Pharm Final- Test Bank Exam Questions and Solutions with
Rationales.
A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis
would be most appropriate for this patient?
A. Acute pain related to gastrointestinal (GI) effects of the drug
B. Deficient knowledge regarding drug therapy
C. Imbalance nutrition: less than body requirements related to multiple GI effects of the drug
D. Constipation
B.
Because this is the first time the patient has taken penicillin, she is likely to have limited
knowledge about the drug. She may not understand the importance of taking the medication as
ordered to increase effectiveness of the drug or to report adverse effects. because the patient
has not started the drug yet, there is no way to know what adverse effects, if any, she will
experience. Only if she develops acute pain related to GI effects of the drug would this be
appropriate. If GI symptoms develop it may lead to imbalanced nutrition, but that remains to be
seen. No indication about constipation exists.
he mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her
child needs an antibiotic. What is the priority rationale the nurse should give the mother?
A) It is better absorbed.
B) It is less costly.
C) It has a less frequent dosing schedule.
D) It tastes better in oral form.
Ans: A
Feedback:
Most penicillins are rapidly absorbed from the GI tract, reaching peak levels in 1 hour. Although
amoxicillin is less expensive, that fact has far less impact on choosing the proper antibiotic than
the effectiveness of the drug. Most oral antibiotics for children are available in pleasant tasting
,syrups so taste would not be a factor. Ampicillin is often given up to 4 times a day so it actually
has a frequent dosing schedule.
25. The nurse is teaching the patient about amoxicillin prior to discharge and includes what
important teaching point?
A) Blackening of the tongue may occur but will subside when the drug is discontinued.
B) Even if it seems like the infection is not improving, the drug is still working.
C) Yeast infections are unlikely to occur with this medication because it is narrow spectrum.
D) Appearance of a rash is common and does not indicate an allergic reaction.
Ans: A
Feedback:
One of the adverse effects of ampicillin is blackening of the tongue but the discoloration goes
away after stopping the drug. If it is accompanied by swelling, the patient should be instructed
to call the prescribing health care provider immediately. Many penicillin-resistant pathogens
exist, so if the infection does not seem to be responding to the drug, the patient should notify
the health care provider because a different antibiotic may be required. Yeast infections are very
likely after taking ampicillin because it is a broad-spectrum antibiotic. Appearance of a rash
should be evaluated by a health care professional because allergic reactions to this class of
antibiotic are very common.
A local bioterrorism medical team is learning about germ warfare. The team is instructed that a
fluoroquinolone may be used to prevent an outbreak of anthrax infection. What
fluoroquinolone would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
,Ans: A
Feedback:
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the prevention
of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute episodes of
chronic bronchitis and community-acquired pneumonia. Norfloxacin is recommended only for
certain types of urinary tract infections.
The nurse is providing patient teaching before discharging a patient home. The patient is taking
ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent
crystalluria caused by ciprofloxacin (Cipro)?
A. Eliminate red meat and seafood from the diet.
B. Encourage at least 2 liters of fluid per day.
C. Avoid caffeine and alcohol.
D. Spend time in the sun each day to optimize vitamin D levels.
B. Encourage at least 2L of fluid per day
Provide the following patient teaching: Avoid driving or operating dangerous machinery
because dizziness, lethargy, and ataxia may occur; try to drink a lot of fluids and maintain
nutrition (very important), even though nausea, vomiting, and diarrhea may occur. There is no
need to eliminate red meat, seafood, caffeine, or alcohol from the diet, although alcohol may
increase the risk of GI irritation. Patients should be taught to avoid the sun due to possible
photosensitivity.
What is the priority reason for the nurse to consider questioning an order for tetracycline in a
child younger than 8 years of age?
A. Children younger than 8 years of age cannot take tetracyclines.
B. Weight-bearing joints have been impaired in young animals given the drugs.
C. Tetracyclines can damage developing teeth and bone in children younger than 8 years of age.
, D. Liver and kidney function may be damaged when it is given to children under 8 years of age.
ANS: C
Use tetracyclines with caution in children younger than 8 years of age because they can
potentially damage developing bones and teeth. Although the drug does not cause damage to
liver and kidneys, it may be contraindicated in patients with hepatic or renal dysfunction
because it is concentrated in the bile and excreted in the urine. Fluoroquinolones, not
tetracyclines, are generally contraindicated for use in children (i.e., those younger than 18 years
of age) because weight-bearing joints have been impaired in young animals given the drugs.
Clindamycin (Dalacin C) warrants monitoring hepatic and renal function when it is given to
neonates and infants. Trimethoprimsulfamethoxazole (Nu-Cotrimox) is used in children,
although children younger than 2 months of age have not been evaluated. Children under 8
years of age can take tetracycline, but it should be used with caution.
The nurse is providing discharge teaching to a patient who is being sent home on oral
tetracycline (Sumycin). What instructions should the nurse include?
A. Take the medication only once a day.
B. Check pulse rate and hold the drug if lower than 60 beats per minute (bpm).
C. Take the drug on an empty stomach.
D. Take the medication with 2 ounces of water.
ANS: C
Tetracycline should be taken on an empty stomach 1 hour before or 2 hours after meals with a
full 8 ounces of water to ensure full absorption. Tetracycline is usually taken at least once every
12 hours. Checking the pulse and holding the dose if below 60 bpm is an action specific to the
use of cardiac glycosides.
Rationales.
A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis
would be most appropriate for this patient?
A. Acute pain related to gastrointestinal (GI) effects of the drug
B. Deficient knowledge regarding drug therapy
C. Imbalance nutrition: less than body requirements related to multiple GI effects of the drug
D. Constipation
B.
Because this is the first time the patient has taken penicillin, she is likely to have limited
knowledge about the drug. She may not understand the importance of taking the medication as
ordered to increase effectiveness of the drug or to report adverse effects. because the patient
has not started the drug yet, there is no way to know what adverse effects, if any, she will
experience. Only if she develops acute pain related to GI effects of the drug would this be
appropriate. If GI symptoms develop it may lead to imbalanced nutrition, but that remains to be
seen. No indication about constipation exists.
he mother of a 5-year-old asks the nurse why it seems amoxicillin is always prescribed when her
child needs an antibiotic. What is the priority rationale the nurse should give the mother?
A) It is better absorbed.
B) It is less costly.
C) It has a less frequent dosing schedule.
D) It tastes better in oral form.
Ans: A
Feedback:
Most penicillins are rapidly absorbed from the GI tract, reaching peak levels in 1 hour. Although
amoxicillin is less expensive, that fact has far less impact on choosing the proper antibiotic than
the effectiveness of the drug. Most oral antibiotics for children are available in pleasant tasting
,syrups so taste would not be a factor. Ampicillin is often given up to 4 times a day so it actually
has a frequent dosing schedule.
25. The nurse is teaching the patient about amoxicillin prior to discharge and includes what
important teaching point?
A) Blackening of the tongue may occur but will subside when the drug is discontinued.
B) Even if it seems like the infection is not improving, the drug is still working.
C) Yeast infections are unlikely to occur with this medication because it is narrow spectrum.
D) Appearance of a rash is common and does not indicate an allergic reaction.
Ans: A
Feedback:
One of the adverse effects of ampicillin is blackening of the tongue but the discoloration goes
away after stopping the drug. If it is accompanied by swelling, the patient should be instructed
to call the prescribing health care provider immediately. Many penicillin-resistant pathogens
exist, so if the infection does not seem to be responding to the drug, the patient should notify
the health care provider because a different antibiotic may be required. Yeast infections are very
likely after taking ampicillin because it is a broad-spectrum antibiotic. Appearance of a rash
should be evaluated by a health care professional because allergic reactions to this class of
antibiotic are very common.
A local bioterrorism medical team is learning about germ warfare. The team is instructed that a
fluoroquinolone may be used to prevent an outbreak of anthrax infection. What
fluoroquinolone would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
,Ans: A
Feedback:
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the prevention
of anthrax infection. Gemifloxacin and sparfloxacin are most useful in treating acute episodes of
chronic bronchitis and community-acquired pneumonia. Norfloxacin is recommended only for
certain types of urinary tract infections.
The nurse is providing patient teaching before discharging a patient home. The patient is taking
ciprofloxacin (Cipro). What would the nurse teach this patient is the best way to prevent
crystalluria caused by ciprofloxacin (Cipro)?
A. Eliminate red meat and seafood from the diet.
B. Encourage at least 2 liters of fluid per day.
C. Avoid caffeine and alcohol.
D. Spend time in the sun each day to optimize vitamin D levels.
B. Encourage at least 2L of fluid per day
Provide the following patient teaching: Avoid driving or operating dangerous machinery
because dizziness, lethargy, and ataxia may occur; try to drink a lot of fluids and maintain
nutrition (very important), even though nausea, vomiting, and diarrhea may occur. There is no
need to eliminate red meat, seafood, caffeine, or alcohol from the diet, although alcohol may
increase the risk of GI irritation. Patients should be taught to avoid the sun due to possible
photosensitivity.
What is the priority reason for the nurse to consider questioning an order for tetracycline in a
child younger than 8 years of age?
A. Children younger than 8 years of age cannot take tetracyclines.
B. Weight-bearing joints have been impaired in young animals given the drugs.
C. Tetracyclines can damage developing teeth and bone in children younger than 8 years of age.
, D. Liver and kidney function may be damaged when it is given to children under 8 years of age.
ANS: C
Use tetracyclines with caution in children younger than 8 years of age because they can
potentially damage developing bones and teeth. Although the drug does not cause damage to
liver and kidneys, it may be contraindicated in patients with hepatic or renal dysfunction
because it is concentrated in the bile and excreted in the urine. Fluoroquinolones, not
tetracyclines, are generally contraindicated for use in children (i.e., those younger than 18 years
of age) because weight-bearing joints have been impaired in young animals given the drugs.
Clindamycin (Dalacin C) warrants monitoring hepatic and renal function when it is given to
neonates and infants. Trimethoprimsulfamethoxazole (Nu-Cotrimox) is used in children,
although children younger than 2 months of age have not been evaluated. Children under 8
years of age can take tetracycline, but it should be used with caution.
The nurse is providing discharge teaching to a patient who is being sent home on oral
tetracycline (Sumycin). What instructions should the nurse include?
A. Take the medication only once a day.
B. Check pulse rate and hold the drug if lower than 60 beats per minute (bpm).
C. Take the drug on an empty stomach.
D. Take the medication with 2 ounces of water.
ANS: C
Tetracycline should be taken on an empty stomach 1 hour before or 2 hours after meals with a
full 8 ounces of water to ensure full absorption. Tetracycline is usually taken at least once every
12 hours. Checking the pulse and holding the dose if below 60 bpm is an action specific to the
use of cardiac glycosides.
