Pharm Chapter 9: Antibiotics, Pharmacology Prep U Chapter 9 Antibiotics, Pharm 9, PrepU Chapter 9

A young lifeguard has been prescribed moxifloxacin (Avelox). The nurse understands that the focus on education would be which adverse reaction?

Photosensitivity

What is an important precaution of fluoroquinolones that should be included in the client teaching?

Tendon Rupture

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, causing another infection to occur."

The health care provider is preparing to order rifampin and pyrazinamide for a female client with active tuberculosis. What question should the provider ask this client before confirming this order?

"Are you pregnant?"

A client has been prescribed INH for the treatment of tuberculosis. The nurse teaches the client about dietary restrictions while taking this medication. What is the most important instruction?

"Do not drink beer or red wine while taking this medication because a serious adverse reaction can occur."

After teaching a client who is receiving doxycycline about the drug, the nurse determines that the teaching was successful when the client makes what statement?

"I need to wear protective clothing when I'm out in the sun."

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

A nurse is teaching a client about the medication regimen surrounding fluoroquinolones. Which statement made by the client would indicate the need for additional education?

"I will only drink enough water to swallow the drug."

The clinic nurse is responsible for teaching a client about a new prescription for doxycycline. The nurse should increase which instruction in the teaching?

"Limit your exposure to the sun."

The nurse is caring for a client whose prescribed course of cefaclor will soon be completed. What health education should the nurse provide to the client?

"Make sure to avoid drinking any alcohol for the next three days."

A pregnant woman calls the clinic and asks if it is suitable to use ofloxacin otic drops that she used prior to pregnancy for a current ear infection. What would be an appropriate response from the nurse?

"The effects of ofloxacin in pregnancy are not known, so the drug should not be used while pregnant."

A client diagnosed with tuberculosis (TB) has begun multi-drug therapy. The client has asked the nurse why it is necessary to take several different drugs. How should the nurse respond to the client's question?

"The use of multiple drugs prevents the development of drug-resistant TB."

An adult client prescribed trimethoprim-sulfamethoxazole should receive what information concerning potential adverse effects?

"This drug might make your stomach a bit upset, so let me know if you experience that."

A client has just been diagnosed with TB. The client is extremely upset and is asking questions concerning the medications. What is an appropriate response by the nurse?

"You will have multidrug therapy for 6 to 24 months."

A patient has just been diagnosed with TB. She is extremely upset and is asking questions concerning the medications she will have to take and how long she will have to take them. Which of the following is an appropriate response by the nurse?

"You will have multidrug therapy for 6 to 24 months."

A client is to receive rifampin. Which would be most important for the nurse to include in the teaching plan for this client?

"Your urine or sweat may become orange in color."

A client is prescribed isoniazid and rifampin for the treatment of active tuberculosis (TB). The client's medication education should stress that initial symptom improvement is likely to take how long?

2 to 3 weeks

Levofloxacin 750 mg IV is ordered for a client with a urinary tract infection. The medication is to mixed yielding 250 mg/15 mL. How many mL should be drawn up in the syringe?

45

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching?

A cross-sensitivity reaction.

Beta-lactam antibacterial drugs, such as penicillins and cephalosporins, combat infection by binding to proteins in bacterial cell membranes. What does this binding produce?

A defective cell wall

A patient seen in the clinic has symptoms of persistent cough, fever, and night sweats. He recently entered the United States from the Philippines. From what condition is the patient suffering?

Active tuberculosis

A nurse works in a community setting and follows clients who have TB. Which clients would likely require the most follow-up from rifampin therapy?

An HIV-positive client

A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction?

Antacids decrease the absorption of the drug.

A 25-year-old female patient who presents at the clinic with vaginal discharge and discomfort is diagnosed with chlamydia. The nurse knows that the drug of choice to treat this infection is doxycycline. What would be a priority assessment for this patient before beginning the medication?

Asking the patient if she is pregnant Tetracyclines, such as doxycycline, are contraindicated in pregnant women and in children under 8 years of age.

A patient with TB has been admitted to a health care facility. When providing instructions for the patient teaching related to antitubercular drugs, which instructions should the nurse provide in order to avoid complications in the patient's GI tract?

Avoid the consumption of alcohol.

A client with a positive sputum culture for TB has been started on streptomycin antitubercular therapy. Upon review of the laboratory results, the nurse notes that the client may be experiencing toxicity if which of the following results is abnormal?

BUN and creatinine

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 administering the drug in separate IV bags

After teaching a group of students about cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as a cephalosporin?

Cefaclor

Culture and sensitivity testing of a client's urine sample reveals a bacterium that is susceptible to cephalosporins. What medication would be most likely for the nurse to administer?

Cefaclor

Which of the following drugs would be classified as a third-generation cephalosporin?

Ceftazidime

After teaching a group of students about carbapenems, the instructor determines the need for additional teaching when the students identify what as an example?

Cefuroxime

An older adult client, diagnosed with community-acquired pneumonia, has been prescribed aztreonam. What action should the nurse perform before administering the first dose?

Confirm the client's allergy status

A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?

Culture tests The nurse should check whether culture tests are conducted before the first dose of drug is administered to the client. Ulcer tests and stool tests are not required to be conducted before administering the first dose of an anti-infective drug to the client. The nurse has to ensure that urinalysis is conducted before the administration of the drug but not specifically before the first dose of the anti-infective drug.

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?

Decrease the drug dose

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

Which nursing diagnoses are used with fluoroquinolones therapy? Select all that apply.

Diarrhea Acute Pain Risk for Impaired Comfort Risk for Impaired Skin Integrity

Which of the following symptoms may indicate optic neuritis resulting from the use of ethambutol?

Difficulty differentiating between red and green A major adverse effect associated with ethambutol is optic neuritis, an inflammatory, demyelinating disorder of the optic nerve that decreases visual acuity and ability to differentiate red from green.

A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event?

Discontinue the infusion and inform the care provider promptly. Severe hypersensitivity reactions have occurred with the administration of fluoroquinolones. The nurse discontinues the antibiotic immediately if skin rash or other signs or symptoms occur. Administration of acetylcysteine or diphenhydramine is not indicated. Slowing down the rate of infusion would not address the problem as it relates to exposure to the medication. Neither the administration of acetylcysteine nor diphenhydramine is indicated initially. Acetylcysteine is prescribed to treat thick mucus lung secretions. Treatment with diphenhydramine would be ineffective if the ciprofloxacin were not first discontinued.

Aminoglycosides due to their low risk of toxicity are replacing many of the other antibiotics today. True or False?

False Aminoglycosides have potentially serious adverse effects, thus they are being replaced by newer, less toxic drugs in the treatment of serious infections.

Which of the following drugs would be classified as an aminoglycoside?

Gentamicin

A client diagnosed with tuberculosis was prescribed antitubercular therapy but stopped after 1 month because of difficulty with the medication scheduling. As a result, secondary drugs are being prescribed. Which nursing diagnosis would the nurse most likely identify?

Ineffective Self-Health Management Difficulties with scheduling most likely led to the client not adhering to the treatment plan. As a result, the nursing diagnosis of Ineffective Self-Health Management would be most appropriate. Although nutrition can be affected, there is no indication that this is the problem. Although the client may have difficulty coping with the disease, there is no indication that this is a problem. The client may experience discomfort related to the adverse effects of the drug; however, there is no indication that this is an issue.

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

Your client is 32 weeks pregnant. She has just been diagnosed with a urinary tract infection. You know that tetracycline is contraindicated for her because

It can cause a life-threatening toxicity for the fetus.

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?

It inhibits cell wall synthesis. Beta-lactam antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes. Penicillin V does not inhibit protein synthesis. Penicillin V does not inhibit protein synthesis, cause mutations, or lower the pH of a bacterium's cellular contents.

A male client is prescribed aminoglycosides for a bladder infection secondary to benign prostatic hypertrophy. The nurse understands that these drugs reach higher concentrations in which areas of the body? (Select all that apply.)

Kidneys Inner ears

In which condition present in the client should macrolides be used with caution?

Liver dysfunction

A male client is placed on an IV regimen of aztreonam. The nurse would expect the physician to order which laboratory test?

Liver function Aztreonam, imipenem, meropenem, and ertapenem may cause abnormalities in liver function test results

A client is receiving rifampin and isoniazid in combination for treatment of tuberculosis. What would the nurse need to monitor closely?

Liver function studies

An elderly patient comes to the clinic and informs the nurse that he feels as if his ear is clogged. He states that he frequently has to have his ears irrigated to get out the wax. He asks the nurse what causes this wax build-up. What is the nurse's best response?

Modified sweat glands in the ear canal

A 72-year-old patient with TB is undergoing standard treatment in a health care facility. Which of the following nursing interventions should the nurse perform during ongoing assessment of the treatment?

Monitor for appearance of adverse reactions.

A 75-year-old patient with a history of renal impairment is admitted to the primary health care center with a UTI and has been prescribed a cephalosporin. Which of the following interventions is most important for the nurse to perform when caring for this patient?

Monitoring blood creatinine levels.

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?

Nausea

The nurse should monitor the client for which common side effects of erythromycin therapy?

Nausea, vomiting, and diarrhea

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

The nurse is assisting in the admission of a client with a suspected urinary tract infection and an oral temperature of 100.9 degrees ferenheit. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?

Obtain urine for culture and sensitivity.

When administering aminoglycosides, the nurse must be aware of which of the following adverse reactions?

Ototoxicity and nephrotoxicity

An instructor is describing an antibiotic that is resistant to the enzyme penicillinase. What would the nurse identify as an example?

Oxacillin

Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies?

Penicillin

Your client has been diagnosed with streptococcal pharyngitis. Which of the following would you anticipate being ordered?

Penicillin G

Your client is being treated for streptococcal pharyngitis and is NPO. Her health care provider has ordered Penicillin G to be given IM. She wants to know why she cannot take her medications via an oral route. Your best response is

Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.

The nurse is caring for a client who is receiving IV vancomycin. The nurse infuses the medication at the prescribed rate to prevent what from occurring?

Red man syndrome With this syndrome, the client's face and upper trunk becomes bright red, and it has led to cardiovascular collapse.

The nurse is aware that sulfonamide therapy is used cautiously in older adults because of decreased function of what organ system?

Renal

A 72-year-old female clinic patient is started on trimethoprim-sulfamethoxazole for treatment of a urinary tract infection. Prior to administering this drug, the nurse should assess the patient for which of the following conditions?

Renal Impairment

A client is started on sulfamethoxazole-trimethoprim (Bactrim) for a urinary infection. What adverse effect should the nurse assess with this client?

Renal damage

A group of students are reviewing information about drugs used to treat tuberculosis. The students demonstrate understanding of the material when they identify which drug as a first-line treatment option?

Rifampin

A nurse is caring for a patient undergoing the second phase of standard TB treatment. The nurse knows that which of the following combinations of drugs need to be administered to the client?

Rifampin and isoniazid

A client is receiving a cephalosporin and an aminoglycoside as combination therapy. What assessment should the nurse prioritize?

Serum BUN and creatinine levels

The nurse is caring for a client who is taking tetracycline for Rocky Mountain spotted fever. The nurse notices that the client has developed painful mouth ulcers. The nurse knows that the client has developed what adverse reaction to the medication?

Stomatitis

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:

Super infection

Mr. Toma is prescribed ciprofloxacin for a urinary tract infection. The nurse is preparing to teach him about the medication. What must the nurse include in the education plan?

Take precautions to prevent photosensitivity. Encourage the patient to take precautions to avoid sunlight or ultraviolet light.

The nurse understands that which is the highest priority when teaching about antitubercular medications?

Taking medications as prescribed

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

Which statement is true in regards to the oral administration of tetracyclines?

Tetracyclines should be administered with a full glass of water

Which statement is true in regard to the oral administration of tetracyclines?

Tetracyclines should be administered with a full glass of water.

The nurse has administered a patient's first scheduled dose of amoxicillin after the patient was diagnosed with acute otitis media. What subsequent assessment finding should prompt the nurse to discontinue the use of this drug?

The patient complains of shortness of breath. Shortness of breath is suggestive of a hypersensitivity reaction and would likely warrant discontinuation of the drug.

A client is prescribed rifampin. What information should the nurse include in the client's medication education?

The urine, tears, sweat, and other body fluids will be a discolored red-orange.

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?

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?

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

A client is asking how fluoroquinolones work. What is the nurse's best response?

They interfere with the DNA of the bacteria.

A client asks the purpose for using three medications in combination to treat his tuberculosis. The nurse informs the client that multiple medications are given for which of the following reasons?

To prevent resistance

The nurse is caring for a client who is taking a sulfonamide and notices that the client has developed itchy hives. After contacting the health care provider, what term will the nurse use to describe the client's symptoms?

Urticaria Hives or itchy wheals on the skin resulting from contact with, or ingestion of, an allergic substance is known as urticaria. Pruritis is simple itching. Toxic epidermal necrolysis is sloughing of skin and mucous membranes. Stevens-Johnson syndrome consists of fever, cough, muscular aches and pains, headache and lesions of the skin (blisters or wheals).

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?

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

The nurse is giving discharge instructions to a woman who will be taking amoxicillin for treatment of acute otitis media. The nurse teaches the client that which symptom indicates the development of a superinfection and should be reported to the physician?

Vaginal itching and discharge

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?

Vomiting and diarrhea Although headache and dizziness, superinfections, and phlebitis (with intravenous administration) can occur, the most common adverse effects of cephalosporins involve the GI tract and include vomiting, diarrhea, nausea, anorexia, abdominal pain, and flatulence.

Extreme caution would be necessary with the use of gentamicin in which client?

a client who has chronic renal failure secondary to diabetes mellitus

When providing health education to a client prescribed isoniazid, the nurse should emphasize the need to avoid what element?

alcohol

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

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

A 9-year-old client has been admitted to the pediatric unit after being diagnosed with pertussis. The pediatric nurse is processing the client's admission orders and notes that IV demeclocycline has been prescribed. After beginning this treatment, the nurse should confirm the results of what laboratory test?

blood urea nitrogen (BUN)

A client previously experienced an anaphylactic reaction to penicillin G. Which medication should not be administered to this client due to the potential for cross-sensitivity?

cefadroxil

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:

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

Which drug is a first-generation cephalosporin used as a surgical prophylaxis?

cefazolin

A client prescribed rifaximin for diarrhea has developed frank bleeding in the stool. What intervention should the nurse anticipate being implemented to best ensure client safety?

changing to a different antibiotic

When reviewing an older client's most recent laboratory values, which finding may contraindicate the use of tetracycline?

creatinine of 2.8 mg/dL (247.52 µmol/L) (high)

A patient has been admitted to the intensive care unit with signs and symptoms of sepsis and preliminary results of the patient's initial blood cultures reveal the presence of methicillin-resistant Staphylococcus aureus (MRSA). This finding is an indication for treatment with

daptomycin. Daptomycin is FDA approved for treatment of bacteremia due to S. aureus (including MRSA). Ciprofloxacin, levofloxacin and polymyxin B are not typically used in cases of MRSA sepsis.

A client, hospitalized with active tuberculosis, is receiving antitubercular drug therapy. When it becomes apparent that the client is not responding to the medications, what condition will the primary health care provider identify as a possible cause?

drug-resistant tuberculosis

A client is allergic to penicillin and has been diagnosed with a genitourinary infection caused by Chlamydia trachomatis. Which medication will most likely be administered?

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

Which medication is the drug of choice for Legionnaires disease?

erythromycin

What potential adverse reaction is most likely to develop during cefazolin therapy?

gastrointestinal upset

After teaching a group of students about the indications for use for aminoglycosides, the instructor determines that the teaching was successful when the students identify which type of infection as a primary indication?

gram-negative infections

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:

he should wear glasses during the therapy.

A nursing instructor is preparing a teaching plan for a nursing pharmacology class on the action of fluoroquinolones. Which action would the instructor most likely include?

interfering with DNA synthesis in the bacterial cell

A client being treated for tuberculosis (TB) is determined to be drug resistant. Which medications will no longer be effective in the treatment of the tuberculosis?

isoniazid (INH) and rifampin (RIF) Isoniazid (INH) and rifampin (RIF) are used to treat tuberculosis. In multidrug resistance, the most effective drugs the client is resistant to are isoniazid and rifampin. Carbamazepine and phenytoin are used to control seizures. Dextroamphetamine and doxapram are central nervous system stimulants. Propranolol and sotalol are beta-adrenergic blocking agents.

A client is prescribed isoniazid (INH) for a diagnosis of tuberculosis (TB). Which adverse effect will result in discontinuation of the medication?

jaundice

A client taking isoniazid is worried about the side effects/adverse reactions. The nurse tells the client that a common adverse reaction of isoniazid is which of the following?

jaundice

What adverse effect would most likely necessitate discontinuing treatment with isoniazid?

jaundice

A 35-year-old man being treated with isoniazid (INH) for exposure to TB has this medical history: diabetes mellitus type 2, hypertension, hyperlipidemia, and coronary artery disease. He drinks one to two glasses of wine on the weekend and smokes two packs of cigarettes per day. Which adverse reaction should the nurse alert the client to report to his health care provider right away?

numbness and tingling in his feet

A nurse is caring for an older adult client with tuberculosis. The client has been prescribed ethambutol. Which adverse reactions of ethambutol should the nurse assess for?

optic neuritis

A 25-year-old woman is being treated with penicillin G as prophylaxis to prevent bacterial endocarditis prior to a dental procedure. The nurse should question the client concerning her the use of:

oral contraceptives

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

penicillins

What event triggers the development of a superinfection?

proliferation of antibiotic-resistant microorganisms

A critical care nurse is caring for a client taking aminoglycosides. The dosage may need to be adjusted if the nurse finds monitored changes in what system?

renal function

A nurse is speaking to a 62-year-old female client who has been started on sulfisoxazole, a sulfonamide antibiotic. The nurse should teach this client to contact the health care provider if the client experiences what adverse effect associated with the drug?

skin rash or itching

A young adult client's acne has responded well to treatment with tetracycline. However, the client has now returned to the clinic 6 weeks later with signs and symptoms of oral candidiasis. The nurse should recognize that this client's current health problem is likely attributable to which occurrence?

superinfection following the eradication of normal oral flora

A client newly diagnosed with syphilis is allergic to penicillin. What medication should this client be prescribed?

tetracycline

A client, being treated for latent tuberculosis (TB) on an out-client basis, tells the nurse, "I've been feeling pretty good lately, so I haven't actually been all that consistent with taking my drugs." Subsequent health education by the nurse should focus on what subject?

the need to consistently take the prescribed drugs in order to cure TB

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

A nurse is preparing to administer a fluoroquinolone. Which infections are treated with fluoroquinolones? Select all that apply.

• skin infections • urinary tract infections • sexually transmitted disease

A nurse is teaching a client how to apply a topical sulfonamide to a burn. Which statement by the client would indicate that the teaching was effective?

"I will apply it in a very thin layer over the area."

A client has been prescribed 4 g of sulfamethoxazole/trimethoprim tablets per day. The available drug is in the form of 500 mg. The nurse would administer how many tablets each day?

8

A patient receiving isoniazid (INH) and rifampin has a decreased urinary output and decreased sensation in the great toes. Which laboratory values should be assessed?

ALT and AST

A patient has a diagnosis of otitis media and has just begun antibiotic treatment. The patient complains of otalgia and has asked for medication. The nurse should anticipate the administration of

Acetaminophen (Tylenol) Tylenol is the first-line analgesic for most cases of otalgia accompanying otitis.

The ability of bacteria to produce substances that inactivate or destroy the antibiotic is known as which of the following?

Bacterial resistance

Drugs that destroy bacteria are known as which type of drug?

Bactericidal

Drugs that destroy the bacteria are known as which of the following? (Choose one)

Bacteriocidal

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?

Cell wall synthesis

A nurse is providing education to a client who is taking INH. The nurse is teaching the client to avoid which foods?

Cheese, dairy products, and bananas

A public health nurse interacts with many members of the community who are at risk for sexually transmitted infections (STIs). The nurse should anticipate the use of tetracycline in a client who is diagnosed with what STI?

Chlamydia

Oral ampicillin has been ordered for a client whose urinary tract infection will be treated in a home setting. When providing antibiotic teaching to this client, the nurse should stress which instruction?

Drink a full glass of water when taking a dose of the drug

A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

Drug-resistant tuberculosis

Because of their low risk of toxicity, aminoglycocides are replacing many of the other antibiotics today.

False

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?

Gentamicin

A client is diagnosed with community-acquired pneumonia, and the physician orders telithromycin. What is the mechanism of action for this antibiotic?

Inhibition of microbial protein synthesis

What is the rationale for not administering tetracycline to children under the age of 8 years?

It will interfere with enamel development.

Ms. Tom, age 24, is prescribed cefazolin for a sinus infection. After administration of the first dose of the medication, Ms. Tom complains of itching. Your nursing assessment reveals a rash over her torso; also, you note that she has a history of allergic reaction to penicillin. What would explain your findings?

Ms. Tom is experiencing an allergic reaction caused by a cross-sensitivity reaction. Because of the structural similarities between cephalosporins and penicillins, patients who are allergic to one type of drug may experience cross-sensitivity to the other.

The nurse is assisting in the admission of a client with a suspected urinary tract infection. The health care provider has written the following orders: acetaminophen 500 mg PO for elevated temperature; urinalysis for culture and sensitivity; sulfasalazine (Azulfidine) 500 mg PO four times daily; and force fluids to 3 L/day. Which order will the nurse complete first?

Obtain urine for culture and sensitivity.

A patient with TB is admitted to a health care facility. The nurse is required to administer an antitubercular drug through the parenteral route to this patient. Which of the following precautions should the nurse take when administering frequent parenteral injections?

Rotate injection sites for frequent parenteral injections.

The drug's effect on what best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?

Teeth

The drug's effect on which of the following best reflects the major reason for avoiding the use of tetracyclines in children under 8 years of age?

Teeth Tetracyclines should be used with caution in children younger than age 8 years because the drugs can potentially damage developing teeth and bones.

Tetracyclines should not be used in children younger than 8 years of age because of their effects on:

Teeth and bones

A client with a complex medical history is showing signs and symptoms of sepsis. What aspect of this client's health history would rule out the safe and effective use of an aminoglycoside antibiotic?

The client has chronic renal failure

The client has been taking her antibiotic for five days. She tells the nurse that she is now experiencing vaginal itching and discharge. The nurse suspects what has occurred?

The client has developed a superinfection.

The nurse is caring for a client taking sulfonamides. The nurse observes sloughing of the skin and mucous membranes. The nurse suspects which hypersensitivity reaction?

Toxic epidermal necrolysis

A client's risk for ototoxicity, nephrotoxicity, and neurotoxicity increases dramatically if he or she receives an aminoglycoside in conjunction with a potent diuretic.

True

A nursing student studying pharmacology is focusing on drugs used to treat tuberculosis (TB). This student correctly identifies the classifications of antitubercular drugs as which of the following?

When classifying antitubercular drugs there are primary (first-line) and secondary (second-line) drugs. Primary drugs provide the foundation for treatment. Secondary drugs are less effective and more toxic than primary drugs.

The nurse should advise the client to avoid taking which medication at the same time as a fluoroquinolone?

antacids

A client is being treated for a urinary tract infection with trimethoprim-sulfamethoxazole. What assessment should the nurse make prior to the administration of the medication?

assessing for renal insufficiency

The physician is selecting an antibiotic for a patient with a known penicillin allergy. The physician knows that cephalosporins are a poor choice for this patient because cephalosporins

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

A client is diagnosed with an infection. What would the nurse anticipate being used to determine the best drug to treat the infection?

culture and sensitivity (C&S)

When fluoroquinolones are administered intravenously, the nurse would check the needle site and area around the needle site for extravasation at which frequency?

every hour

A youngster has just returned home from the family's tropical vacation and is now reporting worsening tenderness in the right ear. When the child is diagnosed with otitis externa, what causative factor of this infection should the nurse focus upon?

frequent swimming and water sports while the child was on vacation

A client has been admitted with leprosy. The nurse completes the health history and physical examination. In addition to a thorough assessment of the skin, what other areas of the body would be important to assess? (Select all that apply.)

peripheral nerves mucosa of the gastrointestinal tract

When instructing the client with tuberculosis (TB) about the drug Isoniazid, the nurse advises that the most common symptom of toxicity is:

peripheral neuropathy.

A client is receiving levofloxacin (Levaquin) IV. During an infusion, the client reports pain and the nurse notes a reddened area along the vein. What does the nurse suspect?

phlebitis

A patient has been treated several times for a recurring ear infection with ofloxacin. The nurse instructs the patient to look for side effects from the prolonged use of the antibiotic and informs the patient that this is known as which of the following?

superinfection

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:

yellowing of the eyes or skin

The nurse would question the use of sulfonamide therapy in which client? Select all that apply.

• 18-month-old female client • breastfeeding client 32 years of age

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

After teaching a group of nursing students about the different classes of drugs, the instructor determines that the teaching was successful when the students identify drugs that slow or retard the multiplication of bacteria as which types of medication?

Bacteriostatic

A client is diagnosed with VRE, and the physician orders chloramphenicol. The nurse should monitor the client for the development of which side effect?

Blood dyscrasias

Tuberculosis is transmitted when a previously uninfected person inhales infectious particles that have been exhaled by an infected individual. In the approximately 30% of exposed individuals who become infected following exposure, spontaneous healing typically begins within six months. What physical change does the disease create in the infected person?

Calcified tubercles

You are the clinic nurse responsible for teaching a patient about his new prescription for doxycycline. Which of the following instructions should you include in your teaching?

"Limit your exposure to the sun." Tetracyclines increase sensitivity to sunlight, placing the patient at increased risk of sunburn. Antacids can decrease the effects of tetracyclines.

The nurse is giving instructions to a client age 77 years who has been prescribed a sulfonamide for treatment of a urinary tract infection. The nurse has instructed the client to increase fluids while taking this medication. What does the nurse anticipate will be the client's greatest fear related to this instruction?

Fear of incontinence.

The nurse knows that sulfonamides are chosen to treat ulcerative colitis because of what action?

Inflammation is decreased because of interaction with intestinal bacteria.