BACTERIAL CELL WALL EXAM QUESTIONS AND ANSWERS ASSURED
Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate
[Augmentin]?
• "Take Augmentin once per day and only at bedtime."
• "Augmentin may be taken with food or meals."
• "Avoid taking Augmentin with grapefruit juice."
• "Use a minimal amount of liquid to swallow the Augmentin."
Amoxicillin/clavulanate is a broad-spectrum aminopenicillin that may be taken with meals. Most other
oral penicillins must be taken with a full glass of water 1 hour before or 2 hours after meals. Taking oral
penicillins only at bedtime, avoiding grapefruit juice, and taking the drug with only minimal water is not
necessary.
An immunocompromised patient who is receiving piperacillin/tazobactam [Zosyn] develops oozing and
bleeding from the gums. Which additional data should the nurse determine?
• Whether the patient has a fever above 100.5°F
• Whether the patient reports any painful teeth
• correct the most recent platelet count
• The last time mouth care was given
Piperacillin/tazobactam [Zosyn] is an extended-spectrum penicillin used primarily for infections caused
by Pseudomonas aeruginosa in immunocompromised hosts. It can cause bleeding secondary to disrupting
platelet function; therefore, the platelet count may be altered. High fever, painful teeth, and mouth care do
not address the patient's bleeding gums.
Correct
When performing a skin test for penicillin allergy, the nurse will do what? (Select all that apply.)
Inject a tiny amount of the allergen subcutaneously.
• Observe for a local allergic response.
Have epinephrine readily available
, • Have respiratory support readily available
• Administer diphenhydramine [Benadryl] as the first-line agent should anaphylaxis
occur.
For a penicillin allergy skin test, a small amount of allergen is injected intradermally. The nurse observes
for a local allergic reaction and has epinephrine and respiratory support readily available. Epinephrine is
administered as the first-line agent should anaphylaxis occur.
Before administering intravenous (IV) penicillin, the nurse should do what?
• Flush the IV site with normal saline.
• Assess the patient for allergies
• Review the patient's intake and output record.
• Determine the latest creatinine clearance result.
The principal adverse effect of penicillin is allergic reactions. Penicillins are contraindicated in patients
with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems. IV patency is
important, as is monitoring renal function, because impairment can cause penicillins to reach toxic levels;
however, these are not as important as determining allergy status.
Awarded 1.0 points out of 1.0 possible points.
Thirty minutes after receiving an intramuscular (IM) injection of penicillin G [Pfizerpen], a patient reports
itching and redness at the injection site. Which action should the nurse take first?
• Elevate the lower legs.
• Place an ice pack on the site.
• Make sure the patient stays calm.
Administer subcutaneous epinephrine.
Itching and redness at the IM injection site indicate an allergy to penicillin. The primary treatment is
epinephrine (subcutaneous, IM, or IV) plus respiratory support. Elevation, ice packs, and calming the
patient are done once epinephrine has been administered.
A patient is receiving penicillin G [Bicillin C-R]. Which assessment should the nurse monitor as an indicator
of an undesired effect?
• Cardiac rhythm
• Serum sodium level
Which instructions should a nurse provide to a patient who is to start taking amoxicillin/clavulanate
[Augmentin]?
• "Take Augmentin once per day and only at bedtime."
• "Augmentin may be taken with food or meals."
• "Avoid taking Augmentin with grapefruit juice."
• "Use a minimal amount of liquid to swallow the Augmentin."
Amoxicillin/clavulanate is a broad-spectrum aminopenicillin that may be taken with meals. Most other
oral penicillins must be taken with a full glass of water 1 hour before or 2 hours after meals. Taking oral
penicillins only at bedtime, avoiding grapefruit juice, and taking the drug with only minimal water is not
necessary.
An immunocompromised patient who is receiving piperacillin/tazobactam [Zosyn] develops oozing and
bleeding from the gums. Which additional data should the nurse determine?
• Whether the patient has a fever above 100.5°F
• Whether the patient reports any painful teeth
• correct the most recent platelet count
• The last time mouth care was given
Piperacillin/tazobactam [Zosyn] is an extended-spectrum penicillin used primarily for infections caused
by Pseudomonas aeruginosa in immunocompromised hosts. It can cause bleeding secondary to disrupting
platelet function; therefore, the platelet count may be altered. High fever, painful teeth, and mouth care do
not address the patient's bleeding gums.
Correct
When performing a skin test for penicillin allergy, the nurse will do what? (Select all that apply.)
Inject a tiny amount of the allergen subcutaneously.
• Observe for a local allergic response.
Have epinephrine readily available
, • Have respiratory support readily available
• Administer diphenhydramine [Benadryl] as the first-line agent should anaphylaxis
occur.
For a penicillin allergy skin test, a small amount of allergen is injected intradermally. The nurse observes
for a local allergic reaction and has epinephrine and respiratory support readily available. Epinephrine is
administered as the first-line agent should anaphylaxis occur.
Before administering intravenous (IV) penicillin, the nurse should do what?
• Flush the IV site with normal saline.
• Assess the patient for allergies
• Review the patient's intake and output record.
• Determine the latest creatinine clearance result.
The principal adverse effect of penicillin is allergic reactions. Penicillins are contraindicated in patients
with a history of severe allergic reactions to penicillins, cephalosporins, or carbapenems. IV patency is
important, as is monitoring renal function, because impairment can cause penicillins to reach toxic levels;
however, these are not as important as determining allergy status.
Awarded 1.0 points out of 1.0 possible points.
Thirty minutes after receiving an intramuscular (IM) injection of penicillin G [Pfizerpen], a patient reports
itching and redness at the injection site. Which action should the nurse take first?
• Elevate the lower legs.
• Place an ice pack on the site.
• Make sure the patient stays calm.
Administer subcutaneous epinephrine.
Itching and redness at the IM injection site indicate an allergy to penicillin. The primary treatment is
epinephrine (subcutaneous, IM, or IV) plus respiratory support. Elevation, ice packs, and calming the
patient are done once epinephrine has been administered.
A patient is receiving penicillin G [Bicillin C-R]. Which assessment should the nurse monitor as an indicator
of an undesired effect?
• Cardiac rhythm
• Serum sodium level
