Deck 85: Drugs That Weaken the Bacterial Cell Wall II: Cephalosporins, Carbapenems, Vancomycin, Telavancin, Aztreonam, and Fosfomycin

Question 1

A woman complains of burning on urination and increased frequency. The patient has a history of frequent urinary tract infections (UTIs)and is going out of town in 2 days. To treat the infection quickly,the nurse would expect the healthcare provider to order:

A) aztreonam [Azactam].
B) fosfomycin [Monurol].
C) trimethoprim/sulfamethoxazole [Bactrim].
D) vancomycin [Vancocin].

Answer 1

fosfomycin [Monurol].

Question 2

A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching?

A) "Cephalosporins are assigned to generations based on their relative costs to administer."
B) "Cephalosporins have increased activity against gram-negative bacteria with each generation."
C) "First-generation cephalosporins have better penetration of the cerebrospinal fluid."
D) "Later generations of cephalosporins have lower resistance to destruction by beta-lactamases."

Answer 2

"Cephalosporins have increased activity against gram-negative bacteria with each generation."

Question 3

A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment?

A) Abstain from alcohol consumption during therapy.
B) Avoid dairy products while taking this drug.
C) Take an antihistamine if a rash occurs.
D) Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.

Answer 3

Abstain from alcohol consumption during therapy.

Question 4

Which cephalosporin may be used to treat meningitis?

A) Cefaclor
B) Cefazolin
C) Cefoxitin
D) Cefotaxime

Question 5

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA). What is an appropriate treatment for this patient?

A) Cefaclor
B) Cefazolin
C) Cefotaxime
D) Ceftaroline

Question 6

A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do?

A) Administer the medication as prescribed.
B) Contact the provider to ask about giving the drug in divided doses.
C) Discuss increasing the interval between doses with the provider.
D) Discuss reducing the dose with the provider.

Question 7

A prescriber has ordered cefoxitin for a patient who has an infection caused by a gram-negative bacteria. The nurse taking the medication history learns that the patient experienced a maculopapular rash when taking amoxicillin [Amoxil] several years earlier. What will the nurse do?

A) Administer the cefoxitin and observe for any side effects.
B) Give the cefoxitin and have epinephrine and respiratory support available.
C) Request an order for a different, nonpenicillin, noncephalosporin antibiotic.
D) Request an order to administer a skin test before giving the cefoxitin.

Question 8

A patient is to undergo orthopedic surgery,and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin?

A) First-generation cephalosporin
B) Second-generation cephalosporin
C) Third-generation cephalosporin
D) Fourth-generation cephalosporin

Question 9

A patient who is receiving a final dose of intravenous (IV)cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action?

A) Apply warm packs to the arm, and infuse the medication at a slower rate.
B) Continue the infusion while elevating the arm.
C) Select an alternate intravenous site and administer the infusion more slowly.
D) Request central venous access.

Question 10

A patient who has cystic fibrosis has a Pseudomonas aeruginosa infection and the provider has ordered aztreonam [Cayston]. What will the nurse teach this patient about administration of this drug?

A) Administer the drug intramuscularly twice daily.
B) Give a daily dose every day for 28 days and then stop.
C) Inhale the powdered drug as ordered three times each day.
D) Use the nebulizer to administer the drug three times daily.

Question 11

Besides the cost of administering a given drug,which are considerations when a provider selects a cephalosporin to treat an infection? (Select all that apply.)

A) Adverse effects
B) Antimicrobial spectrum
C) Brand name
D) Manufacturer
E) Pharmacokinetics

Question 12

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient?

A) Adding an antibiotic, such as vancomycin [Vancocin], to the patient's regimen
B) Discontinuing the cephalosporin and beginning metronidazole [Flagyl]
C) Discontinuing all antibiotics and providing fluid replacement
D) Increasing the dose of the cephalosporin and providing isolation measures

Question 13

The nurse is caring for a patient who is receiving vancomycin [Vancocin]. The nurse notes that the patient is experiencing flushing,rash,pruritus,and urticaria. The patient's heart rate is 120 beats per minute,and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with:

A) allergic reaction.
B) red man syndrome.
C) rhabdomyolysis.
D) Stevens-Johnson syndrome.