NURS 6521 Week 8 Quiz – Question and Answers
Results Displayed: Feedback
Question 1
1 out of 1 points
A child is taking permethrin for head
... [Show More] lice. The nurse will instruct her mother to
Response Feedback: Using creams, ointments, or oils may diminish the therapeutic effect of permethrin. Increasing daily milk intake would not enhance the effects of the drug. The patient does not have to wash her hair every day.
Question 2
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?
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 3
1 out of 1 points
A patient is to begin taking tobramycin (Nebcin) for a nosocomial infection. Which of the following assessments should the nurse prioritize?
Response Feedback: Peak and trough levels should be closely monitored with serious infections being treated with tobramycin. The patient's blood pressure, diet, weight, and other medications would be important to know and necessary for the plan of care, but are secondary to serum levels.
Question 4
1 out of 1 points
An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
Response Feedback: Vancomycin is the drug of choice to manage infections caused by MRSA. MRSA is resistant to all of the antistaphylococcic penicillins, as well as to ciprofloxacin and clindamycin.
Question 5
1 out of 1 points
A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because
Response Feedback: Isoniazid is metabolized in the body through a process called acetylation, which is faster in Eskimos, Asians, and approximately 50% of African Americans or European Americans from North America than in Scandinavians and people of Arab or Jewish heritage. Because the patient is an African American, she may exhibit slow acetylation for the drug, and as a result she may be at greater risk for serum levels and adverse effects. For this reason, the nurse would need to closely monitor this particular patient. Patients of African-American descent do not exhibit slow therapeutic effects of isoniazid or high rates of drug elimination.
Question 6
1 out of 1 points
Laboratory testing has confirmed that a patient has chloroquine-resistant malaria and the patient's physician has prescribed quinine along with an adjunctive drug. The nurse should question the physician's order if the patient has a history of
Response Feedback: Patients with cardiac arrhythmias may be at risk for developing quinine-induced dysrhythmias and patients treated with quinine have shown prolonged Q-T intervals. Low bone density, diabetes, and COPD are not health problems that preclude the use of quinine in the treatment of chloroquine-resistant malaria.
Question 7
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?
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.
Question 8
1 out of 1 points
A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take
Response Feedback: The patient should take antacids not less than 1 hour before or 2 hours after taking INH. INH should not be taken with meals unless the patient has gastrointestinal distress. It does not matter when INH or the antacid is taken during the day as long as the time frame is appropriate.
Question 9
0 out of 1 points
Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent
Response Feedback: The nurse will advise the patient to use the medication once a day. Dosage strength indicates a single daily dose as the therapeutic treatment.
Question 10
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?
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 11
0 out of 1 points
A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule
Response Feedback: Because the absorption of azithromycin capsules is decreased in the presence of food, azithromycin capsules should be taken on an empty stomach rather than after a meal. Unlike azithromycin capsules, azithromycin tablets have an increased absorption when given with a meal with high fat content and may be given with or without food.
Question 12
0 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?
Response Feedback: Ciprofloxacin is contraindicated in patients who are pregnant or lactating. Alternative routes and dosages do not mitigate the risks during pregnancy.
Question 13
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?
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 14
1 out of 1 points
A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi's sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by
Response Feedback: Like other cytokines, interferon alfa-2a inhibits the growth of tumor cells, prevents these cells from multiplying, and modulates the host immune response to help protect the body from tumor cells. This drug does not increase B-cell and T-cell production, induce mutations, or increase the effects of phagocytes and macrophages.
Question 15
1 out of 1 points
A 20-year-old female patient is receiving topical clindamycin for acne vulgaris. She develops a rash and urticaria along with severe itching where the medication is applied. The nurse will formulate which of the following nursing diagnoses for the patient?
Response Feedback: The patient is exhibiting signs and symptoms of an allergic reaction and is at risk for serious injury related to possible anaphylactoid reactions. Diarrhea would be related to other adverse effects of the drug. Imbalanced Nutrition: Less than Body Requirements would be related to the alteration in taste and possible superinfections from the drug. Risk for Injury related to blood dyscrasia would indicate that the patient was exhibiting signs and symptoms of thrombocytopenia, neutropenia, or eosinophilia.
Question 16
0 out of 1 points
Which of the following nursing actions is most important in achieving successful antimicrobial therapy with vancomycin?
Response Feedback: The goal of monitoring antibacterial therapy like vancomycin is to maintain the serum drug level within the therapeutic margin; this also ensures safety. Serum blood levels should be monitored for drugs that have a high potential for severe adverse effects. The other options can be broad goals of a general drug therapy that may or may not include an antibacterial drug. Antibiotic doses are not typically tapered down.
Question 17
1 out of 1 points
A 72-year-old patient is prescribed ophthalmic ciprofloxacin for a bacterial infection in her right eye. The nurse will teach her to observe for which of the following adverse effects of the drug?
Response Feedback: Adverse reactions to ophthalmic ciprofloxacin usually involve local effects such as burning or discomfort. Other adverse effects of ophthalmic ciprofloxacin are lid margin crusting, crystals, scales, foreign body sensation, pruritus, conjunctival hyperemia, and a bad taste in the mouth. Increased intracranial pressure and tendon ruptures are not identified adverse effects of ophthalmic ciprofloxacin. Nephrotoxicity and neurotoxicity are the primary adverse effects of polymyxin B.
Question 18
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?
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 19
1 out of 1 points
A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods?
Response Feedback: Patients who take INH should avoid eating tyramine, histamine-rich foods, and foods containing caffeine. Also, the patient should be told to avoid consuming alcohol on a daily basis. Cheese, dairy products, chicken liver, beer, ale, bananas, and figs are rich in tyramine. Tuna, brine, and yeast extracts are rich in histamine. Patients need not refrain from eating potatoes, root vegetables, chicken, fish, or citrus fruits.
Question 20
0 out of 1 points
The nurse notices a cold sore on a patient's upper lip and requests medication; docosanol (Abreva) is ordered. Before applying the medication, the nurse would first
Response Feedback: The nurse would assess the area first to make sure that there were no open lesions or abrasions that could allow for systemic absorption of the drug. Then, the nurse would apply gloves and clean the area, pat dry, and apply the medication.
Question 21
1 out of 1 points
A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor
Response Feedback: Plasma concentrations should be monitored at least weekly in patients who are on chloramphenicol therapy. It would be important for the nurse to monitor daily urine output with any drug therapy. An increase or decrease in output could indicate pathology. Also, it would be important for the nurse to monitor blood sugar levels and liver enzymes, but not because the patient is taking chloramphenicol.
Question 22
1 out of 1 points
Which of the following would a nurse assess for in a patient who is taking polymyxin B systemically?
Response Feedback: The nurse would observe for the signs and symptoms of nephrotoxicity and hepatotoxicity. This drug is rarely administered systemically but has a potential for causing these serious adverse effects. Peripheral neuropathy, hyperkalemia, hyponatremia, endocarditis, and hypertension are not associated with the ingestion of polymyxin B.
Question 23
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
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 24
0 out of 1 points
A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?
Response Feedback: The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity.
Question 25
1 out of 1 points
Mr. Laird is a 49-year-old electrician who experienced severe burns on his trunk, arms, and hands in a workplace accident 2 weeks ago. Part of his current wound care regimen involves the daily application of silver sulfadiazine to his wounds. The nurses who are providing care for Mr. Laird in the burns and plastics unit of the hospital should perform what action when administering this medication?
Response Feedback: Before applying silver sulfadiazine, it is necessary to cleanse the wound completely and remove dead or burned skin and other debris. It would be inappropriate to perform wound care after the application of the drug and it should be applied in a thin layer no more than about 1/16 inch. Application of topical sulfonamides is a sterile, not clean, procedure.
Question 26
1 out of 1 points
A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will
Response Feedback: The nurse should monitor for bleeding gums when the drug is administered in combination with anticoagulants, because patients who receive oral anticoagulants may experience increased bleeding. Administering the medication with small amounts of food and fluids should help minimize adverse effects of GI distress that occur under normal circumstances. Monitoring the site of injection and continuing therapy until 2 days after the symptoms have resolved would represent good general nursing practice.
Question 27
1 out of 1 points
A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to
Response Feedback: If a patient taking vitamins or herbal supplements is prescribed ciprofloxacin, the nurse should advise the patient to take the vitamins at least 2 hours before or after taking ciprofloxacin. Changing or alternating the dosage must be determined by the prescriber.
Question 28
0 out of 1 points
A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug
Response Feedback: The nurse should instruct the parents to administer penicillin V exactly as prescribed at regular intervals. Penicillin V should be taken on an empty stomach 1 hour before or 2 hours after a meal with a glass of water. Penicillin V should not be taken with meals because food may affect the absorption of the drug. Penicillin V is easy to administer in the home setting; it does not need to be given IV under the supervision of a home health nurse.
Question 29
1 out of 1 points
A 46-year-old man is receiving a quinupristin/dalfopristin IV infusion for a life-threatening infection. Which of the following would be most important for the nurse to monitor?
Response Feedback: During quinupristin/dalfopristin infusion, the nurse should monitor the IV site for signs of infiltration, edema, or phlebitis. The nurse should also question the patient about pain at the injection site. Quinupristin/dalfopristin is not known to affect heart rate or cause breathlessness. Nausea and vomiting have not been identified as common adverse effects of quinupristin/dalfopristin infusion.
Question 30
1 out of 1 points
A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause
Response Feedback: Because of the potential for nephrotoxicity and ototoxicity that is associated with gentamicin, other medications that may lead to these same adverse effects must be used with caution. Gentamicin does not typically affect immune function, ICP, or hematopoiesis.
Question 31
1 out of 1 points
A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?
Response Feedback: An important principle of antimicrobial therapy is selective toxicity, which is the ability to suppress or kill an infecting microbe without injury to the host. This concept does not denote dose-dependent effects, the ability to culture a microorganism, or the production of a drug.
Question 32
1 out of 1 points
A patient has endocarditis and is taking gentamicin. The nurse will be sure to monitor which of the following?
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 33
1 out of 1 points
A patient is receiving long-term clindamycin therapy for a life-threatening infection. The nurse will begin by monitoring this drug therapy by obtaining
Response Feedback: Patients on long-term clindamycin therapy should have a baseline complete blood count because of clindamycin's potential to induce blood dyscrasias. Blood sugar levels, auditory abilities, and liver enzymes need not to be evaluated for long-term or short-term therapy.
Question 34
1 out of 1 points
A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The patient's most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic?
Response Feedback: Vancomycin is used in treating bacterial septicemia, endocarditis, bone and joint infections, and pseudomembranous colitis caused by Clostridium difficile. Vancomycin is exceptionally effective for treating gram-positive infections in penicillin-allergic patients. It is also used for penicillin- and methicillin-resistant staphylococcal infections. Doripenem (Doribax) is used for abdominal or urinary tract infections and neither penicillin G nor cefazolin is effective in the treatment of MRSA infections.
Question 35
1 out of 1 points
A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately?
Response Feedback: The nurse should teach the patient the importance of reporting diarrhea, muscle pain and tingling, and fatigue immediately because these signs and symptoms can indicate potentially severe adverse effects. Nausea and vomiting, palpitations, and abdominal pain are all adverse effects of ciprofloxacin.
Question 36
0 out of 0 points
When completing this quiz, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
Sunday, October 21, 2018 3:45:49 PM EDT [Show Less]