PrepU Ch18 Drug Therapy With Beta-Lactam Antibacterial Agents

The parent of an 8-year-old asks the nurse why it seems amoxicillin is so often prescribed when the child needs an antibiotic. What is the nurse's best response? 1. "Amoxicillin is an inexpensive antibiotic, so clients are more likely to follow through with treatment." 2. "Amoxicillin has the benefit of once-daily dosing, which is easier for both parents and children." 3. "Amoxicillin is effective and has a less offensive taste than many antibiotics." 4. "Amoxicillin is better absorbed than many other antibiotics and it's highly effective."

"Amoxicillin is better absorbed than many other antibiotics and it's highly effective."

A client has been diagnosed with a sinus infection, and the client has been given a prescription for amoxicillin. What teaching point should the nurse make for the client? 1. "This might cause crystals in your urine, so drink plenty of fluids." 2. "Take your medication every 8 hours, as it's been prescribed." 3. "Avoid taking the medication right before bed so it doesn't cause frequent trips to the bathroom." 4. "Make sure you tell your prescriber if you're feeling particularly tired

"Take your medication every 8 hours, as it's been prescribed."

Your client receives IV vancomycin every 12 hours. You know that this infusion should run over: 1. 2 to 4 hours. 2. 30 minutes. 3. 3 to 4 hours. 4. 1 to 2 hours.

1 to 2 hours

A client has been started on Augmentin 250 mg P.O. every 12 hr. It is supplied in 500-mg tablets. How much will the nurse give at each dose? 1. 1/2 tablet 2. 3/4 tablet 3. 2 tablets 4. 1 tablet

1/2 tablet

A clinic nurse is caring for a 66-pound child who has acute otitis media. The health care provider has ordered ceftibuten 9mg/kg per day PO for 10 days. The drug comes in an oral suspension of 90 mg/5 mL. Which dose will the nurse administer? 1. 5 mL 2. 15 mL 3. 10 mL 4. 20 mL

15 mL

A health care provider prescribes a client 3.375 g piperacillin sodium and tazobactam (Zosyn) every six hours. After reconstitution, the concentration of the drug is 2.25 g/50 mL. Which quantity of the reconstituted solution should the nurse administer to the client? 1. 60 mL 2. 70 mL 3. 75 mL 4. 65 mL

75 mL

The nurse administers cefuroxime to a client at least one hour before meals, as prescribed. However, the client experiences a GI upset. Which is an appropriate nursing intervention in this case? 1. Lower the dosage. 2. Administer an antacid. 3. Administer the drug with food. 4. Discontinue the drug.

Administer the drug with foodPenic

It is best to give penicillins on an empty stomach, one hour before or two hours after a meal. Which of the following penicillins can be given without regard to meals? Select all that apply. 1. Penicillin V (Veetids) 2. Dicloxacillin (Dynapen) 3. Amoxicillin (Amoxil) 4. Carbenicillin indanyl (Geocillin) 5. Ampicillin (Principen)

Amoxicillin and penicillin V

A nurse is preparing to give a client an initial dose of a penicillin preparation. What should the first action be for the nurse? 1. Ask the client if the client wears a MedicAlert bracelet. 2. Ask the client if there is a history allergy to a penicillin. 3. Ask the client if there is a history of anaphylaxis. 4. Ask the health care provider to order a skin test to assess for hypersensitivity to penicillin.

Ask the client if there is a history allergy to a penicillin.

Prior to administration of the first dose of ampicillin, the nurse questions the client about her drug history. What condition that developed with a previous dose of this medication would contraindicate the use of it again? 1. Cholestatic jaundice 2. Diarrhea 3. Nausea 4. Vaginal yeast infection

Cholestatic jaundice

The nurse is preparing a teaching plan for a client who is prescribed ceftriaxone. What should the nurse identify as common adverse effects associated with this drug? 1. Superinfections and phlebitis 2. Diarrhea and nausea 3. Lethargy and paresthesias 4. Headache and dizziness

Diarrhea and nausea

Penicillins are more effective when used on infections caused by what organism? 1. Gram-negative bacteria 2. Fungi 3. Gram-negative viruses 4. Gram-positive bacteria

Gram-positive bacteria

Penicillins and cephalosporins are used cautiously in neonates due to what factor? 1. Immature pancreatic function 2. Immature liver function 3. Immature immune function 4. Immature kidney function

Immature kidney function

A nurse needs to administer a cephalosporin to a patient. The patient informs the nurse that he is allergic to penicillin. Which of the following actions is the nurse most likely to take in such a situation? 1. Inform the primary health care provider. 2. Suggest kidney function tests. 3. Obtain patient's occupational history. 4. Administer an antipyretic drug.

Inform the primary health care provider

The nurse is administering penicillin to a client who has strep throat. Which of the following statements accurately describe the action of penicillin? 1. It has many side effects, especially in large doses 2. It is effective against gram-positive organisms 3. It is metabolized in the liver 4. It is not effective against gram-negative organisms

It is effective against gram-positive organisms

An older adult is to receive a low dose of a cephalosporin for an infection. When realizing that this client has age-related diminished renal function, what intervention should the nurse implement? 1. Initiate monitoring of intake and output. 2. Notify the prescribing provider. 3. Hold the drug for lab work. 4. Monitor blood creatinine levels.

Monitor blood creatine levels

Which would be considered a penicillinase-resistant antibiotic? 1. Ticarcillin 2. Nafcillin 3. Carbenicillin 4. Amoxicillin

Nafcillin

A 40-year-old is being treated for an ear infection with a cephalosporin. Which adverse reactions should the nurse monitor for in the client? 1. Excessive tearing 2. Nausea 3. Chest pain 4. Hypotension

Nausea

A young adult has been receiving Keflex P.O. for the last 5 days to treat a respiratory infection. The nurse is concerned when the client reports urinating only once in the last 16 hours. What should the nurse consider as the cause? 1. Nephrotoxicity 2. Superinfection 3. Steven-Johnson syndrome 4. Systemic dehydration

Nephrotoxicity

Which of the following should a nurse carefully monitor in a patient who has been administered cephalosporin as well as aminoglycosides for a wound infection?

Nephrotoxicity

A client diagnosed with streptococcal pharyngitis should be educated concerning which drug? Select all that apply. 1. amoxicillin 2. penicillin V 3. cephalexin 4. dicloxacillin 5. penicillin G

Penicillin G Penicillin V

Cephalosporins are structurally and chemically related to which classes of antibiotics? 1. Fluoroquinolones 2. Tetracyclines 3. Aminoglycosides 4. Penicillins

Penicillins

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize? 1. Complete blood count 2. Serum BUN and creatinine levels 3. Coagulation studies 4. Signs of disulfiram-like reaction

Serum BUN and creatinine levels

A nurse is caring for a patient who has a serious infection. The patient is being treated with combination therapy of a cefazolin and an aminoglycoside. The nurse will be sure to monitor which of the following? 1. Serum sodium and potassium levels 2. Aspartate aminotransferase levels 3. Prothrombin time (PT) and partial thromboplastin time (PTT) 4. Serum BUN and creatinine levels

Serum BUN and creatinine levels

A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions should a nurse perform when preparing penicillin in parenteral form? 1. Use any available diluent for reconstitution. 2. Shake the vial well to distribute the drug evenly. 3. Save excess antibiotic after reconstitution for later use. 4. Extract penicillin from vial and then reconstitute.

Shake the vial well to distribute the drug evenly

A 34-year-old female client is taking oral cephradine, a first-generation cephalosporin, at regular intervals with a 2-hour gap before meals. The client reports gastrointestinal distress. The nurse will encourage the client to do which? 1. Change the drug dosage. 2. Avoid dairy products 3. Drink plenty of fluids. 4. Take the drug with food.

Take the drug with food

A health care center is conducting a seminar on cephalosporins drugs. During the question-and-answer period, the audience wants examples of conditions that can be treated by cephalosporins. Which of the following infections should the nurse state as examples? 1. Jaundice 2. Nausea and diarrhea 3. Hemolysis 4. Urinary tract infections

Urinary tract infections

The nurse is preparing a teaching plan for a client who is receiving cephalosporins. Which of the following would the nurse identify as the most commonly occurring adverse effects? 1. Headache and dizziness 2. Superinfections 3. Phlebitis 4. Vomiting and diarrhea

Vomiting and diarrhea

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? 1. bacteriostatic 2. fungicidal 3. fungistatic 4. bactericidal

bactericidal

The client is receiving keflex 1000 mg/day. The nurse properly identifies this drug as a: 1. fourth-generation cephalosporin. 2. first-generation cephalosporin. 3. second-generation cephalosporin. 4. third-generation cephalosporin.

first-generation cephalosporin.

As a class, penicillins usually are more effective in infections caused by which type of bacteria? 1. Gram-positive 2. Anaerobic 3. Aerobic 4. Gram-negative

gram-positive

What event triggers the development of a superinfection? 1. bone marrow suppression triggered by antibiotic treatment 2. unforeseen interactions between the antibiotic and other prescribed medications 3. complete establishment of the infection prior to initiation of antibiotic therapy 4. proliferation of antibiotic-resistant microorganisms

proliferation of antibiotic-resistant microorganisms

The nurse knows that superinfections are a concern for clients who have been taking oral penicillins. Which is one of the more common superinfections? 1. pseudomembranous colitis 2. meningococcal meningitis 3. septicemia 4. syphilis

pseudomembranous colitis

The client is admitted to the acute care facility with acute septicemia and has orders to receive gentamicin and ampicillin IV. The nurse is performing an admission assessment that includes a complete nursing history. What information provided by the client would indicate the need to consult the healthcare provider before administering the ordered medication? 1. takes high-dose furosemide daily 2. allergy to peanuts and peanut products 3. had prostate surgery 3 months ago 4. history of hypothyroidism

takes high-dose furosemide daily

A 13-year-old male patient has been prescribed oral cefuroxime. The patient's parents should ensure that he takes the medication 1. between meals. 2. immediately upon awakening. 3. on an empty stomach. 4. with food.

with food

When learning about the different classes of cephalosporins, the nurse correctly identifies which of the following statements? 1. Cephalosporins are completely different chemically from penicillin. 2. A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms. 3. Cephalosporins are limited in treating many types of bacteria. 4. Cephalosporins are divided into three different groups.

A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

When learning about the different classes of cephalosporins, the nurse correctly identifies which of the following statements? 1. Cephalosporins are completely different chemically from penicillin. 2. Cephalosporins are limited in treating many types of bacteria. 3. Cephalosporins are divided into three different groups. 4. A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

A first-generation cephalosporin is more useful than a third-generation cephalosporin against gram-positive microorganisms.

In general, progression from first-generation cephalosporins to fourth-generations results in which of the following? Select all that apply. 1. An increase in sensitivity of gram-negative microorganisms. 2. An increase in sensitivity of gram-positive microorganisms. 3. An increase in the sensitivity of viral microorganisms. 4. A decrease in the sensitivity of gram-positive microorganisms. 5. A decrease in sensitivity of gram-negative microorganisms.

An increase in sensitivity of gram-negative microorganisms An decrease in sensitivity of gram-positive microorganisms

Place the following cephalosporins in the proper sequence beginning with first generation cephalosporins up to fourth generation cephalosporins. 1. Cefotaxime 2. Cefuroxime 3. Cefepime 4. Cefazolin

Cefazolin Cefuroxime Cefotaxime Cefepime

Beta-lactam antibiotics, such as penicillins and cephalosporins, fight infection by inhibiting development of the causative bacteria. What specific component development do these drugs affect? 1. Cell wall synthesis 2. DNA replication 3. Protein synthesis 4. Cell division

Cell wall synthesis

A female client is admitted to the critical care unit with sepsis related to a contaminated central line. The health care provider orders intravenous beta-lactam antimicrobials. The client's current laboratory report reflects renal impairment. What would the nurse expect the provider to do? 1. Administer the drug via an intramuscular route. 2. Decrease the drug dose. 3. Maintain the drug dose. 4. Increase the drug dose.

Decrease the drug dose

A male client who has undergone surgery of the urinary tract is administered cephalosporins to prevent infections. When assessing the client on the day after the surgery, the nurse notices that he has an elevated temperature. Which nursing intervention would be most appropriate in this case? 1. Administer a higher dosage of the drug. 2. Discontinue use of the drug. 3. Inform the primary health care provider. 4. Record the client's fluid intake.

Inform the primary health care provider

Probenecid is sometimes given concurrently with penicillins. What effect does probenecid have when given with a penicillin? 1. It breaks down the bacterial cell wall. 2. It prevents anaphylactic reaction. 3. It maintains high serum levels of penicillin. 4. It increases the excretion of penicillin.

It maintains high serum levels of penicillin

Some combination antibacterial drugs consist of a penicillin and a beta-lactamase inhibitor. What is the primary purpose of a beta-lactamase inhibitor in one of these drugs? 1. It is the main antibacterial component. 2. It protects the penicillin. 3. It acts as antiviral agent. 4. It suppresses any allergic reaction.

It protects the penicillin.

When discussing cephalosporins with the nursing class, the pharmacology instructor explains that this classification of drug is primarily excreted through which organ? 1. Lung 2. Skin 3. Liver 4. Kidney

Kidney

While discussing drug combinations, including the beta-lactamase inhibitor combinations, the pharmacology instructor explains their mechanisms of action. What benefit is derived from combining a beta-lactamase inhibitor with a penicillin? 1. The penicillin protects the beta-lactamase inhibitor. 2. The beta-lactamase inhibitor protects the penicillin. 3. The beta-lactamase inhibitor destroys the receptor sites on the cell wall. 4. The penicillin reduces the adverse effects of the beta-lactamase inhibitor.

The beta-lactamase inhibitor protects the penicillin

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? 1. Stop the medication and the health care provider will order you a different antibiotic. 2. Continue to take the medication as prescribed; these are expected side effects from the medication. 3. Stop the medication immediately and go to the emergency room; these could be signs of a life-threatening reaction. 4. These are normal side effects, but if they increase in severity or frequency, you need to contact the office again.

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

The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client? 1. Do not take your oral contraceptives while you are taking this medication. 2. Use a type of barrier birth control while you are taking this antibiotic. 3.Your menstrual cycle will have a heavier flow while on this medication. 4. Taking this antibiotic with your oral contraceptives will cause an increased chance of bleeding.

Use a type of barrier birth control while you are taking this antibiotic.

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: 1. are ineffective in clients who are allergic to penicillins. 2. can cause allergic reactions in clients who are allergic to penicillins. 3. can cause kidney damage in clients who are allergic to penicillins. 4. are derived from penicillin.

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

The nurse has administered the first dose of a client's newly-prescribed antibiotic. What assessment finding should the nurse interpret as adverse effect that suggests a more serious concern? 1. drowsiness 2. rash to the face and trunk 3. decrease in blood pressure from 128/77 mm HG preadministration to 119/70 postadministration 4. new onset of pain

rash to the face and trunk

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 1. immediately before or with a meal. 2. intravenously with the assistance of a home health nurse. 3. with a glass of water 1 hour before or 2 hours after a meal. 4. with a sip of water 1 hour before mealtime.

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