Nursing Quiz: Antibiotics and Vaccines
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Questions and Answers

Which laboratory values will the nurse expect to monitor while caring for a patient receiving a high tetracycline dose?

  • Prothrombin time
  • Electrolytes
  • Complete blood counts
  • Blood urea nitrogen (BUN) and creatinine levels (correct)

    • What information will the nurse include when teaching a female patient about taking doxycycline to treat a sexually transmitted infection (STI)?

  • Increase intake of dairy products with each dose of this medication.
  • The drug is a preferred antibiotic in pregnancy.
  • Use a backup method of contraception if taking oral contraceptives. (correct)
  • Nausea and vomiting are uncommon adverse effects.

    • The nurse is preparing to administer an infant a maintenance dose of intravenous gentamicin through an intermittent needle. The nurse notes that the infant has not had a wet diaper for several hours. Which action will the nurse perform?

  • Delay the administration of gentamicin until the infant's urine output improves. (correct)
  • Administer a bolus of intravenous fluids before giving the gentamicin.
  • Administer the gentamicin as scheduled.
  • Increase the dose of gentamicin to compensate for the decreased urine output.

    • Which of the following statements about tetracyclines is correct?

    <p>Tetracyclines should be used with caution in pregnancy.</p> Signup and view all the answers

    Which laboratory test would the nurse expect to monitor in a patient receiving high-dose tetracycline?

    <p>Blood urea nitrogen and creatinine</p> Signup and view all the answers

    What is the most important recommendation the nurse should provide to a patient taking doxycycline while also taking oral contraceptives?

    <p>Use a backup method of contraception while taking doxycycline.</p> Signup and view all the answers

    What should the nurse do when changes in urine output occur while a patient is receiving gentamicin?

    <p>Hold the dose and contact the provider to request a serum trough drug level</p> Signup and view all the answers

    What is the appropriate action for the nurse if a patient receiving gentamicin reports experiencing ringing in the ears?

    <p>Obtain a serum drug level</p> Signup and view all the answers

    What is the correct dosing regimen for a 70-kg patient receiving gentamicin 85 mg 4 times daily?

    <p>$5 mg/kg/day$ in 4 divided doses</p> Signup and view all the answers

    When preparing to begin a medication regimen for a patient receiving intravenous ampicillin and gentamicin, what is the primary concern the nurse should have?

    <p>Monitoring for nephrotoxicity</p> Signup and view all the answers

    What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?

    <p>To assess for potential nephrotoxicity</p> Signup and view all the answers

    Which of the following is the best way for the nurse to monitor for potential nephrotoxicity in a patient receiving gentamicin?

    <p>Hold the dose and contact the provider to request a serum trough drug level</p> Signup and view all the answers

    Which of the following is the primary mechanism of action for verapamil?

    <p>Relaxing coronary arteries</p> Signup and view all the answers

    If a patient on nifedipine experiences recurrent low blood pressure, what action should the provider take?

    <p>Switch to diltiazem</p> Signup and view all the answers

    A patient has a serum digoxin level of 2.5 ng/mL while taking 0.25 mg of digoxin daily. What should the nurse do?

    <p>Do not administer the digoxin and notify the provider of toxic digoxin levels</p> Signup and view all the answers

    Which of the following statements about calcium channel blockers is true?

    <p>They can cause hypotension as a side effect</p> Signup and view all the answers

    What is the therapeutic range for serum digoxin levels?

    <p>0.8 - 2.0 ng/mL</p> Signup and view all the answers

    Which medication is least likely to cause hypotension as a side effect?

    <p>Diltiazem</p> Signup and view all the answers

    Which of the following statements about broad-spectrum antibiotics is correct?

    <p>They are effective against a wide range of bacteria.</p> Signup and view all the answers

    What is the appropriate action for a patient experiencing diarrhea while taking amoxicillin?

    <p>Discontinue the antibiotic immediately and contact the provider.</p> Signup and view all the answers

    If a patient develops a rash while taking an antibiotic, what is the appropriate action?

    <p>Stop taking the antibiotic and contact the provider.</p> Signup and view all the answers

    Which statement about saving unused antibiotics is correct?

    <p>Unused antibiotics should be discarded after the prescribed course.</p> Signup and view all the answers

    If a patient previously experienced a rash when taking amoxicillin, what is the appropriate action before administering ceftriaxone?

    <p>Do not administer ceftriaxone and consult the provider for an alternative antibiotic.</p> Signup and view all the answers

    Which of the following statements about narrow-spectrum antibiotics is correct?

    <p>They are usually prescribed when culture and sensitivity results indicate their effectiveness.</p> Signup and view all the answers

    Which medication group does fluconazole belong to that can increase the risk of hypoglycemia when taken with oral sulfonylureas?

    <p>Antifungals</p> Signup and view all the answers

    Which type of viruses are purine nucleoside antiviral medications primarily used to treat?

    <p>Herpes viruses</p> Signup and view all the answers

    For an immunocompetent patient diagnosed with herpes zoster virus, what is the correct dosage and frequency of oral acyclovir?

    <p>800 mg five times daily for 7 to 10 days</p> Signup and view all the answers

    Which statement is TRUE regarding the transmission of herpes virus while taking acyclovir?

    <p>The risk of transmitting herpes virus is reduced while taking acyclovir</p> Signup and view all the answers

    Which side effect should the nurse inform a patient about when teaching them about acyclovir?

    <p>Nausea and vomiting are common side effects</p> Signup and view all the answers

    What should the nurse monitor in a patient taking both oral sulfonylureas and fluconazole?

    <p>Blood glucose levels</p> Signup and view all the answers

    Which foods should the nurse instruct the patient to avoid while taking amoxicillin?

    <p>Acidic fruits and juices</p> Signup and view all the answers

    What action should the nurse take when the nurse notes that the penicillin G procaine solution is milky in color?

    <p>Administer the medication as ordered by the physician</p> Signup and view all the answers

    Which of the following actions can contribute to bacterial resistance to antibiotics?

    <p>Frequent use of antibiotics</p> Signup and view all the answers

    Which of the following statements about the use of antibiotics is true?

    <p>Taking a full course of antibiotics as prescribed is important to prevent resistance</p> Signup and view all the answers

    What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?

    <p>To monitor for potential nephrotoxicity</p> Signup and view all the answers

    Which statement is TRUE regarding the transmission of herpes virus while taking acyclovir?

    <p>Acyclovir can reduce the risk of transmission, but does not eliminate it completely</p> Signup and view all the answers

    What is the reason for obtaining an order for INR testing when a macrolide is used with other drugs?

    <p>To monitor serum drug levels</p> Signup and view all the answers

    Why should the nurse question the order of erythromycin for a patient who will take fluconazole?

    <p>Erythromycin blood concentration increases</p> Signup and view all the answers

    Why would a provider order serum drug peak and trough levels for a patient receiving an intravenous antibiotic?

    <p>To optimize dosing and prevent toxicity</p> Signup and view all the answers

    What should the nurse consider when a patient mentions developing vaginal yeast infections with antibiotics?

    <p>Potential drug interactions</p> Signup and view all the answers

    Which action should the nurse take if a patient is allergic to penicillin and needs to start a lower respiratory tract infection antibiotic that may cause a yeast infection?

    <p>Consult the provider for an alternative antibiotic</p> Signup and view all the answers

    Why would continuous cardiovascular monitoring not be necessary in the case of using macrolides?

    <p>Because macrolides do not affect the heart rhythm significantly</p> Signup and view all the answers

    Which statement by the nurse is correct when teaching the patient about taking levofloxacin with their other medications?

    <p>You should monitor your serum glucose more closely while taking levofloxacin.</p> Signup and view all the answers

    Which action will the nurse perform when a female patient taking trimethoprim–sulfamethoxazole (TMP–SMZ) to treat a urinary tract infection reports vaginal itching and discharge?

    <p>Report a possible superinfection to the provider.</p> Signup and view all the answers

    What medication group does fluconazole belong to that can increase the risk of hypoglycemia when taken with oral sulfonylureas?

    <p>Antifungals</p> Signup and view all the answers

    Which statement about saving unused antibiotics is correct?

    <p>Unused antibiotics should be disposed of properly.</p> Signup and view all the answers

    Which type of viruses are purine nucleoside antiviral medications primarily used to treat?

    <p>Herpes viruses</p> Signup and view all the answers

    Which statement about the transmission of herpes virus while taking acyclovir is TRUE?

    <p>Acyclovir reduces the risk of transmission, but does not eliminate it.</p> Signup and view all the answers

    What is the correct dosage for the child in milliliters (mL) per dose according to the text?

    <p>5 mL PO BID</p> Signup and view all the answers

    If bacterial resistance develops to isoniazid in a patient with tuberculosis, which drug is typically ordered to replace isoniazid?

    <p>Ethambutol</p> Signup and view all the answers

    In the treatment of active tuberculosis, which drug is the drug of choice for prophylactic treatment of family members according to the text?

    <p>Isoniazid</p> Signup and view all the answers

    In a patient receiving antitubercular treatment for latent TB who develops peripheral neuropathy, what medication is initiated to counter this condition according to the text?

    <p>Pyridoxine (vitamin B6)</p> Signup and view all the answers

    Which of the following drugs would NOT be considered a first-line antitubercular drug according to the text?

    <p>Ciprofloxacin</p> Signup and view all the answers

    What is an important aspect of care for an 80-year-old patient who has just started a thiazide diuretic to treat hypertension?

    <p>Initiating a fall risk protocol</p> Signup and view all the answers

    What action should the nurse take when caring for a patient with a history of asthma and diabetes who will begin taking propranolol to treat hypertension?

    <p>Contact the provider to discuss another type of antihypertensive medication</p> Signup and view all the answers

    Which statement is true regarding the use of diuretics in the treatment of hypertension in African American patients?

    <p>Hypertension in African American patients can be controlled by combining beta blockers with diuretics</p> Signup and view all the answers

    If a patient on nifedipine (a calcium channel blocker) experiences recurrent low blood pressure, what action should the provider take?

    <p>Discontinue the nifedipine and start a different antihypertensive medication</p> Signup and view all the answers

    Which of the following statements about narrow-spectrum antibiotics is correct?

    <p>Narrow-spectrum antibiotics are less likely to contribute to antibiotic resistance</p> Signup and view all the answers

    What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?

    <p>To ensure the patient is receiving an appropriate dose</p> Signup and view all the answers

    Study Notes

    Administering Medication

    • When administering gentamicin, it's essential to contact the provider to request intravenous fluids to be added to prevent nephrotoxicity, and obtain a serum trough drug level to ensure the drug is not toxic.

    Gentamicin and Ototoxicity

    • Gentamicin can cause ototoxicity, and any changes in hearing should be reported to the provider so that serum drug levels can be monitored.

    Tetracycline and Nephrotoxicity

    • High doses of tetracycline can lead to nephrotoxicity, especially when given with other nephrotoxic drugs, and renal function tests should be performed to monitor for nephrotoxicity.

    Doxycycline and Contraception

    • Doxycycline can reduce the effectiveness of oral contraceptives, so patients taking oral contraceptives should be advised to use a backup method of contraception while taking doxycycline.

    Gentamicin and Renal Function

    • When a patient has not had a wet diaper for several hours, the nurse should notify the provider to request a serum trough drug level to ensure the drug is not toxic and to monitor for nephrotoxicity.

    Calcium Channel Blockers

    • Calcium channel blockers, such as nifedipine, can cause hypotension, and diltiazem is less likely to cause hypotension.

    Digoxin and Serum Levels

    • The therapeutic range of digoxin is between 0.8 and 2 ng/mL, and if the serum level is above 2 ng/mL, the nurse should not administer the next dose and notify the provider of toxic digoxin levels.

    Fluconazole and Sulfonylureas

    • Fluconazole can increase the risk of hypoglycemia when taken with oral sulfonylureas, so the patient's blood glucose should be monitored during treatment.

    Purine Nucleoside Antivirals

    • Purine nucleosides, such as acyclovir, treat herpes simplex viruses (HSV-1, HSV-2) and varicella-zoster viruses (chickenpox and shingles).

    Acyclovir and Herpes Zoster

    • The correct dose of acyclovir for herpes zoster is 800 mg 5 times daily for 7 to 10 days.

    TMP-SMX and Tuberculosis

    • If bacterial resistance to isoniazid develops, the first phase may be changed to ethambutol, rifampin, and pyrazinamide.

    Isoniazid and Peripheral Neuropathy

    • Isoniazid can cause peripheral neuropathy, and pyridoxine (vitamin B6) may be prescribed to treat it.

    Antitubercular Treatment

    • Isoniazid is the drug of choice for the prophylactic treatment of TB.

    Levofloxacin and Interactions

    • Levofloxacin may increase the effects of oral hypoglycemic medications, so patients should be advised to monitor their glucose levels closely.
    • Antacids decrease the absorption of levofloxacin and should be given 2 hours before or after the antibiotic.
    • NSAIDs taken with levofloxacin can cause central nervous system reactions, including seizures.

    Trimethoprim-Sulfamethoxazole (TMP-SMZ) and Vaginal Infections

    • TMP-SMZ can cause vaginal itching and discharge, and the patient may be treated with an antifungal medication.

    Amoxicillin and Food Interactions

    • Amoxicillin may be less effective when taken with acidic fruit or juice, so patients should be advised to avoid acidic fruits and juices.

    Penicillin G Procaine and Appearance

    • Penicillin G procaine has a milky appearance, which is normal.

    Antibiotic Resistance

    • Frequent use of antibiotics, skipping doses, and treating viral infections with antibiotics can contribute to bacterial resistance.

    Macrolides and Interactions

    • Macrolides, such as clarithromycin, can increase serum levels of other drugs, such as warfarin, and INR testing is warranted.
    • Erythromycin should be used with caution when given concurrently with fluconazole, as it can increase the risk of sudden cardiac death.

    Thiazide Diuretics and Fall Risk

    • Older patients taking thiazide diuretics experience a higher risk of orthostatic hypotension and fall risk, and a fall risk protocol should be implemented.

    Propranolol and Contraindications

    • Propranolol should be used with caution in patients with a history of asthma and diabetes.

    Broad-Spectrum Antibiotics

    • Broad-spectrum antibiotics are frequently used to treat infections when the offending organism is not identified by culture and sensitivity (C&S).

    Amoxicillin and Patient Education

    • Patients should be advised to take the full course of antibiotics, even if symptoms improve, and not to save any unused antibiotic for future use.

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    Exam 3 - NSG 318 Questions.docx

    Description

    Test your knowledge on nursing practices by identifying which medication a nurse would expect a patient's provider to order. Learn about the use of broad-spectrum antibiotics, narrow-spectrum antibiotics, and vaccines like the pneumococcal vaccine.

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