NUR 3-11 Pharm CH 9 -12 practice questions – Flashcards
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Anti-infectives that are so active against the microorganisms that they cause the death of the cells that they affect. This is called ___________
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Bactericidal
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Some anti-infectives are not as aggressive against invading microorganisms and they interfere with the ability of the cells to reproduce or divide. This is called __________
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Bacteriostatic
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Bacteria that accept a negative stain, cell walls lose a stain or decolorized by alcohol, and are frequently associated with infections of the GU or GI tract are _______
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Gram-negative
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Bacteria that take a positive stain or resists decolorization with alcohol during a C&S, cell walls retain a stain and are frequently associated with infections of the respiratory tract and soft tissues are ____________
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Gram-positive
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Interference with DNA synthesis in the cell This describes which one of these classifications Penicillins Sulfonamides Aminoglycosides Flouroquinolones Antifungals
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Fluoroquinolones
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Interference with pathogen cell wall biosynthesis This describes which one of these classifications Penicillins Sulfonamides Aminoglycosides Flouroquinolones Antifungals
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Penincillins
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Interference with protein synthesis This describes which one of these classifications Penicillins Sulfonamides Aminoglycosides Flouroquinolones Antifungals
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Aminoglycosides
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Prevention of invading organisms from using cellular substances This describes which one of these classifications Penicillins Sulfonamides Aminoglycosides Flouroquinolones Antifungals
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Sulfonamides
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Alteration in the cell membrane permeability This describes which one of these classifications Penicillins Sulfonamides Aminoglycosides Flouroquinolones Antifungals
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Antifungals
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A nurse is preparing a teaching plan for a patient who is receiving trimethoprim-sulfamethoxazole (Sulfonamide). Which of the following would the nurse need to keep in mind when describing how this drug works? a. interfering with the pathogen cell wall b. preventing the organism's cells from using substances c. interfering with protein synthesis d. altering the permeability of the cell membrane
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b. Sulfonamides prevents the cells of the invading organism from using substances essential to their growth and development, leading to an inability to divide and eventually to cell death
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Which of the following occurs when normal flora is destroyed by the use of anti-infectives? a. Neurotoxicity b. Hypersensitivity c. Superinfection d. Resistance
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c. superinfection occurs its an infection that occurs when opportunistic pathogens that were kept in check by the normal bacteria have the opportunity to invade the tissues
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A patient asks the nurse why the HCP has prescribed two anti-infective agents. Which response by the nurse would be most appropriate? a. " you have a resistant strain of organism that requires the use of more than one drug" b. " the one drug doesn't come in a strong enough strength to clear the infection." c. "you need larger amounts of both drugs so you'll have fewer adverse effects." d. "your infection, like many infections, is caused by more than one organism."
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d combo therapy used when the infection is caused by more than one organism and each pathogen may react to a different anti-infective agent.
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Which of the following would a nurse least expect as an adverse reaction to anti-infective agents? a. kidney damage b. hypersensitivity c. respiratory toxicity d. neurotoxicity
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c respiratory is the least expected adverse reaction The most common with anti-infectives is direct toxic effects on the kidney, GI tract, and nervous system along with hypersensitivity and superinfections
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A patient is receiving an aminoglycoside antibiotic for an infection. The nurse would monitor the patient closely for which of the following? a. hearing loss b. lethargy c. visual changes d. hallucinations
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a Aminoglycosides collect in the cranial nerve VIII and cause hearing loss, dizziness and vertigo.
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A female comes to the clinic complaining of a vaginal discharge with itching. When obtaining the patients med hx, which of the following would the nurse consider as significant? a. inhaled bronchodilator for asthma b. road spectrum anti-infective for recent infection c. oral contraceptive use d. daily multivitamin supplement
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b This is a superinfection caused by the anti-infective
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When describing an anti-infective agent with a narrow spectrum of activity, which of the following would the nurse include? a. the drug is effective against many different organisms b. the drug is highly aggressive in killing the pathogen c. the drug is selective in its action on organisms d. the drug is effective in interfering with the cell's reproduction
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c
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Which of the following would contribute to drug resistance? a. high dosage to eradicate the organism b. antibiotic Rx for virak ikness c. around-the-clock scheduling d. prescribed duration of therapy
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b using an antibiotic for a viral infection contributes to the drugs resistance
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A patient is to receive penicillin. The nurse understands that this drug achieves its effect by which action? a. interfering with the pathogen cell wall b. not allowing the organism to use the substances it needs c. disrupting the steps of protein synthesis d. interfering with DNA synthesis
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a penicillins interfere with the biosynthesis of the cell wall
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A patient is receiving chloroquine as part of her treatment for rheumatic disorder. Which complaint would lead the nurse to suspect that the patient is experiencing toxicity? a. "Im having trouble hearing." b. "my vision is getting really poor." c. "I feel like the room is spinning,." d. "I get so dizzy sometimes."
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b Chloroquine can accumulate in the retina and optic nerve and cause blindness
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An older adult patient is prescribed an anti-infective agent. Which of the following would the nurse need to keep in mind? a. s/s of infection are the same as those for a younger patient b. the patient has a lower risk for developing GI toxicity and neurotoxicity c. liver and kidney function may be reduced, requiring cautious use d. the patient will most likely want to have a rapid cure for his problem
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c Anti-infectives can adversely affect the liver/kidneys and older patients often have decreased organ function
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A patient is prescribed streptomycin (Aminoglycoside). The nurse understands that this drug can be given only by which route? a. oral b. IV c. ophthalmic d. IM
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d Aminoglycosides are not given orally this med is given IM
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A patient is to receive gentamicin (Aminoglycoside) for treatment of infection. Which of the following would be most important for the nurse to assess to establish a baseline? a. nutritional status b. auditory function c. GI function d. muscle strength
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b Aminoglycosides can cause ototoxicity
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A nurse is reviewing info about drugs used to treat TB. The nurse demonstrates understanding of the material when she identifies which of the following drugs as a first-line treatment option? a. Rifampin b, Kanamycin c. Ciprofloxacin d. Capreomycin
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a Rifampin
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The nurse is preparing a teaching plan for a patient who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects? a. vomiting and diarrhea b. headache and dizziness c. superinfections d. phlebitis
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a. The MOST common involves the GI tract
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A patient presents to the ER complaining of a throbbing HA, nausea, vomiting, CP, dyspnea, vertigo, and blurred vision. The patient reveals that he has been taking cefaclor (cephalosporin) for an infection. Which question should the nurse ask next? a. "have you had any alcohol to drink in the past 72 hours." b. "are you taking an oral anticoagulant such as warfarin." c. "did the doctor prescribe any other antibiotics with this one?" d. "have you been drinking enough fluids with the medicine?"
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a the patient is exhibiting s/s of a disulfiramlike reaction that occurs when a cephalosporin interacts with ETOH
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After teaching a patient who is prescribed oral erythromycin (macrolide) the nurse determines that the teaching was successful when the patient states which of the following? a. "I need to take this med with food to avoid upset stomach." b. "I should drink a full 8 oz glass of water when I take it." c. "I might have some bloody diarrhea after taking it." d. "I only need to take one pill every day for this med to work."
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b only take with a full glass of water, food will slow the meds absorption.
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A patient is receiving rifampin and isoniazid in combo for TB treatment. Which of the following would the nurse need to monitor closely? a. liver function studies b. urine culture c. audiometric studies d. pulmonary function studies
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a risk of liver toxicity increases with these 2 drugs combined. monitor ALT and AST (LFT)
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A nurse is explaining the rationale for the use of combo therapy in the treatment of HIV infections. Which of the following would the nurse include as the primary reason? a. more than one drug is needed to ensure ensitivity to the different forms of the virus b. the use of multiple drugs allows attack on the virus at different points in its life cycle c. one drug helps to control the virus, while other frugs help to alleviate the adverse effects d. using several drugs at once helps to improve the patients immune response
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b HIV mutates over time, presenting slightly different configuration with each new generation. So multiple drugs are needed to attack the virus at various points in the life cycle to achieve the max effectiveness with the least toxicity
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Which of the following would be least likely to cause a drug interaction when rimantadine (anti-viral for flu) is prescribed? a. Atropine b. Acetaminophen c. Aspirin d. Ibuprofen
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d the other 3 are anticholinergic type drugs and don't interact well with rimantadine (Anti-viral for flu)
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Which of the following statements best reflects topical antifungal agents? a. they are most effective when applied in a thick manner b. they rarely cause local irritation and burning c. they are too toxic to be used systemically d. they are associated with many drug-to-drug interactions
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c they are used locally only
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Which statement best reflects the use of antimalarial agents for treatment of the protozoan? a. typically, a single drug is sufficient to destroy the sporozoites in the early stages. b.Quinine is considered the current mainstay for malaria treatment c. Combo therapy is used to attack the parasite at various life cycle stages. d. the development of resistant strains of the parasite against antimalarial agents is rare.
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c
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When explaining the action of chloroquine to a patient, the nurse would incorporate knowledge of which of the following about the drug? a. interferes with the parasites ability to reproduce b. causes rupture of the cell, leading to its death c. blocks the use of folic acid needed for protein synthesis d. disrupts the mitochondria of the parasite
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a Chloroquine enters the human RBC and changes the metabolic pathways necessary for reproduction
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Which of the following assessments would be most important to complete for a patient who is to receive an antimalarial agent? a. respiratory status b. ophthalmologic eval c. nutritional status d. pupillary response
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b These drugs can damage the retina and lead to blindness
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A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins A. disinhibit transpeptidases. B. disrupt bacterial cell wall synthesis. C. inhibit autolysins. D. inhibit host cell wall function.
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B
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The spectrum of activity of an anti-infective indicates: a. the acidity of the environment in which they are most effective b. the cell membrane type that the anti-infective affects c. the anti-infective's effectiveness against different invading organisms d. the resistance fator that bacteria have developed to this anti-infective.
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C
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Bacterial resistance to an anti-infective could be the result of which of the following? Select All That Apply a. natural or intrinsic properties of the bacteria b. changes in cellular permeability or cellular transport systems c. the productions of chemicals that antagonize the drug d. initial exposure to the anti-infective e. combo of t many antibiotics for one infection f. narrow spectrum of acctivity
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A, B and C
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Anti-infective drugs destroy cells that have invaded the body, They do not specifically destroy only the cell of the invader, and because of this, many adverse effexts can be anticipated when an anti-infective is used Which of the following adverse effects are often associated with anti-infective use? a. superinfections b. hypotension c. renal toxicity d. diarrhea e. loss of hearing f. constipation
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A, C and D
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A HCP is caring for a pt who is about to begin taking isoniazid (INH) to treat TB. The HCP should tell the patient to report which of the following adverse effects? a. jaundice b. numbness of hands c. dizziness d. hearing loss e. oral ulcers
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a. jaundice b. numbness of hands c. dizziness
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A HCP is caring for a pt who is taking ciprofloxacin to treat a UTI and has RA, for which he takes prednisone. Recognizing the adverse effects of ciprofloxacin (fluoroquinolone), the HCP should tell the pt to report which of the following> a. tachycardia b. hair loss c. insomnia d. tendon pain
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D Tendon pain
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A HCP is caring for a pt who takes oral contraceptive and is about to begin rifampin for TB. What should the HCP include in the education? a. increase rifampin dose b. increase oral contraceptive dose c. allow 2 hr between taking the two drugs d. use additional contraception
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D use additional contraception
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A patient is about to begin taking cephalexin (cephalosporin) for bacterial meningitis. The HCP should explain to the pt the need to monitor which of the following lab tests? a. prothrombin time b. creatinine c aspartate aminotransferase d. potassium
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b. creatinine this first generation drug is excreted by the kidneys
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Cephalosporins are associated with adverse effects involving the eighth cranial nerve. True or False
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False Aminoglycosides collect in eighth cranial nerve, causing ototoxic effects
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A patient is receiving a macrolide. The nurse understands that this drug acts by what mechanism? a. interfering with the steps involved to produce proteins b. disrupting the creation of the bacterial cell wall c. interfering with Da synthesis d. preventing the organism from getting what it needs
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A Macrolides interfere with the steps of protein synthesis Floroquinolones interfere with DNA synthesis Sulfonamides prevent the cells of the invading organism from using substances essential to their growth and development leading to cell death Penicillins interfere with the synthesis of he bacterial wall
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A patient is receiving aminoglycoside therapy. The nurse would be alert for what adverse effect commonly seen with this drug? a. hallucinations b. lethargy c. loss of vision d. kidney dysfunction
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D nephrotoxicity is assoc with these drugs
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When preparing a teaching plan for a group of students about the ways organisms develop resistance to anti-infective therapy, what point would the instructor make? Select All That Apply a. The organism alters the transport system to prevent the drug from entering b. The organism produces a chemical that mimics the drug c. The organism alters the binding sites on the membranes d. The organism produces an enzyme that acts as an antagonist to the drug e. Failure to take the drug the way it was prescribed.
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A, C, D
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A patient is receiving a sulfonamide therapy for an infection. The nurse understands that this drug acts by doing what? a. altering the permeability of the cell membrane b. interfering with the bacterial cell wall c. interfering with protein synthesis d. preventing the organism's cells from using essential substances
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D
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A patient is to receive rifampin. What is the nurses priority teaching point for this patient? a. "your urine, tears, or sweat may become orange." b. "you might experience some nausea or stomach upset." c. " the drug can cause and allergic reaction." d. "call your doctor immediately if you experience HA or dizziness."
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A
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When describing the actions of sulfonamides, what descriptor would an instructor include? a. inhibit folic acid synthesis b. inhibit cell membrane synthesis c. interfere with DNA enzymes necessary for bacterial growth d. prevent biosynthesis of bacterial cell walls
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A
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What group of drugs should be avoided in children under the age of 18 years old? a. aminoglycosides b. penicillins c. cephalosporins d. fluoroquinolones
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D fluoroquinolones
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The nurse is teaching a patient who is prescribed ceftriaxone, a cephalosporin, about the drug. What would the nurse include as common adverse effects associated with this drug? a. HA and dizziness b. diarrhea and abdominal pain c. superinfections and phlebitis d. lethargy and paresthesias
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B
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The nurse cautions a patient who is receiving a cephalosporin to avoid alcohol intake for at least what time period after completing the therapy? a. 24 hrs b. 96 hrs c. 72 hrs d. 48 hrs.
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C 72 hours
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When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route? a. SubQ b. topical c. oral d. IM
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C Oral
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What agents would the nurse expect to administer as first-line agents for TB? Select All That Apply a. pyrazinamide b. rifampin c. ciprofloxacin d. kanamycin e. isoniazid
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A, B, E
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A patients risk for ototoxicity, nephrotoxicity and neurotoxicity increases dramatically if he receives aminoglycosides in conjunction with a potent diuretic T or F
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True
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Infections of the GU tract are commonly the result of gram-positive bacteria T or F
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False Gram negative (E. coli) are frequently associated with infection of the GU tract
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A patient is receiving a cephalosporin and an aminoglycoside as a combo therapy. What is the nurse's priority assessment? a. coagulation studies b, serum BUN levels c. CBC d. signs of disulfiram-like reaction
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B Renal function because combo of these 2 drug classes increases patients risk for renal toxicity
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The nurse is caring for a patient with a new diagnosis of HIV. The patient underwent testing as a screening process and is currently asymptomatic. The provider orders a combination of antiviral medications to prevent progression of the disease to AIDS. What teaching points would the nurse include in the teaching plan for this patient? Select All That Apply a. schedule for when to take meds b. schedule meds to allow for 8 hours of uninterrupted sleep c. see your HCP regularly d. report nausea, vomiting and diarrhea immediately e. avoid operating heavy machinery initially
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A, C, E
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Place the following steps in the stages of the replication cycle of a virus in the correct order: 1. viral nucleic acids replicate 2. virus sheds its coat 3. virus enters host cell by ppinocytosis 4. host cell dies releasing virus to move 5. virus adheres to host cell surface 6. synthesis of viral protein capsid 7. assembly of new virons
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5. virus adheres to host cell surface 3. virus enters host cell by pinocytosis 2. virus sheds its coat 1. viral nucleic acids replicate 6, synthesis of viral protein capsid 7, assembly of new virons 4. host cell dies releasing virus to move
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The nurse learns that what tissue hormone is released in response to viral invasion and acts to block viral replication in the use of antiviral medications? a. Progesterone b. RNA c. DNA d. Interferon
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D
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Rimantadine is a teratogenic drug and classified as a pregnancy category X drug. T or F
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False Ribavirin is a teratogenic and classified category X
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The nurse is caring for a patient receiving antiviral medications to control HIV. What laboratory study would the nurse monitor to determine the effectiveness of the meds? a. CBC with differential b. LFT c. T cell count d. P24 antigen test
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C T cell count HIV attacks helper T cells (CD4 cells) within the immune system.
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The patient is receiving ketoconazole, antifungal. The nurse would be concerned about drug-to-drug interactions if the patient was prescribed what other med? a. digoxin b. pimozide c. lovastatin d. dofetilide
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A digoxin results in an increased serum level of digoxin
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The nurse is teaching peers about fungal infections and describes the cell membrane of a fungal cell how? a. contains mycosis b. contains ergosterol c. has a soft cell wall d. contains monosaccharides
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B ergosterol is a steroid-type protein found in the cell membrane of fungi
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What would a nurse incorporate into the teaching plan for a patient who is receiving fluconazole about how the drug works? a. inhibit the synthesis of glucans b. blocks the activity of a sterol in the fungal wall c. inhibits the cytochrome P2D6 enzyme system d. inhibits the synthesis of ergosterol to prevent cell wall formation
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B
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A nurse reviewing the medical record of a patient for whom a antimalarial therapy is being considered. The nurse would consider a history of what as a contraindication for use? a. porphyria b. psoriasis c. retinal disease d. liver disease
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D Liver disease
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The mainstay of treatment for malaria is chloroquine. T or F
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True
