Chapter 30: Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 30: Macrolides, Tetracyclines, Aminoglycosides, and Fluoroquinolones

Test Bank

MULTIPLE CHOICE

1. The client has a hypersensitivity to penicillin. The nurse anticipates that the drug of choice for this client will be:

a.

cefuroxime (Ceftin, Zinacef).

b.

clindamycin (Cleocin).

c.

erythromycin (E-mycin, Ilotycin).

d.

gentamicin SO4 (Garamycin).

ANS: C

Erythromycin is the drug of choice when penicillin is not an option.

DIF: Cognitive Level: Comprehension REF: pp. 425-426

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. A client has a bacterial infection and is ordered to receive Zithromax. Based on its half-life, the nurse anticipates giving this drug _____ per day.

a.

once

b.

twice

c.

three times

d.

four times

ANS: A

The longer half-life allows for daily dosing and shorter duration of medication.

DIF: Cognitive Level: Application REF: p. 427

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A client is to receive erythromycin intravenously. What is the highest priority nursing intervention?

a.

Call the physician; the drug should not be given IV.

b.

Administer the solution slowly to avoid pain.

c.

Administer the solution quickly to prevent infection.

d.

Call the pharmacist to verify the correct route.

ANS: B

Erythromycin should be given slowly when given IV to avoid pain and the development of phlebitis.

DIF: Cognitive Level: Application REF: pp. 425-426

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A client is taking a high dose of azithromycin (Zithromax). The client should be monitored for which adverse reaction?

a.

Nephrotoxicity

b.

Hepatotoxicity

c.

Neurotoxicity

d.

Blood dyscrasias

ANS: B

This medication may be hepatotoxic, and liver enzymes must be monitored.

DIF: Cognitive Level: Application REF: p. 427

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. The highest priority nursing intervention for the client receiving azithromycin (Zithromax) is to:

a.

assess liver enzymes on a regular basis.

b.

instruct the client to take the drug on an empty stomach.

c.

administer a laxative daily to prevent constipation.

d.

administer each dose of medication with antacids.

ANS: A

This medication is known to cause hepatic damage.

DIF: Cognitive Level: Application REF: p. 427

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A 7-year-old client is being evaluated for treatment with tetracycline. Which knowledge is most important for the nurse to share with the client and parents about tetracycline?

a.

Tetracycline is safe if taken during pregnancy.

b.

Tetracycline may cause permanent discoloration to the teeth if taken before age 8 years.

c.

Tetracycline causes bone marrow suppression in clients of all ages.

d.

Tetracycline should be taken with milk or milk products and antacids to avoid gastrointestinal side effects.

ANS: B

Tetracycline can cause teeth discoloration in young children. The other options are not true.

DIF: Cognitive Level: Comprehension REF: p. 432

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. The client is being treated with minocycline. The nurse anticipates what dosage schedule for the medication?

a.

Coordinated with meals

b.

Given once daily

c.

Given on an empty stomach

d.

Coordinated with bedtime

ANS: A

The absorption of doxycycline and minocycline is improved with food ingestion.

DIF: Cognitive Level: Application REF: pp. 429-430

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A client is ordered to receive tetracycline. The client reports that she is using oral contraceptives. The nurses recommendations are based on the fact that when tetracycline is taken with an oral contraceptive, the desired action of the oral contraceptive is:

a.

increased.

b.

decreased.

c.

affected in an unpredictable way.

d.

nullified.

ANS: B

Tetracycline decreases the effectiveness of oral contraceptives.

DIF: Cognitive Level: Application REF: p. 431

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. The client will be prescribed Achromycin. The nurse anticipates that this medication will be given:

a.

with each meal.

b.

with extra water.

c.

on an empty stomach.

d.

one half-hour after meals.

ANS: C

Tetracycline is best absorbed on an empty stomach.

DIF: Cognitive Level: Application REF: pp. 429-430

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client has been prescribed Garamycin. The highest priority nursing intervention related to a life-threatening side effect of the medication is to monitor for:

a.

blood pressure changes.

b.

decrease in pulse rate.

c.

nausea and vomiting.

d.

decreased urinary output.

ANS: D

Aminoglycosides are nephrotoxic; therefore, urine output must be evaluated.

DIF: Cognitive Level: Application REF: p. 433

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. The client has been started on Garamycin. She complains to the nurse of changes in her level of hearing. What is the highest priority nursing intervention on the part of the nurse?

a.

Restrict fluid intake.

b.

Assess for paralytic ileus.

c.

Hold the next dose of medication and notify the physician.

d.

Monitor urine for sugar.

ANS: C

Aminoglycosides cause ototoxicity.

DIF: Cognitive Level: Comprehension REF: p. 433

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A client who takes oral hypoglycemics for type 2 diabetes mellitus is diagnosed with a severe infection and is ordered to receive levofloxacin (Levaquin). Based on the interaction of the medications, the highest priority nursing intervention is to frequently assess:

a.

complete blood count.

b.

BUN and creatinine levels.

c.

liver enzymes.

d.

serum blood glucose level.

ANS: D

Interaction of these two medications may lead to hypoglycemia.

DIF: Cognitive Level: Application REF: p. 437

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. A young child is diagnosed with meningitis and is prescribed an aminoglycoside. Based on the potentially toxic effects of the medication, what is the highest priority nursing intervention?

a.

Schedule hearing tests and assess of urine output.

b.

Assess urine output and bone marrow function.

c.

Assess renal and hepatic function.

d.

Assess visual acuity and color discrimination.

ANS: A

Aminoglycosides are nephrotoxic and ototoxic.

DIF: Cognitive Level: Application REF: pp. 433-434

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A nurse is administering gentamicin (Garamycin) intravenously to a client. The drug is due to be administered at 2100. The nurse should anticipate that the peak level will be drawn at which time?

a.

2030

b.

2100

c.

2145

d.

2330

ANS: C

This is the time that an intravenous dosage of Garamycin would reach its peak level.

DIF: Cognitive Level: Application REF: p. 433

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. The client has been ordered to be treated with tetracycline. He is also being treated with digoxin. The nurse anticipates that, based on the interaction of the two drugs, the client will experience _____ effects of the _____.

a.

increased; digoxin

b.

increased; tetracycline

c.

decreased; digoxin

d.

decreased; tetracycline

ANS: A

The combination of tetracycline along with digoxin may result in an increased effect of the digoxin.

DIF: Cognitive Level: Application REF: p. 430

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client has been ordered to be treated with Vibramycin. What effect should the nurse anticipate seeing in the clients laboratory values?

a.

Increased serum potassium

b.

Decreased serum potassium

c.

Increased serum calcium

d.

Decreased serum calcium

ANS: B

Vibramycin usually causes the client to experience a decrease in the serum potassium level.

DIF: Cognitive Level: Application REF: p. 430

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client is scheduled to receive a dose of IV tetracycline at 9 PM. At what time should the nurse schedule her peak drug level to be drawn?

a.

9:15 PM

b.

9:45 PM

c.

11:00 PM

d.

11:45 PM

ANS: B

The peak level of IV tetracycline occurs one half-hour to one hour after the dose is administered.

DIF: Cognitive Level: Application REF: p. 430

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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