Question 1

The nurse is administering aminoglycoside therapy.Which signs of toxicity does the nurse monitor the patient closely for? Select all that apply.&#10;A)Electrocardiogram (ECG)changes&#10;B)Urinary casts&#10;C)Hearing loss&#10;D)Dizziness&#10;E)Blood dyscrasias&#10;F)Increased blood urea nitrogen (BUN)levels&#10;G)Jaundice&#10;H)Proteinuria

Accepted Answer

Patients on aminoglycoside therapy must be monitored for signs of nephrotoxicity (urinary casts,increased blood urea nitrogen [BUN] levels,and proteinuria)and ototoxicity (hearing loss and dizziness).

Question 2

When a patient is on gentamicin therapy,what symptoms or laboratory results could indicate a potentially serious toxicity?&#10;A)Skin rash and fever&#10;B)A peak level of 7 mcg/mL&#10;C)Tinnitus and hearing loss&#10;D)Decreased blood urea nitrogen (BUN)and creatinine levels

Accepted Answer

Tinnitus and hearing loss could indicate ototoxicity,a potentially serious toxicity in a patient.
Nephrotoxicity is indicated by rising BUN and creatinine levels.Skin rash and fever are less common adverse effects,and a peak level of 7 mcg/mL does not indicate a potentially serious toxicity.

Question 3

When patients are taking the potent antibiotics aminoglycosides,which laboratory results must the nurse carefully monitor?&#10;A)Alanine aminotransferase (ALT)&#10;B)Glycosylated hemoglobin (A1c)&#10;C)Serum creatinine&#10;D)Aspartate aminotransferase (AST)

Accepted Answer

Nephrotoxicity occurs in 5 to 25% of patients taking aminoglycosides.The nurse must carefully monitor increased blood urea nitrogen and serum creatinine levels and monitor for urinary casts and proteinuria.

Question 4

Which of the following medications is commonly prescribed to treat recurrent pulmonary infections associated with cystic fibrosis?&#10;A)gentamicin&#10;B)tobramycin&#10;C)amikacin&#10;D)norfloxacin (Apo-Norflox)

Accepted Answer

Tobramycin has similar indications to gentamicin,but,unlike gentamicin,it is commonly used to treat recurrent pulmonary infections associated with cystic fibrosis.

Question 5

Which laboratory values are sometimes increased by quinolones?&#10;A)Blood urea nitrogen (BUN)levels&#10;B)Creatinine levels&#10;C)Alanine aminotransferase (ALT) levels&#10;D)Glucose levels

Accepted Answer

Quinolones can increase ALT and aspartate aminotransferase (AST)levels.

Question 6

Metronidazole (Flagyl)is widely used for which type of infection?&#10;A)Skin&#10;B)Gynecological&#10;C)Aerobic&#10;D)Respiratory

Accepted Answer

Metronidazole is widely used for gynecological and intra-abdominal infections caused by anaerobic organisms.

Question 7

Which of the following nursing diagnoses is appropriate for the patient who has started aminoglycoside therapy?&#10;A)Constipation&#10;B)Risk for injury (hearing loss)&#10;C)Disturbed body image related to gynecomastia&#10;D)Imbalanced nutrition,less than body requirements,related to nausea

Accepted Answer

Patients on aminoglycoside therapy have a high risk for injury due to ototoxicity.

Question 8

What is the main advantage of levofloxacin (Levaquin)over other quinolones?&#10;A)Once-daily dosing&#10;B)Twice-daily dosing&#10;C)A more potent anti-infective effect&#10;D)Fewer adverse effects

Accepted Answer

The main advantage of levofloxacin over the other quinolones is the once-daily dosing.

Question 9

A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains methicillin-resistant Staphylococcus aureus (MRSA).Which of the following antibiotics does the nurse expect will be chosen for his therapy?

A)penicillin
B)doxycycline (Apo-Doxy)
C)vancomycin (Vancocin)
D)erythromycin (Pediazole)

Accepted Answer

Vancomycin is the drug of choice for the treatment of MRSA.

Question 10

When administering vancomycin (Vancocin),what important information should the nurse keep in mind?&#10;A)It is ineffective in the treatment of methicillin-resistant Staphylococcus aureus (MRSA).&#10;B)It should be infused over at least 30 minutes.&#10;C)Fluids should be restricted during vancomycin therapy.&#10;D)Infuse the drug over 1 hour to reduce red man syndrome.

Accepted Answer

Vancomycin should be infused over at least 60 minutes to reduce red man syndrome.
Vancomycin is the antibiotic of choice for the treatment of MRSA,and adequate hydration (at least 2 litres of fluid in 24 hours)is important to prevent nephrotoxicity.

Deck 39: Antibiotics, part 2: Aminoglycosides, Fluoroquinolones, and Other Drugs