Antibacterials Topic 10-12? Quiz

Questions and Answers

Which nursing action would be most important before administering an intravenous dose of penicillin?

Recording the daily urine output

Assessing the patient for any allergies (correct)

Locating the intravenous (IV) site

Obtaining serum creatinine levels

Which intervention is the most important when caring for a 22-year-old woman who has been prescribed amoxicillin?

Assess if the patient is on oral contraceptives. (correct)

Instruct the patient not to take the medication before meals.

Obtain a baseline complete blood count (CBC).

Inform the patient about possible superinfections.

Which sign or symptom would require immediate intervention by the nurse after a patient received the first dose of amoxicillin?

Candidiasis

Tongue discoloration

Angioedema (correct)

Nausea

Which patient parameter would lead the nurse to hold the dose of ceftriaxone and contact the healthcare provider?

Cefazolin allergy Signup and view all the answers

Which term is used to describe when an antibacterial drug is no longer effective due to repeated use?

Acquired resistance Signup and view all the answers

Which laboratory value would the nurse assess to ensure safe administration of vancomycin?

Renal function Signup and view all the answers

Which action would the nurse take if the patient develops excessive sweating and reports itching of the face and neck while vancomycin is being administered intravenously?

Stop the vancomycin infusion. Signup and view all the answers

Which teaching will the nurse provide to a patient who has been prescribed azithromycin for otitis media?

You must complete the full course of the medication. Signup and view all the answers

Which cue indicates cranial nerve VIII toxicity in a patient receiving vancomycin?

Hearing loss Signup and view all the answers

Which information would the nurse include when teaching a patient about the administration of an antacid and ciprofloxacin?

Take ciprofloxacin 2 hours before or after the antacid. Signup and view all the answers

For which patient would the nurse question the prescription of tetracycline?

A 6-year-old patient with a Haemophilus influenzae infection Signup and view all the answers

Which instruction would the nurse include in the discharge teaching for a patient receiving tetracycline?

Use sunscreen and protective clothing when outdoors. Signup and view all the answers

After teaching a patient prescribed doxycycline for a skin infection, which patient response reflects an understanding of doxycycline administration? Select all that apply.

I will take all the doses that have been prescribed for me. Signup and view all the answers

Following education from the nurse for a new prescription of tetracycline, which patient statement reflects a need for clarification?

My oral contraceptive will be effective if I continue to take it daily as directed. Signup and view all the answers

A patient is prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) and indicates the patient requires further instruction. Which statement indicates this?

I will take the medication until I feel better. Signup and view all the answers

A patient prescribed trimethoprim-sulfamethoxazole (TMP-SMZ) reports feeling tired along with a painful and blistering rash. Which complication is likely occurring?

Stevens-Johnson syndrome Signup and view all the answers

By which method(s) of transmission is tuberculosis spread? Select all that apply.

Coughing Signup and view all the answers

Which statement describes how superinfection can occur?

It can occur when the antibiotic eliminates the normal bacterial flora. Signup and view all the answers

Which assessment is most important before administering the first dose of ampicillin to an 80-year-old patient?

Renal function Signup and view all the answers

Which occurrence(s) would the nurse mention as causative of bacterial resistance when explaining antibiotic therapy to a patient? (Select all that apply)

Doses of antibiotics are skipped. Signup and view all the answers

Which occurrence would the nurse identify as the cause of reported oral candidiasis in a patient who has been taking an antimicrobial drug for 2 weeks?

Superinfection Signup and view all the answers

Which organ can be damaged by antibacterial drugs? (Select all that apply)

Liver Signup and view all the answers

The nurse is reviewing a patient’s medical history before administering azithromycin. Which patient factor would most likely contribute to hepatotoxicity?

Takes acetaminophen at maximum dosing Signup and view all the answers

Which drug interaction is most likely to contribute to vancomycin nephrotoxicity?

Furosemide Signup and view all the answers

Which action by the nurse is inappropriate in caring for a patient receiving levofloxacin for a urinary tract infection (UTI)?

Encouraging the patient to have caffeinated products Signup and view all the answers

Which complication would the nurse monitor for in a patient who is on nonsteroidal anti-inflammatory drug (NSAID) therapy and has been prescribed levofloxacin?

Seizures Signup and view all the answers

Which assessment will the nurse include when planning care for a patient who is receiving daily gentamicin infusions?

Hearing Signup and view all the answers

Which laboratory test is used to monitor for antibiotic toxicity?

Peak Signup and view all the answers

Which statement correctly describes fluoroquinolones? (Select all that apply)

Treat gram-negative organisms Signup and view all the answers

Which cue in a patient’s medical record would cause concern for a patient receiving gentamicin?

Urinary output of 400 mL in the last 24 hours Signup and view all the answers

Which action would the nurse suspect as the cause of shortness of breath, facial flushing, severe headache, vomiting, and confusion in a patient receiving metronidazole treatment?

Drinking alcohol Signup and view all the answers

Which explanation will the nurse provide if a patient asks why a combination medication, trimethoprim-sulfamethoxazole (TMP-SMZ), is prescribed for a urinary tract infection?

Combination medication reduces bacterial resistance to treatment. Signup and view all the answers

Which intervention(s) would be appropriate when caring for a patient who has been prescribed penicillin G potassium? (Select all that apply)

Monitoring for superinfection Signup and view all the answers

Which instructions should the nurse give regarding the use of bisacodyl?

Eat high-fiber foods consistently. Signup and view all the answers

What mechanism of action describes how diphenoxylate with atropine treats diarrhea due to chemotherapeutic agents?

Inhibits gastric motility Signup and view all the answers

Which outcome assessment is essential to monitor for in a patient taking diphenoxylate with atropine?

Decrease in gastric motility Signup and view all the answers

Which parameter would be monitored closely in a patient receiving narcotic analgesics for pain and diphenoxylate with atropine for diarrhea?

Respiratory rate Signup and view all the answers

Which factors contribute to diarrhea? (Select all that apply)

Spicy foods Signup and view all the answers

Which opioid is used in mild to moderate pain and as an antitussive?

Codeine sulfate Signup and view all the answers

Which substance do antiinflammatories inhibit?

Prostaglandin Signup and view all the answers

Which information would the nurse include in the teaching plan for a patient who has been prescribed sucralfate?

This medication will form a protective barrier over the gastric mucosa. Signup and view all the answers

Which drug is considered a cyclooxygenase-2 (COX-2) inhibitor?

Celecoxib Signup and view all the answers

Which statement by the patient indicates that the nurse’s teaching on the administration of a histamine-2 (H2) receptor antagonist was effective?

Smoking decreases the effects of this medication, so I should look into cessation programs. Signup and view all the answers

Which cells in the stomach secrete hydrochloric acid?

Parietal cells Signup and view all the answers

Which response by the nurse would be most appropriate if a patient with rheumatoid arthritis expresses concern about treatment with infliximab?

The medication suppresses your immune system. Signup and view all the answers

Which adverse reaction would the nurse monitor for in a patient taking an aluminum-containing antacid?

Constipation Signup and view all the answers

Which drug is most appropriate for a patient with back pain caused by inflammation?

Ibuprofen Signup and view all the answers

Which instruction given by the nurse would ensure effective treatment if the nurse is teaching a patient with gout about dietary management during the administration of allopurinol?

Take the medication with lots of fluids. Signup and view all the answers

Which assessment finding in a patient taking nonsteroidal antiinflammatory drugs (NSAIDs) requires intervention?

Black, tarry stools Signup and view all the answers

Which drug would the nurse expect to be added to a patient’s regimen if the patient has hyperuricemia and deposition of sodium urate crystals in the synovial fluid?

Allopurinol Signup and view all the answers

Which antiinflammatory agent inhibits cyclooxygenase-2 (COX-2) but not cyclooxygenase-1 (COX-1)?

Celecoxib Signup and view all the answers

Which food(s) or dietary supplement(s) would the nurse identify as potentially causing increased sedation with opioid therapy? Select all that apply.

St. John's wort Signup and view all the answers

Which test would the nurse anticipate the health care provider (HCP) ordering for a patient who has been chronically taking high doses of acetaminophen?

Liver function test Signup and view all the answers

Which action would the nurse take if a patient receiving morphine sulfate has a respiratory rate of 8 breaths/min and a pain scale of 8 out of 10?

Consult the primary health care provider and obtain another drug prescription. Signup and view all the answers

Which rationale describes why a nurse would record baseline vital signs before administering 5 mg of morphine sulfate intravenously?

Morphine sulfate depresses the respiratory center. Signup and view all the answers

Which drug may cause tinnitus as a side effect?

Aspirin Signup and view all the answers

Which medication is used to treat severe adverse effects of an opioid analgesic?

Naloxone Signup and view all the answers

Which medication would the nurse anticipate incorporating into the plan of care for a postoperative patient who received fentanyl and subsequently developed respiratory depression?

Naloxone Signup and view all the answers

Which symptom is an adverse effect associated with excessive doses of acetaminophen? Select all that apply.

Nausea Signup and view all the answers

Which lifestyle factors would the nurse question if a patient presents with frequent constipation? Select all that apply.

Dietary habits Signup and view all the answers

Which nonpharmacologic intervention is beneficial to a patient experiencing nausea and vomiting? Select all that apply.

Suggest that the patient drink flat soda. Signup and view all the answers

Which of these options are cardinal signs of inflammation? (Select all that apply)

Swelling Signup and view all the answers

Which serious illness would the nurse suspect in a 6-year-old patient with influenza who is vomiting, delirious, extremely lethargic, and has dermatologic symptoms after receiving baby aspirin?

Reye syndrome Signup and view all the answers

What should the nurse respond if a family sees bruises on a patient taking a moderate dose of aspirin?

This is common with people taking aspirin. Signup and view all the answers

Which supporting evidence would the nurse provide regarding a proposed change from aspirin to ibuprofen?

Aspirin is associated with more gastric bleeding than ibuprofen. Signup and view all the answers

What is the mechanism of action of allopurinol?

Reduces uric acid biosynthesis Signup and view all the answers

Which statement indicates a female patient at risk for stroke understands aspirin therapy instructions?

I should take aspirin at mealtime. Signup and view all the answers

Which action could cause complications for a patient on ibuprofen therapy for arthritis?

Eating more ginger and garlic Signup and view all the answers

Which medication would be prescribed to a patient determined to be at increased risk for ischemic stroke?

Aspirin Signup and view all the answers

Which assessment finding indicates that a nonsteroidal anti-inflammatory drug (NSAID) has been effective?

Pain has decreased from a 6 to a 1 on a scale of 10. Signup and view all the answers

What action will the nurse take first for a patient with Crohn’s disease receiving infliximab?

Ensure the patient has a negative TB test Signup and view all the answers

Which patient would be at high risk for respiratory depression with intravenous morphine therapy? (Select all that apply)

45-year-old patient with chronic obstructive pulmonary disease (COPD) Signup and view all the answers

Which question is a priority for a nurse to ask a patient prescribed sumatriptan for migraine headaches?

Do you have a history of coronary artery disease? Signup and view all the answers

Which type of pain originates from the skin and mucous membranes?

Superficial pain Signup and view all the answers

Which statement about somatic pain is accurate?

It originates from skeletal muscles, ligaments, and joints. Signup and view all the answers

Which assessment finding indicates that a patient has overdosed on morphine sulfate?

Pinpoint pupils Signup and view all the answers

Which condition would the nurse expect to see in a patient who ingested 14 grams of acetaminophen?

Acute hepatotoxicity Signup and view all the answers

Which finding would the nurse expect when assessing a patient for adverse effects of morphine sulfate?

Drowsiness Signup and view all the answers

Which condition is a contraindication for the administration of acetaminophen?

Liver disease Signup and view all the answers

Which side effect(s) may occur in a patient receiving isoniazid for tuberculosis? Select all that apply.

Tremors Signup and view all the answers

Which patient(s) would require cautious use, if at all, of fluconazole? Select all that apply.

A patient with kidney failure Signup and view all the answers

Which microorganism is directly affected by acyclovir?

Varicella-zoster virus Signup and view all the answers

Which herpesvirus is commonly known as chickenpox?

Varicella-zoster virus Signup and view all the answers

A patient is taking fluconazole with warfarin. Which laboratory finding describes the possible interaction with these two medications?

Increased prothrombin time Signup and view all the answers

Which type of drug is used to destroy worms?

Anthelmintics Signup and view all the answers

Which drug classification includes antivirals, antimicrobials, antiparasitics, and antifungals?

Anthelmintics Signup and view all the answers

Which adverse reaction is common for ivermectin?

Nausea Signup and view all the answers

Which purpose does pyridoxine (vitamin B6) serve in a patient receiving isoniazid for tuberculosis?

To prevent peripheral nerve damage Signup and view all the answers

Which intervention would the nurse expect to implement in the case of a patient newly diagnosed with oral candidiasis of the mouth and throat?

Teach the patient to swish and gargle with nystatin. Signup and view all the answers

Which is a first-line antitubercular drug?

Isoniazid Signup and view all the answers

Which laboratory value alteration may be observed in a patient receiving isoniazid?

Increase in the alanine aminotransferase serum level Signup and view all the answers

Which drug is used to treat the majority of infections caused by the herpes simplex viruses and the varicella-zoster virus?

Acyclovir Signup and view all the answers

Which infection is a child at risk for developing as an adult if the child had chickenpox?

Shingles Signup and view all the answers

Which patient would receive nystatin therapy?

A patient with oral candidiasis Signup and view all the answers

Which statement best describes how tuberculosis is spread?

Inhaling droplets dispersed in the air Signup and view all the answers

A patient with diabetes is being treated with isoniazid (INH) for tuberculosis. To prevent peripheral neuropathy, which drug or vitamin supplement would the nurse anticipate giving?

Vitamin B6 Signup and view all the answers

Which physical finding may indicate a superinfection in a patient taking an antiinfective agent?

White patches on tongue Signup and view all the answers

Which is the most common site for helminthiasis?

Intestine Signup and view all the answers

The nurse has educated a patient on adverse reactions of antitubercular drugs. Which adverse reaction would be reported to the health care provider?

Numbness and tingling of extremities Signup and view all the answers

Study Notes

Antibacterials Overview

Superinfection occurs when antibiotics destroy normal bacterial flora, allowing opportunistic bacteria or fungi to cause infection.
Critical assessment before administering ampicillin to elderly patients includes monitoring renal function due to high sodium/potassium content in the drug.
Antibiotic resistance can result from stopping antibiotics prematurely, using them for viral infections, or skipping doses.

Oral Candidiasis and Superinfection

Oral candidiasis after antibiotic use is a form of superinfection caused by the overgrowth of fungus when normal gut flora is disrupted.

Organ Toxicity from Antibacterials

Major organs impacted by antibacterial drugs include the liver and kidneys, leading to potential toxicities.
Drug interactions, such as with acetaminophen, can increase hepatotoxic risks with azithromycin.

Nephrotoxicity and Drug Interactions

Vancomycin can cause nephrotoxicity, especially when combined with furosemide.
Continuous renal function assessment is vital for patients receiving aminoglycosides like gentamicin.

Administration Guidelines

Levofloxacin, for urinary tract infections, should not be taken with caffeinated products to avoid CNS effects like seizures.
Maintaining hydration (6 to 8 glasses of water) is important to prevent crystalluria during fluoroquinolone therapy.

Antibiotic Monitoring

Trough levels measure the lowest concentration of antibiotics and help maintain efficacy, while peak levels assist in monitoring toxicity.
Regular urine output should be evaluated, with a threshold of 600 mL in 24 hours to rule out renal insufficiency.

Disulfiram Reaction

Patients on metronidazole should avoid alcohol to prevent severe reactions characterized by flushing, headaches, and confusion.

Combination Antibiotics

Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for UTIs to reduce bacterial resistance and enhance bactericidal response.

Nursing Priorities for Penicillin

Before administering penicillin, it is critical to assess for allergies to prevent severe allergic reactions.
Monitoring for respiratory distress is essential following the administration of penicillin due to the risk of allergic reactions.

Amoxicillin Considerations

Amoxicillin can reduce the effectiveness of oral contraceptives; therefore, assessing for their use is crucial for patient advice and management.

Test-Taking Tips

Careful reading of all options and elimination of clearly wrong answers enhance chances of answering multiple-choice questions correctly.
Look for clues in question details that may guide appropriate responses regarding patient care and medication management.### Antibiotic Usage and Assessment
Long-term antibiotic use can lead to blood dyscrasias; however, baseline CBC assessments are not deemed necessary.
Key nursing priorities include informing patients about potential superinfections and advising against taking medication immediately before meals.

Amoxicillin and Immediate Intervention

Angioedema is a serious, life-threatening reaction that requires immediate nursing intervention.
Nausea, candidiasis, and tongue discoloration are non-life-threatening side effects of amoxicillin.

Ceftriaxone and Allergies

A cefazolin allergy suggests a possible allergy to ceftriaxone; the nurse should hold the dose and contact the healthcare provider.
Conditions like diabetes, WBC count of 8.2 cells/mm³, and creatinine level at 1.1 mg/dL do not contraindicate ceftriaxone use.

Antibiotic Resistance

Acquired resistance occurs when bacteria become resistant to antibiotics due to repeated exposure.
Other terms: potentiative effect enhances drug efficacy, antagonistic effect reduces efficacy, and inherent resistance exists without prior antibiotic exposure.

Vancomycin Administration and Monitoring

Assess renal function before administering vancomycin due to its association with nephrotoxicity.
Rapid infusion can cause red man syndrome, necessitating the immediate cessation of the infusion when symptoms appear.

Azithromycin Patient Education

Patients must complete the full prescribed course of azithromycin even if symptoms improve to avoid resistant bacteria.

Cranial Nerve VIII Toxicity

Ototoxicity associated with vancomycin affects cranial nerve VIII, indicated by symptoms like tinnitus and hearing loss.

Antacid Interaction with Ciprofloxacin

Ciprofloxacin should be taken 2 hours before or after antacids to ensure optimal absorption.

Tetracycline Cautions

Tetracycline is contraindicated in patients under 8 years due to the risk of permanent tooth discoloration.
Photosensitivity is a side effect; patients should use sunscreen and wear protective clothing when outdoors.

Doxycycline Administration Understanding

Doxycycline should be taken with food to mitigate gastrointestinal side effects.
Patients should not stop taking the medication prematurely, even if they feel better.

Trimethoprim-Sulfamethoxazole Guidance

Complete the TMP-SMZ course to avoid antibiotic resistance; photosensitivity and proper hydration, with increased water intake, are advised.

Symptoms of Stevens-Johnson Syndrome

Indicators include fatigue and a painful rash, necessitating immediate medical attention.

Tuberculosis Transmission

Tuberculosis spreads primarily through inhaling droplets from talking, sneezing, or coughing; it is not spread through sexual contact or shared toilet seats.

Isoniazid Side Effects

Potential side effects include tremors, drowsiness, photosensitivity, and changes in vision, but not hearing loss or red-orange urine.

Fluconazole Cautions

Cautious use of fluconazole is advised in pregnant patients, those with kidney failure, or liver disease, while being indicated for candidiasis and cryptococcal meningitis.

Acyclovir Use

Acyclovir specifically targets the varicella-zoster virus, which causes herpes zoster; it is ineffective against Proteus vulgaris, Pneumocystis jiroveci, and Staphylococcus aureus.

Varicella-Zoster Virus

The varicella-zoster virus is responsible for chickenpox; other herpes viruses cause different conditions (e.g., cytomegalovirus leads to pneumonia).

Warfarin and Fluconazole Interaction

Co-administration of fluconazole with warfarin can result in increased prothrombin time, indicating a risk for enhanced anticoagulant effect.### Fluconazole and Warfarin Interaction
Fluconazole may increase prothrombin time in patients taking warfarin, necessitating monitoring for signs of bleeding.
It can elevate liver function tests; however, this does not interact with warfarin.
This combination does not significantly affect potassium or blood glucose levels.
Hypoglycemia risk exists when fluconazole is combined with oral sulfonylureas.

Anthelmintics

Anthelmintics are used to destroy parasitic worms, while antivirals, antibiotics, and antimalarials serve different functions.
Antibiotics target bacterial infections, and antimalarials focus on malaria caused by Plasmodium species.

Antimicrobial Classification

Antimicrobial drug classification encompasses a vast range of medications, including antivirals, antifungals, and antiparasitics.
Antimicrobials such as quinines do not encompass the full scope of these classifications.

Ivermectin Side Effects

Common side effects of ivermectin include gastrointestinal issues like nausea, vomiting, and diarrhea.
Anxiety, hypertension, and constipation are not typical reactions to anthelmintics.

Isoniazid and Pyridoxine

Isoniazid, used for tuberculosis, can cause pyridoxine deficiency, potentially leading to peripheral neuropathy.
Pyridoxine (Vitamin B6) is prescribed to prevent nerve damage caused by isoniazid.

Nystatin for Oral Candidiasis

Patients diagnosed with oral candidiasis should swish and gargle with nystatin to treat the infection effectively.
Nystatin is an antifungal specifically targeting candidal infections.

Tuberculosis Transmission

Tuberculosis spreads via inhalation of droplets from an infected person, not through contact with blood, stool, or surfaces.
Patients with active tuberculosis should be placed on droplet precautions.

Isoniazid Laboratory Values

Isoniazid increases alanine aminotransferase levels but does not affect blood glucose levels significantly.
The drug can potentially lower neutrophil count, leading to agranulocytosis.

Acyclovir for Viral Infections

Acyclovir is the primary drug for treating infections caused by herpes simplex viruses and varicella-zoster virus.
Other antiviral drugs like zanamivir and ganciclovir target different viruses.

Varicella-Zoster Virus and Shingles

Following chickenpox, the varicella-zoster virus can reactivate later in life as shingles.
Gastroenteritis, retinitis, and Kaposi sarcoma are unrelated to a history of chickenpox.

Nystatin Administration Purpose

Nystatin is administered for treating oral candidiasis, effective orally due to its ability to contact mucous membranes.

First-Line Antitubercular Drugs

Isoniazid is identified as a first-line drug in tuberculosis treatment.
Other first-line agents include rifampin, pyrazinamide, and ethambutol; others are considered second-line.

Superinfection Signs

White patches on the tongue may indicate superinfection in patients receiving anti-infective agents.
General symptoms like itching or decreased urinary output do not specifically signify a superinfection.

Helminthiasis Site

The intestine is recognized as the most common site for helminthiasis (worm infection).

Infection Spread Prevention

Effective handwashing before meals and after toilet use is essential to prevent the spread of helminthiasis.
General hygiene measures like daily showers do not directly prevent the spread of infection.

Inflammation Cardinal Signs

Cardinal signs of inflammation include pain, swelling, and redness.
An increase in function is incorrect; typically, function decreases during inflammation.

Reye Syndrome in Children

Aspirin use in febrile children poses a risk for Reye syndrome, characterized by symptoms like vomiting and lethargy.
Reye syndrome is a critical concern, especially following viral infections like influenza.

Aspirin and Bruising

Bruising is a common side effect in patients taking aspirin due to its effect on platelet function.
Nurses should educate families on this typical reaction rather than dismiss concerns outright.

Mechanism of Action of Allopurinol

Allopurinol decreases uric acid biosynthesis, helpful for conditions like gout.
Different drugs target various pathways, emphasizing the importance of understanding specific drug mechanisms.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on antibacterials in this Topic 10 Part 1 quiz. The questions explore various concepts including superinfection and mechanisms of action. Perfect for students studying microbiology or pharmaceutical sciences.