Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 27

Question 1

Type: MCSA

The nurse is caring for a client who is diagnosed with a highly virulent organism. The client's family asks what this means. What is the nurse’s best response?

1. The organism produces disease when present in small numbers.
2. The organism produces the disease with a virus.
3. The organism produces disease when present in large numbers.
4. The organism produces disease when the immune system is suppressed.

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Page Number: 423

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-3 Describe the basic mechanisms by which antibacterial drugs act.

Question 2

Type: MCMA

The nurse is caring for a client with a bacterial infection. The nurse is explaining this type of infection to the family. The nurse states that bacteria are described and classified by which methods? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Ability to use O₂
2. Staining
3. Shape
4. Color
5. Weight

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 423

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-2 Explain how bacteria are described and classified.

Question 3

Type: MCSA

Which term is used to describe the stain of bacteria?

1. Aerobic
2. Cocci
3. Gram-positive
4. Bacillus

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 423

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-2 Explain how bacteria are described and classified.

Question 4

Type: MCSA

The nurse is caring for a client who is prescribed a bacteriostatic medication. Which explanation by the nurse about these medications is most appropriate?

1. Bacteriostatic medications must be given last.
2. Bacteriostatic medications must be given first.
3. Medications kill bacteria.
4. Medications slow the growth of bacteria.

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Page Number: 424

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 27-3 Describe the basic mechanisms by which antibacterial drugs act.

Question 5

Type: MCMA

The client asks the nurse how bacteria become resistant to antibiotics. What should the nurse include in the response? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. The longer an antibiotic is used in the population and the more often it is prescribed, the higher will be the percentage of resistant strains.
2. Prematurely stopping antibiotic therapy allows some pathogens to survive and become resistant to antibiotics.
3. Bacteria reproduce quickly and can have a variation in the genetic code that allows them to become resistant.
4. Frequent handwashing by healthcare providers encourages the spread of bacteria to many clients receiving antibiotics in the hospital.
5. Organisms do not grow resistant to medications.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 425

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-4 Using an example, explain how resistance can develop to an anti-infective drug.

Question 6

Type: MCSA

The nurse is admitting a client with a diagnosis of urinary tract infection. The physician has ordered an IV antibiotic. What is the priority prior to administering this medication?

1. Obtain a platelet count.
2. Obtain a urine specimen for culture and sensitivity.
3. Obtain a PTT.
4. Obtain a full set of vital signs.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 426

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 27-5 Explain the importance of culture and sensitivity testing to anti-infective chemotherapy.

Question 7

Type: MCSA

A sputum culture has been collected and sent for culture and sensitivity. The physician orders a broad-spectrum antibiotic. What is the reason this medication is ordered?

1. It will take 2 weeks for the results of the culture and sensitivity to be available.
2. Treatment for severe infections is started on broad-spectrum antibiotics while the culture is pending and then changed to a narrow-spectrum antibiotic.
3. Most people are allergic to narrow-spectrum antibiotics.
4. The broad-spectrum antibiotic will cure the infection before the culture results are ready.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 426

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-5 Explain the importance of culture and sensitivity testing to anti-infective chemotherapy.

Question 8

Type: MCSA

The nurse is discussing treatment for a superinfection with a client and family members. The family asks the nurse what a superinfection is. What is the best response by the nurse?

1. An infection caused by a weakened immune system
2. A secondary infection that occurs when microorganisms normally present in the body are killed by the drug
3. An infection that is difficult to treat
4. A drug-resistant infection

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 426

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-5 Explain the importance of culture and sensitivity testing to anti-infective chemotherapy.

Question 9

Type: MCMA

The nurse is caring for a client who is diagnosed with a superinfection. What signs and symptoms does the nurse expect upon assessment of the client?

(Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Diarrhea
2. Epistaxis
3. Headache
4. Bladder pain
5. Vaginal discharge

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 426

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-5 Explain the importance of culture and sensitivity testing to anti-infective chemotherapy.

Question 10

Type: MCSA

A client has been prescribed penicillin (penicillin G). Which serious adverse effect will the nurse monitor for upon assessment?

1. Bradycardia
2. Hemorrhage
3. Anaphylaxis
4. Tachycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 428

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-6 Explain the role of penicillins in treating bacterial infections.

Question 11

Type: MCMA

The client has been prescribed cefotaxime (Claforan). Which infections does the nurse anticipate this client to have? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Superinfection
2. Central nervous system infection
3. Joint infection
4. Respiratory tract infection
5. Viral infection

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 430

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-7 Explain the role of cephalosporins in treating bacterial infections.

Question 12

Type: MCSA

Which of the statements is not correct regarding cephalosporins?

1. Clients who are allergic to penicillin might be allergic to cephalosporins.
2. GI-related adverse effects such as diarrhea, vomiting, and nausea can occur.
3. Many must be given IM or IV.
4. All cephalosporins are absorbed well from the GI tract.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 430

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-7 Explain the role of cephalosporins in treating bacterial infections.

Question 13

Type: MCSA

The nurse is instructing a client who has been prescribed tetracycline (Sumycin). What should the nurse advise this client to avoid while taking this medication?

1. Sunlight
2. Foods that contain wheat
3. Exercise
4. Green leafy vegetables

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 431

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-8 Explain the role of tetracyclines in treating bacterial infections.

Question 14

Type: MCSA

The nurse is admitting a client to the floor with a protozoan infection. Which medication would the nurse expect the physician to order?

1. Quinupristin–dalfopristin (Synercid)
2. Penicillin
3. Metronidazole (Flagyl)
4. Ciprofloxacin (Cipro)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 437

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-13 Explain the role of miscellaneous antibiotics in treating bacterial infections.

Question 15

Type: MCSA

The nurse is caring for a client receiving gentamicin IV. Which adverse effect would the nurse report to the prescriber immediately?

1. Nausea
2. Diarrhea
3. Ototoxicity
4. Increased urinary output

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 433

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-10 Explain the role of aminoglycosides in treating bacterial infections.

Question 16

Type: MCSA

The nurse is admitting a client to the acute care floor with methicillin-resistant S. aureus. The nurse would expect the physician to order which medication for this client?

1. Penicillin
2. Streptomycin
3. Kanamycin (Kantrex)
4. Vancomycin (Vancocin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 436

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 27-13 Explain the role of miscellaneous antibiotics in treating bacterial infections.

Question 17

Type: MCSA

The nurse is discharging a client to home with a prescription for clarithromycin (Biaxin). Which statement by the client indicates understanding of the discharge teaching?

1. “I need to take the medication until it is gone.”
2. “I can quit taking this medication when I feel better.”
3. “I need to check my blood pressure while taking this medication.”
4. “I cannot drive while taking this medication.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 425

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-9 Explain the role of macrolides in treating bacterial infections.

Question 18

Type: MCSA

The nurse is admitting a client to the acute care floor. While obtaining the history, the client tells the nurse they are allergic to penicillin. Which medication, if ordered by the prescriber, would be safe for this client?

1. Cefaclor (Ceclor)
2. Erythromycin (E-Mycin)
3. Cefdinir (Omnicef)
4. Cephalexin (Keflex)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 430

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-6 Explain the role of penicillins in treating bacterial infections.

Question 19

Type: MCSA

The nurse is preparing discharge instructions for a client who will be taking penicillin G. The client tells the nurse she is also taking birth control pills. What is the nurse's best response?

1. “You may continue taking the birth control pills as the only means of contraception.”
2. “If you feel you do not need to take the antibiotic, you don’t need to.”
3. “You do not need to take your birth control pills while taking this medication.”
4. “You will need to use another form of contraception while taking the antibiotic and for at least 1 month after you finish treatment.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 428

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-6 Explain the role of penicillins in treating bacterial infections.

Question 20

Type: MCSA

A client enters the emergency department with suspected exposure to anthrax. The physician confirms this suspicion and orders the client an antibiotic. Which medication would the nurse expect the physician to order?

1. Penicillin
2. Ciprofloxacin (Cipro)
3. Oxytetracycline (Terramycin)
4. Doxycycline (Vibramycin)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page number: 434

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-11 Explain the role of fluoroquinolones in treating bacterial infections.

Question 21

Type: MCSA

The nurse is caring for a client who is being discharged with a prescription for a tetracycline. Which statement, if made by the client, would demonstrate an understanding of the discharge instructions?

1. “It is fine for me to become pregnant while taking this medication.”
2. “I am so glad to be leaving today because I have an appointment to get my hair cut.”
3. “I will need to postpone my vacation at the beach until I finish this medication.”
4. “I will stop taking this medication as soon as I feel better.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 431

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-8 Explain the role of tetracyclines in treating bacterial infections.

Question 22

Type: MCMA

The nurse is providing instructions to a client being discharged on ciprofloxacin (Cipro). What should be included in the teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. “Finish the full course of the prescription.”
2. “Do not take with antacids.”
3. “You might have some dizziness.”
4. “Do not take with mineral supplements.”
5. “Take the medication only with grapefruit juice.”

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 425, 434

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-11 Explain the role of fluoroquinolones in treating bacterial infections.

Question 23

Type: MCSA

A client has been diagnosed with tuberculosis. How long does the nurse anticipate this client will require treatment?

1. 2–4 weeks
2. 6–12 months
3. 3–6 months
4. 10–14 days

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 439

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-14 Explain how the pharmacotherapy of tuberculosis differs from that of other infections.

Question 24

Type: MCSA

The nurse is caring for a client with tuberculosis. What does the nurse anticipate regarding this client's treatment?

1. Alternate day dosing of three antibiotics
2. Always two antibiotics
3. Only one antibiotic for 12 months
4. Different combinations of two or more antibiotics

Cognitive Level: Applying

Client Need: Physiological Integrity

Page number: 439

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-14 Explain how the pharmacotherapy of tuberculosis differs from that of other infections.

Question 25

Type: MCMA

A client has been prescribed isoniazid (INH). Which foods should the client avoid while taking this medication? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Chocolate
2. Bananas
3. White wine
4. Aged cheese
5. Red meat

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 441

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-14 Explain how the pharmacotherapy of tuberculosis differs from that of other infections.

Question 26

Type: MCMA

How do pathogens enter the body to cause disease? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Broken skin

2. Inhalation

3. Ingestion

4. Contact with mucous membrane

5. Touch with a gloved hand

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 422

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-1 Explain how bacteria cause disease.

Question 27

Type: MCSA

A client asks the nurse about the word “pathogen.” Which statement by the nurse provides education on pathogen?

1. A pathogen is an organism capable of causing disease in humans.

2. Virus and bacteria are pathogens that infect humans.

3. Antibiotics are effective in controlling pathogens in humans.

4. A virulent pathogen can cause an infection with very large numbers.

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 422

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-1 Explain how bacteria cause disease.

Question 28

Type: MCSA

A client has been prescribed an antibiotic and overhears the prescriber talking about acquired resistance. The client asks the nurse what this means. Which is the nurse’s best statement regarding acquired resistance?

1. It is an infection that is resistant to conventional antibiotics.

2. It is a superinfection that has significant antifungal resistance.

3. There is no such phenomenon of acquired resistance.

4. It is the most frequently used term for antibiotic coverage.

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 424

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-4 Using an example, explain how resistance can develop to an anti-infective drug.

Question 29

Type: MCSA

The nurse is preparing to administer penicillin to a client. Upon reviewing the microbiology data of the cultures, the nurse identifies that the bacteria is resistant to penicillin. Which medication does the nurse anticipate the prescriber to prescribe?

1. Tetracycline

2. Macrolide

3. Cephalosporin

4. Vancomycin

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 431

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-9 Explain the role of macrolides in treating bacterial infections.

Question 30

Type: MCSA

The nurse is caring for a client receiving gentamicin IV. Which laboratory tests should the nurse assess prior to administering the medication?

1. PTT

2. Liver function tests

3. Blood urea nitrogen

4. Complete blood count

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 433

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-10 Explain the role of aminoglycosides in treating bacterial infections.

Question 31

Type: MCSA

The nurse is caring for a client who was recently admitted from a long-term care facility. The client is prescribed trimethoprim–sulfamethoxazole by IV. The nurse understands that the client has which complication?

1. Nausea

2. Endocarditis

3. Urinary tract infection

4. Upper respiratory infection

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 435

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-12 Explain the role of sulfonamides and urinary antiseptics in treating bacterial infections.

Question 32

Type: MCSA

The nurse is caring for a client who was recently admitted from a long-term care facility. The client is prescribed trimethoprim–sulfamethoxazole by IV. Which laboratory tests should the nurse assess prior to administration of the medication?

1. Serum creatinine

2. Electrolytes

3. Allergies

4. C-reactive protein

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 435

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 27-12 Explain the role of sulfonamides and urinary antiseptics in treating bacterial infections.