ANTIBIOTICS PQ
A nurse should teach a patient to observe for which side effect when taking ampicillin (Polycillin)? A. Skin rash and loose stool B. Reddened tongue and gums C. Digit numbness and tingling D. Bruising and petechiae
A Ampicillin's most common side effects are rash and diarrhea; both reactions occur more frequently with ampicillin than with any other penicillin. Reddened tongue and gums, digit numbness and tingling, and bruising and petechiae are not associated side effects of ampicillin.
A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: A. disinhibit transpeptidases. B. disrupt bacterial cell wall synthesis. C. inhibit autolysins. D. inhibit host cell wall function.
B
A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to infuse. When should the nurse plan to obtain a blood sample for a peak serum level of gentamicin? A. 1000 B. 1030 C. 1100 D. 1130
B
Aminoglycosides are primarily used for infections by what type of pathogen? A)Yeast and fungi B) Gram negative bacteria only C) Both Gram negative and Gram positive bacteria D) Gram positive bacteria only
B
Before administering intravenous (IV) penicillin, the nurse should do what? A. Flush the IV site with normal saline B. Assess the patient for allergies. C. Review the patient's intake and output record. D. Determine the latest creatinine clearance result.
B
The development of a new infection as a result of the elimination of normal flora by an antibiotic is referred to as what? A. Resistant infection B. Superinfection C. Nosocomial infection D. Allergic reaction
B
The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high? A) Concentration B) Trough C) Peak D) Dose
B
The patient is schedules for colorectal surgery tomorrow. He does not have sepsis, his white blood count is normal, he has no fever and he is otherwise in good health. However there is an order to administer an antibiotic on call before he goes to surgery. The nurse knows that the rationale for this antibiotic order is to A. provide empiric therapy B. provide prophylactic therapy C. treat for superinfection D. reduce the number of resistant organism
B
A client has been receiving a cephalosporin for 20 days to treat a severe bacterial infection. The client complains of mouth pain, and the nurse assesses white patches in the clients mouth. What is the highest priority action on the part of the nurse? a. Provide mouth care with glycerin swabs. b. Encourage the client to drink more fluids. c. Notify the physician and describe symptoms. d. Administer analgesia for the mouth pain.
C
A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? A) Unsteadiness B) Vertigo C) Headache D) Dizziness
C
A teenage patient is taking a tetracycline drug as part of treatment for severe acne. when the nurse teaches this patient about drug related precautions, which is the most important info to cover. A when the acne clears up the medication may be discontinued B. this med needs to be taken with antacids to reduce GI upset C. the patient meeds to use sunscreen or avoid exposure to sunlight, because this drug may cause photosensitivity D. the teeth sound be observed closely for signs of mottling or other color changes
C
The nurse should assess a patient for nephrotoxicity and ototoxicity when administering which antimicrobial?A. cefazolin B. clindamycin C. gentamicin D. erythromycin
C
The nurse considers administration of gentamycin. Which of the following is not a side effect of this medication? A) Anorexia B) Ototoxicity C) Nephrotoxicity D) Diaphoresis E) Nausea
D
You are the nurse taking care of a patient being treated with metronidazole for a lower gastrointestinal infection. Which of the following instructions should you give the patient? "Do not eat spinach when taking this medication." "Avoid operating heavy machinery while taking this medication." "Do not take your cholesterol medication when taking this medication." "Lie flat for 30 minutes after taking this medication." "Do not consume alcohol while taking this medication."
Do not consume alcohol while taking this medication
A patient is receiving penicillin G (Bicillin C-R). Which assessment should the nurse monitor as an indicator of an undesired effect? A. Cardiac rhythm B. Serum sodium level C. Lung sounds D. Red blood cell (RBC) count
A
A client is ordered to receive a cephalosporin to treat a bacterial infection. Regarding monitoring of the client, the highest priority action on the part of the nurse includes assessing the client for which side effects? a. Nausea, vomiting, and diarrhea b. Photophobia and phototoxicity c. Pain with urination and blood in the urine d. High fevers and sweating
A
A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin [Vancocin]. Which action should a nurse take? A) Reduce the infusion rate. B) Administer diphenhydramine [Benadryl]. C).Change the IV tubing. D)Check the patency of the IV.
A
A patient is receiving an aminoglycoside (tobramycin) antibiotic. A nurse asks the patient to choose daily meal selections, to which the patient responds, "Oh, dear, I don't want another IV." The nurse makes which assessment about the patient's response? A) Some hearing loss may have occurred. B) The confusion is due to the hospital stay. C) A nutrition consult most likely is needed. D) The patient has a family history of dementia.
A
After completing a course of ciprofloxacin [Cipro] for a skin infection, the patient says, "I took the whole bottle of pills, but my infection hasn't gotten any better." Which additional information should the nurse recognize as most significant? A) The patient takes antacids on a daily basis. b) The medication was stored in a cool, dry area. C) The patient did not use sunscreen while taking the ciprofloxacin [Cipro]. D) The patient took two doses of diphenhydramine [Benadryl] while on ciprofloxacin [Cipro] therapy.
A
An older adult patient with a urinary tract infection has been prescribed ciprofloxacin. What route of administration is most commonly used for the administration of ciprofloxacin? A) Oral B) Intravenous C) Subcutaneous D) Intramuscular
A
Both IV ampicillin/sulbactam (Unasyn) and gentamicin (Garamycin) are ordered for a patient. When administering these medications, the nurse will do what? A. Ensure that separate IV solutions are used. B. Use two different peripheral IV sites. C. Administer the gentamicin first. D. There are no necessary precautions.
A
The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 mcg/mL to 2.2 mcg/mL. What will the nurse expect the patient to experience? a. Inadequate drug effects b. Increased risk for superinfection c. Minimal adverse effects d. Slowed onset of action
A
The nurse must administer a tetracycline antibiotic to a patient who takes an oral calcium supplement with each meal. When should the nurse administer the tetracycline? A. 2 hours before meals B. 30 minutes before meals C. with meals D. 1 hour after meals
A
Which statements about vancomycin (Vancocin) does the nurse identify as true? (Select all that apply.) A. Vancomycin is the most widely used antibiotic in U.S. hospitals. B. Vancomycin is effective in the treatment of Clostridium difficile infection. C. Vancomycin is effective in the treatment of MRSA infections. D. Patients who are allergic to penicillin are also allergic to vancomycin. E. The major toxicity of vancomycin therapy is liver failure.
A,B,C
The nurse identifies appropriate use of antimicrobials to prevent infection in which situations? (Select all that apply.) A. Cardiac surgery B. Recurrent urinary tract infections in women C. Anemia D. Treatment of fever of unknown origin E. Hysterectomy
A,B,E
The nurse identifies which statements about penicillins as true? (Select all that apply.) A. Penicillins are the safest antibiotics available. B. The principal adverse effect of penicillins is allergic reaction. C. A patient who is allergic to penicillin always has a cross-allergy to cephalosporins. D. A patient who is allergic to penicillin is also allergic to vancomycin, erythromycin, and clindamycin. E. Penicillins are normally eliminated rapidly by the kidneys but can accumulate to harmful levels if renal function is severely impaired.
A,B,E
A nurse should recognize that antibiotic prophylaxis is appropriate in patients with which medical conditions? (Select all that apply.) A. Aortic valve replacement B. Ruptured appendix C. Bronchitis D. Neutropenia E. Chickenpox
A,D
Which are examples of the improper use of antibiotic therapy? (Select all that apply.) A. Using surgical drainage as an adjunct to antibiotic therapy B. Treating a viral infection C. Basing treatment on sensitivity reports D. Treating fever in an immunodeficient patient E. Using dosing that results in a superinfection
B,E
An immunocompromised patient who is receiving piperacillin/tazobactam (Zosyn) develops oozing and bleeding from the gums. Which additional data should the nurse determine? A. Whether the patient has a fever above 100.5°F B. Whether the patient reports any painful teeth C. The most recent platelet count D. The last time mouth care was given
C
Before administering a cephalosporin to a patient, it is most important for the nurse to assess the patient for an allergy history to what? A. Soy products B. Peanuts C. Penicillins D. Opioids
C
The nurse identifies which medication as posing a significant risk of causing confusion, somnolence, psychosis, and visual disturbances in elderly patients? A) Metronidazole [Flagyl] B) Rifampin [Rifadin] C) Ciprofloxacin [Cipro] D) Daptomycin [Cubicin
C
The nurse is scheduling a client's antibiotic peak and trough levels with the lab personnel. What is the best schedule for drawing the trough level? A. Give the dose of medication, and call the lab to draw the trough stat. B. Arrange for the lab to draw the trough 1 hour after the dose is given. C. Instruct the lab to draw the trough immediately before the next scheduled dose. D. Give the first dose of medication after the lab reports that the trough bas been drawn.
C
A patient who is receiving vancomycin (Vancocin) IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make? A. "The prescription could be changed, because vancomycin comes in two forms." B. "You're allergic to penicillin, and this is the only way this medication can be given." C. "It will cause too much loss of appetite and nausea if given in the oral form." D. "It is more effective by IV, because the pill form will stay in the digestive tract."
D
A patient who takes ciprofloxacin [Cipro] and runs 6 miles daily tells a nurse about heel and calf tenderness. The nurse anticipates the healthcare provider to take which action? A) No action is needed, because this is a temporary but expected side effect. B) Continue the antibiotic with an anti-inflammatory medication. C) Slow the running pace and walk more. D) Discontinue the medication, because severe damage can result
D
The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs? a. Drugs with a broad spectrum b. Drugs with a narrow spectrum c. Drugs with a broad therapeutic index d. Drugs with a narrow therapeutic index
D
Thirty minutes after receiving an intramuscular (IM) injection of penicillin G (Pfizerpen), a patient reports itching and redness at the injection site. Which action should the nurse take first? A. Elevate the lower legs. B. Place an ice pack on the site. C. Make sure the patient stays calm. D. Administer subcutaneous epinephrine.
D
Which adverse effect can result if tetracycline is administered to children younger than 8 years of age? A. Drug-induced neurotoxicity B. Delayed growth development C. Gastrointestinal (GI) and rectal bleeding D. Permanent discoloration of the teeth
D
Which is a complication of vancomycin IV infusions? A. Angioedema B. Neurotoxicity C. Cardiomyopathy D. Red man syndrome
D
