Question 1

Which side effect should you monitor for when a child is prescribed penicillin V potassium 250 mg twice daily?

Accepted Answer

Most cell wall synthesis inhibitors have fewer side effects than other types of antibacterial drugs.However,the cell wall synthesis inhibitors,especially penicillin,are more likely to cause allergic reactions.If a rash or hives develop while taking an antibacterial drug,remind the parents to stop giving the drug and call the prescriber immediately.Explain that this is a sign of drug allergy.Tell the parents to call 911 immediately if the child has trouble breathing or has the feeling of a "lump in the throat" because these are signs of a more serious allergic reaction.

Question 2

A patient prescribed vancomycin (Vancocin)has developed redness on the face,neck,chest,back,and arms.The family asks the nurse if the drug should be stopped because of this response.What is your best answer?

Accepted Answer

Vancomycin is a powerful antibacterial drug that has many side effects,including "red man syndrome." This problem is caused by a histamine release that dilates blood vessels,giving a red appearance to the face,neck,chest,back,and arms.Sometimes this reaction can be reduced by slowing the infusion rate;however,it is not an indication to stop the drug.

Question 3

A patient is to receive linezolid (Zyvox)300 mg orally.You have on hand linezolid tablets of 600 mg/tablet.How many tablets will you give for a 300 mg dose?

Accepted Answer

Want 300 mg in X tablets/Have 600 mg in 1 tablet.300/600 = 0.5 tablet.

Question 4

A patient receiving antibiotics for 3 days reports a skin rash over the chest,back,and arms.What is your first action?

Accepted Answer

A rash is an indication that the patient is allergic to the drug;however,at this time it is not an emergency.First explore the patient's response further and hold the dose,then notify the prescriber of this problem.

Question 5

A patient is prescribed intravenous ertapenem (Invanz).Which question is most important to ask before giving the first dose of this drug?

Accepted Answer

Ertapenem belongs to the carbapenem antibacterial class.Drugs in this class can cause seizures in susceptible people.If a patient has a seizure disorder,the drug should be used with caution.The prescriber is notified of this problem because the dosage of anticonvulsive drug or drugs may need to be adjusted before the ertapenem is administered.

Question 6

A patient is to receive ticarcillin (Ticar)3 g by intravenous piggyback.The solution you have is ticarcillin 200 mg/mL.How many milliliters of this solution will you add to the piggyback bag to make a dose of 3 g?

Accepted Answer

Want 3 g (3000 mg)in X mL/Have 200 mg in 1 mL.3000/200 = 15X = 15 mL.

Question 7

A patient who has been on antibiotic therapy for 3 weeks has a cottage cheese-like coating on the teeth,gums,and roof of the mouth.What your best action?

Accepted Answer

Prolonged antibacterial therapy can cause an oral yeast infection (thrush)by killing off the normal flora of the mouth.This infection causes a white,cottage cheese-like coating on the gums,roof of the mouth,or insides of the cheeks,which is not an allergic reaction nor is it a reason to stop the drug therapy.Teach patient to use good oral hygiene performing frequent toothbrushing and using mouthwash.

Question 8

A woman who is breastfeeding is prescribed amoxicillin/clavulanic acid (Augmentin)250 mg every 8 hours to treat a bacterial infection.What should you teach her?

Accepted Answer

All of these drugs pass into breast milk and will affect a nursing infant,possibly causing the infant to develop a drug allergy.These drugs are usually prescribed for only 5 to 14 days,and the breastfeeding mother should be urged to reduce infant exposure to the drug.

Question 9

A patient who has been prescribed cephalexin (Keflex)reports having a severe allergic reaction to penicillin in the past.What is your best first response or action?

Accepted Answer

Cephalexin is a cephalosporin and has a chemical structure that is very similar to the structure of penicillin.Often a person who is allergic to penicillin is also allergic to cephalosporins.Even if the prescriber wishes to go ahead with cephalosporin therapy,he or she may first prescribe premedication to reduce the risk for an allergic response.

Question 10

A patient taking erythromycin reports experiencing nausea and upset stomach.What is your best action?

Accepted Answer

Side effects common to erythromycin include nausea,vomiting,and GI upset.This is not an indication of allergic reaction.Giving the drug with or after food will help prevent these side effects.

Question 11

A patient experiences facial angioedema after receiving a dose of a new antibacterial drug.Which assessment should be performed first?

Accepted Answer

Angioedema of the face includes the mouth and throat and can quickly lead to laryngeal edema.Edema in either place can obstruct the airway.Although assessing respirations is important,assess the airway first to determine patency.

Question 12

Which antibacterial drug kills bacteria by binding to cell wall proteins and preventing them from being incorporated into cells walls?

Accepted Answer

Of the drugs on this list,only vancomycin is a cell wall synthesis inhibitor.Minocyline and gentamicin are protein synthesis inhibitors.Levofloxacin is a DNA synthesis inhibitor.

Question 13

What is the most important action needed when a patient is first started on an intravenous (IV)antibacterial drug?

Accepted Answer

Anaphylaxis is a severe drug allergy that can quickly lead to death.Although drug-induced anaphylaxis can occur at any time,it is most likely to occur early during IV administration of the drug.Signs and symptoms are hives at the IV site,low blood pressure,rapid irregular pulse,swelling of the lips or lower face,and the patient feeling a "lump in the throat." When the patient is receiving the first dose of an IV antibiotic,checking the patient at least every 15 minutes for symptoms of anaphylaxis is critical.

Question 14

A patient is to receive penicillin G benzathine (Bicillin LA)2,400,000 units intramuscularly.The drug on hand is penicillin G benzathine 600,000 units/mL.How many milliliters should your nurse prepare for the correct dose?

Accepted Answer

Want 2,400,000 units/Have 600,000 units/mL.2,400,000/600,000 = 24/6 = 4 mL.

Question 15

A patient with a bacterial infection has been placed on antibacterial therapy.Which assessment finding in the patient indicates that the therapy is effective?

Accepted Answer

Signs and symptoms of a resolving infection include reduced or absent fever;no chills;wound drainage that is no longer thick,foul-smelling,brown,green,or yellow;wound edges that are not red and raw-looking;and a WBC count that is in the normal range (5000 to 10,000 mm³).

Question 16

A patient who has been prescribed oral cephalexin (Keflex)also takes aluminum hydroxide (Mylanta)1 hour after each meal.When should you give this drug?

Accepted Answer

Cephalexin is a cephalosporin.These drugs are poorly absorbed with iron supplements or antacids.If a patient is receiving an antacid,the cephalosporin should be given 1 hour before or 4 hours after the antacid or iron supplement.

Question 17

A patient is receiving intravenous gentamicin.Which change in condition do you report to the prescriber immediately?

Accepted Answer

Gentamicin is an aminoglycoside antibacterial drug.These drugs are toxic to the kidneys (nephrotoxic).A decrease of urine output by 1000 mL in a 24-hour time period is cause for concern about kidney function.The drug may need to be stopped or the dosage decreased.

Question 18

A patient who has been prescribed amoxicillin (Amoxil)250 mg orally every 8 hours asks if a higher dose of the drug just once a day can be taken instead.What is your best response?

Accepted Answer

For all antibacterial therapy,it is important to keep the blood level high enough to affect the bacteria causing the infection.For this reason it is best for a patient to take the drug evenly throughout a 24-hour period.

Question 19

A patient is having an anaphylactic reaction to an intravenous (IV)antibacterial drug.Which action should you perform first?

Accepted Answer

When a patient is having an anaphylactic reaction to an IV drug,the first priority is to prevent any more drug from entering the patient.Stop the drug from infusing but keep the IV access open.If the drug is infusing high into the IV tubing,change the tubing after stopping the drug,and do not let any drug left in the tubing run into the patient.Starting a new IV line may be difficult or impossible during the hypotension that occurs during anaphylaxis.

Question 20

An older patient is prescribed azithromycin (Zithromax)500 mg on the first day and 250 mg for days 2 through 5.For which drug also prescribed for this patient would you notify the prescriber?

Accepted Answer

If a patient is prescribed a macrolide,check to see whether he or she is also taking digoxin,warfarin,pimozide,astemizole,terfenadine,or ergotamine.If so,notify the prescriber immediately because macrolides change the metabolism of these drugs,which can cause adverse effects.

Quiz 8: Anti-Infectives: Antibacterial Drugs

Which side effect should you monitor for when a child is prescribed penicillin V potassium 250 mg twice daily?

A patient prescribed vancomycin (Vancocin) has developed redness on the face,neck,chest,back,and arms.The family asks the nurse if the drug should be stopped because of this response.What is your best answer?

A patient is to receive linezolid (Zyvox) 300 mg orally.You have on hand linezolid tablets of 600 mg/tablet.How many tablets will you give for a 300 mg dose?

A patient receiving antibiotics for 3 days reports a skin rash over the chest,back,and arms.What is your first action?

A patient is prescribed intravenous ertapenem (Invanz) .Which question is most important to ask before giving the first dose of this drug?

A patient is to receive ticarcillin (Ticar) 3 g by intravenous piggyback.The solution you have is ticarcillin 200 mg/mL.How many milliliters of this solution will you add to the piggyback bag to make a dose of 3 g?

A patient who has been on antibiotic therapy for 3 weeks has a cottage cheese-like coating on the teeth,gums,and roof of the mouth.What your best action?

A woman who is breastfeeding is prescribed amoxicillin/clavulanic acid (Augmentin) 250 mg every 8 hours to treat a bacterial infection.What should you teach her?

A patient who has been prescribed cephalexin (Keflex) reports having a severe allergic reaction to penicillin in the past.What is your best first response or action?

A patient taking erythromycin reports experiencing nausea and upset stomach.What is your best action?

A patient experiences facial angioedema after receiving a dose of a new antibacterial drug.Which assessment should be performed first?

Which antibacterial drug kills bacteria by binding to cell wall proteins and preventing them from being incorporated into cells walls?

What is the most important action needed when a patient is first started on an intravenous (IV) antibacterial drug?

A patient is to receive penicillin G benzathine (Bicillin LA) 2,400,000 units intramuscularly.The drug on hand is penicillin G benzathine 600,000 units/mL.How many milliliters should your nurse prepare for the correct dose?

A patient with a bacterial infection has been placed on antibacterial therapy.Which assessment finding in the patient indicates that the therapy is effective?

A patient who has been prescribed oral cephalexin (Keflex) also takes aluminum hydroxide (Mylanta) 1 hour after each meal.When should you give this drug?

A patient is receiving intravenous gentamicin.Which change in condition do you report to the prescriber immediately?

A patient who has been prescribed amoxicillin (Amoxil) 250 mg orally every 8 hours asks if a higher dose of the drug just once a day can be taken instead.What is your best response?

A patient is having an anaphylactic reaction to an intravenous (IV) antibacterial drug.Which action should you perform first?

An older patient is prescribed azithromycin (Zithromax) 500 mg on the first day and 250 mg for days 2 through 5.For which drug also prescribed for this patient would you notify the prescriber?