Deck 47: Antibiotics Affecting the Bacterial Cell Wall

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?

A)Aminoglycosides
B)Fluoroquinolones
C)Sulfonamides
D)Penicillins

Answer 1

Penicillins

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?

A)"Wait one more day and see if the diarrhea clears."
B)"Yes,give something over the counter,but only one dose."
C)"Yes,give something over the counter according to the dosage directions on the label."
D)"Do not treat the diarrhea,and bring the child to the office."

Answer 2

"Do not treat the diarrhea,and bring the child to the office."

Question 3

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

A)A client with diabetes
B)A client with heart failure
C)A client taking spironolactone for hormonal acne
D)A client taking oral contraceptives
E)A client with pharyngitis

Answer 3

A client with diabetes
A client with heart failure
A client taking spironolactone for hormonal acne

Question 4

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

A)bacterial DNA.
B)the addition of cross-links to the cell wall.
C)protein synthesis.
D)the channels in the cell's internal structure.

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.

A)Your infection was caused by gram-positive bacteria."
B)Penicillin is a narrow-spectrum antibiotic that can be used when the bacteria causing the infection is known."
C)Penicillins are widely distributed to most body tissues."
D)Penicillins are slowly excreted by the kidneys.This allows for less frequent dosing."
E)If you're allergic to penicillin,we can give you a smaller dose to avoid a reaction."

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.

A)Have you ever been exposed to mold?"
B)Do you eat animal products that have been exposed to antibiotics such as penicillin?"
C)Have you ever had another allergic reaction to a group of antibiotics called cephalosporins?"
D)Do you have any seasonal allergies?"
E)Do you have any diseases or are you taking any medications that suppress the immune system?"

Question 7

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

A)prevents diarrhea often associated with penicillin.
B)will prevent an allergic response.
C)is a secondary antibiotic.
D)will allow the penicillin to stay in the body longer.

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.

A)The client is allergic to penicillin.
B)The medication list includes antiseizure medications.
C)The client is an older adult with long-standing diabetes.
D)The urine culture and sensitivity reveals a urinary tract infection (UTI).
E)A wound culture is positive for methicillin-resistant Staphylococcus aureus (MRSA).

Question 9

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

A)A client who has osteomyelitis and will need IV medication for several months
B)A client who had a myocardial infarction 2 days ago and now has a fever of 102°F
C)A client who is postop from corneal transplant
D)A client who has diabetes and is on dialysis

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.

A)Do not become pregnant while on ampicillin.
B)If taking oral contraceptives,use an alternative form of birth control.
C)Ampicillin should be taken on an empty stomach.
D)Contact the health care provider immediately if persistent diarrhea with fever occurs.
E)Stop taking ampicillin if nausea occurs and report to the health care provider immediately.

Question 11

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

A)Streptococcus
B)Herpes simplex
C)Pseudomonas
D)Staphylococcus

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:

A)monitor bowel sounds.
B)teach the client about the side effects of the drug.
C)encourage the client to increase fluid intake.
D)monitor the client closely for hypersensitivity with the first dose.

Question 13

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

A)cephalosporins.
B)aminoglycosides.
C)sulfonamides.
D)erythromycins.

Question 14

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

A)secondary antibiotic.
B)beta-lactamase inhibitor to prevent the excretion of penicillin.
C)anti-inflammatory to prevent allergic response.
D)antiviral to prevent superinfection.

Question 15

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

A)Protozoans.
B)Gram-negative bacteria.
C)Rickettsia.
D)Gram-positive bacteria.

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.

A)Complete blood count (CBC)with platelets
B)Sodium level
C)Potassium level
D)Kidney function
E)Liver function

Question 17

Which statement best describes the bacterial cell wall?

A)It is a rigid structure.
B)It is semipermeable.
C)It is composed of lipids.
D)It is single-layered.

Question 18

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

A)Second
B)Third
C)Fourth
D)First

Question 19

Penicillin's antibacterial activity is based on its:

A)beta-lactam ring,which terminates construction of the cell wall.
B)alteration of bacterial DNA in the cell wall.
C)interference with cellular cytoplasm.
D)interruption of bacterial protein synthesis.

Question 20

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

A)The full course of prescribed drug therapy must be completed.
B)Maintain adequate food intake
C)Maintain an adequate fluid intake
D)Report symptoms of secondary infection,such as vaginal yeast infections

Question 21

Prior to discharge of a client on cephalosporin therapy,the nurse discusses potentially significant adverse effects,including:
Select all that apply.

A)Nausea.
B)Vomiting.
C)Abdominal pain.
D)Transient shortness of breath
E)Vaginal yeast infection.

Question 22

Which interventions would the nurse consider including in a plan of care for clients taking cephalosporins?
Select all that apply.

A)Monitor kidney function in older adults.
B)Monitor for persistent diarrhea in young children.
C)Discuss the concurrent use of alcohol.
D)Teach clients to report any fever that does not decrease within 12 hours of starting therapy.
E)Instruct clients to immediately go to the emergency department if any symptoms of red man syndrome occur during treatment.

Question 23

The emergency department nurse anticipates that which clients may be treated with ertapenem (Invanz)?
Select all that apply.

A)College student diagnosed with community-acquired pneumonia
B)Client diagnosed with complicated urinary tract infection (UTI)
C)Diabetic client with an infected toe
D)Young child diagnosed with H.influenzae otitis media
E)Older client diagnosed with community-acquired methicillin-resistant S.aureus (MRSA)

Question 24

The nurse preparing to infuse vancomycin will monitor the client for:
Select all that apply.

A)loss of hearing and balance.
B)reddening upper body with dizziness.
C)confusion or hallucinations.
D)abnormal liver function.
E)fever and chills.

Question 25

The nurse,administering an infusion of vancomycin,will observe the client for which symptoms of red man syndrome?
Select all that apply.

A)Reddening of the upper body
B)Hypotension
C)Reflex tachycardia
D)Headache
E)Seizure