Question 1

The nurse is providing discharge teaching for a patient who will receive oral levofloxacin (Levaquin)to treat pneumonia.The patient takes an oral hypoglycemic medication and uses over-the-counter (OTC)antacids to treat occasional heartburn.The patient reports frequent arthritis pain and takes acetaminophen when needed.Which statement by the nurse is correct when teaching this patient?

Accepted Answer

A)  "You may take antacids with levofloxacin to decrease gastrointestinal upset." 
B)  "You may take nonsteroidal anti-inflammatory medications (NSAIDs) for arthritis pain." 
C)  "You should monitor your serum glucose more closely while taking levofloxacin." 
D)  "You should take levofloxacin on an empty stomach to improve absorption."

Question 2

The nurse is preparing to administer an antibiotic to a patient who has been receiving the antibiotic for 2 days after a culture was obtained.The nurse notes increased erythema and swelling,and the patient has a persistent high fever of 39° C.What is the nurse's next action?

Accepted Answer

A)  Administer the antibiotic as ordered. 
B)  Contact the provider to request another culture. 
C)  Discuss the need to add a second antibiotic with the provider. 
D)  Review the sensitivity results from the patient's culture.

Question 3

A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ)(Bactrim,Septra)to treat a urinary tract infection reports vaginal itching and discharge.The nurse will perform which action?

Accepted Answer

A)  Ask the patient if she might be pregnant. 
B)  Reassure the patient that this is a normal side effect. 
C)  Report a possible superinfection to the provider. 
D)  Suspect that the patient is having a hematologic reaction.

Question 4

A patient is diagnosed with mycoplasma pneumonia.Which antibiotic will the nurse expect the provider to order to treat this infection?

Accepted Answer

A)  Azithromycin (Zithromax) 
B)  Clarithromycin (Biaxin) 
C)  Erythromycin (E-Mycin) 
D)  Fidaxomicin (Dificid)

Question 5

The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX)and learns that the patient takes warfarin (Coumadin).The nurse will request an order for

Accepted Answer

A)  a decreased dose of TMP-SMX. 
B)  a different antibiotic. 
C)  an increased dose of warfarin. 
D)  coagulation studies.

Question 6

The nurse is caring for a patient who takes low-dose erythromycin as a prophylactic medication.The patient will begin taking cefaclor for treatment of an acute infection.The nurse should discuss this with the provider because taking both of these medications simultaneously can cause which effect?

Accepted Answer

A)  Decreased effectiveness of cefaclor 
B)  Increased effectiveness of cefaclor 
C)  Decreased effectiveness of erythromycin 
D)  Increased effectiveness of erythromycin

Question 7

The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin)infusing at 20 mg/min.The nurse notes red blotches on the patient's face,neck,and chest and assesses a blood pressure of 80/55 mm Hg.Which action will the nurse take?

Accepted Answer

A)  Request an order for IV epinephrine to treat anaphylactic shock. 
B)  Slow the infusion to 10 mg/min and observe the patient closely. 
C)  Stop the infusion and obtain an order for a BUN and serum creatinine. 
D)  Suspect Stevens-Johnson syndrome and notify the provider immediately.

Question 8

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?

Accepted Answer

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

Question 9

A female patient will receive doxycycline to treat a sexually transmitted illness (STI).What information will the nurse include when teaching this patient about this medication?

Accepted Answer

A)  Nausea and vomiting are uncommon adverse effects. 
B)  The drug may cause possible teratogenic effects. 
C)  Increase intake of dairy products with each dose of this medication. 
D)  Use a back-up method of contraception if taking oral contraceptives.

Question 10

The nurse is preparing to give a dose of a cephalosporin medication to a patient who has been receiving the antibiotic for 2 weeks.The nurse notes ulcers on the patient's tongue and buccal mucosa.Which action will the nurse take?

Accepted Answer

A)  Hold the drug and notify the provider. 
B)  Obtain an order to culture the oral lesions. 
C)  Gather emergency equipment to prepare for anaphylaxis. 
D)  Report a possible superinfection side effect of the cephalosporin.

Question 11

The nurse is caring for a patient who is receiving a high dose of intravenous azithromycin to treat an infection.The patient is also taking acetaminophen for pain.The nurse should expect to review which lab values when monitoring for this drug's side effects?

Accepted Answer

A)  Complete blood counts 
B)  Electrolytes 
C)  Liver enzymes 
D)  Urinalysis

Question 12

A female patient who is allergic to penicillin will begin taking an antibiotic to treat a lower respiratory tract infection.The patient tells the nurse that she almost always develops a vaginal yeast infection when she takes antibiotics and that she will take fluconazole (Diflucan)with the antibiotic being prescribed.Which macrolide order would the nurse question for this patient?

Accepted Answer

A)  Azithromycin (Zithromax) 
B)  Clarithromycin (Biaxin) 
C)  Erythromycin (E-Mycin) 
D)  Fidaxomicin (Dificid)

Question 13

The nurse is preparing to give a dose of oral clindamycin (Cleocin)to a patient who is being treated for a skin infection caused by Staphylococcus aureus.The patient has had several doses of the medication and reports having nausea.Which action will the nurse take next?

Accepted Answer

A)  Administer the next dose when the patient has an empty stomach. 
B)  Hold the next dose and contact the patient's provider. 
C)  Instruct the patient to take the next dose with a full glass of water. 
D)  Request an order for an antacid to give along with the next dose.

Question 14

The nurse is preparing to administer clarithromycin to a patient.When performing a medication history,the nurse learns that the patient takes warfarin to treat atrial fibrillation.The nurse will perform which action?

Accepted Answer

A)  Ask the provider if azithromycin may be used instead of clarithromycin. 
B)  Obtain an order for continuous cardiovascular monitoring. 
C)  Request an order for periodic serum warfarin levels. 
D)  Withhold the clarithromycin and notify the provider.

Question 15

The nurse caring for a patient who will receive penicillin to treat an infection asks the patient about previous drug reactions.The patient reports having had a rash when taking amoxicillin (Amoxil).The nurse will contact the provider to

Accepted Answer

A)  discuss giving a smaller dose of penicillin. 
B)  discuss using erythromycin (E-Mycin) instead of penicillin. 
C)  request an order for diphenhydramine (Benadryl). 
D)  suggest that the patient receive cefuroxime (Ceftin).

Question 16

The nurse is preparing to begin a medication regimen for a patient who will receive intravenous ampicillin and gentamicin.Which is an important nursing action?

Accepted Answer

A)  Administer each antibiotic to infuse over 15 to 20 minutes. 
B)  Order serum peak and trough levels of ampicillin. 
C)  Prepare the schedule so that the drugs are given at the same time. 
D)  Set up separate tubing sets for each drug labeled with the drug name and date.

Question 17

A patient is receiving high doses of a cephalosporin.Which laboratory values will this patient's nurse monitor closely?

Accepted Answer

A)  Blood urea nitrogen (BUN), serum creatinine, and liver function tests 
B)  Complete blood count and electrolytes 
C)  Serum calcium and magnesium 
D)  Serum glucose and lipids

Question 18

A patient will begin taking amoxicillin.The nurse should instruct the patient to avoid which foods?

Accepted Answer

A)  Green leafy vegetables 
B)  Beef and other red meat 
C)  Coffee, tea, and colas 
D)  Acidic fruits and juices

Question 19

The nurse is preparing to administer the first dose of intravenous ceftriaxone (Rocephin)to a patient.When reviewing the patient's chart,the nurse notes that the patient previously experienced a rash when taking amoxicillin.What is the nurse's next action?

Accepted Answer

A)  Administer the drug and observe closely for hypersensitivity reactions. 
B)  Ask the provider whether a cephalosporin from a different generation may be used. 
C)  Contact the provider to report drug hypersensitivity. 
D)  Notify the provider and suggest an oral cephalosporin.

Question 20

The nurse is caring for a 7-year-old patient who will receive oral antibiotics.Which antibiotic order will the nurse question for this patient?

Accepted Answer

A)  Azithromycin (Zithromax) 
B)  Clarithromycin (Biaxin) 
C)  Clindamycin (Cleocin) 
D)  Tetracycline (Sumycin)

Exam 26: Antibacterials

The nurse is preparing to administer an antibiotic to a patient who has been receiving the antibiotic for 2 days after a culture was obtained.The nurse notes increased erythema and swelling,and the patient has a persistent high fever of 39° C.What is the nurse's next action?

A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim,Septra) to treat a urinary tract infection reports vaginal itching and discharge.The nurse will perform which action?

A patient is diagnosed with mycoplasma pneumonia.Which antibiotic will the nurse expect the provider to order to treat this infection?

The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX) and learns that the patient takes warfarin (Coumadin) .The nurse will request an order for

The nurse is caring for a patient who takes low-dose erythromycin as a prophylactic medication.The patient will begin taking cefaclor for treatment of an acute infection.The nurse should discuss this with the provider because taking both of these medications simultaneously can cause which effect?

The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min.The nurse notes red blotches on the patient's face,neck,and chest and assesses a blood pressure of 80/55 mm Hg.Which action will the nurse take?

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 female patient will receive doxycycline to treat a sexually transmitted illness (STI) .What information will the nurse include when teaching this patient about this medication?