Adams4e Tif Ch34

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 34
Question 1 Type: MCMA The nurse plans to teach the client with acquired immune deficiency syndrome (AIDS) about bacterial infections. hich information should the nurse include in this teachin!" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. #If $ust a few bacteria ma%e you sic%& this is 'irulence.# 2. #Most bacteria ha'e de'eloped antibiotic resistance.# 3. #(atho!ens are di'ided into two classes& bacteria and 'iruses.# 4. #(atho!enicity means the bacteria can cause an infection.# 5. #Actually& most bacteria will not harm us.# Corre t Ans!er: )&*&+ "ationa#e 1, A hi!hly 'irulent microbe is one that can produce disease when present in minute numbers. "ationa#e 2, Antibiotic resistance is a problem- howe'er only a few& not most& bacteria ha'e de'eloped it. "ationa#e 3, .uman patho!ens include 'iruses& bacteria& fun!i& unicellular or!anisms& and multicellular animals. "ationa#e 4, The ability of an or!anism to cause infection is called patho!enicity. "ationa#e 5, /nly a few do0en patho!ens commonly cause disease in humans- most are harmless. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (hysiolo!ical Adaptation )ursin&/*nte&rated Con epts: 1ursin! (rocess, (lannin! (earnin& +ut ome: 2*3) Question 2 Type: MCMA
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, *45 Copyri!ht 67)* by (earson 5ducation& Inc.
The student nurse as%s the nursin! instructor for help with her microbiolo!y class. The student is studyin! bacteria. hat does the best plan by the nursin! instructor include" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. 8acteria are either aerobic or anaerobic. 2. 8acteria are multicellular or!anisms. 3. 53coli are !ram3ne!ati'e bacteria. 4. 9ram3stainin! is one way to identify bacteria. 5. Spherical3shaped bacteria are called cocci. Corre t Ans!er: 2&*&+ "ationa#e 1, Some or!anisms ha'e the ability to chan!e their metabolism and sur'i'e in either aerobic or anaerobic conditions. "ationa#e 2, 8acteria are sin!le cell or!anisms. "ationa#e 3, 9ram3stainin! is one way to identify bacteria. 53coli are !ram3ne!ati'e bacteria. "ationa#e 4, 9ram3stainin! is one way to identify bacteria. "ationa#e 5, Spherical3shaped bacteria are called cocci. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (hysiolo!ical Adaptation )ursin&/*nte&rated Con epts: 1ursin! (rocess, (lannin! (earnin& +ut ome: 2*36 Question 3 Type: MCSA The client tells the nurse that the doctor told him his antibiotic did not %ill his infection& but $ust slowed its !rowth. The client is an:ious. hat is the best response by the nurse to decrease the client;s an:iety" 1. #This is o%ay because your body will help %ill the infection too.# 2. #This is o%ay because your doctor is an infectious disease specialist.#
3. #This is o%ay because your blood wor% is bein! monitored daily.# 4. #This is o%ay because your infection is not really that serious.# Corre t Ans!er: ) "ationa#e 1, Some dru!s do not %ill the bacteria& but instead slow their !rowth and depend on the body;s natural defenses to dispose of the microor!anisms. These dru!s which slow the !rowth of bacteria are called bacteriostatic. "ationa#e 2, Tellin! the client that the doctor is a specialist does not answer the question and will increase an:iety. "ationa#e 3, Tellin! the client that his blood wor% is bein! monitored does not answer the question and will increase an:iety. "ationa#e 4, Tellin! a client with an infection that the infection is not serious will increase an:iety because to the client& all infections are serious. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*32 Question 4 Type: MCSA The client recei'es multiple antibiotics to treat a serious infection. by the nurse include" 1. Assessin! blood cultures for the presence of bacteria 2. Assessin! chan!es in stool& white patches in the mouth& and uro!enital itchin! or rash 3. Assessin! renal and li'er function tests 4. Assessin! whether or not the client has adequate food and fluid inta%e Corre t Ans!er: 6 "ationa#e 1, Assessin! blood cultures is important& but not as important as assessin! for superinfections. "ationa#e 2, A superinfection occurs when microor!anisms normally present in the body& host flora& are destroyed by antibiotic therapy. A superinfection can be lethal and should be suspected if a new infection appears
hat will the priority assessment of the client
while the client is recei'in! antibiotics. Si!ns of superinfection commonly include diarrhea& white patches in the mouth& uro!enital itchin!& and presence of a blisterin! itchy rash. "ationa#e 3, Assessin! renal and li'er function tests is 'ery important& but not as important as assessin! for superinfections. "ationa#e 4, Assessin! food and fluid inta%e is 'ery important& but not as important as assessin! for superinfections. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Assessment (earnin& +ut ome: 2*3< Question 5 Type: MCSA The nurse wor%s in infection control and teaches a class to staff nurses about the ways that resistance to antibiotics can occur. The nurse e'aluates that learnin! has occurred when the nurses ma%e which statement" 1. #=esistance to antibiotics most often occurs when physicians prescribe too many of them for elderly clients.# 2. #=esistance to antibiotics can occur by the common use of them for nosocomial infections.# 3. #=esistance to antibiotics most often occurs when physicians prescribe too many of them for children with ear infections.# 4. #=esistance to antibiotics can occur by the prophylactic use of them for pre3operati'e clients.# Corre t Ans!er: 6 "ationa#e 1, The use of antibiotics by physicians with elderly clients is not the ma$or cause of antibiotic resistance. "ationa#e 2, The or!anisms that cause nosocomial infections ha'e most li%ely been treated with antibiotics& and are the most li%ely or!anisms to de'elop resistance to antibiotics. "ationa#e 3, The use of antibiotics by physicians for children with ear infections is not the primary cause of antibiotic resistance. "ationa#e 4, The prophylactic use of antibiotics does not promote antibiotic resistance. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in!
C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: 1ursin! (rocess, 5'aluation (earnin& +ut ome: 2*3* Question , Type: MCSA A client comes to the emer!ency department with a fe'er of )7*> ?. 1. (lan to obtain li'er and renal function tests. 2. (lan to obtain a complete blood count (C8C) test. 3. (lan to obtain a sterile urine specimen. 4. (lan to obtain blood for culture and sensiti'ity. Corre t Ans!er: * "ationa#e 1, @i'er and renal function tests will not identify the causati'e or!anism. "ationa#e 2, The C8C will re'eal the impact of infecti'e a!ents on the immune system& but will not identify the a!ent. "ationa#e 3, /btainin! a urine specimen is not the best method of determinin! this clientAs infecti'e a!ent. "ationa#e 4, A hi!h fe'er is usually indicati'e of a systemic infection. 8lood cultures are the best way of identifyin! the causati'e or!anism. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (hysiolo!ical Adaptation )ursin&/*nte&rated Con epts: 1ursin! (rocess, (lannin! (earnin& +ut ome: 2*3+ Question Type: MCSA The client recei'es !entamicin (9aramycin) intra'enously (IB) in the clinical settin!. action" 1. Monitor the client for hearin! loss. 2. Draw daily blood chemistries.
hat will the best plan by the nurse include"
hat is a priority nursin!
3. Decrease the fluids for the client durin! therapy. 4. (lace the client on isolation precautions. Corre t Ans!er: ) "ationa#e 1, Amino!lycocides are ototo:ic dru!s& and the client should be monitored for hearin! loss. "ationa#e 2, Serum le'els of the dru! are indicated& but not blood chemistries. "ationa#e 3, Decreasin! fluids durin! therapy is not indicated. "ationa#e 4, Isolation is determined by the causati'e or!anism& not the dru! used for treatment. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3< Question . Type: MCSA The client has M=SA and recei'es 'ancomycin (Bancocin) intra'enously (IB). The nurse assesses an upper body rash and decreased urine output. hat is the nurse;s priority action" 1. .old the ne:t dose of 'ancomycin (Bancocin)& and notify the physician. 2. /btain a stat C3ray& and notify the physician. 3. Administer an antihistamine& and notify the physician. 4. /btain a sterile urine specimen& and notify the physician. Corre t Ans!er: ) "ationa#e 1, Dpper body rash and decreased urine output are most li%ely symptoms of 'ancomycin (Bancocin) to:icity& so the medication should be held and the physician notified. "ationa#e 2, There is no reason to obtain a chest :3ray. "ationa#e 3, The nurse should collaborate with the physician re!ardin! medications for treatment of this situation.
"ationa#e 4, The client;s symptoms are most li%ely not due to a urinary tract infection& so a sterile urine specimen is not indicated. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3E Question / Type: MCSA The client recei'es multiple dru!s for treatment of tuberculosis. The nurse teaches the client the rationale for multiple dru! treatment& and e'aluates learnin! as effecti'e when the client ma%es which statement" 1. #Current research indicates that the most effecti'e way to treat tuberculosis is with multiple dru!s.# 2. #Multiple dru!s are necessary because the bacteria are li%ely to de'elop resistance to $ust one dru!.# 3. #Treatment for tuberculosis is comple:& and multiple dru!s must be continued for as lon! as I am conta!ious.# 4. #Multiple dru! treatment is necessary for me to be able to de'elop immunity to tuberculosis.# Corre t Ans!er: 6 "ationa#e 1, Current research does support multiple dru! treatment& but this does not e:plain the rationale for this to the client. "ationa#e 2, Tuberculosis bacilli are li%ely to de'elop resistance to one dru!& so multiple dru!s must be used. "ationa#e 3, Treatment must be continued lon! after the client is no lon!er conta!ious. "ationa#e 4, Clients cannot de'elop immunity to bacterial infections. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, 5'aluation (earnin& +ut ome: 2*3 Question 10 Type: MCMA
The client is to recei'e an in$ection of penicillin 9 ben0athine (8icillin @A) in the outpatient clinic. priority nursin! action by the nurse prior to administerin! this in$ection" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. .a'e the client lie down and assess 'ital si!ns before she lea'es. 2. As% the client if she has e'er had an aller!y to penicillin before. 3. Inform the client that she will need to wait 27 minutes before lea'in! the clinic. 4. Inform the client that she must ha'e someone dri'e her home. 5. Ad'ise the client to rest for the remainder of the day. Corre t Ans!er: 6&2
hat is a
"ationa#e 1, There is no reason to ha'e the client lie down. It is not important to assess 'ital si!ns unless a problem has de'eloped. "ationa#e 2, It is always important to as% about aller!ies. The nurse must be aware& howe'er& that no history of aller!y does not !uarantee there will not be an aller!ic response with this administration. "ationa#e 3, It is important that the client be reassessed for de'elopment of aller!ic reaction before lea'in! the clinic. "ationa#e 4, There is no indication that the client will require someone else to dri'e her home. "ationa#e 5, There is no specific reason the client should rest related to administration of penicillin. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3E Question 11 Type: MCSA A client comes to the emer!ency department complainin! of a sore throat. .e has white patches on his tonsils& and he has swollen cer'ical lymph nodes. hat will the best plan by the nurse include" 1. (lan to administer a narrow3spectrum antibiotic.
2. (lan to administer a broad3spectrum antibiotic. 3. (lan to obtain blood cultures. 4. (lan to obtain a throat culture. Corre t Ans!er: * "ationa#e 1, Initial therapy with a narrow3spectrum antibiotic is too specific without %nowin! the causati'e or!anism. "ationa#e 2, A broad3spectrum antibiotic is commonly ordered& but a throat culture should be obtained first. "ationa#e 3, 8lood cultures are not necessary at this point because the infection is in the throat- it is not systemic. "ationa#e 4, A throat culture is necessary to identify the causati'e or!anism and initiate the best antibiotic treatment. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (hysiolo!ical Adaptation )ursin&/*nte&rated Con epts: 1ursin! (rocess, (lannin! (earnin& +ut ome: 2*3+ Question 12 Type: MCSA The client is prescribed amo:icillin (Amo:il) for )7 days to treat strep throat. After + days& the client tells the nurse he plans to stop the medication because he feels better. hat is the best response by the nurse" 1. #If you stop the medicine early you ha'e not effecti'ely %illed out the bacteria ma%in! you sic%.# 2. #Fou should !et another throat culture if your symptoms return.# 3. #If you stop the medicine early& this could result in resistance to the antibiotic.# 4. #Fou should !et another throat culture to see if the infection is !one.# Corre t Ans!er: ) "ationa#e 1, If all the medication is not ta%en& there is a stron! possibility that not all bacteria ha'e been eliminated. "ationa#e 2, Another throat culture is inappropriate- the client must finish the medication.
"ationa#e 3, Stoppin! the medicine early can result in resistance to the antibiotic& but the client may not care about this unless he can see how it directly affects him. "ationa#e 4, Another throat culture is inappropriate- the client must finish the medication. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3E Question 13 Type: MCSA The physician orders penicillin for a female client who has a sinus infection. client prior to administerin! the medication" 1. #Are you pre!nant"# 2. #Do you plan to become pre!nant"# 3. #Are you breastfeedin!"# 4. #Are you ta%in! birth control pills"# Corre t Ans!er: * "ationa#e 1, (enicillin is a (re!nancy Cate!ory 8 dru!& and is safe to ta%e if a client is pre!nant. "ationa#e 2, (enicillin is a (re!nancy Cate!ory 8 dru!& and is safe to ta%e if a client plans to become pre!nant. "ationa#e 3, (enicillin is a (re!nancy Cate!ory 8 dru!& and is safe to ta%e if a client is breastfeedin!. "ationa#e 4, (enicillin can cause birth control pills to lose their effecti'eness. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Assessment (earnin& +ut ome: 2*3< Question 14 Type: MCSA
hat is a priority question to as% the
The physician orders cefepime (Ma:ipime) for a client. prior to administration of this dru!" 1. #Are you breastfeedin!"# 2. #Are you pre!nant"# 3. #Are you aller!ic to penicillin"# 4. #Are you aller!ic to tetracycline"# Corre t Ans!er: 2
hat is a priority question for the nurse to as% the client
"ationa#e 1, Cefepime (Ma:ipime) is a (re!nancy Cate!ory 8 dru!& and is safe to use while breastfeedin!. "ationa#e 2, Cefepime (Ma:ipime) is a (re!nancy Cate!ory 8 dru!& and is safe for use durin! pre!nancy. "ationa#e 3, Cephalosporins are contraindicated in clients who ha'e e:perienced a se'ere aller!ic reaction to penicillin. "ationa#e 4, Cephalosporins are contraindicated in clients who ha'e e:perienced a se'ere aller!ic reaction to penicillin& not tetracycline. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Assessment (earnin& +ut ome: 2*3< Question 15 Type: MCSA (atho!enicity is different than 'irulence in that patho!enicity can 1. lead to the ability of or!anisms to cause infection. 2. %ill patho!ens. 3. cause a disease when patho!ens are present. 4. disrupt cell linin!. Corre t Ans!er: ) "ationa#e 1, (atho!enicity can lead to an or!anism;s causin! an infection.
"ationa#e 2, 8actericidal ability leads to %illin! patho!ens. "ationa#e 3, Birulence can cause a disease to be present& e'en in small numbers. "ationa#e 4, Cell linin! is not disrupted in this process. $#o%a# "ationa#e: Co&niti'e (e'e#: =ememberin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 2*3) Question 1, Type: MCSA hat is the action of bactericidal dru!s" 1. They disrupt normal cell function. 2. They will slow the !rowth of the bacteria. 3. They ha'e a hi!h potency. 4. They will %ill the bacteria. Corre t Ans!er: * "ationa#e 1, They do not disrupt normal cell function. "ationa#e 2, 8acteriostatic dru!s slow the !rowth of bacteria. "ationa#e 3, (otency is related to the properties of resistance. "ationa#e 4, 8actericidal dru!s %ill the bacteria. $#o%a# "ationa#e: Co&niti'e (e'e#: =ememberin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 2*32 Question 1Type: MCSA
Dischar!e plannin! for the client prescribed tetracycline will include which of the followin!" 1. Ta%e the medication with antacids. 2. Ta%e the medication with iron supplements. 3. Do not ta%e the medication with mil%. 4. Decrease the amount of 'itamins. Corre t Ans!er: 2 "ationa#e 1, Antacids can decrease the effecti'eness of tetracycline. "ationa#e 2, Iron can decrease the effecti'eness of tetracycline. "ationa#e 3, Tetracycline effecti'eness can be decreased by usin! mil% products. "ationa#e 4, It is not necessary to decrease 'itamins. $#o%a# "ationa#e: Co&niti'e (e'e#: =ememberin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3< Question 1. Type: MCSA The nurse is carin! for a client recei'in! !entamicin IB. The nurse would obser'e for ad'erse effects of 1. diarrhea. 2. nausea. 3. increased urinary output. 4. ototo:icity. Corre t Ans!er: * "ationa#e 1, Diarrhea is not a common ad'erse effect of !entamicin. "ationa#e 2, 1ausea is not a common ad'erse effect.
"ationa#e 3, Increased urinary output is not an ad'erse effect. "ationa#e 4, /toto:icity is an ad'erse effect that could occur while recei'in! !entamicin. This could become permanent with continued use. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstandin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Assessment (earnin& +ut ome: 2*3< Question 1/ Type: MCSA hich of the followin! laboratory tests will be performed to determine whether a specific bacterium is resistant to a specific dru!" 1. Culture and sensiti'ity test 2. Complete blood count 3. 8lood urea nitro!en 4. Drinalysis Corre t Ans!er: ) "ationa#e 1, Culture and sensiti'ity is the e:amination for a specific or!anism& and can determine the correct medication. "ationa#e 2, Complete blood count would not determine the specific dru! for the specific or!anism. "ationa#e 3, 8lood urea nitro!en would not determine the specific dru! for the specific or!anism. "ationa#e 4, Drinalysis would not determine the specific dru! for the specific or!anism. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstandin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (hysiolo!ical Adaptation )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*3+ Question 20
Type: MCSA The dru! that would most li%ely be used in the treatment of tuberculosis is 1. erythromycin (53mycin). 2. Bancomycin (Bancocin). 3. Isonia0id (I1.). 4. 9entamicin (9aramycin). Corre t Ans!er: 2 "ationa#e 1, 5rythromycin is most effecti'e a!ainst !ram3positi'e bacteria. "ationa#e 2, Bancomycin is used for bactericidal reasons. "ationa#e 3, Isonia0id (I1.) is the dru! of choice for anti3tuberculosis therapy. "ationa#e 4, 9entamicin is used for bactericidal reasons. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstandin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 2*3G Question 21 Type: MCSA Treatment of tuberculosis usually in'ol'es 1. the use of two or more dru!s at the same time. 2. sur!ical remo'al of tubercular lesions. 3. %eepin! the client hospitali0ed. 4. the use of a sin!le dru!. Corre t Ans!er: ) "ationa#e 1, Multi3dru! therapy for HI)6 months is the usual pharmacotherapy for tuberculosis.
"ationa#e 2, Sur!ery is not the treatment. "ationa#e 3, It is not necessary to %eep the client in the hospital. "ationa#e 4, Multi3dru! therapy is usually the treatment& so use of a sin!le dru! is not usual. $#o%a# "ationa#e: Co&niti'e (e'e#: =ememberin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: )ursin&/*nte&rated Con epts: (earnin& +ut ome: 2*3G)7 Question 22 Type: MCSA ?ollowin! sur!ery& a client is placed on cefota:ine (Claforan). The assessment for possible ad'erse effects should include obser'in! for 1. diarrhea. 2. headache. 3. constipation. 4. tachycardia. Corre t Ans!er: ) "ationa#e 1, Diarrhea is a frequent ad'erse effect of cephalosporins. "ationa#e 2, .eadache is not an ad'erse effect. "ationa#e 3, Diarrhea& not constipation& is a common problem. "ationa#e 4, Tachycardia is not an ad'erse effect. $#o%a# "ationa#e: Co&niti'e (e'e#: Dnderstandin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, 5'aluation (earnin& +ut ome: 2*3< Question 23
Type: MCMA A client has been prescribed trimethoprim3sulfametho:a0ole (Septra) for treatment of a urinary tract infection. hich comments& made by the client& would the nurse discuss with the prescriber before allowin! the client to lea'e the clinic" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. JMy husband and I plan to start a family as soon as possible.K 2. JI for!ot to ta%e my potassium supplement today.K 3. JIs it o%ay to ta%e this with my warfarin"K 4. JIt is so cloudy today.K 5. JMy G73year3old mother is comin! to 'isit today.K Corre t Ans!er: 6&2 "ationa#e 1, Sulfa dru!s are contraindicated for use by women at term. "ationa#e 2, (otassium supplements should not be ta%en durin! therapy unless directed by the health care pro'ider. "ationa#e 3, Sulfa dru!s may enhance the effects of oral anticoa!ulants. "ationa#e 4, Sulfa dru!s can result in photosensiti'ity. "ationa#e 5, There is no reason this 'isit should be of concern re!ardin! the medication prescribed. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy0in! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Assessment (earnin& +ut ome: 2*.< Question 24 Type: MCMA A client who has diabetes mellitus is dia!nosed with tuberculosis and has been prescribed multiple3dru! therapy. hat instruction should the nurse pro'ide to this client"
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. These medications can cause hypo!lycemia& so you should always carry a su!ar source. 2. Test your blood !lucose more frequently while on these medications. 3. If your blood !lucose le'els ele'ate consistently& contact us. 4. Ta%e your medication for diabetes at least H hours after ta%in! these medications. 5. hile on these medications you will be more prone to infections in your feet.
Corre t Ans!er: 6&2 "ationa#e 1, The medication re!imen is more li%ely to cause hyper!lycemia. "ationa#e 2, These medications may cause hyper!lycemia. The client should monitor blood !lucose le'els more closely. "ationa#e 3, Constant ele'ation of blood !lucose le'els may warrant alteration in medication therapy for diabetes. "ationa#e 4, There is no reason to separate the administration of these medications by H hours. "ationa#e 5, There is no e'idence that medications used to treat tuberculosis will increase the li%elihood of infections in the feet. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: @/ L< Question 25 Type: MCMA A client recei'in! chemotherapy has a 'ery low white blood cell count. Antibiotic therapy is initiated. rationales should the nurse pro'ide for the addition of this dru!" Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Fou ha'e an infection.
hat
2.
e would li%e to pre'ent you from de'elopin! any infections.
3. Chemotherapy often causes infections. 4. This antibiotic will help your chemotherapy fi!ht off your cancer. 5. If you are de'elopin! an infection& this medication will help %ill it out early. Corre t Ans!er: 6&+ "ationa#e 1, There is no e'idence of infection bein! present. "ationa#e 2, Antibiotics are !i'en to those with low 8Cs to help pre'ent or lessen infections.
"ationa#e 3, The chemotherapy does not cause an infection& but does decrease immunity& allowin! infection to occur. "ationa#e 4, This antibiotic is not bein! !i'en to %ill cancer cells. "ationa#e 5, (rophylactic antibiotics are !i'en to %ill bacteria while their numbers are small. $#o%a# "ationa#e: Co&niti'e (e'e#: Applyin! C#ient )eed: (hysiolo!ical Inte!rity C#ient )eed Su%: (harmacolo!ical and (arenteral Therapies )ursin&/*nte&rated Con epts: 1ursin! (rocess, Implementation (earnin& +ut ome: 2*.H

Adams4e Tif Ch34

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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 34

hat will the priority assessment of the client

hat will the best plan by the nurse include"

hat is a priority nursin!

hat is a priority question to as% the

hat is a priority question for the nurse to as% the client

e would li%e to pre'ent you from de'elopin! any infections.

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