Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
Lehne's Pharmacology for Nursing Care 9th Edition by Jacqueline Burchum
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Chapter 91: Miscellaneous Antibacterial Drugs: Fluoroquinolones, Metronidazole, Daptomycin, Rifampin, Rifaximin, Bacitracin, and Polymyxins
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Daptomycin [Cubicin] |
| b. | Levofloxacin [Levaquin] |
| c. | Norfloxacin [Noroxin] |
| d. | Ciprofloxacin [Cipro] |
ANS: A
Daptomycin is active against MRSA. Levofloxacin and norfloxacin are not approved to treat MRSA. Ciprofloxacin is a poor choice for staphylococcal infections, including MRSA.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1089-1090
TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | Withhold the dose of ciprofloxacin and notify the provider of the patient’s symptoms. |
| b. | Instruct the patient to exercise the right foot and ankle to minimize the pain. |
| c. | Question the patient about the consumption of milk and any other dairy products. |
| d. | Request an order to increase this patient’s dose of glucocorticoids. |
ANS: A
A rare but serious adverse effect associated with fluoroquinolones is tendon rupture, and those at highest risk are children, patients older than 60 years, transplant patients, and any patients taking glucocorticoids. Any pain in either heel should be reported and the drug should be discontinued. Patients should be instructed not to exercise until tendonitis has been ruled out. Dairy products can reduce the absorption of ciprofloxacin, so this is not a concern with this patient. Because the pain may be caused by tendonitis associated with ciprofloxacin, it is not correct to request an increase in the glucocorticoid dosing.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1086-1087
TOP: Nursing Process: Evaluation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential
| a. | “I may have abdominal pain and nausea, but these are usually mild.” |
| b. | “I should take this medication with food or milk to improve absorption.” |
| c. | “I should stop taking the medication immediately if I experience heel pain.” |
| d. | “I will need to use sunscreen every time I go outdoors.” |
ANS: B
Dairy products inhibit the absorption of ciprofloxacin, so they should be avoided. Abdominal pain and nausea and vomiting are common and usually mild. Patients should stop taking the drug if heel pain occurs until tendonitis has been ruled out. Photosensitivity can occur, so sunscreen should be used.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1086-1087
TOP: Nursing Process: Planning
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
| a. | consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. |
| b. | stop taking the calcium supplements while taking the ciprofloxacin. |
| c. | take the two medications together to increase the absorption of both. |
| d. | take the calcium either 6 hours before or 2 hours after taking the ciprofloxacin. |
ANS: D
Cationic compounds, including calcium supplements, can reduce the absorption of ciprofloxacin, so proper interval dosing is necessary. Consuming extra fluids is not indicated. With proper interval dosing, it is not necessary to discontinue the calcium while giving the ciprofloxacin. These two medications should not be given together.
PTS: 1 DIF: Cognitive Level: Application REF: pp. 1086-1087
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies
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