Pharm module 2 quiz The nurse wants to evaluate a nursing student’s understanding of chemotherapy. The nurse asks, “Which factor would be a major obstacle to successful chemotherapy?” What is the student’s best response? a. “The patient’s reluctance about the doses administered.” b. “The difficulty attaining and maintaining venous access.” c. “The toxicity of anticancer drugs to normal tissues.” d. “The patient’s degree of nausea.” A patient who takes the loop diuretic ethacrynic acid is given intravenous gentamicin for an infection. After several days of treatment with gentamicin, the nurse reviews the patient’s most recent laboratory results and notes a gentamicin trough of 2.1 mcg/mL and normal blood urea nitrogen (BUN) and serum creatinine levels. The nurse will question the patient about: a. urine output. b. headache, dizziness, or vertigo. c. presence of rash. d. gastrointestinal (GI) symptoms. A patient is to begin taking doxycycline to treat a rickettsial infection. Which statement by the patient indicates a need for teaching about this drug? a. “I should consult my provider before using laxatives or antacids while taking this drug.” b. “If I get diarrhea, I should stop taking the drug and let my provider know immediately.” c. “I should not take a calcium supplement or consume dairy products with this drug.” d. “I should take this drug with food to ensure more complete absorption.” Which infections may be treated with linezolid [Zyvox])? (Select all that apply.) a. Superficial methicillin-resistant S. aureus skin infections (MRSA) b. Nosocomial pneumonia caused by methicillin-sensitive Staphylococcus aureus (MSSA) c. Pneumonias caused Mycoplasma by avium d. Vancomycin-resistant infections e. Community-acquired pneumonia (CAP) that is penicillin sensitive A patient with an infection caused P. byaeruginosa is being treated with piperacillin. The nurse providing care reviews the patient’s laboratory reports and notes that the patient’s blood urea nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: a. ordering nafcillin. b. adding an aminoglycoside. c. reducing the dose of piperacillin. d. changing to penicillin G. A patient has an infection causedStreptococcus by pyogenes. The prescriber has ordered dicloxacillin PO. What will the nurse do? a. Suggest ordering vancomycin to treat this infection. b. Administer the medication as ordered. c. Contact the provider to suggest giving the drug IV. d. Question the need for a penicillinase-resistant penicillin. A patient with cancer who is receiving chemotherapy develops a fever. The patient’s chest 3 radiograph is normal. The patient’s neutrophil count is 750/mm . The nurse expects the provider to: a. begin empiric therapy with intravenous antibiotics. b. order colony-stimulating factor to minimize neutrophilia. c. reassure the patient that serious infection is unlikely. d. obtain cultures and wait for results before prescribing antibiotics. The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching? a. “Some agents act to block the conversion para of -aminobenzoic acid (PABA) to folic acid.” b. “Some agents cause phagocytosis of bacterial cells.” c. “Some agents weaken the cell wall, causing cell wall lysis.” d. “Some agents disrupt the bacterial cell wall.” Tetracyclines are considered first-line drugs for which disorders? (Select all that apply.) a. Chlamydia trachomatis cervicitis b. Lyme disease c. Methicillin-resistantStaphylococus aureus skin infections d. Typhus fever e. Clostridium difficile diarrhea The parent of a 2-month-old infant who has just received the first dose of DTaP asks the nurse about expected reactions to the vaccine. The nurse will respond by saying that: a. “Mild reactions, including a low-grade fever, are common.” b. “Seizures are common and may require anticonvulsant medication.” c. “Most children do not experience any reaction.” d. “The most common reaction is a rash that develops into itchy vesicles.” A patient who has undergone surgical removal of a solid tumor has just begun chemotherapy. The patient experiences severe nausea and vomiting as well as alopecia. The nurse will expect the provider to: a. decrease the dose of chemotherapy to minimize side effects. b. order lab tests to evaluate for the presence of residual cancer cells. c. continue the chemotherapeutic agent at the same dose. d. stop the chemotherapy because the tumor has been removed. A patient is receiving tobramycin three times daily. A tobramycin peak level is 4.5 and the trough is 1.2. What will the nurse do? a. Tell the patient to report tinnitus. b. Give the next dose as ordered. c. Hold the next dose and notify the provider. d. Monitor the patient for signs of nephrotoxicity. A patient who is taking immunosuppressant medications develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct? a. “Patients who are immunosuppressed are more likely to develop resistance.” b. “Sulfonamides intensify the effects of immunosuppression.” c. “Immunosuppressed patients are folate deficient.” d. “Sulfonamides are bacteriostatic and depend on host immunity to work.” A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a. Second-generation cephalosporin b. First-generation cephalosporin c. Third-generation cephalosporin d. Fourth-generation cephalosporin A 3-year-old child who has asthma is in the clinic for a well-child checkup. The nurse notes that the child is up-to-date for the DTaP, hepatitis A, hepatitis B, and the MMR vaccines but has only had one each of the Hib, the rotavirus, and the PCV13 vaccines. Which vaccine(s) will the nurse anticipate administering to this child? a. PCV13 and Hib b. PCV13 c. Rotavirus d. Hib and rotavirus vaccines A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. The nurse will request an order to: a. give an analgesic to control headache discomfort. b. discontinue the gentamicin. c. obtain a gentamicin trough before the next dose is given. d. obtain renal function tests to evaluate for potential nephrotoxicity. A nurse is teaching a group of nursing students about how cytotoxic anticancer drugs affect normal cells. Which statement by a student indicates an understanding of this teaching? a. “Neoplastic cells and normal tissue cells are very different.” b. “Differences between cancer cells and normal cells are qualitative.” c. “Cytotoxic drugs lack tissue specificity.” d. “Cytotoxic drugs have a high degree of selective toxicity.” The parent of a 5-year-old child who has had four urinary tract infections in the past year asks the nurse why the provider doesn’t just order an antibiotic for the child’s current symptoms of low-grade fever, flank pain, and dysuria since these are similar symptoms as before. Which is the most important reason given by the nurse? a. “Your child may need tests to assess for urinary tract abnormalities.” b. “Your child may need to be hospitalized for treatment.” c. “Your child may need a urine culture before and after treatment.” d. “Your child may need additional medications, such as urinary tract antiseptics.” A child has been receiving chloramphenicol for Neisseria a meningitidis central nervous system (CNS) infection. The nurse administers the dose and subsequently notes that the child has vomited and appears dusky and gray in color. The child’s abdomen is distended. What will the nurse do? a. Recognize this as initial signs ofC.adifficile infection. b. Notify the provider that the child’s meningitis is worsening. c. Stop the infusion immediately and notify the provider. d. Contact the provider for an order to obtain a chloramphenicol level. A 30-year-old male patient reports having two to four urinary tract infections a year. What will the nurse expect to teach this patient? a. “You will need to take antibiotics for 4 to 6 weeks each time you have an infection.” b. “Make sure you void after intercourse and drink extra fluids to stay well hydrated.” c. “We will treat each infection as a separate infection and treat with short-course therapy.” d. “You will need to take a low dose of medication for 6 months to prevent infections.” A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do? a. Assess the skin at the infusion site for signs of tissue necrosis. b. Request an order for serum electrolytes and cardiac monitoring. c. Watch the patient’s actions and report any bizarre behaviors. d. Observe the patient closely for confusion and other neurotoxic effects. A pregnant patient with fever, flank pain, and chills has a history of two previous bladder infections before getting pregnant. She is allergic to several antibiotics. She reports having taken methenamine successfully in the past. What will the nurse tell her? a. “This agent is not effective against infections of the upper urinary tract.” “This drug is linked to many serious birth defects and is not recommended during b. pregnancy.” c. “This antiseptic agent is safe for use during pregnancy and has no drug resistance.” d. “You will need to take this medication with meals to avoid gastric upset.” A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? a. The patient should stop taking the glipizide while taking the TMP/SMZ. b. The patient should check the blood glucose level more often while taking TMP/SMZ. c. Patients taking TMP/SMZ may need increased doses of glipizide. d. Patients with diabetes have an increased risk of an allergic reaction. A 4 ½ -year-old child who has been receiving high-dose systemic glucocorticoids for several months comes to a clinic for school immunizations, which usually include the DTaP vaccine; varicella virus vaccine [Varivax]; the measles, mumps, and rubella virus (MMR) vaccine; and the inactivated poliovirus vaccine (IPV). The clinic nurse will expect to administer which vaccines to this child? a. DTaP and IPV only b. DTaP and IPV, along with immunoglobulins c. DTaP, OPV, and Varivax only d. All four school immunizations A hospitalized patient who is taking demeclocycline [Declomycin] reports increased urination, fatigue, and thirst. What will the nurse do? a. Contact the provider to report potential toxic side effects. b. Perform bedside glucometer testing to evaluate the serum glucose level. c. Notify the provider to discuss changing the medication to doxycycline. d. Provide extra fluids and reassure the patient that these are expected side effects.