Ch 40 Antibiotics Affecting Protein Synthesis
Quiz for Ch 40 Antibiotics affecting protein synthesisGSU Fall 2009
Questions and Answers
- 1.
Patients with aminoglycodise therapy should be monitored for
- A.
Cardiotoxicity and nephrotoxicity
- B.
Ototoxicity and nephrotoxicity
- C.
Peripheral neuropathy and cardiotoxicity
- D.
Hepatotoxicity and ototoxicity
Correct Answer
B. Ototoxicity and nephrotoxicityExplanation
Patients who are undergoing aminoglycoside therapy should be monitored for ototoxicity and nephrotoxicity. Ototoxicity refers to damage to the inner ear, which can lead to hearing loss or balance problems. Aminoglycosides have the potential to cause damage to the structures of the inner ear, leading to this side effect. Nephrotoxicity refers to damage to the kidneys, which can result in impaired kidney function. Aminoglycosides can be toxic to the kidneys and may cause kidney damage, so monitoring for this side effect is important.Rate this question:
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- 2.
What is the correct time to obtain a trough level of gentamicin?
- A.
30 min after IM administration
- B.
60 min after IV administration
- C.
2 h before the next dose
- D.
30 min before the next dose
Correct Answer
D. 30 min before the next doseExplanation
The correct time to obtain a trough level of gentamicin is 30 minutes before the next dose. This is because trough levels are measured just before the next dose is administered in order to determine the lowest concentration of the drug in the bloodstream. By measuring the trough level 30 minutes before the next dose, healthcare professionals can accurately assess the drug's effectiveness and adjust the dosage if necessary.Rate this question:
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- 3.
Which of the following statements about drug-drug interactions with gentamicin is correct? There are
- A.
Many interactions, and most are very significant
- B.
Many interactions, and most are significant
- C.
Very few interactions, and most are significant
- D.
Very few interactions, and most are insignificant
Correct Answer
A. Many interactions, and most are very significantExplanation
Gentamicin is a medication known to have many interactions with other drugs. These interactions are generally considered to be significant, meaning that they can have a significant impact on the effectiveness or safety of the medications involved. Therefore, the correct statement is that there are many interactions, and most of them are very significant.Rate this question:
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- 4.
The appropriate route of administration for neomycin is
- A.
PO
- B.
SC
- C.
IM
- D.
IV
Correct Answer
A. POExplanation
PO stands for per oral, which means the medication is taken by mouth. Neomycin is an antibiotic that is commonly used to treat bacterial infections in the gastrointestinal tract, particularly in the intestines. It is not well absorbed through other routes of administration such as subcutaneous (SC), intramuscular (IM), or intravenous (IV). Therefore, the most appropriate and effective route of administration for neomycin is PO.Rate this question:
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- 5.
Clindamycin is reserved for the management of
- A.
Severe systemic gram-positive bacteria
- B.
Severe systemic gram-negative bacteria
- C.
Infections by bacteria with known sensitivity
- D.
Anaerobes only
Correct Answer
C. Infections by bacteria with known sensitivityExplanation
Clindamycin is reserved for the management of infections caused by bacteria with known sensitivity. This means that it is used when the specific bacteria causing the infection have been identified and are known to be susceptible to clindamycin. Clindamycin is not effective against all types of bacteria, so it is important to confirm the sensitivity of the bacteria before prescribing this antibiotic.Rate this question:
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- 6.
Although clindamycin is reserved for serious infections, topical clindamycin is useful in the treatment of
- A.
Hives
- B.
Stevens-Johnson syndrome
- C.
Acne vulgaris
- D.
Pruritus
Correct Answer
C. Acne vulgarisExplanation
Clindamycin is a medication that is typically used for serious infections. However, when used topically, it can be effective in treating acne vulgaris. Acne vulgaris is a common skin condition characterized by the presence of pimples, blackheads, and whiteheads. Topical clindamycin works by reducing the number of bacteria on the skin and decreasing inflammation, which can help to improve acne symptoms. Therefore, although clindamycin is usually reserved for more severe infections, it can be beneficial in the treatment of acne vulgaris when used topically.Rate this question:
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- 7.
Clindamycin is associated with the development of
- A.
Hearing loss
- B.
Pseudomembranous colitis
- C.
Azotemia
- D.
Migraine headaches
Correct Answer
B. Pseudomembranous colitisExplanation
Clindamycin is an antibiotic that is known to be associated with the development of pseudomembranous colitis. Pseudomembranous colitis is a severe inflammation of the colon that is often caused by an overgrowth of a bacterium called Clostridium difficile. Clindamycin can disrupt the normal balance of bacteria in the gut, allowing Clostridium difficile to multiply and cause infection. This can lead to symptoms such as diarrhea, abdominal pain, and fever. Therefore, it is important to monitor patients taking clindamycin for signs of pseudomembranous colitis and to discontinue the medication if necessary.Rate this question:
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- 8.
The antibiotic class of choice for penicillin-allergic patients is
- A.
Cephalosporins
- B.
Macrolides
- C.
Fluoroquinolones
- D.
Aminoglycosides
Correct Answer
B. MacrolidesExplanation
Macrolides are the antibiotic class of choice for penicillin-allergic patients. This is because macrolides have a different chemical structure compared to penicillin, reducing the likelihood of cross-reactivity and allergic reactions. Macrolides are effective against a wide range of bacterial infections and are commonly used as an alternative treatment option for individuals with penicillin allergies. Cephalosporins, fluoroquinolones, and aminoglycosides are not the preferred choice for penicillin-allergic patients due to a higher risk of allergic reactions.Rate this question:
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- 9.
The most common adverse effects of erythromycin affect the _______ system
- A.
Central nervous
- B.
Respiratory
- C.
Hematopoietic
- D.
GI
Correct Answer
D. GIExplanation
Erythromycin is known to cause gastrointestinal (GI) adverse effects. These can include nausea, vomiting, diarrhea, and abdominal pain. This is because erythromycin can stimulate the motility of the GI tract, leading to these symptoms. Therefore, the correct answer is GI.Rate this question:
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- 10.
A benefit of clarithromycin therapy is
- A.
Twice a day dosing
- B.
That it is less expensive than erythromycin
- C.
Alternate-day dosing
- D.
All of the above
Correct Answer
A. Twice a day dosingExplanation
The benefit of clarithromycin therapy being twice a day dosing means that patients only need to take the medication two times a day, which can improve medication adherence and convenience for the patient. This dosing schedule may also help maintain consistent drug levels in the body, leading to effective treatment outcomes.Rate this question:
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- 11.
The pharmacokinetics of linezolid is unusual in that
- A.
The oral formulation has a duration twice as long as the IV formulation
- B.
The oral formulation has 100% bioavailability
- C.
The Iv formulation has 98% bioavailability
- D.
The IV onset is longer than the PO onset
Correct Answer
B. The oral formulation has 100% bioavailabilityExplanation
The pharmacokinetics of linezolid is unusual in that the oral formulation has 100% bioavailability. This means that when linezolid is taken orally, the entire dose is absorbed into the bloodstream and is available for the body to use. This is not the case with many other drugs, where the oral formulation may have lower bioavailability due to incomplete absorption or metabolism in the gut. The high bioavailability of the oral formulation of linezolid makes it an effective and reliable option for treatment.Rate this question:
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- 12.
The most common adverse effects associated with the use of linezolid include
- A.
Pseudomembranous colitis
- B.
Rebound hypertension
- C.
Diarrhea, headache, nausea, and vomiting
- D.
Constipation
Correct Answer
C. Diarrhea, headache, nausea, and vomitingExplanation
Linezolid is an antibiotic commonly used to treat various infections. Its most common adverse effects include diarrhea, headache, nausea, and vomiting. These side effects are typically mild and temporary, and they usually resolve on their own without any specific treatment. However, if these symptoms persist or worsen, it is important to consult a healthcare professional. Pseudomembranous colitis, rebound hypertension, and constipation are not commonly associated with the use of linezolid.Rate this question:
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- 13.
Quinupristin/dalfopristin is indicated for the management of
- A.
Brain absesses
- B.
Pseudomembranous colitis
- C.
Trichomoniasis
- D.
VRE
Correct Answer
D. VREExplanation
Quinupristin/dalfopristin is indicated for the management of VRE (vancomycin-resistant enterococcus). This antibiotic combination is specifically effective against VRE infections, which are caused by enterococcal bacteria that have developed resistance to vancomycin, a commonly used antibiotic. Quinupristin/dalfopristin works by inhibiting bacterial protein synthesis, ultimately leading to the death of the VRE bacteria. Therefore, it is the appropriate treatment option for managing VRE infections.Rate this question:
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- 14.
Potential serious adverse effects to quinupristin/dalfopristin include all of the following except
- A.
Pseudomembranous colitis
- B.
Superinfection
- C.
Nephrotoxicity
- D.
Hepatotoxicity
Correct Answer
C. NephrotoxicityExplanation
Quinupristin/dalfopristin is a combination antibiotic used to treat serious infections. It is known to have potential serious adverse effects. Pseudomembranous colitis, superinfection, and hepatotoxicity are all possible adverse effects of quinupristin/dalfopristin. However, nephrotoxicity, which refers to kidney damage, is not typically associated with this medication. Therefore, nephrotoxicity is the exception among the listed potential adverse effects.Rate this question:
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- 15.
During quinupristin/dalfopristin therapy, the nurse should arrange for which of the following lab tests?
- A.
Hepatic function and bilirubin
- B.
CBC and renal function
- C.
Hepatic and renal function
- D.
CBC and hepatic function
Correct Answer
A. Hepatic function and bilirubinExplanation
During quinupristin/dalfopristin therapy, it is important to monitor hepatic function and bilirubin levels. Quinupristin/dalfopristin is known to cause hepatotoxicity, so monitoring hepatic function is necessary to detect any liver damage or dysfunction. Bilirubin levels are also important to monitor as elevated levels can indicate liver dysfunction or obstruction. CBC (complete blood count) and renal function tests are not specifically indicated during quinupristin/dalfopristin therapy.Rate this question:
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- 16.
To maximize the absorption of tetracycline, the patient should avoid concurrent administration of
- A.
Antacids
- B.
Fluids
- C.
Corticosteroids
- D.
All of the above
Correct Answer
A. AntacidsExplanation
Tetracycline is a type of antibiotic that can bind to certain minerals, such as calcium, magnesium, and aluminum, found in antacids. When tetracycline binds to these minerals, it forms an insoluble complex that cannot be absorbed by the body. Therefore, to maximize the absorption of tetracycline, the patient should avoid taking antacids concurrently.Rate this question:
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- 17.
Chloramphenicol is the drug of choice in the treatment of
- A.
MRSA
- B.
Serious systemic fungal infections
- C.
Brain absesses
- D.
Urinary tract infections
Correct Answer
C. Brain absessesExplanation
Chloramphenicol is the drug of choice in the treatment of brain abscesses. Brain abscesses are serious infections in the brain that require prompt and effective treatment. Chloramphenicol is a broad-spectrum antibiotic that can penetrate the blood-brain barrier, making it effective in treating infections within the brain. It has good activity against a wide range of bacteria, including those commonly associated with brain abscesses. Therefore, chloramphenicol is the preferred choice for treating this specific condition.Rate this question:
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- 18.
A serious adverse effect associated with chloramphenicol therapy in newborn infants is
- A.
Gray baby syndrome
- B.
Red neck syndrome
- C.
Pseudomembranous colitis
- D.
Hypotension
Correct Answer
A. Gray baby syndromeExplanation
Gray baby syndrome is a serious adverse effect associated with chloramphenicol therapy in newborn infants. It occurs due to the inability of newborns to metabolize and eliminate chloramphenicol efficiently. This leads to high drug levels in the baby's blood, causing symptoms such as grayish skin color, hypothermia, lethargy, and cardiovascular collapse. This condition can be life-threatening and requires immediate medical attention.Rate this question:
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- 19.
In an adult, a common serious adverse effect associated with chloramphenicol therapy is
- A.
Hepatic insufficiency
- B.
Diverticulitis
- C.
CNS depression
- D.
Aplastic anemia
Correct Answer
D. Aplastic anemiaExplanation
Chloramphenicol therapy in adults commonly leads to aplastic anemia, which is a serious adverse effect. Aplastic anemia is a condition where the bone marrow fails to produce enough new blood cells, resulting in low levels of red blood cells, white blood cells, and platelets. This can lead to fatigue, infections, and bleeding. It is important to monitor blood cell counts regularly during chloramphenicol therapy to detect and manage this potential complication.Rate this question:
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- 20.
Your patient is receiving IV gentamicin therapy. After the blood tech draws a specimen, the patient asks, "Why are they taking so much blood?" Which is the best response?
- A.
"They want to be sure this is the right drug for you"
- B.
"It is important to keep gentamicin levels within a certain range to avoid adverse effects"
- C.
"The lab frequently makes mistakes and has to redraw the specimen"
- D.
"The are really only taking a little bit each time"
Correct Answer
B. "It is important to keep gentamicin levels within a certain range to avoid adverse effects"Explanation
The best response is "It is important to keep gentamicin levels within a certain range to avoid adverse effects." This answer explains the reason for drawing blood by emphasizing the importance of maintaining appropriate levels of gentamicin in the patient's body to prevent any harmful effects. It provides a clear and relevant explanation for the patient's question.Rate this question:
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- 21.
Your patient has been receiving IV gentamicin for the past 2 days. The patient is scheduled for surgery today. To ensure the patient's safety, you should
- A.
Be sure to tape a note to the front of the chart documenting the administration of gentamicin
- B.
Refrain from giving any benzodiazepine as a preoperative medicine
- C.
Refrain from giving any anticholinergic before surgery
- D.
Ask the anesthesiologist for an increased dose of premedication
Correct Answer
A. Be sure to tape a note to the front of the chart documenting the administration of gentamicinExplanation
To ensure the patient's safety, it is important to document the administration of gentamicin on the front of the chart. This is crucial information for the surgical team to be aware of, as gentamicin is an antibiotic that can have potential interactions or effects on the patient during surgery. By taping a note to the front of the chart, the surgical team will be able to take this into consideration and make any necessary adjustments or precautions during the surgery.Rate this question:
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- 22.
Your patient is to start PO clindamycin. To maximize the therapeutic effects of the drug, you should administer the first dose
- A.
On an empty stomach
- B.
With a high-fat meal
- C.
With small, frequent meals
- D.
With grapefruit juice
Correct Answer
A. On an empty stomachExplanation
To maximize the therapeutic effects of PO clindamycin, it should be administered on an empty stomach. This is because taking the medication with food, especially a high-fat meal, can decrease its absorption and effectiveness. Taking it with small, frequent meals or grapefruit juice may also interfere with its absorption and therapeutic effects. Therefore, to ensure optimal absorption and efficacy, it is recommended to take clindamycin on an empty stomach.Rate this question:
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- 23.
Your patient is using clindamycin lotion on her skin. The patient reports that her skin is extremely dry. You would suggest
- A.
Hydration
- B.
Moisturizing cream
- C.
Hydration and moisturizing cream
- D.
Soaking in a bathtub
Correct Answer
C. Hydration and moisturizing creamExplanation
The patient's complaint of extremely dry skin while using clindamycin lotion suggests that the medication may be causing excessive drying of the skin. Hydration is important to maintain the skin's moisture levels, so suggesting hydration would help alleviate the dryness. Additionally, moisturizing cream can provide a protective barrier and replenish the skin's moisture, further improving the dryness. Therefore, suggesting hydration and moisturizing cream would be the most appropriate solution for the patient's dry skin.Rate this question:
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- 24.
Your patient is hospitalized with a serious infection and is receiving IV clindamycin. This patient should be monitored for which of the following symptoms?
- A.
Rash
- B.
Facial ridgidity
- C.
Resp depression
- D.
Blood tinged diarrhea
Correct Answer
D. Blood tinged diarrheaExplanation
Patients receiving IV clindamycin should be monitored for blood tinged diarrhea. Clindamycin is an antibiotic that can cause a condition called pseudomembranous colitis, which is characterized by severe inflammation of the colon. This can lead to bloody diarrhea. Monitoring for this symptom is important to detect and manage this potentially serious adverse effect.Rate this question:
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- 25.
Your 55 yo patient has had type 1 diabetes since the age of 12 years and experiences diabetic gastroparesis. Which of the following drugs may be helpful in this disorder?
- A.
Cefixime
- B.
Neomycin
- C.
Erythromycin
- D.
Lincomycin
Correct Answer
C. ErythromycinExplanation
Erythromycin may be helpful in treating diabetic gastroparesis. Gastroparesis is a condition where the stomach takes longer than usual to empty its contents. Erythromycin is a macrolide antibiotic that can stimulate the muscles in the stomach and improve gastric emptying. It acts as a prokinetic agent, helping to move food through the digestive system. This can alleviate symptoms such as nausea, vomiting, and bloating in patients with gastroparesis.Rate this question:
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- 26.
Your patient has asthma and takes theophylline. The patient has an acute exacerbation of bronchitis and is prescribed erythromycin. This patient should be monitored for
- A.
Treatment failure of erythromycin
- B.
Treatment failure of theophylline
- C.
Toxicity of erythromycin
- D.
All of the above
Correct Answer
A. Treatment failure of erythromycinExplanation
The patient with asthma who is taking theophylline and is prescribed erythromycin should be monitored for treatment failure of erythromycin. This is because theophylline can increase the metabolism of erythromycin, leading to lower levels of the drug in the body and potentially reducing its effectiveness. Monitoring for treatment failure of erythromycin is important to ensure that the patient's bronchitis is adequately treated.Rate this question:
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- 27.
Your patient has an order for IV erythromycin. To safely administer this medication, you should
- A.
Dilute with sterile water and administer refrigerated solutions within 8 hours
- B.
Dilute with normal saline and administer non refrigerated solutions within 24 h
- C.
Dilute with sterile water and administer refrigerated solutions within 24 h
- D.
Dilute with normal saline and administer non refrigerated solutions within 8 h
Correct Answer
C. Dilute with sterile water and administer refrigerated solutions within 24 hExplanation
To safely administer IV erythromycin, it should be diluted with sterile water and the diluted solution should be refrigerated. The refrigerated solution should be used within 24 hours to ensure its effectiveness and prevent bacterial growth. Diluting with sterile water helps maintain the sterility of the medication, while refrigeration helps preserve its stability. Administering the medication within 24 hours ensures that it is still potent and safe for the patient. Diluting with normal saline and administering non-refrigerated solutions may compromise the effectiveness and safety of the medication.Rate this question:
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- 28.
During linezolid therapy, the nurse should assist the patient to choose a diet that limits the intake of
- A.
K
- B.
Sugar
- C.
Salt
- D.
Tyramine
Correct Answer
D. TyramineExplanation
During linezolid therapy, the nurse should assist the patient to choose a diet that limits the intake of tyramine. This is because linezolid is an antibiotic that belongs to a class called monoamine oxidase inhibitors (MAOIs). Tyramine is a substance found in certain foods and beverages, such as aged cheeses, cured meats, and fermented products, that can cause a dangerous increase in blood pressure when combined with MAOIs. Therefore, limiting the intake of tyramine-rich foods is important to prevent potential drug interactions and adverse effects.Rate this question:
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- 29.
Your patient is scheduled to receive IV quinupristin/dalfopristin. To safely administer this medication, you should flush the line with
- A.
D5W
- B.
Saline
- C.
Heparin
- D.
Saline or heparin
Correct Answer
A. D5WExplanation
To safely administer IV quinupristin/dalfopristin, the line should be flushed with D5W. This is because D5W is a compatible solution that can be used to flush the line before and after the administration of the medication. It helps to ensure that the medication is properly administered without any interference from other substances. Saline and heparin are not recommended for flushing the line in this case as they may not be compatible with the medication and could potentially cause adverse reactions. Therefore, D5W is the correct choice for flushing the line in this situation.Rate this question:
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- 30.
Your female patient has received a diagnosis of acne vulgaris and is prescribed tetracycline. What assessment should be done before initiating therapy?
- A.
Pregnancy status
- B.
BP
- C.
Skin turgor
- D.
Temperature
Correct Answer
A. Pregnancy statusExplanation
Before initiating therapy with tetracycline for a female patient with acne vulgaris, it is important to assess the patient's pregnancy status. Tetracycline is contraindicated during pregnancy as it can cause harm to the developing fetus, including discoloration of the teeth and inhibition of bone growth. Therefore, it is crucial to confirm that the patient is not pregnant before starting this medication. This assessment is important to ensure the safety and well-being of both the patient and the potential fetus.Rate this question:
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- 31.
Your 16 yo pregnant patient comes to the prenatal clinic crying and states her boyfriend has chlamydia. His doctor gave him a prescription for doxycycline for both himself and the patient. Which of the following statements would be the most appropriate?
- A.
"Take the medication. Let's gets this resolved before it causes you any discomfort"
- B.
"You can take the medication, but be sure you take your prenatal vitamins at least 2 h after the doxy"
- C.
"It's best you do not take this medication because it may cause problems with the baby's teeth and bones"
- D.
"I would advise against it, but you can do what you wish"
Correct Answer
C. "It's best you do not take this medication because it may cause problems with the baby's teeth and bones"Explanation
The correct answer is "It's best you do not take this medication because it may cause problems with the baby's teeth and bones." This is the most appropriate statement because doxycycline is contraindicated during pregnancy due to its potential to cause harm to the developing baby's teeth and bones. It is important for the patient to be aware of this risk and to seek alternative treatment options that are safe for use during pregnancy.Rate this question:
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- 32.
Your patient has recently completed a 10 day course of chemotherapy. The patient now has bacterial memingitis and is prescribed chloramphenicol. This patient should be closely monitored for
- A.
Bone marrow suppression
- B.
Renal toxicity
- C.
Ototoxicity
- D.
Superinfection
Correct Answer
A. Bone marrow suppressionExplanation
After completing a 10-day course of chemotherapy, the patient's immune system may already be compromised. Chloramphenicol, an antibiotic, is known to have potential side effects such as bone marrow suppression, which can further weaken the immune system. Therefore, it is crucial to closely monitor the patient for any signs of bone marrow suppression, such as decreased white blood cell count, increased susceptibility to infections, and fatigue. This will help in timely intervention and management of any potential complications.Rate this question:
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- 33.
Which of these assessment findings, if identified in a patient who has been prescribed telithromycin, should the nurse report to the prescriber prior to administration of the drug? Current use of
- A.
Antihistamines
- B.
Antiarrhythmic drugs
- C.
Beta-blocking agents
- D.
Aminoglycoside antibiotics
Correct Answer
B. Antiarrhythmic drugsExplanation
If a patient who has been prescribed telithromycin is found to be currently using antiarrhythmic drugs, it should be reported to the prescriber prior to administration of the drug. This is because telithromycin can interact with antiarrhythmic drugs, leading to potential adverse effects or reduced effectiveness of either medication. It is important for the prescriber to be aware of this potential interaction and make any necessary adjustments to the patient's treatment plan.Rate this question:
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- 34.
Your 65 yo patient is receiving gentamicin, an aminoglycoside, for peritonitis. To minimize adverse effects, what should you do?
- A.
Monitor I/O closely
- B.
Assess for tinnitus
- C.
Assess for loss of balance
- D.
Monitor BUN and creatinine levels
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
To minimize adverse effects of gentamicin, all of the mentioned actions should be taken. Monitoring the patient's intake and output closely helps to identify any potential fluid imbalances. Assessing for tinnitus is important as it can be a sign of ototoxicity, a potential adverse effect of aminoglycosides. Assessing for loss of balance is crucial as it can indicate vestibular toxicity. Monitoring BUN and creatinine levels is necessary to detect any renal toxicity caused by the medication. By implementing all of these measures, the healthcare provider can ensure the safety and well-being of the patient.Rate this question:
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- 35.
You are administering IV erythromycin, a macrolide, to your patient to treat bacterial endocarditis. The patient reports burning during the infusion. Your most initial appropriate action is to
- A.
Document that the patient is allergic to erythromycin
- B.
Apply warm compress to the vein
- C.
Slow the rate of the infusion
- D.
Remove the IV from the patient
Correct Answer
C. Slow the rate of the infusionExplanation
The correct answer is to slow the rate of the infusion. The patient reporting burning during the infusion indicates a possible adverse reaction to erythromycin. Slowing down the rate of the infusion can help alleviate the symptoms and prevent further complications. Documenting the patient's allergy to erythromycin would be important, but it is not the most initial appropriate action in this situation. Applying a warm compress to the vein or removing the IV from the patient would not address the underlying issue of the adverse reaction.Rate this question:
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- 36.
Your patient is receiving clindamycin for treatment of pelvic inflammatory disease. She begins to have diarrhea, with loose stools 5 or 6 times a day. You should
- A.
Obtain an order for an antidiarrheal
- B.
Obtain an order for laboratory examination of the stool specimen
- C.
Obtain an order for a high-roughage diet
- D.
All of the above
- E.
None of the above
Correct Answer
B. Obtain an order for laboratory examination of the stool specimenExplanation
When a patient receiving clindamycin develops diarrhea, it is important to obtain an order for laboratory examination of the stool specimen. This is because clindamycin can cause a serious condition called Clostridium difficile-associated diarrhea (CDAD). Laboratory examination of the stool specimen can help determine if the patient has CDAD and guide appropriate treatment. Antidiarrheals should generally be avoided in cases of CDAD, as they can worsen the condition. A high-roughage diet may be beneficial in some cases, but it is not the first priority in this situation.Rate this question:
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- 37.
You are caring for a patient who is to be discharged on a regimen of tetracycline as treatment for a chlamydia infection. She has a 2 year old child at home. Patient education should emphasize which of the following?
- A.
Take the drug with milk
- B.
Stop taking the drug when the symptoms are gone
- C.
Exposure to sunlight will increase the effectiveness of this drug
- D.
Keep this drug secured and out of reach of children
Correct Answer
D. Keep this drug secured and out of reach of childrenExplanation
It is important to emphasize to the patient that tetracycline should be kept secured and out of reach of children. Tetracycline is a medication that can be harmful if ingested by children, and it is essential to prevent accidental ingestion or overdose.Rate this question:
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- 38.
Your patient is receiving chloramphenicol for meningitis. For which of the following adverse effects should you withhold administration of the drug and contact the physician?
- A.
Excessive bruising
- B.
Elevation of hepatic enzymes
- C.
Fatigue
- D.
All of the above
- E.
None of the above
Correct Answer
D. All of the aboveExplanation
The correct answer is "all of the above". Chloramphenicol is associated with several adverse effects, including excessive bruising, elevation of hepatic enzymes, and fatigue. These adverse effects can indicate serious complications such as bone marrow suppression, liver dysfunction, or anemia. Therefore, it is important to withhold administration of the drug and contact the physician if any of these adverse effects occur.Rate this question:
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- 39.
You are to administer a dose of quinupristin/dalfopristin to a patient who has a severe VRE infection. The patient is NPO and has a peripherally inserted central catheter (PICC) line in the left arm. This patient also receives diazepan for seizures. What are the appropriate nursing actions?
- A.
Administer the quinupristin/dalfopristin PO
- B.
Flush the PICC line after the drug is given with D5W solution
- C.
Flush the PICC line after the drug is given with heparin flush solution
- D.
Avoid administering the diazepam while the patient is taking quinupristin/dalfopristin
- E.
Notify the physician that you cannot safely administer the drug
Correct Answer
B. Flush the PICC line after the drug is given with D5W solutionExplanation
The correct answer is to flush the PICC line after the drug is given with D5W solution. This is because quinupristin/dalfopristin is administered intravenously, and it is important to flush the PICC line after the drug is given to prevent any medication residue from remaining in the line. Flushing the line with D5W solution helps to ensure that the line is clear and free from any blockages or residual medication. The other options are not relevant to the administration of the medication or the management of the PICC line.Rate this question:
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- 40.
Which of the following foods should a patient who is receiving linezolid avoid?
- A.
Bleu cheese
- B.
Strawberries
- C.
Graham crackers
- D.
Carrotts
Correct Answer
A. Bleu cheeseExplanation
Linezolid is an antibiotic medication that belongs to a class called monoamine oxidase inhibitors (MAOIs). MAOIs can interact with certain foods and beverages, leading to a dangerous increase in blood pressure. Bleu cheese is one of the foods that should be avoided while taking linezolid because it contains high levels of tyramine, a substance that can trigger this interaction. Therefore, a patient who is receiving linezolid should avoid consuming bleu cheese to prevent any potential complications.Rate this question:
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- 41.
Your patient has community-acquired pneumonia caused by multidrug-resistant Streptococcus pneumoniae. Telithromycin, the new ketolide antibiotic, is prescribed. The patient questions why he must take to "fancy new drug" that is not available as generic and will likely cost more. What should patient education about this drug therapy include?
- A.
This drug will kill the organism that is making his sick; other meds will not work bc the organism is resistant to their effects
- B.
The drug needs to be taken only once a day
- C.
The drug needs to be taken only for 5 to 10 days
- D.
This drug quickly reaches a therapeutic concentration in the respiratory tract.
- E.
All of the above
Correct Answer
E. All of the aboveExplanation
The patient should be educated about the use of Telithromycin for their community-acquired pneumonia caused by multidrug-resistant Streptococcus pneumoniae. The drug is necessary because it can effectively kill the resistant organism that is causing their illness, unlike other medications. Additionally, the patient should know that Telithromycin only needs to be taken once a day and for a relatively short duration of 5 to 10 days. Lastly, the drug quickly reaches a therapeutic concentration in the respiratory tract, ensuring its effectiveness. Overall, all of these points should be included in the patient education about this drug therapy.Rate this question:
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