NURS 6521 FINAL EXAM 2020 / NURS6521 FINAL EXAM 2020 (100 CORRECT Q & A IN EACH VERSION, Q & A) GRADED A

• Question 1 1 out of 1 points A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient\'s pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis?

Réponse: Correct Answer: A. The use of ciprofloxacin is contraindicated in pregnancy. Response Feedback: Ciprofloxacin is contraindicated in patients who are pregnant or lactating. Alternative routes and dosages do not mitigate the risks during pregnancy.

• Question 2 1 out of 1 points An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?

Réponse: Correct Answer: C. Infuse the drug over 2 to 4 hours into a central line using an infusion pump Response Feedback: Amphotericin B should be administered in a central line, if possible, using an in-line filter. The solution should be placed on an infusion pump and delivered over 2 to 4 hours. Amphotericin B is not hung with lactated Ringer\'s, given by IV direct (IV push) or provided as a constant infusion.

• Question 3 1 out of 1 points A nurse is explaining the use of acyclovir therapy to a 72-year-old man. Nephrotoxicity is discussed as a major adverse effect in older patients. To minimize the risk of the patient developing this adverse effect, the nurse will advise him to

Réponse: Correct Answer: D. stay well hydrated by drinking at least eight 8-oz glasses of water daily. Response Feedback: To minimize the risk of developing nephrotoxicity, the patient should stay well hydrated by drinking at least eight 8-oz glasses of water daily. Eating light meals or taking the drug on an empty stomach would not decrease the risk of developing nephrotoxicity. A nurse should never alter the drug dosage without consulting the prescriber.

• Question 4 1 out of 1 points A patient has been prescribed oral tetracycline. The nurse will instruct the patient to take the drug

Réponse: Correct Answer: D. on an empty stomach 1 hour before or 2 hours after taking any meals or other drugs. Response Feedback: Oral preparations of tetracycline should be administered on an empty stomach 1 hour before or 2 hours after taking a meal or other drugs to maximize absorption. Tetracycline is not absorbed effectively if taken with food or dairy products. The dosage must be distributed around the clock, and not just at bedtime, to increase effectiveness.

• Question 5 1 out of 1 points A patient is prescribed ganciclovir to treat a CMV infection. An oral dosage is prescribed. To help increase bioavailability of the drug, the nurse will encourage the patient to take the medication

Réponse: Correct Answer: B. with high-fat meals. Response Feedback: After oral administration, ganciclovir is absorbed poorly from the GI tract. Bioavailability is increased when the medication is administered with a high-fat meal. High-protein meals, orange juice, and an empty stomach will not help increase bioavailability of this drug.

• Question 6 1 out of 1 points A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following?

Réponse: Correct Answer: A. Creatinine clearance Response Feedback: Gentamicin is nephrotoxic and can result in acute tubular necrosis. The nurse will need to monitor for excessive urea level in the blood, decreased creatinine clearance, loss of the ability to concentrate urine, increased white blood cell count in the urine, and cells or casts in the urine. Potassium, albumin level, and prothrombin time are not associated with the adverse effects of gentamicin.

• Question 7 1 out of 1 points A 15-year-old boy is being carefully monitored for a skin infection and is being given ciprofloxacin. The nurse will observe for which of the following?

Réponse: Correct Answer: B. Arthropathy Response Feedback: A serious adverse reaction of ciprofloxacin is arthropathy, or joint pain, especially in children. This irreversible adverse reaction tends to occur in children under 18 years of age. Colitis is another adverse reaction of ciprofloxacin that the nurse needs to monitor for, but it generally does not affect children under 18 years of age. Hepatitis and hypotension are not identified adverse effects of ciprofloxacin in children or adults.

• Question 8 1 out of 1 points A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?

Réponse: Correct Answer: D. The importance of vigilant hygiene for the boy and the other members of the family Response Feedback: It is important to teach patients who are being treated for helminthic infections about hygiene (such as laundering infested bed linens and undergarments daily) and other measures that help prevent reinfection. However, neither prescription skin cleansers nor antibiotics are indicated. Serial stool samples do not reduce the chance of reinfection.

• Question 9 1 out of 1 points A 49-year-old farmer who normally enjoys good health has become seriously ill in recent days and the results of an extensive diagnostic work up have resulted in a diagnosis of histoplasmosis. The patient has been admitted to the hospital and has begun treatment with amphotericin B. The nurse who is providing care for the patient should prioritize which of the following diagnostic results during his course of treatment?

Réponse: Correct Answer: D. Electrolytes, blood urea nitrogen, and creatinine Response Feedback: Amphotericin B is associated with numerous adverse effects that influence a variety of body systems. Paramount among these, however, is the drug\'s potential for nephrotoxicity and electrolyte disturbances. Erythropoiesis and coagulation may also be affected, but these adverse effects are normally less profound. Changes in C-reactive protein levels are not associated with the use of amphotericin B.

• Question 10 1 out of 1 points A nurse has questioned why a patient\'s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of a patient\'s infection. Which of the following facts provides the best rationale for the use of narrow-spectrum antibiotics whenever possible?

Réponse: Correct Answer: B. The use of broad-spectrum antibiotics can create a risk for a superinfection. Response Feedback: The benefit of a narrow-spectrum antimicrobial agent is that it limits the potential for adverse effects, such as superinfection. In a superinfection, an antibiotic suppresses all susceptible microbes, including the body\'s natural flora, which may keep other microbes in check. In the absence of these bacteria, nonsusceptible microbes can proliferate. Narrow-spectrum antibiotics do not lack demonstrated efficacy and they do not necessarily require a shorter duration of treatment. All antimicrobial drugs have the potential to impact subsequent C&S testing.