NURS 6521 QUIZ WEEK 8 QUESTIONS WITH ANSWERS

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 Question 1 1 out of 1 points A patient has been admitted to the critical care unit of the hospital with bacterial septicemia that has failed to respond to initial antibiotic treatment. The pati... ent's most recent blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA) in the patient's blood. The nurse will anticipate that this patient will likely require intravenous administration of what antibiotic? Selected Answer: D. Vancomycin Correct Answer: D. Vancomycin Response Feedback: Vancomycin is used in treating bacterial septicemia, endocarditis, bone and joint infections, and pseudomembranous colitis caused by Clostridium difficile. Vancomycin is exceptionally effective for treating gram-positive infections in penicillin-allergic patients. It is also used for penicillin- and methicillin-resistant staphylococcal infections. Doripenem (Doribax) is used for abdominal or urinary tract infections and neither penicillin G nor cefazolin is effective in the treatment of MRSA infections.  Question 2 1 out of 1 points A patient has been prescribed daptomycin for a complicated skin infection. Which of the following will the nurse advise the patient to report immediately? Selected Answer: B. Muscle pain or tingling Correct Answer: B. Muscle pain or tingling Response Feedback: The nurse should teach the patient the importance of reporting diarrhea, muscle pain and tingling, and fatigue immediately because these signs and symptoms can indicate potentially severe adverse effects. Nausea and vomiting, palpitations, and abdominal pain are all adverse effects of ciprofloxacin.  Question 3 0 out of 1 points A patient is being treated for Mycoplasma pneumoniae pneumonia. She is allergic to penicillin NURS 6521 QUIZ WEEK 8 QUESTIONS WITH ANSWERS and is being given azithromycin (Zithromax) in capsule form. The nurse will inform the patient that she will need to take the capsule Selected Answer: C. with or without food. Correct Answer: B. on an empty stomach. Response Feedback: Because the absorption of azithromycin capsules is decreased in the presence of food, azithromycin capsules should be taken on an empty stomach rather than after a meal. Unlike azithromycin capsules, azithromycin tablets have an increased absorption when given with a meal with high fat content and may be given with or without food.  Question 4 1 out of 1 points Which of the following is critical to helping prevent development of resistant strains of microbes in patients? Selected Answer: A. Maintain the optimum duration of the antimicrobial agent Correct Answer: A. Maintain the optimum duration of the antimicrobial agent Response Feedback: Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of these agents to the treatments of specific pathogens known to be sensitive to the drug being used. Drug dosages are also important in preventing the development of resistance. However, the duration of drug use is critical to ensure that microbes are completely eliminated and not given the chance to grow and develop resistant strains. It is hard to convince patients that the timing of the dose and length of time they continue to take the drug are important. Patients who stop the drug when they start to feel better encourage the emergence of resistant strains.  Question 5 1 out of 1 points A nurse is providing education to a patient who is taking INH. The nurse will advise the patient to avoid which of the following foods? Selected Answer: D. Cheese, dairy products, and bananas Correct Answer: D. Cheese, dairy products, and bananas Response Feedback: Patients who take INH should avoid eating tyramine, histamine-rich foods, and foods containing caffeine. Also, the patient should be told to avoid consuming alcohol on a daily basis. Cheese, dairy products, chicken liver, beer, ale, bananas, and figs are rich in tyramine. Tuna, brine, and yeast extracts are rich in histamine. Patients need not refrain from eating potatoes, root vegetables, chicken, fish, or citrus fruits.  Question 6 1 out of 1 points A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the patient's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Selected Answer: D. The use of ciprofloxacin is contraindicated in pregnancy. Correct Answer: D. The use of ciprofloxacin is contraindicated in pregnancy. Response Feedback: Ciprofloxacin is contraindicated in patients who are pregnant or lactating. Alternative routes and dosages do not mitigate the risks during pregnancy.  Question 7 1 out of 1 points A patient is taking rifampin (Rifadin) for active TB. When discussing this drug with the patient, the nurse should stress that Selected Answer: D. body fluids such as urine, saliva, tears, and sputum may become discolored. Correct Answer: D. body fluids such as urine, saliva, tears, and sputum may become discolored. Response Feedback: Rifampin can discolor body fluids red–orange. The patient should be informed that this is an expected adverse effect and is harmless. However, wearers of soft contact lenses should be cautioned that the lenses may be permanently discolored and that hard contacts or regular glasses should be used during the therapy. Although rifampin is often well tolerated, it may cause GI disturbances such as nausea and vomiting, anorexia, flatulence, cramps, and diarrhea. Cardiac arrhythmias, seizures, and facial flushing are not typically associated with the use of this drug.  Question 8 1 out of 1 points An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with Selected Answer: D. vancomycin. Correct Answer: D. vancomycin. Response Feedback: Vancomycin is the drug of choice to manage infections caused by MRSA. MRSA is resistant to all of the antistaphylococcic penicillins, as well as to ciprofloxacin and clindamycin.  Question 9 1 out of 1 points A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results? Selected Answer: A. Serum alanine transaminase, aspartate transaminase, and bilirubin Correct Answer: A. Serum alanine transaminase, aspartate transaminase, and bilirubin Response Feedback: The major adverse effect of INH therapy is hepatotoxicity. In hepatotoxicity the hepatic enzyme levels of aspartate transaminase and alanine transaminase will be elevated. Bilirubin will also be elevated, and the patient may present with jaundice. Red and white blood counts and differential would indicate possible hematologic effects, which could be considered adverse effects of the drug therapy, but would not be diagnostic for hepatotoxicity. Thyroid-stimulating hormone, thyroxine, and triiodothyronine levels would indicate a thyroid glandular concern, not hepatotoxicity. Fasting blood sugar and 2-hour postprandial blood sugar would be indicative of diabetes, not hepatotoxicity.  Question 10 0 out of 1 points A nurse is caring for a patient who is on amphotericin B. On morning rounds the patient reports weakness, numbness, and a tingling sensation in his feet. What would be a priority action by the nurse? Selected Answer: B. Reduce the drug dosage Correct Answer: C. Keep the bed in a low position and the side rails up at all times. Response Feedback: For the patient with sensory-perceptual disturbances, such as numbness and a tingling sensation, or weakness, the nurse should make sure that the patient understands the need to ask for assistance when getting out of bed. The patient's bed should be kept low, and the side rails should be kept up at all times. Using aseptic technique is essential to reduce the risk of infection, and increased fluid intake is advised in amphotericin B therapy, but these would not help relieve the patient's symptoms or provide a measure of patient safety.  Question 11 1 out of 1 points A 34-year-old male has been diagnosed with TB and will be started on INH therapy. The medication history reveals that he currently takes antacids on a regular basis. The nurse will instruct the patient to take Selected Answer: D. antacids not less than 1 hour before or 2 hours after taking INH. Correct Answer: D. antacids not less than 1 hour before or 2 hours after taking INH. Response Feedback: The patient should take antacids not less than 1 hour before or 2 hours after taking INH. INH should not be taken with meals unless the patient has gastrointestinal distress. It does not matter when INH or the antacid is taken during the day as long as the time frame is appropriate.  Question 12 1 out of 1 points A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity? Selected Answer: A. A drug harms microbes without harming human cells. Correct Answer: A. A drug harms microbes without harming human cells. Response Feedback: An important principle of antimicrobial therapy is selective toxicity, which is the ability to suppress or kill an infecting microbe without injury to the host. This concept does not denote dose-dependent effects, the ability to culture a microorganism, or the production of a drug.  Question 13 1 out of 1 points A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment? Selected Answer: D. The importance of vigilant hygiene for the boy and the other members of the family Correct Answer: D. The importance of vigilant hygiene for the boy and the other members of the family Response Feedback: It is important to teach patients who are being treated for helminthic infections about hygiene (such as laundering infested bed linens and undergarments daily) and other measures that help prevent reinfection. However, neither prescription skin cleansers nor antibiotics are indicated. Serial stool samples do not reduce the chance of reinfection.  Question 14 1 out of 1 points A 15-year-old patient has meningitis caused by Haemophilus influenzae. She is being treated with chloramphenicol. The most important nursing action for this patient would be to monitor Selected Answer: D. plasma concentrations regularly. Correct Answer: D. plasma concentrations regularly. Response Feedback: Plasma concentrations should be monitored at least weekly in patients who are on chloramphenicol therapy. It would be important for the nurse to monitor daily urine output with any drug therapy. An increase or decrease in output could indicate pathology. Also, it would be important for the nurse to monitor blood sugar levels and liver enzymes, but not because the patient is taking chloramphenicol.  Question 15 1 out of 1 points A patient has been admitted to the critical care unit with a diagnosis of peritonitis that has necessitated treatment with gentamicin. As a result, the care team should be cautious when concurrently administering other medications that may cause Selected Answer: D. ototoxicity or nephrotoxicity. Correct Answer: D. ototoxicity or nephrotoxicity. Response Feedback: Because of the potential for nephrotoxicity and ototoxicity that is associated with gentamicin, other medications that may lead to these same adverse effects must be used with caution. Gentamicin does not typically affect immune function, ICP, or hematopoiesis.  Question 16 0 out of 1 points Sulconazole has been prescribed for a patient with tinea pedis. The nurse will instruct the patient to use the topical agent Selected Answer: A. twice a day. Correct Answer: D. once a day. Response Feedback: The nurse will advise the patient to use the medication once a day. Dosage strength indicates a single daily dose as the therapeutic treatment.  Question 17 1 out of 1 points A 30-year-old African-American woman tested positive for TB and is prescribed isoniazid. The nurse will plan the patient's care to include close monitoring of the drug therapy because Selected Answer: C. the patient is at greater risk for high serum levels of the drug. Correct Answer: C. the patient is at greater risk for high serum levels of the drug. Response Feedback: Isoniazid is metabolized in the body through a process called acetylation, which is faster in Eskimos, Asians, and approximately 50% of African Americans or European Americans from North America than in Scandinavians and people of Arab or Jewish heritage. Because the patient is an African American, she may exhibit slow acetylation for the drug, and as a result she may be at greater risk for serum levels and adverse effects. For this reason, the nurse would need to closely monitor this particular patient. Patients of African-American descent do not exhibit slow therapeutic effects of isoniazid or high rates of drug elimination.  Question 18 0 out of 1 points The nurse notices a cold sore on a patient's upper lip a [Show More]

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