Patho MOD 4 Review

Which instruction will the nurse include when teaching a patient about cephalosporin therapy? Select all that apply. One, some, or all responses may be correct. "Take aspirin if you develop a headache." "Cephalosporins may not be taken with food." "'Notify your healthcare providerterm-51 if you develop a rash " "'It is important to call your healthcare provider if you develop diarrhea." "Do not take cephalosporins if you have lactose intolerance."

"'Notify your healthcare providerterm-51 if you develop a rash " "'It is important to call your healthcare provider if you develop diarrhea."

Which instruction will the nurse include in discharge teaching for a patient prescribed amoxicillin/clavulanate? "Amoxicillin/clavulanate may be taken with food or meals.!" "Avoid taking amoxicillin/clavulanate with grapefruit juice. "Take amoxicillin/clavulanate once per day and only at bedtime!' "Use a minimal amount of liquid to swallow the amoxicillin/clavulanate.

"Amoxicillin/clavulanate may be taken with food or meals.!"

Which response would the nurse make when asked by a patient why azithromycin does not have to be taken as often as antibiotics previously prescribed? "You'll need to ask your healthcare provider questions like that. "This drug has a longer duration of action than some of the other antibiotics "I'll call the pharmacy and ask about the chemical makeup of the drug." "This is a much more effective drug than what you received previously.

"This drug has a longer duration of action than some of the other antibiotics

Which response by the nurse is appropriate when a patient prescribed azithromycin expresses concern regarding gastrointestinal (Gl) upset experienced when taking erythromycin? "I will call the healthcare provider and ask for a different antibiotic." "You need this medication and will have to tolerate the nausea." "I will ask the healthcare provider for a prescription for an antiemetic for possible nausea. "This drug is like erythromycin but has less severe gastrointestinal side effects."

"This drug is like erythromycin but has less severe gastrointestinal side effects."

Which instruction will the nurse include in the discharge teaching for a patient receiving tetracycline? "Take the medication until you feel better! "Use sunscreen and protective clothing when outdoors." "Keep the remainder of the medication in case of recurrence.' "Be sure to drink a glass of milk with the dose to minimize gastrointestinal upset."

"Use sunscreen and protective clothing when outdoors."

Which response by the nurse is correct when providing instructions related to vancomycin? Select all that apply. One, some, or all responses may be correct. "The maior toxicity of vancomycin therapy is liver failure." "Vancomycin is effective in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. "You may receive this medication if you are diagnosed with Clostridium difficile infection." "Patients who are allergic to penicillin are also allergic to vancomvcin. "This medication is the most widely used antibiotic in U.S. hospitals."

"Vancomycin is effective in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. "You may receive this medication if you are diagnosed with Clostridium difficile infection." "This medication is the most widely used antibiotic in U.S. hospitals."

Which response by the nurse is appropriate when asked by a patient receiving intravenous (IV) vancomycin for a methicillin-resistant Staphylococcus aureus (MRSA) why the medication cannot be administered orally? "You're allergic to penicillin, and this is the only way this medication can be given." "it is more effective by IV because the pill form will stay in the digestive tract." I "It will cause too much loss of appetite and nausea if given in the oral form. "The prescription could be changed because vancomycin comes in two forms."

"it is more effective by IV because the pill form will stay in the digestive tract." I

Which time is the fastest rate that vancomycin will be infused intravenously? 30 minutes 60 minutes 90 minutes 120 minutes

60 minutes

Which patient situation will prompt the nurse to question a prescription of tetracycline? A 6-year-old patient with Haemophilus influenza A 60-year-old patient with a history of hypertension An 18-year-old patient with a history of diabetes mellitus A 40-year-old patient diagnosed with rickettsia infection

A 6-year-old patient with Haemophilus influenza

In which patient would the use of doxycycline be contraindicated? A 2-month-old child with pneumonia A 7-year-old child with Lyme disease A 14-year-old child with severe acne An 18-year-old adolescent with a sexually transmitted infection

A 7-year-old child with Lyme disease

Which broad-spectrum penicillin has the same antimicrobial spectrum as penicillin G, plus increased activity against certain gram-negative bacilli? Select all that apply. One, some, or all responses may be correct. Oxacillin Nafcillin Ampicillin Amoxicillin Piperacillin

Amoxicillin Ampicillin

Which condition will the healthcare provider suspect when a patient taking antibiotics presents with a rapid, irregular pulse and reports flushing, itching, hives, anxiety, and throat and tongue swelling? Tolerance to the antibiotic drugs An allergic anaphylactic reaction Clostridium difficile bacterial infection Glucose-6-phosphate dehydrogenase (G6PD) deficiency

An allergic anaphylactic reaction

Which type of allergic reaction is more common in penicillin allergies than in other drug allergies? Delayed Accelerated Interarterial Anaphylaxis

Anaphylaxis

Which infection will the nurse expect the healthcare provider to treat with penicillin G? Select all that apply. One, some, or all responses may be correct. Anthrax (caused by Bacillus anthracis) Tetanus (caused by Clostridium tetani) Syphilis (caused by Treponema pallidum) Gonorrhea (caused by Neisseria gonorrhoeae) Gas gangrene (caused by Clostridium perfringens)

Anthrax (caused by Bacillus anthracis) Tetanus (caused by Clostridium tetani) Syphilis (caused by Treponema pallidum) Gas gangrene (caused by Clostridium perfringens)

Which statement is true regarding the similarities between cephalosporins and penicillins? Select all that apply. Are bactericidal antibiotics Activate Autolysin enzymes Bind to penicillin-binding proteins (PBPs) Take up excess water and cause the cell wall to rupture Active only against bacteria undergoing growth and division

Are bactericidal antibiotics Activate Autolysin enzymes Bind to penicillin-binding proteins (PBPs) Active only against bacteria undergoing growth and division

Which major group is a classification of penicillin based on modifications made to the basic nucleus? Select all that apply. One, some, or all responses may be correct. Broad-spectrum penicillins Partial-spectrum penicillins Extended-spectrum penicillins Narrow-spectrum penicillins that are penicillinase resistant Narrow-spectrum penicillins that are penicillinase sensitive

Broad-spectrum penicillins Extended-spectrum penicillins Narrow-spectrum penicillins that are penicillinase resistant Narrow-spectrum penicillins that are penicillinase sensitive

Which assessment finding will the nurse monitor as an indicator of an undesired effect of penicillin G? Lung sounds Cardiac rhythm Tetany Red blood cell (RBC) count

Cardiac rhythm

Which cephalosporin can induce a state of alcohol intolerance? Select all that apply. One, some, or all responses may be correct. Cefdinir Cefazolin Cefotetan Ceftaroline Ceftriaxone

Cefazolin Cefotetan

Which cephalosporin prescription would the nurse question in a patient with a history of alcoholism being treated for a urinary tract infection? Select all that apply. One, some, or all responses may be correct. Cefdinir Cefazolin Cefotetan Cefadroxil Ceftaroline

Cefazolin Cefotetan

Which cephalosporin is active against methicillin-resistant Staphylococcus aureus (MRSA)? Cefdinir Cefazolin Cefadroxil Ceftaroline

Ceftaroline

Which cephalosporin is the safest to administer without dosage reduction to a patient with a blood urea nitrogen (BUN) level of 65 and a creatinine level of 4.1? Cefdinir Cefazolin Ceftaroline Ceftriaxone

Ceftriaxone

Which instruction will the nurse provide a patient prescribed cephalexin to improve drug efficacy? Take the drug for 5 days. Administer 2 hours before eating. Cephalexin can be taken with meals to avoid gastric upset. Notify the primary healthcare provider if there is milk protein hypersensitivity.

Cephalexin can be taken with meals to avoid gastric upset.

Which group of antibiotics is the most widely used because of their bactericidal nature, resistance to beta-lactamases, and activity against a broad spectrum of pathogens? Penicillins Tetracyclines Cephalosporins Aminoglycosides

Cephalosporins

Which medication will be prescribed by the primary healthcare provider to enhance the effectiveness of ampicillin? Calcium citrate Clavulanic acid Acetaminophen Carbamazepine

Clavulanic acid

Which antibiotic will the nurse plan to administer if a patient with bacterial endocarditis has a culture revealing gram-positive streptococcus? Amikacin Tobramvcin Gentamicin Clindamycin

Clindamycin

Which drug is likely being prescribed when the nurse teaches a patient to promptly report any diarrhea to the healthcare provider? Linezolid Minocycline Clindamycin Doxycycline

Clindamycin

Which further testing will the nurse anticipate when assessing a patient who has developed watery diarrhea and was recently treated with antibiotics? Sputum test Acinetobacter test Clostridium difficile test Culture and sensitivity test

Clostridium difficile test

Which laboratory parameter will the nurse monitor to prevent complications from linezolid? Liver function tests Complete blood count Serum creatinine level Peak and trough drug levels

Complete blood count

Which serum laboratory reports will the nurse evaluate if the patient is administered vancomycin and tobramycin? Glucose Creatinine Prothrombin time Electrolytes

Creatinine

Which test will the nurse monitor to detect toxicity in a patient receiving vancomycin? Creatinine level Alkaline phosphatase Electroencephalogram Creatine phosphokinase (CPK)

Creatinine level

Which nursing action is best when a patient develops excessive sweating and reports itching on the face and neck during an intravenous infusion of vancomycin? Increase the rate of infusion of vancomycin. Decrease the rate of infusion of vancomycin. Stop the administration of the vancomycin infusion. Advise the patient to get his or her blood pressure checked.

Decrease the rate of infusion of vancomycin.

Which possible pharmacokinetic implication will the nurse assess for in a patient with chronic alcoholism and cirrhosis of the liver when prescribed erythromycin in addition to maintenance medications? Delay in drug absorption Development of drug toxicity Shortened duration of drug actions Decreased pharmacologic effects of drugs

Development of drug toxicity

Which manifestation of Clostridioides difficile associated diarrhea (CDAD) is most important for the nurse to assess for? lleus Ascites Diarrhea Abdominal rigidity

Diarrhea

Which penicillinase-resistant drug will the nurse expect the healthcare provider to prescribe for a patient diagnosed with a respiratory infection caused by staphylococci? Ampicillin Amoxicillin Penicillin G Dicloxacillin

Dicloxacillin

Which condition is a potential side effect of tetracyclines when prescribed to a preschool-age child? Anabolic change Cartilage damage Discoloration of teeth Suppression of growth

Discoloration of teeth

Which assessment finding in a 12-year-old child will the nurse attribute to a prescription of tetracycline when younger? Early onset of puberty Discoloration of the teeth Delay in long bone growth Severe face and body acne

Discoloration of the teeth

Which information will the nurse include as a difference when comparing the various penicillins? Select all that apply. One, some, or all responses may be correct. Duration of action Antibacterial spectrum Stability in stomach acid Speed of elimination by the kidneys Allergy to one type without cross-allergy to others

Duration of action Antibacterial spectrum Stability in stomach acid

Which action will the nurse take when administering both intravenous (IV) ampicillin/sulbactam and gentamicin? Administer the gentamicin first. There are no necessary precautions. Use two different peripheral IV sites. Ensure that separate IV solutions are used.

Ensure that separate IV solutions are used.

Which medication will the nurse expect the healthcare provider to prescribe when the patient presents to a follow-up visit with wheezing, swelling of the throat, dizziness, hypotension, a weak pulse, and reports of difficulty breathing after Helicobacter pylori infection? Ranitidine Epinephrine Tetracycline Azithromycin

Epinephrine

Which medication is used as an alternative therapy for patients with a penicillin allergy? Linezolid Tetracycline Doxycycline Erythromycin

Erythromycin

Which medication prescription would the nurse question for a patient diagnosed with Bordetella pertussis (whooping cough) who is currently taking verapamil for hypertension? Tigecycline Tetracycline Clindamycin Erythromycin

Erythromycin

Which substance will the nurse suspect a patient has consumed when, after receiving cefotetan for a urinary tract infection 2 days prior, the patient presents with stomach cramps, nausea and vomiting, excessive sweating, itching, and headache? Ranitidine Probenecid Methotrexate Ethanol

Ethanol

Which phrase describes an adverse effect of clindamycin therapy? Cyanosis and gray discoloration of the skin Elevated bilirubin with dark urine and jaundice Frequent, loose, watery stools with mucus and blood Reduction in all blood cells produced in the bone marrow

Frequent, loose, watery stools with mucus and blood

Which nursing action is appropriate while performing a penicillin allergy skin test? Select all that apply. One, some, or all responses may be correct. Have epinephrine readily available. Observe for a local allergic response. Have respiratory support readily available. Inject a tiny amount of the allergen subcutaneously. Administer diphenhydramine as the first-line agent should anaphylaxis occur.

Have epinephrine readily available. Observe for a local allergic response. Have respiratory support readily available.

Which side effect will be less likely to occur when the nurse administers intravenous vancomycin to a patient slowly, over 1 hour? Edema Hemolysis Hypotension Abdominal flatulence

Hypotension

Which type of allergic reaction is the patient most likely experiencing when urticaria develops 10 minutes after receiving a penicillin intramuscular injection? Delayed Immediate Accelerated Anaphylaxis

Immediate

Which change will the nurse expect the healthcare provider to make when the serum drug concentration in the patient is 8 mcg mL after the second dose of vancomycin for treatment of a methicillin-resistant Staphylococcus aureus (MRSA) infection? Rapidly infuse the vancomycin. Increase the dose of vancomycin. Stop the administration of vancomycin. Replace vancomycin with another antibiotic.

Increase the dose of vancomycin.

Which best describes the action of vancomycin? Contains a beta-lactam ring Inhibits cell wall synthesis promoting bacterial lysis Must have a trough serum level of 8 mcg/mL to be effective Produces allergic reactions in patients allergic to beta-lactam antibiotics

Inhibits cell wall synthesis promoting bacterial lysis

Which laboratory result will the nurse monitor frequently when a patient is receiving clarithromycin and warfarin? Platelet count International normalized ratio (INR) Erythrocyte sedimentation rate (ESR) Activated partial thromboplastin time (aPTT)

International normalized ratio (INR)

Which statement is true regarding Clostridium difficile-associated diarrhea (CDAD) with clindamycin therapy? Select all that apply. One, some, or all responses may be correct. Leukopenia commonly occurs. It is a potentially fatal condition. Patients usually experience abdominal pain. Anticholinergics are effective in treating the diarrhea. Clindamycin therapy should be discontinued and vancomycin started.

It is a potentially fatal condition. Patients usually experience abdominal pain. Clindamycin therapy should be discontinued and vancomycin started.

Which characteristic is true regarding penicillins? Select all that apply. One, some, or all responses may be correct. Bacteriostatic Known as beta-lactam antibiotics Considered one of the safest antibiotics Active only against bacteria that are growing and dividing Causes bacteria to take up excess amounts of water and rupture

Known as beta-lactam antibiotics Considered one of the safest antibiotics Active only against bacteria that are growing and dividing Causes bacteria to take up excess amounts of water and rupture

Which substance is most important for a nurse to avoid mixing ceftriaxone with when administered intravenously? Sterile water Normal saline D5 0.45% normal saline Lactated Ringer's solution

Lactated Ringer's solution

Which drug is part of the tetracycline group of antibiotics? Select all that apply. One, some, or all responses may be correct. Linezolid Minocycline Clindamycin Doxycycline Demeclocycline

Minocycline Doxycycline Demeclocycline

Which penicillin was first and continues to be the drug of choice for many infections? Penicillin A Penicillin G Penicillin V Penicillin VK

Penicillin G

Which class of penicillin antibiotic is known as antistaphylococcal penicillin? Aminopenicillins Natural Penicillins Extended-spectrum drugs Penicillinase-resistant drugs

Penicillinase-resistant drugs

Which allergy history is most important for the nurse to assess in the patient before administering a cephalosporin to a patient? Opioids Peanuts Penicillins Soy products

Penicillins

Which complication of intravenous (IV) therapy will the nurse document has occurred after observing a red streak and palpating a hard and cordlike vein at the IV site of a patient receiving cefepime? The drug has infiltrated the extravascular tissues. An allergic reaction has developed to the drug solution. Phlebitis of the vein used for the antibiotic has developed. Local infection from bacterial contamination has occurred

Phlebitis of the vein used for the antibiotic has developed.

Which penicillin is classified as an extended-spectrum penicillin that can treat bacteria such as Pseudomonas aeruginosa? Select all that apply. One, some, or all responses may be correct. Oxacillin Nafcillin Ampicillin Amoxicillin Piperacillin

Piperacillin

Which information provided during collection of the nursing history is most important in a patient admitted to the hospital with a medical diagnosis of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA)? Plays a contact sport and is an athlete Currently resides in a long-term care facility Did not complete the last course of antibiotics Had gallbladder surgery in the previous month

Plays a contact sport and is an athlete

Which phrase describes the principal cause of cephalosporin resistance? Rupture of the cell wall Production of beta-lactamases Bacteriostatic nature of cephalosporin Alpha-lactam ring fused to a second ring of the nucleus

Production of beta-lactamases

Which nursing action is appropriate when a patient receiving intravenous vancomycin reports facial pruritus? Give diphenhydramine with the infusion. Wrap the infusion in foil to protect from light. Program the vancomycin to infuse at a slower rate. Document that the patient has a hypersensitivity reaction.

Program the vancomycin to infuse at a slower rate.

Which cardiovascular finding will the nurse assess for as a possible adverse effect of erythromycin therapy? Prolonged QT interval Jugular vein distention Heart rate of 52 beats/min Grade Ill diastolic murmur

Prolonged QT interval

Which action will the nurse take when a patient develops flushing, rash, and pruritus during an intravenous (IV) infusion of vancomycin? Change the IV tubing. Reduce the infusion rate. Check the patency of the IV. Administer diphenhydramine.

Reduce the infusion rate.

Which assessment data will be collected before administration of vancomycin for treatment of a streptococcal infection to ensure safe administration? Skin integrity Renal function Red blood cell count Blood glucose concentration

Renal function

Which nursing assessment is the priority before administering ampicillin to an 80-year-old patient? Renal function Total body fluid Hepatic function Cross sensitivity

Renal function

Which type of toxicity is the most common toxic effect of vancomycin therapy? Ototoxicity Renal toxicity Hepatotoxicity Cardiac toxicity

Renal toxicity

Which laboratory test results will a nurse monitor in a patient with a Clostridium difficile infection who is prescribed vancomycin? Select all that apply. One, some, or all responses may be correct. Serum electrolytes Creatinine Trough serum levels Alkaline phosphatase Creatine phosphokinase (CPK)

Serum electrolytes Creatinine Trough serum levels

Which side effects will the nurse include when providing discharge teaching related to ampicillin? Bruising and petechiae Skin rash and loose stools Digit numbness and tingling Reddened tongue and gums

Skin rash and loose stools

Which food should be avoided by a patient taking linezolid for treatment of hospital-acquired pneumonia? Yogurt Citrus fruits Smoked meat or fish Food containing excess fiber

Smoked meat or fish

Which drug will the nurse identify as a short-acting tetracycline? Demeclocycline Tetracycline Doxycycline Minocycline

Tetracycline

Which medication is the healthcare provider most likely to use to when treating a patient with acne? Bacitracin Polymyxin Tetracycline Vancomvcin

Tetracycline

Which medication is a bacteriostatic inhibitor of protein synthesis? Select all that apply. One, some, or all responses may be correct. Gentamicin Tetracycline Clindamycin Erythromycin Aminoglycosides

Tetracycline Clindamycin Erythromycin

Which statement is true regarding gram-negative and gram-positive bacteria? Select all that apply. One, some, or all responses may be correct. The gram-negative cell envelope has three layers. Gram-positive bacteria have only two layers in the cell envelope. Gram-negative bacteria have a relatively thick cell wall. Gram-positive bacteria have a relatively thick cell wall. Penicillins in general are very active against gram-positive organisms.

The gram-negative cell envelope has three layers. Gram-positive bacteria have only two layers in the cell envelope. Gram-positive bacteria have a relatively thick cell wall. Penicillins in general are very active against gram-positive organisms.

Which factor determines bacterial resistance to penicillin? Select all that apply. One, some, or all responses may be correct. The rupture of the cell wall The bacteriostatic nature of penicillins The inactivation of penicillins by bacterial enzymes Production of penicilin-binding proteins (BPs) that have a low affinity for penicillins The inability of penicillins to reach their target PBPs

The inactivation of penicillins by bacterial enzymes Production of penicilin-binding proteins (BPs) that have a low affinity for penicillins The inability of penicillins to reach their target PBPs

Which statement is true regarding penicillins? Select all that apply. One, some, or all responses may be correct. They are the safest antibiotics available. The principal effect of penicillins is allergic reaction. They are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins. Allergies to penicillin also influence allergies to vancomycin, erythromycin, and clindamycin.

They are the safest antibiotics available. The principal effect of penicillins is allergic reaction. They are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.

Which generation of cephalosporins is highly resistant to beta-lactamases? Select all that apply. One, some, or all responses may be correct. First-generation cephalosporins Second-generation cephalosporins Third-generation cephalosporins Fourth-generation cephalosporins Fifth-generation cephalosporins

Third-generation cephalosporins Fourth-generation cephalosporins Fifth-generation cephalosporins

Which patient condition is a contraindication for the administration of clindamycin? Arthritis Skin infection Ulcerative colitis Diabetes mellitus

Ulcerative colitis

Which medication is most likely to be offered for treatment of healthcare-associated methicillin-resistant Staphylococcus aureus (HCA-MRSA)? Amoxicillin Clindamycin Tetracycline Vancomycin

Vancomycin

Which infection will the nurse suspect a patient has had in the past when linezolid is listed on a previous medication history? Select all that apply. One, some, or all responses may be correct. Streptococcus pyogenes Streptococcus pneumonia Human immunodeficiency virus (HIV) Vancomycin resistant enterococci (VRE) Methicillin-resistant Staphylococcus aureus (MRSA)

Vancomycin resistant enterococci (VRE) Methicillin-resistant Staphylococcus aureus (MRSA)

Which laboratory result indicates that the patient is having an adverse effect related to linezolid used for treatment of a vancomycin-resistant enterococci (VRE) infection? Glucose level of 200 mg/dL Potassium level of 3.0 mEq/dL Hemoglobin (Hgb) level of 18 g/dL White blood cell (WBC) count of 1200 units/L

White blood cell (WBC) count of 1200 units/L