Nursing 320 Pharmacology exam 5
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Free Nursing 320 Pharmacology exam 5 Questions
1. 19. A nurse is caring for a client with a severe bacterial infection. The healthcare provider is considering starting either a bactericidal or bacteriostatic antibiotic. Which of the following factors is most important in determining the appropriate choice of antibiotic?
- A. The cost of the antibiotics
- B. The frequency of dosing
- C. The patient's immune status
- D. The route of administration
Explanation
The patient’s immune status is the most critical factor in determining whether to use a bactericidal or bacteriostatic antibiotic. Bactericidal drugs kill bacteria directly and are preferred for clients who are immunocompromised or critically ill, as their immune system may not be strong enough to eliminate the bacteria. Bacteriostatic drugs, on the other hand, inhibit bacterial growth and rely on the body’s immune defenses to eradicate the infection, making them suitable for patients with a functional immune system.
2. 13. A client with GERD has been taking omeprazole 40 mg daily for 18 months. The nurse knows that what potential adverse effect is the client at risk for?
- A. Exostosis, or bone overgrowth
- B. Drug-induced ototoxicity
- C. Osteoporosis-related fracture risk
- D. Diminished visual acuity
Explanation
Omeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion. Long-term use (typically over one year) is associated with decreased calcium absorption, leading to osteopenia or osteoporosis and a higher risk of hip, wrist, and spine fractures. PPIs can also reduce magnesium and vitamin B12 levels with chronic use, requiring monitoring and supplementation when appropriate.
3. 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.
4. 16. The nurse knows that the antibiotic, piperacillin/tazobactam (Zosyn), can best be described as a:
- A. It is a natural penicillin indicated for Gram + organisms only
- B. It is a narrow-spectrum macrolide antibiotic
- C. It is broad-spectrum penicillin combined with a beta-lactamase inhibitor
- D. It is an anti-fungal medication
Explanation
Piperacillin/tazobactam (Zosyn) is a broad-spectrum antibiotic that combines piperacillin, an extended-spectrum penicillin, with tazobactam, a beta-lactamase inhibitor. This combination allows the drug to be effective against a wide range of Gram-positive and Gram-negative bacteria, including those that produce beta-lactamase enzymes, which normally render other penicillins ineffective. It’s commonly used to treat serious infections such as pneumonia, intra-abdominal infections, and sepsis.
5. 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.
6. 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.
7. 32. A patient weighs 75 lbs. How many kilograms is this? (Round to the nearest tenth.)
- A. 32.9 kg
- B. 34.0 kg
- C. 35.4 kg
- D. 36.1 kg
Explanation
To convert pounds to kilograms: 75 lbs ÷ 2.2 = 34.09 → 34.0 kg (rounded to the nearest tenth).
8. 9. 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:
- A. Treat a superinfection in the patient
- B. Provide empiric therapy
- C. Provide prophylactic therapy
- D. 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.
9. 12. A client has been diagnosed with delayed gastric emptying. The nurse knows that which drug would best treat this condition?
- A. Prokinetic drugs, such as metoclopramide (Reglan)
- B. Serotonin blockers, such as ondansetron (Zofran)
- C. Anticholinergic drugs, such as scopolamine
- D. Neuroleptic drugs, such as chlorpromazine (Thorazine)
Explanation
Metoclopramide (Reglan) is a prokinetic drug that enhances gastric motility and accelerates gastric emptying without increasing gastric secretions. It works by increasing the release of acetylcholine in the gastrointestinal tract, promoting movement of stomach contents into the small intestine. It is often used for gastroparesis (delayed gastric emptying), nausea, and GERD management.
10. 1.Which statement represents the advantage of prescribing Ondansetron rather than Promethazine for a client with nausea?
- A. Ondansetron can be given earlier and remain effective
- B. Ondansetron has minimal adverse effects and Promethazine affects the CNS
- C. Ondansetron is an anti-emetic drug and Promethazine doesn’t stop nausea
- D. 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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