The nurse caring for a patient who has tuberculosis and who is taking isoniazid, rifampin, and streptomycin reviews the medical record and notes the patient's sputum cultures reveal resistance to streptomycin. The nurse will anticipate that the provider will take which action?
- A. Add ethambutol (Myambutol)
- B. Change the streptomycin to clarithromycin
- C. Change the streptomycin to kanamycin
- D. Order renal function tests
Correct Answer: C
Rationale: Kanamycin replaces streptomycin in phase I resistance; ethambutol is for INH resistance, and clarithromycin is phase II. The patient's current regimen is first-phase treatment. If resistance to streptomycin develops, the provider can change to kanamycin or to ciprofloxacin.
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Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
- A. OTC drugs are safe and do not cause adverse effects if taken properly.
- B. OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).
- C. OTC drugs are different from any drugs available by prescription and cost less.
- D. OTC drugs could cause serious harm if not taken according to directions.
Correct Answer: D
Rationale: It is important to follow package directions because OTCs are medications that can cause serious harm if not taken properly. OTCs are drugs that have been determined to be safe when taken as directed; however, all drugs can produce adverse effects even when taken properly. They may have originally been prescription drugs that were tested by the FDA or they may have been grandfathered in when the FDA laws changed. OTC education should always be included as a part of the hospital discharge instructions.
A nurse is teaching a client who has a new prescription for Beclomethasone. Which of the following instructions should the nurse include?
- A. Rinse your mouth after each use of this medication.
- B. Limit fluid intake while taking this medication.
- C. Increase your intake and the medication.
- D. You can take the medication as needed.
Correct Answer: A
Rationale: Rinsing the mouth prevents oral thrush, a common side effect of inhaled corticosteroids.
All of the following are protein bound except:
- A. Propranolol
- B. Atenolol
- C. Phenylbutazone
- D. Warfarin
Correct Answer: B
Rationale: Atenolol has low protein binding; others bind extensively.
Cough and cold medications that contain a sympathomimetic decongestant such as phenylephrine should be used cautiously in what population:
- A. Older adults
- B. Hypertensive patients
- C. Infants
- D. All of the above
Correct Answer: D
Rationale: Sympathomimetic decongestants like phenylephrine can raise blood pressure or cause adverse effects in older adults, hypertensives, and infants.
Before administering a prescription medication, what information does the nurse find on the drug label? (Select all that apply.)
- A. Brand name
- B. Generic name
- C. Drug concentration
- D. Adverse effects
Correct Answer: D
Rationale: Prescription drug labels will contain the brand name, generic name, drug concentration, and expiration date. Adverse effects will not be listed on drug labels.