Critical Care Practice Exam With Answers (72 Solved Questions)

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Unit 9, 10, & 11 – Practice questions for EXAM #4 FINAL1)Which nursing intervention has the highest priority for the patient who is takingcefepime?a.Wait until culture results are received before initiating antibioticb.Monitor patient for s/s of superinfectionc.Administer IV over 2 hours to prevent phlebitisd.Instruct the patient to take the drug for 5 days onlyAnswer: BRationale: Superinfection is a common adverse effect of antibiotics. The nurse should culturethe infected area before initiating antibiotics and may begin drug therapy before culture resultsare received. IV cephalosporins should be administered over 30 to 45 minutes, not 2 hours.Cephalosporins are usually given 10 days for a full regimen.2)A patient enters the emergency department with a draining wound. Once the patient isadmitted and assessed, the priority nursing intervention is to:a.Administer the ordered antibioticsb.Teach the patient about the ordered antibioticsc.Culture the woundd.Enforce droplet isolation precautionsAnswer: CRationale: The priority nursing intervention is to obtain a culture and antibiotic sensitivitytesting of infective organism (C&S).3)Which statement will the nurse include when teaching a patient about cephalosporintherapy?a.“avoid ingesting buttermilk or yogurt when taking this medication”b.“stop taking the medication when you feel better”c.“immediately stop taking the medication if you develop nausea”d.“inform your MD if you develop mouth ulcers”Answer: DRationale: The patient should be instructed to report signs of superinfection, such as mouthulcers or discharge from the anal or genital area. Ingestion of buttermilk or yogurt may preventsuperinfection of the intestinal flora; the entire course of the medication should be taken; andthe medication should be taken with food if nausea develops.

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4)A patient asks the nurse why she gets yeast infections after a course of antibiotics. Thenurse explains,a.“The antibiotics lower your WBC count”b.“People are poorly nourished and hydrated after an infection”c.“Yeast infections happen if the antibiotic is not taken for the full course”d.“Yeast infections are common when the normal body flora are disrupted”Answer: DRationale: The patient should be advised to ingest buttermilk or yogurt to prevent thissuperinfection of the body's normal flora.5)A patient is admitted to the health care facility with methicillin-resistant Staphylococcus aureus(MRSA). The nurse anticipates administration of which drug?a.Nafcillin (Nallpen)b.Vancomycin (Vancocin)c.Aztreonam (Azactam)d.Piperacillin-tazobactam (Zosyn)Answer: BRationale: The treatment of choice for MRSA is vancomycin (Vancocin).6)Which teaching by the nurse has the highest priority for the patient taking azithromycin(Zithromax)?a.Instruct the patient to use sunblock and protective clothing during sun exposureb.Instruct the patient to store drug out of light and extreme heatc.Inform patient that children younger than 8 years should not take the drug, to avoidtooth discolorationd.Instruct the patient to report any loose stools or diarrheaAnswer: DRationale: The patient should be instructed to report loose stools or diarrhea because of possiblepseudomembranous colitis. Photosensitivity during sun exposure is common with tetracyclines, whichshould not be given to children younger than 8 years; the drugs are affected by light and extreme heat.7)Which statement by a patient who has received teaching on tetracycline therapy indicates thatmore teaching is indicated?a.“I will store the medication away from light and extreme heat”b.“I will use an additional contraceptive technique because this drug may cause the oralcontraceptive I take to be less effective”c.“I will take this medication with an antacid”d.“If my stomach becomes upset when taking this medication, I will take it with non-dairyfoods”Answer: C

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Rationale: Patients taking tetracycline therapy should avoid milk products, iron, and antacids. Themedication should be stored away from light and extreme heat. Tetracycline can decrease theeffectiveness of oral contraceptives.8)A patient is ordered to receive vancomycin (Vancocin) for a severe infection. It is most importantfor the nurse to assess the patient for the development of:a.Neurotoxicityb.Hepatotoxicityc.Ototoxicityd.CardiotoxicityAnswer: CRationale: Vancomycin may cause nephrotoxicity and ototoxicity. Ototoxicity results indamage to the auditory or vestibular branch of cranial nerve VIII. Such damage can result in permanenthearing loss (auditory branch) or temporary or permanent loss of balance (vestibular branch).9)A patient is receiving gentamicin therapy: 100 mg IV at 0800, 1600, and 2400. At 0730, the nurseis informed that peak and trough levels need to be drawn. When is the best time to obtain thepeak level?a.0800b.0900c.1600d.2330Answer: BRationale: Blood should be drawn 45 to 60 minutes after drug has been administered forpeak levels and minutes before next drug dosing for trough levels.10) When teaching a patient about trimethoprim-sulfamethoxazole (TMP-SMZ), the nurse giveshighest priority to teaching the patient to:a.Increase fluid intakeb.Report signs of ringing in the ears or loss of hearingc.Expect the color of their urine to change to a reddish oranged.Take this drug with dairy products or antacids to protect the stomachAnswer: ARationale: Fluid intake should be increased to at least 2000 mL/day when taking sulfonamides to preventcrystalluria. Ototoxicity is not a common adverse effect of sulfonamides. The urine will not changecolors. Dairy products or antacids should not be taken at the same time as sulfonamides because theydecrease absorption.11) A patient has been prescribed trimethoprim-sulfamethoxazole (TMP-SMZ). The nurse realizesthat this drug is most likely used to treat which condition?a.Gonorrhea

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b.Rickettsial infectionc.Chlamydial infectiond.Urinary tract infectionAnswer: DRationale: TMP-SMZ is used to treat urinary tract infections, otitis media, bronchitis, pneumonia,rheumatic fever, and burns. It does not treat gonorrhea, rickettsial or chlamydial infections.12) A patient is ordered to receive cotrimoxazol/TMP-SMZ (Bactrim). This medication is acombination of two medications that are:a.Antagonisticb.Additivec.Synergisticd.ContraindicatedAnswer: CRationale: A synergistic effect results in increasing the desired drug response.13) Which statement about sulfonamide therapy is true?a.When used with sulfonylureas, sulfonamides decrease the hypoglycemic effect.b.When sulfonamides are used with warfarin, the anticoagulant effect is decreased.c.Sulfonamides must be taken with antacids to prevent gastric ulceration.d.Patients on sulfonamide therapy need to increase their fluid intake.Answer: DRationale: Patients taking sulfonamides need to drink several quarts of fluid daily to avoid thecomplication of crystalluria. These drugs increase the hypoglycemic effect of sulfonylureas, increase theanticoagulant effect of warfarin, and should not be taken with antacids because antacids decrease theabsorption rate of the drug.14) A patient is diagnosed with aCandidainfection in the mouth. The nurse anticipates that thepatient will be treated with:a.Metronidazole (Flagyl)b.Amphotericin B (Fungizone)c.Isoniazid (INH)

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