NUR2407 Pharmacology Quiz 4 Answers

NUR2407 Pharmacology Quiz 4 Answers

Pharmacology Quiz 4

•             Question 1          The nurse is administering the first dose of Vancomycin to a client with MRSA. The client suddenly becomes hypotensive, nauseated and develops hives. What should the nurse do?

Answers:             Give Benadryl to control the symptoms and continue the infusion

Stop the IV and consult the MD for next steps

Report that sepsis is setting in and obtain a stat order for blood cultures

Slow down the infusion and offer the client hydroxyzine

•             Question 2          An adolescent recently tested positive for Human immunodeficiency virus (HIV). What would be appropriate nursing goals for the patient? (select all that apply)

 

Answers:

The patient will name social service organizations available to assist in managing the disease and treatment regimen.

The patient will identify symptoms of opportunistic infections commonly associated with HIV infections.

The patient will adhere to the clinical quarantine plan until signs and symptoms of the initial infection have subsided and the patient is no longer contagious.

The patient will closely adhere to the dosing schedule of antiretroviral medications

•             Question 3          A client is receiving Diflucan. What should the nurse know to give this medication safely

Answers:             It is safe to take in states of liver insufficiency but not with renal insufficiency

It can only be given with orange juice

It is a class D medication but breastfeeding is fine due to its short half life

It is sometimes taken as a single dose because of its lingering effects

•             Question 4          A patient is being discharged from the emergency department following second-degree burns to the forearm. Discharge instruction state for the patient to “apply 1% silver sulfadiazine to the area twice a day.”  What is the rationale for the order? NUR2407 Pharmacology Quiz 4 Answers

Answers:

Silver sulfadiazine is an antiinfective and will prevent bacteria and fungi from growing in the damaged tissue.

Silver sulfadiazine is a topical analgesic and will help with pain control by decreasing the action potential of damaged nerve cells.

Silver sulfadiazine will help prevent dehydration by creating a barrier between the damaged tissue and outside air, so water cannot evaporate from the wound.

Silver sulfadiazine will help in debriding the damaged tissue by cause dead tissue to separate from living tissue.

•             Question 5          What advice should the nurse offer a client who is being started on a significant amount of Prednisone?

Answers:

Consult your doctor if nausea prevents you from taking this drug. Don’t stop it abruptly.

Take the medication on an empty stomach. This will help assure full absorption

Snack often on simple starches and comfort foods. This will help you avoid hypoglycemia

Use table salt. Avoid salt substitute because steroids cause potassium retention and sodium losses

•             Question 6          An elderly client who lives alone in the community is concerned about recent exposure to the flu and asks for an influenza vaccination. What client education should the nurse provide?

Answers:             “Because exposure has already occurred, the injection will not be of any use to you”

“Protection against the flu should begin about 1 to 2 weeks after injection.”

“A person should not receive the vaccine unless direct contact has been confirmed.”

“The vaccine is given only if the exposures have been verified as type A influenza.”

•             Question 7          The nurse is giving an injection to a client with suspected hepatitis B. After the injection the nurse suffers a dirty needle stick. What is the most important thing the nurse should do for self protection?

Answers:             Have repeated titers to determine exposure to Hepatitis B

Start hepatitis immune globulin injections and the hepatitis B vaccine series (if needed).

Start antibiotic therapy immediately

Go on sick leave until all screening tests are negative.

•             Question 8          A young adult patient is in the clinic to receive a tetanus vaccine after sustaining a laceration injury. The nurse learns that the patient, who works in a day care center, has not had any vaccines for more than 10 years. Which vaccine will the nurse expect to administer?  NUR2407 Pharmacology Quiz 4 Answers

Answers:             DT

DTaP

Tdap

Td

•             Question 9          After performing a nystatin “swish and spit” for an oral candida infection, a patient asks why she needs to spit the medication out. What is a suitable response from the nurse?

Answers:             “Nystatin dislodges candidiasis fungi and we do not want them to get into the GI system.”

“Nystatin can decrease the effectiveness of the corticosteroids you are taking.”

“Nystatin is toxic to the liver, so we do not want the drug into the systemic circulation.”

•             Question 10        The following family members were exposed to Tuberculosis (TB) and have converted from a negative to a positive TB skin test (TST). Which member should not be prophylactically treated with isoniazid, an antimycobacterial?    NUR2407 Pharmacology Quiz 4 Answers

Answers:             a 38-year-old woman with an allergy to penicillin

A 62-year-old woman taking prednisone, corticosteroid, for rheumatoid arthritis

A healthy 10-year-old girl

A 48-year-old male with cirrhosis of the liver.

•             Question 11        A 35-year-old female is 30-days post-liver transplant and is taking calcineurin inhibitors, costimulation blockers, and prednisone (immunosuppressants and corticosteroid). What nursing interventions are beneficial to the patient as a result of the medications?  (Check all that apply)

Answers:

Develop a plan with the patient on adherence to the drug regimen.

Teach the patient how to administer an EpiPen autoinjector, an adrenergic agonist, in case of an allergic reaction.

Teach the patient what food contain tyramine, to prevent a hypertensive crisis.

Teach the patient to identify signs and symptoms of infection.

•             Question 12        A client, who is taking rifampin, telephones the nurse to say, “My urine and saliva have looked orange-red for the past 2 days.” Select the nurse’s best response.

Answers:             “This is consistent with an allergic response, and the drug should be stopped.”

“Continue the drug for another week to see if the color worsens.”

“Stop the drug immediately to protect against hepatic harm.”

“This is a harmless effect of the drug. Check labs to confirm”

•             Question 13        Given these reports on clients receiving chemotherapy, which client should the nurse see first?

Answers:             The client whose gums bleed when he brushes his teeth

The client with persistent nausea

The client with a fever of 100.3° F

The client with perianal irritation and mouth sores

 

•             Question 14        A patient is diagnosed with contact dermatitis after working in her garden. What topical medication would be appropriate to use on the intact skin? (check all that apply)

Answers:

2% diphenhydramine hydrochloride cream

Zinc oxide ointment

Triple antibiotic ointment

2% minoxidil cream

2% hydrocortisone cream

•             Question 15        A patient calls the clinic inquiring about what medication he should take while traveling in an area with a known malaria risk. The nurse should advise the patient to do the following?         NUR2407 Pharmacology Quiz 4 Answers

Answers:             As long as he drinks only bottled water on his trip, he cannot develop malaria. Therefore, he does not any treatment.

Come to the clinic to obtain a prescription for antimalarial medication that can be taken prophetically.

Come to the clinical to obtain a malaria vaccination that is highly effective against the disease.

Buy some chloroquine phosphate, an antimalarial, to take if he develops symptoms of malaria while on his trip.

•             Question 16        When metronidazole (Flagyl) is a component of the H. pylori treatment regimen, what instructions should the client receive?

Answers:             Avoid foods containing tyramine.

Take the drug with food.

Take the drug on an empty stomach.

Avoid any alcoholic beverages.

•             Question 17        A steroid dependent client has a blood glucose level of 249 mg/dL. Her blood pressure is 178/99 and she is complaining of muscle aches and weakness. Her face appears very round and puffy.” What would the nurse suspect? What type of advocacy does the client need?

Answers:             Advocacy for a TSH level is needed because these symptoms indicate Graves disease

Advocacy for fludrocortisone is needed because these symptoms are consistent with Addison’s disease

Diuretics and glucose control may be needed. Cushing’s syndrome presents this way

Diabetic ketoacidosis is causing the clients sodium pump to shut down. An IV insulin drip is needed.

•             Question 18        The nurse assesses a PPD on the forearm of a client being screened for employment in an outpatient clinic. The induration is 4 mm. How should this finding be interpreted?

Answers:

Negative, insignificant

Moderately significant, requiring chest radiograph

Moderately significant, requiring sputum culture

Significant, requiring treatment

•             Question 19        Which is an example of acquired passive immunity?

Answers:             Immune response to an attenuated virus

Inherent resistance to a disease antigen

Administration of an antigen via an immunization

Administration of IgG to an unimmunized person exposed to a disease

•             Question 20        A provider has ordered recombinant HPV quadrivalent vaccine (Gardasil) to be given to a prepubertal 9-year-old female. The parent asks the nurse if this vaccine can be postponed until the child is in high school. The nurse will tell the parent that Gardasil

Answers:             is more effective if given prior to the hormonal changes of puberty.

is more effective if given before sexual activity begins.

is not effective if given after the onset of menses.

is less effective in older adolescents. NUR2407 Pharmacology Quiz 4 Answers

 

 

MORE INFO 

Vancomycin and MRSA

Introduction

Vancomycin is an antibiotic that kills bacteria, fungi, and some viruses. It works by inhibiting bacterial cell wall synthesis. This can cause bacterial cells to rupture and die.

Vancomycin is a type of antibiotic.

Vancomycin is a type of antibiotic. It’s used to treat infections caused by bacteria, such as pneumonia and skin infections.

You may hear some people refer to vancomycin as “drug-resistant,” because it can stop certain strains of bacteria from growing in the body. But this isn’t always true—sometimes antibiotics work against all types of bacteria at once! For example, vancomycin doesn’t work against gram-positive cocci (which include staphylococci).

It is effective against several types of bacteria, including Staphylococcus aureus, Streptococcus pneumoniae, and Enterococcus faecalis.

Vancomycin is an antibiotic that treats a number of infections caused by different types of bacteria, including Staphylococcus aureus and Streptococcus pneumoniae. It works by stopping the growth of these harmful organisms.

Vancomycin can also be used to treat skin infections such as impetigo (a skin infection) or boils. In addition to treating MRSA, it can be used to treat other serious conditions like meningitis (an inflammation in the brain), bone infections (osteomyelitis) caused by bacteria called Pseudomonas aeruginosa, cellulitis (a bacterial infection on the skin), endocarditis (an inflammatory disease affecting heart tissue), and others.

Adverse effects include diarrhea, vomiting and nausea; diarrhea may occur within 2 hours after taking vancomycin but should improve within 24 hours without treatment other than drinking plenty of fluids such as water or sports drinks whenever possible

It also works against methicillin-resistant Staphylococcus aureus (MRSA).

While Vancomycin is not an effective treatment for MRSA, it can help prevent the growth of bacteria in the body.

• It also works against methicillin-resistant Staphylococcus aureus (MRSA).

• MRSA is a type of bacteria that is resistant to many antibiotics, including Vancomycin. This makes it dangerous because it can cause infections that are hard to treat and even deadly if left untreated.

Vancomycin does not work against viruses or fungi.

Vancomycin is not effective against viruses or fungi. It can be used to treat infections caused by certain types of bacteria, but it’s not the best antibiotic for treating MRSA.

Your doctor may prescribe vancomycin for an abscess caused by MRSA.

Your doctor may prescribe vancomycin for an abscess caused by MRSA.

MRSA is a type of bacteria that is resistant to many antibiotics, and it can cause infections in people who have weak immune systems. Vancomycin is an antibiotic that can be used to treat MRSA infections.

Other uses may include skin and soft tissue infections from MRSA.

Vancomycin is effective against many different kinds of MRSA infections. It may be used to treat the following:

• Skin and soft tissue infections caused by MRSA.

• Pulmonary infections caused by MRSA.

• Sepsis, a life-threatening condition caused by an overgrowth of bacteria in the bloodstream (sepsis).

Bloodstream infections and endocarditis are two other serious conditions that might be treated with vancomycin.

If you’re taking vancomycin and have a blood infection, it’s important to follow up with your doctor. You may need to stay in the hospital for treatment of any complications that arise.

Vancomycin is sometimes used as the last line of defense against certain life-threatening infections caused by bacteria like MRSA (methicillin-resistant Staphylococcus aureus) or VRE (vancomycin-resistant Enterococcus). These strains are resistant to many other antibiotics, so physicians often turn to vancomycin as their last resort when an infection goes unresponsive to other drugs

Vancomycin can help treat infections caused by certain types of bacteria

You might be wondering: “What is vancomycin?” Vancomycin is an antibiotic used to treat infections caused by certain types of bacteria. It does not work against viruses or fungi and it can be used in combination with other antibiotics such as gentamicin or cefotaxime (penicillin).

Vancomycin is usually given intravenously (by IV) over several days or weeks. It may also be taken by mouth if possible, although this form of treatment has lower effectiveness than IV administration because absorption from the gastrointestinal tract is slower than from the bloodstream.

Vancomycin has been shown to be effective against MRSA strains in animal studies but its effectiveness for humans has not yet been established

Conclusion

It is important to follow your doctor’s instructions when taking vancomycin. If you have any questions, contact us at the number listed above or visit our website at www.medicinenet.com/vancomycin-and-mrsa/.