Unit 9, 10, & 11 – Practice questions for EXAM #4 FINAL
1) Which nursing intervention has the highest priority for the patient who is taking
cefepime?
a. Wait until culture results are received before initiating antibiotic
b. Monitor patient for s/s of superinfection
c. Administer IV over 2 hours to prevent phlebitis
d. Instruct the patient to take the drug for 5 days only
Answer: B
Rationale: Superinfection is a common adverse effect of antibiotics. The nurse should culture
the infected area before initiating antibiotics and may begin drug therapy before culture results
are received. IV cephalosporins should be administered over 30 to 45 minutes, not 2 hours.
Cephalosporins are usually given 10 days for a full regimen.
2) A patient enters the emergency department with a draining wound. Once the patient is
admitted and assessed, the priority nursing intervention is to:
a. Administer the ordered antibiotics
b. Teach the patient about the ordered antibiotics
c. Culture the wound
d. Enforce droplet isolation precautions
Answer: C
Rationale: The priority nursing intervention is to obtain a culture and antibiotic sensitivity
testing of infective organism (C&S).
3) Which statement will the nurse include when teaching a patient about cephalosporin
therapy?
a. “avoid ingesting buttermilk or yogurt when taking this medication”
b. “stop taking the medication when you feel better”
c. “immediately stop taking the medication if you develop nausea”
d. “inform your MD if you develop mouth ulcers”
Answer: D
Rationale: The patient should be instructed to report signs of superinfection, such as mouth
ulcers or discharge from the anal or genital area. Ingestion of buttermilk or yogurt may prevent
superinfection of the intestinal flora; the entire course of the medication should be taken; and
the medication should be taken with food if nausea develops.
, 4) A patient asks the nurse why she gets yeast infections after a course of antibiotics. The
nurse explains,
a. “The antibiotics lower your WBC count”
b. “People are poorly nourished and hydrated after an infection”
c. “Yeast infections happen if the antibiotic is not taken for the full course”
d. “Yeast infections are common when the normal body flora are disrupted”
Answer: D
Rationale: The patient should be advised to ingest buttermilk or yogurt to prevent this
superinfection of the body's normal flora.
5) A patient is admitted to the health care facility with methicillin-resistant Staphylococcus aureus
(MRSA). The nurse anticipates administration of which drug?
a. Nafcillin (Nallpen)
b. Vancomycin (Vancocin)
c. Aztreonam (Azactam)
d. Piperacillin-tazobactam (Zosyn)
Answer: B Rationale: The treatment of choice for MRSA is vancomycin (Vancocin).
6) Which teaching by the nurse has the highest priority for the patient taking azithromycin
(Zithromax)?
a. Instruct the patient to use sunblock and protective clothing during sun exposure
b. Instruct the patient to store drug out of light and extreme heat
c. Inform patient that children younger than 8 years should not take the drug, to avoid
tooth discoloration
d. Instruct the patient to report any loose stools or diarrhea
Answer: D
Rationale: The patient should be instructed to report loose stools or diarrhea because of possible
pseudomembranous colitis. Photosensitivity during sun exposure is common with tetracyclines, which
should not be given to children younger than 8 years; the drugs are affected by light and extreme heat.
7) Which statement by a patient who has received teaching on tetracycline therapy indicates that
more teaching is indicated?
a. “I will store the medication away from light and extreme heat”
b. “I will use an additional contraceptive technique because this drug may cause the oral
contraceptive I take to be less effective”
c. “I will take this medication with an antacid”
d. “If my stomach becomes upset when taking this medication, I will take it with non-dairy
foods”
, Answer: C
Rationale: Patients taking tetracycline therapy should avoid milk products, iron, and antacids. The
medication should be stored away from light and extreme heat. Tetracycline can decrease the
effectiveness of oral contraceptives.
8) A patient is ordered to receive vancomycin (Vancocin) for a severe infection. It is most
important for the nurse to assess the patient for the development of:
a. Neurotoxicity
b. Hepatotoxicity
c. Ototoxicity
d. Cardiotoxicity
Answer: C Rationale: Vancomycin may cause nephrotoxicity and ototoxicity. Ototoxicity results in
damage to the auditory or vestibular branch of cranial nerve VIII. Such damage can result in permanent
hearing loss (auditory branch) or temporary or permanent loss of balance (vestibular branch).
9) A patient is receiving gentamicin therapy: 100 mg IV at 0800, 1600, and 2400. At 0730, the nurse
is informed that peak and trough levels need to be drawn. When is the best time to obtain the
peak level?
a. 0800
b. 0900
c. 1600
d. 2330
Answer: B Rationale: Blood should be drawn 45 to 60 minutes after drug has been administered for
peak levels and minutes before next drug dosing for trough levels.
10) When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives
highest priority to teaching the patient to:
a. Increase fluid intake
b. Report signs of ringing in the ears or loss of hearing
c. Expect the color of their urine to change to a reddish orange
d. Take this drug with dairy products or antacids to protect the stomach
Answer: A
Rationale: Fluid intake should be increased to at least 2000 mL/day when taking sulfonamides to
prevent crystalluria. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not
change colors. Dairy products or antacids should not be taken at the same time as sulfonamides because
they decrease absorption.
1) Which nursing intervention has the highest priority for the patient who is taking
cefepime?
a. Wait until culture results are received before initiating antibiotic
b. Monitor patient for s/s of superinfection
c. Administer IV over 2 hours to prevent phlebitis
d. Instruct the patient to take the drug for 5 days only
Answer: B
Rationale: Superinfection is a common adverse effect of antibiotics. The nurse should culture
the infected area before initiating antibiotics and may begin drug therapy before culture results
are received. IV cephalosporins should be administered over 30 to 45 minutes, not 2 hours.
Cephalosporins are usually given 10 days for a full regimen.
2) A patient enters the emergency department with a draining wound. Once the patient is
admitted and assessed, the priority nursing intervention is to:
a. Administer the ordered antibiotics
b. Teach the patient about the ordered antibiotics
c. Culture the wound
d. Enforce droplet isolation precautions
Answer: C
Rationale: The priority nursing intervention is to obtain a culture and antibiotic sensitivity
testing of infective organism (C&S).
3) Which statement will the nurse include when teaching a patient about cephalosporin
therapy?
a. “avoid ingesting buttermilk or yogurt when taking this medication”
b. “stop taking the medication when you feel better”
c. “immediately stop taking the medication if you develop nausea”
d. “inform your MD if you develop mouth ulcers”
Answer: D
Rationale: The patient should be instructed to report signs of superinfection, such as mouth
ulcers or discharge from the anal or genital area. Ingestion of buttermilk or yogurt may prevent
superinfection of the intestinal flora; the entire course of the medication should be taken; and
the medication should be taken with food if nausea develops.
, 4) A patient asks the nurse why she gets yeast infections after a course of antibiotics. The
nurse explains,
a. “The antibiotics lower your WBC count”
b. “People are poorly nourished and hydrated after an infection”
c. “Yeast infections happen if the antibiotic is not taken for the full course”
d. “Yeast infections are common when the normal body flora are disrupted”
Answer: D
Rationale: The patient should be advised to ingest buttermilk or yogurt to prevent this
superinfection of the body's normal flora.
5) A patient is admitted to the health care facility with methicillin-resistant Staphylococcus aureus
(MRSA). The nurse anticipates administration of which drug?
a. Nafcillin (Nallpen)
b. Vancomycin (Vancocin)
c. Aztreonam (Azactam)
d. Piperacillin-tazobactam (Zosyn)
Answer: B Rationale: The treatment of choice for MRSA is vancomycin (Vancocin).
6) Which teaching by the nurse has the highest priority for the patient taking azithromycin
(Zithromax)?
a. Instruct the patient to use sunblock and protective clothing during sun exposure
b. Instruct the patient to store drug out of light and extreme heat
c. Inform patient that children younger than 8 years should not take the drug, to avoid
tooth discoloration
d. Instruct the patient to report any loose stools or diarrhea
Answer: D
Rationale: The patient should be instructed to report loose stools or diarrhea because of possible
pseudomembranous colitis. Photosensitivity during sun exposure is common with tetracyclines, which
should not be given to children younger than 8 years; the drugs are affected by light and extreme heat.
7) Which statement by a patient who has received teaching on tetracycline therapy indicates that
more teaching is indicated?
a. “I will store the medication away from light and extreme heat”
b. “I will use an additional contraceptive technique because this drug may cause the oral
contraceptive I take to be less effective”
c. “I will take this medication with an antacid”
d. “If my stomach becomes upset when taking this medication, I will take it with non-dairy
foods”
, Answer: C
Rationale: Patients taking tetracycline therapy should avoid milk products, iron, and antacids. The
medication should be stored away from light and extreme heat. Tetracycline can decrease the
effectiveness of oral contraceptives.
8) A patient is ordered to receive vancomycin (Vancocin) for a severe infection. It is most
important for the nurse to assess the patient for the development of:
a. Neurotoxicity
b. Hepatotoxicity
c. Ototoxicity
d. Cardiotoxicity
Answer: C Rationale: Vancomycin may cause nephrotoxicity and ototoxicity. Ototoxicity results in
damage to the auditory or vestibular branch of cranial nerve VIII. Such damage can result in permanent
hearing loss (auditory branch) or temporary or permanent loss of balance (vestibular branch).
9) A patient is receiving gentamicin therapy: 100 mg IV at 0800, 1600, and 2400. At 0730, the nurse
is informed that peak and trough levels need to be drawn. When is the best time to obtain the
peak level?
a. 0800
b. 0900
c. 1600
d. 2330
Answer: B Rationale: Blood should be drawn 45 to 60 minutes after drug has been administered for
peak levels and minutes before next drug dosing for trough levels.
10) When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse gives
highest priority to teaching the patient to:
a. Increase fluid intake
b. Report signs of ringing in the ears or loss of hearing
c. Expect the color of their urine to change to a reddish orange
d. Take this drug with dairy products or antacids to protect the stomach
Answer: A
Rationale: Fluid intake should be increased to at least 2000 mL/day when taking sulfonamides to
prevent crystalluria. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not
change colors. Dairy products or antacids should not be taken at the same time as sulfonamides because
they decrease absorption.
