Nokea
A nurse is reviewing the medical records of several patients who are to receive antibacterial drug therapy. The nurse understands that aminoglycosides would be contraindicated in clients with which of the following conditions? Select all that apply.
- A. Pre-existing hearing loss
- B. Pregnancy
- C. Parkinsonism
- D. None of the above
Correct Answer: A, B, C
Rationale: The aminoglycosides are contraindicated in clients with pre-existing hearing loss, myasthenia gravis, and parkinsonism and during lactation and pregnancy.
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A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?
- A. Take the drug on an empty stomach.
- B. Take the drug along with a meal.
- C. Take the drug along with milk or fruit juice.
- D. Take the drug immediately after meals.
Correct Answer: A
Rationale: Oral preparations of tetracycline should be administered on an empty stomach with a full glass of water to maximize absorption. Tetracycline is not absorbed effectively if taken with food, with dairy products, or immediately after meals.
A nursing instructor is preparing a class on various antibacterial drugs interfering with protein synthesis, with the discussion focusing on quinupristin/dalfopristin. Which of the following medications would the instructor include as interacting with quinupristin/dalfopristin, thus increasing the risk for toxicity? Select all that apply.
- A. Lorazepam (Ativan)
- B. Quinapril (Accupril)
- C. Ritonavir (Norvir)
- D. Atorvastatin (Lipitor)
Correct Answer: A, C, D
Rationale: When quinupristin/dalfopristin is prescribed, it may interact with the following drugs, increasing serum levels and thus the risk for toxicity: antiretrovirals, antineoplastic and immunosuppressant agents, calcium channel blockers, benzodiazepines, and cisapride.
A nurse is preparing to administer lincomycin via IM injection. Which of the following would be most appropriate for the nurse to do? Select all that apply.
- A. Inspect previous injection sites.
- B. Rotate the injection site.
- C. Use the abdomen for intramuscular injections.
- D. Note the site used for injection in the client's chart.
Correct Answer: A, B, D, E
Rationale: When giving lincomycin intramuscularly, the nurse inspects previous injection sites for signs of pain or tenderness, redness, and swelling; reports the persistence of a localized reaction to the physician; rotates the injection sites; and records the site used for injection in the client's chart.
A nurse suspects that a patient receiving an aminoglycoside is developing neurotoxicity based on assessment of which of the following? Select all that apply.
- A. Paresthesias
- B. Tingling around the mouth
- C. Ringing in the ears
- D. Vertigo
Correct Answer: A, B, E
Rationale: Signs and symptoms of neurotoxicity include numbness, skin tingling, circumoral (around the mouth) paresthesia, peripheral paresthesia, tremors, muscle twitching, convulsions, muscle weakness, and neuromuscular blockade (acute muscular paralysis and apnea). Ringing in the ears and vertigo would suggest ototoxicity.
After teaching a group of nursing students about indications for linezolid (Zyvox), the instructor determines a need for additional teaching when the students identify which of the following as an indication?
- A. Community-acquired pneumonia (CAP)
- B. Vancomycin-resistant Enterococcus faecium (VREF)
- C. Methicillin-resistant Staphylococcus aureus (MRSA)
- D. Acute otitis media
Correct Answer: D
Rationale: Linezolid is used in the treatment of vancomycin-resistant Enterococcus faecium (VREF), health care? and community-acquired pneumonias, and skin and skin structure infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA). It is not used to treat otitis media.