Nursing 320 Pharmacology exam 5
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Free Nursing 320 Pharmacology exam 5 Questions
1. 31. A patient has an order for 500 mL of NS to infuse over 8 hours. How many mL per hour should be set on the pump? (Round to the nearest whole number.)
- A. 50 mL/h
- B. 63 mL/h
- C. 75 mL/h
- D. 90 mL/h
Explanation
To find mL per hour: 500 mL ÷ 8 hours = 62.5 mL/h → 63 mL/h (rounded to the nearest whole number)
2. 15.A female client develops vaginal candidiasis while on antibiotic therapy for an upper respiratory infection. The nurse knows that this is caused by:
- A. Antibiotic therapy reduces normal vaginal bacterial flora, resulting in a superinfection.
- B. The infection spreading from the patient's lungs to the new site of infection.
- C. Unprotected sex during antibiotic treatment.
- D. An allergic reaction to the antibiotics.
Explanation
Antibiotic therapy can destroy normal bacterial flora that help maintain balance in areas like the vagina. When beneficial bacteria such as Lactobacillus are reduced, Candida albicans, a naturally occurring yeast, can overgrow and cause vaginal candidiasis (yeast infection). This type of infection is considered a superinfection resulting from microbial imbalance due to antibiotic use.
3. 29. A patient has an order for 1000 mL of D5W to infuse at 90 mL/h. The tubing drop factor is 15 gtt/mL. Calculate the drops per minute. Round to the nearest whole number.
- A. 18 gtt/min
- B. 23 gtt/min
- C. 30 gtt/min
- D. 36 gtt/min
Explanation
mL per minute = 90 mL/h ÷ 60 min/h = 1.5 mL/min gtt per minute = 1.5 mL/min × 15 gtt/mL = 22.5 gtt/min → 23 gtt/min (rounded)
4. 28. The nurse has an order for 50 mcg of Synthroid daily. Available: 0.05 mg tablets. How many tablets will the nurse give?
- A. 0.5
- B. 1
- C. 2
- D. 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.
5. 2. An elderly client presents to the Emergency Room with sepsis. The provider immediately starts the client on a broad-spectrum antibiotic but then changes the antibiotic when the culture and sensitivity results come back. The new antibiotic would be considered what type of antibiotic therapy?
- A. Definitive therapy
- B. Empiric therapy
- C. Prophylactic therapy
- D. Palliative therapy
Explanation
Definitive therapy is initiated after the causative organism has been identified through culture and sensitivity testing. Once the results are available, the healthcare provider changes from a broad-spectrum antibiotic to a targeted (narrow-spectrum) antibiotic that is most effective against the specific pathogen. This approach improves effectiveness, minimizes resistance, and reduces unnecessary exposure to broad-spectrum agents.
6. 10. Which of the following acne drugs require very strict guidelines for prescribing and use because of the high teratogenic quality that requires forms of birth control and the iPLEDGE program?
- A. Tazarotene
- B. Benzoyl peroxide
- C. Salicylic acid
- D. Isotretinoin
Explanation
Isotretinoin (Accutane) is a retinoid used for severe, cystic, or treatment-resistant acne. It is highly teratogenic, meaning it can cause severe birth defects if taken during pregnancy. Because of this risk, the FDA requires enrollment in the iPLEDGE program, where patients must use two forms of contraception and undergo regular pregnancy testing before, during, and after therapy.
7. 18. A nurse is caring for a patient receiving gentamicin sulfate, an Aminoglycoside antibiotic, for a severe bacterial infection. Which assessment finding should the nurse report immediately to the healthcare provider?
- A. Decreased urine output
- B. Mild nausea
- C. Slightly elevated heart rate
- D. Headache
Explanation
Gentamicin, an aminoglycoside antibiotic, is nephrotoxic (toxic to the kidneys) and ototoxic (toxic to the ears). A decrease in urine output may indicate acute kidney injury, a serious complication caused by accumulation of the drug in renal tissues. The nurse must immediately notify the healthcare provider to adjust or discontinue the medication to prevent permanent renal damage. Monitoring renal function (BUN, creatinine, and urine output) is essential during therapy.
8. 22. A nurse is caring for a patient with a confirmed Gram-negative bacterial infection. The healthcare provider has prescribed an antibiotic regimen. Which of the following considerations is most important when treating Gram-negative organisms compared to Gram-positive organisms?
- A. Gram-negative bacteria have a thicker peptidoglycan (cell wall), making them more susceptible to antibiotics
- B. Gram-negative bacteria possess a multi-layered cell wall that can impede antibiotic penetration more skillfully, requiring specific antibiotic selection
- C. Gram-negative bacteria are less likely to develop antibiotic resistance, simplifying treatment choices
- D. Gram-negative bacteria have a thinner cell wall, making them more susceptible to antibiotic therapy
Explanation
Gram-negative bacteria have a complex cell wall structure with an outer membrane composed of lipopolysaccharides that acts as a barrier to many antibiotics. This makes them more resistant to common treatments than Gram-positive bacteria, which lack this outer membrane. Effective therapy requires antibiotics capable of penetrating this barrier, such as carbapenems, aminoglycosides, or cephalosporins designed for Gram-negative coverage.
9. 23. 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?
- A. Reduction in frequency of COPD exacerbations
- B. Exacerbation of inflammation and bronchoconstriction
- C. Cure of underlying COPD pathology
- D. 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.
10. 3. A client with a diagnosis of sepsis is prescribed an antibiotic that kills bacteria. What type of antibiotic is this?
- A. Bacteriostatic
- B. Bactericidal
- C. Disinfectant
- D. Bacterial resistant
Explanation
A bactericidal antibiotic works by killing bacteria directly, leading to the destruction of the infectious organism. These antibiotics are especially useful in serious infections such as sepsis, meningitis, and endocarditis, where rapid bacterial eradication is critical. Examples include penicillins, cephalosporins, and aminoglycosides.
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