Question 1

The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take?

Accepted Answer

The patient's history of a rash with penicillin suggests a possible allergy to penicillin and other drugs in the beta-lactam antibiotic class, which includes amoxicillin. The nurse should contact the provider to discuss using a different antibiotic that is not in the same class as penicillin. Administering the amoxicillin or requesting an antihistamine or beta-lactamase resistant drug could put the patient at risk for an allergic reaction.

Question 2

The nurse is caring for several patients who are receiving antibiotics. Which order will the nurse question?

Accepted Answer

Erythromycin 300 mg IM QID is an unusual route of administration for this medication, and the nurse should question the order to ensure there is not an error or potential harm to the patient. The other medication orders are within normal dosing and route guidelines.

Question 3

The nurse is caring for a patient who has recurrent urinary tract infections. The patient's current infection is not responding to an antibiotic that has been used successfully several times in the past. The nurse understands that this is most likely due to:

Accepted Answer

Acquired bacterial resistance occurs when bacteria mutate or acquire genes that allow them to resist the effects of antibiotics. This can happen through natural selection or exposure to antibiotics, which can kill off susceptible bacteria and allow resistant strains to thrive. In this case, it is likely that the patient's recurrent infections have selected for bacterial strains that are resistant to the previously effective antibiotic.

Question 4

A patient is receiving high doses of cefazolin. Which laboratory values will this patient's nurse monitor closely?

Accepted Answer

High doses of cefazolin can affect kidney function and liver enzymes, so the nurse should monitor BUN, serum creatinine, and liver function tests. Monitoring the complete blood count and electrolytes is important with any antibiotic therapy, but cefazolin is not known to significantly affect serum calcium and magnesium levels or serum glucose and lipid levels.

Question 5

The nurse is preparing to administer an antibiotic to a patient who has been receiving the antibiotic for 2 days after a culture was obtained. The nurse notes increased erythema and swelling, and the patient has a persistent high fever of 39° C. What is the nurse's next best action?

Accepted Answer

Reviewing the sensitivity results from the patient's culture is crucial in this scenario because the patient's condition has not improved and has actually worsened, indicating that the current antibiotic may not be effective against the infecting organism. The sensitivity results will guide the healthcare team in selecting the most appropriate antibiotic to treat the infection effectively.

Question 6

The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for a urinary tract infection. Which action is most important prior to administering the antibiotic?

Accepted Answer

Obtaining a urine specimen for culture and sensitivity is the most important action prior to administering antibiotics for a urinary tract infection. This will help determine the type of bacteria causing the infection and which antibiotic is most appropriate to use. It is important to note that while administering a small test dose to determine hypersensitivity and having epinephrine available are important safety measures, obtaining a urine specimen takes priority in this situation. Monitoring baseline vital signs is also important, but is not the most crucial action prior to administering the antibiotic.

Question 7

A patient will begin taking amoxicillin. The nurse should instruct the patient to avoid which foods?

Accepted Answer

Patients taking amoxicillin should avoid acidic fruits and juices as they can decrease the effectiveness of the medication.

Question 8

The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs?

Accepted Answer

Serum drug peak and trough levels are necessary for drugs with a narrow therapeutic index. These drugs have a small difference between the therapeutic dose and the toxic dose, and monitoring levels is necessary to ensure the drug is effective without causing harm. Examples of drugs with a narrow therapeutic index include digoxin and vancomycin.

Question 9

The nurse caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions. The patient reports having had a rash when taking amoxicillin (Amoxil). The nurse will contact the provider to:

Accepted Answer

The patient's previous rash with amoxicillin indicates a possible allergic reaction to penicillin. Therefore, the provider should be contacted to discuss alternative antibiotic options such as erythromycin. A smaller or larger dose of penicillin would not be appropriate in this situation. Diphenhydramine may be used to treat allergic reactions, but it would not address the issue of using an antibiotic to which the patient may be allergic.

Question 10

The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin) to a patient. When reviewing the patient's chart, the nurse notes that the patient previously experienced a rash when taking amoxicillin. What is the nurse's next action?

Accepted Answer

The answer of The nurse is preparing to administer the...

Question 11

A patient is diagnosed with mycoplasma pneumonia. Which antibiotic will the nurse expect the provider to order to treat this infection?

Accepted Answer

The answer of A patient is diagnosed with mycoplasma pneumonia....

Question 12

The nurse is caring for a patient who takes low-dose erythromycin as a prophylactic medication. The patient will begin taking cefaclor for treatment of an acute infection. The nurse should discuss this with the provider because taking both of these medications simultaneously can cause which effect?

Accepted Answer

Erythromycin is a macrolide antibiotic that can inhibit the metabolism of other drugs by the liver, potentially leading to increased levels of those drugs in the body. However, in the context of cefaclor, a cephalosporin antibiotic, the concern is not about increased drug levels but rather the potential for antagonistic effects when used with other bacteriostatic agents like erythromycin. This can lead to decreased effectiveness of cefaclor because erythromycin may inhibit the growth of bacteria that cefaclor needs to be actively dividing in order to exert its bactericidal effect.

Question 13

The nurse is teaching a nursing student about the minimal effective concentration (MEC) of antibiotics. Which statement by the nursing student indicates understanding of this concept?

Accepted Answer

The minimal effective concentration (MEC) of an antibiotic is the lowest concentration of the drug that is needed to inhibit the growth of a particular microorganism. Therefore, a serum drug level greater than the MEC is sufficient to halt the growth of the microorganism, as stated in option C. Option A is incorrect because a serum drug level greater than the MEC may result in the drug being bactericidal rather than bacteriostatic. Option B is incorrect because a serum drug level greater than the MEC does not necessarily broaden the spectrum of the drug. Option D is incorrect because the therapeutic index is a measure of the safety of a drug, and increasing the serum drug level does not necessarily increase the drug's safety.

Question 14

The nurse is preparing to give a dose of a cephalosporin medication to a patient who has been receiving the antibiotic for 2 weeks. The nurse notes ulcers on the patient's tongue and buccal mucosa. Which action will the nurse take?

Accepted Answer

The ulcers on the tongue and buccal mucosa may indicate a superinfection, which is a known side effect of prolonged antibiotic use, including cephalosporins. The nurse should report this to the provider.

Question 15

The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin to treat an infection. The patient is also taking acetaminophen for pain. The nurse should expect to review which lab values when monitoring for this drug's side effects?

Accepted Answer

When monitoring for the side effects of azithromycin, the nurse should review the patient's liver enzymes as the drug can cause hepatotoxicity. Acetaminophen can also cause liver damage, so monitoring liver enzymes is even more important in this case. Complete blood counts and electrolytes are not directly associated with the side effects of azithromycin or acetaminophen. Urinalysis may be performed to monitor for kidney function, but it is not the most appropriate lab value to monitor in this situation.

Question 16

The patient will begin taking penicillin G procaine (Wycillin). The nurse notes that the solution is milky in color. What action will the nurse take?

Accepted Answer

Penicillin G procaine is typically milky in color due to the addition of procaine, a local anesthetic, to the solution. This is a normal characteristic of the medication and does not require any action by the nurse. Therefore, the nurse should administer the medication as ordered by the physician.

Question 17

The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 to 2.2 mcg/mL. What will the nurse expect the patient to experience?

Accepted Answer

The patient's serum drug trough is below the normal range, indicating that they may not be receiving enough of the medication to achieve the desired therapeutic effects. This could result in inadequate treatment of the underlying condition for which the antibiotic was prescribed.

Question 18

The nurse is providing teaching to a patient who will begin taking a cephalosporin to treat an infection. Which statement by the patient indicates a need for further teaching?

Accepted Answer

It is important for patients to complete the full course of antibiotics, even if their symptoms improve, in order to fully eradicate the infection and prevent the development of antibiotic-resistant bacteria.

Question 19

A patient is admitted to the hospital for treatment of pneumonia after complaining of high fever and shortness of breath. The patient was not able to produce sputum for a culture. The nurse will expect the patient's provider to order which of the following?

Accepted Answer

Since the patient was not able to produce sputum for a culture, the provider may order a broad-spectrum antibiotic to cover a wide range of possible bacterial pathogens that could be causing the pneumonia. Once the culture and sensitivity results are available, the provider may adjust the antibiotic therapy accordingly.

Question 20

The nurse is teaching a patient who will be discharged home from the hospital to take amoxicillin (Amoxil) twice daily for 10 days. Which statement by the nurse is correct?

Accepted Answer

Option A is incorrect because the patient shouldn't stop taking the antibiotic until completing the full course. Option B is incorrect because diarrhea is a common side effect of amoxicillin and stopping the drug is not necessary unless it is severe or bloody. Option D is incorrect because the patient should not save any unused antibiotic and should dispose of it properly. Option C is correct because a rash could be indicative of an allergic reaction, and the patient should stop taking the drug and notify their provider immediately.

Quiz 26: Antibacterials