Deck 30: Macrolides,tetracyclines,aminoglycosides,and Fluoroquinolones

Question 1

The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin)to treat pneumonia.The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC)antacids to treat occasional heartburn.The patient reports frequent arthritis pain and takes acetaminophen when needed.Which statement by the nurse is correct when teaching this patient?

A)"You may take antacids with levofloxacin to decrease gastrointestinal upset."
B)"You may take nonsteroidal anti-inflammatory medications (NSAIDs)for arthritis pain."
C)"You should monitor your serum glucose more closely while taking levofloxacin."
D)"You should take levofloxacin on an empty stomach to improve absorption."

Answer 1

"You should monitor your serum glucose more closely while taking levofloxacin."

Question 2

The nurse is preparing to give a dose of oral clindamycin (Cleocin)to a patient who is being treated for a skin infection caused by Staphylococcus aureus.The patient has had several doses of the medication and reports having nausea.Which action will the nurse take next?

A)Administer the next dose when the patient has an empty stomach.
B)Hold the next dose and contact the patient's provider.
C)Instruct the patient to take the next dose with a full glass of water.
D)Request an order for an antacid to give along with the next dose.

Answer 2

Instruct the patient to take the next dose with a full glass of water.

Question 3

The nurse is caring for a 70-kg patient who is receiving gentamicin (Garamycin)85 mg 4 times daily.The patient reports experiencing ringing in the ears.The nurse will contact the provider to discuss

A)decreasing the dose to 50 mg QID.
B)giving the dose 3 times daily.
C)obtaining a serum drug level.
D)ordering a hearing test.

Answer 3

obtaining a serum drug level.

Question 4

A female patient who is allergic to penicillin will begin taking an antibiotic to treat a lower respiratory tract infection.The patient tells the nurse that she almost always develops a vaginal yeast infection when she takes antibiotics and that she will take fluconazole (Diflucan)with the antibiotic being prescribed.Which macrolide order would the nurse question for this patient?

A)Azithromycin (Zithromax)
B)Clarithromycin (Biaxin)
C)Erythromycin (E-Mycin)
D)Fidaxomicin (Dificid)

Question 5

The nurse is caring for a 7-year-old patient who will receive oral antibiotics.Which antibiotic order will the nurse question for this patient?

A)Azithromycin (Zithromax)
B)Clarithromycin (Biaxin)
C)Clindamycin (Cleocin)
D)Tetracycline (Sumycin)

Question 6

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

A)Azithromycin (Zithromax)
B)Clarithromycin (Biaxin)
C)Erythromycin (E-Mycin)
D)Fidaxomicin (Dificid)

Question 7

The nurse is preparing to administer clarithromycin to a patient.When performing a medication history,the nurse learns that the patient takes warfarin to treat atrial fibrillation.The nurse will perform which action?

A)Ask the provider if azithromycin may be used instead of clarithromycin.
B)Obtain an order for continuous cardiovascular monitoring.
C)Request an order for periodic serum warfarin levels.
D)Withhold the clarithromycin and notify the provider.

Question 8

A female patient will receive doxycycline to treat a sexually transmitted illness (STI).What information will the nurse include when teaching this patient about this medication?

A)Nausea and vomiting are uncommon adverse effects.
B)The drug may cause possible teratogenic effects.
C)Increase intake of dairy products with each dose of this medication.
D)Use a backup method of contraception if taking oral contraceptives.

Question 9

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

A)Azithromycin (Zithromax)500 mg IV in 500 mL fluid
B)Azithromycin (Zithromax)500 mg PO once daily
C)Erythromycin 300 mg IM QID
D)Erythromycin 300 mg PO QID

Question 10

The nurse provides home care instructions for a patient who will take a high dose of azithromycin after discharge from the hospital.Which statement by the patient indicates understanding of the teaching?

A)"I may take antacids 2 hours before taking this drug."
B)"I should take acetaminophen for fever or mild pain."
C)"I should expect diarrhea to be a common,mild side effect."
D)"I should avoid dairy products while taking this drug."

Question 11

The nurse is caring for a patient who will begin taking doxycycline to treat an infection.The nurse should plan to give this medication

A)1 hour before or 2 hours after a meal.
B)with an antacid to minimize GI irritation.
C)with food to improve absorption.
D)with small sips of water.

Question 12

The nurse is caring for a patient who is receiving a high dose of tetracycline (Sumycin).Which laboratory values will the nurse expect to monitor while caring for this patient?

A)Blood urea nitrogen (BUN)and creatinine levels
B)Complete blood counts
C)Electrolytes
D)Liver enzyme levels

Question 13

The nurse is preparing to administer intravenous gentamicin to an infant through an intermittent needle.The nurse notes that the infant has not had a wet diaper for several hours.The nurse will perform which action?

A)Administer the medication and give the infant extra oral fluids.
B)Contact the provider to request adding intravenous fluids when giving the medication.
C)Give the medication and obtain a serum peak drug level 45 minutes after the dose.
D)Hold the dose and contact the provider to request a serum trough drug level.

Question 14

The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin)infusing at 20 mg/min.The nurse notes red blotches on the patient's face,neck,and chest and assesses a blood pressure of 80/55 mm Hg.Which action will the nurse take?

A)Request an order for IV epinephrine to treat anaphylactic shock.
B)Slow the infusion to 10 mg/min and observe the patient closely.
C)Stop the infusion and obtain an order for a BUN and serum creatinine.
D)Suspect Stevens-Johnson syndrome and notify the provider immediately.

Question 15

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

A)discuss giving a smaller dose of penicillin.
B)discuss using erythromycin (E-mycin)instead of penicillin.
C)request an order for diphenhydramine (Benadryl).
D)suggest that the patient receive cefuroxime (Ceftin).

Question 16

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?

A)Complete blood counts
B)Electrolytes
C)Liver enzymes
D)Urinalysis

Question 17

The nurse is reviewing a patient's chart prior to administering gentamycin (Garamycin)and notes that the last serum peak drug level was 9 mcg/mL and the last trough level was 2 mcg/mL.What action will the nurse take?

A)Administer the next dose as ordered.
B)Obtain repeat peak and trough levels before giving the next dose.
C)Report possible drug toxicity to the patient's provider.
D)Report a decreased drug therapeutic level to the patient's provider.

Question 18

The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin.Which is an important nursing action?

A)Administer each antibiotic to infuse over 15 to 20 minutes.
B)Order serum peak and trough levels of ampicillin.
C)Prepare the schedule so that the drugs are given at the same time.
D)Set up separate tubing sets for each drug labeled with the drug name and date.