Chapter 9

A client has been on an antibiotic for two weeks for treatment of an infection. The client asks the nurse why a superinfection has been caused by this medication. What is the nurse's best response? "Antibiotics can disrupt the normal bacteria in your body and cause them to grow out of control." "Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur." "The antibiotics are only effective in killing off some of the bacteria in the body." "The antibiotics are only effective against some types of bacteria."

"Antibiotics can disrupt the normal bacteria in your body, causing another infection to occur."

After teaching a client who is prescribed oral erythromycin, the nurse determines that the teaching was successful when the client states which of the following? "I need to take the medicine with a meal so I don't get an upset stomach." "I should drink a full 8-oz glass of water when I take the medicine." "I might have some bloody diarrhea after using this medicine." "I only need to take one pill every day for this medicine to work."

"I should drink a full 8-oz glass of water when I take the medicine."

The health care provider has ordered penicillin V for a client. What should the nurse instruct the client to take with the medication? A full glass of orange juice A full glass of water A full glass of milk A full glass of tea

A full glass of water

A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for? Inflammation of the tongue and mouth Impaired oral mucous membranes Severe hypotension Sudden loss of consciousness

Inflammation of the tongue and mouth

A client with a urinary tract infection is being treated with a sulfonamide antibiotic. The nurse should recognize that pathogens are being eradiated by what means? Inhibition of folic acid synthesis Inhibition of cell membrane synthesis. Prevention of biosynthesis of bacterial cell walls. Interferance with DNA enzymes necessary for bacterial growth.

Inhibition of folic acid synthesis

A nurse is preparing the medical history report of a patient with a urinary tract infection. Which of the following conditions should the nurse identify as one in which the use of cephalosporins is restricted? Aplastic anemia Renal disease Abdominal cramps Headache

Renal disease

The nurse has administered a client's first scheduled dose of amoxicillin. What subsequent client report should prompt the nurse to seek the discontinuation of this drug? shortness of breath nausea heartburn frontal lobe headache

SOB

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? Serum BUN and creatinine levels Coagulation studies Signs of disulfiram-like reaction Complete blood count

Serum BUN and creatinine levels

A clent has been diagnosed with acute uncomplicated cystitis. She is receiving ciprofloxacin (Cipro) 250 mg PO BID x 7 days. When teaching the client about this medication, which should the nurse include? Select all that apply. You will need to use a backup method of birth control if you are taking oral contraceptives. You should take Cipro in the morning when you take your daily vitamins. Antacids can interfere with the absorption of Cipro. You will have to stop drinking coffee while taking this medication. To minimize side effects, Cipro should be taken with food

You will need to use a backup method of birth control if you are taking oral contraceptives. Antacids can interfere with the absorption of Cipro.

A client is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which anti-infective agent is most reliable in treating this microorganism? aminoglycoside antifungal aminopenicillin GABA analog

aminoglycosides

After teaching a group of nursing students about the action of penicillins, the instructor determines that the teaching was effective when the students identify natural penicillins as exerting which type of effect on microorganisms? bactericidal bacteriostatic fungicidal fungistatic

bacteriocidal

A client with a gram-negative bacterial infection has been prescribed a fluoroquinolone. During the preadministration assessment, the nurse should ensure that which laboratory tests, if prescribed, are obtained before the first dose of fluoroquinolones is administered to the client? renal and hepatic function tests complete blood count culture and sensitivity test urinalysis

c&s

The client has been taking levofloxacin IV since admission 12 hours ago for a urinary tract infection. The nurse assesses the client's temperature at 99.8ºF. What is the nurse's best response? Continue to monitor vital signs. Notify the health care provider. Administer an extra dose of levofloxacin. Administer an antipyretic.

continue to monitor vitals

Which medication is the drug of choice for Legionnaires disease? erythromycin loxapine hydrochloride meclizine pravastatin

erythromycin

A client reports having had a "bad reaction" the last time receiving penicillin. Prior to a scheduled dental procedure, the client is likely to be prescribed what drug? erythromycin clindamycin metronidazole vancomycin

erythromycin Prophylactically, erythromycin is administered to prevent alpha-hemolytic streptococcal endocarditis before dental or other procedures in clients who have valvular heart disease and are allergic to penicillin. Clindamycin may be useful as a penicillin substitute in clients who are allergic to penicillin and who have serious streptococcal, staphylococcal, or pneumococcal infections in which the causative organism is susceptible to clindamycin

The nurse is preparing to administer a sulfonamide to a client who is a Type 2 diabetic taking an oral hypoglycemic agent. The nurse will monitor the client for what reaction? Hyperglycemia Hypoglycemia Increased bruising Elevated temperature

hypoglycemia

The nurse should suggest to the parents of a toddler diagnosed with otitis media that their child's ear pain can be treated with what over-the-counter (OTC) adjuvant medication therapy? Select all that apply. aspirin ibuprofen acetaminophen lidocaine benzocaine

ibuprofen, acetaminophen

A group of nursing students are reviewing information about fluoroquinolones. The students demonstrate a need for additional review when they identify which as an example? metronidazole ciprofloxacin levofloxacin gemifloxacin

metronidazole

A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will monitor the site of injection. monitor the patient for bleeding gums. continue therapy until 2 days after symptoms have resolved. administer the medication with small amounts of food and fluids.

monitor the patient for bleeding gums

A nurse monitors a client closely for anaphylactic reactions secondary to penicillin therapy. The nurse understands that this occurs more commonly after which route of administration? parenteral oral topical transdermal

parenteral Adverse effects mainly occur with parenteral administration, and penicillin is never administered topically or transdermally.

Tetracycline is often a viable treatment option when a client has an allergy to what antibiotics? penicillins aminoglycosides fluoroquinolones cephalosporins

penicillin

The nurse is teaching a client about his prescription for a macrolide antibiotic. What should the nurse teach the client to report? Lessening of symptoms of infection Missed doses Increased urinary output Recurring symptoms of infection

recurring symptoms of infection

A client with a diagnosis of rhinosinusitis has been prescribed ciprofloxacin 250 mg SC b.i.d. When contacting the prescriber, the nurse should question the: route. dose. frequency. choice of drug.

route ciprofloxacin is given PO

A client has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the client to look for side effects from the prolonged use of the antibiotic and informs the client that this is known as: allergic reaction. superinfection. analphylactic reaction. allergy. skin rash.

superinfection

A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan? Take the drug on an empty stomach. Take the drug along with a meal. Take the drug along with milk or fruit juice. Take the drug immediately after meals.

take drug on empty stomach

A male client is admitted to the unit with Pseudomonas aeruginosa sepsis. The health care provider orders aminoglycoside to be given concomitantly with penicillin intravenously. How would the nurse administer these drugs? By mixing both drugs in normal saline solution By administering the drug in separate IV bags By administering the drugs dextrose 5% and 0.9% normal saline By administering the drugs every other day

By administering the drug in separate IV bags

How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media? It extends the spectrum of antibacterial activity of penicillin. It extends the spectrum of the beta-lactamase inhibitor. It decreases the side effects of high-dose penicillin. It increases the absorption of the penicillin.

It extends the spectrum of antibacterial activity of penicillin.

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication? It inhibits protein synthesis. It lowers the pH of cellular contents. It causes mutations. It inhibits cell wall synthesis.

It inhibits cell wall synthesis.

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? Ciprofloxacin is safe to use in pregnancy and the client may use to same dose and route as a nonpregnant client. The use of ciprofloxacin is contraindicated in pregnancy. It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client.

The use of ciprofloxacin is contraindicated in pregnancy.

A client is taking penicillin for an upper respiratory infection. The client calls the office after 2 days of therapy reporting nausea and abdominal pain. Which would be the best instruction for the nurse to give the client? Continue to take the medication as prescribed; these are expected side effects from the medication. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. These are normal side effects, but if they increase in severity or frequency, you need to contact the office again. Stop the medication and the health care provider will order you a different antibiotic.

These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone? antacids antihypertensives antidiabetic agents oral contraceptives

antacids

The health care provider is selecting an antibiotic for a client with a known penicillin allergy. The provider knows that cephalosporins are a poor choice for this client because cephalosporins: are ineffective in clients who are allergic to penicillins. can cause kidney damage in clients who are allergic to penicillins. are derived from penicillin. can cause allergic reactions in clients who are allergic to penicillins.

can cause allergic reactions in clients who are allergic to penicillins.

A nurse is preparing to administer a client's first scheduled dose of tetracycline. The nurse should first ensure that the client has not recently eaten what type of foods? dairy products leafy green vegetables any high-fat foods acidic foods

dairy products

A client who takes zinc daily is diagnosed with a severe infection and is ordered levofloxacin (Levaquin). The nurse is aware that taking these two drugs may have what affect on the antibiotic? Decreased absorption Increased absorption Increased elimination Decreased elimination

decreased absorption

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply. drop in blood pressure increase in respiratory rate sudden increase in temperature regular urine output pulse rate within usual parameters

drop in blood pressure increase in respiratory rate sudden increase in temperature

The nurse knows that pseudomembranous colitis is a superinfection of fluoroquinolones, especially when they are administered in high doses, because these medications have what effect in the body? They disrupt the normal flora of the body. They disrupt the existing bacterial infection. They increase the infectious bacterial process. They decrease the infectious bacterial process.

they disrupt the normal flora of the body

A 7-year-old child has tonsillitis and is prescribed penicillin V, which is to be administered at home. The nurse will instruct the parents to administer the drug with a sip of water 1 hour before mealtime. immediately before or with a meal. with a glass of water 1 hour before or 2 hours after a meal. intravenously with the assistance of a home health nurse.

with a glass of water 1 hour before or 2 hours after a meal.