Question 1

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 (Wycillin)has a milky appearance; therefore,the appearance should not concern the nurse.

Question 2

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

Erythromycin is the drug of choice when penicillin is not an option.Giving smaller doses of penicillin does not prevent hypersensitivity reactions.Benadryl is useful when a hypersensitivity reaction has occurred.A small percentage of patients allergic to penicillins may be hypersensitive to cephalosporins.

Question 3

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

The interaction of cefaclor and erythromycin will produce a decrease in the action of the cefaclor.

Question 4

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

Accepted Answer

Cefazolin will produce an increase in the patient's BUN,creatinine,AST,ALT,ALP,LDH,and bilirubin.

Question 5

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

Patients who develop signs of allergy,such as rash,should notify their provider before continuing medication therapy.Patients should be counseled to continue taking their antibiotics until completion of the prescribed regimen even when they feel well.Diarrhea is an adverse effect but does not warrant cessation of the drug.Before deciding to stop taking a medication due to a side effect,encourage the patient to contact the provider first.Patients should discard any unused antibiotic.

Question 6

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

Low peak levels may indicate that the medication is below the therapeutic level.They do not indicate altered risk for superinfection,a decrease in adverse effects,or a slowed onset of action.

Question 7

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

Accepted Answer

Acidic fruits and juices should be avoided while the client is being treated with amoxicillin because amoxicillin can be irritating to the stomach.Stomach irritation will be increased with the ingestion of citrus and acidic foods.Amoxicillin may also be less effective when taken with acidic fruit or juice.

Question 8

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

Patients who have previously experienced manifestations of allergy to a penicillin should not use penicillins again unless necessary.The nurse should contact the provider to discuss using another antibiotic from a different class.Epinephrine and antihistamines are useful when patients are experiencing allergic reactions,depending on severity.

Question 9

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

High doses of macrolides,when taken with other,potentially hepatotoxic drugs such as acetaminophen may cause hepatotoxicity,so liver enzymes should be carefully monitored.

Question 10

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 patient's symptoms may indicate a superinfection and should be reported to the physician so it can be treated; however,the drug does not need to be held.It is not necessary to culture the lesions.The symptoms do not indicate impending anaphylaxis.

Question 11

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

To obtain the most accurate culture,the specimen should be obtained before antibiotic therapy begins.It is important to obtain cultures when possible to correctly identify the organism and help determine which antibiotic will be most effective.Administering test doses to determine hypersensitivity is sometimes done when there is a strong suspicion of allergy when a particular antibiotic is needed.Epinephrine is kept close at hand when there is a strong suspicion of allergy.

Question 12

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

Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose.It is important to monitor these medications closely by evaluating regular serum peak and trough levels.

Question 13

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 resistance occurs when an organism has been exposed to the antibacterial drug.Cross-resistance occurs when an organism that is resistant to one drug is also resistant to another.Inherent resistance occurs without previous exposure to the drug.Transferred resistance occurs when the resistant genes of one organism are passed to another organism.

Question 14

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 action?

Accepted Answer

The sensitivity results from the patient's culture will reveal whether the organism is sensitive or resistant to a particular antibiotic.The patient is not responding to the antibiotic being given,so the antibiotic should be held and the provider notified.Another culture is not indicated.Antibiotics should be added only when indicated by the sensitivity.

Question 15

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

Accepted Answer

Erythromycin is the drug of choice for treating mycoplasma pneumonia.

Question 16

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

Accepted Answer

Erythromycin and other macrolides should not be given intramuscularly because they cause painful tissue irritation.

Question 17

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

Patients should take all of an antibiotic regimen even after symptoms clear to ensure complete treatment of the infection.Patients are often advised to eat yogurt or drink buttermilk to prevent superinfection.A rash is a sign of hypersensitivity,and patients should be counseled to stop taking the drug and notify the provider if this occurs.Alcohol consumption may cause adverse effects and should be avoided by patients while they are taking cephalosporins.

Question 18

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

A small percentage of patients who are allergic to penicillin could also be allergic to a cephalosporin product.Patients should be monitored closely after receiving a cephalosporin if they are allergic to penicillin.There is no difference in hypersensitivity potential between different generations or method of delivery of cephalosporins.

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

Accepted Answer

Broad-spectrum antibiotics are frequently used to treat infections when the offending organism has not been identified by culture and sensitivity (C&S).Narrow-spectrum antibiotics are usually effective against one type of organism and are used when the C&S indicates sensitivity to that antibiotic.The use of multiple antibiotics,unless indicated by C&S,can increase resistance.The pneumococcal vaccine is used to prevent,not treat,an infection.

Question 20

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 MEC is the minimum amount of drug needed to halt the growth of a microorganism.A level greater than the MEC helps eradicate infections.Drugs at or above the MEC are usually bactericidal,not bacteriostatic.Raising the drug level does not usually broaden the spectrum or increase the therapeutic index of a drug.

Quiz 26: Antibacterials

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?

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