Question 1

A patient is receiving high doses of a cephalosporin.Which laboratory values will this patient's nurse monitor closely?&#10;A)Blood urea nitrogen (BUN),serum creatinine,and liver function tests&#10;B)Complete blood count and electrolytes&#10;C)Serum calcium and magnesium&#10;D)Serum glucose and lipids

Accepted Answer

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

Question 2

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?

A)Hold the drug and notify the provider.
B)Obtain an order to culture the oral lesions.
C)Gather emergency equipment to prepare for anaphylaxis.
D)Report a possible superinfection side effect of the cephalosporin.

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 3

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?&#10;A)Administer the amoxicillin and have epinephrine available.&#10;B)Ask the provider to order an antihistamine.&#10;C)Contact the provider to discuss using a different antibiotic.&#10;D)Request an order for a beta-lactamase resistant drug.

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 4

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?

A)Drugs with a broad spectrum
B)Drugs with a narrow spectrum
C)Drugs with a broad therapeutic index
D)Drugs with a narrow therapeutic index

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 5

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?&#10;A)&#34;A serum drug level greater than the MEC ensures that the drug is bacteriostatic.&#34;&#10;B)&#34;A serum drug level greater than the MEC broadens the spectrum of the drug.&#34;&#10;C)&#34;A serum drug level greater than the MEC helps eradicate bacterial infections.&#34;&#10;D)&#34;A serum drug level greater than the MEC increases the therapeutic index.&#34;

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.

Question 6

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

A)acquired bacterial resistance.
B)cross-resistance.
C)inherent bacterial resistance.
D)transferred resistance.

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 7

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?

A)Decreased effectiveness of cefaclor.
B)Increased effectiveness of cefaclor.
C)Decreased effectiveness of erythromycin.
D)Increased effectiveness of erythromycin.

Accepted Answer

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

Question 8

Which actions can contribute to bacterial resistance to antibiotics? (Select all that apply.)&#10;A)Frequent use of antibiotics&#10;B)Giving large doses of antibiotics&#10;C)Skipping doses&#10;D)Taking a full course of antibiotics&#10;E) Treating viral infections with antibiotics

Accepted Answer

Frequent use of antibiotics increases the exposure of bacteria to an antibiotic and results in acquired resistance.Skipping doses of an antibiotic can lead to incomplete treatment of an infection,and the remaining bacteria may develop acquired resistance.Treating viral infections with antibiotics is unnecessary and may cause acquired resistance to develop from unneeded exposure to a drug.Infections adequately treated with an antibiotic do not result in resistance.

Question 9

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?&#10;A)&#34;I may stop taking the medication if my symptoms clear up.&#34;&#10;B)&#34;I should eat yogurt while taking this medication.&#34;&#10;C)&#34;I should stop taking the drug and call my provider if I develop a rash.&#34;&#10;D)&#34;I will not consume alcohol while taking this medication.&#34;

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 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?

A)Administer the drug and observe closely for hypersensitivity reactions.
B)Ask the provider whether a cephalosporin from a different generation may be used.
C)Contact the provider to report drug hypersensitivity.
D)Notify the provider and suggest an oral cephalosporin.

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 in order 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 11

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?

A)Administer the antibiotic as ordered.
B)Contact the provider to request another culture.
C)Discuss the need to add a second antibiotic with the provider.
D)Review the sensitivity results from the patient's culture.

Accepted Answer

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

Question 12

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?

A)Administer the drug and observe closely for hypersensitivity reactions.
B)Ask the provider whether a cephalosporin from a different generation may be used.
C)Contact the provider to report drug hypersensitivity.
D)Notify the provider and suggest an oral cephalosporin.

Accepted Answer

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

Question 13

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?&#10;A)Call the pharmacist and report the milky color.&#10;B)Add normal saline to dilute the medication.&#10;C)Call the physician and report the milky appearance.&#10;D)Administer the medication as ordered by the physician.

Accepted Answer

The answer of The patient will begin taking penicillin G...

Question 14

A patient will begin taking amoxicillin.The nurse should instruct the patient to avoid which foods?&#10;A)Green leafy vegetables&#10;B)Beef and other red meat&#10;C)Coffee,tea,and colas&#10;D)Acidic fruits and juices

Accepted Answer

The answer of A patient will begin taking amoxicillin.The nurse...

Question 15

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?&#10;A)&#34;Discontinue the antibiotic when your temperature returns to normal and your symptoms have improved.&#34;&#10;B)&#34;If diarrhea occurs,stop taking the drug immediately and contact your provider.&#34;&#10;C)&#34;Stop taking the drug and notify your provider if you develop a rash while taking this drug.&#34;&#10;D)&#34;You may save any unused antibiotic to use if your symptoms recur.&#34;

Accepted Answer

The answer of The nurse is teaching a patient who...

Question 16

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

A)a broad-spectrum antibiotic.
B)a narrow-spectrum antibiotic.
C)multiple antibiotics.
D)the pneumococcal vaccine.

Accepted Answer

The answer of A patient is admitted to the hospital...

Question 17

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?

A)Drugs with a broad spectrum
B)Drugs with a narrow spectrum
C)Drugs with a broad therapeutic index
D)Drugs with a narrow therapeutic index

Accepted Answer

The answer of The nurse is caring for a patient...

Deck 29: Penicillins and Cephalosporins