 1. A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because A the patient is at greater risk for high serum levels . of the drug. B the process of drug elimination will be faster in this . patient. C the therapeutic effect of the drug may be too slow . to be effective. D the process of drug metabolism may be faster in . this patient. QUESTION 5 1. A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? A Infiltration, edema, or phlebitis at the . infusion site B Breathlessness . C Nausea and vomiting . D Increased heart rate . QUESTION 6 1. A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods? A Citrus fruits . B Cheese, dairy products, and . bananas C Chicken and fish . D Potatoes and root . vegetables QUESTION 7 1. A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? A Fasting blood sugar and 2-hour postprandial blood . sugar B Thyroid-stimulating hormone, thyroxine, and . triiodothyronine levels C Red blood count, white blood count, and differential . D Serum alanine transaminase, aspartate transaminase, . and bilirubin QUESTION 8 1. An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on A the production and maturation of . CD4+ T-cells. B the osmolarity of fungal intracellular . fluid. C the permeability of fungal cell walls. . D protein synthesis of fungal cells. . QUESTION 9 1. A nurse has questioned why a patient's physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible? A The use of broad-spectrum antibiotics can create a risk for a . superinfection. B The efficacy of most narrow-spectrum antibiotics has not been proven. . C Broad-spectrum antibiotics confound the results of subsequent culture . and sensitivity testing. D Narrow-spectrum antibiotics normally require a shorter duration of . treatment. QUESTION 10 1. A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication A with high-protein . meals. B with high-fat . meals. C on an empty . stomach. D with orange juice. . QUESTION 11 1. A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take A antacids during the day and INH only at night. . B INH before meals and antacids 1 or 2 hours after . meals. C antacids not less than 1 hour before or 2 hours . after taking INH. D antacids before meals and INH 1 or 2 hours after . meals. QUESTION 12 1. A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule A with or without food. . B with food. . C on an empty . stomach. D immediately after . she eats. QUESTION 13 1. A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient? A Diarrhea . B Imbalanced Nutrition: Less than Body . Requirements C Risk for Injury related to allergic reactions . D Risk of Injury related to blood dyscrasia . QUESTION 14 1. Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin? A Promote adequate intake of fluids and . nutrients B Monitor serum drug level . C Provide maximum physical comfort to . the patient D Taper down the drug dosage gradually . QUESTION 15 1. A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? A A drug harms microbes without harming human cells. . B Most microbes may be collected from a host and cultured on an . alternative medium. C A drug can be isolated and produced in a controlled manner in a . laboratory setting. D A drug's effect on microorganisms is proportionate to dose. . QUESTION 16 1. An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin- resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with A ciprofloxacin. . B vancomycin. . C an antistaphylococcic . penicillin. D clindamycin. . QUESTION 17 1. A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? A Tendon ruptures . B Cognitive changes . C Lid margin crusting and . pruritus D Nephrotoxicity and . neurotoxicity QUESTION 18 1. An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? A Flush the patient's central line with normal saline and infuse the . amphotericin B by intravenous push over 5 to 7 minutes. B Hang the drug by piggyback with lactated Ringer's and infuse over . several hours to minimize the risk of infusion reaction C Infuse the drug over 2 to 4 hours into a central line using an infusion . pump D Place the patient on a constant infusion of amphotericin B at a rate . determined by the patient's body weight. QUESTION 19 1. A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug A with a glass of water 1 hour before or 2 hours . after a meal. B intravenously with the assistance of a home . health nurse. C immediately before or with a meal. . D with a sip of water 1 hour before mealtime. . QUESTION 20 1. A 15-year-old boy is being carefully monitored for a skin infection and is being given ciprofloxacin. The nurse will observe for which of the following? A Hepatitis . B Colitis . C Hypotensi . on D Arthropat . hy QUESTION 21 1. A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause A ototoxicity or nephrotoxicity. . B neutropenia or autoimmune effects. . C increased intracranial pressure or changes . in cognition. D anemia or impaired erythropoiesis. . QUESTION 22 1. A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. Which of the following should be included in the nurse's teaching? A Selective toxicity determines the appropriate drug dosage needed. . B Fluoroquinolones interfere with the growth and development of the . bacteria cell wall. C The first drugs used to treat infections date back to the 17th . century. D Penicillin interferes with synthesis of the bacteria cell wall. . QUESTION 23 1. A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment? A PT, PTT, and platelets . B C-reactive protein . C Hemoglobin, hematocrit, and red . blood cells D Electrolytes, blood urea nitrogen, and . creatinine QUESTION 24 1. A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to A take the vitamins at least 2 hours before or after taking . ciprofloxacin. B reduce the dosage of vitamin supplements and double the . dosage of ciprofloxacin. C alternate the dosage of ciprofloxacin and vitamin supplements. . D reduce the dosage of vitamin supplements. . QUESTION 25 1. A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will A monitor the patient for bleeding gums. . B administer the medication with small amounts of . food and fluids. C monitor the site of injection. . D continue therapy until 2 days after symptoms have . resolved. QUESTION 26 1. Which of the following would a nurse assess for in a patient who is taking polymyxin B systemically? A Endocarditis and . hypertension B Nephrotoxicity and . hepatotoxicity C Hyperkalemia and . hyponatremia D Peripheral neuropathy . QUESTION 27 1. A child is taking permethrin for head lice. The nurse will instruct her mother to A maximize the child's fluid intake. . B wash her hair daily with a good shampoo. . C increase her daily intake of milk. . D stop using creams, ointments, and oils on the child's . skin and scalp. QUESTION 28 1. A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor A urine output daily. . B blood sugar levels daily. . C plasma concentrations . regularly. D liver enzymes monthly. . QUESTION 29 1. A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? A It is safe for the patient to use topical ciprofloxacin but the oral route is . potential teratogenic. B The patient will require a lower dose and longer course of ciprofloxacin . than a nonpregnant, adult patient. C Ciprofloxacin is safe to use in pregnancy and the patient may use to . same dose and route as a nonpregnant patient. D The use of ciprofloxacin is contraindicated in pregnancy. . QUESTION 30 1. The nurse notices a cold sore on a patient's upper lip and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first A assess the area and make sure that there are no open . lesions or abrasions. B put gloves on to protect herself. . C clean the area to be treated and then pat it dry. . D prepare the applicator for drug administration. . QUESTION 31 1. Which of the following is critical to helping prevent development of resistant strains of microbes in patients? A Limit the exposure of bacteria to an antimicrobial agent . B Maintain the optimum duration of the antimicrobial . agent C Keep the antimicrobial drug dosage high . D Maintain the maximum safe frequency of antimicrobial . drug ingestion QUESTION 32 1. A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? A The importance of vigilant hygiene for the boy and the other . members of the family B The need to supplement the anthelminthic drug with prophylactic . antibiotics C The need to use prescription skin cleansers during treatment and . for 6 weeks after D The need for the boy to provide serial stool samples for 6 months . following treatment QUESTION 33 1. Laboratory testing has confirmed that a patient has chloroquine- resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of A osteoporosis or low bone density. . B chronic obstructive pulmonary . disease (COPD). C cardiac arrhythmias. . D diabetes mellitus. . QUESTION 34 1. A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately? A Muscle pain or . tingling B Abdominal pain . C Palpitations . D Nausea and . vomiting QUESTION 35 1. A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to A take the tablets on an empty stomach. . B eat light meals every day. . C decrease the drug dosage if initial symptoms of . nephrotoxicity appear. D stay well hydrated by drinking at least eight 8-oz glasses . of water daily. • Question 1 1 out of 1 points Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent Response Feedback: The nurse will advise the patient to use the medication once a day. Dosage strength indicates a single daily dose as the therapeutic treatment. • Question 2 1 out of 1 points A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following? Response Feedback : Gentamicin is nephrotoxic and can result in acute tubular necrosis. The nurse will need to monitor for excessive urea level in the blood, decreased creatinine clearance, loss of the ability to concentrate urine, increased white blood cell count in the urine, and cells or casts in the urine. Potassium, albumin level, and prothrombin time are not associated with the adverse effects of gentamicin. • Question 3 1 out of 1 points Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication? Response Feedback : Before applying silver sulfadiazine, it is necessary to cleanse the wound completely and remove dead or burned skin and other debris. It would be inappropriate to perform wound care after the application of the drug and it should be applied in a thin layer no more than about 1/16 inch. Application of topical sulfonamides is a sterile, not clean, procedure. • Question 4 A 30-year-old African-American woman tested positive for TB and is 1 out of 1 points prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because Response Feedback : Isoniazid is metabolized in the body through a process called acetylation, which is faster in Eskimos, Asians, and approximately 50% of African Americans or European Americans from North America than in Scandinavians and people of Arab or Jewish heritage. Because the patient is an African American, she may exhibit slow acetylation for the drug, and as a result she may be at greater risk for serum levels and adverse effects. For this reason, the nurse would need to closely monitor this particular patient. Patients of African-American descent do not exhibit slow therapeutic effects of isoniazid or high rates of drug elimination. • Question 5 1 out of 1 points A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor? Response Feedback : During quinupristin/dalfopristin infusion, the nurse should monitor the IV site for signs of infiltration, edema, or phlebitis. The nurse should also question the patient about pain at the injection site. Quinupristin/dalfopristin is not known to affect heart rate or cause breathlessness. Nausea and vomiting have not been identified as common adverse effects of quinupristin/dalfopristin infusion. • Question 6 A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods? 1 out of 1 points Response Feedback : Patients who take INH should avoid eating tyramine, histamine- rich foods, and foods containing caffeine. Also, the patient should be told to avoid consuming alcohol on a daily basis. Cheese, dairy products, chicken liver, beer, ale, bananas, and figs are rich in tyramine. Tuna, brine, and yeast extracts are rich in histamine. Patients need not refrain from eating potatoes, root vegetables, chicken, fish, or citrus fruits. • Question 7 1 out of 1 points A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Response Feedback : The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity. • Question 8 1 out of 1 points An immunocompromised patient with a diagnosis of candidiasis has failed to respond to conservative therapy and has consequently begun treatment with amphotericin B. The nurse is aware that this drug achieves a therapeutic effect by way of its influence on Response Feedback: Amphotericin B works by binding to sterols in fungal cell membranes. This binding appears to form pores or channels and results in increased cell permeability, cell leakage, and death. The drug does not influence human immune function, fungal reproduction, or the osmolarity within fungal cells. • Question 9 1 out of 1 points A nurse has questioned why a patient's physician has prescribed a narrow- spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient's infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible? Response Feedback : The benefit of a narrow-spectrum antimicrobial agent is that it limits the potential for adverse effects, such as superinfection. In a superinfection, an antibiotic suppresses all susceptible microbes, including the body's natural flora, which may keep other microbes in check. In the absence of these bacteria, nonsusceptible microbes can proliferate. Narrow-spectrum antibiotics do not lack demonstrated efficacy and they do not necessarily require a shorter duration of treatment. All antimicrobial drugs have the potential to impact subsequent C&S testing. • Question 10 1 out of 1 points A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication Response Feedback: After oral administration, ganciclovir is absorbed poorly from the GI tract. Bioavailability is increased when the medication is administered with a high-fat meal. High-protein meals, orange juice, and an empty stomach will not help increase bioavailability of this drug. • Question 11 1 out of 1 points A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take Response Feedback: The patient should take antacids not less than 1 hour before or 2 hours after taking INH. INH should not be taken with meals unless the patient has gastrointestinal distress. It does not matter when INH or the antacid is taken during the day as long as the time frame is appropriate. • Question 12 1 out of 1 points A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule Response Feedback : Because the absorption of azithromycin capsules is decreased in the presence of food, azithromycin capsules should be taken on an empty stomach rather than after a meal. Unlike azithromycin capsules, azithromycin tablets have an increased absorption when given with a meal with high fat content and may be given with or without food. • Question 13 A 20-year-old female patient is receiving topical clindamycin for acne 1 out of 1 points vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient? Response Feedback : The patient is exhibiting signs and symptoms of an allergic reaction and is at risk for serious injury related to possible anaphylactoid reactions. Diarrhea would be related to other adverse effects of the drug. Imbalanced Nutrition: Less than Body Requirements would be related to the alteration in taste and possible superinfections from the drug. Risk for Injury related to blood dyscrasia would indicate that the patient was exhibiting signs and symptoms of thrombocytopenia, neutropenia, or eosinophilia. • Question 14 Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin? 1 out of 1 points Response Feedback : The goal of monitoring antibacterial therapy like vancomycin is to maintain the serum drug level within the therapeutic margin; this also ensures safety. Serum blood levels should be monitored for drugs that have a high potential for severe adverse effects. The other options can be broad goals of a general drug therapy that may or may not include an antibacterial drug. Antibiotic doses are not typically tapered down. • Question 15 A nurse is aware that the concept of selective toxicity is foundational to 1 out of 1 points antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? Response Feedback: An important principle of antimicrobial therapy is selective toxicity, which is the ability to suppress or kill an infecting microbe without injury to the host. This concept does not denote dose-dependent effects, the ability to culture a microorganism, or the production of a drug. • Question 16 1 out of 1 points An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin- resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with Response Feedback: Vancomycin is the drug of choice to manage infections caused by MRSA. MRSA is resistant to all of the antistaphylococcic penicillins, as well as to ciprofloxacin and clindamycin. • Question 17 1 out of 1 points A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug? Response Feedback : Adverse reactions to ophthalmic ciprofloxacin usually involve local effects such as burning or discomfort. Other adverse effects of ophthalmic ciprofloxacin are lid margin crusting, crystals, scales, foreign body sensation, pruritus, conjunctival hyperemia, and a bad taste in the mouth. Increased intracranial pressure and tendon ruptures are not identified adverse effects of ophthalmic ciprofloxacin. Nephrotoxicity and neurotoxicity are the primary adverse effects of polymyxin B. • Question 18 An immunocompromised cancer patient has developed cryptococcal 1 out of 1 points meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug? Response Feedback: Amphotericin B should be administered in a central line, if possible, using an in-line filter. The solution should be placed on an infusion pump and delivered over 2 to 4 hours. Amphotericin B is not hung with lactated Ringer's, given by IV direct (IV push) or provided as a constant infusion. • Question 19 1 out of 1 points A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug Response Feedback : The nurse should instruct the parents to administer penicillin V exactly as prescribed at regular intervals. Penicillin V should be taken on an empty stomach 1 hour before or 2 hours after a meal with a glass of water. Penicillin V should not be taken with meals because food may affect the absorption of the drug. Penicillin V is easy to administer in the home setting; it does not need to be given IV under the supervision of a home health nurse. • Question 20 A 15-year-old boy is being carefully monitored for a skin infection and is being given ciprofloxacin. The nurse will observe for which of the following? 1 out of 1 points Response Feedback : A serious adverse reaction of ciprofloxacin is arthropathy, or joint pain, especially in children. This irreversible adverse reaction tends to occur in children under 18 years of age. Colitis is another adverse reaction of ciprofloxacin that the nurse needs to monitor for, but it generally does not affect children under 18 years of age. Hepatitis and hypotension are not identified adverse effects of ciprofloxacin in children or adults. • Question 21 A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, 1 out of 1 points the care team should be cautious when concurrently administering other medications that may cause Response Feedback: Because of the potential for nephrotoxicity and ototoxicity that is associated with gentamicin, other medications that may lead to these same adverse effects must be used with caution. Gentamicin does not typically affect immune function, ICP, or hematopoiesis. • Question 22 A nurse is instructing a colleague on how an antimicrobial produces a 0 out of 1 points therapeutic effect. Which of the following should be included in the nurse's teaching? Response Feedback : The action of antimicrobials is to interfere with the normal function of the invading organism to prevent it from reproducing and to cause cell death without affecting host cells. Penicillin interferes with biosynthesis of the bacterial cell wall. Because bacteria cells have a slightly different composition than human cells, the bacteria are destroyed without interfering with the host. The first drugs used to treat systemic infections were developed in the early 20th century. Fluoroquinolones act by interfering with DNA synthesis. Sulfonamides interfere with growth and development of bacterial cells. The term selective toxicity refers to the ability to affect certain proteins or enzyme systems that are used by infecting organisms but not by human cells. • Question 23 A 49-year-old farmer who normally enjoys good health has become 1 out of 1 points seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment? Response Feedback : Amphotericin B is associated with numerous adverse effects that influence a variety of body systems. Paramount among these, however, is the drug's potential for nephrotoxicity and electrolyte disturbances. Erythropoiesis and coagulation may also be affected, but these adverse effects are normally less profound. Changes in C-reactive protein levels are not associated with the use of amphotericin B. • Question 24 1 out of 1 points A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to Response Feedback: If a patient taking vitamins or herbal supplements is prescribed ciprofloxacin, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. Changing or alternating the dosage must be determined by the prescriber. • Question 25 A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will 1 out of 1 points Response Feedback : The nurse should monitor for bleeding gums when the drug is administered in combination with anticoagulants, because patients who receive oral anticoagulants may experience increased bleeding. Administering the medication with small amounts of food and fluids should help minimize adverse effects of GI distress that occur under normal circumstances. Monitoring the site of injection and continuing therapy until 2 days after the symptoms have resolved would represent good general nursing practice. • Question 26 1 out of 1 points Which of the following would a nurse assess for in a patient who is taking polymyxin B systemically? Response Feedback : The nurse would observe for the signs and symptoms of nephrotoxicity and hepatotoxicity. This drug is rarely administered systemically but has a potential for causing these serious adverse effects. Peripheral neuropathy, hyperkalemia, hyponatremia, endocarditis, and hypertension are not associated with the ingestion of polymyxin B. • Question 27 A child is taking permethrin for head lice. The nurse will instruct her mother to 1 out of 1 points Response Feedback: Using creams, ointments, or oils may diminish the therapeutic effect of permethrin. Increasing daily milk intake would not enhance the effects of the drug. The patient does not have to wash her hair every day. • Question 28 1 out of 1 points A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor Response Feedback : Plasma concentrations should be monitored at least weekly in patients who are on chloramphenicol therapy. It would be important for the nurse to monitor daily urine output with any drug therapy. An increase or decrease in output could indicate pathology. Also, it would be important for the nurse to monitor blood sugar levels and liver enzymes, but not because the patient is taking chloramphenicol. • Question 29 A 30-year-old woman who is in the first trimester of pregnancy has 1 out of 1 points presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Response Feedback: Ciprofloxacin is contraindicated in patients who are pregnant or lactating. Alternative routes and dosages do not mitigate the risks during pregnancy. • Question 30 The nurse notices a cold sore on a patient's upper lip and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first 1 out of 1 points Response Feedback: The nurse would assess the area first to make sure that there were no open lesions or abrasions that could allow for systemic absorption of the drug. Then, the nurse would apply gloves and clean the area, pat dry, and apply the medication. • Question 31 Which of the following is critical to helping prevent development of resistant strains of microbes in patients? 1 out of 1 points Response Feedback : Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of these agents to the treatments of specific pathogens known to be sensitive to the drug being used. Drug dosages are also important in preventing the development of resistance. However, the duration of drug use is critical to ensure that microbes are completely eliminated and not given the chance to grow and develop resistant strains. It is hard to convince patients that the timing of the dose and length of time they continue to take the drug are important. Patients who stop the drug when they start to feel better encourage the emergence of resistant strains. • Question 32 A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family 1 out of 1 points education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? Response Feedback : It is important to teach patients who are being treated for helminthic infections about hygiene (such as laundering infested bed linens and undergarments daily) and other measures that help prevent reinfection. However, neither prescription skin cleansers nor antibiotics are indicated. Serial stool samples do not reduce the chance of reinfection. • Question 33 1 out of 1 points Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of Response Feedback : Patients with cardiac arrhythmias may be at risk for developing quinine-induced dysrhythmias and patients treated with quinine have shown prolonged Q-T intervals. Low bone density, diabetes, and COPD are not health problems that preclude the use of quinine in the treatment of chloroquine-resistant malaria. • Question 34 1 out of 1 points A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately? Response Feedback : The nurse should teach the patient the importance of reporting diarrhea, muscle pain and tingling, and fatigue immediately because these signs and symptoms can indicate potentially severe adverse effects. Nausea and vomiting, palpitations, and abdominal pain are all adverse effects of ciprofloxacin. • Question 35 A nurse is explaining the use of acyclovir therapy to a 72-year-old man. 1 out of 1 points Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to Response Feedback : To minimize the risk of developing nephrotoxicity, the patient should stay well hydrated by drinking at least eight 8-oz glasses of water daily. Eating light meals or taking the drug on an empty stomach would not decrease the risk of developing nephrotoxicity. A nurse should never alter the drug dosage without consulting the prescriber.