Question 1

The nurse caring for a client with an allergy to cephalosporins would be cautious in implementing an order for an anti-infective agent from which class?

Accepted Answer

Cephalosporins and penicillins are closely related in structure and there is a high likelihood of cross-reactivity between the two classes of antibiotics. Therefore, a nurse would be cautious implementing an order for a penicillin for a client with an allergy to cephalosporins. Aminoglycosides, fluoroquinolones, and sulfonamides are not structurally related to cephalosporins, so they would not pose the same risk of cross-reactivity.

Question 2

The mother of a 4-year-old calls the nurse to report her child has been having diarrhea since he began taking an antibiotic 48 hours ago.The mother asks if she should give her child an over-the-counter medication for the diarrhea.What is the nurse's best response?

Accepted Answer

Antibiotic-associated diarrhea can be a sign of a more serious condition such as Clostridium difficile infection. It's important to evaluate the child before attempting over-the-counter treatments, as these could mask symptoms or worsen the condition.

Question 3

Which clients taking penicillin G should the nurse plan to monitor closely?
Select all that apply.

Accepted Answer

Clients taking penicillin G who should be monitored closely include those with diabetes (A), heart failure (B), and those taking spironolactone for hormonal acne (C).

Question 4

Bacterial enzymes participate in the construction of the bacterial cell wall.Penicillin targets these enzymes and interferes with:

Accepted Answer

Penicillin targets the enzymes involved in the construction of the bacterial cell wall and interferes with the addition of cross-links to the cell wall, leading to the weakening and eventual lysis of the bacterial cell.

Question 5

A client asks why the health care provider ordered penicillin for the client's infection.How should the nurse respond?
Select all that apply.

Accepted Answer

- A) Penicillin is effective against gram-positive bacteria, which is why it may have been chosen for the client's infection.- B) Penicillin can act as a narrow-spectrum antibiotic, making it suitable for targeting specific bacteria once they are identified.- C) Penicillins have the ability to be widely distributed throughout most body tissues, making them effective in treating infections in various parts of the body.

Question 6

A client in the emergency department experienced a severe allergic response to penicillin.The client tells the nurse this is the first time she has ever taken this particular drug.Which questions can the nurse ask to determine the reason for the allergic response?
Select all that apply.

Accepted Answer

Exposure to mold (A) or animal products with antibiotics (B) can sensitize a person to penicillin. Cross-reactivity with cephalosporins (C) can also indicate a predisposition to penicillin allergy.

Question 7

A client being discharged with a prescription for penicillin also takes probenecid.The nurse explains that probenecid:

Accepted Answer

Probenecid is a medication that inhibits the excretion of penicillin by the kidneys, thereby allowing the penicillin to stay in the body for a longer duration. This helps the medication to be more effective against the infection.

Question 8

The nurse has received an order to give imipenem-cilastatin (Primaxin)intravenously (IV)to a client.Which assessments should alert the nurse to contact the health care provider?
Select all that apply.

Accepted Answer

The answer of The nurse has received an order to...

Question 9

Which client should be most closely monitored for adverse effects directly related to receiving penicillin G?

Accepted Answer

Clients with diabetes and on dialysis have impaired kidney function, which can affect the excretion of penicillin G, leading to an increased risk of adverse effects. Penicillin G is primarily excreted by the kidneys, and impaired renal function can lead to accumulation of the drug in the body.

Question 10

A female client has been prescribed ampicillin (Principen).What should the nurse emphasize when instructing the client about the medication?
Select all that apply.

Accepted Answer

The answer of A female client has been prescribed ampicillin...

Question 11

The nurse anticipates use of an extended-spectrum penicillins such as piperacillin when the patient is infected with which microbe?

Accepted Answer

Extended-spectrum penicillins such as piperacillin are effective against Pseudomonas, which is a gram-negative bacteria that can cause serious infections, particularly in immunocompromised individuals. This medication is not typically used for infections caused by Streptococcus or Staphylococcus, and it is not effective against viruses such as Herpes simplex.

Question 12

The nurse is administering the first dose of ampicillin intramuscularly to a client with a severe infection.In addition to the six rights of medication administration,an important priority nursing action is to:

Accepted Answer

Monitoring the client closely for hypersensitivity with the first dose of a new medication is an important nursing action that should be done in addition to the six rights of medication administration. This is particularly important with ampicillin, as hypersensitivity reactions, including anaphylaxis, can occur. Monitoring the client closely for any signs of hypersensitivity, such as rash, itching, swelling, or difficulty breathing, can aid in early identification and treatment of a potential reaction. While monitoring bowel sounds, teaching about side effects, and encouraging fluid intake may also be important nursing actions depending on the client's situation, they are not the most important priority action when administering the first dose of a new medication with the potential for hypersensitivity.

Question 13

Classes of antibiotics that exert their antibacterial effect by interfering with the synthesis of the bacterial cell wall include:

Accepted Answer

Cephalosporins are a class of antibiotics that interfere with the synthesis of the bacterial cell wall. This inhibition leads to the eventual lysis of the bacterial cell.

Question 14

The nurse would explain that Augmentin is a combination drug containing the antibiotic amoxicillin and clavulanate,which is a(n):

Accepted Answer

Clavulanate is a beta-lactamase inhibitor that prevents bacteria from producing enzymes that can destroy amoxicillin, thereby extending its spectrum of activity.

Question 15

First-generation cephalosporins are the most effective of this class of antibiotics against:

Accepted Answer

First-generation cephalosporins are most effective against gram-positive bacteria, including Streptococcus and Staphylococcus species. They have limited activity against gram-negative bacteria, and virtually no activity against protozoans or Rickettsia.

Question 16

A client is admitted with a severe gram-negative bacterial infection of the skin.Which diagnostic lab work should the nurse expect to see if ticarcillin-clavulanate (Timentin)is ordered in high doses?
Select all that apply.

Accepted Answer

The answer of A client is admitted with a severe...

Question 17

Which statement best describes the bacterial cell wall?

Accepted Answer

The bacterial cell wall is a rigid structure that provides shape and protection to the bacterial cell.

Question 18

Which generation of cephalosporin would be selected to treat complicated,drug-resistant meningitis?

Accepted Answer

Fourth generation cephalosporins such as cefepime have broad-spectrum activity against gram-positive and gram-negative bacteria, Including resistance to beta-lactamases, making them an appropriate choice for complicated, drug-resistant meningitis.

Question 19

Penicillin's antibacterial activity is based on its:

Accepted Answer

Penicillin's antibacterial activity is based on its beta-lactam ring, which terminates construction of the cell wall. This leads to bacterial cell death through osmotic lysis.

Question 20

Which instruction should take priority in client teaching for any antibiotic therapy?

Accepted Answer

Completing the full course of prescribed drug therapy is critical to ensure that the infection is fully treated and to prevent the development of antibiotic resistance. Maintaining adequate food and fluid intake and reporting symptoms of secondary infection are also important, but completing the full course of antibiotics is the top priority.

Quiz 47: Antibiotics Affecting the Bacterial Cell Wall

The nurse caring for a client with an allergy to cephalosporins would be cautious in implementing an order for an anti-infective agent from which class?

The mother of a 4-year-old calls the nurse to report her child has been having diarrhea since he began taking an antibiotic 48 hours ago.The mother asks if she should give her child an over-the-counter medication for the diarrhea.What is the nurse's best response?

Which clients taking penicillin G should the nurse plan to monitor closely? Select all that apply.

Bacterial enzymes participate in the construction of the bacterial cell wall.Penicillin targets these enzymes and interferes with:

A client asks why the health care provider ordered penicillin for the client's infection.How should the nurse respond? Select all that apply.

A client in the emergency department experienced a severe allergic response to penicillin.The client tells the nurse this is the first time she has ever taken this particular drug.Which questions can the nurse ask to determine the reason for the allergic response? Select all that apply.