59 Questions
Which laboratory values will the nurse expect to monitor while caring for a patient receiving a high tetracycline dose?
Blood urea nitrogen (BUN) and creatinine levels
What information will the nurse include when teaching a female patient about taking doxycycline to treat a sexually transmitted infection (STI)?
Use a backup method of contraception if taking oral contraceptives.
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.
Which of the following statements about tetracyclines is correct?
Tetracyclines should be used with caution in pregnancy.
Which laboratory test would the nurse expect to monitor in a patient receiving high-dose tetracycline?
Blood urea nitrogen and creatinine
What is the most important recommendation the nurse should provide to a patient taking doxycycline while also taking oral contraceptives?
Use a backup method of contraception while taking doxycycline.
What should the nurse do when changes in urine output occur while a patient is receiving gentamicin?
Hold the dose and contact the provider to request a serum trough drug level
What is the appropriate action for the nurse if a patient receiving gentamicin reports experiencing ringing in the ears?
Obtain a serum drug level
What is the correct dosing regimen for a 70-kg patient receiving gentamicin 85 mg 4 times daily?
$5 mg/kg/day$ in 4 divided doses
When preparing to begin a medication regimen for a patient receiving intravenous ampicillin and gentamicin, what is the primary concern the nurse should have?
Monitoring for nephrotoxicity
What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?
To assess for potential nephrotoxicity
Which of the following is the best way for the nurse to monitor for potential nephrotoxicity in a patient receiving gentamicin?
Hold the dose and contact the provider to request a serum trough drug level
Which of the following is the primary mechanism of action for verapamil?
Relaxing coronary arteries
If a patient on nifedipine experiences recurrent low blood pressure, what action should the provider take?
Switch to diltiazem
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?
Do not administer the digoxin and notify the provider of toxic digoxin levels
Which of the following statements about calcium channel blockers is true?
They can cause hypotension as a side effect
What is the therapeutic range for serum digoxin levels?
0.8 - 2.0 ng/mL
Which medication is least likely to cause hypotension as a side effect?
Diltiazem
Which of the following statements about broad-spectrum antibiotics is correct?
They are effective against a wide range of bacteria.
What is the appropriate action for a patient experiencing diarrhea while taking amoxicillin?
Discontinue the antibiotic immediately and contact the provider.
If a patient develops a rash while taking an antibiotic, what is the appropriate action?
Stop taking the antibiotic and contact the provider.
Which statement about saving unused antibiotics is correct?
Unused antibiotics should be discarded after the prescribed course.
If a patient previously experienced a rash when taking amoxicillin, what is the appropriate action before administering ceftriaxone?
Do not administer ceftriaxone and consult the provider for an alternative antibiotic.
Which of the following statements about narrow-spectrum antibiotics is correct?
They are usually prescribed when culture and sensitivity results indicate their effectiveness.
Which medication group does fluconazole belong to that can increase the risk of hypoglycemia when taken with oral sulfonylureas?
Antifungals
Which type of viruses are purine nucleoside antiviral medications primarily used to treat?
Herpes viruses
For an immunocompetent patient diagnosed with herpes zoster virus, what is the correct dosage and frequency of oral acyclovir?
800 mg five times daily for 7 to 10 days
Which statement is TRUE regarding the transmission of herpes virus while taking acyclovir?
The risk of transmitting herpes virus is reduced while taking acyclovir
Which side effect should the nurse inform a patient about when teaching them about acyclovir?
Nausea and vomiting are common side effects
What should the nurse monitor in a patient taking both oral sulfonylureas and fluconazole?
Blood glucose levels
Which foods should the nurse instruct the patient to avoid while taking amoxicillin?
Acidic fruits and juices
What action should the nurse take when the nurse notes that the penicillin G procaine solution is milky in color?
Administer the medication as ordered by the physician
Which of the following actions can contribute to bacterial resistance to antibiotics?
Frequent use of antibiotics
Which of the following statements about the use of antibiotics is true?
Taking a full course of antibiotics as prescribed is important to prevent resistance
What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?
To monitor for potential nephrotoxicity
Which statement is TRUE regarding the transmission of herpes virus while taking acyclovir?
Acyclovir can reduce the risk of transmission, but does not eliminate it completely
What is the reason for obtaining an order for INR testing when a macrolide is used with other drugs?
To monitor serum drug levels
Why should the nurse question the order of erythromycin for a patient who will take fluconazole?
Erythromycin blood concentration increases
Why would a provider order serum drug peak and trough levels for a patient receiving an intravenous antibiotic?
To optimize dosing and prevent toxicity
What should the nurse consider when a patient mentions developing vaginal yeast infections with antibiotics?
Potential drug interactions
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?
Consult the provider for an alternative antibiotic
Why would continuous cardiovascular monitoring not be necessary in the case of using macrolides?
Because macrolides do not affect the heart rhythm significantly
Which statement by the nurse is correct when teaching the patient about taking levofloxacin with their other medications?
You should monitor your serum glucose more closely while taking levofloxacin.
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?
Report a possible superinfection to the provider.
What medication group does fluconazole belong to that can increase the risk of hypoglycemia when taken with oral sulfonylureas?
Antifungals
Which statement about saving unused antibiotics is correct?
Unused antibiotics should be disposed of properly.
Which type of viruses are purine nucleoside antiviral medications primarily used to treat?
Herpes viruses
Which statement about the transmission of herpes virus while taking acyclovir is TRUE?
Acyclovir reduces the risk of transmission, but does not eliminate it.
What is the correct dosage for the child in milliliters (mL) per dose according to the text?
5 mL PO BID
If bacterial resistance develops to isoniazid in a patient with tuberculosis, which drug is typically ordered to replace isoniazid?
Ethambutol
In the treatment of active tuberculosis, which drug is the drug of choice for prophylactic treatment of family members according to the text?
Isoniazid
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?
Pyridoxine (vitamin B6)
Which of the following drugs would NOT be considered a first-line antitubercular drug according to the text?
Ciprofloxacin
What is an important aspect of care for an 80-year-old patient who has just started a thiazide diuretic to treat hypertension?
Initiating a fall risk protocol
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?
Contact the provider to discuss another type of antihypertensive medication
Which statement is true regarding the use of diuretics in the treatment of hypertension in African American patients?
Hypertension in African American patients can be controlled by combining beta blockers with diuretics
If a patient on nifedipine (a calcium channel blocker) experiences recurrent low blood pressure, what action should the provider take?
Discontinue the nifedipine and start a different antihypertensive medication
Which of the following statements about narrow-spectrum antibiotics is correct?
Narrow-spectrum antibiotics are less likely to contribute to antibiotic resistance
What is the primary reason the nurse should contact the provider to request a serum trough drug level for a patient receiving gentamicin?
To ensure the patient is receiving an appropriate dose
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.
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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