Question 1

A 70-year-old patient will begin taking cefdinir (Omnicef)for an acute exacerbation of COPD.Before initiating therapy,the primary care NP should order:&#10;A) liver function tests (LFTs).&#10;B) coagulation studies.&#10;C) an electrocardiogram (ECG).&#10;D) a creatinine clearance test.

Accepted Answer

Geriatric patients may need adjusted doses based on creatinine clearance testing,so obtaining a creatinine clearance test before initiating therapy is indicated.LFTs,coagulation studies,and an ECG are not indicated.

Question 2

A patient is taking an aminoglycoside and a cephalosporin.The primary care NP should consider _____ the dose of _____.&#10;A) increasing; cephalosporin&#10;B) decreasing; cephalosporin&#10;C) increasing; aminoglycoside&#10;D) decreasing; aminoglycoside

Accepted Answer

Cephalosporins can heighten aminoglycoside toxicity,so a decrease in the dose of the aminoglycoside should be considered.

Question 3

A child with a febrile illness is taking a cephalosporin.While in the clinic for a follow-up visit,the child has a tonic-clonic seizure.The primary care NP should:&#10;A) administer acetaminophen because this is likely a febrile seizure.&#10;B) reassure the parent that seizures can occur while taking cephalosporins.&#10;C) ask the child's parent how much of the cephalosporin the child has taken.&#10;D) suspect the development of a secondary central nervous system infection.

Accepted Answer

Seizures can occur with an overdose of cephalosporins,so the NP should determine whether this has occurred.It is not correct to assume that the seizure is fever-related or that it is a normal side effect of the cephalosporin.

Question 4

A primary care NP provides teaching to a patient who will begin taking cefadroxil (Duricef).Which statement by the patient indicates a need for further teaching?&#10;A) &#34;I should report any rash that occurs.&#34;&#10;B) &#34;I will take this medication twice daily.&#34;&#10;C) &#34;I should take this medication with food.&#34;&#10;D) &#34;Gastrointestinal (GI) symptoms are common but not worrisome.&#34;

Accepted Answer

The FDA advises that CDAD be considered in all patients who present with diarrhea after antibiotic use.Patients should be taught to report all GI symptoms.

Question 5

An adult patient has cellulitis.The patient is a single parent with health insurance who works and is attending classes at a local university.To treat this infection,the primary care nurse practitioner (NP)should prescribe:

A) cefdinir (Omnicef).
B) cephalexin (Keflex).
C) cefadroxil (Duricef).
D) ceftriaxone (Rocephin).

Accepted Answer

First-generation cephalosporins,such as cephalexin and cefadroxil,are used for skin and soft tissue infections.Cefadroxil is preferred in this case because it can be given twice daily instead of four times daily,and this patient will be more likely to comply with the drug regimen.Cefdinir and ceftriaxone are both third-generation cephalosporins.

Question 6

A patient is taking cefadroxil (Duricef)and comes to the clinic complaining of loose stools for several days.The primary care NP notes normal vital signs; warm,pink skin with elastic turgor; and moist mucous membranes.The NP should:

A) order tests for Clostridium difficile-associated disease (CDAD).
B) discontinue the cefadroxil.
C) reassure the patient that loose stools are common with antibiotics.
D) recommend consuming lactobacillus-containing foods to minimize diarrhea.

Accepted Answer

The U.S.Food and Drug Administration (FDA)advises that CDAD be considered in all patients who present with diarrhea after antibiotic use.This patient's symptoms are mild,so discontinuation of the drug is not warranted unless CDAD is present.

Question 7

A primary care NP sees a patient who has dysuria,fever,and urinary frequency.The NP orders a urine dipstick,which is positive for nitrates and leukocyte esterase,and sends the urine to the laboratory for a culture.The patient is allergic to sulfa drugs.The NP should:

A) order cefaclor (Ceclor).
B) prescribe cefixime (Suprax).
C) administer intramuscular ceftriaxone (Rocephin).
D) wait for culture results before ordering an antibiotic.

Accepted Answer

Cephalosporins are useful for empirical treatment of many of the most common infections seen in primary care.Cefixime is a third-generation cephalosporin,which has greater activity against Escherichia coli and excellent penetration into body fluids,making it a good choice for empirical treatment of urinary tract infection.

Deck 60: Cephalosporins