A
What is used to identify a pathogen before antibiotic therapy is started?
Culture and Sensitivity Test
What are the symptoms of Hypothyroidism?
Low & Slow
pale, puffy face
cold and dry
hair loss
bradycardia
low temperature
lethargy
A patient is prescribed vancomycin (Vancocin) orally for antibiotic-associated pseudomembranous colitis. The nurse will monitor the patient for:
A. leukopenia.
B. Vancomycin infusion reaction
C. liver impairment.
D. ototoxicity.
D
Rationale: The most serious adverse effect of vancomycin is ototoxicity.
Red person syndrome occurs only with rapid intravenous administration.
Thrombocytopenia is an adverse effect of vancomycin.
What are the symptoms of Hyperthyroidism?
High & Fast
tachycardia
angina
tremors
nervous
palpitations
diarrhea
sweating
A patient is prescribed trimethoprim-sulfamethoxazole (Bactrim) to
treat a urinary tract infection. Which of the following statements
made by the patient indicate that teaching was effective?
A. “It is safe to take this medication if I become pregnant.”
B. “I will drink at least 8 to 10 glasses of water every day.”
C. “I will be able to stop this medication when I’m symptom free.”
D. “I may have increased blood sugar while taking this medication.”
B
Rationale: Sulfamethoxazole may cause crystalluria
unless adequate hydration is maintained.
What is are two major complications of Penicillin that some patients can develop?
Steven Johnson Syndrome
angioedema
A patient with a history of a severe anaphylactic reaction to penicillin has an order to receive cephalosporin. The nurse should:
A. administer the cephalosporin as ordered.
B. contact the healthcare provider for a different antibiotic.
C. administer a test dose of cephalosporin to determine reactivity.
D. have an epinephrine dose available when administering the cephalosporin.
B; if the patient had a history of a mild allergic reaction to PCN then the answer should be A
When is Insulin Glargine (Lantus) typically administered?
at bedtime
A patient is prescribed metformin (Glucophage). Which is a side effect/adverse effect common to metformin?
A. Seizures
B. Constipation
C. Bitter or metallic taste
D. Polyuria and polydipsia
C. Bitter or metallic taste
Which statement will the nurse include when teaching a patient about cephalosporin therapy?
A.“Avoid ingesting buttermilk or yogurt when taking this medication.”
B.“Stop taking the medication when you feel better.”
C.“Immediately stop taking the medication if you develop nausea.”
D. “Inform your health care provider if you develop mouth ulcers.”
D. “Inform your health care provider if you develop mouth ulcers.”
Which class of antibiotics must we be careful not to give if it's expired?
tetracycline
A patient receiving vancomycin IV for MRSA reports new ringing in the ears and has a BP of 86/52 during the infusion. The nurse also notes the patient’s face is flushed and red. Which action is priority?
A. Slow the infusion rate immediately
B. Stop the antibiotic permanently
C. Give acetaminophen
D. Increase IV fluids
A. Slow the infusion rate immediately
Ototoxicity + hypotension + flushing = Red Man Syndrome, caused by infusing vancomycin too fast. Priority is to slow the infusion to reduce histamine release and protect perfusion. You don’t stop the antibiotic completely unless the patient has anaphylaxis.
What class of diabetic medications is contraindicated in patients with symptomatic heart disease?
Thiazolidinesiones (glimepiride & glipizide)
Trimethoprim-sulfamethoxazole (Bactrim) is prescribed for the client. The nurse tells the client to report which of the following symptoms if it develops during the course of this medication therapy?
A. nausea
B. diarrhea
C. headache
D. sore throat
D
Clients taking Bactrim, should be informed about early signs of blood disorders that can occur from this medication. Signs include sore throat, fever, or pallor
What are important considerations for patients taking Levothyroxine Sodium (Synthroid)?
Start low and slow with dose
take on empty stomach
may cause thyroid crisis
tachycardia
HTN
What should patients taking tetracycline avoid?
Sun
Calcium products
A patient receiving gentamicin develops urine output of 300 mL in 24 hours, a BUN of 32, and creatinine of 2.0 mg/dL. The patient states they feel “full in the ears.” Which finding is the most concerning?
A. Low urine output
B. Tinnitus
C. Elevated BUN
D. Mild nausea
A. Low urine output
Gentamicin is extremely nephrotoxic. Oliguria is the first sign of acute kidney injury → threat to life. Tinnitus is important but kidney failure takes priority because it directly affects filtration and can progress rapidly.
What group of people need to be careful with Methimazole (Tapazole)?
A 58-year-old patient taking levothyroxine states they now have chest pain, palpitations, and tremors. VS: HR 128, BP 150/92, temp 99.9. Which explanation best fits the assessment?
A. The dose is too high causing hyperthyroidism
B. The medication is not working yet
C. The symptoms are expected during adjustment
D. The patient needs iron supplementation
A. The dose is too high causing hyperthyroidism
Levothyroxine overdose → hyperthyroid state → tachycardia, hypertension, heat intolerance, palpitations.
This drug increases myocardial oxygen demand and can precipitate MI, especially in older adults.
A patient with a documented penicillin anaphylaxis history is ordered ceftriaxone. They receive the first dose and soon develop shortness of breath, wheezing, and hives. What is the best interpretation?
A. Cross-sensitivity reaction to a cephalosporin
B. Expected medication reaction
C. Mild side effect that resolves
D. Reaction unrelated to the antibiotic
A. Cross-sensitivity reaction to a cephalosporin
Ceftriaxone is a cephalosporin, and patients with true penicillin anaphylaxis have a higher risk of cross-reactivity.
Respiratory symptoms + hives = anaphylaxis, which is life-threatening.
Which antibiotic has a lot of drug interactions?
Erythromycin
Which patients should avoid taking Metformin (Glucophage)?
liver patients (drug is hepatotoxic)
A patient has been on prednisone for 3 months. Their provider discontinues it abruptly. Twelve hours later the patient reports severe fatigue, dizziness, abdominal pain, and BP 88/46. What condition does the nurse suspect?
A. Acute adrenal insufficiency
B. Hypoglycemia from lack of cortisol
C. Addisonian crisis
D. All of the above
D. All of the above
Stopping steroids abruptly causes adrenal crisis → life-threatening. Symptoms include hypotension, abdominal pain, dehydration, and severe weakness. Hypoglycemia also occurs because cortisol maintains glucose. This is a medical emergency.
A patient receives lispro (Humalog) at 0730. At 0745 they say they feel shaky, sweaty, and anxious. Which action is most appropriate?
A. Give 4 oz juice
B. Recheck blood glucose in 30 min
C. Give long-acting insulin
D. Encourage deep breathing exercises
A. Give 4 oz juice
Lispro onset = 15–30 minutes, so symptoms at 0745 are consistent with early hypoglycemia.
Give FAST sugar immediately to prevent seizures or loss of consciousness.
A nurse gives a patient NPH insulin at 8:00 am. At 2:00 pm the nurse finds the patient extremely lethargic but conscious. The patient is diaphoretic and slightly combative. The nurse should
A. call the health care provider.
B. ensure that the patient has a meal.
C. provide the patient with 4 ounces of orange juice.
D. administer the next dose of insulin.
C. provide the patient with 4 ounces of orange juice.
NPH is an intermediate-acting insulin that peaks in 6 to 12 hours. Because the patient is conscious, it is most important for the nurse to provide the orange juice to prevent a possible hypoglycemic reaction (insulin shock).