Pharmacological Aspects of Nursing Care 8Th Ed By Broyles Reiss Evans – Test Bank

Pharmacological Aspects of Nursing Care 8Th Ed By Broyles Reiss Evans – Test Bank

CHAPTER 7: ANTIMICROBIAL AGENTS

TRUE/FALSE

1. Routine handwashing between clients is the most important health care professionals can help prevent the spread of nosocomial infections.

ANS: T PTS: 1 REF: p. 197 | p. 200, Safe Nursing Practice 7-1

OBJ: Cognitive Level: Comprehension

2. Intramuscular injections of cephalosporins should be given in a large muscle to help decrease pain.

ANS: T PTS: 1 REF: p. 210, Safe Nursing Practice 7-3

OBJ: Cognitive Level: Application

3. Oral antimicrobials agents should be taken with a full glass of water for best absorption.

ANS: T PTS: 1 REF: p. 215

OBJ: Cognitive Level: Comprehension

4. Clients taking antitubercular medications should consume only small amounts of alcohol.

ANS: F

Feedback

Correct

Clients taking isoniazid should avoid alcohol, because it could result in crystalluria.

Incorrect

PTS: 1 REF: p. 204 OBJ: Cognitive Level: Comprehension

5. People who are allergic to penicillins should be given cephalosporins to avoid allergic responses.

ANS: F

Feedback

Correct

Clients who are allergic to penicillins also may have allergic reactions to cephalosporins.

Incorrect

PTS: 1 REF: p. 201, Safe Nursing Practice 7-3

OBJ: Cognitive Level: Comprehension

MULTIPLE CHOICE

1. In reconstituting an antibiotic in powder form, the nurse:

a.

always uses normal saline.

b.

uses as small a gauge needle as is available.

c.

changes the needle used to reconstitute the medication before administering the drug to the client.

d.

always administers the medication intramuscularly.

ANS: C

Feedback

A

Incorrect: Most often the diluent is sterile water, but you must follow the manufacturer’s instructions or those in the current nursing reference.

B

Incorrect: An 18-gauge needle is best.

C

Correct: The nurse should change the needle, because there may be medication on the outside of the needle. Plus, the needle may have dulled while being inserted through the rubber stopper.

D

Incorrect: Not all reconstituted medication is administered IM; most is administered IV.

PTS: 1 REF: p. 199 Box 7-2

OBJ: Cognitive Level: Application

2. The nurse is preparing to administer oral penicillin and plans to give it to the client:

a.

every 12 hours, with breakfast and with dinner.

b.

at bedtime, because it works better on an empty stomach.

c.

with meals to decrease the risk of GI manifestations.

d.

one-to-two hours before meals or two-to-three hours after meals.

ANS: D

Feedback

A

Incorrect: Penicillin usually is administered every six hours, but this is determined by the health care provider.

B

Incorrect: This is not a nursing action. The time is determined by the prescriber.

C

Incorrect: Food may interfere with the absorption of oral penicillin.

D

Correct: Oral penicillin should be administered on an empty stomach, because food may interfere with the absorption of oral penicillin.

PTS: 1 REF: p. 200, Safe Nursing Practice 7-2

OBJ: Cognitive Level: Application

3. To reduce the possibility of local tissue reactions to intramuscular injection of penicillin, the nurse:

a.

replaces the needle that was used to withdraw medication from the vial.

b.

places pressure on the site following injection.

c.

uses a large-gauge needle for administration.

d.

uses a small-gauge needle for administration.

ANS: A

Feedback

A

Correct: If the needle is not changed, some medication adheres on the outside of the needle after withdrawal from the vial. This can cause local tissue reactions.

B

Incorrect: This will help prevent the medication from seeping out the injection hole.

C

Incorrect: This has no impact on preventing local tissue reactions.

D

Incorrect: This has no impact on preventing local tissue reactions.

PTS: 1 REF: p. 201 OBJ: Cognitive Level: Application

A nurse working in a physician’s office has frequent contact with persons taking antibiotics. In order to be prepared to instruct clients in the proper use of antibiotics and to alert them to potential problems, the nurse reviews the following information about antibiotic therapy.

4. Because of the likelihood of cross-sensitivity reaction, cephalosporins should be administered with extreme caution to clients with a history of allergic reaction to:

a.

aminoglycosides.

c.

penicillins.

b.

macrolides.

d.

tetracyclines.

ANS: C

Feedback

A

Incorrect: There is no cross-hypersensitivity between penicillins and aminoglycosides.

B

Incorrect: There is no cross-hypersensitivity between penicillins and macrolides.

C

Correct: Because cephalosporins were developed as offshoots of penicillins, there may be cross-sensitivities between penicillins and cephalosporins.

D

Incorrect: There is no cross-hypersensitivity between penicillins and tetracyclines.

PTS: 1 REF: p. 201, Safe Nursing Practice 7-3

OBJ: Cognitive Level: Comprehension

5. The likelihood of nephrotoxicity may be increased for clients taking cephalosporin antibiotics and:

a.

loop diuretics.

c.

vitamin C.

b.

sedatives.

d.

antacids.

ANS: A

Feedback

A

Correct: If a client is taking furosemide with either cephalosporins or aminoglycosides, the risk of nephrotoxicity is increased.

B

Incorrect: Sedatives do not increase the risk of nephrotoxicity when taken with cephalosporins.

C

Incorrect: Vitamin C does not relate to nephrotoxicity.

D

Incorrect: Antacids do not increase the risk of nephrotoxicity when taken with cephalosporins.

PTS: 1 REF: p. 201 OBJ: Cognitive Level: Comprehension

6. The absorption of most oral tetracyclines may be adversely affected by:

a.

vitamin C.

c.

pork.

b.

calcium-containing antacids.

d.

peppermint.

ANS: B

Feedback

A

Incorrect: Vitamin C does not affect tetracycline absorption.

B

Correct: Calcium, aluminum, or magnesium containing antacids or laxatives impair tetracycline absorption.

C

Incorrect: Consuming pork does not affect tetracycline absorption.

D

Incorrect: Peppermint does not affect tetracycline absorption.

PTS: 1 REF: p. 201 | p. 202, Safe Nursing Practice 7-4

OBJ: Cognitive Level: Comprehension

7. Tetracycline should not be given to:

a.

children under eight years.

c.

persons with hypertension.

b.

elderly persons.

d.

debilitated persons.

ANS: A

Feedback

A

Correct: Because of the effects on teeth and bone development, tetracycline should not be taken by children under the age of eight.

B

Incorrect: Tetracyclines are not contraindicated in the elderly.

C

Incorrect: Tetracyclines are not contraindicated in persons with hypertension.

D

Incorrect: Tetracyclines are not contraindicated in debilitated persons.

PTS: 1 REF: p. 202, Safe Nursing Practice 7-4

OBJ: Cognitive Level: Comprehension

8. A client is prescribed an aminoglycoside and the nurse understands that the usual route by which most aminoglycosides are administered is:

a.

oral.

c.

topical.

b.

parenteral.

d.

intrathecal.

ANS: B

Feedback

A

Incorrect: Except for oral neomycin and occasional topical aminoglycosides, most are administered parenterally.

B

Correct: Most aminoglycosides are administered parenterally.

C

Incorrect: Aminoglycosides are only occasionally used topically.

D

Incorrect: Aminoglycosides are rarely used intrathecally.

PTS: 1 REF: p. 202 OBJ: Cognitive Level: Knowledge

9. Clients taking aminoglycosides should have the functioning of the ____ tested before and during treatment.

a.

liver.

c.

ulnar nerve.

b.

eighth cranial nerve.

d.

vision.

ANS: B

Feedback

A

Incorrect: The primary adverse effect of aminoglycosides is ototoxicity.

B

Correct: This is to monitor for ototoxicity.

C

Incorrect: Aminoglycosides are not associated with peripheral neuropathy.

D

Incorrect: Aminoglycosides are not associated with visual changes.

PTS: 1 REF: p. 203, Safe Nursing Practice 7-5

OBJ: Cognitive Level: Application

10. Clients at risk of developing nephrotoxicity while taking aminoglycosides are:

a.

those with urinary tract infections (UTI).

b.

those who have upper respiratory infections (URI).

c.

those with dehydration.

d.

those being treated for sepsis.

ANS: C

Feedback

A

Incorrect: These clients are not at increased risk for nephrotoxicity. Aminoglycosides are used to treat some UTIs.

B

Incorrect: These clients are not at increased risk for nephrotoxicity.

C

Correct: Clients who are dehydrated are at increased risk for nephrotoxicity if taking aminoglycosides, because the dehydration decreases renal perfusion.

D

Incorrect: Aminoglycosides are used to treat sepsis.

PTS: 1 REF: p. 203 OBJ: Cognitive Level: Comprehension

11. Second-generation fluoroquinolones are frequently used to treat:

a.

genitourinary infections.

c.

colitis.

b.

upper respiratory infections.

d.

syphilis

ANS: A

Feedback

A

Correct: Ciprofloxacin is a commonly used antibiotic to treat UTIs.

B

Incorrect: Fluoroquinolones are used to treat lower respiratory infections.

C

Incorrect: Fluoroquinolones are not used to treat colitis.

D

Incorrect: Fluoroquinolones are not the drugs of choice for syphilis.

PTS: 1 REF: p. 168 OBJ: Cognitive Level: Comprehension

12. Carbapenems are contraindicated in clients with history of anaphylaxis with:

a.

fluoroquinolones.

c.

aminoglycosides.

b.

cephalosporins.

d.

all of the above.

ANS: B

Feedback

A

Incorrect: Carbapenems are contraindicated in clients with history of anaphylaxis with the use of penicillins, cephalosporins, or other beta-lactam antibiotics.

B

Correct: Carbapenems are contraindicated in clients with a history of anaphylaxis with the use of cephalosporins.

C

Incorrect: Carbapenems are contraindicated in clients with history of anaphylaxis with the use of penicillins, cephalosporins, or other beta-lactam antibiotics.

D

Incorrect: a and c are incorrect.

PTS: 1 REF: p. 168 OBJ: Cognitive Level: Knowledge

A client visits the local clinic complaining of weight loss, afternoon sweats, and a productive cough. A general workup is conducted, resulting in a diagnosis of tuberculosis. The client is given prescriptions for isoniazid (INH) and para-aminosalicylic acid (PAS) and asked to return to the clinic in two weeks.

13. The client asks why she will be taking two medications to treat her tuberculosis. The best response by the nurse is:

a.

“Clients tend to develop bacterial resistance when only one medication is used.”

b.

“Two medications are more effective against the tuberculosis organism.”

c.

“The client suffers fewer adverse side effects when two drugs are taken.”

d.

”Treatment with two drugs takes half the time.”

ANS: A

Feedback

A

Correct: Monotherapy is associated with the development of bacterial drug resistance.

B

Incorrect: Although this is true, this is not the primary reason for using duel therapy.

C

Incorrect: This is a false statement. Each medication carries its own adverse effects.

D

Incorrect: This is a false statement. Drug therapy for TB is long term.

PTS: 1 REF: p. 181 OBJ: Cognitive Level: Application

14. A client with TB is prescribed isoniazid (INH), rifampin, and pyridoxine. The nurse understands that pyridoxine is used in this combination to:

a.

increase the action of INH and rifampin.

b.

decrease the side effects of rifampin.

c.

prevent INH-induced peripheral neuropathy.

d.

increase the absorption of INH and rifampin.

ANS: C

Feedback

A

Incorrect: Pyridoxine does not increase the action of INH and rifampin.

B

Incorrect: Pyridoxine does not decrease the side effects of rifampin.

C

Correct: Pyridoxine is used to prevent peripheral neuropathy associated with decreased levels of pyridoxine caused by INH.

D

Incorrect: Pyridoxine does not increase INH or rifampin absorption.

PTS: 1 REF: p. 204, Safe Nursing Practice 7-6

OBJ: Cognitive Level: Comprehension

15. Some persons metabolize isoniazid (INH) more rapidly than others. It is important for the nurse to remember that:

a.

nearly all Caucasians and African Americans are rapid acetylators.

b.

nearly all Asians are slow acetylators.

c.

slow acetylators are more likely to experience drug toxicity.

d.

rapid acetylators have increased isoniazid effectiveness

ANS: C

Feedback

A

Incorrect: Fifty percent of Caucasians and African Americans are slow acetylators.

B

Incorrect: The majority of Asians and Eskimos are rapid acetylators.

C

Correct: Slow acetylators are more likely to have the drug accumulate in their bodies to toxic levels.

D

Incorrect: Regardless of how rapid or slowly INH is metabolized, it does not affects its effectiveness.

PTS: 1 REF: p. 181 OBJ: Cognitive Level: Comprehension

The client is an elderly man who experiences frequent bladder infections because of an enlarged prostate gland. On his last visit to the physician, he was prescribed a sulfonamide and methenamine mandelate (Mandelamine). In the past, the client has taken phenazopyridine (Pyridium) and nalidixic acid (NegGram) for treatment of these infections. The nurse provides instruction about fluid intake and appropriate administration of the medication, and advises the client to call if he has any problems.

16. Two days later, the client calls the nurse to report a sore throat, fever, and jaundice. The nurse should advise the client to:

a.

decrease the dose of the sulfonamide.

b.

go to bed and rest.

c.

call the health care provider tomorrow, if he feels worse.

d.

stop the sulfonamide and see the health care provider as soon as possible.

ANS: D

Feedback

A

Incorrect: The drug must be stopped, and the client should see his prescriber as soon as possible, as these may be manifestations of a blood dyscrasia.

B

Incorrect: This is not the appropriate advice.

C

Incorrect: This is not the appropriate advice.

D

Correct: The drug must be stopped and the client should see his prescriber as soon as possible, as these may be manifestations of a blood dyscrasia.

PTS: 1 REF: p. 204 OBJ: Cognitive Level: Application

17. Clients taking phenazopyridine (Pyridium) for the treatment of a urinary tract infection should be told:

a.

to limit their fluid intake.

b.

to avoid the use of acidic juices

c.

that their urine may decrease in volume.

d.

that their urine may turn orange-red.

ANS: D

Feedback

A

Incorrect: Clients taking antimicrobial agents for any type of infection should be encouraged to consume 3,000-4,000 mL of fluid/day.

B

Incorrect: Clients with urinary tract infections should be encouraged to drink acidic fluids to acidify the urine.

C

Incorrect: Phenazopyridine does not decrease urine output.

D

Correct: Phenazopyridine normally causes the client’s urine to turn orange-red, which may frighten the client (who may believe there is bleeding).

PTS: 1 REF: p. 205, Safe Nursing Practice 7-7

OBJ: Cognitive Level: Application

18. The nurse understands that the proper solution for administration of amphotericin B (Fungizone) is:

a.

normal saline.

c.

Ringer’s lactate.

b.

dextrose 5% in water.

d.

any sterile IV solution.

ANS: B

Feedback

A

Incorrect: Amphotericin B is incompatible with normal saline.

B

Correct: IV solutions of amphotericin should be added to infusion of dextrose and water only.

C

Incorrect: Amphotericin B is incompatible with LR.

D

Incorrect: IV solutions of amphotericin should be added to infusion of dextrose and water only.

PTS: 1 REF: p. 206, Safe Nursing Practice 7-8

OBJ: Cognitive Level: Application

19. The nurse should monitor clients receiving IV infusions of amphotericin B (Fungizone) for:

a.

hypernatremia.

c.

hypokalemia.

b.

respiratory acidosis.

d.

hypercalcemia.

ANS: C

Feedback

A

Incorrect: Amphotericin B is not associated with the development of hypernatremia.

B

Incorrect: Amphotericin B is not associated with the development of respiratory acidosis.

C

Correct: Clients receiving amphotericin B can develop hypokalemia.

D

Incorrect: Amphotericin B is not associated with the development of hypercalcemia.

PTS: 1 REF: p. 206, Safe Nursing Practice 7-8

OBJ: Cognitive Level: Application

20. Prior to administering vidarabine (Vira-A) to a client, the nurse should:

a.

inquire if the client is pregnant

c.

inquire if the client is allergic to eggs

b.

prepare to administer it orally

d.

prepare an intramuscular injection

ANS: A

Feedback

A

Correct: Vidarabine should not be administered to pregnant clients.

B

Incorrect: Vidarabine is administered intravenously.

C

Incorrect: Egg allergies do not pose a risk to a client receiving vidarabine.

D

Incorrect: Vidarabine is administered intravenously.

PTS: 1 REF: p. 207 OBJ: Cognitive Level: Application

A client is hospitalized several times over the course of six months with complications related to AIDS. The client has received medication for the treatment of viral and fungal diseases and is now using pentamidine (Nebupent) aerosol to prevent the development of Pneumocystis carinii pneumonia and also is taking zidovudine (Retrovir).

21. When preparing the client’s pentamidine (Nebupent) powder, the nurse:

a.

inserts the powder into the client’s nebulizer for inhalation.

b.

reconstitutes the powder with bacteriostatic sterile water.

c.

pours the powder into a medicine cup and mixes it with tap water.

d.

reconstitutes the powder with sterile bacteriostatic normal saline.

ANS: B

Feedback

A

Incorrect: Powder should not be inhaled by a client.

B

Correct: The powder should be reconstituted with 6 mL of bacteriostatic sterile water.

C

Incorrect: This medication is reconstituted using sterile technique.

D

Incorrect: The powder should not be reconstituted using normal saline.

PTS: 1 REF: p. 195 OBJ: Cognitive Level: Application

22. A client with HIV is prescribed pentamidine IM daily for 14 days. The client weighs 121 pounds. What dose should be prescribed for this client?

a.

4 mg

c.

220 mg

b.

55 mg

d.

500 mg

ANS: C

Feedback

A

Incorrect: This dose is too small.

B

Incorrect: This dose is too small.

C

Correct: The recommended dose of pentamidine IM is 4 mg/kg. Divide 121 pounds by 2.2 = 55 kg, then multiply 55 kg by 4 mg = 220 mg.

D

Incorrect: This is over twice the safe recommended dose.

PTS: 1 REF: p. 195 OBJ: Cognitive Level: Application

23. All of the following are true about zidovudine (Retrovir) except:

a.

it may cause anemia and low granulocyte counts.

b.

clients may develop flulike symptoms.

c.

clients cannot transmit HIV while taking zidovudine

d.

clients taking it should avoid the use of acetaminophen (Tylenol).

ANS: C

Feedback

A

Incorrect: This statement is true and client should be monitored for these adverse effects.

B

Incorrect: This statement is true.

C

Correct: Zidovudine is a virustatic agent not virucidal, so clients can still transmit HIV while receiving treatment.

D

Incorrect: This is a true statement.

PTS: 1 REF: p. 208 OBJ: Cognitive Level: Comprehension

24. Antimicrobial agents that inhibit growth of bacteria, allowing the host’s immunological defenses to complete the job of destroying the organism, are called:

a.

bactericidal.

c.

antibiotics.

b.

bacteriostatic.

d.

infectious.

ANS: B

Feedback

A

Incorrect: Bactericidal agents have a killing effect on bacteria.

B

Correct: Bacteriostatic agents inhibit the growth of bacteria, but do not actively kill the bacteria that are present.

C

Incorrect: Some antibiotics are bacteriocidal and some are bacteriostatic.

D

Incorrect: Antimicrobial agents are used to treat infectious diseases.

PTS: 1 REF: p. 150 OBJ: Cognitive Level: Knowledge

25. What is a major disadvantage of using broad-spectrum antibmicrobial agents to treat infections?

a.

They are only effective against a small number of microorganisms.

b.

They destroy normal flora, enabling superinfections to develop.

c.

They are especially effective against viruses.

d.

They are more likely to cause an allergic reaction.

ANS: B

Feedback

A

Incorrect: This is not a true statement.

B

Correct: This is the disadvantage the broad-spectrum antimicrobials.

C

Incorrect: Most of our broad-spectrum antimicrobials are antibacterials.

D

Incorrect: This is not a true statement.

PTS: 1 REF: p. 151 OBJ: Cognitive Level: Knowledge

26. It is generally not advisable to use a bactericidal and bacteriostatic agent at the same time because:

a.

the cost is prohibitive.

b.

both agents work in the same manner.

c.

the bacteriostatic agent may interfere with the action of the bactericidal agent.

d.

they will cause an allergic response in the client.

ANS: C

Feedback

A

Incorrect: This is not a true statement.

B

Incorrect: Bacteriostatic and bactericidal do not have the same action.

C

Correct: Bacteriostatic agents may interfere with the action of the bactericidal agents.

D

Incorrect: This is not necessarily true.

PTS: 1 REF: p. 150 OBJ: Cognitive Level: Knowledge

27. A client was admitted to the hospital with pneumonia. The client’s health care provider prescribes “Zinacef, (a second generation cephalosporin) 2 grams IV q8h.” While preparing to administer the first dose of Zinacef, the nurse notices that the client has a penicillin allergy. The best action by the nurse is to:

a.

administer the Zinacef as prescribed, but watch the client carefully for any signs of an allergic reaction.

b.

ask the pharmacist if another antibiotic can be substituted for the Zinacef.

c.

give the Zinacef as prescribed.

d.

hold the Zinacef and notify the health care provider of the client’s allergy to penicillin.

ANS: D

Feedback

A

Incorrect: It should be held until the nurse collaborate with the health care provider.

B

Incorrect: This is not the scope of practice for a pharmacist.

C

Incorrect: With an allergy to penicillin, there is an increased risk of allergic reactions to cephalosporin.

D

Correct: This is the appropriate action by the nurse.

PTS: 1 REF: p. 201, Safe Nursing Practice 7-3

OBJ: Cognitive Level: Application

28. A client is diagnosed with gram-negative sepsis. The nurse anticipates which of the following cephalosporin agents to be prescribed?

a.

cefepime HCl

c.

amikacin

b.

cephalexin

d.

cefozolin sodium

ANS: A

Feedback

A

Correct: Cefepime HCl is a fourth-generation cephalosporin. Fourth-generation cephalosporins are used against gram-negative infections.

B

Incorrect: Cephalexin is a first-generation cephalosporin used to treat gram-positive microorganisms.

C

Incorrect: Amikacin is an aminoglycoside.

D

Incorrect: Cefozolin sodium is a first-generation cephalosporin used to treat gram-positive microorganisms.

PTS: 1 REF: p. 164, Table 7-2

OBJ: Cognitive Level: Comprehension

29. The nurse is teaching a client about the risk of antibiotic-resistant microorganism. Which response by the client indicates that more teaching is needed?

a.

“I will be sure to complete my entire prescription.”

b.

“I will be sure to avoid direct sunlight until my doxycycline prescription is finished.”

c.

“I will watch for itching or a rash while I am taking penicillin V.”

d.

“If this medication doesn’t work within five days, I will quit taking it and make an appointment with my doctor.”

ANS: D

Feedback

A

Incorrect: This is evidence of client understanding.

B

Incorrect: This is evidence of client understanding.

C

Incorrect: This is evidence of client understanding.

D

Correct: Clients should not stop taking an antibiotic without the direction of their health care provider.

PTS: 1 REF: p. 198, Box 7-1 OBJ: Cognitive Level: Evaluation

30. For a client receiving tetracycline, the nurse needs to instruct to:

a.

take medication with meals.

b.

have potassium level checked.

c.

avoid juices when taking this drug.

d.

take medication one-to-two hours before or two-to-three hours after meals.

ANS: A

Feedback

A

Correct: Tetracyclines should not be taken on an empty stomach.

B

Incorrect: Oral penicillin may alter potassium levels, but taking penicillin does not require a potassium level to be drawn.

C

Incorrect: Juices do not need to be avoided when taking tetracyclines.

D

Incorrect: Tetracyclines should not be taken on an empty stomach.

PTS: 1 REF: p. 202, Safe Nursing Practice 7-4

OBJ: Cognitive Level: Application

31. A client with cystic fibrosis is being treated with IV ceftazidime and gentamicin. The nurse should:

a.

isolate the client.

c.

instruct the client to avoid sunlight.

b.

monitor for nephrotoxicity.

d.

perform a hearing test.

ANS: B

Feedback

A

Incorrect: There is no evidence that the client requires isolation.

B

Correct: The use of a cephalosporin and aminoglycoside increases the risk of nephrotoxicity.

C

Incorrect: These medications do not cause photosensitivity.

D

Incorrect: Gentamicin can cause ototoxicity, but this does not increase with the concurrent use of a cephalosporin.

PTS: 1 REF: p. 201 OBJ: Cognitive Level: Application

32. When teaching a client taking ciprofloxacin (Cipro), the nurse should instruct the client to avoid:

a.

taking the medication with meals.

b.

antacids four hours before and two hours after oral dosing.

c.

direct sunlight.

d.

taking medication with vitamins without iron.

ANS: B

Feedback

A

Incorrect: Taking Cipro with meals will decrease the N/V (nausea and vomiting) associated with this drug.

B

Correct: Antacids interfere with the absorption of ciprofloxacin.

C

Incorrect: Ciprofloxacin is not associated with photosensitivity.

D

Incorrect: Cipro should not be taken with iron.

PTS: 1 REF: p. 170 OBJ: Cognitive Level: Application

33. A client is prescribed azithromycin for a respiratory infection. The nurse understands that this agent is a:

a.

fluoroquinolone.

c.

carbapenem.

b.

tetracycline.

d.

macrolide.

ANS: D

Feedback

A

Incorrect: Azithromycin is a macrolide antimicrobial.

B

Incorrect: Azithromycin is a macrolide antimicrobial.

C

Incorrect: Azithromycin is a macrolide antimicrobial.

D

Correct: Azithromycin is a macrolide antimicrobial.

PTS: 1 REF: p. 160 | p. 167, Table 7-4 OBJ: Cognitive Level: Knowledge

34. A nurse working in a health care providers office sees a number of cases of the most common tick-transmitted disease, which is:

a.

Rocky Mountain spotted fever (RMSF).

b.

Lyme disease.

c.

aspergillosis.

d.

histoplasmosis.

ANS: B

Feedback

A

Incorrect: Although tick-transmitted, RMSF is not the most common.

B

Correct: Lyme disease is the most common tick-transmitted disease in the U.S.

C

Incorrect: This is a fungal disease.

D

Incorrect: This is a fungal disease.

PTS: 1 REF: p. 181 OBJ: Cognitive Level: Knowledge

35. When preparing amphotericin B, the nurse understands it:

a.

should never be reconstituted with a solution containing a bacteriostatic agent.

b.

should always be reconstituted with bacteriostatic 5% dextrose in water.

c.

usually has a precipitate in the solution, so this is not an abnormal finding and should be administered.

d.

seldom causes phlebitis in peripheral intravenous access.

ANS: A

Feedback

A

Correct: Amphotericin B should not be reconstituted with saline or sterile water containing a bacteriostatic agent.

B

Incorrect: Amphotericin is not reconstituted with 5% dextrose in water.

C

Incorrect: Never use a solution of amphotericin that contains a precipitate.

D

Incorrect: Amphotericin is caustic to peripheral veins, so they should be monitored for phlebitis.

PTS: 1 REF: p. 206, Safe Nursing Practice 7-8

OBJ: Cognitive Level: Comprehension