Deck 9: Anti-Infectives: Antibacterial Drugs

Question 1

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

A) Airway adequacy
B) Peripheral lung sounds
C) Rate and depth of respirations
D) Symmetry of respiratory movement

Answer 1

Airway adequacy

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?

A) Reassure the patient that Keflex is not penicillin.
B) Place an allergy alert band on the patient's wrist.
C) Notify the prescriber immediately before the first Keflex dose.
D) Highlight this important information in the patient's medical record.

Answer 2

Highlight this important information in the patient's medical record.

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?

A) "Do you have a hearing problem or any trouble with your ears?"
B) "Do you take medications for seizures?"
C) "Are you allergic to sulfa drugs?"
D) "Have you ever had asthma?"

Answer 3

"Do you take medications for seizures?"

Question 4

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

A) Temperature increase from 38° C to 39° C.
B) Blood pressure decrease from 132/80 to 118/66.
C) Total 24-hour urine output decrease from 2100 mL to 1100 mL.
D) White blood cell (WBC) count decrease from 11,000/mm³ to 8500/mm³.

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?

A) "Taking this drug every 8 hours helps keep the blood level of the drug high enough to affect the bacteria."
B) "Giving the drug at regular intervals over a 24-hour period helps prevent side effects."
C) "Let me contact your prescriber and ask whether the drug can be given once a day."
D) "When given once a day, the dose is higher so allergic reactions are more common."

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?

A) Ask the patient whether he or she has ever developed a rash while taking another drug.
B) Reassure the patient that many people have this expected reaction to antibiotic therapy.
C) Ask the patient whether the rash itches, burns, or causes other types of discomfort.
D) Document the report as the only action.

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?

A) Give the two drugs at the same time to prevent GI upset.
B) Give the cephalexin 1 hour before the aluminum hydroxide.
C) Give the aluminum hydroxide 1 hour before the cephalexin.
D) Give the aluminum hydroxide 4 hours after the cephalexin.

Question 8

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

A) Pathogenic
B) Nonpathogenic
C) Gram negative
D) Opportunistic

Question 9

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

A) Discontinue the IV therapy immediately and place the patient in shock position.
B) Hold the next dose and notify the prescriber immediately.
C) Discontinue the IV therapy and restart it at a different site.
D) Discontinue the drug and maintain the IV access.

Question 10

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

A) Normal flora can help provide protection against the development of pathogenic infections.
B) Normal flora result in opportunistic infections while other bacteria result in pathogenic infections.
C) When normal flora are not present, the immune system is suppressed, increasing the risk for infection.
D) When normal flora are not present, the immune system is overactive, increasing the risk for autoimmune diseases.

Question 11

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

A) Hold the drug and notify the prescriber immediately.
B) Ensure that the drug is given with or after food.
C) Ask if the patient has any drug allergies.
D) Document the report as the only action.

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?

A) Take a specimen and send it to the laboratory for culture.
B) Hold the dose and notify the prescriber immediately.
C) Document this expected finding as the only response.
D) Assist the patient to perform frequent mouth care.

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?

A) "If my temperature is normal for 3 days in a row, the infection is gone and I can stop taking the drug."
B) "If my temperature goes above 100 ^$\circ$ for 2 days, I should double the dose of the drug."
C) "Even if I feel completely well, I should take the drug exactly as prescribed until it is gone."
D) "I should notify my prescriber to change the medication if I develop diarrhea while taking this drug."

Question 14

How are bactericidal drugs different from bacteriostatic drugs?

A) Bacteriostatic drugs are more likely to cause an allergic response than bactericidal drugs.
B) Bacteriostatic drugs work only on bacteria, whereas bactericidal drugs are effective against other types of organisms.
C) Bactericidal drug actions result in killing the bacteria, whereas bacteriostatic drugs only slow bacterial growth.
D) Bactericidal drugs require assistance from the patient's immune system to be effective, whereas bacteriostatic drugs are effective even when function is poor.

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?

A) Red blood cell count is 4,500,000 cells/mm³
B) White blood cell (WBC) count is 8000 cells/mm³
C) Wound drainage is thick and yellow
D) Temperature is 102.4 ^$\circ$ Fahrenheit

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?

A) 0.25
B) 0.5
C) 2
D) 4

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?

A) "Yes, these problems indicate an allergic reaction."
B) "Yes, these side effects eventually lead to difficulty breathing."
C) "No, these uncomfortable problems are an expected drug side effect."
D) "No, the problems are caused by the presence of the infection and are not related to the drug."

Question 18

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

A) Check the IV site every 4 hours for redness around the site and the presence of cordlike veins.
B) Check the drip rate every hour to ensure that the proper blood drug level is maintained.
C) Assess the patient's pulse, blood pressure, and respiratory effect every 15 minutes.
D) Assess the patient's white blood cell count daily to determine drug effectiveness.

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?

A) Narrow-spectrum
B) Limited-spectrum
C) Extended-spectrum
D) Broad-spectrum

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?

A) "Drug therapy for lung infections works better when less sputum is present."
B) "A sputum sample will help us determine what drug will work best against your infection."
C) "The lab will be able to determine which drug will treat your infection without harming your normal tissues."
D) "The dosage of your antibacterial drug is determined by the organism that is causing your infection."

Question 21

A patient is to receive trimethoprim/sulfamethoxazole (Septra)intravenously.The drug is mixed in 250 mL of D₅W and is to be administered over 90 minutes.With a drop factor of 15 gtt/mL,how many drops per minute will the nurse set for the correct infusion rate?

A) 10
B) 20
C) 30
D) 40

Question 22

Which are general surface protections that prevent bacteria from entering the body?

A) Intact skin
B) pH of body secretions
C) Antibodies
D) Mucous membranes
E) White blood cells

Question 23

Why should tetracycline drugs be avoided during pregnancy and lactation?

A) Tetracycline crosses the placenta and causes brain hemorrhage in the fetus.
B) The fetal and newborn liver cannot metabolize the drug and anemia results.
C) The fetus and newborn are more likely to have allergic reactions to tetracycline.
D) The drug interferes with tooth enamel development causing permanently stained teeth.

Question 24

A patient is being discharged home on antibacterial drug therapy.What instructions must the nurse teach the patient about allergic reactions?

A) "Notify your prescriber immediately if you vomit."
B) "Stop taking the drug if you develop hives or a rash."
C) "If you notice diarrhea be sure to stop taking the drug."
D) "Continue taking the drug even if you feel well because it is fighting the infection."
E) "Call 911 if you experience difficulty with breathing."
F) "Avoid drinking caffeinated beverages with the drug."

Question 25

A patient taking ciprofloxacin (Cipro)reports pain and burning on urination.What is the nurse's best action?

A) Notify the prescriber that the patient's urinary tract infection is not responding to the drug.
B) Remind the patient that the pain is related to the body eliminating the infectious bacteria.
C) Instruct the patient to drink a full glass of water with each drug dose and increase fluids.
D) Ask the patient whether blood or pus also is present in the urine.

Question 26

Which laboratory blood test result for a patient taking clarithromycin (Biaxin)and warfarin (Coumadin)does the nurse report immediately to the prescriber?

A) Potassium 3.6 mEq/L
B) Sodium 134 mEq/L
C) Blood urea nitrogen (BUN) 21 mg/dL
D) International normalized ratio (INR) 4.6

Question 27

Why must fluoroquinolone drugs be avoided during pregnancy,lactation,and childhood?

A) The drug damages muscles, tendons, and bones in the fetus and growing children.
B) The fetal and newborn liver cannot metabolize the drug, leading to anemia and jaundice.
C) The fetus and newborn are more likely to have allergic reactions to fluoroquinolones.
D) The drug interferes with tooth enamel development causing permanently stained teeth.

Question 28

The nurse is teaching a patient who has been prescribed azithromycin (Zithromax).Which statement made by the patient indicates that additional teaching is needed?

A) "To avoid nausea, I will take my medicine along with food."
B) "I will use another form of birth control along with my oral contraceptives."
C) "Since I only have to take this drug once a day, it will be easy to remember."
D) "To help get rid of the infection, I will spend 30 minutes each day out in the sun."

Question 29

Which actions are most likely to reduce the spread of community-acquired methicillin-resistant Staphylococcus aureas (CA-MRSA)in a family in which only one member is infected?

A) Starting the noninfected family members on methicillin therapy.
B) Not sharing towels or bed linens with the infected person.
C) Washing the infected person's dishes separately from those of other family members.
D) Having the infected person wear a mask when in the same room with other family members.
E) Using good daily personal hygiene for all family members.
F) Washing hands with soap and water after any physical contact with an infected person.

Question 30

An older adult patient has been prescribed oral erythromycin tablets.Which precaution is most important for the nurse to teach?

A) "Take this drug with food or right after eating to reduce intestinal side effects."
B) "Avoid driving or operating dangerous equipment while taking this drug."
C) "Take your pulse daily and notify your prescriber if it becomes irregular."
D) "Wear a hat and sunscreen when outdoors."

Question 31

A patient is prescribed minocycline (Dynacin)750 mg orally.What is the nurse's best action before giving the first dose?

A) Check that the patient is not allergic to penicillin or sulfa drugs.
B) Use a new IV administration set to administer the drug.
C) Hold the dose and contact the prescriber.
D) Give the drug with milk or food.

Question 32

Why must sulfonamide drugs be avoided during the last trimester of pregnancy and lactation?

A) The drug crosses the placenta and causes brain hemorrhage in the fetus.
B) The fetal and newborn liver cannot metabolize the drug and jaundice results.
C) The fetus and newborn are more likely to have allergic reactions to sulfonamides.
D) The drug interferes with tooth enamel development causing permanently stained teeth.

Question 33

An older adult patient is prescribed linezolid (Zyvox)500 mg oral suspension.The drug on hand is 100 mg/5 mL.How many mL does the nurse prepare?

A) 2
B) 10
C) 25
D) 50

Question 34

Which precaution is most important for the nurse to teach a patient who has been prescribed sulfisoxizole (Gantrisin)?

A) Evenly space this drug throughout the 24-hour day.
B) Take the drug 1 hour before or 2 hours after a meal.
C) Drink at least 3 liters of liquids throughout the day.
D) Stop the drug immediately if diarrhea develops.

Question 35

A 75-year-old patient taking levofloxacin (Levaquin)reports all of the following new problems.For which problem does the nurse advise the patient to stop taking the drug immediately and notify the prescriber?

A) Having to get up at night to urinate
B) Swelling and pain in the right wrist
C) Feeling the heart pound after drinking coffee
D) Feeling light-headed when changing positions rapidly

Question 36

Which laboratory blood test result for a patient taking trimethoprim/sulfamethoxazole (Septra)does the nurse report immediately to the prescriber?

A) Red blood cells (RBCs) 2.2 million/mm³
B) International normalized ratio (INR) 1.6
C) White blood cells (WBCs) 6,000/mm³
D) Sodium 134 mEq/L

Question 37

With which antibacterial drugs is teaching patients to wear protective clothing,hats,and sunscreen,and to avoid tanning beds most important?

A) amoxicillin/clavulanic acid (Augmentin)
B) cefdinir (Omnicef)
C) clindamycin (Cleocin)
D) erythromycin (E-mycin)
E) lomefloxacin (Maxaquin)
F) tetracycline (Tetracon)
G) trimethoprim/sulfamethoxazole (Bactrim)

Question 38

An older adult patient is prescribed amikacin (Amikin).Which assessment technique is most important for the nurse to perform daily?

A) Asking about numbness in fingers and toes
B) Measuring calf circumference of both legs
C) Checking the mouth for open sores
D) Asking about ringing in the ears

Question 39

For which patient with a bacterial infection does the nurse question a prescription for tetracycline (Tetracon)?

A) 35-year-old patient with AIDS
B) 16-year-old patient with severe acne
C) 65-year-old patient with hypertension
D) 25-year-old patient taking oral contraceptives

Question 40

The nurse is to administer doxycycline (Doxy)intravenously to a patient who is also receiving intravenous (IV)penicillin.Which action is most important for the nurse to implement?

A) Use IV tubing for doxycycline that has never come into contact with penicillin.
B) Use a glass container for the tetracycline and a plastic container for the penicillin.
C) Infuse the doxycycline only into a central line and the penicillin into a peripheral line.
D) Administer doxycycline with sterile saline and administer the penicillin with sterile water.