Pharmacology Exam 4 Practice Questions with Complete Solutions

Pharmacology Exam 4 Practice Questions with Complete Solutions 1. The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs? a.Drugs with a broad spectrum b.Drugs with a narrow spectrum c.Drugs with a broad therapeutic index d.Drugs with a narrow therapeutic index ANS: D Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose. It is important to monitor these medications closely by evaluating regular serum peak and trough levels. 2. The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take? a.Administer the amoxicillin and have epinephrine available. b.Ask the provider to order an antihistamine. c.Contact the provider to discuss using a different antibiotic. d.Request an order for a beta-lactamase resistant drug.____ ANS: C Patients who have previously experienced manifestations of allergy to a penicillin should not use penicillins again unless necessary. The nurse should contact the provider to discuss using another antibiotic from a different class. Epinephrine and antihistamines are useful when patients are experiencing allergic reactions, depending on severity. 3. 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? a.Administering a small test dose to determine whether hypersensitivity exists b.Having epinephrine available in the event of a severe hypersensitivity reaction c.Monitoring baseline vital signs, including temperature and blood pressured. d.Obtaining a urine specimen for culture and sensitivity___ ANS: D To obtain the most accurate culture, the specimen should be obtained before antibiotic therapy begins. It is important to obtain cultures when possible to correctly identify the organism and help determine which antibiotic will be most effective. Administering test doses to determine hypersensitivity is sometimes done when there is a strong suspicion of allergy when a particular antibiotic is needed. Epinephrine is kept close at hand when there is a strong suspicion of allergy. 4. 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? a."Discontinue the antibiotic when your temperature returns to normal and your symptoms have improved." b."If diarrhea occurs, stop taking the drug immediately and contact your provider." c."Stop taking the drug and notify your provider if you develop a rash while taking this drug." d."You may save any unused antibiotic to use if your symptoms recur."____ ANS: C Patients who develop signs of allergy, such as rash, should notify their provider before continuing medication therapy. Patients should be counseled to continue taking their antibiotics until completion of the prescribed regimen even when they feel well. Diarrhea is an adverse effect but does not warrant cessation of the drug. Before deciding to stop taking a medication due to a side effect, encourage the patient to contact the provider first. Patients should discard any unused antibiotic. 5. 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? a.Administer the drug and observe closely for hypersensitivity reactions. b.Ask the provider whether a cephalosporin from a different generation may be used. c.Contact the provider to report drug hypersensitivity. d.Notify the provider and suggest an oral cephalosporin.____ ANS: A A small percentage of patients who are allergic to penicillin could also be allergic to a cephalosporin product. Patients should be monitored closely after receiving a cephalosporin if they are allergic to penicillin. There is no difference in hypersensitivity potential between different generations or method of delivery of cephalosporins 6. 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? a.Hold the drug and notify the provider. b.Obtain an order to culture the oral lesions. c.Gather emergency equipment to prepare for anaphylaxis. d.Report a possible superinfection side effect of the cephalosporin.____ ANS: D The patient's symptoms may indicate a superinfection and should be reported to the physician so it can be treated; however, the drug does not need to be held. It is not necessary to culture the lesions. The symptoms do not indicate impending