Deck 46: Basic Principles of Anti-Infective Pharmacotherapy

Question 1

Which type of antibiotic carries the highest risk of an allergic response?

A)Tetracyclines
B)Aminoglycosides
C)Cephalosporins
D)Penicillins

Answer 1

Penicillins

Question 2

Anti-infectives are grouped into pharmacological classes by their:

A)staining ability.
B)size or shape.
C)sensitivity.
D)mechanism of action.

Answer 2

mechanism of action.

Question 3

Classification of bacteria by their response to Gram stain includes:

A)rods,spirals,and spheres.
B)aerobic and anaerobic.
C)fungi and viruses.
D)gram-positive and gram-negative.

Answer 3

gram-positive and gram-negative.

Question 4

The nurse caring for a client with an infection knows a contributing factor to the development of drug resistance is the presence of bacterial genetic errors called:

A)plasmids.
B)mutations.
C)conjugates.
D)duplications.

Question 5

Guidelines for preventing antimicrobial resistance include:
Select all that apply.

A)using proper infection-control procedures.
B)shortening the duration of antibiotic administration.
C)using antimicrobials wisely.
D)preventing infections.
E)treating infections properly.

Question 6

The nurse is preparing to administer a broad-spectrum antibiotic medication to a client.An important nursing intervention prior to administration of the anti-infective is:

A)performing a culture within 24 hours after starting the medication.
B)obtaining the culture report,as when starting any medication.
C)performing a culture prior to administering the first dose of the anti-infective.
D)administering the medicine without performing cultures.

Question 7

The primary factor in the development of drug-resistant bacteria is the:

A)unwarranted use of antibiotics.
B)selection of the incorrect antibiotic.
C)lack of new antibiotics.
D)lack of client adherence.

Question 8

A leading factor in the development of bacterial resistance is the ability of bacteria to undergo:

A)replication.
B)conjugation.
C)mutation.
D)colonization.

Question 9

The client's culture report indicates the presence of gram-negative cocci in the urine.This means that the bacteria are:

A)round with thin cell walls.
B)round with thick cell walls.
C)rod-shaped with thin cell walls.
D)spiral-shaped with thin cell walls.

Question 10

An advantage of using a broad-spectrum antibiotic is that:

A)it is effective against a large number of organisms.
B)it is effective against a small number of organisms.
C)it has a high potency.
D)it produces a large number of side effects.

Question 11

The nurse knows that which antibiotic,when taken by a pregnant woman,can adversely affect the newborn's hearing?

A)Mycins
B)Aminoglycosides
C)Sulfonamides
D)Tetracyclines

Question 12

The nursing student asks the instructor how concepts from microbiology directly relate to client care.The instructor's best response is:

A)It will assist you in understanding how health care providers choose anti-infective agents."
B)Knowledge of bacteria and their classification assists in the management of anti-infective therapy."
C)Studying microbiology will help you understand laboratory reports."
D)Microbiology is one of the few science electives that do not really have any direct effects on client care."

Question 13

Pathogenicity refers to an organism's ability to:

A)cause disease.
B)penetrate anatomic barriers more easily.
C)multiply more rapidly.
D)use oxygen.

Question 14

The ability of an organism to become unresponsive over time to an anti-infective is termed:

A)superinfection.
B)sensitivity.
C)mutation.
D)acquired resistance.

Question 15

The nurse sending a wound culture to the laboratory knows that the purpose of culture and sensitivity testing is to:

A)prevent an infection,a practice called chemoprophylaxis.
B)identify bacteria that have acquired resistance.
C)promote the development of drug-resistant bacterial strains by killing the bacteria sensitive to a drug.
D)determine which antibiotic is most effective against the infecting microorganism.

Question 16

A new antibiotic is classified as a bacteriocidal agent.This means that the drug:

A)slows the growth of the infectious agent.
B)has a high potency.
C)is highly efficacious.
D)kills the infectious agent.

Question 17

Hyaluronidase,an enzyme secreted by certain bacteria,allows the bacteria to:

A)protect themselves from phagocytes.
B)penetrate anatomic barriers more easily.
C)multiply more rapidly.
D)produce exotoxins in greater abundance.

Question 18

The client asks the nurse why the health care provider did not prescribe the same antibiotic that the client always receives for an infection.The best response by the nurse would be:

A)It doesn't matter which antibiotic you take."
B)You don't want to take the same antibiotic all the time."
C)Try this medicine,and if you're not better in 10 days,return to the office."
D)These bacteria have developed resistance and will respond better to this antibiotic."

Question 19

Invasiveness refers to a pathogen's ability to:

A)produce endotoxins in greater abundance.
B)multiply more rapidly.
C)increase its virulence.
D)penetrate anatomic barriers more easily.

Question 20

The ability of an antibiotic to target pathogens without major effects on human cells is termed:

A)selective toxicity.
B)selective synthesis.
C)bacteriostatic action.
D)opportunistic action.

Question 21

A client is admitted to the emergency department with symptoms of meningitis.Reviewing the client's culture and sensitivity (C&S)report,the nurse would expect evidence of which organisms to confirm this diagnosis?
Select all that apply.

A)Streptococci
B)Escherichia coli
C)Haemophilus influenzae
D)Rickettsia rickettsii
E)Shigella

Question 22

A client has been on an antibiotic for 2 weeks for treatment of an ulcer caused by Helicobacter pylori.The client asks the nurse if the antibiotic could be causing diarrhea.What is the nurse's most accurate response?

A)The infection has become severe."
B)This might be a secondary infection due to the antibiotic therapy."
C)The infection has a restricted group of microorganisms."
D)The organisms that caused the infection have developed immunity to the drug."

Question 23

The nurse is preparing to admit a client with a serious methicillin-resistant Staphylococcus aureus (MRSA)infection.The nurse knows MRSA will not respond to treatment with:
Select all that apply.

A)fluoroquinolones.
B)macrolides.
C)aminoglycosides.
D)tetracyclines.
E)linezolid.

Question 24

A client is unable to give a urine sample for a culture and sensitivity (C&S)and asks the nurse why the health care provider does not just prescribe a really strong" antibiotic.The nurse responds that careful selection of the correct antibiotic is important because prescribing the wrong antibiotic:
Select all that apply.

A)will delay effective treatment.
B)will give the bacteria more time to grow.
C)can contribute to the development of drug-resistant bacteria.
D)could result in a lawsuit.
E)could result in an allergic response.

Question 25

Which location is the most difficult to reach with antibiotic therapy?

A)Gastrointestinal system
B)Integumentary system
C)Central nervous system
D)Lungs

Question 26

The clinic nurse is calling back clients with various symptoms.Which symptoms would suggest a superinfection?
Select all that apply.

A)Diarrhea
B)Painful urination
C)Abnormal vaginal discharge
D)Cough
E)Joint pain

Question 27

The community outreach nurse is teaching a group of older clients how bacterial organisms become resistant to antibiotics.Which statements by the clients demonstrate understanding of the instruction?
Select all that apply.

A)I need to get the recommended immunizations so I don't get an infection and need an antibiotic."
B)If possible,my doctor will need to culture any infections I have to make sure I am taking the correct antibiotics."
C)I need to take antibiotics only when my health care provider thinks I have an infection."
D)As soon as my infection is gone,I can stop the antibiotic.This way,I'll avoid becoming resistant to the antibiotic."
E)I should never take an antibiotic for more than 10 days.This is what causes resistance."

Question 28

The health care provider asks the nurse to tell a client that tests confirm the client has a health care-associated infection (HAI).The nurse explains to the client that common sources of HAIs include:
Select all that apply.

A)the respiratory tract.
B)the urinary tract.
C)intravascular (IV)lines.
D)visitors with infectious illness.
E)drug-resistant bacteria.

Question 29

The client asks the nurse why culture and sensitivity (C&S)testing has to be done prior to starting the antibiotic for a urinary tract infection (UTI).The nurse explains that several organisms can cause UTIs and a C&S is performed to identify the organism.Which organism could be isolated on this client's C&S?
Select all that apply.

A)Escherichia coli
B)Enterococci
C)Proteus mirabilis
D)Treponema
E)Borrelia burgdorferi

Question 30

Which client would require the administration of prophylactic antibiotics?

A)A client with inflammation at the infection site
B)A client with a viral infection
C)A client with a suppressed immune system
D)A client with pus at the infection site

Question 31

The nurse tells a client that the antibiotic the health care provider has prescribed is for Clostridium,the organism responsible for a number of diseases,including:
Select all that apply.

A)food poisoning.
B)gas gangrene.
C)tetanus.
D)pneumonia.
E)venereal disease.

Question 32

A client is admitted to the emergency department with an infection of the skin on the upper right thigh.The nurse knows this infection could be caused by which organism?
Select all that apply.

A)Streptococci
B)Proteus mirabilis
C)Pseudomonas aeruginosa
D)Salmonella enteritides
E)Bacillus anthracis

Question 33

A female client is prescribed tetracycline for acne.When providing information regarding this drug,the nurse explains that tetracycline:

A)is contraindicated in people over 20 years old.
B)is classified as a narrow-spectrum antibiotic.
C)has been identified to be unsafe during pregnancy.
D)is used to treat a wide variety of disease processes.

Question 34

A client is admitted to the emergency department for an infection.The nurse recognizes that host factors that play a role in the selection of anti-infective therapy include:
Select all that apply.

A)status of immune system.
B)location of the infection.
C)history of allergic reactions.
D)previous infections.
E)results of culture and sensitivity (C&S).

Question 35

The client on penicillin who is complaining of an abnormal vaginal discharge has a superinfection secondary to:

A)a nosocomial infection.
B)an overdose of penicillin.
C)the destruction by penicillin of normal flora in the vagina.
D)the development of an organism resistant to penicillin.

Question 36

The nurse is discharging a client with a prescription for penicillin.The client asks the nurse how this antibiotic works.The nurse's response is based on the knowledge that the mechanism of action of this class of anti-infectives is:
Select all that apply.

A)inhibiting cell wall synthesis.
B)causing disruption of the cell wall,resulting in the cell absorbing water and lysing.
C)binding to specific proteins,resulting in the cell's inability to build a wall.
D)interfering with the transfer of ribonucleic acid (RNA).
E)changing the permeability of the cell membrane.

Question 37

The emergency department nurse anticipates that prophylactic antibiotics will likely be used to treat:
Select all that apply.

A)a client with a suppressed immune system.
B)a client who has been bitten by a dog.
C)a client whose spouse has been diagnosed with tuberculosis (TB).
D)a client who is being treated for a venereal disease.
E)a client who has just delivered a premature baby.

Question 38

A pediatric nurse is caring for a child who has an infectious organism that produces beta lactamase.The nurse knows that which drugs should not be prescribed for this infection?
Select all that apply.

A)Penicillins
B)Cephalosporins
C)Macrolides
D)Fluoroquinolones
E)Sulfonamides

Question 39

A pregnant client is seen in the emergency department for an infection.The nurse anticipates that antibiotics prescribed for this client would not include:
Select all that apply.

A)ampicillin.
B)minocycline.
C)neomycin.
D)streptomycin.
E)doxycycline.

Question 40

The nurse caring for a group of clients recognizes that which client has a superinfection?

A)47-year-old client with type 2 diabetes and pneumonia
B)50-year-old AIDS client with candida
C)46-year-old client with vascular disease and cellulitis of the leg
D)52-year-old client with gastroesophageal reflux disease (GERD)and gastritis