NRSG 245 Study guide exam 2 questions with
complete solutions
A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take?
a Reduce the infusion rate.
b Administer diphenhydramine [Benadryl].
c Change the IV tubing.
d Check the patency of the IV CORRECT ANSWER a
A patient is admitted to a medical unit and prescribed IV ampicillin/sulbactam after a specimen was sent for culture/sensitivity from the ed. The nurse knows the priority reason for notifying the prescriber of culture results as soon as they are available is that ampicillin/sulbactam a. has many more adverse effects than most other antibiotics
b. is a broad spectrum antibiotic, and there may be an effective narrow-spectrum antibiotic
c. is a very expensive antibiotic
d. is a narrow spectrum antibiotic and may not be effective for the cultured organism CORRECT ANSWER b
Which patient would most likely have an infection that is resistant to antibiotic therapy
a. a child with asthma who develops pneumonia
b. an adult construction worker who drinks from a worksite water supply and develops giardiasis c. an adult who developed a wound infection while in the hospital after surgery
d. an older adult who got an infected paper cut CORRECT ANSWER c The nurse has consulted the prescriber because a patient reports an allergy to the prescribed penicillin antibiotic. The prescriber is aware of the allergy but the patient is experiencing a life threatening infection and no other antibiotic is available. What is the priority nursing action a. administer the antibiotic
b. ask the patient if he or she is willing to the the med
c. Obtain orders for treatment of a possible allergic reaction
d. Refuse to administer the antibiotic CORRECT ANSWER c
It would be a priority to report which diagnostic test if a patient is prescribed tetracycline?
a. glucose - 6 phosphate dehydrogenase 8.3 U/g of hemoglobin
b. human chorionic gonadotropic 5325 mIU/mL
c. International normalized ratio 1.1
d. sodium 132 mEq/L CORRECT ANSWER B - tetracycline should be avoided during pregnancy due to risk for bone/teeth discoloration of fetus
In most infections, the level of antibiotic at the site of infection needs to be: a. at the minimum inhibitory concentration
b. 2-3 times the MIC
c. 4-8 times the MIC
d. 10-20 times the MIC CORRECT ANSWER c
Which assessment is of greatest priority for the nurse to compete before administering a penicillin antibiotic
a. allergy history.
b. Blood urea nitrogen c. temperature
d. would drainage CORRECT ANSWER a
Which assessment finding would be a priority to report the prescriber if it occurred
after administration of a large IV dose of penicillin a. discomfort at IV site
b. fever higher than 100.4 c. wheezing
d. shivering CORRECT ANSWER c
What is the drug of choice for MRSA?
a. dicloxacillin
b. naficillin
c. oxacillin
d. doxycycline CORRECT ANSWER d
The nurse is preparing to administer 8am meds to a patient who is to receive nafcillin 2 g via secondary IV infusion. The drug is dissolved in 100ml of normal saline solution. The drug handbook states the drug should be infused over 30-90 min. Just before the nurse hangs the nafcillin, the nurse is informed the patient is to
be placed on a cart to go off the unit for a diagnostic test in 30-45 min. The patient is expected to be off the floor in 30 min. What should the nurse do?
A. hold the drug infusion until the patient returns from test
B. infuse the drug in 30 min before placing the patient on the cart
c. infusing the drug in 45 min while loading the patient on the cart
d. set the infusion to run over 90 min CORRECT ANSWER a The nurse reviews correct lab tests results before administering piperacillin/tazobactam. It would be priority to report which laboratory result to the
provider?
a. brain natriuretic peptide 65 pictograms/dL
b. BUN 22mg/dL
c. Platelets 100,000/mL
d. White blood cell count 15,000/mm3 CORRECT ANSWER c
which result would be of greatest priority to report to the prescriber of cefotaxime?
a. albumin 3.4 g/dL
b. alanine aminotransferase (ALT) 158 international units/L
c. Estimated glomerular filtration rate (eGFR) 48 ml/mn
d. international normalized ratio 1 CORRECT ANSWER c because cefotaxime is eliminated by kidneys
Which result would be of greatest priority to report to prescriber of ceftriaxone?
a. albumin 3.4 g/dL
b. eGFR 88ml/min
c. Hemoglobin 9.2 g/dL and hematocrit 27%
d. INR 1 CORRECT ANSWER c because ceftriaxone can cause bleeding tendencies
When performing shift assessment, the nurse notes a maculopapular rash over the trunk of a patient who has been taking a ceftriaxone for four days. What is the nursing priority action?
a. administer standing order for epinephrine as needed
b. complete the assessment
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