NURS 340 EXAM 3 NEWEST 2024 /NURS 340 HEALTH
ASSESSMENT EXAM AND PRACTICE QUESTIONS
NEWEST 2024 ACTUAL EXAM 150 QUESTIONS AND
CORRECT DETAILED ANSWERS AND RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
A nurse is preparing to administer the antibiotic for a hospitalized patient who acquired a
Methicillinresistant Staph. aureus (MRSA) infection. Based on the nurses' knowledge of antibiotics for
the treatment of MRSA, which medication may be ordered?
Vancomycin
Neomycin
Cefazolin
Ceftaroline
Metronidazole
Piperacillin - CORRECT ANSWER-Answer: Vancomycin and ceftaroline
Rationale: Methicillin-resistant Staph. aureus(MRSA), highly resistant bacteria, are resistant to all
penicillins and all cephalosporins. Because most strains of MRSA are multidrug resistant, many other
antibiotics are ineffective, including tetracyclines, clindamycin, trimethoprim/sulfamethoxazole, and
beta-lactam agents (except ceftaroline). Preferred drugs are IV vancomycin, linezolid [Zyvox], daptomycin
[Cubicin], telavancin [Vibativ], clindamycin, and ceftaroline. See Lehne p. 1017
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) q 8 hours and
gentamicin IV q 12 hours. Which plan is the best schedule for administering these drugs?
a.) penicillin at 0800, 1600, and 2400; gentamicin at 1200 and 2400
b.) penicillin at 0600, 1400, and 2200; gentamicin at 0600 and 1800
c.) penicillin at 0800, 1600, and 2400; gentamicin at 0600 and 1800
d.) penicillin at 0100, 0900, and 1700; gentamicin at 0900 and 1800 - CORRECT ANSWER-Answer:
C Rationale: Gentamicin should never be administered concurrently with penicillin, because they will
interact, and the penicillin may inactivate the aminoglycoside. All options except A show concurrent
administration. See Lehne p. 1064
,A patient who works as a landscaper is preparing to be discharged home. Ciprofloxacin (Cipro) has been
prescribed for outpatient therapy. Which of the following will the nurse include in the discharge teaching
for this patient?
"You may take the medication with milk of magnesia."
"Use sunscreen and protective clothing when outdoors."
"Take the medication with crackers and cheese."
"Take the medication until all symptoms subside." - CORRECT ANSWER-"Use sunscreen and
protective clothing when outdoors."
Rationale: The patient, a landscaper, should be advised to wear sunscreen and protective clothing when
outdoors, because the medication may cause phototoxicity. The medication should be taken until it is
gone, not just until the patient's symptoms are improved. Absorption of fluoroquinolones is reduced
when taken with a number of products including aluminum or magnesium containing antacids and milk
or other dairy products. See Lehne p. 1087
A hospitalized patient is receiving gentamicin (Garamycin) 80 mg IV twice daily for acute osteomyelitis.
Which data about the patient is most important for the nurse to obtain before administering the
gentamicin?
a.) oral temperature
b.) reports of nausea
c.) BUN and creatinine levels
d.) when an antacid was administered - CORRECT ANSWER-Answer: C
Rationale: Although the patient's temperature will be monitored on a regular basis in the hospital,
gentamicin is nephrotoxic and can cause renal failure. Therefore monitoring renal function is critical.
Nausea is not a common side effect of IV gentamicin. Because the drug is administered IV, an antacid will
not affect absorption of the gentamicin.
What are cephalosporins? - CORRECT ANSWER--Most widely used group of antibiotics
-Beta-lactam antibiotics
-Similar to penicillin structure
-Bactericidal
-Broad spectrum
,-Usually given parenterally
-Toxicity is low
What are the cephalosporin pharmacokinetics? - CORRECT ANSWER-Administration/Absorption
Limited number by po; may take with food
More commonly by IM or IV
Only cefuroxime available by oral (Ceftin) & parenteral (Zinacef)routes
Distribution
Well-distributed to most tissue
Exceptions:
Ocular fluid
CSF for 1st & 2nd generation
Elimination
Renal
Reduce dosage for renal insufficiency to prevent toxic accumulation
Hepatic
Only one - 3rd generation ceftriaxone (Rocephin)
Dosage reduction not necessary for renal insufficiency
What cephalosporin drug is eliminated through the liver? - CORRECT ANSWER-3rd generation
ceftriaxone (Rocephin)
Dosage reduction not necessary for renal insufficiency
, First generation cephalosporin drugs are mostly used for? - CORRECT ANSWER-Most widely used for
pre-op prophylaxis
Rarely used for active infections
What are second generation cephalosporins commonly used for? - CORRECT ANSWER-May be used
for respiratory, abdominal, or pelvic infections
What generation of cephalosporins are preferred? - CORRECT ANSWER-Third generation
Preferred therapy
More active against gram negative aerobes
What generations of cephalosporins are highly resistant to beta lactamases? - CORRECT ANSWER-
Both
3rd & 4th generation highly resistant
to beta lactamases reach clinically
significant levels in CSF
What is Ceftaroline (Teflaro)? - CORRECT ANSWER-New cephalosporin
*Only cephalosporin effective against MRSA*
May be classified as 3rd generation because of antimicrobial spectrum, but sometimes classified as 5th
generation
What are the adverse reactions from cephalosporins? - CORRECT ANSWER-Rare
Allergic reactions
Most common: maculopapular rash within several days of starting treatment
Severe anaphylactic reaction rare: epinephrine & respiratory support Rarely
may see cross-reactivity with penicillin
ASSESSMENT EXAM AND PRACTICE QUESTIONS
NEWEST 2024 ACTUAL EXAM 150 QUESTIONS AND
CORRECT DETAILED ANSWERS AND RATIONALES
(VERIFIED ANSWERS) |ALREADY GRADED A+
A nurse is preparing to administer the antibiotic for a hospitalized patient who acquired a
Methicillinresistant Staph. aureus (MRSA) infection. Based on the nurses' knowledge of antibiotics for
the treatment of MRSA, which medication may be ordered?
Vancomycin
Neomycin
Cefazolin
Ceftaroline
Metronidazole
Piperacillin - CORRECT ANSWER-Answer: Vancomycin and ceftaroline
Rationale: Methicillin-resistant Staph. aureus(MRSA), highly resistant bacteria, are resistant to all
penicillins and all cephalosporins. Because most strains of MRSA are multidrug resistant, many other
antibiotics are ineffective, including tetracyclines, clindamycin, trimethoprim/sulfamethoxazole, and
beta-lactam agents (except ceftaroline). Preferred drugs are IV vancomycin, linezolid [Zyvox], daptomycin
[Cubicin], telavancin [Vibativ], clindamycin, and ceftaroline. See Lehne p. 1017
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) q 8 hours and
gentamicin IV q 12 hours. Which plan is the best schedule for administering these drugs?
a.) penicillin at 0800, 1600, and 2400; gentamicin at 1200 and 2400
b.) penicillin at 0600, 1400, and 2200; gentamicin at 0600 and 1800
c.) penicillin at 0800, 1600, and 2400; gentamicin at 0600 and 1800
d.) penicillin at 0100, 0900, and 1700; gentamicin at 0900 and 1800 - CORRECT ANSWER-Answer:
C Rationale: Gentamicin should never be administered concurrently with penicillin, because they will
interact, and the penicillin may inactivate the aminoglycoside. All options except A show concurrent
administration. See Lehne p. 1064
,A patient who works as a landscaper is preparing to be discharged home. Ciprofloxacin (Cipro) has been
prescribed for outpatient therapy. Which of the following will the nurse include in the discharge teaching
for this patient?
"You may take the medication with milk of magnesia."
"Use sunscreen and protective clothing when outdoors."
"Take the medication with crackers and cheese."
"Take the medication until all symptoms subside." - CORRECT ANSWER-"Use sunscreen and
protective clothing when outdoors."
Rationale: The patient, a landscaper, should be advised to wear sunscreen and protective clothing when
outdoors, because the medication may cause phototoxicity. The medication should be taken until it is
gone, not just until the patient's symptoms are improved. Absorption of fluoroquinolones is reduced
when taken with a number of products including aluminum or magnesium containing antacids and milk
or other dairy products. See Lehne p. 1087
A hospitalized patient is receiving gentamicin (Garamycin) 80 mg IV twice daily for acute osteomyelitis.
Which data about the patient is most important for the nurse to obtain before administering the
gentamicin?
a.) oral temperature
b.) reports of nausea
c.) BUN and creatinine levels
d.) when an antacid was administered - CORRECT ANSWER-Answer: C
Rationale: Although the patient's temperature will be monitored on a regular basis in the hospital,
gentamicin is nephrotoxic and can cause renal failure. Therefore monitoring renal function is critical.
Nausea is not a common side effect of IV gentamicin. Because the drug is administered IV, an antacid will
not affect absorption of the gentamicin.
What are cephalosporins? - CORRECT ANSWER--Most widely used group of antibiotics
-Beta-lactam antibiotics
-Similar to penicillin structure
-Bactericidal
-Broad spectrum
,-Usually given parenterally
-Toxicity is low
What are the cephalosporin pharmacokinetics? - CORRECT ANSWER-Administration/Absorption
Limited number by po; may take with food
More commonly by IM or IV
Only cefuroxime available by oral (Ceftin) & parenteral (Zinacef)routes
Distribution
Well-distributed to most tissue
Exceptions:
Ocular fluid
CSF for 1st & 2nd generation
Elimination
Renal
Reduce dosage for renal insufficiency to prevent toxic accumulation
Hepatic
Only one - 3rd generation ceftriaxone (Rocephin)
Dosage reduction not necessary for renal insufficiency
What cephalosporin drug is eliminated through the liver? - CORRECT ANSWER-3rd generation
ceftriaxone (Rocephin)
Dosage reduction not necessary for renal insufficiency
, First generation cephalosporin drugs are mostly used for? - CORRECT ANSWER-Most widely used for
pre-op prophylaxis
Rarely used for active infections
What are second generation cephalosporins commonly used for? - CORRECT ANSWER-May be used
for respiratory, abdominal, or pelvic infections
What generation of cephalosporins are preferred? - CORRECT ANSWER-Third generation
Preferred therapy
More active against gram negative aerobes
What generations of cephalosporins are highly resistant to beta lactamases? - CORRECT ANSWER-
Both
3rd & 4th generation highly resistant
to beta lactamases reach clinically
significant levels in CSF
What is Ceftaroline (Teflaro)? - CORRECT ANSWER-New cephalosporin
*Only cephalosporin effective against MRSA*
May be classified as 3rd generation because of antimicrobial spectrum, but sometimes classified as 5th
generation
What are the adverse reactions from cephalosporins? - CORRECT ANSWER-Rare
Allergic reactions
Most common: maculopapular rash within several days of starting treatment
Severe anaphylactic reaction rare: epinephrine & respiratory support Rarely
may see cross-reactivity with penicillin
