Question 1

A patient is receiving aminoglycoside therapy and will be receiving a beta-lactam antibiotic as well.The patient asks why two antibiotics have been ordered.What is the nurse's best response?&#10;A) &#34;The combined effect of both antibiotics is greater than each of them alone.&#34;&#10;B) &#34;One antibiotic is not strong enough to fight the infection.&#34;&#10;C) &#34;We have not yet isolated the bacteria,so the two antibiotics are given to cover a wide range of microorganisms.&#34;&#10;D) &#34;We can give a reduced amount of each one if we give them together.&#34;

Accepted Answer

The combination of aminoglycoside and beta-lactam antibiotics has a synergistic effect, meaning the combination is more effective than either antibiotic alone. This is because they target different aspects of bacterial cell walls and can work together to increase bacterial cell death.

Question 2

The nurse checks the patient's laboratory work prior to administering a dose of vancomycin (Vancocin)and finds that the trough vancomycin level is 24 mcg/mL.What will the nurse do next?&#10;A) Administer the vancomycin as ordered.&#10;B) Hold the drug,and administer 4 hours later.&#10;C) Hold the drug,and notify the prescriber.&#10;D) Repeat the test to verify results.

Accepted Answer

A trough level of 24 mcg/mL indicates that the patient has a high level of vancomycin in their bloodstream, which may put them at risk for toxicity. The nurse should hold the drug and notify the prescriber for further instructions. It is important to follow the prescriber's instructions to prevent harm to the patient.

Question 3

A patient has been diagnosed with carbapenemase-resistant Enterobacteriaceae (CRE).The nurse expects to see orders for which drug?&#10;A) Dapsone (Cubicin),a miscellaneous antibiotic&#10;B) Ciprofloxacin (Cipro),a quinolone&#10;C) Linezolid (Zyvox),an oxazolidinone&#10;D) Colistimethate sodium (Coly-Mycin),a polypeptide antibiotic

Accepted Answer

Colistimethate sodium (Coly-Mycin) is one of the few remaining options for treating carbapenemase-resistant Enterobacteriaceae (CRE) infections. Dapsone (Cubicin), ciprofloxacin (Cipro), and linezolid (Zyvox) are not effective against CRE.

Question 4

The nurse is reviewing the medication orders for a patient who will be receiving gentamicin therapy.Which other medication or medication class,if ordered,would be a potential interaction concern?&#10;A) Calcium channel blockers&#10;B) Phenytoin&#10;C) Proton pump inhibitors&#10;D) Loop diuretics

Accepted Answer

Loop diuretics such as furosemide can increase the risk of gentamicin toxicity by increasing the concentration of the drug in the body. Therefore, it is important to monitor the patient's kidney function and adjust the dosage accordingly. Calcium channel blockers, phenytoin, and proton pump inhibitors do not have significant interactions with gentamicin.

Question 5

A patient with a Pseudomonas species urinary infection will be receiving amikacin (Amikin)15 mg/kg once daily via intravenous infusion.The patient weighs 198 pounds,and the medication is available in an injection solution strength of 250 mg/mL.Identify how many milliliters of medication will be drawn up for this injection.(record answer using one decimal place)_______

Accepted Answer

The answer of A patient with a Pseudomonas species urinary...

Question 6

A patient will be receiving nitrofurantoin (Macrodantin)treatment for a urinary tract infection.The nurse is reviewing the patient's history and will question the nitrofurantoin order if which disorder is present in the history? (Select all that apply.)

A) Liver disease
B) Coronary artery disease
C) Hyperthyroidism
D) Type 1 diabetes mellitus
E) Chronic renal disease

Accepted Answer

Nitrofurantoin is contraindicated in patients with significant renal impairment (chronic renal disease) because it requires adequate kidney function for excretion. Liver disease is also a concern as it can affect drug metabolism and increase the risk of toxicity.

Question 7

Which nursing diagnosis is appropriate for a patient who has started aminoglycoside therapy?&#10;A) Constipation&#10;B) Risk for injury (renal damage)&#10;C) Disturbed body image related to gynecomastia&#10;D) Imbalanced nutrition,less than body requirements,related to nausea

Accepted Answer

Aminoglycosides can be nephrotoxic, so there is a risk for renal damage, making "Risk for injury (renal damage)" an appropriate nursing diagnosis.

Question 8

When a patient is on aminoglycoside therapy,the nurse will monitor the patient for which indicators of potential toxicity? A) Fever B) White blood cell count of 8000 cells/mm³ C) Tinnitus and dizziness D) Decreased blood urea nitrogen (BUN)levels

Accepted Answer

Aminoglycosides are known to cause nephrotoxicity and ototoxicity. Tinnitus and dizziness are early signs of ototoxicity and should be immediately reported to the healthcare provider. Fever and decreased BUN levels are not specific indicators of aminoglycoside toxicity and a WBC count of 8000 cells/mm3 is within the normal range.

Question 9

A 79-year-old patient is receiving a quinolone as treatment for a complicated incision infection.The nurse will monitor for which adverse effect that is associated with these drugs?&#10;A) Neuralgia&#10;B) Double vision&#10;C) Hypotension&#10;D) Tendonitis and tendon rupture

Accepted Answer

Quinolones are known to increase the risk of tendonitis and tendon rupture, particularly in elderly patients. Monitoring for signs of tendon pain or weakness is important during treatment. A, B, and C are not common adverse effects associated with quinolones.

Question 10

A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA).Which drug would the nurse expect to be chosen for therapy?

A) Metronidazole (Flagyl)
B) Ciprofloxacin (Cipro)
C) Vancomycin (Vancocin)
D) Tobramycin (Nebcin)

Accepted Answer

Vancomycin is the drug of choice for MRSA infections. Metronidazole is used for anaerobic infections, Ciprofloxacin is used for gram-negative infections, and Tobramycin is used for Pseudomonas aeruginosa infections.

Question 11

The nurse is administering a vancomycin (Vancocin)infusion.Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this drug's administration?&#10;A) Monitoring blood pressure for hypertension during the infusion&#10;B) Discontinuing the drug immediately if red man syndrome occurs&#10;C) Restricting fluids during vancomycin therapy&#10;D) Infusing the drug over at least 1 hour

Accepted Answer

The answer of The nurse is administering a vancomycin (Vancocin)infusion.Which...

Deck 39: Antibiotics Part 2