Question 1

A patient experiences facial angioedema after receiving a dose of a new antibacterial drug.Which assessment does the nurse perform 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 2

A patient who has been prescribed cephalexin (Keflex)reports having a severe allergic reaction to penicillin in the past.What is the nurse's best response?

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 also is 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 3

A patient is prescribed intravenous ertapenem (Invanz).Which question is most important for the nurse 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 4

A patient is receiving intravenous gentamicin.Which change in condition does the nurse 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 5

A patient who has been prescribed amoxicillin (Amoxil)250 mg orally every 8 hours asks the nurse if a higher dose of the drug just once a day can be taken instead.What is the nurse's 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 6

A patient receiving antibiotics for 3 days reports a skin rash over the chest,back,and arms.What is the nurse's 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.The nurse will first explore the patient's response further and hold the dose,then notify the prescriber of this problem.

Question 7

A patient who has been prescribed oral cephalexin (Keflex)also takes aluminum hydroxide (Mylanta)1 hour after each meal.What is the nurse's best action?

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 8

Which type of bacteria cause infection when a patient's immune system is impaired?

Accepted Answer

Pathogenic bacteria cause disease or tissue damage while nonpathogenic bacteria do not.Opportunistic bacteria cause disease or tissue damage only when the immune system is not working well.

Question 9

A patient is having an anaphylactic reaction to an intravenous (IV)antibacterial drug.Which action does the nurse 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 10

Why is it important to avoid killing off normal flora with antibacterial drugs?

Accepted Answer

Normal flora are the nonpathogenic bacteria that are always present on skin,mucous membranes,and in the digestive tract.They provide protection by "crowding out" pathogenic organisms and preventing them from entering the body.

Question 11

A patient taking erythromycin reports experiencing nausea and upset stomach.What is the nurse's 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 12

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 is the nurse's 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.Help the patient use good oral hygiene with tooth-brushing and mouthwash at least every shift.

Question 13

The nurse is teaching a patient in whom a wound infection developed after surgery about antibiotic therapy.Which statement made by the patient indicates a correct understanding of the therapy?

Accepted Answer

Antibiotic therapy is most effective when the patient takes the prescribed drug for the entire course and not just when symptoms are present.Most antibiotic therapy results in some degree of diarrhea.Although additional drugs may be needed to control this side effect,it is usually not necessary to stop the drug.

Question 14

How are bactericidal drugs different from bacteriostatic drugs?

Accepted Answer

Bactericidal drugs directly kill bacteria; bacteriostatic drugs only stop bacteria from reproducing while the immune system kills the bacteria.

Question 15

A patient with a bacterial infection has been placed on antibacterial therapy.Which assessment finding in the patient indicates to the nurse 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 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 does the nurse prepare?

Accepted Answer

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

Question 17

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 the nurse's 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 18

What is the most important nursing action 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 19

A patient has a bacterial infection,but the causative organism is not known.Which type of antibacterial drug will most likely be prescribed?

Accepted Answer

A broad-spectrum antibacterial drug is effective against a wide range of bacteria,both gram-positive and gram-negative.Narrow-spectrum drugs are effective against a few bacteria,while extended-spectrum drugs are effective against several types of bacteria.

Question 20

A patient with a respiratory bacterial infection asks why a sputum sample is being collected before starting antibacterial drug therapy.What is the nurse's best response?

Accepted Answer

Identifying the type of bacteria causing an infection is important for selection of the appropriate drug to treat the infection.The most common way of identifying bacteria is culture and sensitivity.When a drug is effective against the bacteria,the bacteria do not grow.

Quiz 9: Anti-Infectives: Antibacterial Drugs

A patient experiences facial angioedema after receiving a dose of a new antibacterial drug.Which assessment does the nurse perform first?

A patient who has been prescribed cephalexin (Keflex) reports having a severe allergic reaction to penicillin in the past.What is the nurse's best response?

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

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

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

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

A patient who has been prescribed oral cephalexin (Keflex) also takes aluminum hydroxide (Mylanta) 1 hour after each meal.What is the nurse's best action?

Which type of bacteria cause infection when a patient's immune system is impaired?

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