Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario A 42-year-old male is admitted to the medical-
surgical unit with a severe deep tissue infection. The healthcare
provider prescribes intravenous gentamicin. Before
administering the first dose, the nurse reviews the patient's
medical history to screen for contraindications associated with
aminoglycoside therapy.
,Question Which condition in the patient's medical history
should the nurse identify as a major contraindication or caution
requiring immediate notification of the healthcare provider
before administering gentamicin?
Options A. Chronic plaque psoriasis B. Pre-existing severe
hearing loss C. Essential hypertension D. Gastroesophageal
reflux disease (GERD)
Correct Answer B
Rationale Gentamicin is an aminoglycoside antibiotic known for
significant toxicities, specifically nephrotoxicity and ototoxicity.
Pre-existing severe hearing loss or vestibular impairment is a
major caution/contraindication because the drug can cause
irreversible damage to the eighth cranial nerve, severely
worsening the patient's hearing loss or vestibular function.
Why the Other Options Are Incorrect A. Psoriasis is a
dermatological condition that does not interact with the
systemic mechanisms or toxicities of aminoglycosides. C.
Controlled essential hypertension is not a direct
contraindication for aminoglycoside use, though renal function
must be monitored. D. GERD involves gastric acid reflux and
does not alter or conflict with the pharmacodynamics or
renal/ototoxic profile of intravenous gentamicin.
,Learning Objective Identify absolute contraindications and
major clinical cautions associated with the administration of
aminoglycoside antibiotics.
Bloom's Taxonomy Understand
Difficulty Easy
NCLEX Client Needs Category Physiological Integrity:
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill Recognize Cues
Question 2
Clinical Scenario A nurse is preparing an educational session for
a group of newly licensed nurses regarding the
pharmacokinetics of anti-infective medications. The
presentation focuses on how structural differences between
human cells and microbial cells allow for therapeutic efficacy
without destroying host tissue.
Question Which pharmacological concept best describes the
ability of an anti-infective drug to target specific proteins or
structures unique to a microorganism while sparing human host
cells?
Options A. Selective toxicity B. Synergistic effect C.
Bioavailability D. Therapeutic index
Correct Answer A
, Rationale Selective toxicity is the core principle of anti-infective
therapy. It refers to the ability of a drug to affect specific
structures, enzymes, or pathways found in the invading
microorganism (such as bacterial cell walls or specific ribosomal
subunits) that are absent or different in human host cells,
thereby minimizing damage to the host.
Why the Other Options Are Incorrect A. Synergism refers to a
therapeutic combination where two drugs work better together
than the sum of their individual effects. C. Bioavailability
measures the rate and extent to which the active ingredient is
absorbed from a drug product and becomes available at the site
of drug action. D. Therapeutic index is the ratio between the
toxic dose and the therapeutic dose of a drug, indicating its
margin of safety.
Learning Objective Define and explain the principle of selective
toxicity as it applies to anti-infective agents.
Bloom's Taxonomy Remember
Difficulty Easy
NCLEX Client Needs Category Physiological Integrity:
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill Recognize Cues
Question 3
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario A 42-year-old male is admitted to the medical-
surgical unit with a severe deep tissue infection. The healthcare
provider prescribes intravenous gentamicin. Before
administering the first dose, the nurse reviews the patient's
medical history to screen for contraindications associated with
aminoglycoside therapy.
,Question Which condition in the patient's medical history
should the nurse identify as a major contraindication or caution
requiring immediate notification of the healthcare provider
before administering gentamicin?
Options A. Chronic plaque psoriasis B. Pre-existing severe
hearing loss C. Essential hypertension D. Gastroesophageal
reflux disease (GERD)
Correct Answer B
Rationale Gentamicin is an aminoglycoside antibiotic known for
significant toxicities, specifically nephrotoxicity and ototoxicity.
Pre-existing severe hearing loss or vestibular impairment is a
major caution/contraindication because the drug can cause
irreversible damage to the eighth cranial nerve, severely
worsening the patient's hearing loss or vestibular function.
Why the Other Options Are Incorrect A. Psoriasis is a
dermatological condition that does not interact with the
systemic mechanisms or toxicities of aminoglycosides. C.
Controlled essential hypertension is not a direct
contraindication for aminoglycoside use, though renal function
must be monitored. D. GERD involves gastric acid reflux and
does not alter or conflict with the pharmacodynamics or
renal/ototoxic profile of intravenous gentamicin.
,Learning Objective Identify absolute contraindications and
major clinical cautions associated with the administration of
aminoglycoside antibiotics.
Bloom's Taxonomy Understand
Difficulty Easy
NCLEX Client Needs Category Physiological Integrity:
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill Recognize Cues
Question 2
Clinical Scenario A nurse is preparing an educational session for
a group of newly licensed nurses regarding the
pharmacokinetics of anti-infective medications. The
presentation focuses on how structural differences between
human cells and microbial cells allow for therapeutic efficacy
without destroying host tissue.
Question Which pharmacological concept best describes the
ability of an anti-infective drug to target specific proteins or
structures unique to a microorganism while sparing human host
cells?
Options A. Selective toxicity B. Synergistic effect C.
Bioavailability D. Therapeutic index
Correct Answer A
, Rationale Selective toxicity is the core principle of anti-infective
therapy. It refers to the ability of a drug to affect specific
structures, enzymes, or pathways found in the invading
microorganism (such as bacterial cell walls or specific ribosomal
subunits) that are absent or different in human host cells,
thereby minimizing damage to the host.
Why the Other Options Are Incorrect A. Synergism refers to a
therapeutic combination where two drugs work better together
than the sum of their individual effects. C. Bioavailability
measures the rate and extent to which the active ingredient is
absorbed from a drug product and becomes available at the site
of drug action. D. Therapeutic index is the ratio between the
toxic dose and the therapeutic dose of a drug, indicating its
margin of safety.
Learning Objective Define and explain the principle of selective
toxicity as it applies to anti-infective agents.
Bloom's Taxonomy Remember
Difficulty Easy
NCLEX Client Needs Category Physiological Integrity:
Pharmacological and Parenteral Therapies
NCJMM Clinical Judgment Skill Recognize Cues
Question 3
