Chapter 38: Antibiotics Part 1 204
Chapter 38: Antibiotics Part 1
MULTIPLE CHOICE
1. When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to
penicillin. Based on this finding, the nurse would question an order for which class of
antibiotics?
a. Tetracyclines
b. Sulfonamides
c. Cephalosporins
d. Quinolones
ANS: C
Allergy to penicillin may also result in hypersensitivity to cephalosporins. The other options are
incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension)
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which
statement by the nurse is correct?
a. “Avoid direct sunlight and tanning beds while on this medication.”
b. “Milk and cheese products result in increased levels of tetracycline.”
c. “Antacids taken with the medication help to reduce gastrointestinal distress.”
d. “Take the medication until you are feeling better.”
ANS: A
Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for
several days after therapy. Milk and cheese products result in decreased levels of tetracycline
when the two are taken together. Antacids also interfere with absorption and should not be taken
with tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if
they feel that they are no longer ill.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that
the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may
occur as the result of an interaction between these drugs?
a. The penicillin will cause an enhanced anticoagulant effect of the warfarin.
b. The penicillin will cause the anticoagulant effect of the warfarin to decrease.
c. The warfarin will reduce the anti-infective action of the penicillin.
d. The warfarin will increase the effectiveness of the penicillin.
ANS: A
, Chapter 38: Antibiotics Part 1 205
Administering penicillin reduces the vitamin K in the gut (intestines); therefore, enhanced
anticoagulant effect of warfarin may occur. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report
that he is feeling “anxious” and is having trouble breathing. What will the nurse do first?
a. Notify the prescriber.
b. Take the patient’s vital signs.
c. Stop the antibiotic infusion.
d. Check for allergies.
ANS: C
Hypersensitivity reactions are characterized by wheezing; shortness of breath; swelling of the
face, tongue, or hands; itching; or rash. The nurse should immediately stop the antibiotic
infusion, have someone notify the prescriber, and stay with the patient to monitor the patient’s
vital signs and condition. Checking for allergies should have been done before the infusion.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals
cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain
stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will
complete these orders in which sequence?
a. Blood culture, antibiotic dose, urine culture
b. Urine culture, antibiotic dose, blood culture
c. Antibiotic dose, blood and urine cultures
d. Blood and urine cultures, antibiotic dose
ANS: D
Culture specimens should be obtained before initiating antibiotic drug therapy; otherwise, the
presence of antibiotics in the tissues may result in misleading culture and sensitivity results. The
other responses are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and
decreased appetite. Which statement is the nurse’s best advice to the patient?
a. “Take it with cheese and crackers or yogurt.”
b. “Take each dose with a glass of milk.”
c. “Take an antacid with each dose as needed.”
d. “Drink a full glass of water with each dose.”
, Chapter 38: Antibiotics Part 1 206
ANS: D
Oral doses should be given with at least 8 ounces of fluids and food to minimize gastrointestinal
upset; however, antacids and dairy products will bind with the tetracycline and make it inactive.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the
patient tells the nurse that he has had watery diarrhea since the day before and is having
abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which
conclusion will the nurse draw?
a. The patient’s original infection has not responded to the antibiotic therapy.
b. The patient is showing typical adverse effects of antibiotic therapy.
c. The patient needs to be tested for Clostridium difficile infection.
d. The patient will need to take a different antibiotic.
ANS: C
Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a
serious superinfection when it causes antibiotic-associated colitis, also known as
pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics
disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most
common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever.
Whenever a patient who was previously treated with antibiotics develops watery diarrhea, the
patient needs to be tested for C. difficile infection. If the results are positive, the patient will need
to be treated for this serious superinfection.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection.
Which laboratory value would indicate therapeutic effectiveness of this therapy?
a. Increased red blood cell count
b. Increased hemoglobin level
c. Decreased white blood cell count
d. Decreased platelet count
ANS: C
Decreased white blood cell counts are an indication of reduction of infection and are a
therapeutic effect of antibiotic therapy. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the
patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for
this type of infection?
Chapter 38: Antibiotics Part 1
MULTIPLE CHOICE
1. When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to
penicillin. Based on this finding, the nurse would question an order for which class of
antibiotics?
a. Tetracyclines
b. Sulfonamides
c. Cephalosporins
d. Quinolones
ANS: C
Allergy to penicillin may also result in hypersensitivity to cephalosporins. The other options are
incorrect.
DIF: COGNITIVE LEVEL: Understanding (Comprehension)
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
2. The nurse is providing teaching to a patient taking an oral tetracycline antibiotic. Which
statement by the nurse is correct?
a. “Avoid direct sunlight and tanning beds while on this medication.”
b. “Milk and cheese products result in increased levels of tetracycline.”
c. “Antacids taken with the medication help to reduce gastrointestinal distress.”
d. “Take the medication until you are feeling better.”
ANS: A
Drug-related photosensitivity occurs when patients take tetracyclines, and it may continue for
several days after therapy. Milk and cheese products result in decreased levels of tetracycline
when the two are taken together. Antacids also interfere with absorption and should not be taken
with tetracycline. Counsel patients to take the entire course of prescribed antibiotic drugs, even if
they feel that they are no longer ill.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
3. When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that
the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may
occur as the result of an interaction between these drugs?
a. The penicillin will cause an enhanced anticoagulant effect of the warfarin.
b. The penicillin will cause the anticoagulant effect of the warfarin to decrease.
c. The warfarin will reduce the anti-infective action of the penicillin.
d. The warfarin will increase the effectiveness of the penicillin.
ANS: A
, Chapter 38: Antibiotics Part 1 205
Administering penicillin reduces the vitamin K in the gut (intestines); therefore, enhanced
anticoagulant effect of warfarin may occur. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Assessment
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
4. A patient is receiving his third intravenous dose of a penicillin drug. He calls the nurse to report
that he is feeling “anxious” and is having trouble breathing. What will the nurse do first?
a. Notify the prescriber.
b. Take the patient’s vital signs.
c. Stop the antibiotic infusion.
d. Check for allergies.
ANS: C
Hypersensitivity reactions are characterized by wheezing; shortness of breath; swelling of the
face, tongue, or hands; itching; or rash. The nurse should immediately stop the antibiotic
infusion, have someone notify the prescriber, and stay with the patient to monitor the patient’s
vital signs and condition. Checking for allergies should have been done before the infusion.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Planning
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
5. A patient is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals
cloudy, foul-smelling urine that is dark amber in color. Orders have just been written to obtain
stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will
complete these orders in which sequence?
a. Blood culture, antibiotic dose, urine culture
b. Urine culture, antibiotic dose, blood culture
c. Antibiotic dose, blood and urine cultures
d. Blood and urine cultures, antibiotic dose
ANS: D
Culture specimens should be obtained before initiating antibiotic drug therapy; otherwise, the
presence of antibiotics in the tissues may result in misleading culture and sensitivity results. The
other responses are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
6. During drug therapy with a tetracycline antibiotic, a patient complains of some nausea and
decreased appetite. Which statement is the nurse’s best advice to the patient?
a. “Take it with cheese and crackers or yogurt.”
b. “Take each dose with a glass of milk.”
c. “Take an antacid with each dose as needed.”
d. “Drink a full glass of water with each dose.”
, Chapter 38: Antibiotics Part 1 206
ANS: D
Oral doses should be given with at least 8 ounces of fluids and food to minimize gastrointestinal
upset; however, antacids and dairy products will bind with the tetracycline and make it inactive.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Implementation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
7. The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the
patient tells the nurse that he has had watery diarrhea since the day before and is having
abdominal cramps. His oral temperature is 101° F (38.3° C). Based on these findings, which
conclusion will the nurse draw?
a. The patient’s original infection has not responded to the antibiotic therapy.
b. The patient is showing typical adverse effects of antibiotic therapy.
c. The patient needs to be tested for Clostridium difficile infection.
d. The patient will need to take a different antibiotic.
ANS: C
Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a
serious superinfection when it causes antibiotic-associated colitis, also known as
pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics
disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most
common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever.
Whenever a patient who was previously treated with antibiotics develops watery diarrhea, the
patient needs to be tested for C. difficile infection. If the results are positive, the patient will need
to be treated for this serious superinfection.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
8. The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection.
Which laboratory value would indicate therapeutic effectiveness of this therapy?
a. Increased red blood cell count
b. Increased hemoglobin level
c. Decreased white blood cell count
d. Decreased platelet count
ANS: C
Decreased white blood cell counts are an indication of reduction of infection and are a
therapeutic effect of antibiotic therapy. The other options are incorrect.
DIF: COGNITIVE LEVEL: Applying (Application)
TOP: NURSING PROCESS: Evaluation
MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies
9. The nurse is reviewing the sputum culture results of a patient with pneumonia and notes that the
patient has a gram-positive infection. Which generation of cephalosporin is most appropriate for
this type of infection?
