Anti-Infectives: Antibacterial Drugs

Understanding Pharmacology Essentials for Medication Safety

Nursing
40
Questions
0
True/False
36
Choices
4
Essay
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Questions

Q1
Free

Why is it important to avoid killing off normal flora with antibacterial drugs?

Multiple Choice
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A) Normal flora can help provide protection against the development of pathogenic infections.
B) Normal flora result in opportunistic infections while other bacteria result in pathogenic infections.
C) When normal flora are not present, the immune system is suppressed, increasing the risk for infection.
D) When normal flora are not present, the immune system is overactive, increasing the risk for autoimmune diseases.
Answer:
A) Normal flora can help provide protection against the development of pathogenic infections.

Explanation:
Normal flora are the nonpathogenic bacteria that are always present on skin, mucous membranes, and in the digestive tract. They provide protection by crowding out pathogenic organisms and preventing them from entering the body.
Q2
Free

Which type of bacteria cause infection when a patients immune system is impaired?

Multiple Choice
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A) Pathogenic
B) Nonpathogenic
C) Gram negative
D) Opportunistic
Answer:
D) Opportunistic

Explanation:
Pathogenic bacteria cause disease or tissue damage while nonpathogenic bacteria do not. Opportunistic bacteria cause disease or tissue damage only when the immune system is not working well.
Q3
Free

How are bactericidal drugs different from bacteriostatic drugs?

Multiple Choice
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A) Bacteriostatic drugs are more likely to cause an allergic response than bactericidal drugs.
B) Bacteriostatic drugs work only on bacteria, whereas bactericidal drugs are effective against other types of organisms.
C) Bactericidal drug actions result in killing the bacteria, whereas bacteriostatic drugs only slow bacterial growth.
D) Bactericidal drugs require assistance from the patients immune system to be effective, whereas bacteriostatic drugs are effective even when function is poor.
Answer:
C) Bactericidal drug actions result in killing the bacteria, whereas bacteriostatic drugs only slow bacterial growth.

Explanation:
Bactericidal drugs directly kill bacteria; bacteriostatic drugs only stop bacteria from reproducing while the immune system kills the bacteria.
Q4

A patient has a bacterial infection, but the causative organism is not known. Which type of antibacterial drug will most likely be prescribed?

Multiple Choice
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A) Narrow-spectrum
B) Limited-spectrum
C) Extended-spectrum
D) Broad-spectrum
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Q5

The nurse is teaching a patient in whom a wound infection developed after surgery about antibiotic therapy. Which statement made by the patient indicates a correct understanding of the therapy?

Multiple Choice
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A) If my temperature is normal for 3 days in a row, the infection is gone and I can stop taking the drug.
B) If my temperature goes above 100 for 2 days, I should double the dose of the drug.
C) Even if I feel completely well, I should take the drug exactly as prescribed until it is gone.
D) I should notify my prescriber to change the medication if I develop diarrhea while taking this drug.
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Q6

A patient with a respiratory bacterial infection asks why a sputum sample is being collected before starting antibacterial drug therapy. What is the nurses best response?

Multiple Choice
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A) Drug therapy for lung infections works better when less sputum is present.
B) A sputum sample will help us determine what drug will work best against your infection.
C) The lab will be able to determine which drug will treat your infection without harming your normal tissues.
D) The dosage of your antibacterial drug is determined by the organism that is causing your infection.
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Q7

A patient receiving antibiotics for 3 days reports a skin rash over the chest, back, and arms. What is the nurses first action?

Multiple Choice
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A) Ask the patient whether he or she has ever developed a rash while taking another drug.
B) Reassure the patient that many people have this expected reaction to antibiotic therapy.
C) Ask the patient whether the rash itches, burns, or causes other types of discomfort.
D) Document the report as the only action.
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Q8

A patient who has been on antibiotic therapy for 3 weeks has a cottage cheeselike coating on the teeth, gums, and roof of the mouth. What is the nurses best action?

Multiple Choice
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A) Take a specimen and send it to the laboratory for culture.
B) Hold the dose and notify the prescriber immediately.
C) Document this expected finding as the only response.
D) Assist the patient to perform frequent mouth care.
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Q9

What is the most important nursing action when a patient is first started on an intravenous (IV) antibacterial drug?

Multiple Choice
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A) Check the IV site every 4 hours for redness around the site and the presence of cordlike veins.
B) Check the drip rate every hour to ensure that the proper blood drug level is maintained.
C) Assess the patients pulse, blood pressure, and respiratory effect every 15 minutes.
D) Assess the patients white blood cell count daily to determine drug effectiveness.
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Q10

A patient experiences facial angioedema after receiving a dose of a new antibacterial drug. Which assessment does the nurse perform first?

Multiple Choice
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A) Airway adequacy
B) Peripheral lung sounds
C) Rate and depth of respirations
D) Symmetry of respiratory movement
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Q11

A patient with a bacterial infection has been placed on antibacterial therapy. Which assessment finding in the patient indicates to the nurse that the therapy is effective?

Multiple Choice
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A) Red blood cell count is 4,500,000 cells/mm3
B) White blood cell (WBC) count is 8000 cells/mm3
C) Wound drainage is thick and yellow
D) Temperature is 102.4 Fahrenheit
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Q12

A patient is having an anaphylactic reaction to an intravenous (IV) antibacterial drug. Which action does the nurse perform first?

Multiple Choice
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A) Discontinue the IV therapy immediately and place the patient in shock position.
B) Hold the next dose and notify the prescriber immediately.
C) Discontinue the IV therapy and restart it at a different site.
D) Discontinue the drug and maintain the IV access.
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Q13

A patient who has been prescribed cephalexin (Keflex) reports having a severe allergic reaction to penicillin in the past. What is the nurses best response?

Multiple Choice
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A) Reassure the patient that Keflex is not penicillin.
B) Place an allergy alert band on the patients wrist.
C) Notify the prescriber immediately before the first Keflex dose.
D) Highlight this important information in the patients medical record.
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Q14

A patient who has been prescribed amoxicillin (Amoxil) 250 mg orally every 8 hours asks the nurse if a higher dose of the drug just once a day can be taken instead. What is the nurses best response?

Multiple Choice
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A) Taking this drug every 8 hours helps keep the blood level of the drug high enough to affect the bacteria.
B) Giving the drug at regular intervals over a 24-hour period helps prevent side effects.
C) Let me contact your prescriber and ask whether the drug can be given once a day.
D) When given once a day, the dose is higher so allergic reactions are more common.
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Q15

A patient who has been prescribed oral cephalexin (Keflex) also takes aluminum hydroxide (Mylanta) 1 hour after each meal. What is the nurses best action?

Multiple Choice
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A) Give the two drugs at the same time to prevent GI upset.
B) Give the cephalexin 1 hour before the aluminum hydroxide.
C) Give the aluminum hydroxide 1 hour before the cephalexin.
D) Give the aluminum hydroxide 4 hours after the cephalexin.
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Q16

A patient is to receive penicillin G benzathine (Bicillin LA) 2,400,000 units intramuscularly. The drug on hand is penicillin G benzathine 600,000 units/mL. How many milliliters does the nurse prepare?

Multiple Choice
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A) 0.25
B) 0.5
C) 2
D) 4
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Q17

A patient prescribed vancomycin (Vancocin) has developed redness on the face, neck, chest, back, and arms. The family asks the nurse if the drug should be stopped because of this response. What is the nurses best answer?

Multiple Choice
expand_more
A) Yes, these problems indicate an allergic reaction.
B) Yes, these side effects eventually lead to difficulty breathing.
C) No, these uncomfortable problems are an expected drug side effect.
D) No, the problems are caused by the presence of the infection and are not related to the drug.
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Q18

A patient is prescribed intravenous ertapenem (Invanz). Which question is most important for the nurse to ask before giving the first dose of this drug?

Multiple Choice
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A) Do you have a hearing problem or any trouble with your ears?
B) Do you take medications for seizures?
C) Are you allergic to sulfa drugs?
D) Have you ever had asthma?
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Q19

A patient is receiving intravenous gentamicin. Which change in condition does the nurse report to the prescriber immediately?

Multiple Choice
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A) Temperature increase from 38 C to 39 C.
B) Blood pressure decrease from 132/80 to 118/66.
C) Total 24-hour urine output decrease from 2100 mL to 1100 mL.
D) White blood cell (WBC) count decrease from 11,000/mm3 to 8500/mm3.
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Q20

A patient taking erythromycin reports experiencing nausea and upset stomach. What is the nurses best action?

Multiple Choice
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A) Hold the drug and notify the prescriber immediately.
B) Ensure that the drug is given with or after food.
C) Ask if the patient has any drug allergies.
D) Document the report as the only action.
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Q21

An older adult patient is prescribed amikacin (Amikin). Which assessment technique is most important for the nurse to perform daily?

Multiple Choice
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A) Asking about numbness in fingers and toes
B) Measuring calf circumference of both legs
C) Checking the mouth for open sores
D) Asking about ringing in the ears
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Q22

For which patient with a bacterial infection does the nurse question a prescription for tetracycline (Tetracon)?

Multiple Choice
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A) 35-year-old patient with AIDS
B) 16-year-old patient with severe acne
C) 65-year-old patient with hypertension
D) 25-year-old patient taking oral contraceptives
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Q23

An older adult patient has been prescribed oral erythromycin tablets. Which precaution is most important for the nurse to teach?

Multiple Choice
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A) Take this drug with food or right after eating to reduce intestinal side effects.
B) Avoid driving or operating dangerous equipment while taking this drug.
C) Take your pulse daily and notify your prescriber if it becomes irregular.
D) Wear a hat and sunscreen when outdoors.
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Q24

A patient is prescribed minocycline (Dynacin) 750 mg orally. What is the nurses best action before giving the first dose?

Multiple Choice
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A) Check that the patient is not allergic to penicillin or sulfa drugs.
B) Use a new IV administration set to administer the drug.
C) Hold the dose and contact the prescriber.
D) Give the drug with milk or food.
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Q25

Why should tetracycline drugs be avoided during pregnancy and lactation?

Multiple Choice
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A) Tetracycline crosses the placenta and causes brain hemorrhage in the fetus.
B) The fetal and newborn liver cannot metabolize the drug and anemia results.
C) The fetus and newborn are more likely to have allergic reactions to tetracycline.
D) The drug interferes with tooth enamel development causing permanently stained teeth.
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Q26

The nurse is to administer doxycycline (Doxy) intravenously to a patient who is also receiving intravenous (IV) penicillin. Which action is most important for the nurse to implement?

Multiple Choice
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A) Use IV tubing for doxycycline that has never come into contact with penicillin.
B) Use a glass container for the tetracycline and a plastic container for the penicillin.
C) Infuse the doxycycline only into a central line and the penicillin into a peripheral line.
D) Administer doxycycline with sterile saline and administer the penicillin with sterile water.
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Q27

An older adult patient is prescribed linezolid (Zyvox) 500 mg oral suspension. The drug on hand is 100 mg/5 mL. How many mL does the nurse prepare?

Multiple Choice
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A) 2
B) 10
C) 25
D) 50
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Q28

Which laboratory blood test result for a patient taking clarithromycin (Biaxin) and warfarin (Coumadin) does the nurse report immediately to the prescriber?

Multiple Choice
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A) Potassium 3.6 mEq/L
B) Sodium 134 mEq/L
C) Blood urea nitrogen (BUN) 21 mg/dL
D) International normalized ratio (INR) 4.6
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Q29

The nurse is teaching a patient who has been prescribed azithromycin (Zithromax). Which statement made by the patient indicates that additional teaching is needed?

Multiple Choice
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A) To avoid nausea, I will take my medicine along with food.
B) I will use another form of birth control along with my oral contraceptives.
C) Since I only have to take this drug once a day, it will be easy to remember.
D) To help get rid of the infection, I will spend 30 minutes each day out in the sun.
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Q30

Why must sulfonamide drugs be avoided during the last trimester of pregnancy and lactation?

Multiple Choice
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A) The drug crosses the placenta and causes brain hemorrhage in the fetus.
B) The fetal and newborn liver cannot metabolize the drug and jaundice results.
C) The fetus and newborn are more likely to have allergic reactions to sulfonamides.
D) The drug interferes with tooth enamel development causing permanently stained teeth.
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Q31

Which laboratory blood test result for a patient taking trimethoprim/sulfamethoxazole (Septra) does the nurse report immediately to the prescriber?

Multiple Choice
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A) Red blood cells (RBCs) 2.2 million/mm3
B) International normalized ratio (INR) 1.6
C) White blood cells (WBCs) 6,000/mm3
D) Sodium 134 mEq/L
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Q32

Which precaution is most important for the nurse to teach a patient who has been prescribed sulfisoxizole (Gantrisin)?

Multiple Choice
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A) Evenly space this drug throughout the 24-hour day.
B) Take the drug 1 hour before or 2 hours after a meal.
C) Drink at least 3 liters of liquids throughout the day.
D) Stop the drug immediately if diarrhea develops.
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Q33

A patient is to receive trimethoprim/sulfamethoxazole (Septra) intravenously. The drug is mixed in 250 mL of D5W and is to be administered over 90 minutes. With a drop factor of 15 gtt/mL, how many drops per minute will the nurse set for the correct infusion rate?

Multiple Choice
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A) 10
B) 20
C) 30
D) 40
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Q34

A patient taking ciprofloxacin (Cipro) reports pain and burning on urination. What is the nurses best action?

Multiple Choice
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A) Notify the prescriber that the patients urinary tract infection is not responding to the drug.
B) Remind the patient that the pain is related to the body eliminating the infectious bacteria.
C) Instruct the patient to drink a full glass of water with each drug dose and increase fluids.
D) Ask the patient whether blood or pus also is present in the urine.
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Q35

A 75-year-old patient taking levofloxacin (Levaquin) reports all of the following new problems. For which problem does the nurse advise the patient to stop taking the drug immediately and notify the prescriber?

Multiple Choice
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A) Having to get up at night to urinate
B) Swelling and pain in the right wrist
C) Feeling the heart pound after drinking coffee
D) Feeling light-headed when changing positions rapidly
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Q36

Why must fluoroquinolone drugs be avoided during pregnancy, lactation, and childhood?

Multiple Choice
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A) The drug damages muscles, tendons, and bones in the fetus and growing children.
B) The fetal and newborn liver cannot metabolize the drug, leading to anemia and jaundice.
C) The fetus and newborn are more likely to have allergic reactions to fluoroquinolones.
D) The drug interferes with tooth enamel development causing permanently stained teeth.
Answer:

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Q37

[Multiple Response] Which are general surface protections that prevent bacteria from entering the body? (Select all that apply.)
a. Intact skin
b. pH of body secretions
c. Antibodies
d. Mucous membranes
e. White blood cells

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Q38

[Multiple Response] A patient is being discharged home on antibacterial drug therapy. What instructions must the nurse teach the patient about allergic reactions? (Select all that apply.)
a. Notify your prescriber immediately if you vomit.
b. Stop taking the drug if you develop hives or a rash.
c. If you notice diarrhea be sure to stop taking the drug.
d. Continue taking the drug even if you feel well because it is fighting the infection.
e. Call 911 if you experience difficulty with breathing.
f. Avoid drinking caffeinated beverages with the drug.

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Q39

[Multiple Response] With which antibacterial drugs is teaching patients to wear protective clothing, hats, and sunscreen, and to avoid tanning beds most important? (Select all that apply.)
a. amoxicillin/clavulanic acid (Augmentin)
b. cefdinir (Omnicef)
c. clindamycin (Cleocin)
d. erythromycin (E-mycin)
e. lomefloxacin (Maxaquin)
f. tetracycline (Tetracon) g. trimethoprim/sulfamethoxazole (Bactrim)

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Q40

[Multiple Response] Which actions are most likely to reduce the spread of community-acquired methicillin-resistant Staphylococcus aureas (CA-MRSA) in a family in which only one member is infected? (Select all that apply.)
a. Starting the noninfected family members on methicillin therapy.
b. Not sharing towels or bed linens with the infected person.
c. Washing the infected persons dishes separately from those of other family members.
d. Having the infected person wear a mask when in the same room with other family members.
e. Using good daily personal hygiene for all family members.
f. Washing hands with soap and water after any physical contact with an infected person.

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