NCLEX - Week 8 Flashcards
A nurse is caring for a client with a wound infection. What is the nurse’s priority action?
A. Administer antibiotic medication.
B. Obtain a wound specimen for culture.
C. Monitor the client for a superinfection. D. Teach the client about wound care.
B. Obtain a wound specimen for culture.
Obtaining a wound culture before administering antibiotics is crucial to identify the causative organism and its sensitivities.
This guides appropriate antibiotic selection and prevents unnecessary broad-spectrum antibiotic use.
While the other options are important, obtaining a culture is the priority.
Which of the following best describes selective toxicity in antimicrobial therapy?
A. The ability of a drug to injure only host cells.
B. The ability of a drug to kill or suppress microbial pathogens without harming host cells.
C. The ability of a drug to work synergistically with host defenses.
D. The ability of a drug to be equally effective against a wide range of pathogens.
B. The ability of a drug to kill or suppress microbial pathogens without harming host cells.
Selective toxicity refers to the drug’s ability to harm the target microbe without harming the host. This is the basis of successful antibiotic therapy
A client is prescribed a broad-spectrum antibiotic. What is a potential risk associated with this type of antibiotic?
A. Increased susceptibility to viral infections.
B. Development of superinfection.
C. Decreased drug resistance.
D. Improved immune response.
B. Development of superinfection.
Broad-spectrum antibiotics kill a wider range of bacteria, including beneficial normal flora, leading to the overgrowth of resistant organisms and the development of a superinfection
A client develops C. difficile infection (CDI) during antibiotic therapy. This is an example of what?
A. Innate resistance
B. Acquired resistance
C. Superinfection
D. Synergistic effect
C. Superinfection
CDI is a common superinfection that occurs when antibiotics eliminate normal gut flora, allowing C. difficile to overgrow
Before initiating antibiotic therapy, what is a crucial nursing intervention?
A. Administer the first dose immediately. B. Obtain a specimen for culture and sensitivity testing.
C. Teach the client about potential drug interactions.
D. Assess the client’s renal function.
B. Obtain a specimen for culture and sensitivity testing.
Collecting specimens for culture and sensitivity before starting antibiotics allows for precise identification of the pathogen and guides selection of the most effective antibiotic
What is conjugation in the context of bacterial resistance?
A. A spontaneous genetic mutation.
B. Transfer of extrachromosomal DNA containing resistance genes.
C. The process by which bacteria produce enzymes that inactivate antibiotics.
D. The development of resistant strains through prolonged antibiotic exposure.
B. Transfer of extrachromosomal DNA containing resistance genes.
Conjugation is the transfer of extrachromosomal DNA (R factors) carrying resistance genes between bacteria, leading to multiple drug resistance
What is the minimum inhibitory concentration (MIC)?
A. The lowest concentration of antibiotic that kills 99.9% of bacteria.
B. The lowest concentration of antibiotic that completely inhibits bacterial growth. C. The highest concentration of antibiotic that can be safely administered.
D. The concentration of antibiotic needed to prevent bacterial resistance.
B. The lowest concentration of antibiotic that completely inhibits bacterial growth.
The MIC is the lowest antibiotic concentration completely preventing bacterial growth. It’s important for determining appropriate dosage
A client with a prosthetic heart valve is scheduled for dental work. What type of antimicrobial therapy is indicated?
A. Empiric therapy
B. Prophylactic therapy
C. Therapeutic therapy
D. Superinfection prevention
B. Prophylactic therapy
Prophylactic antimicrobial therapy is recommended before dental procedures in clients with prosthetic heart valves to prevent bacterial endocarditis
Which of the following is an example of a misuse of antibiotics?
A. Treating a bacterial infection based on culture and sensitivity results.
B. Administering antibiotics for a proven bacterial infection.
C. Treating a viral infection with antibiotics. D. Using antibiotics prophylactically before surgery.
C. Treating a viral infection with antibiotics.
Antibiotics are ineffective against viral infections. Their use in such cases promotes antibiotic resistance and exposes the patient to unnecessary risk
A nurse is monitoring a client receiving vancomycin. Which lab value is most important to monitor?
A. White blood cell count
B. Liver function tests
C. Serum creatinine
D. Blood glucose
C. Serum creatinine
Vancomycin’s main toxicity is nephrotoxicity, therefore monitoring serum creatinine (a measure of kidney function) is essential
A client receiving a penicillin antibiotic reports difficulty breathing and a skin rash. What is the nurse’s priority action?
A. Administer diphenhydramine.
B. Assess the client’s vital signs and notify the provider immediately.
C. Document the findings and continue monitoring the client.
D. Stop the medication and wait for the provider’s order.
B. Assess the client’s vital signs and notify the provider immediately.
This presentation suggests a severe allergic reaction, potentially anaphylaxis, requiring immediate action. Assess vital signs and alert the provider.
Which of the following clients is at highest risk for antibiotic toxicity?
A. A 30-year-old with a mild respiratory infection.
B. A 65-year-old with renal impairment.
C. A 25-year-old with a urinary tract infection.
D. A 40-year-old with a localized skin infection.
B. A 65-year-old with renal impairment.
Impaired renal function reduces drug elimination and significantly increases the risk of antibiotic toxicity in older adults
What is a key nursing intervention to prevent the spread of C. difficile?
A. Using alcohol-based hand sanitizer.
B. Wearing gloves and a gown when caring for infected clients.
C. Using disposable rectal thermometers. D. All of the above.
D. All of the above.
All these are key interventions to prevent CDI transmission. Alcohol-based sanitizer isn’t effective against C. difficile spores
Which of the following antibiotics is considered penicillinase-resistant?
A. Penicillin G
B. Amoxicillin
C. Nafcillin
D. Ampicillin
C. Nafcillin
Nafcillin is a penicillinase-resistant penicillin.
A client with a history of penicillin allergy requires treatment for a bacterial infection. Which antibiotic class should be approached with caution?
A. Aminoglycosides
B. Fluoroquinolones
C. Cephalosporins
D. Macrolides
C. Cephalosporins
Cross-reactivity between penicillins and cephalosporins exists, although it is not always significant. Caution is advised
- What is a key component of antimicrobial stewardship?
A. Administering antibiotics to all hospitalized patients.
B. Using broad-spectrum antibiotics routinely.
C. Using antibiotics judiciously only when needed.
D. Discouraging vaccination programs.
C. Using antibiotics judiciously only when needed.
Antimicrobial stewardship focuses on using antibiotics only when necessary to minimize resistance
A client is receiving cefazolin. Which of the following should be avoided?
A. Dairy products
B. Caffeine
C. Alcohol
D. Aspirin
C. Alcohol
Cefazolin can cause a disulfiram-like reaction with alcohol
- What is a common adverse effect of vancomycin?
A. Hepatotoxicity
B. Nephrotoxicity
C. Ototoxicity
D. B and C
D. B and C
Vancomycin can cause both nephrotoxicity and ototoxicity
What is red man syndrome?
A. A rare allergic reaction to vancomycin. B. An adverse effect of rapid vancomycin infusion.
C. A common side effect of penicillin therapy.
D. A type of superinfection.
B. An adverse effect of rapid vancomycin infusion.
Rapid infusion of vancomycin can cause “red man syndrome” due to histamine release
Which antibiotic is effective against methicillin-resistant Staphylococcus aureus (MRSA)?
A. Penicillin G
B. Amoxicillin
C. Ceftaroline
D. Cefazolin
C. Ceftaroline
Ceftaroline is a fifth-generation cephalosporin active against MRSA
Which of the following is a bacteriostatic antibiotic?
A. Penicillin G
B. Vancomycin
C. Tetracycline
D. Aminoglycoside
C. Tetracycline
Tetracycline is bacteriostatic, inhibiting bacterial growth rather than killing them directly
Which type of antibiotic is active against a wide range of bacteria?
A. Narrow-spectrum
B. Broad-spectrum
C. Bactericidal
D. Bacteriostatic
B. Broad-spectrum
Broad-spectrum antibiotics are effective against a variety of bacteria
What is the priority nursing intervention when a patient experiences anaphylaxis to penicillin?
A. Administer epinephrine
B. Administer diphenhydramine
C. Monitor the patient’s vital signs
D. Contact the provider
A. Administer epinephrine
Epinephrine is the first-line treatment for anaphylaxis, a life-threatening allergic reaction
What is a characteristic of first-generation cephalosporins?
A. High activity against gram-negative bacteria
B. Resistance to beta-lactamases
C. Good penetration into the cerebrospinal fluid
D. Susceptibility to beta-lactamases
D. Susceptibility to beta-lactamases
First-generation cephalosporins are often susceptible to inactivation by beta-lactamases
Which antibiotic is frequently used to treat C. difficile infection (CDI)?
A. Penicillin G
B. Vancomycin
C. Azithromycin
D. Ciprofloxacin
B. Vancomycin
Oral or rectal vancomycin is a common treatment for CDI
What is a crucial nursing intervention for clients receiving intravenous (IV) vancomycin?
A. Administering it as a rapid IV push
B. Infusing it slowly over 60 minutes or longer
C. Discontinuing it if the patient develops a mild rash
D. Not monitoring blood levels
B. Infusing it slowly over 60 minutes or longer
Slow infusion is crucial to minimize the risk of red man syndrome
Which class of antibiotics does imipenem belong to?
A. Penicillins
B. Cephalosporins
C. Carbapenems
D. Glycopeptides
C. Carbapenems
Imipenem is a carbapenem
What is a potential drug interaction with imipenem-cilastatin?
A. Valproic acid
B. Vitamin K
C. Aspirin
D. Diphenhydramine
A. Valproic acid
Imipenem-cilastatin can lower valproic acid levels, increasing seizure risk
Which of the following factors should be considered when selecting an antibiotic?
A. The client’s age
B. The site of infection
C. The client’s allergies
D. All of the above
D. All of the above
All these factors are critical in choosing an antibiotic
What is a potential adverse effect of cefotetan?
A. Ototoxicity
B. Nephrotoxicity
C. Bleeding tendencies
D. Hepatotoxicity
C. Bleeding tendencies
Cefotetan can increase bleeding risk
What is a sign of clinical improvement in a client receiving antimicrobial therapy?
A. Increased white blood cell count
B. Resolution of fever
C. Increased serum creatinine level
D. Development of a new infection
B. Resolution of fever
Reduction of fever is a positive indicator of treatment effectiveness
Which generation of cephalosporins generally has better penetration into the cerebrospinal fluid (CSF)?
Select all that apply
A. First generation
B. Second generation
C. Third generation
D. Fourth generation
C. Third generation
D. Fourth generation
Third and fourth-generation cephalosporins have better CSF penetration
What is an important teaching point for clients taking oral antibiotics?
A. They can stop taking them as soon as symptoms improve.
B. They should take them with food to enhance absorption.
C. They should complete the entire prescribed course of therapy.
D. They do not need to report any adverse effects.
C. They should complete the entire prescribed course of therapy.
Completing the full course is crucial to prevent relapse and development of resistance
Which of the following is a risk factor for healthcare-associated MRSA (HCA-MRSA) infection?
A. Recent hospitalization
B. Long-term care facility residence
C. Prolonged antibiotic therapy
D. All of the above
D. All of the above
All are risk factors for HCA-MRSA
Which of the following is a common sign of antibiotic-associated pseudomembranous colitis?
A. Constipation
B. Diarrhea
C. Increased appetite
D. Weight gain
B. Diarrhea
Diarrhea is a key symptom of antibiotic-associated colitis caused by C. difficile
What should be done before administering nafcillin IM to a client?
A. Check the client’s blood glucose
B. Inquire about any penicillin allergies
C. Obtain a urine sample
D. Draw a blood culture
B. Inquire about any penicillin allergies
Penicillin allergy is a contraindication for nafcillin
What is a common mechanism of bacterial resistance to penicillins?
A. Increased cell wall permeability
B. Production of penicillin-binding proteins with low affinity
C. Increased drug efflux
D. Altered ribosome function
B. Production of penicillin-binding proteins with low affinity
Production of altered PBPs is a major mechanism of penicillin resistance
Which of the following is an appropriate indication for prophylactic antibiotic use?
A. Treatment of a common cold
B. Prevention of infection before surgery
C. Treatment of a viral infection
D. Treatment of fever of unknown origin
B. Prevention of infection before surgery
Prophylactic antibiotics are used before certain surgeries to prevent infection
What is a potential adverse effect of extended-spectrum penicillins?
A. Hyperkalemia
B. Hyponatremia
C. Hypokalemia
D. Hypernatremia
A. Hyperkalemia
High doses of penicillin G potassium can cause hyperkalemia
Which of the following is a common side effect of cephalosporins?
A. Hepatotoxicity
B. Nephrotoxicity
C. Allergic reaction
D. Ototoxicity
C. Allergic reaction
Allergic reactions are common with cephalosporins
What is an important nursing assessment to perform before administering a cephalosporin?
A. Assess the client’s weight
B. Assess for penicillin allergy
C. Check the client’s potassium level
D. Measure the client’s blood glucose
B. Assess for penicillin allergy
Because of the potential for cross-reactivity, penicillin allergy should be assessed
What is a crucial nursing intervention when administering IV cephalosporins?
A. Rapid IV push
B. Slow IV infusion
C. Administration with meals
D. Continuous IV infusion
B. Slow IV infusion
Slow IV infusion is often recommended to reduce the risk of thrombo
Which antibiotic can cause a disulfiram-like reaction with alcohol?
A. Vancomycin
B. Cefazolin
C. Erythromycin
D. Gentamicin
B. Cefazolin
Cefazolin can cause a disulfiram-like reaction with alcohol
What type of infection is commonly treated with fosfomycin?
A. Pneumonia
B. Sepsis
C. Urinary tract infection
D. Endocarditis
C. Urinary tract infection
Fosfomycin is used for uncomplicated urinary tract infections
Which antibiotic requires dose adjustments in clients with renal impairment?
A. Ceftaroline
B. Ceftriaxone
C. Most cephalosporins
D. Both A and C
D. Both A and C
Most cephalosporins (except ceftriaxone) require dosage adjustment for renal impairment. Ceftaroline also needs dose adjustments for renal impairment
What is a potential complication associated with aztreonam?
A. Ototoxicity
B. Nephrotoxicity
C. Hepatotoxicity
D. Thrombophlebitis
D. Thrombophlebitis
Thrombophlebitis at the IV site is a potential adverse effect of aztreonam
Which antibiotic is commonly used for severe infections and is often a last resort due to potential toxicity?
A. Amoxicillin
B. Cephalexin
C. Vancomycin
D. Amoxicillin/clavulanate
C. Vancomycin
Vancomycin is reserved for serious infections due to its potential for toxicity
Which of the following is a mechanism of action of vancomycin?
A. Inhibition of protein synthesis
B. Inhibition of cell wall synthesis
C. Disruption of bacterial cell membrane
D. Inhibition of nucleic acid synthesis
B. Inhibition of cell wall synthesis
Vancomycin inhibits cell wall synthesis
Which of the following measures helps prevent MRSA transmission?
A. Frequent hand washing
B. Avoiding contact with infected individuals
C. Keeping infected wounds covered
D. All of the above
D. All of the above
All measures help prevent MRSA transmission
What is an important instruction for patients taking penicillin V?
A. Take it on an empty stomach
B. Take it with meals
C. Take it only when symptoms are present D. Take it with a glass of milk
B. Take it with meals
Penicillin V may be taken with food. The other options are incorrect.
The full course should be completed even if symptoms improve.
It should not be taken with milk due to potential calcium interactions.
