Pharm Antibiotics
A 32-year-old female patient is admitted to the floor with a superinfection. Her orders read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over 30 to 60 minutes for five days. What would be important for the nurse to educate this patient about? a) Contraceptives b) Antihistamines c) Decongestants d) Analgesics
A
A 76 year old female is taking 6 medications. Her NP starts her on a course of clarithromycin, however s/he recognizes that this drug may present interaction problems with her other medications. This is an example of: A. pharmakokinetics B. pharmacodynamic
A
A nurse has returned to a patient's hospital room for a follow-up assessment during the intravenous infusion of vancomycin. What assessment finding would signal the nurse to the possibility that the patient's infusion is running too quickly? A) The patient is flushed and has a visible skin rash. B) The patient's apical heart rate is irregular C) The patient is difficult to rouse and has dilated pupils D) The patient complains of pain at the IV access site
A
A patient is administered daptomycin (Cubicin) to treat a gram-negative infection caused by Staphylococcus aureus. Which of the following symptoms should be reported immediately to the physician based on the known adverse effects of daptomycin? A) weakness of legs and arms B) decreased wound drainage C) hematuria D) SOB
A
A patient is administered telithromycin (Ketek) to treat a community-acquired pneumonia. A change in what blood level may necessitate a reduction in the dosage? A) creatinine B) AST and ALT C) CPK D) differential
A
A patient is admitted to the emergency room with a diagnosis of Legionnaire's disease and is placed on isolation. Which of the following medications is the drug of choice for Legionnaire's disease? a) Erythromycin (Ery-Tab) b) Meclizine (Antivert) c) Pravastatin (Pravachol) d) Loxapine hydrochloride (Loxitane)
A
A patient is admitted to the emergency room with a diagnosis of Legionnaires' disease and is placed on isolation. Which of the following medications is the drug of choice for Legionnaires' disease? A) Erythromycin (Ery-Tab) B) loxapine hydrochloride C) meclizine D) pravastatin
A
A patient is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which of the following medications will be administered? a) Erythromycin (Ery-Tab) b) Atazanavir (Reyataz) c) Acamprosate calcium (Campral) d) Flumazenil (Mazicon)
A
A patient returns from a trip to the Caribbean and is suffering from severe diarrhea related to E. coli. Which of the following medications is the drug of choice for traveler's diarrhea? A) Rifaximin (Xifaxan) B) spectinomycin C) Chloramphenicol D) erythromycin
A
A patient who is being treated in the intensive care unit has been diagnosed with ventilator-associated pneumonia. Culture and sensitivity testing of the patient's sputum indicates that erythromycin is a treatment option. The nurse knows that this drug is likely contraindicated for what reason? A) erythromycin inhibits normal liver function B) erythromycin is associated with GI upset C) erythromycin is nephrotoxic D) erythromycin cannot be administered orally
A
A patient with acne vulgaris was administered MACROLIDES, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case? a) Inspect stools for blood or mucus. b) Measure urine output. c) Obtain allergy history. d) Record symptoms of infection.
A
An older adult patient has been prescribed telithromycin for community-acquired pneumonia. The nurse has contacted the patient's primary care provider because the patient is on replacement corticosteroid therapy. Why is concomitant use of telithromycin and corticosteroids contraindicated? A) The woman may be unable to adequately metabolize her corticosteroid. B) The effect of the corticosteroid may be greatly increased C) The woman may have increased risk of thromboembolism D) the corticosteroid may negate the efficacy of the telithromycin
A
Erythromycin is the drug of choice for treating a. Legionnaire's disease b. Bacterial endocarditis c. Urinary tract infections d. Acne
A
It is recommended that erythromycin be administered a. With meals b. On an empty stomach c. With iron supplements d. Between meals with large amounts of water
A
The nurse is administering telithromycin (Ketek) to a child with Streptococcus pneumoniae infection. What nursing intervention is implemented when administering this medication? A) Administer the medication with or without food. B) administer with grapefruit juice C) increase dose if QT elongation D) administer with lovastatin
A
The nurse is preparing to discharge a client who has been prescribed telithromycin. The client understands the unique adverse effect associated with this drug when the client makes which statement? a) "This drug may cause visual disturbances so I won't drive until I am finished with the medication." b) "I know that this drug can make me constipated so I will take a laxative every evening." c) "It is common to have a rash when taking this medication, so I will use an anti-itch cream." d) "Some people develop fevers while taking this drug, so I will take aspirin every four hours."
A
The nurse receives a call from a client who is taking clindamycin (Cleocin) and reports of a burning feeling when swallowing. The nurse knows that the client has developed which adverse reaction related to this medication? a) esophagitis b) nausea c) gastritis d) peptic ulcer
A
The physician considers prescribing an oral tetracycline for a patient suspected of having a urinary tract infection. What action needs to be completed before the medication can be prescribed? a) The physician should order culture and susceptibility studies. b) The patient should be assessed for penicillin allergy to rule out cross-allergenicity. c) The patient should be warned of the risk for photosensitivity. d) The patient should be taught how to store the medication appropriately.
A
What patient needs more teaching from the nurse? a) The patient who takes erythromycin with grapefruit juice in the morning b) The patient who takes erythromycin with water and crackers c) The patient who takes erythromycin at night d) The patient who takes erythromycin every morning with breakfast
A
Which of the following organisms are treated with tetracyclines? A) chlamydia trachomatis B) H. influenzae C) mycoplasma D) S. pneumoniae
A
Your client is scheduled to undergo major abdominal surgery. A preoperative order for neomycin has been given. Neomycin is used preoperatively for the following reason: a) To suppress intestinal bacteria. b) To enhance intestinal bacteria. c) To sterilize intestinal bacteria. d) To produce ammonia.
A
Which medications may be administered by the nurse for infections in a patient with a severe penicillin allergy? (Select all that apply) a. Vancomycin b. Erythromycin c. Clindamycin d. Amoxicillin
ABC
A patient with severe sepsis is at risk for pseudomembranous colitis when taking with of the following medications? (Select all that apply) a. Clindamycin (Cleocin) b. Ceftriaxone (Rocephin) c. Amoxicillin (Amoxil d. Miconazole (Zeasorb) e. Ampicillin (Principen
ABCE
The nurse is giving dietary instructions to a client who is taking linezolid and cautions the client to avoid eating which foods while taking this medication? Select all that apply. a) Pepperoni pizza (six slices) b) Cottage cheese (4 oz) c) Red wine (8 oz) d) Lemon lime carbonated beverage (6 oz) e) Decaffeinated coffee (2 cups)
AC
Robin is on gentamicin. The nurse shows understanding of gentamicin when the nurse states that the side effects can include (Select all that apply): a. Ototoxicity b. Seizure c. Angioedema d. Nephrotoxicity
AD
A 22-year-old college student is allergic to penicillin. Consequently, her current chlamydial infection is being treated with oral erythromycin. What assessment should the nurse prioritize during this patient's course of treatment? A) Apical heart rate B) hearing C) peripheral pulses D) renal function
B
A 78-year-old female, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication the nurse discovers that the patient is taking azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? a) It can be given without consideration to drug-drug- interactions. b) It is taken only once a day. c) The half-life of the drug is 3 to 7 hours. d) It has very few adverse effects.
B
A client with a severe staphylococcal infection is receiving the aminoglycoside gentamicin sulfate (Garamycin) by the I.V. route. The nurse should assess the client for which adverse reaction to this drug? a. Aplastic anemia b. Ototoxicity c. Cardiac arrhythmias d. Seizures
B
A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic. a) False b) True
B
A patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline? a) Increased risk for digitalis toxicity b) Increased risk of bleeding c) Increased serum theophylline level d) Decreased effectiveness of tetracycline
B
A patient is diagnosed with the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism? a) Antifungal b) Aminoglycosides c) GABA analog d) Aminopenicillin
B
A patient is receiving gentamicin (Garamycin) 80 mg IV twice daily for acute osteomyelitis. Which action should the nurse take before administering the gentamicin? a. Obtain the patient's oral temperature. b. Review the patient's BUN and creatinine levels. c. Ask the patient about any nausea. d. Change the wet-to-dry dressing.
B
A teenager asks the nurse how tetracycline (Sumycin) will improve her acne. Which of the following is the best statement the nurse can provide to the patient regarding the action of tetracycline? a) "Tetracycline treats the Chlamydia organism that causes acne." b) "Tetracycline interferes with the production of free fatty acids." c) "Tetracycline decreases redness and swelling of the pustules." d) "Tetracycline is used in combination with doxycycline to treat acne."
B
All of the following statements are true regarding beta lactams except: A) Beta lactams are a class of narrow spectrum antibiotics B) Clavulanic acid decreases the spectrum activity C) Probenecid prolongs the half-life D) Inhibit the synthesis of the peptidoglycan layer
B
An acute care NP working in the ER decides that s/he is going to administer a cephalosporin IV in order to achieve a therapeutic range more rapidly. This is an example of: A. pharmakokinetics B. pharmacodynamics
B
Macrolides must be used with caution in clients who have which of the following conditions? a) Hypertension b) Liver dysfunction c) Glaucoma d) Diabetes mellitus
B
When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include: A) Metronidazole is safe in the first trimester of pregnancy. B) Consuming alcohol in any form may cause a severe reaction. C) Sexual partners need concurrent therapy. D) Headaches are a sign of a serious adverse reaction and need immediate evaluation.
B
Which of the following miscellaneous antibacterial drugs is administered topically in the treatment of acne? A) chloramphenicol B) clindamycin C) daptomycin D) tigecycline
B
Tetracyclines may decrease the requirement for which drugs? (Select all that apply) a) Vancomycin (Vancocin) b) Warfarin (Coumadin) c) Atorvastatin (Lipitor) d) Lantus (Glargine) e) Losartan (Cozaar)
BD
A patient has been prescribed chloramphenicol (Chloromycetin) for vancomycin-resistant enterococci. How is this medication eliminated from the body? A) liver B) lungs C) urine D) bile
C
A patient is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which of the following medications will most likely be administered? A) Acamprosate calcium B) atazanivir C) Erythromycin (Ery-Tab) D) flumazenil
C
A patient is allergic to penicillin. Which of the following would be a good substitute? a. cefamandol (Mandol) b. carbenicillin c. erythromycin d. dicloxacillin
C
A patient is seen in the clinic after a bite from a tick. She has a rash over her arms and legs and arthritic pain in the joints. What is the drug of choice for Lyme disease? a) Nitrofurantoin (Macrodantin) b) Ibuprofen (Motrin) c) Tetracycline (Sumycin) d) Phenazopyridine (Pyridium)
C
A patient received erythromycin before dental surgery. The patient has a past history of a cardiac surgery. The rest of the patient's history is unremarkable. What does the nurse teach the patient about this medication? a) "You cannot receive other antibiotics because of your history." b) "This medication will help them remove your tooth easier." c) "You are receiving this medication to prevent the growth of bacteria in your heart." d) "You need this medication to decrease the pain of surgery."
C
A patient who is being administered metronidazole (Flagyl) to treat Clostridium difficile will also be administered which medication orally to assist in restructuring the flora of the intestinal tract? A) spectinomycin B) rifaximin C) vancomycin D) quinupristin-dalfopristin
C
A patient with diabetes who has bacterial pneumonia is being treated with IV gentamicin (Garamycin) 60 mg IV BID. The nurse will monitor for adverse effects of the medication by evaluating the patient's a. blood glucose. b. urine osmolality. c. serum creatinine. d. serum potassium.
C
After teaching a group of students about aminoglycosides, the instructor determines that the teaching was successful when the group identifies which drug as the prototype for this class? a) Tobramycin b) Kanamycin c) Gentamicin d) Neomycin
C
Common side effects that occur after the administration of erythromycin include a. rash, fever, and itching b. urticaria and colitis c. nausea, vomiting, and diarrhea d. shortness of breath
C
Numerous residents of a long-term care facility have developed Clostridium difficile-associated diarrhea over the past week. The nurses at this facility would anticipate that many residents would require which of the following drugs? A) linezolid B) daptomycin C) Metronidazole (Flagyl) D) chloramphenicol
C
There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because: a. Renal excretion is similar in both classes of drug b. When these drug classes are metabolized in the liver they both produce resistant enzymes. c. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-producing organisms. d. There is not an issue with cross-resistance between the penicillins and cephalosporins.
C
Which statement is true concerning macrolides? a) Macrolides cannot kill gram-positive bacteria. b) Macrolides are not absorbed well in body tissues. c) Macrolides are bacteriocidal or bacteriostatic. d) Macrolides are not absorbed in body fluids
C
Your client has been diagnosed with intermittent colitis. You know that the following antibiotic is contraindicated for use in this client: a) Doxycycline. b) Tetracycline. c) Clindamycin. d) Bactrim.
C
Your patient is receiving a multiple-dose regimen of an aminoglycoside. On what serum drug levels will you base the patient's maintenance dose? a) Mean and trough levels b) Peak levels only c) Peak and trough levels d) Mean levels only
C
A nurse is preparing a patient's scheduled dose of oral vancomycin. This patient's current illness was most likely manifested by what sign or symptom? A) Vomiting B) Inflamed, swollen skin C) Shortness of breath D) Diarrhea
D
A patient has been diagnosed with a community-acquired skin infection and has been prescribed linezolid (Zyvox). Which of the following foods should not be eaten during the administration of this medication? A) pasta B) garlic C) green leafy vegetables D) cheddar cheese
D
A patient has developed Clostridium difficile associated with pseudomembranous colitis. Which of the following medications is effective in the treatment of Clostridium difficile? A) Linezolid B) Cladribine C) clarythromycin D) Metronidazole (Flagyl)
D
A patient is diagnosed with peptic ulcer disease. He has been prescribed clarithromycin (Biaxin). Which of the following organisms is this medication used to treat? A) s. pneumoniae B) H. influenzae C) mycobacterium avium complex D) H. pylori
D
A patient states that he has been taking his prescribed clindamycin as ordered, but that it has been causing him to have frequent diarrhea. How should the nurse best respond to this patient's statement? A) Reemphasize the importance of taking clindamycin with food. B) Encourage the patient to temporarily use an over-the-counter antidiarrheal. C) Encourage the patient to increase his fluid intake until the course of treatment is complete. D) Liaise with the patient's care provider to have the drug discontinued.
D
Aminoglycosides are used primarily in the treatment on what type of infection? (Choose one) a) Fungal infections b) Viral infections c) Gram-positive infections d) Gram-negative infections
D
An adult patient has been diagnosed with bacterial sinusitis, and her care provider has prescribed oral erythromycin. The nurse has cautioned the patient against taking the drug together with antacids because this practice A) delays metabolism of the drug B) can exacerbate nausea and reflux C) causes a dangerous rise in gastric pH D) decreases the absorption of the drug
D
In preparation for discharge, the nurse is teaching a client about the prescription for telithromycin. The nurse should instruct the client to contact a health care provider if the client experiences: a) increased appetite. b) leg pain. c) pale urine. d) yellowing of the eyes or skin.
D
It is recommended that fluoroquinolones be reserved for treatment of: a. Urinary tract infections in young women b. Upper respiratory infections in adults c. Skin and soft tissue infections in adults d. Community-acquired pneumonia in patients with comorbidities
D
Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be: A) Penicillin VK, because his rash does not sound like a serious rash B) Amoxicillin C) Cefadroxil (Duricef) D) Azithromycin
D
The nurse is administering TELITHROMYCIN (Ketek) to a child with Streptococcus pneumoniae infection. What nursing intervention is implemented when administering this medication? a) Administer the medication with grapefruit juice b) Increase the dose in the event of QT elongation c) Administer the medication with lovastatin d) Administer the medication with or without food
D
The nurse is preparing to administer amikacin to a client with a complicated Staphylococcus aureus infection. What assessment should the nurse prioritize? a) Gastrointestinal function b) Muscle strength c) Nutritional status d) Renal function
D
The patient in the intensive care unit is receiving gentamicin for pneumonia from Pseudomonas. What assessment results should the nurse report to the health care provider? a. Decreased weight b. Increased appetite c. Increased urinary output d. Elevated creatinine level
D
Which of these clients would the nurse monitory for the complication of C. difficile diarrhea? a. An adolescent taking medications for acne. b. An elderly client living in a retirement center taking prednisone. c. A young adult at home taking a prescribed aminoglycoside. d. A hospitalized middle aged client receiving clindamycin.
D
patient is given tetracycline (Sumycin) to treat acne-related skin eruptions. How does tetracycline work? a) It reduces central nervous system stimulation. b) It works on the final stage of cell wall synthesis. c) It is a beta-lactam antibiotic inhibiting cell wall synthesis. d) It binds to the 30S ribosome to inhibit protein synthesis.
D
Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. The appropriate antibiotic to prescribe would be:
ERYTHROMYCIN
Which patient should not receive erythromycin as ordered at 8 a.m.?
The patient with elevated liver enzymes
