Review questions from slides: A patient’s sputum specimen is sent to the laboratory for gram stain testing. The nurse should assess the patient for signs of what type of infection? A: Bacterial B: Viral C: Parasitic D: Fungal When assessing a patient for toxicities associated with tobramycin therapy, the nurse should include evaluation of which patient data? (SATA) A: Hand strength- Due to Neurotoxicity B: Creatinine levels- Due to Nephrotoxicity C: Alanine aminotransferase (ALT) levels D: Amylase levels E: Ringing in the ears- Ototoxicity The prescriber has just ordered cefdinir for a patient with a staphylococcal infection. The nurse collaborates with the prescriber about which data is related to the patient? A: BUN of 14 B: Elevated WBC C: Culture and sensitivity results not yet available D: History of allergic reaction to penicillin After liquid tetracycline is prescribed for a 4-year-old child, the nurse provides which most important instructions to the LPN (licensed practical nurse) who is administering the medication? A: “Have the child drink the liquid medication through a straw.” B: “Hold the dose until I contact the provider.” C: “Monitor the patient for diarrhea.” D: “Administer with 6-8 ounces of milk.” * Do not give Tetracyclines to children 8 years or younger unless otherwise directed by the provider * After taking Clindamycin for 10 days, the patient has developed diarrhea with approximately 8 watery stools per day. The nurse should anticipate the need for which priority interventions? (Select all that apply) A: Monitor for clinical manifestation of metabolic acidosis B: Administer an antidiarrheal agent like kaolin and pectin C: Administer an antiperistalsis agent like dicyclomine hydrochloride D: Collect stool specimen for clostridium difficile E: Instruct patient to increase intake of fruit juices *This question was edited to include Clindamycin to allow for consistency with your review. However please note that CDiff is caused by extended/prolonged use of antibiotics* A patient has been prescribed to take both a tetracycline and a sulfonamide drug. When providing patient teaching, what priority information should the nurse give the patient related to adverse drug effects? A: Avoid exposure to upper respiratory infections B: Use protective measures when exposed to the sun C: Report problems with constipation to your provider D: Change positions slowly to avoid orthostatic hypotension *Both antibiotics can cause photosensitivity or sensitivity to sunlight. Teaching: using sunscreen, wearing protective clothing, & avoiding direct sunlight* A patient is taking levofloxacin. What does the nurse know to be true regarding this drug? A: It is administered by IV only B: Levofloxacin may cause hypertension C: This drug is an aminoglycoside D: An adverse effect is tendon rupture Which patient statement indicates an understanding of the use of erythromycin? (SATA) A: “I will always take this medication with fruit juice.” B: “If I experience bloating, I will contact my provider.” C: “I know I should not crush the pills.” D: “I understand it is common to have some hearing loss while taking this medication.” E: “I will let my provider know if I begin to have a lot of diarrheas,” A patient is receiving imipenem/cilastatin (Primaxin) intravenously to treat severe pneumonia. Which of the following statements is true about Primaxin? (Select all that apply) A: Renal function should be monitored B: Hepatic function should be monitored C: IV doses should be given on an infusion pump D: Hypertension is a major side effect E: Cross sensitivity may occur with penicillins and cephalosporins F: This medication can be taken orally Lincosamides, like clindamycin, carry the highest risk for causing clostridium-difficile superinfections. True or False? When hanging an intravenous dose of vancomycin, the nurse administers the drug over 90 minutes to prevent what adverse reaction? A: Hypertension B: Projectile vomiting C: Flushing of face and trunk D: Clostridium difficile While teaching the patient about newly prescribed oral metronidazole, what information would be the MOST important for the nurse to include? A: Avoid alcoholic beverages B: Headaches may occur while taking this medication C: This medication may cause constipation D: This medication may cause vaginal dryness A patient who smoked one pack of cigarettes a day for 2 years abruptly stopped smoking 2 days ago. The nurse performing an assessment on the patient identifies manifestations of nicotine withdrawal as including: A: Increased appetite and blood pressure B: Restlessness and increased blood pressure C: Depression and decreased blood pressure D: Nausea, confusion, and seizures The nurse performing an assessment on a patient identifies the manifestations of cocaine use, which include: A: Fatigue and hallucinations B: Cardiac dysrhythmias and violent behavior C: Shock and hypotension D: Shallow respirations and pallor *Individuals on Cocaine will present with tachycardia, hypertension, paranoid thoughts, nosebleeds* A patient with a known opioid addiction is to have surgery. In planning the patient’s postoperative pain management, the nurse will: A: Withhold opioid medications B: Treat the addiction before managing pain C: Provide pain management as needed D: Anticipate that the patient will experience less pain The nurse is admitting a patient who is diagnosed with SIADH and has a serum sodium of 118 mEq/ml. Which prescription should the nurse anticipate receiving? (Select all that apply) A: Initiate infusion of 3% NaCl B: Administer intravenous furosemide C: Restrict fluids to 800 mls over 24 hours D: Elevate the head of the bed to high Fowler's position E: Administer a vasopressin antagonist as prescribed *The main treatment protocols for SIADH is fluid restriction, this syndrome impairs water excretion. Remember the pt w/ SIADH is holding fluid, presenting hyponatremic* A patient is admitted to an emergency department and a diagnosis of myxedema coma is made. Which action should the nurse prepare to carry out FIRST? A: Warm the patient B: Maintain a patent airway C: Administer thyroid hormone D: Administer fluid replacement The nurse is completing an assessment on a patient who is being admitted for a diagnostic work-up for primary hyperparathyroidism. Which patient complaints would be characteristic of this disorder? A: Polyuria B: Headache C: Bone pain D: Nervousness E: Weight gain A patient with a diagnosis of Addisonian crisis is brought to the intensive care unit. Which findings will the health care team focus on? (Select all that apply) A: Hypotension B: Leukocytosis C: Hyperkalemia D: Hypercalcemia E: Hypernatremia *Addisonian crisis is a life-threatening situation. It is the inability to increase production of cortisol. The clinical presentation includes high potassium, low blood sugar & low BP* The nurse is preparing a patient with a new diagnosis of hypothyroidism for discharge. The nurse determines that the patient understands discharge instructions if the patient states that which signs and symptoms are associated with this diagnosis? (Select all that apply) A: Tremors B: Weight loss C: Feeling cold D: Loss of body hair E: Persistent lethargy F: Puffiness of the face A patient has been diagnosed with hyperthyroidism. The nurse monitors for which signs and symptoms indicating a complication of this disorder? (Select all that apply) A: Fever B: Nausea C: Lethargy D: Tremors E: Confusion F: Bradycardia The nurse is teaching the patient about his prescribed prednisone. Which statement, if made by the patient, indicates that FURTHER teaching is necessary? A: “I can take aspirin, or my antihistamine as I need it.” B: “I need to take the medication every day at the same time.” C: “I need to avoid coffee, tea, cola, and chocolate in my diet.” D: “If I gain 5 pounds or more a week, I will call my provider.” A patient with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? (Select all that apply) A: Administer with food B: Place the patient on a low-calorie and low-protein diet C: Assess the patient for unexplained bruising or bleeding D: Instruct the patient to report side effects such as sore throat, fever, or headaches E: Use special radioactive precautions when handling the patient’s urine for the first 24 hours following initial administration The nurse is monitoring a patient receiving levothyroxine for hypothyroidism. Which finding indicates the presence of a side effect associated with this medication? (Select all that apply) A: Insomnia B: Weight loss C: Bradycardia D: Constipation E: Mild heat intolerance The nurse teaches the patient who is newly diagnosed with diabetes insipidus about the prescribed intranasal desmopressin. Which statements by the patient indicate understanding? (Select all that apply) A: “This medication will turn my urine orange.” B: “I should decrease my oral fluids when I start this medication.” C: “The amount of urine I make should increase if this medication is working.” D: “I need to follow a low-fat diet to avoid pancreatitis when taking this medication.” E: “I should report headaches and drowsiness to my doctor since these symptoms could be related to me desmopressin.” A daily dose of prednisone is prescribed for a patient. The nurse provides instructions to the patient regarding administration of the medication and should instruct the patient that which time is BEST to take this medication? A: At noon B: At bedtime C: Early morning D: Anytime, at the same time, each day The patient with hyperparathyroidism is taking alendronate. Which statement by the patient indicates understanding of the proper way to take this medication? (Select all that apply) A: “I should take this medication with food.” B: “I should take this medication at bedtime.” C: “I should sit up for at least 30 minutes after taking this medication.” D: “I should take this medication first thing in the morning on an empty stomach.” E: “I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day.”