Pharm Ch 8: Anti-Infective Agents

A sputum sample of a postsurgical client with coarse crackles audible in the lungs has been sent for culture and sensitivity testing. What response should the nurse provide when the client asks why the sample needed to be analyzed? A. "It will help us to stop the infection from spreading to others." B. "It will identify what drug will best kill this microorganism." C. "It will identity what microorganism is causing your infection." D. "It will help in determining where the microorganism came from."

B. "It will identify what drug will best kill this microorganism."

What would contribute to drug resistance? A. High dosage to eradicate the organism B. Antibiotic prescription for viral illness C. Around-the-clock scheduling D. Prescribed duration of therapy

B. Antibiotic prescription for viral illness

A client is to be started on an antibiotic. Which is most important to take into consideration before beginning the antibiotic regimen? A. Duration of symptoms B. Culture and susceptibility C. Client's hydration status D. Client's age and weight

B. Culture and susceptibility

A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead? A. Decreased absorption of the drug B. Development of drug resistance C. Increased rate of elimination of the drug D. Increased chances of serious adverse events

B. Development of drug resistance

What information about antibiotic therapy should the nurse should include in a client's medication education? A. Bacteria can remain in the body for up to 48 to 72 hours after the completion of antibiotic therapy. B. Maintenance of normal bacterial flora is essential to health during the therapy. C. The healthy human body hosts dozens of minor infections at any given time. D. An aseptic internal environment only exists in young adults.

B. Maintenance of normal bacterial flora is essential to health during the therapy.

To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first? A. Using combination therapy B. Obtaining sensitivity testing C. Checking client allergies D. Evaluating the bactericidal effects

B. Obtaining sensitivity testing

A critically ill client has developed a fever of 38.9°C, and blood cultures have been drawn and sent to the laboratory for culture and sensitivity testing. Determination of the culture will give the care team what information? A. whether the infection is antibiotic resistant B. the exact identity of the infectious microorganism C. the most likely location of the infection D. the most likely origin of the infection

B. the exact identity of the infectious microorganism

A nurse is caring for a client who is hospitalized for pneumonia. The nurse reviews the electronic health record and evaluates that the microbiology data does not support the use of the broad spectrum antibiotic. Which statement is the nurse's best response to the provider about the results? A. "I think you need to review the microbiology report for the client." B. "I have reviewed the client's record and the client does not want the antibiotic." C. "The microbiology data is identifying another antibiotic appropriate for the client." D. "The charge nurse prefers that you call her about the antibiotic coverage for the client."

C. "The microbiology data is identifying another antibiotic appropriate for the client."

The nurse caring for a 24-year-old woman admitted with pneumonia explains how antibiotics work to help cure her pneumonia. Which statement would be correct about how antibiotic therapy works? A. Antibiotics work by increasing the cells' metabolic pathways. B. Antibiotics work by increasing nucleic acid synthesis. C. Antibiotics work by inhibiting cell wall synthesis. D. Antibiotics work by increasing protein synthesis.

C. Antibiotics work by inhibiting cell wall synthesis.

An adult client has been treated for strep throat with ampicillin by mouth. The client visits the occupational health nurse and states she has vaginal itching. What organism is the cause of the vaginal itching? A. Klebsiella B. Enterobacter C. Candida D. Proteus

C. Candida

An infant has been brought to the emergency department by the parents, and initial assessment is highly suggestive of bacterial meningitis. Consequently, the infant has been admitted, and empiric antibiotic therapy has been prescribed. The nurse should understand what characteristic of this infant's current treatment plan? A. Success or failure of treatment will not be apparent for several weeks. B. The infant will receive aggressive treatment with a narrow-spectrum antibiotic. C. Culture and sensitivity results of the infant's cerebrospinal fluid are still pending. D. The infant is suspected of having an antibiotic-resistant infection.

C. Culture and sensitivity results of the infant's cerebrospinal fluid are still pending.

Bacitracin (Baciguent) interferes with the cell wall synthesis of which type of bacteria? A. Proteus B. Streptococcal C. Staphylococcal D. Pseudomonas

C. Staphylococcal

When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include? A. The drug is effective against many different organisms. B. The drug is highly aggressive in killing the pathogen. C. The drug is selective in its action on organisms. D. The drug is effective in interfering with the cell's reproduction.

C. The drug is selective in its action on organisms.

Aminogylcoside antibiotics tend to collect in the eighth cranial nerve. The nurse would anticipate that which clinical manifestation may occur from the cranial nerve involvement? A. Inability to swallow B. Blindness C. Vertigo D. Slurred speech

C. Vertigo

An adult client with an autoimmune disorder regularly takes oral corticosteroids. The nurse knows that corticosteroids can be used in the successful treatment of inflammation but that they also create a risk for: A. bleeding. B. leukocytosis. C. infection. D. electrolyte imbalances.

C. infection.

What intervention is necessary for the nurse to perform prior to initiating prescribed antibiotic therapy? A. increasing the client's fluid intake B. educating the client about adverse effects C. obtaining a specimen for culture and sensitivity D. administer an antidiarrheal to prevent gastrointestinal (GI) upset

C. obtaining a specimen for culture and sensitivity

A client is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of: A. chemotherapy. B. curative treatment. C. prophylaxis. D. synergism.

C. prophylaxis.

An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with A. ciprofloxacin. B. clindamycin. C. vancomycin. D. an antistaphylococcic penicillin.

C. vancomycin.

Which type of testing should be completed prior to an anti-infective being prescribed? A. H & H B. CBC C. EKG D. Culture

D. Culture

A medical nurse on a night shift is reviewing a client's medication administration record for the following day. The nurse notes that a combination antimicrobial drug is prescribed. What is implied by the fact that the client has been prescribed a combination drug? A. The client's infection likely has a fungal or protozoal etiology. B. The client likely has a history of recurrent, multisystemic infections. C. The client may be unable to tolerate treatment with a single antimicrobial. D. The client may have an infection caused by multiple microorganisms.

D. The client may have an infection caused by multiple microorganisms.

A nurse has questioned why a client's health care provider has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible? A. Broad-spectrum antibiotics confound the results of subsequent culture and sensitivity testing. B. Narrow-spectrum antibiotics normally require a shorter duration of treatment. C. The efficacy of most narrow-spectrum antibiotics has not been proven. D. The use of broad-spectrum antibiotics can create a risk for a superinfection.

D. The use of broad-spectrum antibiotics can create a risk for a superinfection.

A group of students are reviewing information about anti-infective agents. The students demonstrate a need for additional review when they identify what as an anti-infective agent? A. antibiotic B. anthelmintic C. antiprotozoal D. anticoagulant

D. anticoagulant

A client is diagnosed with a drug-resistant infection. The client is at greatest risk for: A. hepatic dysfunction. B. cardiomyopathy. C. edema. D. death.

D. death.

A group of nursing students are learning about the factors that underlie recent increases in the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to contribute to antibiotic resistance? A. increased survival rates from acute infections B. increased population density C. use of antibiotics that are ineffective against the infectious microorganism D. overuse of antibiotics

D. overuse of antibiotics

Cephalosporins are associated with adverse effects involving the eighth cranial nerve. True / False

False

A nurse is asked to explain the difference between community-acquired infections and nosocomial infections. What response best describes the difference? A. Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired. B. Usually, nosocomial infections are less severe and easier to treat since community-acquired infections often result from drug-resistant microorganisms. C. There is no epidemiological difference between the infection types; they are simply categorized as community-acquired or nosocomial. D. Only drug-resistant strains of staphylococci, Pseudomonas, and Proteus are categorized as nosocomial infections.

A. Usually, community-acquired infections are less severe and easier to treat since nosocomial infections often occur in people whose immunity is impaired.

Which client is most at risk for the development of an opportunistic infection? A. a young adult who is being treated for electrical burns to his lower body B. a 51-year-old being treated for the exacerbation of rheumatoid arthritis C. a woman who has just given birth vaginally to a premature infant D. a 70-year-old who is being treated for ischemic heart disease

A. a young adult who is being treated for electrical burns to his lower body

A client comes to the clinic reporting mouth sores that appear consistent with an oral yeast infection. The nurse should question the client about recent use of: A. antibiotics. B. oral contraceptive agents. C. antivirals. D. antiprotozoals.

A. antibiotics.

A drug that does not actually cause the death of a cell but does interfere with its ability to reproduce is said to be: A. bacteriostatic. B. drug resistant. C. broad spectrum. D. bactericidal.

A. bacteriostatic.

A client is febrile and is suspected of having a respiratory infection. A sputum culture has been collected and the results of sensitivity testing are expected within 48 hours. The nurse should anticipate that the client may: A. be immediately prescribed a broad-spectrum antibiotic. receive supportive care until an antibiotic can B. be prescribed in 48 hours. C. be treated with antiviral medication on a short-term basis. D. need to provide a follow-up sputum culture before medications can be prescribed.

A. be immediately prescribed a broad-spectrum antibiotic. receive supportive care until an antibiotic can

A client has been diagnosed with an infection. The nurse can help to ensure the success of anti-infective treatment by: A. confirming that the medication prescribed is the drug of choice for the specific microorganism. B. teaching the client that significant adverse effects are expected, and must be endured during treatment. C. administering antihistamines, as ordered, to prevent the development of adverse effects. D. monitoring the client closely for signs of arrhythmias or cardiac ischemia.

A. confirming that the medication prescribed is the drug of choice for the specific microorganism.

The nurse administering an anti-infective agent recognizes that the drug will destroy some human cells as well as pathogens because of the absence of: A. selective toxicity. B. virulence. C. resistance. D. antigens.

A. selective toxicity.

People taking antimicrobial drugs should be instructed to report any problem that could indicate adverse drug effects, lack of therapeutic response, or emergence of another infection. One such problem is: A. skin rash. B. headache. C. constipation. D. muscle soreness.

A. skin rash.

Which are examples of bacteriostatic control used in the healthcare environment? Select all that apply. - Use of cleaning agents daily for the nursing computer stations. - Temperature cooler in many areas of a hospital. - Routine cleaning of areas with many visitors. - Hand washing by all healthcare providers and visitors. - Sharing of stethoscopes by providers

- Temperature cooler in many areas of a hospital. - Routine cleaning of areas with many visitors.

Successful treatment with bacteriostatic antibiotics depends upon what factor? Select all that apply. -The ability of the host's immune system to eliminate the inhibited bacteria. -Appropriately stopping drug therapy promptly when the client's symptoms have begun to subside. -Regularly using broad-spectrum antibacterial drugs to treat acute viral infections. -Accurately prescribing the maximum antibiotic dose that the client can tolerate. -Providing an adequate duration of appropriate drug therapy.

-Providing an adequate duration of appropriate drug therapy. -The ability of the host's immune system to eliminate the inhibited bacteria.

After teaching a group of nursing students about the use of anti-infectives for prophylaxis, the instructor determines that the students need additional teaching when a student identifies what as an example? A. A client with an oral yeast infection who receives antifungal therapy. B. A client who is scheduled for abdominal surgery receives antibiotic therapy. C. A client with a mitral valve replacement receives antibiotics before a tooth extraction. D. A client who receives antimalarial therapy in preparation for travel to Africa.

A. A client with an oral yeast infection who receives antifungal therapy.

The hospital nurse is caring for a group of adult clients. For which client should the nurse most likely administer prophylactic anti-infectives? A. A client with colorectal cancer who is pre-operative for a bowel resection B. A client with diabetic nephropathy who has recently begun dialysis C. A client who has hyperkalemia and who is receiving sodium polystyrene D. A client who is undergoing cardiac rehabilitation following a myocardial infarction

A. A client with colorectal cancer who is pre-operative for a bowel resection

The nurse is caring for several medical clients who have infections. For which client would the administration of a broad spectrum antibiotic be most appropriate? A. A client with signs of infection who is awaiting the results of laboratory testing B. A client with pneumonia who has a confirmed allergy to penicillins C. A client who is being treated for a urinary tract infection for the third time this year D. A client with an infected surgical wound

A. A client with signs of infection who is awaiting the results of laboratory testing

A nurse is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which statement most accurately describes selective toxicity? A. A drug harms microbes without harming human cells. B. A drug's effect on microorganisms is proportionate to dose. C. Most microbes may be collected from a host and cultured on an alternative medium. D. A drug can be isolated and produced in a controlled manner in a laboratory setting.

A. A drug harms microbes without harming human cells.

What would be categorized as an anti-infective agent? A. Anthelmintics B. Anticoagulants C. Anticonvulsants D. Anticholinergics

A. Anthelmintics

A client has been taking antibiotics at home for the treatment of a respiratory infection for the past 6 days, and there is no evident improvement in the infection. Which nursing assessment is most appropriate? A. Assess the client's adherence to the medication regimen. B. Assess the client's home hygiene. C. Assess the client's understanding of the illness. D. Assess the client's use of herbal or alternative remedies.

A. Assess the client's adherence to the medication regimen.

A client is to receive penicillin. The nurse understands that this drug achieves its effect by which action? A. Interfering with the pathogen cell wall B. Not allowing the organism to use the substances it needs C. Disrupting the steps of protein synthesis D. Interfering with DNA synthesis

A. Interfering with the pathogen cell wall

The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug? A. It will directly cause the death of pathogenic cells. B. It is selective in its action on organisms. C. It is effective in interfering with cell reproduction. D. It is effective against many different organisms.

A. It will directly cause the death of pathogenic cells.

The nurse is preparing to administer an anti-infective agent that is prescribed for an older adult. The nurse should prioritize what action? A. Monitor the client closely for signs of adverse effects B. Educate the client about the mechanism of action C. Educate the client about the role of culture testing D. Encourage fluid intake for the duration of treatment

A. Monitor the client closely for signs of adverse effects

A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse's best action? A. Refer the client to the health care provider because the client may be experiencing resistance. B. Assess the client for additional signs of superinfection. C. Assess the client for a new onset of drug hypersensitivity. D. Educate the client about the phenomenon of drug tolerance.

A. Refer the client to the health care provider because the client may be experiencing resistance.

A hospital client has been prescribed IV ceftriaxone, a cephalosporin antibiotic. What assessment finding related to drug therapy would be of greatest concern to the nurse? A. The client develops jaundice B. The client has a fever C. The client's urine output is 450 mL over eight hours D. The client's IV site becomes infiltrated

A. The client develops jaundice

The nurse is providing care for an older adult who has a urinary tract infection. What aspect of this client's current health status should the nurse focus on when ensuring safe and effective antibiotic therapy? A. The client has a history of cirrhosis. B. The client has type 2 diabetes controlled with diet. C. The client uses bronchodilators for the treatment of asthma. D. The client had a hip fracture 8 months ago.

A. The client has a history of cirrhosis.

A client is being treated for urosepsis with ceftriaxone IV. What assessment finding should prompt the nurse to contact the care provider immediately? A. The client has a new onset of jaundice and edema B. The client vomited 20 minutes ago and still reports nausea C. The client's peripheral IV site has gone interstitial D. The client is tearful and expresses fear of a bad prognosis

A. The client has a new onset of jaundice and edema

Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture? A. To identify the organism causing the infection B. To determine the severity of the infection C. To identify the drugs that might be effective in treatment D. To determine the body's response to the infection

A. To identify the organism causing the infection