Pharmacology 101 Chapter 6-10 study guide pharm. Easy Comprehension and Mastery. Rated 5 star
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Nursing
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Nursing
1. After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was
successful when the students identify which of the following as an example of a sulfonamide antibiotic? Select all that apply.
C) Sulfamethoxazole/trimethoprim (Bactrim)
E) Silver s...
after teaching a group of nursing students about sulfonamides
the instructor determines that the teaching was successful when the students identify which of the following as an example of a sulfonam
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Pharmacology 101 Chapter 6-10 study guide pharm
Pharm Chapter 6-10 study guide questions
1. After teaching a group of nursing students about sulfonamides, the instructor determines that the teaching was
successful when the students identify which of the following as an example of a sulfonamide antibiotic? Select all that apply.
C) Sulfamethoxazole/trimethoprim (Bactrim)
E) Silver sulfadiazine (Silvadene)
Feedback:
Silver sulfadiazine (Silvadene) and sulfamethoxazole/trimethoprim (Bactrim) are sulfonamide antibiotics. Amoxicillin
is an aminopenicillin. Ciprofloxacin is classified as a fluoroquinolone. Clarithromycin is a macrolide.
2. A group of nursing students are reviewing information about sulfonamides. Which of the following if stated by the
students indicate understanding of this drug class? Select all that apply.
A) Sulfonamides are well absorbed when given orally.
E) Sulfonamides are excreted by the kidneys.
Feedback:
Sulfonamides are well absorbed by the GI tract and are excreted by the kidneys. Sulfonamides treat both gram-positive
and gram-negative infections.
3. When reviewing the medical records of several clients who are prescribed sulfonamide therapy, the nurse would expect
laboratory findings related to which bacteria? Select all that apply.
B) Escherichia coli
C) Klebsiella pneumoniae
E) Staphylococcus aureus
Feedback:
Sulfonamides are often used to control infections caused by both gram-negative and gram-positive bacteria, such as
Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus. Typically, sulfonamides are not used to treat infections
caused by Pseudomonas aeruginosa or Streptococcus pyogenes.
4. Sulfonamides are commonly used to treat which of the following types of infections?
Select all that apply.
A) Ulcerative colitis
B) Urinary tract infection
C) Acute otitis media
Feedback:
Sulfonamides are often used to treat ulcerative colitis, urinary tract infection, and acute otitis media.
5. A client is taking trimethoprim and sulfamethoxazole (Bactrim DS) one tablet twice daily for 14 days. Which of the
following would the nurse include when teaching the client about possible adverse reactions? Select all that apply.
C) Anorexia
D) Crystalluria
E) Photosensitivity
Feedback:
Teaching should address potential adverse reactions that can occur while taking a sulfonamide. These adverse reactions
include nausea, vomiting, anorexia, stomatitis, chills, fever, crystalluria, and photosensitivity.
6. The nurse suspects that a client who is taking a sulfonamide has leukopenia. Which assessment findings would support
this suspicion? Select all that apply.
A) Sore throat
B) Cough
Feedback:
Antibiotics including sulfonamides can lead to leukopenia, which would be manifested by fever, sore throat, or cough.
Thrombocytopenia is also possible and would be manifested by easy bruising or unusual bleeding from minor to moderate
trauma. Nausea and photosensitivity are adverse reactions to sulfonamides.
7. A nurse is reviewing the laboratory test results of a client receiving sulfasalazine therapy for ulcerative colitis. Which of
the following would the nurse anticipate finding? Select all that apply.
B) Leukopenia
C) Thrombocytopenia
D) Aplastic anemia
Feedback:
Leukopenia, thrombocytopenia, and aplastic anemia are hematologic changes that may occur during prolonged
sulfonamide therapy, such as during ulcerative colitis treatment with sulfasalazine.
,8. Which of the following represent contraindications to treatment with a sulfonamide? Select all that apply.
C) Lactating females
D) Clients with group A beta-hemolytic streptococci infections
Feedback:
The sulfonamides are contraindicated in clients with hypersensitivity to the sulfonamides, during lactation, in children
younger than 2 years of age, near the end of pregnancy, and for infections caused by group A beta-hemolytic streptococci.
9. The nurse is providing care to a client with diabetes who is receiving sulfonamides. The nurse counsels the client about
the increased risk of hypoglycemia, especially if the client is taking which of the following medications? Select all that apply.
A) Tolbutamide (Orinase)
E) Chlorpropamide (Diabinese)
Feedback:
Sulfonamides may inhibit the hepatic metabolism of the oral hypoglycemic drugs tolbutamide (Orinase) and
chlorpropamide (Diabinese). Elderly clients may be especially sensitive to this reaction. Lisinopril, simvastatin, and losartan are
used for cardiac conditions.
10. A client is diagnosed with a urinary tract infection. When obtaining the client's drug history, the client reports using an
herbal product in the past to prevent and relieve the symptoms. Which of the following would the client most likely identify?
D) Cranberry
Feedback:
Cranberries and cranberry juice are commonly used remedies for preventing and relieving symptoms of UTIs.
However, if an individual suspects a UTI, medical attention is necessary.
11. A nurse is working in an ambulatory care setting that involves seeing clients with infections that require treatment.
Which of the following would be important for the nurse to assess in these clients? Select all that apply.
A) Client's use of self-remedies
B) Review of lab results
C) Vital signs
D) Client's symptoms
E) Client's general appearance
Feedback:
When assessing a client who may have an infection, the nurse should gather information about the client's general
appearance; vital signs; symptoms, including the length of time the client has been experiencing them; and any self-remedies
used. In addition, the nurse should review the results of any laboratory and diagnostic tests.
12. A client with a fever is ordered to receive sulfonamide therapy for an infection. The nurse needs to evaluate the client
for which of the following during the course of therapy? Select all that apply.
A) Response to drug therapy
D) Occurrence of adverse reactions
E) Decrease in temperature
Feedback:
During the course of therapy, the nurse evaluates the client at periodic intervals for response to the drug, including
relief of symptoms and decrease in temperature, as well as the occurrence of any adverse reactions.
13. The nurse is preparing to administer a prescribed sulfonamide. Which of the following would the nurse do? Select all
that apply.
A) Have the client sit up to take the drug
B) Give the prescribed drug on an empty stomach
E) Encourage the client to drink additional fluids
Feedback:
Oral medication should be administered to clients only when they are in an upright or sitting position. Sulfonamides
should be administered on an empty stomach if tolerated with 8 ounces of water. Increased fluid intake is encouraged to prevent
crystalluria.
14. A nurse is preparing a plan of care for an older adult client who is receiving sulfonamide therapy. Which of the
following would the nurse include in the plan of care to reduce the likelihood of causing renal damage? Select all that apply.
B) Increase fluid intake up to 2000 mL if tolerated.
C) Use sulfonamides cautiously in clients with renal impairment.
Feedback:
Older adults experience a decline in renal function with aging. Therefore, sulfonamides must be used cautiously in
older clients. In addition, increasing fluid intake up to 2000 mL daily can decrease the likelihood of causing renal damage in
older clients. The drug is administered throughout the day, not as a once-daily dose. Sulfonamides can affect renal function
,regardless of the route administered. Asking the prescriber to change the medication ordered may be appropriate but is not
necessary as long as the drug is administered cautiously and the client is monitored closely.
15. A nurse is applying silver sulfadiazine to a client's burn. Which of the following would be important for the nurse to
do? Select all that apply.
A) Clean and remove debris from the burned area before application
D) Wear sterile gloves when applying the cream to the burn
E) Warn client of burning sensation during and shortly following application
Feedback:
When applying silver sulfadiazine cream to a burn, clean and remove debris from the burned area, apply cream while
wearing sterile gloves, apply a 1/16-inch-thick layer to the area, keep the client away from air drafts to decrease pain, and warn
the client that he or she may experience a burning sensation during and shortly following cream application.
16. A client is being discharged with a prescription for sulfasalazine. Which of the following would the nurse include in the
discharge teaching plan? Select all that apply.
B) Use protective sunscreen or cover exposed areas when going outside.
C) Finish the entire course of sulfonamide even if you begin feeling better.
E) Keep all follow-up appointments.
Feedback:
The nurse should teach the client to take sulfasalazine with food or immediately after a meal, to use sunscreen or cover
exposed areas to prevent severe sunburn, to increase fluid intake to prevent renal calculi, to finish the entire course of drug even
if the symptoms go away, and to keep all follow-up appointments.
17. A female client receiving methotrexate for the treatment of rheumatoid arthritis is given a prescription for trimethoprim
and sulfamethoxazole (Bactrim DS). The client returns to the physician's office feeling worse than before. She now has a cough
and unusual bruising on the extremities. The physician orders a complete blood count and a complete metabolic profile. Which
test results would the nurse expect to find? Select all that apply.
B) Decreased number of white blood cells
D) Decreased number of platelets
Feedback:
The concomitant use of methotrexate and sulfonamides, like trimethoprim and sulfamethoxazole (Bactrim DS), can
result in increased bone marrow suppression, leading to decreased amounts of white blood cells, red blood cells, and platelets in
the blood.
18. A client is prescribed sulfadiazine one tablet twice daily for 10 days. When reviewing the client's history, the nurse
notes that the client is also taking warfarin. The nurse would be alert for which of the following?
A) Prolonged clotting times
Feedback:
When warfarin and sulfonamides are given concomitantly, an increase in action of the anticoagulant is seen, leading to
an increase in clotting time, such as PT/INR, and an increased risk of bleeding. An increased risk of infection and a decrease in
the white blood cell count would occur when a sulfonamide is given with methotrexate. The combination of warfarin and
sulfonamide does not impact the effect of the antibiotic.
19. A nurse is to administer sulfasalazine to a client with ulcerative colitis. Which of the following interventions would be
most important while caring for this client?
B) Regularly inspect client's stool samples.
Feedback:
While providing care to a client receiving sulfasalazine therapy for ulcerative colitis, the nurse should regularly inspect
all stool samples and record their number and appearance. Yellow skin or urine in clients receiving sulfasalazine is normal, and
the nurse should not stop the dosage. Sulfasalazine is administered with meals or immediately afterward, not on an empty
stomach. Administering cranberry juice is helpful for clients with urinary tract infections, but not for clients with ulcerative
colitis.
20. A nurse is caring for a client with a urinary tract infection. After administering a sandwich and a large glass of
cranberry juice to a client, the nurse observes that the client has developed diarrhea. Which of the following is the most likely
cause of the client's condition?
A) Extremely large dosage of cranberry juice
Feedback:
Clients may develop gastrointestinal distress such as diarrhea if they have consumed extremely large doses of cranberry
juice. The recommended dose is 6 ounces of juice twice daily. Cranberry juice on an empty stomach or immediately after dosage
, will not lead to diarrhea if taken in the recommended amount. Minimized food and fluid intake or lack of exercise does not
increase the chances of diarrhea. Crystalluria does not cause diarrhea.
21. A nurse is to administer mafenide to a client. The nurse would be alert for which of the following?
A) Rash, itching, or other allergic reactions
Feedback:
The nurse should assess for allergic reactions such as rash, itching, edema, and urticaria when administering mafenide.
Topical sulfonamides like mafenide do not cause crystalluria, inflammation of the mouth, or loss of appetite.
22. After administering sulfonamides to a client, the nurse observes that he has developed a fever, cough, and muscular
aches. The nurse also observes that the client has developed lesions in the form of red wheals on the neck and the mouth. The
nurse interprets these findings as indicating which of the following?
A) Stevens-Johnson syndrome (SJS)
Feedback:
Clients with Stevens-Johnson syndrome (SJS) may complain of fever, cough, muscular aches and pains, and headache.
Additional signs include lesions on the neck and mouth. Lesions are not symptoms of leukopenia or anaphylactic shock. A client
with thrombocytopenia develops bruises on the skin but not lesions in the form of red wheals.
23. The health care professional has recommended sulfonamide therapy for a client. While obtaining the client's medical
history, the nurse discovers that he is taking oral anticoagulants. Which of the following are the possible effects of combining
sulfonamide therapy with oral anticoagulants?
A) Increased action of the anticoagulant
Feedback:
Taking sulfonamide drugs when the client is already taking oral anticoagulants may result in increased action of the
anticoagulants. Anaphylactic shock and leukopenia are some of the adverse reactions of sulfonamides but are not associated with
mixing sulfonamides and anticoagulants. Oral anticoagulants do not decrease the effectiveness of sulfonamides.
24. A client who is on sulfonamide therapy is about to be discharged. Which of the following precautions should the nurse
instruct the client to follow to reduce the effects of photosensitivity?
A) Wear protective clothing and sunscreen when outside.
Feedback:
The nurse should encourage a client to wear protective clothing while going out in the sun to reduce the effect of
photosensitivity. While increasing the fluid intake is recommended, it does not help combat the effects of photosensitivity. There
is no need to avoid lights while indoors; the skin becomes sensitive only to harsh sunlight during sulfonamide therapy. Wearing
protective footwear may protect the feet from injury, but it will not protect the skin from the harmful effects of photosensitivity.
25. A 60-year-old client who is on sulfonamide therapy has impaired urinary elimination. She does not want to increase her
oral fluid intake because of fear of incontinence. Which of the following nursing interventions would be most appropriate?
C) Teach the client the times to take fluids to maintain continence
Feedback:
The nurse's responsibility is to help the client overcome the fear of incontinence and to teach her when to take fluids to
maintain continence. Instead of telling the client that increasing fluid intake has no effect on continence, the nurse should focus
on helping the client with her problems of incontinence. The nurse should instruct the client to increase the fluid intake by at least
2000 mL, instead of only 1000 mL; however, this will not help control incontinence.
26. A nurse is caring for a client who is being administered sulfasalazine. Which of the following instructions should the
nurse include to ensure that the client gets the full benefits of the treatment?
A) Take dosage while eating or immediately after eating.
Feedback:
The nurse should administer sulfasalazine with food or immediately afterward. Increasing the food intake during
sulfonamide therapy is not necessary, as long as a proper diet is maintained and the physician's recommendations are followed.
Two to three 8-ounce glasses of fluid is not enough; the client should drink at least eight to ten 8-ounce glasses of fluid every day.
All drugs should be taken with water and not milk, juice, or any other liquid, unless specifically instructed by the physician.
27. A client who is being discharged has been instructed to continue with sulfonamide therapy for a week. Which of the
following points should the nurse include in the teaching plan to educate the client about the therapy?
D) Ensure that all follow-up appointments are met.
Feedback:
The nurse's plan should include educating the client about the importance of keeping the follow-up appointments. The
nurse should instruct the client to adhere to the dosage schedule and not discontinue it even if the symptoms of the infection have
gone. The client should inform the primary health care provider if fever, skin rash, or nausea occurs during the therapy. The client
should be instructed to take the drug on an empty stomach (at least 2 hours before or after a meal) and not just before a meal.
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