Chapter 32: Antituberculars, Antifungals, Peptides, and Metronidazole Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 32: Antituberculars, Antifungals, Peptides, and Metronidazole

Test Bank

MULTIPLE CHOICE

1. Which client would be highest priority to receive prophylactic antitubercular therapy?

a.

Client who has been in close contact with a person having tuberculosis (TB)

b.

Client with longstanding chronic liver disease

c.

Healthcare professionals employed in health institutions

d.

Family members of a client with TB, regardless of the type of contact

ANS: A

Personal contact with a person having a diagnosis of tuberculosis is required to indicate prophylactic treatment with antitubercular therapy.

DIF: Cognitive Level: Application REF: p. 448

TOP: Nursing Process: Analysis

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

2. The client asks the nurse why more than one drug is needed to treat his TB. The most accurate response from the nurse is that single-drug therapy to treat tuberculosis:

a.

is effective with fewer side effects.

b.

is ineffective because of possible drug resistance.

c.

requires a short period to achieve effectiveness.

d.

is useful for clients with many allergies.

ANS: B

Multidrug therapy is more effective than single-drug therapy because of problems with drug resistance.

DIF: Cognitive Level: Application REF: p. 448

TOP: Nursing Process: Analysis

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

3. A client is diagnosed with tuberculosis. The nurse practitioner plans to treat the clients family. The nurse anticipates that which drug will be ordered?

a.

Streptomycin

b.

Rifampin (Rifadin)

c.

Isoniazid (INH)

d.

Colistin

ANS: C

INH is the drug of choice in exposed family members who are not immunocompromised.

DIF: Cognitive Level: Application REF: p. 448

TOP: Nursing Process: Analysis

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

4. A client asks the purpose for using isoniazid (INH) and rifampin (Rifadin) in combination to treat his tuberculosis. The nurse informs him that both agents are given:

a.

to prevent side effects.

b.

to prevent drug resistance.

c.

to lengthen drug therapy.

d.

for clients who are allergic to one of the antitubercular drugs.

ANS: B

Multiple agents are necessary because of the ability of the TB bacteria to mutate and become antibiotic resistant.

DIF: Cognitive Level: Application REF: p. 448

TOP: Nursing Process: Intervention/Teaching

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

5. A client taking isoniazid (INH) complains of pins and needles in her fingertips. The nurse would recommend vitamin _____ to treat this neuropathy.

a.

C

b.

B6

c.

D

d.

B12

ANS: B

INH impairs vitamin B6 absorption, so vitamin B6 is supplemented to treat and prevent peripheral neuropathy.

DIF: Cognitive Level: Application REF: p. 451

TOP: Nursing Process: Planning

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

6. The client is being treated with isoniazid (INH). The highest priority nursing intervention is to frequently monitor:

a.

liver enzymes.

b.

red blood cell count.

c.

serum creatinine level.

d.

blood urea nitrogen level.

ANS: A

INH may lead to hepatotoxicity. This may be monitored by determining liver enzyme levels.

DIF: Cognitive Level: Application REF: pp. 449, 451

TOP: Nursing Process: Assessment

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

7. A client with tuberculosis is being monitored via periodic sputum testing. To obtain acid-fast bacilli, the nurse should plan to obtain the sputum specimen:

a.

in the evening after dinner.

b.

before sleep.

c.

in the morning before breakfast.

d.

before lunch and before the evening meal.

ANS: C

An early morning sputum sample is easier to obtain and will not be contaminated with food.

DIF: Cognitive Level: Application REF: p. 451

TOP: Nursing Process: Planning

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

8. A patient with a seizure disorder is exposed to a person with tuberculosis. The patient is taking phenytoin (Dilantin) and prophylactic isoniazid (INH). Based on the interaction of the medications, the nurse anticipates that the effect of phenytoin will be:

a.

significantly increased.

b.

significantly decreased.

c.

slightly increased.

d.

negated completely.

ANS: B

INH is known to decrease the effectiveness of phenytoin.

DIF: Cognitive Level: Application REF: p. 449

TOP: Nursing Process: Planning

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

9. The nurse notes that the client has been placed on amphotericin B (Fungizone). Based on the medication being used, the nurse recognizes that the client has been diagnosed with a _____ infection.

a.

mild fungal

b.

severe fungal

c.

mild bacterial

d.

severe bacterial

ANS: B

Because of the significant side effects associated with this medication, it is reserved for severe fungal infections.

DIF: Cognitive Level: Comprehension REF: p. 452

TOP: Nursing Process: Analysis

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

10. A client is to receive amphotericin B (Fungizone). The nurse is planning care for the client based on the fact that this medication is administered via which route?

a.

Oral

b.

Intramuscular

c.

Intravenous

d.

Subcutaneous

ANS: C

This medication is not absorbed well by the GI tract and therefore must be given IV.

DIF: Cognitive Level: Application REF: p. 452

TOP: Nursing Process: Planning

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

11. Which assessment is most important when a client begins to receive an infusion of Amphotericin B (Fungizone)?

a.

Count apical heart rate for 1 full minute.

b.

Assess blood pressure for hypotension.

c.

Assess lower extremity motor function.

d.

Determine a change in pulse pressure.

ANS: B

This medication may cause hypotension, and it must be monitored closely.

DIF: Cognitive Level: Application REF: p. 452

TOP: Nursing Process: Assessment

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

12. Nystatin (Mycostatin), a polyene antifungal drug, is frequently administered as an oral suspension for Candida infection in the mouth. Client instruction regarding the administration of nystatin is to:

a.

dilute the oral suspension with water and then swallow the solution.

b.

drink the oral suspension and follow with 4 ounces of water.

c.

drink the oral suspension but do not follow with fluid or food.

d.

swish the liquid in the mouth and then swallow or expel the suspension.

ANS: D

Contact with the infected lesions is ensured by the client swishing the liquid in the mouth and then swallowing or expelling the suspension.

DIF: Cognitive Level: Application REF: p. 456

TOP: Nursing Process: Intervention/Teaching

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

13. A client is to receive amphotericin B (Fungizone). Laboratory tests should be monitored when the client is receiving this potent antifungal drug. These tests include serum _____ levels.

a.

calcium

b.

potassium

c.

albumin

d.

glucose

ANS: B

This medication can cause significant hypomagnesemia and hypokalemia.

DIF: Cognitive Level: Application REF: pp. 449, 451

TOP: Nursing Process: Planning

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

14. The highest priority nursing intervention while the client is being treated with polymyxin B (Aerosporin) is frequent monitoring of:

a.

blood glucose and fasting blood glucose levels.

b.

liver enzymes and liver function studies.

c.

serum creatinine levels and urinary output.

d.

hydration and serum albumin levels.

ANS: C

Creatinine levels and urine output assess renal function associated with the nephrotoxicity that can be caused by polymyxin B.

DIF: Cognitive Level: Application REF: p. 457

TOP: Nursing Process: Assessment

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

15. A client is receiving IV caspofungin (Cancidas) for a severe Candida infection. During an infusion of the dose, the nurse notes a reddened area along the vein tract, and the client complains of pain. What is the highest priority nursing intervention?

a.

Stop the infusion.

b.

Speed up the infusion.

c.

Administer an analgesic during the infusion.

d.

Elevate the infusion extremity above the heart.

ANS: A

Redness and pain along the vein tract may mean phlebitis. The IV infusion must be discontinued.

DIF: Cognitive Level: Application REF: pp. 454-455

TOP: Nursing Process: Analysis

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

16. The client has been diagnosed with candidiasis (thrush). The nurse anticipates that the client will be treated with:

a.

co-trimoxazole.

b.

pyrimethamine.

c.

sulfamethoxazole.

d.

fluconazole.

ANS: D

Fluconazole is a potent medication for yeast/fungal infections.

DIF: Cognitive Level: Application REF: p. 454

TOP: Nursing Process: Analysis

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

17. A client is being treated with multidrug therapy for acute tuberculosis. The drug regimen includes streptomycin. What will be the highest priority nursing intervention while the client is being treated with streptomycin?

a.

Assess urine output and kidney function.

b.

Assess hearing acuity.

c.

Monitor hepatic function.

d.

Conduct an ECG to watch for changes.

ANS: B

Streptomycin is ototoxic and warrants monitoring of hearing function.

DIF: Cognitive Level: Application REF: p. 451

TOP: Nursing Process: Assessment

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

18. The client is being treated with rifapentine. The nurse plans to administer the medication every _____ hours.

a.

8

b.

16

c.

36

d.

72

ANS: D

The drug should be given every 72 hours.

DIF: Cognitive Level: Application REF: p. 450

TOP: Nursing Process: Planning

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

19. The client is being treated with ketoconazole. He tells the nurse that he frequently self-medicates with echinacea. The highest priority instruction that the nurse should give the client is that the combination of the two medications:

a.

should enhance the action of the ketoconazole.

b.

should diminish the action of the ketoconazole.

c.

may result in hepatotoxicity developing.

d.

may result in nephrotoxicity developing.

ANS: C

The combination of ketoconazole and echinacea may result in hepatotoxicity.

DIF: Cognitive Level: Application REF: p. 454

TOP: Nursing Process: Intervention/Teaching

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

20. The client is being treated with Metronidazole. She complains to the nurse of experiencing reddish brown urine. The nurse interprets this finding as a(n):

a.

potentially life-threatening reaction to the medication.

b.

symptom of an anaphylactic reaction to the medication.

c.

sign that the medication dosage needs to be increased.

d.

expected side effect of a high dose of the medication.

ANS: D

High doses of Metronidazole may cause the client to develop reddish brown urine.

DIF: Cognitive Level: Application REF: p. 457

TOP: Nursing Process: Assessment

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

21. The nurse is instructing the client on the proper way to self-administer nystatin. The client tells the nurse that he has been simply drinking a small amount of the medication from the bottle. The nurse explain to the client that the medication dosage should consist of 1 to 2:

a.

teaspoons, swished and then swallowed.

b.

teaspoons, swished and then expelled.

c.

ounces, swallowed twice daily.

d.

ounces, used to swab the oral cavity.

ANS: A

Nystatin is given as 1 to 2 teaspoons that is swished in the oral cavity and then swallowed.

DIF: Cognitive Level: Application REF: p. 456

TOP: Nursing Process: Intervention/Teaching

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

MULTIPLE RESPONSE

1. A client is being treated for tuberculosis. Which medications are used to treat this condition? (Select all that apply.)

a.

Streptomycin sulfate

b.

Amoxicillin (Amoxil)

c.

Ethambutol (Myambutol)

d.

Gentamicin (Garamycin)

e.

Rifabutin (Mycobutin)

f.

Ethionamide (Trecator-SC)

g.

Pyrazinamide

ANS: A, C, E, F, G

These are the medications used to treat TB. The medications in the other options are not used.

DIF: Cognitive Level: Application REF: p. 448

TOP: Nursing Process: Analysis

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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