ATI LPN
Pharmacology and the Nursing Process 10th Edition Test Bank
Chapter 39 : Antibiotics Part 2 Questions
Question 1 of 5
The nurse is administering intravenous vancomycin to a patient who has had gastrointestinal surgery. Which nursing measures are appropriate? (Select all that apply.)
Correct Answer: A,C,D,F
Rationale: Constant monitoring for drug-related neurotoxicity, nephrotoxicity, ototoxicity, and superinfection remains critical to patient safety. Monitor for nephrotoxicity by monitoring serum creatinine levels. Ototoxicity may be indicated if the patient experiences dizziness or a feeling of fullness in the ears, and these symptoms must be reported immediately. Vancomycin infusions may cause red man syndrome, which is characterized by flushing of the neck and face and a decrease in blood pressure. Optimal trough blood levels of vancomycin are 10 to 20 mcg/mL; therefore, the drug should not be administered when there is a trough level of 24 mcg/mL.
Question 2 of 5
A patient will be receiving nitrofurantoin treatment for a urinary tract infection. The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.)
Correct Answer: A,E
Rationale: Nitrofurantoin is contraindicated in cases of known drug allergy and also in cases of significant renal function impairment, because the drug concentrates in the urine. Because adverse effects include hepatotoxicity, which is rare but often fatal, the nurse should also question the order if liver disease is present. The other options are not contraindications.
Question 3 of 5
A patient with a Pseudomonas species urinary infection will be receiving amikacin 5 mg/kg once daily via intravenous infusion. The patient weighs 143 pounds, and the medication is available in an injection solution strength of 250 mg/mL. Identify how many milliliters of medication will be drawn up for this injection. (record answer using one decimal place)
Correct Answer: 1.3 Ml
Rationale: Calculate the patient's weight in kilograms: 143 pounds ?· 2.2 = 65 kg. Calculate mg/kg/dose: 5 mg/kg ?? 65 kg = 325 mg. Calculate volume: 325 mg ?· 250 mg/mL = 1.3 mL.
Question 4 of 5
When a patient is on aminoglycoside therapy, the nurse will monitor the patient for which indicators of potential toxicity?
Correct Answer: C
Rationale: Dizziness, tinnitus, hearing loss, or a sense of fullness in the ears could indicate ototoxicity, a potentially serious toxicity in a patient. Nephrotoxicity is indicated by rising blood urea nitrogen and creatinine levels. Fever may be indicative of the patient's infection; a white blood cell count of 7000 cells/mm^3 is within the normal range of 5000 to 10,000 cells/mm^3.
Question 5 of 5
The nurse is administering a vancomycin infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration?
Correct Answer: D
Rationale: Infuse the medication over at least 1 hour to reduce the occurrence of red man syndrome. Adequate hydration (at least 2 L of fluid in 24 hours) during vancomycin therapy is important for the prevention of nephrotoxicity. Hypotension may occur during the infusion, especially if it is given too rapidly.