Week One Flashcards
A patient is prescribed penicillin G for a bacterial infection. The nurse understands that penicillin G is effective during which bacterial phase?
A: During bacterial dormancy
B. During bacterial spore formation
C. During bacterial growth and division
D. During bacterial phagocytosis
C. During bacterial growth and division
Rationale: Pen G is a bactericidal antibiotic that is only effective when bacteria are growing and dividing, as it inhibits the formation of the bacterial cell wall by targeting penicillin-binding proteins (PBPs) essential for cell wall synthesis.
A patient has been prescribed a combination of penicillin and aminoglycoside for a severe infection. Which of the following nursing actions is appropriate when administering these medications?
A. Administer the medications in the same IV solution for synergistic effects.
B. Administer the penicillin first, then the aminoglycoside in separate IV solutions.
C. Delay administration of the aminoglycoside until after the penicillin course is complete.
D. Administer both medications orally to avoid interactions.
Answer: B. Administer the penicillin first, then the aminoglycoside in separate IV solutions.
Rationale: Penicillin weakens the bacterial cell wall, which allows aminoglycosides to penetrate and effectively kill the bacteria. However, penicillin can inactivate aminoglycosides if mixed in the same IV solution, so they should be administered separately.
Which of the following is a common side effect that patients should be educated about when taking tetracycline antibiotics?
A. Hypertension
B. Photosensitivity
C. Bradycardia
D. Diarrhea without the risk of superinfection
Answer: B. Photosensitivity
Rationale: Tetracycline antibiotics can cause photosensitivity, leading to exaggerated sunburns. Patients should be advised to use sun protection, such as wearing sunscreen and protective clothing
A nurse is assessing a patient taking vancomycin for the treatment of a serious infection. Which of the following lab values is most important to monitor?
A. Serum potassium levels
B. Trough levels of vancomycin
C. Hemoglobin levels
D. Serum glucose levels
Answer: B. Trough levels of vancomycin
Rationale: Vancomycin has a narrow therapeutic window, and trough levels must be monitored to avoid toxicity. Renal failure is a significant adverse effect, and if the patient’s creatinine level increases by 50%, vancomycin should be discontinued.
A patient taking clindamycin develops severe diarrhea. What is the nurse’s priority action?
A. Administer an antidiarrheal agent
B. Encourage the patient to increase fluid intake
C. Assess for the presence of Clostridium difficile infection
D. Discontinue the medication immediately
Answer: C. Assess for the presence of Clostridium difficile infection
Rationale: Clindamycin can lead to an overgrowth of drug-resistant microbes, particularly Clostridium difficile (C. diff), which can cause severe diarrhea. It’s essential to assess for C. diff and manage appropriately, rather than immediately stopping the medication
Which of the following best describes selective toxicity in antimicrobial therapy?
A. Ability of the drug to suppress host immune responses
B. Ability of the drug to injure target organisms without harming the host
C. Ability of the drug to eliminate all microbes in the body
D. Ability of the drug to promote bacterial growth
Answer: B. Ability of the drug to injure target organisms without harming the host
Rationale: Selective toxicity is a critical concept in antimicrobial therapy, where the drug targets the microbe without damaging the host’s cells
Penicillin exerts its bactericidal effect by which of the following mechanisms?
A. Disrupting bacterial protein synthesis
B. Inhibiting bacterial DNA replication
C. Inhibiting bacterial cell wall synthesis
D. Disrupting bacterial RNA synthesis
Answer: C. Inhibiting bacterial cell wall synthesis
Rationale: Penicillin disrupts the bacterial cell wall by inhibiting transpeptidases necessary for cell wall synthesis
A patient is receiving vancomycin IV for MRSA. Why is it important to monitor the trough level of vancomycin?
A. To assess liver function
B. To evaluate the potential for allergic reactions
C. To avoid nephrotoxicity
D. To monitor the effectiveness of the drug
Answer: C. To avoid nephrotoxicity
Rationale: Vancomycin is nephrotoxic, and monitoring trough levels helps prevent renal damage.
Which of the following antibiotics is excreted by the liver rather than the kidneys?
A. Cephalexin
B. Ceftriaxone
C. Vancomycin
D. Penicillin G
Answer: B. Ceftriaxone
Rationale: Ceftriaxone is primarily excreted via the liver, unlike most cephalosporins, which are eliminated through the kidneys
Which of the following is an example of a broad-spectrum antibiotic?
A. Penicillin G
B. Vancomycin
C. Amoxicillin
D. Erythromycin
Answer: C. Amoxicillin
Rationale: Amoxicillin is a broad-spectrum penicillin that works against both Gram-positive and Gram-negative organisms
Which of the following antibiotics is classified as narrow-spectrum?
A. Tetracycline
B. Penicillin V
C. Piperacillin
D. Cefepime
Answer: B. Penicillin V
Rationale: Penicillin V is a narrow-spectrum antibiotic effective against Gram-positive bacteria
Bacterial resistance to antibiotics occurs primarily due to which of the following?
A. Genetic changes in the host
B. Development of altered drug receptors in the bacteria
C. Overproduction of natural enzymes by the host
D. Prolonged exposure to UV radiation
Answer: B. Development of altered drug receptors in the bacteria
Rationale: Bacteria develop resistance by changing the structure of their drug receptors, preventing antibiotics from binding effectively.
Which of the following antibiotics is effective against MRSA due to its resistance to beta-lactamase?
A. Cefazolin
B. Ceftaroline
C. Tetracycline
D. Penicillin G
Answer: B. Ceftaroline
Rationale: Ceftaroline is a 5th generation cephalosporin effective against MRSA because it binds to altered PBPs.
A patient receiving penicillin reports experiencing throat swelling and difficulty breathing. What is the nurse’s first priority?
A. Administer antihistamines
B. Monitor for anaphylactic shock
C. Administer epinephrine
D. Discontinue the antibiotic immediately
Answer: C. Administer epinephrine
Rationale: The patient’s symptoms indicate anaphylaxis, which requires immediate treatment with epinephrine
Which antibiotic is most likely to cause a superinfection?
A. Clindamycin
B. Amoxicillin
C. Vancomycin
D. Ceftriaxone
Answer: A. Clindamycin
Rationale: Clindamycin has a high risk of causing superinfections like C. difficile due to its broad-spectrum activity
What adverse effect should the nurse educate the patient about when taking tetracycline?
A. Photosensitivity
B. Hypertension
C. Seizures
D. Hyperglycemia
Answer: A. Photosensitivity
Rationale: Tetracyclines can cause photosensitivity, leading to an exaggerated response to sunlight.
A patient taking aminoglycosides for a bacterial infection reports hearing loss. What is the most likely cause?
A. Nephrotoxicity
B. Hepatotoxicity
C. Ototoxicity
D. Photosensitivity
Answer: C. Ototoxicity
Rationale: Aminoglycosides can cause ototoxicity, leading to hearing loss, especially with prolonged use or high doses
Which of the following drugs should not be mixed with penicillin in the same IV solution due to inactivation?
A. Tetracycline
B. Vancomycin
C. Aminoglycosides
D. Cephalosporins
Answer: C. Aminoglycosides
Rationale: Penicillin can inactivate aminoglycosides when mixed in the same IV solution, reducing the effectiveness of both drugs
A patient taking erythromycin should avoid which of the following drugs due to the risk of QT prolongation?
A. Digoxin
B. Warfarin
C. Verapamil
D. Acetaminophen
Answer: C. Verapamil
Rationale: Erythromycin can cause QT prolongation, and concurrent use with drugs like verapamil increases the risk of arrhythmias.
Which of the following best describes the mechanism of action of vancomycin?
A. Inhibits protein synthesis
B. Inhibits DNA synthesis
C. Disrupts the formation of the bacterial cell wall
D. Binds to ribosomal sub-units.
Answer: C. Disrupts the formation of the bacterial cell wall
Rationale: Vancomycin inhibits cell wall synthesis by preventing precursor molecules from forming the bacterial cell wall
