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Roachs Introductory Clinical Pharmacology 10th Edition Ford Roach Test Bank

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Roachs Introductory Clinical Pharmacology 10th Edition Ford Roach Test Bank

ISBN-13: 978-1451186710

ISBN-10: 1451188951

 

Description

Roachs Introductory Clinical Pharmacology 10th Edition Ford Roach Test Bank

ISBN-13: 978-1451186710

ISBN-10: 1451188951

 

 

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Below you will find some free nursing test bank questions from this test bank:

Chapter 48- Urinary Tract Anti-Infectives and Other Urinary Drugs

1. When describing the use of anti-infectives to treat urinary tract infections, which of the following would the nurse identify as the most common structure affected?
  A) Bladder
  B) Kidney
  C) Prostate gland
  D) Urethra
  E) Ureters
  Ans: A
  Feedback:
  The urinary tract consists of the following anatomic structures: kidneys, ureters, bladder, prostate gland, and urethra. UTIs most commonly affect the bladder.

 

 

2. A nurse caring for a client being treated with nitrofurantoin (Macrodantin) for a UTI should ask the client specifically about resolution of which of the following symptoms during ongoing assessment? Select all that apply.
  A) Urgency
  B) Frequency
  C) Pressure
  D) Burning during urination
  E) Pain during urination
  Ans: A, B, C, D, E
  Feedback:
  Clinical manifestations of a UTI include urgency, frequency, pressure, burning and pain on urination, and pain caused by spasm in the region of the bladder and the suprapubic area and should be assessed by the nurse during ongoing assessment to determine effectiveness of drug therapy.

 

 

3. A client with a UTI is experiencing dysuria. The nurse would expect which of the following to be prescribed?
  A) Nitrofurantoin (Macrodantin)
  B) Oxybutynin (Ditropan)
  C) Sulfamethoxazole/trimethoprim (Bactrim)
  D) Phenazopyridine (Pyridium)
  Ans: D
  Feedback:
  Phenazopyridine (Pyridium) is a urinary tract analgesic that is useful in treating dysuria caused by a UTI.

 

 

4. A nurse is educating a client receiving sulfamethoxazole/trimethoprim (Septra) about common dermatologic adverse reactions. Which of the following would the nurse include in the teaching? Select all that apply.
  A) Rash
  B) Stevens-Johnson syndrome
  C) Photosensitivity
  D) Exfoliative dermatitis
  E) Pruritus
  Ans: A, C, E
  Feedback:
  Common dermatologic adverse reactions seen with the use of sulfamethoxazole/trimethoprim (Septra) include rash, photosensitivity, pruritus, and urticaria.

 

 

5. A nurse is developing a teaching plan for a client diagnosed with a UTI and prescribed nitrofurantoin (Macrodantin). The nurse would warn the client about which of the following common gastrointestinal adverse reactions? Select all that apply.
  A) Anorexia
  B) Ileus
  C) Toxic megacolon
  D) Nausea
  E) Diarrhea
  Ans: A, D, E
  Feedback:
  Common gastrointestinal adverse reactions seen with the use of nitrofurantoin (Macrodantin) include anorexia, nausea, vomiting, diarrhea, and abdominal pain.

 

 

6. A nurse caring for a client taking warfarin (Coumadin) develops a UTI. The nurse should monitor the client for increased risk of bleeding if which of the following anti-infectives is prescribed?
  A) Amoxicillin
  B) Methenamine
  C) Sulfamethoxazole
  D) Nitrofurantoin
  Ans: C
  Feedback:
  Sulfamethoxazole, when administered concomitantly with warfarin (Coumadin), can increase a client’s risk for bleeding. This interaction is not associated with amoxicillin, methenamine, or nitrofurantoin.

 

 

7. Based on the nurse’s understanding about anti-infectives, the nurse would administer nitrofurantoin cautiously to a client with which condition? Select all that apply.
  A) Hypertension
  B) Diabetes
  C) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  D) Cerebral arteriosclerosis
  E) Myasthenia gravis
  Ans: B, C, D
  Feedback:
  A nurse should administer nitrofurantoin cautiously to a client with the following conditions: diabetes, G6PD deficiency, and cerebral arteriosclerosis.

 

 

8. A nurse caring for a client taking which of the following drugs may notice increased adverse reactions if the client was prescribed nitrofurantoin (Macrodantin) resulting from an increased absorption of nitrofurantoin (Macrodantin)? Select all that apply.
  A) Benztropine (Cogentin)
  B) Simvastatin (Zocor)
  C) Tiotropium (Spiriva)
  D) Albuterol (Proventil)
  E) Dicyclomine (Bentyl)
  Ans: A, C, E
  Feedback:
  Anticholinergic drugs, like benztropine (Cogentin), tiotropium (Spiriva), and dicyclomine (Bentyl), can cause delayed gastric emptying, leading to increased absorption of nitrofurantoin (Macrodantin), which may result in increased adverse reactions.

 

 

9. A nurse monitoring a hospitalized client with a UTI notifies the physician if which of the following occur with drug therapy? Select all that apply.
  A) Fever
  B) Poor fluid intake
  C) Decreased urinary output
  D) Appearance of concentrated urine
  E) Worsening of UTI symptoms
  Ans: A, B, C, D, E
  Feedback:
  A nurse monitoring a hospitalized client with a UTI notifies the physician if any of the following occur: fever, poor fluid intake, decreased urinary output, appearance of concentrated urine, or worsening of UTI symptoms.

 

 

10. A nurse is to obtain a daily urine pH as ordered. The client would most likely be receiving which of the following anti-infectives for a UTI because they work better in acidic urine? Select all that apply.
  A) Methenamine (Hiprex)
  B) Amoxicillin (Amoxil)
  C) Fosfomycin (Monurol)
  D) Nitrofurantoin (Macrodantin)
  E) Nalidixic (NegGram)
  Ans: A, D
  Feedback:
  A daily urine pH level may be ordered by the physician for clients taking methenamine (Hiprex) or nitrofurantoin (Macrodantin) for a UTI because they work better in acidic urine.

 

 

11. A nurse informs a client prescribed nitrofurantoin (Macrodantin) and her family that pulmonary reactions have been reported with the drug’s use hours to 3 weeks after the drug therapy is initiated. The nurse determines that the teaching was successful when the client states that she will notify the primary health care provider if which of the following occur? Select all that apply.
  A) Dyspnea
  B) Chest pain
  C) Cough
  D) Fever
  E) Chills
  Ans: A, B, C, D, E
  Feedback:
  Signs and symptoms of an acute pulmonary reaction to nitrofurantoin (Macrodantin) include dyspnea, chest pain, cough, fever, and chills, and any of these should be reported to the physician immediately.

 

 

12. A nurse is caring for a client receiving amoxicillin for the treatment of an acute bacterial urinary tract infection. After administering the drug, the nurse would be alert for which of the following as an adverse reaction to the drug?
  A) Abdominal cramps
  B) Vaginitis
  C) Bladder irritation
  D) Stomatitis
  Ans: D
  Feedback:
  The nurse should monitor for stomatitis in the client, which is an adverse reaction to amoxicillin, an anti-infective drug. Vaginitis is an adverse reaction to an anti-infective drug called fosfomycin. Abdominal cramps and bladder irritation are adverse reactions to the anti-infective drug methenamine.

 

 

13. A nurse needs to start methenamine for a client. The nurse checks the client’s medical record for an allergy to which of the following?
  A) Sulfa
  B) Tartrazine
  C) Shellfish
  D) Penicillin
  Ans: B
  Feedback:
  Clients who are allergic to tartrazine, a food dye, should not receive methenamine.

 

 

14. A nurse is caring for a client receiving fosfomycin for the treatment of an acute bacterial UTI. Which of the following interventions should the nurse include in the teaching plan for the client about this drug?
  A) Ensure that the drug is administered every 3 hours.
  B) Administer the drug after dissolving it in 90 to 120 mL of hot water.
  C) Ensure that the drug is administered immediately after mixing with water.
  D) Administer the drug on an empty stomach.
  Ans: C
  Feedback:
  The nurse should instruct the client to take the drug immediately after mixing it with water. The nurse need not instruct the client to take the drug at an interval of 3 hours, to take the drug after dissolving it in 90 to 120 mL of hot water, or to take the drug on an empty stomach. Fosfomycin, which comes in dry form, should be dissolved in 90 to 120 mL water, but not hot water. The nurse should instruct the client to take the drug with food to prevent gastric upset, which occurs with the administration of fosfomycin.

 

 

15. A nurse is caring for a client receiving methenamine as outpatient treatment for chronic bacterial UTIs. Which instruction should the nurse include in the teaching plan for the client about the administration of the drug?
  A) Avoid prolonged exposure to sunlight.
  B) Increase the intake of milk products.
  C) Avoid an excessive intake of citrus fruits.
  D) Take the drug preferably with food.
  Ans: C
  Feedback:
  The nurse should instruct the client taking the anti-infective methenamine to avoid an excessive intake of citrus fruits. The nurse need not instruct the client taking methenamine to avoid prolonged exposure to sunlight, to increase the intake of milk products, or to take the drug preferably with food. Instead, the nurse should instruct the client to avoid milk and milk products when the client is taking methenamine.

 

 

16. After nitrofurantoin is administered to a client with an acute bacterial UTI, assessment reveals dyspnea, chest pain, cough, fever, and chills. Which of the following actions would be most appropriate?
  A) Monitor client for tightness of the chest.
  B) Offer fluids to the client at regular intervals.
  C) Provide oxygen support to the client.
  D) Withhold the drug and contact the primary health care provider.
  Ans: D
  Feedback:
  The nurse should immediately notify the primary health care provider and withhold the next dose of the drug until the client is seen by the primary health care provider if acute pulmonary reactions are observed in the client. The nurse should monitor the client for signs of a nonproductive cough or malaise, which may indicate a chronic pulmonary reaction, which may occur during prolonged therapy. Tightness of the chest is not known to occur in the case of a chronic pulmonary reaction, so the nurse need not monitor the client for this. The nurse offers fluids at regular intervals to elderly clients who develop decreased thirst sensation as an adverse reaction to the urinary tract anti-infectives.

 

 

17. A nurse is caring for an older adult client who is hospitalized. The client develops a UTI and is receiving prescribed anti-infective therapy. Which of the following should the nurse perform while caring for this client?
  A) Document symptoms of the client’s condition.
  B) Monitor the client’s vital signs every 4 hours.
  C) Document the client’s urine output every hour.
  D) Assess the client for bladder distension.
  Ans: B
  Feedback:
  When caring for a client with a UTI undergoing urinary tract anti-infective drug therapy, the nurse should monitor the vital signs of the client every 4 hours after administration of the drug or as ordered by the primary health care provider. Any significant rise in body temperature is reported to the primary health care provider because the methods of reducing the fever or culture and sensitivity tests may need to be repeated. The nurse should document the symptoms experienced by the client and assess the client for bladder distension as part of the preadministration assessment before administering the drug to the client. The nurse need not document the client’s urine output every hour or monitor the client’s respiratory rate in this case.

 

 

18. A nurse is caring for a client who is being prescribed phenazopyridine. The client is distressed on seeing that the urine is exhibiting a reddish-orange discoloration. Which response by the nurse would be most appropriate?
  A) “We will have to get a specimen for a urinalysis.”
  B) “I will have to notify the primary health care provider immediately.”
  C) “You will need to increase your fluid intake.”
  D) “This discoloration is a normal result of the medication. Nothing is wrong.”
  Ans: D
  Feedback:
  The nurse should inform the client that phenazopyridine may cause a reddish-orange discoloration of the urine, which is normal, so there is no cause to worry. Periodic urinalyses are conducted as part of the ongoing assessment when caring for a client with a UTI. Since the reddish-orange discoloration of the urine is normal, the nurse need not notify the primary health care provider immediately. The nurse also need not ask the client to increase intake of fluids.

 

 

19. A nurse is educating a client undergoing treatment for genitourinary tract bacterial infections on an outpatient basis. What instructions should the nurse offer the client as part of the client teaching plan?
  A) Notify the primary health care provider if abdominal pain occurs.
  B) Discontinue the therapy if symptoms vanish.
  C) Decrease fluid intake if symptoms subside.
  D) Increase fluid intake to at least 2000 mL/day.
  Ans: D
  Feedback:
  The nurse should instruct the client to increase the fluid intake to at least 2000 mL/day to help remove bacteria from the genitourinary tract when caring for a client with a genitourinary tract bacterial infection. The nurse should stress the importance of continued therapy even if symptoms vanish or the client feels better after a few doses. The nurse should encourage continued increased fluid intake even if the symptoms subside. Abdominal pain is not commonly associated with genitourinary tract bacterial infections, so this instruction would not be necessary.

 

 

20. When describing the adverse reactions associated with anti-infectives for UTIs, which of the following would the nurse explain as being most common?
  A) Gastrointestinal
  B) Dermatologic
  C) Neurologic
  D) Urologic
  Ans: A
  Feedback:
  Although dermatologic reactions such as rash, pruritus, and photosensitivity reactions can occur and neurologic reactions such as dizziness, drowsiness, headache, blurred vision, and weakness can occur, adverse reactions associated with anti-infectives are primarily gastrointestinal in nature.

 

 

21. A nurse is administering methenamine to a client with a UTI. Which of the following would the nurse instruct the client to avoid?
  A) Ascorbic acid
  B) Sodium bicarbonate
  C) Acetaminophen
  D) Ibuprofen
  Ans: B
  Feedback:
  An increased urinary pH (alkaline urine) decreases the effectiveness of methenamine. Therefore, to avoid raising the urine pH when taking methenamine, the client should not use antacids containing sodium bicarbonate or sodium carbonate.

 

 

22. A client asks the nurse about drinking cranberry juice to prevent UTIs. The nurse informs the client that it is safe to use, suggesting an intake of which amount daily?
  A) 1 to 2 ounces
  B) 4 to 8 ounces
  C) 8 to 12 ounces
  D) 12 to 16 ounces
  Ans: B
  Feedback:
  Cranberry juice is safe for use as a food and for urinary tract health. The recommended dosage is 4 to 8 ounces of juice per day.

 

 

23. A nurse is conducting an in-service presentation for a group of nurses about UTIs and hospitalized clients. When discussing preventive measures, the nurse would identify which of the following as the primary nursing intervention for prevention?
  A) Proper perineal hygiene
  B) Use of urinary acidifiers
  C) Hand hygiene
  D) Routine urinalysis
  Ans: C
  Feedback:
  UTIs may affect the hospitalized client or nursing home resident with an indwelling catheter or a disorder such as a stone in the urinary tract. The primary nursing intervention to prevent UTIs in the hospitalized client is good hand hygiene or handwashing. Proper perineal hygiene may be helpful but not as effective as hand hygiene. The use of urinary acidifiers is appropriate to maintain pH of the urine but not prevent UTIs. Routine urinalysis would help identify potential infections but not prevent them.

 

 

24. A nurse is preparing to administer phenazopyridine to a client. To help promote maximum effectiveness, the nurse would expect to administer this drug at which time?
  A) Before meals
  B) At bedtime
  C) Around the clock
  D) After meals
  Ans: D
  Feedback:
  Phenazopyridine is administered after meals to prevent GI upset.

 

 

25. The nurse is developing a plan of care for a client who is receiving an anti-infective drug for treatment of a UTI. The nurse has identified a nursing diagnosis of Impaired Urinary Elimination. Which of the following would the nurse include?
  A) Encouraging a fluid intake of at least 2000 mL/day
  B) Offering the client orange juice when administering the medication
  C) Monitoring urine output every 1 to 2 hours
  D) Checking the urine pH every 4 hours
  Ans: A
  Feedback:
  Encouraging a fluid intake of at least 2000 mL/day would be appropriate. The nurse should offer fluids such as water, cranberry juice, or prune juice rather than orange juice or other citrus or vegetable juices. Intake and output are usually measured every 8 hours, not every 1 to 2 hours. Urine pH measurements would be appropriate if the client was receiving methenamine or nitrofurantoin.

 

 

26. After teaching a client about her prescribed anti-infective therapy for her UTI, the nurse determines that the teaching was successful when the client states which of the following? Select all that apply.
  A) “I can stop the drug once my symptoms disappear.”
  B) “I can take the medication with food or meals.”
  C) “I can drink pineapple juice to keep things acidic.”
  D) “I’ll call my primary health care provider if I don’t feel better in about 3 days.”
  E) “I should avoid drinking any beverages that contain alcohol.”
  Ans: B, D, E
  Feedback:
  The client should complete the full course of therapy even with symptom relief to ensure that all bacteria have been eliminated from the urinary tract. The client should take the drug with food or meals. Cranberry juice, prune juice, and water are recommended. Alcohol and citrus juices such as orange or pineapple juice are to be avoided. The client should notify her primary health care provider if the symptoms do not subside within 3 to 4 days.