Nursing 320 Pharmacology exam 5 at Denver College of Nursing
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Free Nursing 320 Pharmacology exam 5 at Denver College of Nursing Questions
1. The nurse knows that which of the following antibiotics are resistant to beta-lactamase bacteria? Select all that apply. One, some, or all may be correct.
- Ceftaroline
- Ampicillin
- Amoxicillin/Clavulanic acid
- Piperacillin/Tazobactam
Explanation
A. Ceftaroline is a fifth-generation cephalosporin that is resistant to many beta-lactamases. It has broad-spectrum activity and is effective against methicillin-resistant Staphylococcus aureus (MRSA) and other resistant gram-positive organisms. C. Amoxicillin/Clavulanic acid This combination pairs a beta-lactam antibiotic (amoxicillin) with a beta-lactamase inhibitor (clavulanic acid). The inhibitor protects the amoxicillin from enzymatic destruction, making the drug effective against beta-lactamase–producing bacteria. D. Piperacillin/Tazobactam This is another penicillin/beta-lactamase inhibitor combination. Tazobactam prevents bacterial enzymes from inactivating piperacillin, thereby extending its spectrum of activity against resistant gram-negative and anaerobic bacteria.
2. A patient has an order for Zithromax 1 g PO stat. The Zithromax bottle concentration is 200 mg per 5 mL. How many mL will you give? (Round to the nearest whole number.)
- 10 mL
- 15 mL
- 20 mL
- 25 mL
Explanation
Total dose needed = 1000 mg Concentration = 200 mg ÷ 5 mL = 40 mg/mL Volume = 1000 mg ÷ 40 mg/mL = 25 mL (already a whole number)
3. A client is prescribed a beta-lactam antibiotic. The nurse knows that which of the following antibiotics are in the beta-lactam class? Select all that apply. One, some, or all may be correct.
- Tetracyclines
- Carbapenems
- Penicillins
- Cephalosporins
- Vancomycin
Explanation
B. Carbapenems (e.g., imipenem, meropenem) are broad-spectrum beta-lactam antibiotics. They work by inhibiting bacterial cell wall synthesis, making them effective against many resistant bacterial strains. C. Penicillins were the first beta-lactam antibiotics discovered. They contain a beta-lactam ring that interferes with bacterial cell wall formation, leading to cell lysis. D. Cephalosporins (e.g., ceftriaxone, cephalexin) also contain a beta-lactam ring and share a similar mechanism to penicillins but have a broader spectrum and greater resistance to beta-lactamases.
4. A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who has been prescribed a combination inhaler containing a long-acting beta2-agonist (LABA) and an inhaled corticosteroid (ICS). Which therapeutic effect should the nurse expect from this medication?
- Reduction in frequency of COPD exacerbations
- Exacerbation of inflammation and bronchoconstriction
- Cure of underlying COPD pathology
- Prevention of pneumonia
Explanation
A combination of a long-acting beta2-agonist (LABA) and an inhaled corticosteroid (ICS) helps in reducing airway inflammation and maintaining bronchodilation, which leads to a decrease in the frequency and severity of COPD exacerbations. LABAs relax bronchial smooth muscles for sustained airflow improvement, while ICSs reduce airway inflammation and hyper-responsiveness, improving overall respiratory function and quality of life.
5. A client with a diagnosis of cancer is scheduled for chemotherapy. The nurse anticipates administering which of the following medications 30–60 minutes prior to chemotherapy treatment?
- Scopolamine
- Metoclopramide
- Methylcellulose
- Ondansetron
Explanation
Ondansetron (Zofran) is a serotonin 5-HT₃ receptor antagonist commonly administered 30–60 minutes before chemotherapy to prevent nausea and vomiting induced by chemotherapy agents. It works by blocking serotonin receptors in the brain and gastrointestinal tract that trigger the vomiting reflex. This medication is a mainstay in antiemetic prophylaxis for patients undergoing cancer treatment.
6. A patient is scheduled to have a pacemaker implanted at 0800 in the cardiac cath lab. The night shift nurse has an order to draw labs, check the patient’s vital signs, and start antibiotics prior to the day shift arriving. The nurse understands that the antibiotics are intended to:
- Treat a superinfection in the patient
- Provide empiric therapy
- Provide prophylactic therapy
- Provide definitive therapy
Explanation
Prophylactic therapy refers to the preventive use of antibiotics before surgery or certain medical procedures to reduce the risk of infection. In this case, administering antibiotics prior to pacemaker implantation helps prevent surgical site infection or endocarditis, which are serious complications in cardiac procedures. The goal is prevention—not treatment—of infection.
7. The nurse knows that which of the following interventions are appropriate steps in the administration of ear drops to a child under three years of age?
- Pulling the child's ear upward and backward to straighten the ear canal
- Touch the dropper to the ear canal to steady it for accurate drop administration
- Warm the ear drops by holding the bottle in the hand for 1–2 minutes before administration
- Have the child lay on the affected side for 1–5 minutes after instillation
Explanation
C. Warm the ear drops by holding the bottle in the hand for 1–2 minutes before administration This step ensures the drops are at body temperature, reducing the chance of dizziness or discomfort that may occur when cold drops enter the ear canal. It also increases the child’s comfort and cooperation during the procedure. D. Have the child lay on the affected side for 1–5 minutes after instillation Keeping the child in this position allows the medication to stay within the ear canal longer, improving absorption and effectiveness. It also helps prevent the drops from running out before they can act.
8. The nurse has an order for 50 mcg of Synthroid daily. Available: 0.05 mg tablets. How many tablets will the nurse give?
- 0.5
- 1
- 2
- 10
Explanation
Convert 50 mcg → mg: 50 mcg=0.05 mg. Available tablet strength = 0.05 mg per tablet. Required dose (0.05 mg) ÷ tablet strength (0.05 mg/tab) = 1 tablet.
9. A client with primary open-angle glaucoma is prescribed latanoprost 0.005% ophthalmic solution. Which instructions should the nurse give to the client to maximize efficacy and minimize adverse effects?
- Instill one drop in each eye every evening.
- Instill one drop in each eye only when experiencing visual disturbances.
- Instill one drop in each eye every morning.
- Instill one drop in each eye every 12 hours.
Explanation
Latanoprost is a prostaglandin analog used to lower intraocular pressure in patients with open-angle glaucoma by increasing the outflow of aqueous humor. It is most effective when administered once daily in the evening, as nighttime dosing enhances absorption and reduces intraocular pressure during the early morning—when it tends to be highest. Evening administration also helps minimize systemic absorption and potential side effects such as conjunctival hyperemia and eyelash changes.
10. Which statement represents the advantage of prescribing Ondansetron rather than Promethazine for a client with nausea?
- Ondansetron can be given earlier and remain effective
- Ondansetron has minimal adverse effects and Promethazine affects the CNS
- Ondansetron is an anti-emetic drug and Promethazine doesn’t stop nausea
- Ondansetron is a newer medication and more available
Explanation
Ondansetron (Zofran) is a selective serotonin 5-HT₃ receptor antagonist that effectively controls nausea and vomiting with minimal sedation or CNS effects. In contrast, Promethazine (Phenergan) is an antihistamine and dopamine antagonist that can cause drowsiness, confusion, dizziness, and extrapyramidal symptoms, especially in older adults. Ondansetron’s safety profile and lower risk of CNS depression make it preferable in many patients, particularly postoperative or chemotherapy clients.
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