Test Bank for Pharmacology and the Nursing Process 8th Edition – Lilley | Complete Questions & Answers

Chapter 39: Antibiotics Part 2 MULTIPLE CHOICE 1. When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity? a. Fever b. White blood cell count of 8000 cells/mm3 c. Tinnitus and dizziness d. Decreased blood urea nitrogen (BUN) levels ANS: C Dizziness, tinnitus, hearing loss, or a sense of fullness in the ears could indicate ototoxicity, a potentially serious toxicity in a patient. Nephrotoxicity is indicated by rising blood urea nitrogen and creatinine levels. Fever may be indicative of the patient’s infection; a white blood cell count of 7000 cells/mm3 is within the normal range of 5000 to 10,000 cells/mm3 . DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Evaluation MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 2. The nurse is administering a vancomycin (Vancocin) infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug’s administration? a. Monitoring blood pressure for hypertension during the infusion b. Discontinuing the drug immediately if red man syndrome occurs c. Restricting fluids during vancomycin therapy d. Infusing the drug over at least 1 hour ANS: D Infuse the medication over at least 1 hour to reduce the occurrence of red man syndrome. Adequate hydration (at least 2 L of fluid in 24 hours) during vancomycin therapy is important for the prevention of nephrotoxicity. Hypotension may occur during the infusion, especially if it is given too rapidly. DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 3. Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy? a. Constipation b. Risk for injury (renal damage) c. Disturbed body image related to gynecomastia d. Imbalanced nutrition, less than body requirements, related to nausea ANS: B Patients on aminoglycoside therapy have an increased risk for injury caused by nephrotoxicity. The other options are incorrect. Chapter 39: Antibiotics Part 2 212 DIF: COGNITIVE LEVEL: Applying (Application) TOP: NURSING PROCESS: Nursing Diagnosis MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 4. A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for therapy? a. Metronidazole (Flagyl) b. Ciprofloxacin (Cipro) c. Vancomycin (Vancocin) d. Tobramycin (Nebcin) ANS: C Vancomycin is the drug of choice for the treatment of MRSA. The other drugs are not used for MRSA. DIF: COGNITIVE LEVEL: Understanding (Comprehension) TOP: NURSING PROCESS: Assessment MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 5. A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well. The patient asks why two antibiotics have been ordered. What is the nurse’s best response? a. “The combined effect of both antibiotics is greater than each of them alone.” b. “One antibiotic is not strong enough to fight the infection.” c. “We have not yet isolated the bacteria, so the two antibiotics are given to cover a wide range of microorganisms.” d. “We can give a reduced amount of each one if we give them together.” ANS: A Aminoglycosides are often used in combination with other antibiotics, such as beta-lactams or vancomycin, in the treatment of various infections because the combined effect of the two antibiotics is greater than that of either drug alone. DIF: COGNITIVE LEVEL: Analyzing (Analysis) TOP: NURSING PROCESS: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 6. The nurse is reviewing the medication orders for a patient who will be receiving gentamicin therapy. Which other medication or medication class, if ordered, would be a potential interaction concern? a. Calcium channel blockers b. Phenytoin c. Proton pump inhibitors d. Loop diuretics ANS: D Concurrent use of aminoglycosides, such as gentamicin, with loop diuretics increases the risk for ototoxicity. The other drugs and drug classes do not cause interactions.