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 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.
2. A nurse is caring for a patient who has been prescribed a sulfonamide antibiotic for a urinary tract infection. Which of the following patient statements indicates a need for further teaching?
- "I will drink plenty of water while taking this medication."
- "I should avoid prolonged sun exposure."
- "I can stop the medication once I feel better."
- "I will report any rash to my healthcare provider."
Explanation
Stopping the antibiotic early can lead to bacterial resistance and infection recurrence. Even if symptoms improve, the full course of sulfonamides must be completed to ensure that all bacteria are eradicated. Incomplete therapy may also increase the risk of resistant strains developing, making future infections harder to treat.
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 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?
- Exostosis, or bone overgrowth
- Drug-induced ototoxicity
- Osteoporosis-related fracture risk
- 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.
5. 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)
6. A client with a diagnosis of sepsis is prescribed an antibiotic that kills bacteria. What type of antibiotic is this?
- Bacteriostatic
- Bactericidal
- Disinfectant
- 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. 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?
- Definitive therapy
- Empiric therapy
- Prophylactic therapy
- 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.
8. A client is hospitalized for pneumonia and started on intravenous ceftriaxone. After several days of antibiotic therapy, the healthcare team also initiates probiotics as part of the client's treatment plan. The nurse knows that probiotics are indicated for which of the following reasons?
- To prevent inflammatory bowel disease
- To prevent antibiotic-induced constipation
- To prevent antibiotic-associated diarrhea
- To provide secondary antibiotic coverage of the patient’s pneumonia
Explanation
Probiotics contain beneficial microorganisms such as Lactobacillus and Bifidobacterium, which help maintain or restore the balance of intestinal flora disrupted by antibiotic therapy. Antibiotics, like ceftriaxone, can destroy both harmful and beneficial bacteria in the gut, leading to antibiotic-associated diarrhea (AAD) or even Clostridioides difficile infection. Probiotics help repopulate the gut with “good bacteria,” thereby reducing this risk.
9. The nurse knows that the antibiotic, piperacillin/tazobactam (Zosyn), can best be described as a:
- It is a natural penicillin indicated for Gram + organisms only
- It is a narrow-spectrum macrolide antibiotic
- It is broad-spectrum penicillin combined with a beta-lactamase inhibitor
- 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.
10. 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.
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