General Knowledge
a. To provide empiric therapy
b. To provide prophylactic therapy
c. To treat for a superinfection
d. To reduce the number of resistant organisms
b. To provide prophylactic therapy
The nurse is completing the admission assessment for a patient who will receive antibiotic therapy. Which assessments are appropriate? Select all that apply.
Choices:
A. Review baseline kidney and liver function studies
B. Obtain a complete list of prescription drugs, over-the-counter drugs, herbals, and supplements
C. Perform a baseline neurologic assessment
D. Withhold all baseline vital-sign measurements until therapy is completed
E. Assess for a history of antibiotic allergies or hypersensitivity reactions
F. Assume that alternative therapies cannot affect antibiotic treatment
A. Review baseline kidney and liver function studies
B. Obtain a complete list of prescription drugs, over-the-counter drugs, herbals, and supplements
C. Perform a baseline neurologic assessment
E. Assess for a history of antibiotic allergies or hypersensitivity reactions
A patient taking a sulfonamide develops a fever followed by a widespread rash. Which nursing action is the priority?
Choices:
A. Notify the prescriber promptly about the fever and rash.
B. Apply lotion and reassess the skin at the next scheduled assessment.
C. Administer the next dose and document the rash as an expected effect.
D. Encourage sunlight exposure to determine whether the rash is photosensitive.
A. Notify the prescriber promptly about the fever and rash.
Before administering a cephalosporin to a patient who reports a penicillin allergy, which information is most important for the nurse to obtain?
Choices:
A. How many years ago the patient took penicillin
B. The patient’s age at the time of the penicillin reaction
C. The total number of penicillin doses previously received
D. The specific symptoms and severity of the previous penicillin reaction
E. Whether the patient experienced mild diarrhea while taking penicillin
D. The specific symptoms and severity of the previous penicillin reaction
A patient receiving intravenous penicillin suddenly develops wheezing, facial swelling, and hypotension. Which action should the nurse take first?
Choices:
A. Document the findings before notifying the prescriber.
B. Activate emergency measures and administer epinephrine according to protocol.
C. Offer the patient oral fluids to dilute the medication.
D. Continue the infusion and reassess the patient in 30 minutes.
B. Activate emergency measures and administer epinephrine according to protocol.
A patient taking oral tetracycline asks how to schedule the medication with meals and supplements. Which instruction should the nurse provide?
Choices:
A. Take an antacid at the same time to prevent gastrointestinal upset.
B. Administer tetracycline through the feeding tube with the enteral feeding.
C. Take tetracycline with milk to improve absorption.
D. Take the iron supplement with each tetracycline dose.
E. Take tetracycline with water and separate it from dairy products, antacids, calcium, magnesium, and iron.
E. Take tetracycline with water and separate it from dairy products, antacids, calcium, magnesium, and iron.
The nurse is teaching a patient about oral vancomycin. Which statement by the patient indicates an accurate understanding of the medication's use?
Choices:
A. Oral vancomycin provides higher blood levels than intravenous vancomycin
B. Oral vancomycin is used to treat susceptible microbes in the gastrointestinal tract
C. Oral vancomycin is preferred for infections outside the gastrointestinal tract
D. Oral vancomycin should routinely replace intravenous therapy for systemic infections
B. Oral vancomycin is used to treat susceptible microbes in the gastrointestinal tract
a. When the acne clears up, the medication may be discontinued.
b. This medication needs to be taken with antacids to reduce gastrointestinal upset.
c. The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity.
d. The teeth should be observed closely for signs of mottling or other color changes.
c. The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity.
a. It also has an antibacterial effect on the infection.
b. It reduces the adverse effects of the imipenem.
c. It enhances the absorption of the imipenem.
d. It inhibits an enzyme that breaks down the imipenem.
d. It inhibits an enzyme that breaks down the imipenem.
The nurse is completing baseline assessments for a patient who will begin sulfonamide therapy. Which actions are appropriate? Select all that apply.
Choices:
A. Obtain a baseline complete blood cell count.
B. Perform a baseline and ongoing skin assessment.
C. Assess for allergies to sulfonamide drugs and sulfites.
D. Assess renal function when therapy is frequent or long term.
E. Skip assessment for G6PD-related history because it does not affect sulfonamide safety.
F. Avoid reviewing the medication history because sulfonamides have few clinically important interactions.
A. Obtain a baseline complete blood cell count.
B. Perform a baseline and ongoing skin assessment.
C. Assess for allergies to sulfonamide drugs and sulfites.
D. Assess renal function when therapy is frequent or long term.
The nurse is teaching a patient how to take oral penicillin V. Which instruction is most appropriate?
Choices:
A. Stop taking the medication as soon as symptoms resolve.
B. Take every dose immediately after a full meal.
C. Double the next dose if a scheduled dose is missed.
D. Take the medication with at least 6 ounces of water, preferably 1 hour before or 2 hours after meals.
E. Take each dose with fruit juice to improve absorption.
D. Take the medication with at least 6 ounces of water, preferably 1 hour before or 2 hours after meals.
A patient is prescribed intravenous penicillin for a suspected bacterial infection. Which action should the nurse take before administering the first dose?
Choices:
A. Wait until the patient has received several doses before collecting the specimen.
B. Omit the culture because the patient is afebrile.
C. Obtain the prescribed culture and sensitivity specimen.
D. Administer the antibiotic before collecting the specimen.
C. Obtain the prescribed culture and sensitivity specimen.
The nurse is reviewing medications for a patient prescribed tetracycline. Which findings require follow-up? Select all that apply.
Choices:
A. The patient takes an oral anticoagulant.
B. The patient uses an oral contraceptive.
C. The patient takes each dose with at least 8 ounces of water.
D. The patient drinks water with each dose.
E. The patient is also receiving a bactericidal antibiotic.
F. The patient previously had a vaginal yeast infection.
A. The patient takes an oral anticoagulant.
B. The patient uses an oral contraceptive.
E. The patient is also receiving a bactericidal antibiotic.
A patient receiving intravenous vancomycin develops flushing and itching of the face, neck, and upper trunk during the infusion. Which action should the nurse take?
Choices:
A. Continue the infusion without reassessing the patient
B. Slow the infusion rate and assess the patient's blood pressure
C. Increase the infusion rate to complete the dose quickly
D. Administer the remaining dose by intravenous push
B. Slow the infusion rate and assess the patient's blood pressure
a. This is an expected response to antibiotic therapy.
b. The UTI has become worse instead of better.
c. A superinfection has developed.
d. The UTI is resistant to the antibiotic.
c. A superinfection has developed.
The nurse is teaching a patient who is beginning oral antibiotic therapy. Which patient statement indicates a need for additional teaching?
Choices:
A. I will take the doses around the clock as instructed
B. I will ask before taking an antacid with this antibiotic
C. I will take the medication for the entire prescribed length of time
D. I will double the next dose if I forget to take one
D. I will double the next dose if I forget to take one
A patient taking warfarin is prescribed a sulfonamide. Which nursing responsibility is most appropriate?
Choices:
A. Conclude that no additional monitoring is needed because the medications treat different conditions.
B. Expect the sulfonamide to reduce warfarin's anticoagulant effect.
C. Monitor the patient more frequently for anticoagulant effects and bleeding.
D. Increase the warfarin dose to compensate for the sulfonamide.
E. Restrict the patient's fluids to prevent a warfarin interaction.
C. Monitor the patient more frequently for anticoagulant effects and bleeding.
The nurse is completing the initial assessment before antibiotic therapy begins. Which actions are appropriate? Select all that apply.
Choices:
A. Assess for a history of drug allergies and previous hypersensitivity reactions.
B. Review ordered baseline laboratory tests and perform relevant physical assessments.
C. Administer the first antibiotic dose before collecting any prescribed culture.
D. Assess intake and output when indicated by the patient’s condition or institutional protocol.
E. Obtain prescribed culture and sensitivity specimens before initiating antibiotic therapy.
F. Stop monitoring for allergic reactions after the first dose is tolerated.
A. Assess for a history of drug allergies and previous hypersensitivity reactions.
B. Review ordered baseline laboratory tests and perform relevant physical assessments.
D. Assess intake and output when indicated by the patient’s condition or institutional protocol.
E. Obtain prescribed culture and sensitivity specimens before initiating antibiotic therapy.
The nurse is completing an assessment before administering a penicillin preparation. Which findings or actions are important to include? Select all that apply.
Choices:
A. Stop monitoring for hypersensitivity after the first dose is tolerated.
B. Assess for a history of drug allergies and hypersensitivity reactions.
C. Review serum sodium and potassium levels when clinically indicated.
D. Avoid reviewing the medication and medical history because penicillins have few interactions.
E. Obtain prescribed culture and sensitivity specimens before the first dose.
F. Complete neurologic, abdominal, and bowel assessments.
B. Assess for a history of drug allergies and hypersensitivity reactions.
C. Review serum sodium and potassium levels when clinically indicated.
E. Obtain prescribed culture and sensitivity specimens before the first dose.
F. Complete neurologic, abdominal, and bowel assessments.
Which patient should the nurse question before administering a prescribed tetracycline?
Choices:
A. An adult who is not pregnant and has no medication allergies
B. A 10-year-old child
C. A pregnant patient
D. A nonpregnant adult with a bacterial infection
C. A pregnant patient
When should the nurse obtain a vancomycin trough level for a patient beginning a new dosing regimen?
Choices:
A. Only after the patient reports hearing changes
B. Before the fourth dose and within 30 minutes before the next scheduled dose
C. Immediately after the first dose is administered
D. At the midpoint between the second and third doses
B. Before the fourth dose and within 30 minutes before the next scheduled dose
The nurse is preparing to administer the first dose of an antibiotic. Which action is the priority when a culture and sensitivity test has been prescribed?
Choices:
A. Collect the specimen only if the patient reports worsening symptoms
B. Administer the antibiotic and collect the specimen after the dose
C. Obtain the ordered specimen before administering the antibiotic
D. Wait until the patient becomes afebrile before collecting the specimen
C. Obtain the ordered specimen before administering the antibiotic
a. Use another form of birth control if the patient is taking oral contraceptives.
b. If gastrointestinal upset occurs, the drug will have to be stopped.
c. The drug needs to be taken with an antacid to avoid gastrointestinal problems.
d. The patient needs to take each dose with a sip of water.
e. The patient may take the drug with a small snack to reduce gastrointestinal irritation.
f. The patient needs to avoid exposure to direct sunlight or tanning beds to avoid a photosensitivity reaction.
g. Instruct the patient to take the entire prescription and not to stop the drug when symptoms subside.
a. Use another form of birth control if the patient is taking oral contraceptives.
e. The patient may take the drug with a small snack to reduce gastrointestinal irritation.
g. Instruct the patient to take the entire prescription and not to stop the drug when symptoms subside.
Which patient should the nurse question before a sulfonamide is administered?
Choices:
A. A 30-year-old patient who is not pregnant.
B. An adult patient with no reported medication allergies.
C. A 6-week-old infant prescribed a sulfonamide.
D. A patient who is 22 weeks pregnant.
C. A 6-week-old infant prescribed a sulfonamide.
A patient is prescribed cefotetan. Which teaching should the nurse provide?
Choices:
A. Alcohol is safe immediately after the dose because the medication is already absorbed.
B. Increase alcohol intake if nausea or headache develops.
C. Use alcohol with each dose to prevent gastrointestinal upset.
D. Drink alcohol if diaphoresis or hypotension occurs to reverse the reaction.
E. Avoid alcohol and alcohol-containing products during therapy and for up to 72 hours after taking cefotetan.
E. Avoid alcohol and alcohol-containing products during therapy and for up to 72 hours after taking cefotetan.
Which instruction should the nurse provide to a patient taking oral penicillin?
Choices:
A. Take each dose with at least 6 ounces of water rather than juice.
B. Take the medication only when symptoms are present.
C. Take the medication with fruit juice to improve absorption.
D. Double the next dose if a dose is missed.
E. Stop taking the medication when symptoms improve.
A. Take each dose with at least 6 ounces of water rather than juice.
The nurse is caring for patients receiving tetracycline antibiotics. Which nursing actions are appropriate? Select all that apply.
Choices:
A. Stop assessing for adverse effects after the first dose is tolerated.
B. Teach the patient to avoid sun exposure and tanning beds.
C. Inspect the oral mucosa for whitish, sore patches.
D. Monitor for diarrhea and vaginal itching or cottage cheese-like discharge.
E. Give calcium supplements at the same time as oral tetracycline.
F. Frequently assess the intravenous site when administering doxycycline intravenously.
B. Teach the patient to avoid sun exposure and tanning beds.
C. Inspect the oral mucosa for whitish, sore patches.
D. Monitor for diarrhea and vaginal itching or cottage cheese-like discharge.
F. Frequently assess the intravenous site when administering doxycycline intravenously.
The nurse is preparing to administer vancomycin to a patient. Which nursing actions are appropriate? Select all that apply.
Choices:
A. Obtain the trough level within 30 minutes before the next scheduled dose
B. Administer the medication by intravenous push when access is limited
C. Ask about other medications that may be nephrotoxic or ototoxic
D. Assess for a history of renal disease and hearing loss
E. Monitor the intravenous site frequently during infusion
F. Request routine peak levels instead of trough levels
A. Obtain the trough level within 30 minutes before the next scheduled dose
C. Ask about other medications that may be nephrotoxic or ototoxic
D. Assess for a history of renal disease and hearing loss
E. Monitor the intravenous site frequently during infusion
The nurse is reviewing the orders for wound care, which include the use of an antiseptic. Which statements best describe the use of antiseptics? (Select all that apply.)
a. Antiseptics are appropriate for use on living tissue.
b. Antiseptics work by sterilizing the surface of the wound.
c. Antiseptics are applied to nonliving objects to kill microorganisms.
d. The patient’s allergies must be assessed before using the antiseptic.
e. Antiseptics are used to inhibit the growth of microorganisms on the wound surface.
a. Antiseptics are appropriate for use on living tissue.
d. The patient’s allergies must be assessed before using the antiseptic.
e. Antiseptics are used to inhibit the growth of microorganisms on the wound surface.
a. Warfarin
b. Beta blockers
c. Simvastatin
d. Oral contraceptives
e. Digoxin
a. Warfarin
c. Simvastatin
e. Digoxin
The nurse is teaching a patient who is beginning sulfonamide therapy. Which instructions should the nurse include? Select all that apply.
Choices:
A. Use an additional contraceptive method while taking the medication.
B. Spend extra time in direct sunlight to maintain vitamin D levels.
C. Report fever or a new rash promptly.
D. Tell the nurse or prescriber about all prescription medications and supplements.
E. Rely exclusively on the oral contraceptive during treatment.
F. Use protection from sunlight during therapy.
A. Use an additional contraceptive method while taking the medication.
C. Report fever or a new rash promptly.
D. Tell the nurse or prescriber about all prescription medications and supplements.
F. Use protection from sunlight during therapy.
The nurse is preparing to administer intravenous ampicillin. Which actions are appropriate? Select all that apply.
Choices:
A. Calculate the intravenous rate according to the prescribed dose and time.
B. Keep the same intravenous site in place for the entire course of therapy.
C. Assume the intravenous drug is compatible with the infusing solution.
D. Use the proper diluent and infuse the medication over the recommended time.
E. Have epinephrine, oxygen, and supportive airway equipment available.
F. Assess the intravenous site for redness, swelling, tenderness, heat, pain, or leakage.
A. Calculate the intravenous rate according to the prescribed dose and time.
D. Use the proper diluent and infuse the medication over the recommended time.
E. Have epinephrine, oxygen, and supportive airway equipment available.
F. Assess the intravenous site for redness, swelling, tenderness, heat, pain, or leakage.
The nurse is preparing to administer intravenous ampicillin. Which actions are appropriate? Select all that apply.
Choices:
A. Leave the same intravenous site in place for the entire course of therapy.
B. Assume the medication is compatible with the infusing solution.
C. Calculate the intravenous rate based on the prescribed dose and infusion time.
D. Have epinephrine, oxygen, and supportive airway equipment available.
E. Monitor the intravenous site for signs of complications.
F. Use the proper diluent and infuse the medication over the recommended time.
C. Calculate the intravenous rate based on the prescribed dose and infusion time.
D. Have epinephrine, oxygen, and supportive airway equipment available.
E. Monitor the intravenous site for signs of complications.
F. Use the proper diluent and infuse the medication over the recommended time.
A patient receiving tetracycline reports new symptoms. Which finding requires the nurse to notify the prescriber?
Choices:
A. Drinking water with each dose
B. Avoiding tanning beds
C. Persistent or severe diarrhea
D. Taking iron 3 hours after tetracycline
C. Persistent or severe diarrhea
The nurse is monitoring a patient receiving vancomycin. Which findings or interventions are appropriate? Select all that apply.
Choices:
A. Monitor for superinfection during therapy
B. Monitor renal function for evidence of nephrotoxicity
C. Assess hearing status for possible ototoxicity
D. Monitor only for gastrointestinal effects because systemic toxicity is unlikely
E. Encourage adequate hydration unless contraindicated
F. Restrict fluids to prevent vancomycin accumulation
A. Monitor for superinfection during therapy
B. Monitor renal function for evidence of nephrotoxicity
C. Assess hearing status for possible ototoxicity
E. Encourage adequate hydration unless contraindicated