Chapter 5 Drugs Bacterial Infections Flashcards
(35 cards)
A patient receiving antibiotics for the treatment of a bacterial wound infection develops a
secondary fungal infection. The patient asks you to explain why the fungal infection
developed. What is your best response?
a. “Antibiotics can upset the balance of normal flora and allow yeast or fungus to
grow.”
b. “Antibiotic resistance has allowed the bacteria in your wound to become a fungus.”
c. “Genetic changes induced by antibiotics lead to this fungal infection.”
d. “There is no known cause for this secondary fungal infection.”
ANS: A
Antibiotic use can upset the normal flora balance in the body and cause yeast or fungal
infections to occur. Candida is a common body yeast and often overgrows to cause a fungal
infection. When a person is given antibiotics to kill infectious bacteria, the normal flora is
killed off as well.
A breast-feeding mother has been prescribed antimicrobial therapy for an infection. What
information should be included in her teaching plan?
a. Breast-feeding is permitted during antimicrobial therapy and should be continued.
b. Breast-feeding can continue if the breast milk is pumped, and given by bottle.
c. Breast-feeding should be avoided during antimicrobial therapy.
d. Breast-feeding during antimicrobial therapy can lead to mastitis.
ANS: C
Breast-feeding should be avoided during antimicrobial therapy because most of these drugs
are excreted into breast milk and the infant (who may not have an infection) will be exposed
to the actions, side effects, and adverse effects.
What is the action of an antibiotic that is classified as bacteriostatic?
a. Bacteriostatic drugs kill the bacteria.
b. Bacteriostatic drugs slow the growth of bacteria.
c. Bacteriostatic drugs are only effective against gram-positive organisms.
d. Bacteriostatic drugs are only effective against gram-negative organisms.
ANS: B
Bacteriostatic drugs limit or slow the growth of the bacteria, weakening or eventually
leading to the death of the bacteria.
Which term refers to an antibiotic with a high degree of activity against many different
organisms?
a. Antimycotic
b. Bacteriostatic
c. Antimicrobial
d. Broad-spectrum
ANS: D
Drugs that are effective against a variety of organisms are called broad-spectrum antibiotics.
You are caring for an elderly patient who is newly admitted with a suspected urinary tract
infection requiring antimicrobial therapy. Which of the following tests would you expect the
healthcare provider to order before initiating treatment?
a. Abdominal x-ray
b. Blood chemistry
c. Laparoscopic examination
d. Culture and sensitivity studies
ANS: D
The organisms present in the urine must be carefully cultured and tested to see which drugs
are effective against them (drug sensitivity).
You are caring for a patient with an upper respiratory infection from group A beta-hemolytic
streptococci. The patient asks you what antimicrobial drug is effective for this infection.
What is your best response?
a. Cefazolin
b. Penicillin
c. Vancomycin
d. Sulfamethoxazole/trimethoprim
ANS: B
Penicillin is effective in the treatment of the following susceptible organisms: group A beta-
hemolytic streptococci and other less common organisms.
You are teaching a patient about possible side effects when taking penicillin, a broad-
spectrum antibiotic. What is the most common side effect you would stress in teaching the
patient about this drug?
a. Edema of the lower extremities
b. Metallic taste in the mouth
c. Ringing in the ears
d. Loose stools
ANS: D
The most common side effect of penicillin (and many other antibiotics) is simple diarrhea of
two to four loose stools daily.
Which statement is true of any antibiotic used to treat an infection caused by a penicillinase-
producing organism?
a. The antibiotic should be acid stable.
b. The antibiotic should be penicillinase resistant.
c. The antibiotic should have an extended-release formulation.
d. The antibiotic should be a narrow-spectrum preparation.
ANS: B
Penicillins come in different forms; one class is natural penicillinase-resistant penicillin.
Which effect or drug interaction of ampicillin would be important to teach to female patient
of childbearing age?
a. “Ampicillin can reduce the effect of oral contraceptives.”
b. “Ampicillin is given only to patients allergic to penicillin.”
c. “Taking ampicillin can upset your menstrual cycle for the next month.”
d. “NSAIDS taken for menstrual pain can decrease serum levels of ampicillin.”
ANS: A
Ampicillin reduces the effectiveness of oral contraceptives, which can lead to an unplanned
pregnancy. Teach women of childbearing age to use two reliable methods of birth control
while taking any penicillin to prevent unplanned pregnancy.
You are caring for an elderly patient in a long-term care facility who has been prescribed a
cephalosporin. Which adverse effect should you monitor the patient for while taking this
drug?
a. Lethargy
b. Nephrotoxicity
c. Peripheral edema
d. Sleep disturbance
ANS: B
Nephrotoxicity (kidney toxic effects) has been reported with some cephalosporins, and the
incidence is greater in older adult patients and in patients with poor renal function.
A patient who was prescribed a cephalosporin for the treatment of an infection states he has
an allergy to penicillin. What action should you take before giving this drug to the patient?
a. Inform the healthcare provider immediately.
b. Inform the patient that he can take the prescribed drug safely.
c. Instruct the patient to call the healthcare provider only if a rash appears.
d. Instruct the patient to take a dose in your presence to observe for adverse effects.
ANS: A
Patients who are allergic to penicillin are often allergic to the cephalosporins because the
chemical structures are similar. Inform the prescriber about a penicillin allergy.
A patient receiving antibiotics for 3 days reports a skin rash over the chest, back, and arms.
What is your first action?
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.
ANS: A
A rash is an indication that the patient is allergic to the drug; however, at this time it is not
an emergency. First explore the patient’s response further and hold the dose; then notify the
prescriber of this problem.
Which of the following methods is the correct procedure for giving IM penicillin?
a. Inject the penicillin into the dorsal gluteal site by deep IM injection; do not
aspirate.
b. Inject the penicillin using the Z-track method; aspirate before injecting the drug.
c. Inject subcutaneously as a bleb; if no reaction, then proceed to inject IM.
d. Penicillin is not permitted to be given by IM injection, but by IV only.
ANS: B
Penicillin is given by the Z-track method and aspiration is performed before injecting the
drug. If blood appears in the syringe, remove the syringe, dispose of the drug, and prepare
another dose.
Which cell wall synthesis inhibitor drug is given in an oral form to treat Clostridium
difficile?
a. Gabapentin
b. Vancomycin
c. Doxycycline
d. Clindamycin
ANS: B
Vancomycin has an oral form of a cell wall synthesis inhibitor that is used to combat the
pseudomembranous colitis caused by Clostridium difficile.
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 should
you prepare for the correct dose?
a. 0.25
b. 0.5
c. 2
d. 4
ANS: D
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 your best answer?
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.”
ANS: C
Vancomycin is a powerful antibacterial drug that has many side effects, including “red man
syndrome.” This problem is caused by a histamine release that dilates blood vessels, giving
a red appearance to the face, neck, chest, back, and arms. Sometimes this reaction can be
reduced by slowing the infusion rate; however, it is not an indication to stop the drug.
You are counseling a patient who is to begin a course of tetracycline for the treatment of
Lyme disease. What instructions would be important to provide to this patient?
a. “Tetracycline can cause sun sensitivity, so protect yourself from sun exposure.”
b. “Tetracycline alters blood clotting; avoid injury while taking this drug.
c. “Tetracycline should be taken with food to avoid stomach upset.”
d. “Tetracycline may cause irritation to the vein when it is injected.”
ANS: A
The tetracyclines increase the sensitivity of the skin to the sun and severe sunburns are
possible, even among people with dark complexions.
- The mother of a 6-year-old child with a skin infection asks why her child is not being treated
with tetracycline as she was for a similar infection. What is your best response?
a. “Tetracycline can impair the development of teeth and bones in young children.”
b. “Tetracycline is a large pill and difficult for a young child to swallow.”
c. “Tetracycline can cause severe headaches in young children.”
d. “Tetracycline can cause seizures in young children.”
ANS: A
Tetracycline interferes with bone development and the development of tooth enamel.
Exposure to tetracycline can cause permanent tooth staining.
Which statement is true regarding macrolides?
a. Macrolides are the first treatment for MRSA infection.
b. Macrolides always require a longer course of treatment.
c. Macrolides cannot be used for patients with a penicillin allergy.
d. Macrolides are effective against the same organisms as penicillin.
ANS: D
Macrolides are effective against the same infectious organisms that are sensitive to penicillin
and are used for patients who have a penicillin allergy. These drugs are not effective against
MRSA.
You are caring for a hospitalized patient receiving gentamycin IV, an aminoglycoside, for
the treatment of Pseudomonas pneumonia. Which laboratory values would be important to
monitor to avoid adverse effects from drugs of this classification?
a. Complete blood count
b. BUN and creatinine
c. Troponin levels
d. Liver enzymes
ANS: B
Patients who are given aminoglycosides must be monitored for nephrotoxicity (kidney
damage) as well as ototoxicity. The nurse should monitor BUN and creatinine during
treatment, and report elevations to the healthcare provider.
A sulfonamide, Bactrim, is ordered for a patient with a urinary tract infection. What should
you include in the teaching plan for the patient who is taking this drug?
a. Take the drug on a full stomach.
b. Drink milk when taking the drug.
c. Take the drug at night before going to bed.
d. Drink large amounts of water with this drug.
ANS: D
To prevent crystals in the urine, the patient should be told to drink large amounts of water
while taking this drug.
You are caring for a patient with type 2 diabetes who has been prescribed a course of a
sulfonamide (Bactrim) for a urinary tract infection. Which statement by the patient reflects
understanding of potential drug interactions?
a. “I will need to watch for symptoms of low blood glucose levels.”
b. “I will need to restrict the amount of fluids I drink to prevent edema.”
c. “I will need to take the Bactrim on an empty stomach to increase drug absorption.”
d. “I will need to add additional salt to my food to replace sodium excreted with this
drug.”
ANS: A
Sulphonamides can interact with some type 2 diabetic drugs, such as sulfonylureas that can
cause symptoms of hypoglycemia (fatigue, shakiness, anxiety, and irritability).
In reviewing a patient’s reported drug allergies, which drug class sensitivity would suggest
the patient should not be given a sulfonamide?
a. Beta blockers
b. ACE-inhibitors
c. Thiazide diuretics
d. Calcium channel blockers
ANS: C
Patients with an allergy or sensitivity to thiazide diuretics, oral sulfonylureas, or carbonic
anhydrase inhibitors may exhibit the same allergy or sensitivity to sulfonamides.
You are providing education for a patient prescribed a fluoroquinolone. Which response
made by the patient indicates that teaching has been effective?
a. “There are no drug interactions associated with fluoroquinolones.”
b. “I should take this drug with food to decrease GI upset.”
c. “I can take this drug with caffeine such as a cup of coffee.”
d. “I can discontinue this drug once I feel better.”
ANS: B
Fluoroquinolones should be taken with food to decrease adverse GI effects.
