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1

The nurse is working with a patient who has been diagnosed with tapeworms. The nurse anticipates that the health care provider is most likely to place the patient on which medication?

Praziquantel
Praziquantel is the drug of choice for the treatment of tapeworms.

2

Which instruction should be included in the education of a patient beginning therapy with metronidazole for diarrhea due to a clostridium infection?

Avoid alcohol and products containing alcohol.

Patients taking metronidazole should avoid alcohol and products containing alcohol.

3

Which instruction should be included in the education of a patient beginning therapy with ivermectin for a helminth infection?

Take on an empty stomach.

Ivermectin should be taken on an empty stomach with water.

4

A patient who will be traveling to a malaria-infested country is receiving instructions on the prophylactic use of chloroquine. What instruction will the nurse give the patient?

Start the medication 2 weeks before the trip.

Treatment for malaria prophylaxis is usually started 2 weeks before travel and continued for 8 weeks after travel is completed.

5

The nurse is working with a patient who will be traveling to a country where the incidence of malaria is high. The nurse anticipates that the health care provider is most likely to place the patient on which medication?

Atovaquone/proguanil

Of the drugs listed, atovaquone/proguanil is the drug of choice for prevention of malaria.

6

The nurse is caring for a patient taking a polymyxin. What should the nurse monitor to identify potential side effects of this medication?

Blood urea nitrogen and creatinine

Polymyxins can cause kidney damage. Blood urea nitrogen and creatinine should be closely monitored.

7

Which is the most appropriate nursing intervention for a patient who is taking mefloquine and hydroxychloroquine?

Assess the patient's hearing

Hearing should be assessed because antimalarials may lead to eighth cranial nerve damage and ototoxicity

8

The nurse is aware that most patients receiving metronidazole are being treated for infections of the

Gastrointestinal system

Metronidazole acts by imparing DNA function of susceptible bacteria. This drug is used primarily to treat various disorders associated with organisms in the GI tract. . It is prescribed to treat intestinal amebiasis, trichomoniasis, inflammatory bowel disease, anaerobic infections, and bacterial vaginosis, and is used as perioperative prophylaxis in colorectal surgery.

9

A patient calls the clinic in November to report a temperature of 103° F, headache, a nonproductive cough, and muscle aches. The patient reports feeling well earlier that day. The nurse will schedule the patient to see the provider and will expect the provider to order which medication?

Rimantadine HCl (Flumadine)

Rimantadine is used for treatment of influenza.

10

A nurse whose last flu vaccine was 1 year prior is exposed to the influenza A virus. The occupational health nurse will administer which medication?

Amantadine HCl (Symmetrel)

The primary use for amantadine is prophylaxis against influenza A.

11

The nurse receives an order to administer a purine nucleoside antiviral medication. The nurse understands that this medication treats which type of virus?

Herpes virus

Purine nucleosides, such as acyclovir, are used to treat herpes simplex viruses 1 and 2, herpes zoster virus, varicella-zoster virus, and cytomegalovirus.

12

The nurse is caring for an infant who has respiratory syncytial virus (RSV) and who will receive ribavirin. The nurse expects to administer this drug by which route?

Inhalation

Ribavirin is given by inhalation to treat RSV. Oral ribavirin is used to treat hepatitis C, and intravenous ribavirin is used to treat hepatitis C and Lassa fever.

13

The nurse is teaching a patient who will receive acyclovir for a herpes virus infection. What information will the nurse include when teaching this patient?

Increase fluid intake while taking this medication.

Patients taking acyclovir should increase fluid intake to maintain hydration.

14

A patient is taking chloroquine (Aralen) to treat acute malaria. Which statement by the patient indicates understanding of this medication?

"I should report visual changes immediately."

Patients taking chloroquine (Aralen) have a risk of visual injury related to side effects of blurred vision and should report visual changes to the provider.

15

A child is diagnosed with pinworms. Which anthelmintic drug will the provider order for this child?

Mebendazole (Vermox)

Mebendazole is used to treat pinworms.

16

The nurse is working with a patient who has been diagnosed with tapeworms. The nurse anticipates that the health care provider is most likely to place the patient on which medication?

Praziquantel
Praziquantel is the drug of choice for the treatment of tapeworms.

17

Which instruction should be included in the education of a patient beginning therapy with metronidazole for diarrhea due to a clostridium infection?

Avoid alcohol and products containing alcohol.

Patients taking metronidazole should avoid alcohol and products containing alcohol.

18

Which instruction should be included in the education of a patient beginning therapy with ivermectin for a helminth infection?

Take on an empty stomach.

Ivermectin should be taken on an empty stomach with water.

19

A patient who will be traveling to a malaria-infested country is receiving instructions on the prophylactic use of chloroquine. What instruction will the nurse give the patient?

Start the medication 2 weeks before the trip.

Treatment for malaria prophylaxis is usually started 2 weeks before travel and continued for 8 weeks after travel is completed.

20

The nurse is working with a patient who will be traveling to a country where the incidence of malaria is high. The nurse anticipates that the health care provider is most likely to place the patient on which medication?

Atovaquone/proguanil

Of the drugs listed, atovaquone/proguanil is the drug of choice for prevention of malaria.

21

The nurse is caring for a patient taking a polymyxin. What should the nurse monitor to identify potential side effects of this medication?

Blood urea nitrogen and creatinine

Polymyxins can cause kidney damage. Blood urea nitrogen and creatinine should be closely monitored.

22

Which is the most appropriate nursing intervention for a patient who is taking mefloquine and hydroxychloroquine?

Assess the patient's hearing

Hearing should be assessed because antimalarials may lead to eighth cranial nerve damage and ototoxicity

23

Which information will the nurse include when teaching a patient about anthelmintic therapy?

Be aware that drowsiness may occur

Warn patient that drowsiness may occur, and operating a car or machinery should be avoided if this should happen.

24

The nurse is aware that most patients receiving metronidazole are being treated for infections of the

Gastrointestinal system

Metronidazole acts by imparing DNA function of susceptible bacteria. This drug is used primarily to treat various disorders associated with organisms in the GI tract. . It is prescribed to treat intestinal amebiasis, trichomoniasis, inflammatory bowel disease, anaerobic infections, and bacterial vaginosis, and is used as perioperative prophylaxis in colorectal surgery.

25

A patient calls the clinic in November to report a temperature of 103° F, headache, a nonproductive cough, and muscle aches. The patient reports feeling well earlier that day. The nurse will schedule the patient to see the provider and will expect the provider to order which medication?

Rimantadine HCl (Flumadine)

Rimantadine is used for treatment of influenza.

26

A nurse whose last flu vaccine was 1 year prior is exposed to the influenza A virus. The occupational health nurse will administer which medication?

Amantadine HCl (Symmetrel)

The primary use for amantadine is prophylaxis against influenza A.

27

A patient is diagnosed with influenza and will begin taking a neuraminidase inhibitor. The nurse knows that this drug is effective when taken within how many hours of onset of flu symptoms?

48 hours

Neuraminidase inhibitors, such as zanamivir and oseltamivir, should be taken within 48 hours of onset of symptoms for best effect.

28

The nurse receives an order to administer a purine nucleoside antiviral medication. The nurse understands that this medication treats which type of virus?

Herpes virus

Purine nucleosides, such as acyclovir, are used to treat herpes simplex viruses 1 and 2, herpes zoster virus, varicella-zoster virus, and cytomegalovirus.

29

The nurse is caring for an infant who has respiratory syncytial virus (RSV) and who will receive ribavirin. The nurse expects to administer this drug by which route?

Inhalation

Ribavirin is given by inhalation to treat RSV. Oral ribavirin is used to treat hepatitis C, and intravenous ribavirin is used to treat hepatitis C and Lassa fever.

30

The nurse receives the following order for a patient who is diagnosed with herpes zoster virus: PO acyclovir (Zovirax) 400 mg TID for 7 to 10 days. The nurse will contact the provider to clarify which part of the order?

Dose and frequency

Acyclovir is used for herpes zoster, but the dose should be 800 mg 5 times daily for 7 to 10 days. The nurse should clarify the dose and frequency. For herpes simplex, 400 mg 3 times daily is correct.

31

The nurse is teaching a patient who will receive acyclovir for a herpes virus infection. What information will the nurse include when teaching this patient?

Increase fluid intake while taking this medication.

Patients taking acyclovir should increase fluid intake to maintain hydration.

32

A patient who has travelled to an area with prevalent malaria has chills, fever, and diaphoresis. The nurse recognizes this as which phase of malarial infection?

Erythrocytic phase

The erythrocytic phase of malarial infection occurs when the parasite invades the red blood cells and is characterized by chills, fever, and sweating.

33

A patient is preparing to travel to a country with prevalent malaria. To prevent contracting the disease, the provider has ordered chloroquine HCl (Aralen). The nurse will instruct the patient to take this drug according to which schedule?

500 mg weekly beginning 2 weeks prior to travel and continuing for 6 to 8 weeks after travel

For malaria prophylaxis, chloroquine is given 500 mg/dose weekly for 2 weeks prior to travel and then weekly until 6 to 8 weeks after exposure.

34

A patient is taking chloroquine (Aralen) to treat acute malaria. Which statement by the patient indicates understanding of this medication?

"I should report visual changes immediately."

Patients taking chloroquine (Aralen) have a risk of visual injury related to side effects of blurred vision and should report visual changes to the provider.

35

A patient will take an anthelmintic medication and asks the nurse about side effects. The nurse will tell the patient that anthelmintic drugs

Commonly have GI side effects

Anthelmintic drugs have many GI side effects, including anorexia, nausea, vomiting, diarrhea, and cramps.

36

A child is being treated for pinworms, and the parent asks the nurse how to prevent spreading this to other family members. What will the nurse tell the parent?

"Your child should wash hands well after using the toilet."

To prevent the spread of pinworms, good hand washing after toileting is recommended.

37

A patient who is taking acyclovir (Zovirax) to treat an oral HSV-1 infection asks the nurse why oral care is so important. The nurse will tell the patient that meticulous oral care helps to

prevent gingival hyperplasia.

Good oral care can prevent gingival hyperplasia in patients with HSV-1.

38

A child is diagnosed with pinworms. Which anthelmintic drug will the provider order for this child?

Mebendazole (Vermox)

Mebendazole is used to treat pinworms.

39

The patient has been ordered treatment with rimantadine (Flumadine). The patient has renal impairment. The nurse anticipates what change to the dose of medication?

Decreased

The dosage of the medication will be decreased when the patient has renal impairment.

40

The nurse is teaching a patient who is receiving chloroquine (Aralen) for malaria prophylaxis. Which statement by the patient indicates a need for further teaching?

If I have gastrointestinal upset, I should take an antacid.

Patients should not take these drugs with antacids.

41

Which diseases are caused by herpes viruses? (Select all that apply.)

Chicken pox
Mononucleosis
Shingles

Herpes viruses cause chicken pox, mononucleosis, and shingles.

42

The nurse is caring for a patient who is taking rifampin. The patient has a heart rate of 90 beats/min, blood pressure of 100/89 mm Hg, and red-orange urine. What is the nurse's best action?

A) document the findings and teach the patient
B) call the health care provider
C) collect a urine culture
D) discard the first void and start a 24-hour urine collection

A) document the findings and teach the patient

Red-orange discoloration of body fluids is a common side effect of rifampin, but it is not harmful and does not indicate infection. There is no need to call the health care provider, collect a urine culture, or start 24-hour urine collection.

43

A patient enters the emergency department with suspected influenza. Prior to starting the patient on the prescribed oseltamivir phosphate, what should the nurse determine?

A) allergies to antibiotics
B) over-the-counter medications taken in the last 48 hours
C) immunization history
D) length of time since onset of symptoms

D) length of time since onset of symptoms

Oseltamivir phosphate inhibits the replication and spread of influenza if given within 48 hours of symptoms.

44

Before administration of intravenous amphotericin B, what will the nurse do?

A) set up an IV solution with potassium
B) premedicate the patient with an antipyretic, antihistamine, and antiemetic as prescribed
C) administer insulin as prescribed to prevent severe hyperglycemia
D) administer intravenous dextrose as prescribed to prevent severe hypoglycemia

B) premedicate the patient with an antipyretic, antihistamine, and antiemetic as prescribed

Almost all patients given intravenous amphotericin B develop fever, chills, nausea and vomiting, and hypotension. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. There is no need to treat with IV potassium or administer insulin or IV dextrose.

45

The patient has been diagnosed with candidiasis. The nurse recognizes that the patient is most likely to be ordered which drug?

A) sulconazole
B) haloprogin
C) miconazole nitrate
D) tolnaftate

C) miconazole nitrate

Miconazole nitrate can be ordered to treat candidiasis. The other drugs listed can be used to treat tinea pedis, corporis, and cruris.

46

A patient with Mycobacterium tuberculosis is prescribed ethambutol for long-term use. Which statement by the patient indicates understanding of the instructions?

A) "dizziness, drowsiness, and decreased urinary output are common with this drug, but they will subside over time"
B) "constipation will be a problem, so I will increase the fiber and fluids in my diet"
C) "I will need to have my eyes checked regularly while I am taking this drug"
D) "this medication may cause my bodily secretions to turn red-orange

C) "I will need to have my eyes checked regularly while I am taking this drug)

Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity.

47

A patient is diagnosed with an oral candidal infection. Which intervention is best?

A) start an IV so the patient does not have to eat by mouth
B) instruct the patient to brush her teeth and gargle hourly
C) teach the patient how to take nystatin
D) administer valacyclovir hydrochloride and monitor lips and gums

C) teach the patient how to take nystatin

Nystatin is an antifungal ointment that is used for a variety of candidal infections. The patient needs to be taught how to "swish and swallow" to treat this infection. There is no need to brush the teeth hourly or administer Valtrex, and starting an IV is an extreme measure.

48

Which statement indicates to the nurse that the patient understands the medication instructions regarding ketoconazole for treatment of candidiasis?

A) I will take this medication with orange juice for better absorption
B) I need to take this drug with food to minimize gastrointestinal distress
C) I can take this medication with antacids if it causes gastrointestinal discomfort
D) I can expect my skin to turn yellow from taking this drug

B) I need to take this drug with food to minimize gastrointestinal distress

Taking this medication with food will help minimize gastrointestinal upset. Ketoconazole should not be taken with coffee, tea, or acidic fruit juices. Additionally, it needs to be taken at least 2 hours before or after the ingestion of alkaline products or antacids.

49

The patient has been diagnosed with tinea pedis. The nurse recognizes that the patient is most likely to be ordered which drug?

A) terconazole
B) miconazole nitrate
C) butoconazole nitrate
D) griseofulvin

D) griseofulvin

Of the drugs listed, the patient is most likely to be treated with griseofulvin. The other drugs treat candidiasis.

50

What will the nurse teach a patient who is taking isoniazid (INH)?

A) you will need to take vitamin C to potentiate the action of INH
B) you should not be on that drug, I will check with the health care provider
C) pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid
D) multidrug therapy is necessary to prevent the occurrence of resistant bacteria

C) pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid

Isoniazid can cause neurotoxicity. Pyridoxine (vitamin B6) is the drug of choice to prevent this adverse reaction. It is not an anti-infective agent and thus will work to destroy the mycobacterium or prevent drug resistance. Vitamin C is not taken with this drug; the drug is appropriate for most patients, and INH with pyridoxine is not multidrug therapy.

51

The health care provider has ordered amphotericin B for the patient. The nurse recognizes that which is the most effective way to administer this medication to the patient?

A) intravenously over 1 hour
B) orally at regular intervals
C) by subcutaneous injection
D) intravenously over 2 to 6 hours

D) intravenously over 2 to 6 hours

Amphotericin B should be administered by slow intravenous infusion.

52

What is the primary assessment the nurse should make for a patient who is taking ganciclovir sodium?

A) blood urea nitrogen
B) bowel elimination
C) complete blood count
D) input and output

C) complete blood count

Bone marrow suppression is a dose-limiting toxicity of ganciclovir, and a complete blood count should be monitored.

53

The nurse is caring for a patient who has been diagnosed with genital herpes. Which medication is the drug of choice for this patient?

A) acyclovir
B) amantadine
C) ribavirin
D) zidovudine

A) acyclovir

Acyclovir is the drug of choice to treat herpes simplex infections. Ribavirin is effective against respiratory syncytial virus (RSV); zidovudine is effective against HIV; amantadine is effective against influenza A.

54

A patient taking amantadine complains of depression and dizziness. What intervention will the nurse perform first?

A) evaluate the patient for other central nervous system effects from the medication
B) order a consult for counseling
C) take the patient's blood pressure sitting and standing
D) call the health care provider

C) take the patient's blood pressure sitting and standing

The side effects and adverse reactions to amantadine include central nervous system effects, such as insomnia, depression, anxiety, confusion, and ataxia; orthostatic hypotension; neurologic problems, such as weakness, dizziness, and slurred speech; and gastrointestinal disturbances, such as anorexia, nausea, vomiting, and diarrhea. The nurse should evaluate the patient for orthostatic hypotension first to address safety issues.

55

The patient is being treated with intravenous amphotericin B. What is the nurse's primary intervention?

A) encourage the patient to drink at least a liter of fluid per shift
B) assess the IV site for infiltration
C) administer with dextrose
D) assess blood urea nitrogen and creatinine

D) assess blood urea nitrogen and creatinine

Nephrotoxicity can occur when taking amphotericin B so it is important to assess BUN and creatinine levels to determine how well the kidneys are functioning. Urinary output, electrolyte levels, and complete blood counts should also be monitored while taking amphotericin B.

56

The health care provider has ordered ribavirin for the patient with respiratory syncytial virus (RSV). The nurse recognizes that which route is the most effective way to administer this medication to the patient?

A) intravenously over 1 hour
B) orally at regular intervals
C) by subcutaneous injection
D) aerosol inhalation

D) aerosol inhalation

Ribavirin should be administered by aerosol inhalation.

57

What will the nurse monitor to evaluate the effectiveness of antiviral agents administered to treat human immunodeficiency virus infection?

A) megakaryocyte counts
B) lymphocyte counts
C) red blood cell counts
D) viral load

D) viral load

All antiretroviral agents work to reduce the viral load, which is the number of viral RNA copies per milliliter of blood.

58

The patient states that she has been prescribed prophylactic medication for tuberculosis for a period of 4 weeks. What is the nurse's best response?

A) "let me teach you about the medications"
B) "we do not use medications prophylactically for tuberculosis"
C) "you should be on the drugs for at least 6 months"
D) "you should be on the medications for only 2 weeks"

C) "you should be on the drugs for at least 6 months"

Between 6 months and 1 year is sufficient time for prevention of active tuberculosis. Because the tuberculosis mycobacterium is slow-growing, shorter lengths of time may not sufficiently eradicate the organism.

59

Which teaching for the patient who is taking fluconazole is a priority for the nurse?

A) take concurrent vitamin B6 to prevent peripheral neuropathy
B) take 1 hour before or 2 hours after meals
C) advise that hypoglycemia may occur with concurrent oral sulfonylureas
D) warn that gingival hyperplasia may occur with prolonged use

C) advise that hypoglycemia may occur with concurrent oral sulfonylureas

According to the orange chart on pg. 382, there is an increased risk for hypoglycemia in a patient taking fluconazole with oral sulfonylureas. Answers A and B are teaching points for a patient taking isoniazid. Answer D is a potential adverse effect for a patient taking acyclovir.

60

A patient has developed active tuberculosis and is prescribed isoniazid and rifampin. Which information will the nurse include in teaching the patient about taking this drug? (Select all that apply)

A) isoniazid should be given 1 hour before or 2 hours after meals
B) have periodic eye examinations as ordered by the health care provider
C) compliance with drug regimen is essential
D) report numbness, tingling, and burning of hands and feet
E) warn patient that rifampin may turn body fluids a harmless green color

A) isoniazid should be given 1 hour before or 2 hours after meals
B) have periodic eye examinations as ordered by the health care provider
C) compliance with drug regimen is essential
D) report numbness, tingling, and burning of hands and feet

Isoniazid should be given 1 hour before or 2 hours after meals because food decreases isoniazid absorption. The patient should have periodic eye exams because antitubercular drugs can cause ocular toxicity. The patient should take the drug regimen as prescribed to ensure the entire infection is treated and to prevent drug resistance. The patient should report numbness, tingling, and burning of hands and feet because these symptoms may indicate that peripheral neuropathy is developing. Rifampin may turn body fluids into a harmless reddish-orange color, not green.

61

A middle-aged adult is diagnosed with tuberculosis. Which is true of treatment for this diagnosis?

A) treatment may take about 10 days to 2 weeks
B) usually two to three agents are needed
C) the bacteria is usually resistant to treatment therapy
D) treatment for tuberculosis is usually without side effects

B) usually two to three agents are needed

Single-drug therapy for the treatment of tuberculosis is usually not effective. Multi-drug therapy is typically used to decrease bacterial resistance to the drugs and to decrease the duration of treatment.

62

When teaching a patient about isoniazid (INH) and rifampin drug therapy, which statement will the nurse include?

A) "take isoniazid with meals"
B) "double the amount of vitamin C in your diet to prevent the peripheral neuropathy associated with isoniazid therapy"
C) "notify the primary health care provider immediately if your urine turns a red-orange color"
D) "avoid exposure to direct sunlight"

D) "avoid exposure to direct sunlight"

The nurse should instruct the patient to avoid exposure to direct sunlight because isoniazid can cause photosensitivity. Isoniazid should be taken 1 hour before or 2 hours after meals. The patient should take vitamin B6, not vitamin C, to prevent peripheral neuropathy. Isoniazid may turn urine a red-orange color but this is harmless.

63

A patient is diagnosed with a Candida infection in the mouth. The nurse anticipates that the patient will be treated with:

A) metronidazole
B) amphotericin B
C) isoniazid
D) nystatin

D) nystatin

Nystatin is most commonly used to treat Candida infection in the mouth.

64

A patient is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the patient which instruction?

A) do not skip doses
B) take both drugs three times daily with food
C) take an antacid with the drugs to decrease GI distress
D) take rifampin initially, and begin isoniazid after 2 months

A) do not skip doses

The nurse should teach the patient to not skip doses because this can lead to bacterial drug resistance. Antitubercular drugs should be taken 1 hour before or 2 hours after meals for better absorption. Antitubercular drugs should not be taken with an antacid because this decreases their absorption. The health care provider will decide when the antitubercular drugs should be taken and for how long.

65

The nurse teaches a patient taking amphotericin B to report which signs and symptoms to the health care provider?

A) change in sight
B) decrease in hearing
C) decrease in urine
D) painful red rash and blisters

C) decrease in urine

Amphotericin B can cause nephrotoxicity so it is very important for the nurse to monitor urine output and kidney function. A change in sight, a decrease in hearing, and a painful red rash and blisters are not side effects of taking amphotericin B.

66

A patient has been diagnosed with tuberculosis and is to begin antitubercular therapy with isoniazid, rifampin, and ethambutol. What should the nurse do? (Select all that apply)

A) encourage periodic eye examinations
B) instruct the patient to take medications with meals
C) suggest that the patient take antacids with medications to prevent GI distress
D) advise the patient to report numbness and tingling of the hands or feet
E) alert the patient that body fluids may develop a red-orange color

F) teach the patient to avoid direct sunlight and to use sunblock

A) encourage periodic eye examinations
D) advise the patient to report numbness and tingling of the hands or feet
E) alert the patient that body fluids may develop a red-orange color
F) teach the patient to avoid direct sunlight and to use sunblock

Antitubercular drugs should not be taken with food or with antacids.

67

Zanamivir is ordered for a patient. What does the nurse know about the use of this drug?

A) it is a treatment for herpes simplex virus type 2
B) oral administration is for treatment of herpes simplex virus type 1
C) it treats varicella-zoster virus
D) administration must be within 48 hours of onset of symptoms to be effective

D) administration must be within 48 hours of onset of symptoms to be effective

Zanamivir is used to treat influenzas A and B but it must begin within 48 hours of onset of flu symptoms to be effective.

68

Acyclovir has been ordered for a patient with genital herpes. Which nursing interventions are appropriate for this patient? (Select all that apply)

A) monitor the patient's blood urea nitrogen (BUN) and creatinine
B) monitor the patient's blood pressure for hypertension
C) administer intravenous acyclovir over 30 minutes
D) advise maintenance of adequate fluid intake
E) monitor complete blood count (CBC) for blood dyscrasias

A) monitor the patient's blood urea nitrogen (BUN) and creatinine
D) advise maintenance of adequate fluid intake
E) monitor complete blood count (CBC) for blood dyscrasias

The nurse would also need to monitor the patient for orthostatic hypotension, not hypertension and acyclovir should be administered intravenously over 60 minutes, not 30 minutes.

69

A mother of two children was just diagnosed with hepatitis C virus. Which of the following is incorrect about hepatitis C virus?

A) a vaccine is available
B) hepatitis C virus can be transmitted by blood and body fluids
C) hepatitis C virus can cause hepatic carcinoma
D) persons with hepatitis C virus can become chronic carriers

A) a vaccine is available

Both hepatitis B virus and hepatitis C virus are spread via blood and body fluids. Hepatitis A virus is spread by eating contaminated food. There is a vaccine available for hepatitis A virus and hepatitis B virus, but no vaccine is currently available for the hepatitis C virus.

70

Which statement indicates to the nurse that the patient understands the medication instructions regarding ketoconazole for treatment of candidiasis?

A) I will take this medication with orange juice for better absorption
B) I need to take this drug with food to minimize gastrointestinal distress
C) I can take this medication with antacids if it causes gastrointestinal discomfort
D) I can expect my skin to turn yellow from taking this drug

B) I need to take this drug with food to minimize gastrointestinal distress

Taking this medication with food will help minimize gastrointestinal upset. Ketoconazole should not be taken with coffee, tea, or acidic fruit juices. Additionally, it needs to be taken at least 2 hours before or after the ingestion of alkaline products or antacids.

71

The patient has been diagnosed with tinea pedis. The nurse recognizes that the patient is most likely to be ordered which drug?

A) terconazole
B) miconazole nitrate
C) butoconazole nitrate
D) griseofulvin

D) griseofulvin

Of the drugs listed, the patient is most likely to be treated with griseofulvin. The other drugs treat candidiasis.

72

What will the nurse teach a patient who is taking isoniazid (INH)?

A) you will need to take vitamin C to potentiate the action of INH
B) you should not be on that drug, I will check with the health care provider
C) pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid
D) multidrug therapy is necessary to prevent the occurrence of resistant bacteria

C) pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid

Isoniazid can cause neurotoxicity. Pyridoxine (vitamin B6) is the drug of choice to prevent this adverse reaction. It is not an anti-infective agent and thus will work to destroy the mycobacterium or prevent drug resistance. Vitamin C is not taken with this drug; the drug is appropriate for most patients, and INH with pyridoxine is not multidrug therapy.

73

The health care provider has ordered amphotericin B for the patient. The nurse recognizes that which is the most effective way to administer this medication to the patient?

A) intravenously over 1 hour
B) orally at regular intervals
C) by subcutaneous injection
D) intravenously over 2 to 6 hours

D) intravenously over 2 to 6 hours

Amphotericin B should be administered by slow intravenous infusion.

74

What is the primary assessment the nurse should make for a patient who is taking ganciclovir sodium?

A) blood urea nitrogen
B) bowel elimination
C) complete blood count
D) input and output

C) complete blood count

Bone marrow suppression is a dose-limiting toxicity of ganciclovir, and a complete blood count should be monitored.

75

The nurse is caring for a patient who has been diagnosed with genital herpes. Which medication is the drug of choice for this patient?

A) acyclovir
B) amantadine
C) ribavirin
D) zidovudine

A) acyclovir

Acyclovir is the drug of choice to treat herpes simplex infections. Ribavirin is effective against respiratory syncytial virus (RSV); zidovudine is effective against HIV; amantadine is effective against influenza A.

76

A patient taking amantadine complains of depression and dizziness. What intervention will the nurse perform first?

A) evaluate the patient for other central nervous system effects from the medication
B) order a consult for counseling
C) take the patient's blood pressure sitting and standing
D) call the health care provider

C) take the patient's blood pressure sitting and standing

The side effects and adverse reactions to amantadine include central nervous system effects, such as insomnia, depression, anxiety, confusion, and ataxia; orthostatic hypotension; neurologic problems, such as weakness, dizziness, and slurred speech; and gastrointestinal disturbances, such as anorexia, nausea, vomiting, and diarrhea. The nurse should evaluate the patient for orthostatic hypotension first to address safety issues.

77

The patient is being treated with intravenous amphotericin B. What is the nurse's primary intervention?

A) encourage the patient to drink at least a liter of fluid per shift
B) assess the IV site for infiltration
C) administer with dextrose
D) assess blood urea nitrogen and creatinine

D) assess blood urea nitrogen and creatinine

Nephrotoxicity can occur when taking amphotericin B so it is important to assess BUN and creatinine levels to determine how well the kidneys are functioning. Urinary output, electrolyte levels, and complete blood counts should also be monitored while taking amphotericin B.

78

A patient with type 1 diabetes mellitus has been ordered insulin aspart (Novolog) 10 units at 7:00 AM. What nursing intervention will the nurse perform after administering this medication?

Make sure the patient eats breakfast immediately.

79

The patient newly diagnosed with type 2 diabetes mellitus has been ordered insulin glargine (Lantus). What information is essential for the nurse to teach this patient?

"This medication has a duration of action of 24 hours."

80

The nurse is teaching the patient how to administer insulin. What information is essential to include in the plan?

"For the most consistent absorption, inject the insulin into the abdomen."

81

The nurse administers NPH insulin at 8 AM. What intervention is essential for the nurse to perform?

Make sure patient eats by 5 PM.

82

Which statement indicates to the nurse that the patient needs additional teaching on oral hypoglycemic agents?

"I will take the medication only when I need it."

83

What information will the nurse teach the patient who has been prescribed an alpha glucosidase inhibitor?

"This medication will delay the absorption of carbohydrates from the intestines."

84

The patient with type 1 diabetes mellitus asks, "Why can't I take a sulfonylurea like my friend who has diabetes?" What is the nurse's best response?

"Sulfonylurea increases beta-cell stimulation to secrete insulin, and with your type of diabetes, the beta cells do not contain insulin. This medication will not work for you."

85

The nurse is teaching a patient who has been prescribed repaglinide (Prandin). Which information will the nurse include in the teaching plan?

"You will need to be sure you eat as soon as you take this medication."

86

Which technique is most appropriate regarding mixing insulin when the patient must administer 30 units regular insulin and 70 units NPH insulin in the morning?

Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin.

87

The nurse would include which statement when teaching a patient about insulin glargine (Lantus)?

"You cannot mix this insulin with any other insulin in the same syringe."

88

Which is the most appropriate action for the nurse who is told that a patient typically takes his glipizide (Glucotrol) with food?

Inform the patient that it is better to take the medication 30 minutes before a meal.

89

What is the nurse's best action when finding a patient with type 1 diabetes mellitus unresponsive, cold, and clammy?

Administer glucagon.