Pharm Final- Test Bank Practice Questions 2024

A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis would be most appropriate for this patient? A. Acute pain related to gastrointestinal (GI) effects of the drug B. Deficient knowledge regarding drug therapy C. Imbalance nutrition: less than body requirements related to multiple GI effects of the drug D. Constipation - ANSWERSB. Because this is the first time the patient has taken penicillin, she is likely to have limited knowledge about the drug. She may not understand the importance of taking the medication as ordered to increase effectiveness of the drug or to report adverse effects. because the patient has not started the drug yet, there is no way to know what adverse effects, if any, she will experience. Only if she develops acute pain related to GI effects of the drug would this be appropriate. If GI symptoms develop it may lead to imbalanced nutrition, but that remains to be seen. No indication about constipation exists. he mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her child needs an antibiotic. What is the priority rationale the nurse should give the mother? A) It is better absorbed. B) It is less costly. C) It has a less frequent dosing schedule. D) It tastes better in oral form. - ANSWERSAns: A Feedback: Most penicillins are rapidly absorbed from the GI tract, reaching peak levels in 1 hour. Although amoxicillin is less expensive, that fact has far less impact on choosing the proper antibiotic than the effectiveness of the drug. Most oral antibiotics for children are available in pleasant tasting syrups so taste would not be a factor. Ampicillin is often given up to 4 times a day so it actually has a frequent dosing schedule. 25. The nurse is teaching the patient about amoxicillin prior to discharge and includes what important teaching point? A) Blackening of the tongue may occur but will subside when the drug is discontinued. B) Even if it seems like the infection is not improving, the drug is still working. C) Yeast infections are unlikely to occur with this medication because it is narrow spectrum. D) Appearance of a rash is common and does not indicate an allergic reaction. - ANSWERSAns: A Feedback: One of the adverse effects of ampicillin is blackening of the tongue but the discoloration goes away after stopping the drug. If it is accompanied by swelling, the patient should be instructed to call the prescribing health care provider immediately. Many penicillin-resistant pathogens exist, so if the infection does not seem to be responding to the drug, the patient should notify the health care provider because a different antibiotic may be required. Yeast infections are very likely after taking ampicillin because it is a broad-spectrum antibiotic. Appearance of a rash should be evaluated by a health care professional because allergic reactions to this class of antibiotic are very common. A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose? A) Ciprofloxacin (Cipro) B) Gemifloxacin (Factive) C) Norfloxacin (Noroxin) D) Sparfloxacin (Zagam) - ANSWERSAns: A Feedback: Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute episodes of chronic bronchitis and community-acquired pneumonia. Norfloxacin is recommended only for certain types of urinary tract infections. The nurse is providing patient teaching before discharging a patient home. The patient is taking ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent crystalluria caused by ciprofloxacin (Cipro)? A. Eliminate red meat and seafood from the diet. B. Encourage at least 2 liters of fluid per day. C. Avoid caffeine and alcohol. D. Spend time in the sun each day to optimize vitamin D levels. - ANSWERSB. Encourage at least 2L of fluid per day Provide the following patient teaching: Avoid driving or operating dangerous machinery because dizziness, lethargy, and ataxia may occur; try to drink a lot of fluids and maintain nutrition (very important), even though nausea, vomiting, and diarrhea may occur. There is no need to eliminate red meat, seafood, caffeine, or alcohol from the diet, although alcohol may increase the risk of GI irritation. Patients should be taught to avoid the sun due to possible photosensitivity. What is the priority reason for the nurse to consider questioning an order for tetracycline in a child younger than 8 years of age? A. Children younger than 8 years of age cannot take tetracyclines. B. Weight-bearing joints have been impaired in young animals given the drugs. C. Tetracyclines can damage developing teeth and bone in children younger than 8 years of age. D. Liver and kidney function may be damaged when it is given to children under 8 years of age. - ANSWERSANS: C Use tetracyclines with caution in children younger than 8 years of age because they can potentially damage developing bones and teeth. Although the drug does not cause damage to liver and kidneys, it may be contraindicated in patients with hepatic or renal dysfunction because it is concentrated in the bile and excreted in the urine. Fluoroquinolones, not tetracyclines, are generally contraindicated for use in children (i.e., those younger than 18 years of age) because weight-bearing joints have been impaired in young animals given the drugs. Clindamycin (Dalacin C) warrants monitoring hepatic and renal function when it is given to neonates and infants. Trimethoprimsulfamethoxazole (Nu-Cotrimox) is used in children, although children younger than 2 months of age have not been evaluated. Children under 8 years of age can take tetracycline, but it should be used with caution. The nurse is providing discharge teaching to a patient who is being sent home on oral tetracycline (Sumycin). What instructions should the nurse include? A. Take the medication only once a day. B. Check pulse rate and hold the drug if lower than 60 beats per minute (bpm). C. Take the drug on an empty stomach. D. Take the medication with 2 ounces of water. - ANSWERSANS: C Tetracycline should be taken on an empty stomach 1 hour before or 2 hours after meals with a full 8 ounces of water to ensure full absorption. Tetracycline is usually taken at least once every 12 hours. Checking the pulse and holding the dose if below 60 bpm is an action specific to the use of cardiac glycosides. The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question would the nurse ask? A. Has she ever received tetracycline? B. Has she ever received gentamicin? C. Has she ever received ampicillin? D. Has she ever received cephalexin? - ANSWERSANS: A The nurse would question whether the child was ever given tetracycline because this drug is commonly associated with discoloration of secondary teeth when it is administered to children who still have their primary teeth. Gentamicin, ampicillin, and cephalexin are not associated with discoloration of the teeth. The clinic nurse is providing health teaching to a patient who has been prescribed doxycycline (Doxycin). What is a priority teaching point for this patient? A) Stay out of the sun. B) Avoid sexual activity. C) Take an antacid with the drug if nausea occurs. D) Chew the tablets completely before swallowing. - ANSWERSANS: A Encourage the patient to apply sunscreen and wear protective clothing if sun exposure cannot be avoided to protect exposed skin from rashes and sunburn associated with photosensitivity reactions. If the patient is a woman the nurse may advise the patient to use barrier methods of contraceptives (if she is taking oral contraceptives) due to the drugdrug interaction but the patient would not be told to avoid sexual activity. Antacid therapy and chewing the tablets would be inaccurate information. A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication, the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? A) The half-life of the drug is 3 to 7 hours. B) It is taken only once a day. C) It has very few adverse effects. D) It can be given without consideration to drugdrug interactions. - ANSWERSANS: B A mother brings her 3-year-old child to the emergency department telling the nurse the child has eaten a bottle of baby aspirin. The mother cannot tell the nurse how many tablets were in the bottle. What dose of salicylate would be toxic in a child? A) 2g B) 3g C) 4g D) 5g - ANSWERSANS: C A patient arrives at the emergency department brought by his or her friends. The friends tell the nurse that the patient has taken a whole bottle of aspirin. Blood work for salicylate toxicity is run. What does the nurse expect the results to be? A) >5 g B) >10 g C) >15 g D) >20 g - ANSWERSANS: D Antipyretic drugs (e.g., aspirin, ibuprofen, acetaminophen) often are used to alleviate the discomforts of fever and to protect vulnerable organs, such as the brain, from extreme elevations in body temperature. However, the use of aspirin in children is limited due to the possibility of what disease? A) Munchausen's syndrome B) Guillain-Barré syndrome C) Angelman's syndrome D) Reye's syndrome - ANSWERSAND: D A patient presents at the emergency department complaining of dizziness, mental confusion, and difficulty hearing. What should the nurse suspect is wrong with the patient? A) Anakinra toxicity B) Ibuprofen toxicity C) Salicylism D) Acetaminophen toxicity - ANSWERSANS: C The nurse is caring for a patient who reports taking 800 mg of ibuprofen three times a day for relief of menstrual cramps. What lab results will the nurse find most significant in assessing this patient? A) Complete blood count B) White blood cell differential C) Arterial blood gas D) Cholesterol and triglyceride profile - ANSWERSANS: A When nonsteroidal anti-inflammatory drugs (NSAIDs) are combined with loop diuretics, there is a potential for what? A) Decreased antihypertensive effect B) Decreased diuretic effect C) Lithium toxicity D) Anaphylactoid reactions - ANSWERSANS: B A nurse is presenting an educational event for a group of new parents. One topic