NUR 635 FINAL EXAM WITH VERIFIED
QUESTIONS AND ANSWERS|| ALREADY
GRADED A+|| GUARANTEED PASS|| LATEST
VERSION 2025
A patient with an infection caused by Pseudomonas aeruginosa is being treated
with piperacillin. The nurse providing care reviews the patient's laboratory
reports and notes that the patient's blood urea nitrogen and serum creatinine
levels are elevated. The nurse will contact the provider to discuss:
a. adding an aminoglycoside.
b. changing to penicillin G.
c. reducing the dose of piperacillin.
d. ordering nafcillin. - ANSWER-ANS: C
Patients with renal impairment should receive lower doses of piperacillin than
patients with normal renal function. Aminoglycosides are nephrotoxic.
Penicillin G and nafcillin are not effective against Pseudomonas infections.
A patient has a skin infection and the culture reveals methicillin-resistant
Staphylococcus aureus (MRSA). What is an appropriate treatment for this
patient?
a. Cefaclor
b. Cefazolin
c. Cefotaxime
d. Ceftaroline - ANSWER-ANS: D
,Ceftaroline is a fifth-generation cephalosporin with a spectrum similar to third-
generation cephalosporins but also with activity against MRSA. Cefaclor is a
second-generation cephalosporin. Cefazolin is a first-generation cephalosporin.
Cefotaxime is a third-generation cephalosporin.
Pt develops C.Diff what antibiotic is prescribed? - ANSWER-Vancomycin PO
A patient recently began receiving clindamycin [Cleocin] to treat an infection.
After 8 days of treatment, the patient reports having 10 to 15 watery stools per
day. What will the nurse tell this patient?
a. The provider may increase the clindamycin dose to treat this infection.
b. This is a known side effect of clindamycin, and the patient should consume
extra fluids.
c. The patient should stop taking the clindamycin now and contact the provider
immediately.
d. The patient should try taking Lomotil or a bulk laxative to minimize the
diarrheal symptoms - ANSWER-ANS: C
Clostridium difficile-associated diarrhea (CDAD) is the most severe toxicity of
clindamycin; if severe diarrhea occurs the patient should be told to stop taking
clindamycin immediately and to contact the provider so that treatment with
vancomycin or metronidazole can be initiated.
Increasing the dose of clindamycin will not treat this infection. Consuming extra
fluids while still taking the clindamycin is not correct, because CDAD can be
fatal if not treated. Taking Lomotil or bulk laxatives only slows the transit of the
stools and does not treat the cause.
A patient received 500 mg of azithromycin [Zithromax] at 0800 as a first dose.
What are the usual amount and time of the second dose of azithromycin?
a. 250 mg at 2000 the same day
b. 500 mg at 2000 the same day
c. 250 mg at 0800 the next day
d. 500 mg at 0800 the next day - ANSWER-ANS: C
,Azithromycin generally is given as 500 mg on the first day and then 250 mg/day
for the next 4 days, so the second dose would be 24 hours after the first dose
A nurse is reviewing the culture results of a patient receiving an
aminoglycoside. The report reveals an anaerobic organism as the cause of
infection. What will the nurse do?
a. Contact the provider to discuss an increased risk of aminoglycoside toxicity.
b. Continue giving the aminoglycoside as ordered.
c. Request an order for a different class of antibiotic.
d. Suggest adding a penicillin to the patient's drug regimen. - ANSWER-ANS:
C
Aminoglycosides are not effective against anaerobic microbes, so another class
of antibiotics is indicated. There is no associated increase in aminoglycoside
toxicity with anaerobic infection. The aminoglycoside will not be effective, so
continuing to administer this drug is not indicated. Adding another antibiotic is
not useful, because the aminoglycoside is not necessary
A young, nonpregnant female patient with a history of a previous urinary tract
infection is experiencing dysuria, urinary urgency and frequency, and
suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive
for more than 100,000/mL of urine. The nurse caring for this patient knows that
which treatment is most effective?
a. A 14-day course of amoxicillin with clavulanic acid [Augmentin]
b. A 7-day course of ciprofloxacin [Cipro]
c. A single dose of fosfomycin [Monurol]
d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim] - ANSWER-
ANS: D
Short-course therapy is recommended for uncomplicated, community-acquired
lower urinary tract infections. The short course is more effective than a single
dose, and compared with longer-course therapies, it is less costly, has fewer side
effects, and is more likely to foster compliance. Amoxicillin with clavulanic
acid is a second-line drug used for pyelonephritis. Fosfomycin is a second-line
drug and can be useful in patients with drug allergies
, A patient is diagnosed with anxiety after describing symptoms of tension, poor
concentration, and difficulty sleeping that have persisted for over 6 months.
Which medication will the nurse expect the provider to order for this patient?
a. Alprazolam [Xanax]
b. Amitriptyline [Elavil]
c. Buspirone [Buspar]
d. Paroxetine [Paxil] - ANSWER-c. Buspirone [Buspar]
Prior to starting antidepressants, patients should have laboratory testing to rule
out:
a.Hypothyroidism
b.Anemia
c.Diabetes mellitus
d.Low estrogen levels - ANSWER-a.Hypothyroidism
An appropriate drug for the treatment of depression with anxiety would be:
a.Alprazolam (Xanax)
b.Escitalopram (Lexapro)
c.Buspirone (Buspar)
d.Amitriptyline (Elavil - ANSWER-b. Escitalopram (Lexapro)
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try
tapering off of the SSRI. What is the initial dosage adjustment when starting a
taper off antidepressants?
a. Change dose to every other day dosing for a week
b. Reduce dose by 50% for 3 to 4 days
c. Reduce dose by 50% every other day
QUESTIONS AND ANSWERS|| ALREADY
GRADED A+|| GUARANTEED PASS|| LATEST
VERSION 2025
A patient with an infection caused by Pseudomonas aeruginosa is being treated
with piperacillin. The nurse providing care reviews the patient's laboratory
reports and notes that the patient's blood urea nitrogen and serum creatinine
levels are elevated. The nurse will contact the provider to discuss:
a. adding an aminoglycoside.
b. changing to penicillin G.
c. reducing the dose of piperacillin.
d. ordering nafcillin. - ANSWER-ANS: C
Patients with renal impairment should receive lower doses of piperacillin than
patients with normal renal function. Aminoglycosides are nephrotoxic.
Penicillin G and nafcillin are not effective against Pseudomonas infections.
A patient has a skin infection and the culture reveals methicillin-resistant
Staphylococcus aureus (MRSA). What is an appropriate treatment for this
patient?
a. Cefaclor
b. Cefazolin
c. Cefotaxime
d. Ceftaroline - ANSWER-ANS: D
,Ceftaroline is a fifth-generation cephalosporin with a spectrum similar to third-
generation cephalosporins but also with activity against MRSA. Cefaclor is a
second-generation cephalosporin. Cefazolin is a first-generation cephalosporin.
Cefotaxime is a third-generation cephalosporin.
Pt develops C.Diff what antibiotic is prescribed? - ANSWER-Vancomycin PO
A patient recently began receiving clindamycin [Cleocin] to treat an infection.
After 8 days of treatment, the patient reports having 10 to 15 watery stools per
day. What will the nurse tell this patient?
a. The provider may increase the clindamycin dose to treat this infection.
b. This is a known side effect of clindamycin, and the patient should consume
extra fluids.
c. The patient should stop taking the clindamycin now and contact the provider
immediately.
d. The patient should try taking Lomotil or a bulk laxative to minimize the
diarrheal symptoms - ANSWER-ANS: C
Clostridium difficile-associated diarrhea (CDAD) is the most severe toxicity of
clindamycin; if severe diarrhea occurs the patient should be told to stop taking
clindamycin immediately and to contact the provider so that treatment with
vancomycin or metronidazole can be initiated.
Increasing the dose of clindamycin will not treat this infection. Consuming extra
fluids while still taking the clindamycin is not correct, because CDAD can be
fatal if not treated. Taking Lomotil or bulk laxatives only slows the transit of the
stools and does not treat the cause.
A patient received 500 mg of azithromycin [Zithromax] at 0800 as a first dose.
What are the usual amount and time of the second dose of azithromycin?
a. 250 mg at 2000 the same day
b. 500 mg at 2000 the same day
c. 250 mg at 0800 the next day
d. 500 mg at 0800 the next day - ANSWER-ANS: C
,Azithromycin generally is given as 500 mg on the first day and then 250 mg/day
for the next 4 days, so the second dose would be 24 hours after the first dose
A nurse is reviewing the culture results of a patient receiving an
aminoglycoside. The report reveals an anaerobic organism as the cause of
infection. What will the nurse do?
a. Contact the provider to discuss an increased risk of aminoglycoside toxicity.
b. Continue giving the aminoglycoside as ordered.
c. Request an order for a different class of antibiotic.
d. Suggest adding a penicillin to the patient's drug regimen. - ANSWER-ANS:
C
Aminoglycosides are not effective against anaerobic microbes, so another class
of antibiotics is indicated. There is no associated increase in aminoglycoside
toxicity with anaerobic infection. The aminoglycoside will not be effective, so
continuing to administer this drug is not indicated. Adding another antibiotic is
not useful, because the aminoglycoside is not necessary
A young, nonpregnant female patient with a history of a previous urinary tract
infection is experiencing dysuria, urinary urgency and frequency, and
suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive
for more than 100,000/mL of urine. The nurse caring for this patient knows that
which treatment is most effective?
a. A 14-day course of amoxicillin with clavulanic acid [Augmentin]
b. A 7-day course of ciprofloxacin [Cipro]
c. A single dose of fosfomycin [Monurol]
d. A 3-day course of trimethoprim/sulfamethoxazole [Bactrim] - ANSWER-
ANS: D
Short-course therapy is recommended for uncomplicated, community-acquired
lower urinary tract infections. The short course is more effective than a single
dose, and compared with longer-course therapies, it is less costly, has fewer side
effects, and is more likely to foster compliance. Amoxicillin with clavulanic
acid is a second-line drug used for pyelonephritis. Fosfomycin is a second-line
drug and can be useful in patients with drug allergies
, A patient is diagnosed with anxiety after describing symptoms of tension, poor
concentration, and difficulty sleeping that have persisted for over 6 months.
Which medication will the nurse expect the provider to order for this patient?
a. Alprazolam [Xanax]
b. Amitriptyline [Elavil]
c. Buspirone [Buspar]
d. Paroxetine [Paxil] - ANSWER-c. Buspirone [Buspar]
Prior to starting antidepressants, patients should have laboratory testing to rule
out:
a.Hypothyroidism
b.Anemia
c.Diabetes mellitus
d.Low estrogen levels - ANSWER-a.Hypothyroidism
An appropriate drug for the treatment of depression with anxiety would be:
a.Alprazolam (Xanax)
b.Escitalopram (Lexapro)
c.Buspirone (Buspar)
d.Amitriptyline (Elavil - ANSWER-b. Escitalopram (Lexapro)
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try
tapering off of the SSRI. What is the initial dosage adjustment when starting a
taper off antidepressants?
a. Change dose to every other day dosing for a week
b. Reduce dose by 50% for 3 to 4 days
c. Reduce dose by 50% every other day
