Chapter 7
A client develops a mild skin irritation while receiving penicillin therapy. Which of the following would the nurse advise the client to avoid? Select all that apply. A) Harsh soaps B) Perfumed lotions C) Antipyretic creams D) Rubbing the irritating area E) Wearing rough or irritating clothing
Ans: A, B, D, E
A group of nursing students are reviewing the different groups of penicillins. The students demonstrate understanding when they identify which of the following as an example of a penicillinase-resistant penicillin? Select all that apply. A) Dicloxacillin B) Penicillin G C) Nafcillin D) Oxacillin E) Ampicillin
Ans: A, C, D
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? A) Monitoring fluid intake B) Monitoring blood creatinine levels C) Testing for occult blood D) Testing for increased glucose levels
Ans: B
After teaching a group of students about antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the students identify which of the following as an example of a carbapenem? Select all that apply. A) Vancomycin B) Imipenem-cilastatin C) Meropenem D) Aztreonam E) Ceftriaxone
Ans: B, C
A nurse is caring for a patient who is receiving penicillin. The nurse would assess for which of the following as a common adverse reaction? A) Inflammation of the tongue and mouth B) Impaired oral mucous membranes C) Severe hypotension D) Sudden loss of consciousness
Ans: A
A nurse needs to administer a cephalosporin to a patient. The patient informs the nurse that he is allergic to penicillin. Which action by the nurse would be most appropriate? A) Inform the primary health care provider. B) Obtain the patient's occupational history. C) Administer an antipyretic drug. D) Obtain specimens for kidney function tests.
Ans: A
A nurse suspects that a client receiving oral penicillin therapy is developing pseudomembranous colitis based on assessment of which of the following? A) Bloody diarrhea B) Pruritus C) Chills D) Hives
Ans: A
A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform? A) Inspect mouth and gums regularly. B) Instruct patient to avoid brushing teeth. C) Offer patient a liquid diet. D) Instruct the patient to gargle every 2 hours.
Ans: A
After taking penicillin as prescribed, a patient shows signs of diarrhea and informs the nurse that there is blood in his stools. Which of the following interventions should the nurse do next? A) Contact primary health provider immediately. B) Have the patient consume yogurt with his next meal. C) Decrease fiber content in diet. D) Continue with prescribed regimen.
Ans: A
The nurse is obtaining a medication history of a 48-year-old patient with an ear infection who is to receive penicillin therapy. The patient reports taking a beta-adrenergic blocker for his hypertension. The nurse would identify that this patient is at increased risk for which of the following if penicillin is administered? A) Anaphylactic shock B) Higher blood pressure C) Excess bleeding D) Heart attack
Ans: A
A client is prescribed penicillin therapy to treat an infection. Which of the following would the nurse include in the teaching plan for the client to reduce her risk of fungal superinfections? Select all that apply. A) "Yogurt can sometimes help." B) "Try drinking some buttermilk." C) "You could take Acidophilus capsules." D) "Rinse your mouth daily with an alcohol-based mouthwash." E) "Use a soft-bristle toothbrush when brushing."
Ans: A, B, C, E
Which of the following should be included in the nurse's preadministration assessment prior to administering a penicillin to a client? Select all that apply. A) Allergy history B) Medical history C) Medication history D) Blood glucose levels E) Current symptoms
Ans: A, B, C, E
A nurse is monitoring a client who is receiving penicillin. The nurse would assess the client for which of the following common GI tract adverse reactions? Select all that apply. A) Glossitis B) Stomatitis C) Esophagitis D) Diarrhea E) Gastritis
Ans: A, B, D, E
A nurse suspects that a client who is receiving a cephalosporin and has ingested alcohol may be experiencing a disulfiram-like reaction based on assessment of which of the following? Select all that apply. A) Flushing B) Respiratory difficulty C) Hypertension D) Vomiting E) Sweating
Ans: A, B, D, E
A group of nursing students are reviewing information about administering penicillins. The students demonstrate an understanding of the information when they identify which drugs as being given without regard to meals? Select all that apply. A) Amoxicillin (Amoxil) B) Ampicillin (Principen) C) Penicillin V (Veetids) D) Amoxicillin/clavulanate (Augmentin) E) Carbenicillin indanyl (Geocillin)
Ans: A, C
A nurse is preparing to administer penicillin therapy. The nurse would expect to administer penicillins cautiously to clients with which of the following? Select all that apply. A) History of allergies B) Diabetes C) Asthma D) Bleeding disorders E) Hypertension
Ans: A, C, D
A nurse is preparing to administer a prescribed cephalosporin by injection. Which of the following would be most important for the nurse to keep in mind? Select all that apply. A) Thrombophlebitis can occur when cephalosporins are given IV. B) Phlebitis can occur when cephalosporins are given IM. C) Pain can occur when cephalosporins are given IM. D) Tenderness can occur when cephalosporins are given IM. E) Swelling can occur when cephalosporins are given IM.
Ans: A, C, D, E
When performing an ongoing assessment of a client receiving amoxicillin (Amoxil), the nurse should monitor the client for which of the following? Select all that apply. A) Relief of symptoms B) Development of a rash C) Increase in appetite D) Change in appearance or amount of drainage E) Decrease in temperature
Ans: A, C, D, E
A nursing instructor is preparing a class about cephalosporins for a group of nursing students. When describing progression from first-generation to fourth-generation cephalosporins, which of the following would the instructor include as the result? Select all that apply. A) An increase in the sensitivity of gram-negative microorganisms B) A decrease in the sensitivity of gram-negative microorganisms C) An increase in the sensitivity of gram-positive microorganisms D) A decrease in the sensitivity of gram-positive microorganisms E) An increase in the sensitivity of viral microorganisms
Ans: A, D
A 26-year-old female patient with a skin infection has been prescribed 400 mg ampicillin to be taken orally. Which of the following instructions should the nurse include in the patient teaching plan? A) If a dosage is missed, increase the next dosage to meet the daily quota. B) Ampicillin will reduce the effectiveness of birth control pills. C) Take drug on an empty stomach, an hour before or 2 hours after meals. D) Avoid use of skin care products, like moisturizers, when on penicillin therapy.
Ans: B
A nurse is conducting an in-service training program for a group of nurses about antibacterial drugs such as penicillins and cephalosporins. During the question-and-answer period, the audience asks for examples of conditions that can be treated by cephalosporins. Which of the following would the nurse include in the response? A) Hemolysis B) Urinary tract infections C) Nausea and diarrhea D) Jaundice
Ans: B
A patient receiving penicillin therapy tells the nurse that she feels like her mouth is irritated and that she has a sore throat. Inspection reveals a red, swollen tongue with ulcerations. The nurse suspects a fungal superinfection and identifies which nursing diagnosis as most appropriate for this patient? A) Impaired Comfort B) Impaired Oral Mucous Membranes C) Deficient Knowledge D) Inadequate Nutrition: Less Than Body Requirements
Ans: B
The nurse is providing care to a patient who is receiving an aminoglycoside for a wound infection. The patient is also ordered to receive a cephalosporin. The nurse would carefully assess the patient for which of the following? A) Nausea B) Nephrotoxicity C) Increased bleeding D) Respiratory difficulty
Ans: B
While the nurse is obtaining a drug history from a patient, the patient tells the nurse that he is allergic to penicillins and has also experienced a rash when he took a cephalosporin. The nurse interprets this information as indicating which of the following? A) Hypersensitivity B) Cross-sensitivity C) Anaphylactoid reaction D) Anaphylaxis
Ans: B
A nurse is reviewing the laboratory test results of a client receiving penicillin therapy. Which of the following would the nurse identify as indicating an adverse hematologic reaction? Select all that apply. A) Pancytopenia B) Anemia C) Thrombocytopenia D) Leukopenia E) Hemoglobulinemia
Ans: B, C, D
While administering vancomycin IV to a patient, the nurse suspects that the patient is developing red-man syndrome based on assessment of which of the following? Select all that apply. A) Headache B) Throbbing neck pain C) Chills D) Erythema of the neck and back E) Difficulty breathing
Ans: B, C, D
After teaching a group of nursing students about penicillins, the instructor determines that the teaching was successful when the students identify which of the following as a group? Select all that apply. A) Synthetic penicillins B) Natural penicillins C) Penicillinase-resistant penicillins D) Aminopenicillins E) Extended-spectrum penicillins
Ans: B, C, D, E
After teaching a group of nursing students about the different generations of cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a first-generation cephalosporin? Select all that apply. A) Cefepime (Maxipime) B) Cefazolin (Ancef) C) Cefoxitin (Mefoxin) D) Cephalexin (Keflex) E) Cefaclor (Raniclor)
Ans: B, D
A nurse is teaching a patient about the common adverse reactions that can occur with his prescribed therapy with cephalosporins. The nurse determines that the teaching was successful when the patient identifies which of the following? Select all that apply. A) Drowsiness B) Headache C) Constipation D) Heartburn E) Vomiting
Ans: B, D, E
A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation? A) Instruct patient to increase dietary intake. B) Inform the primary health provider immediately. C) Record assessments on patient's chart. D) Inquire about any previous drug allergies.
Ans: C
A group of students are reviewing information about the different penicillins. The students demonstrate understanding of the information when they identify which of the following as an example of a beta-lactamase inhibitor? Select all that apply. A) Piperacillin B) Amoxicillin C) Tazobactam D) Sulbactam E) Clavulanic acid
Ans: C, D, E
A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions would be most appropriate for the nurse to do when preparing penicillin in parenteral form? A) Extract penicillin from vial and then reconstitute. B) Save excess antibiotic after reconstitution for later use. C) Use any available diluent for reconstitution. D) Shake the vial well to distribute the drug evenly.
Ans: D
A patient is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame? A) 15 minutes B) 30 minutes C) 45 minutes D) 60 minutes
Ans: D
Before administering the first dose to the client, which assessment should the nurse perform as part of the preadministration assessment? A) Review of renal and hepatic function tests B) Inspection of patient's stools C) Evaluation of patient's lifestyle and diet D) General history of patient's health
Ans: D
The nurse administers cefuroxime to a patient at least 1 hour before meals, as prescribed. However, the patient experiences GI upset. Which of the following would be most appropriate for the nurse to do? A) Administer an antacid. B) Lower the dosage. C) Discontinue the drug. D) Administer the drug with food.
Ans: D