Chapter 31: Sulfonamides Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 31: Sulfonamides

Test Bank

MULTIPLE CHOICE

1. A nurse is aware that crystalluria is a common problem with sulfonamides. What is a nursing intervention to prevent this problem?

a.

Intravenous therapy

b.

Giving the medication in the morning

c.

Increasing intake of calcium

d.

Increasing fluid intake

ANS: D

Crystalluria and kidney stones may occur related to these medications. A brisk urine flow decreases sedimentation. There is no need for this medication to be IV.

DIF: Cognitive Level: Application REF: p. 443

TOP: Nursing Process: Planning

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

2. A client with a UTI is ordered to receive trimethoprim-sulfamethoxazole, also known as co-trimoxazole (Bactrim, Septra). The nurse is aware that Bactrim is a combination of two drugs. What is the purpose of this combination?

a.

It decreases the response against disease-producing organisms.

b.

The two drugs have an antagonistic drug effect.

c.

Trimethoprim prevents bacterial resistance to sulfamethoxazole.

d.

It prevents toxic drug effects.

ANS: C

Use of sulfonamides leads to bacterial resistance. The trimethoprim prevents this.

DIF: Cognitive Level: Comprehension REF: pp. 440-441

TOP: Nursing Process: Analysis

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

3. Co-trimoxazole (Bactrim, Septra) has a half-life of 8 to 12 hours. Based on this information, the nurse decides to administer the drug at which time(s) each day?

a.

9:00 AM

b.

8:00 AM and 8:00 PM

c.

8:00 AM, 12:00 PM, 4:00 PM, and 8:00 PM

d.

8:00 AM, 12:00 PM, 4:00 PM, 8:00 PM, and 12:00 AM

ANS: B

Sulfonamides, like co-trimoxazole, are scheduled bid.

DIF: Cognitive Level: Application REF: p. 441

TOP: Nursing Process: Planning

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

4. A client is ordered to receive co-trimoxazole (Bactrim, Septra). The nurse assesses for side effects. What causes the nurse the greatest concern?

a.

Neutropenia and agranulocytosis

b.

Nausea and vomiting

c.

Headache and vertigo

d.

Fatigue and anorexia

ANS: A

Although all of these may be side effects of this medication, neutropenia and agranulocytosis causes most concern because of immunosuppression and the potential for infections.

DIF: Cognitive Level: Analysis REF: p. 442

TOP: Nursing Process: Analysis

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

5. A client with type 2 diabetes is treated with a sulfonylurea agent. The client is diagnosed with a urinary tract infection and is ordered to receive co-trimoxazole (Bactrim, Septra). The nurse should evaluate for a(n):

a.

increased hyperglycemic response.

b.

increased hypoglycemic response.

c.

decreased action of the sulfonamide drug.

d.

prolonged action of the sulfonamide drug.

ANS: B

Co-trimoxazole has hypoglycemic actions.

DIF: Cognitive Level: Application REF: p. 442

TOP: Nursing Process: Analysis

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

6. A client is ordered to take the anticoagulant warfarin (Coumadin) with co-trimoxazole (Bactrim, Septra). Based on the interaction of the drugs, the clients warfarin level should be monitored and the dose may need to be adjusted in which way?

a.

Increased

b.

Decreased

c.

Taken every other day

d.

Discontinued

ANS: B

Sulfonamides can increase the anticoagulant effects of warfarin.

DIF: Cognitive Level: Comprehension REF: p. 442

TOP: Nursing Process: Assessment

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

7. A client is diagnosed with an infection and is ordered to receive a sulfonamide. What would the nurse evaluate as a positive response to the treatment?

a.

Temperature within normal limits

b.

A decrease in urine output

c.

Increase in dysuria

d.

A rising white blood cell count

ANS: A

A body temperature within normal limits indicates that the medication is effective.

DIF: Cognitive Level: Application REF: p. 443

TOP: Nursing Process: Evaluation

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

8. Which nursing instruction related to photosensitivity is highest priority for the client receiving a sulfonamide?

a.

Use a high SPF sunblock when out in the sun.

b.

Avoid driving during daylight hours.

c.

Take vitamin D to prevent photosensitivity.

d.

Apply a moisturizer before going outside.

ANS: A

Using a high SPF sunblock decreases the risk of photosensitive reactions.

DIF: Cognitive Level: Application REF: p. 443

TOP: Nursing Process: Intervention/Teaching

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

9. A client is diagnosed with a urinary tract infection and is ordered to receive 160 mg trimethoprim/200 mg sulfamethoxazole. Based on the physicians order, what is the highest priority nursing intervention?

a.

Call the pharmacist to clarify the order.

b.

Call the physician to clarify the order.

c.

Give the medication as ordered.

d.

Hold the dosage to prevent anaphylaxis.

ANS: B

The dosage is inappropriate and should be 160 mg trimethoprim/800 mg sulfamethoxazole.

DIF: Cognitive Level: Application REF: p. 442

TOP: Nursing Process: Planning

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

10. The client has been ordered treatment with Gantanol. The highest priority instruction to provide this client is:

a.

to take on an empty stomach.

b.

to increase fluid intake to at least 2 L daily.

c.

to take with meals.

d.

it may produce bloody diarrhea.

ANS: B

The client who is being treated with Gantanol should increase his or her fluid intake to at least 2 L daily.

DIF: Cognitive Level: Application REF: p. 442

TOP: Nursing Process: Intervention/Teaching

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

11. The client is being treated with one of the sulfonamides. She complains to the nurse of experiencing a sore throat. What is the highest priority action on the part of the nurse?

a.

Administer the medication; this is an expected side effect of the medication.

b.

Call the physician; this is symptomatic of development of a superinfection.

c.

Call the physician; this is symptomatic of a life-threatening anemia.

d.

Hold the medication and call the pharmacist for clarification.

ANS: C

Observe the client for hematologic reaction that may lead to life-threatening anemias. Early signs are sore throat, purpura, and decreasing white blood cell and platelet counts.

DIF: Cognitive Level: Application REF: p. 443

TOP: Nursing Process: Intervention

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

12. The client is being treated with Bactrim. The nurse should anticipate seeing an increase in the clients serum:

a.

glucose.

b.

potassium.

c.

BUN and creatinine.

d.

calcium.

ANS: C

Bactrim will produce an increase in the clients BUN and creatinine levels.

DIF: Cognitive Level: Application REF: p. 442

TOP: Nursing Process: Planning

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

ESSAY

1. A client is ordered to receive sulfisoxazole (Gantrisin) for chronic otitis media. The medication is ordered 5 mg/kg/dose. The client weighs 132 pounds. The medication is available as 125 mg/5 mL. The nurse should administer how many milliliters for each dose?

ANS:

12 mL

The client weighs 60 kg. 5 60 = 300 mg. (125 mg/5 mL) = (300 mg/X mL); 125X = 1500; X = 12.

DIF: Cognitive Level: Application REF: See Chapter 5

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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