Chapter 45 Antimicrobial Agents

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Chapter 45  Antimicrobial Agents

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

MULTIPLE CHOICE

1. A patient allergic to penicillin is being evaluated for a gram-negative infection. Which antimicrobial drug class would the health care provider be cautious in prescribing because of a possible cross sensitivity and/or allergic reaction?
a.
Cephalosporins
b.
Aminoglycosides
c.
Sulfonamides
d.
Quinolones

ANS: A
Cephalosporins may be used with caution as alternatives when patients are allergic to the penicillins, but cephalosporins are chemically similar in structure to penicillins and may produce a cross sensitivity and/or allergic reaction. Aminoglycosides, sulfonamides, and quinolones do not tend to produce cross sensitivities.

DIF: Cognitive Level: Comprehension REF: Page 695 OBJ: 3
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety

2. The health care provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease. What is the purpose of combining these medications?
a.
To accelerate the excretion of the penicillin
b.
To inhibit the absorption of penicillin to allow the drug to remain in the transport phase
c.
To inhibit the excretion of the penicillin
d.
To reduce toxic effects associated with penicillin

ANS: C
The combination therapy of penicillin and probenecid allows the penicillin to remain in the body longer, which enhances drug availability and action. The combination may be used advantageously in treating serious or resistant infections. Probenecid inhibits the excretion of penicillin, slows down the excretion of penicillin, and does not affect absorption or toxic effects.

DIF: Cognitive Level: Comprehension REF: Page 690 OBJ: 1 | 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety

3. An older adult who has septicemia is receiving IV aminoglycoside therapy. Which symptom is most important for the nurse to monitor?
a.
Bone marrow suppression
b.
Ototoxicity
c.
Gastrointestinal (GI) distress
d.
Photosensitivity

ANS: B
Eighth cranial nerve damage can result from aminoglycoside therapy. Patients should be monitored during therapy and after therapy has been discontinued for signs and symptoms of ototoxicity, including dizziness, tinnitus, and progressive hearing loss. Aminoglycosides do not produce bone marrow depression; this is characteristic of treatment with chloramphenicol. Aminoglycosides do not typically produce GI distress. Aminogylcosides do not produce photosensitivity; this is characteristic of treatment with glycylcyclines.

DIF: Cognitive Level: Application REF: Page 690 OBJ: 4
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
NOT: CONCEPT(S): Clinical Judgment; Safety; Sensory Perception

4. On what is the selection of an antimicrobial agent based?
a.
Sensitivity of the microorganism to the drug
b.
Half-life of the medication
c.
Therapeutic levels of the drug
d.
Bioavailability of the drug

ANS: A
The selection of the antimicrobial agent must be based on the sensitivity of the pathogen and the possible toxicity to the patient. The half-life of the drug is not a concern with selection in comparison to sensitivity. Therapeutic levels of the drug are not criteria for selection. Bioavailability is a lesser concern than sensitivity.

DIF: Cognitive Level: Comprehension REF: Page 687 OBJ: 1 | 5
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment

5. A patient is scheduled to take tetracycline and aluminum hydroxide (Amphojel) at the same time. When will the nurse administer the medications to achieve the optimal effects?
a.
Both medications together
b.
Amphojel 30 minutes before tetracycline
c.
Tetracycline with orange juice
d.
Tetracycline 1 hour before Amphojel

ANS: D
For optimal effectiveness, tetracyclines should be administered 1 hour before or 2 hours after ingesting antacids, milk, or other dairy products or products containing calcium, aluminum, magnesium, or iron. Taking the drugs this closely together will most likely inhibit absorption of the antibiotic. Tetracycline does not tend to interact with orange juice, but the beverage may be contraindicated in a patient who needs to take antacids.

DIF: Cognitive Level: Application REF: Page 709 OBJ: 1 | 5
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
NOT: CONCEPT(S): Clinical Judgment

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