Chapter 16 Drug Therapy With Beta-Lactam Antibacterial Agents


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Chapter 16  Drug Therapy With Beta-Lactam Antibacterial Agents



Complete chapter Questions And Answers

Sample Questions



1. A patient is administered penicillin V orally for a strep throat. What is the mechanism of action of this medication?

  1. A)  It inhibits protein synthesis.
  2. B)  It lowers the pH of cellular contents.
  3. C)  It causes mutations.
  4. D)  It inhibits cell wall synthesis.

Ans: D
Beta-lactam antibacterial drugs inhibit synthesis of bacterial cell walls by binding to proteins in bacterial cell membranes. Penicillin V does not inhibit protein synthesis, cause mutations, or lower the pH of a bacterium’s cellular contents.

2. A patient previously experienced an anaphylactic reaction to penicillin G. Which of the following medications should not be administered to this patient due to the potential for cross-sensitivity?

  1. A)  Lactulose (Chronulac)
  2. B)  Ketoconazole (Nizoral)
  3. C)  Kanamycin (Kantrex)
  4. D)  Cefadroxil (Duricef)

Ans: D


Cefadroxil (Duricef) is a cephalosporin. Administration of cephalosporins or carbapenems should be avoided if possible in people with life-threatening allergic reactions to penicillin. Lactulose reduces blood ammonia by resident intestinal bacteria. It is not contraindicated in the event of penicillin anaphylaxis. Ketoconazole is an antifungal and does not possess cross-sensitivity to penicillin. Kanamycin is an aminoglycoside and does not possess cross-sensitivity to penicillin.

3. An adult patient has a history of rheumatic fever. Which of the following medications should be administered as prophylaxis for rheumatic fever?

  1. A)  Cyclacillin (Cyclapen)
  2. B)  Amoxicillin (Augmentin)
  3. C)  Dicloxacillin
  4. D)  Penicillin G benzathine (Bicillin LA)

Ans: D
Penicillin G benzathine (Bicillin LA) is administered as prophylaxis for rheumatic fever. Cyclacillin, amoxicillin, and dicloxacillin are not routinely administered for prophylaxis of rheumatic fever.

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4. A patient has been prescribed an oral penicillin for an infection caused by gram-negative bacilli. When conducting health education for this patient, the nurse should emphasize which of the following?

  1. A)  The need to take the medication on an empty stomach
  2. B)  The fact that a mild rash frequently follows the first few doses
  3. C)  The need to increase fluid intake for the duration of treatment
  4. D)  The fact that the drug should be discontinued once symptoms subside

Ans: A
Most penicillins should be best taken on an empty stomach. Increased fluid intake is not normally necessary. A rash is an unexpected finding that should be reported promptly. The patient should take the full course of antibiotics.

5. Unasyn is being administered to a patient with an infection caused by Staphylococcus aureus. What type of anti-infective is Unasyn?

  1. A)  Extended-spectrum antipseudomonal penicillin
  2. B)  Penicillin–beta-lactamase inhibitor combination
  3. C)  Cephalosporin
  4. D)  Aminopenicillin

Ans: B
Unasyn is a penicillin–beta-lactamase inhibitor combination. It is ampicillin and sulbactam. Unasyn is not classified as an extended-spectrum antipseudomonal penicillin, cephalosporin, or aminopenicillin.

6. A patient is administered Augmentin (amoxicillin and clavulanate potassium) to treat otitis media. How does a beta-lactamase inhibitor agent achieve a therapeutic effect?

  1. A)  It extends the spectrum of antibacterial activity of penicillin.
  2. B)  It extends the spectrum of the beta-lactamase inhibitor.
  3. C)  It decreases the side effects of high-dose penicillin.
  4. D)  It increases the absorption of the penicillin.

Ans: A Feedback:

When combined with a penicillin, the beta-lactamase inhibitor protects the penicillin from destruction by the enzymes and extends the penicillin’s spectrum of antimicrobial activity. Augmentin does not extend the spectrum of beta-lactamase inhibitor. Augmentin does not decrease the side effects of high-dose penicillin. Augmentin does not increase the absorption of penicillin.

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