Abrams' Clinical Drug Therapy
Rationales for Nursing Practice
13th Edition
• Author(s)Geralyn Frandsen;
Sandra Pennington
TEST BANK
,Question 1
A nurse is preparing to administer the first dose of an
intravenous cephalosporin to a patient with a severe respiratory
tract infection. Which statement by the patient would require
the nurse to hold the medication and clarify the order with the
healthcare provider?
A. "I get a mild upset stomach whenever I take oral
erythromycin." B. "I had a severe rash and swelling of my lips
after taking penicillin as a child." C. "My skin becomes very
sensitive to the sun when I take doxycycline." D. "I developed a
metallic taste in my mouth the last time I took metronidazole."
Correct Answer: B
Rationale: Cephalosporins share a structural similarity (beta-
lactam ring) with penicillins. There is a documented risk of
cross-sensitivity, particularly in patients who have experienced
severe, immediate hypersensitivity reactions (such as
anaphylaxis, angioedema, or bronchospasm) to penicillin. A
severe rash and swelling of the lips indicate a potential type I
hypersensitivity reaction, requiring caution and provider
clarification before administering a cephalosporin. Mild
gastrointestinal upset from erythromycin, photosensitivity from
doxycycline, and a metallic taste from metronidazole are
,common side effects or class-specific characteristics that do not
indicate a cross-sensitivity to cephalosporins.
Question 2
A patient is prescribed oral ciprofloxacin for a complicated
urinary tract infection. Which instruction should the nurse
include in the patient's discharge teaching plan?
A. "Take this medication with a full glass of milk or yogurt to
protect your stomach." B. "Avoid drinking large amounts of
water while taking this drug to keep it concentrated." C. "Report
any sudden pain, swelling, or redness at the back of your ankle
immediately." D. "Expect your urine to turn a bright orange or
red color while on this therapy."
Correct Answer: C
Rationale: Fluoroquinolones, such as ciprofloxacin, carry a black
box warning due to the increased risk of tendinitis and tendon
rupture, most commonly affecting the Achilles tendon. Patients
should be instructed to stop the medication, rest, and notify
their provider immediately if they experience tendon pain or
inflammation. Fluoroquinolones should not be taken with milk,
dairy products, or calcium-fortified juices alone, as calcium
binds to the drug and significantly decreases its absorption.
Patients should maintain high fluid intake to prevent
crystalluria. Orange or red urine is associated with drugs like
rifampin or phenazopyridine, not ciprofloxacin.
, Question 3
The nurse is monitoring a patient receiving a continuous
intravenous infusion of gentamicin for a pseudomonal infection.
Which laboratory value requires the most immediate
intervention by the nurse?
A. Serum creatinine of 2.1 mg/dL B. White blood cell count of
11,500/mm³ C. Serum potassium of 3.6 mEq/L D. Hemoglobin
of 12.5 g/dL
Correct Answer: A
Rationale: Aminoglycosides, including gentamicin, are highly
nephrotoxic. A serum creatinine level of 2.1 mg/dL is elevated
above the normal range (typically 0.6 to 1.2 mg/dL) and
indicates acute kidney injury or declining renal function. This
requires immediate intervention, including holding the dose or
adjusting the infusion based on trough levels to prevent
permanent renal damage. An elevated white blood cell count is
expected in a patient being treated for a severe infection. The
potassium and hemoglobin levels are within or very close to
normal physiological limits and do not represent acute toxicity
from gentamicin.
Question 4
Rationales for Nursing Practice
13th Edition
• Author(s)Geralyn Frandsen;
Sandra Pennington
TEST BANK
,Question 1
A nurse is preparing to administer the first dose of an
intravenous cephalosporin to a patient with a severe respiratory
tract infection. Which statement by the patient would require
the nurse to hold the medication and clarify the order with the
healthcare provider?
A. "I get a mild upset stomach whenever I take oral
erythromycin." B. "I had a severe rash and swelling of my lips
after taking penicillin as a child." C. "My skin becomes very
sensitive to the sun when I take doxycycline." D. "I developed a
metallic taste in my mouth the last time I took metronidazole."
Correct Answer: B
Rationale: Cephalosporins share a structural similarity (beta-
lactam ring) with penicillins. There is a documented risk of
cross-sensitivity, particularly in patients who have experienced
severe, immediate hypersensitivity reactions (such as
anaphylaxis, angioedema, or bronchospasm) to penicillin. A
severe rash and swelling of the lips indicate a potential type I
hypersensitivity reaction, requiring caution and provider
clarification before administering a cephalosporin. Mild
gastrointestinal upset from erythromycin, photosensitivity from
doxycycline, and a metallic taste from metronidazole are
,common side effects or class-specific characteristics that do not
indicate a cross-sensitivity to cephalosporins.
Question 2
A patient is prescribed oral ciprofloxacin for a complicated
urinary tract infection. Which instruction should the nurse
include in the patient's discharge teaching plan?
A. "Take this medication with a full glass of milk or yogurt to
protect your stomach." B. "Avoid drinking large amounts of
water while taking this drug to keep it concentrated." C. "Report
any sudden pain, swelling, or redness at the back of your ankle
immediately." D. "Expect your urine to turn a bright orange or
red color while on this therapy."
Correct Answer: C
Rationale: Fluoroquinolones, such as ciprofloxacin, carry a black
box warning due to the increased risk of tendinitis and tendon
rupture, most commonly affecting the Achilles tendon. Patients
should be instructed to stop the medication, rest, and notify
their provider immediately if they experience tendon pain or
inflammation. Fluoroquinolones should not be taken with milk,
dairy products, or calcium-fortified juices alone, as calcium
binds to the drug and significantly decreases its absorption.
Patients should maintain high fluid intake to prevent
crystalluria. Orange or red urine is associated with drugs like
rifampin or phenazopyridine, not ciprofloxacin.
, Question 3
The nurse is monitoring a patient receiving a continuous
intravenous infusion of gentamicin for a pseudomonal infection.
Which laboratory value requires the most immediate
intervention by the nurse?
A. Serum creatinine of 2.1 mg/dL B. White blood cell count of
11,500/mm³ C. Serum potassium of 3.6 mEq/L D. Hemoglobin
of 12.5 g/dL
Correct Answer: A
Rationale: Aminoglycosides, including gentamicin, are highly
nephrotoxic. A serum creatinine level of 2.1 mg/dL is elevated
above the normal range (typically 0.6 to 1.2 mg/dL) and
indicates acute kidney injury or declining renal function. This
requires immediate intervention, including holding the dose or
adjusting the infusion based on trough levels to prevent
permanent renal damage. An elevated white blood cell count is
expected in a patient being treated for a severe infection. The
potassium and hemoglobin levels are within or very close to
normal physiological limits and do not represent acute toxicity
from gentamicin.
Question 4
