Chapter 75: Sulfonamides and
Trimethoprim Exam 2025 With 100%
Correct Answers
811. A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student
asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the
two are similar products, and both contain sulfonamides. What does the nurse tell the student about
silver sulfadiazine?
a. It causes increased pain when the medication is applied.
b. It has a broader spectrum of antimicrobial sensitivity.
c. It has antibacterial effects related to release of free silver.
d. It suppresses renal excretion of acid, causing acido - correct answers ✔✔ANS: C
Silver sulfadiazine has antibacterial effects primarily related to the release of free silver and not to the
sulfonamide portion of the molecule. Unlike mafenide, silver sulfadiazine reduces pain when applied.
Silver sulfadiazine and mafenide have similar antibacterial effects. Because silver sulfadiazine does not
suppress renal excretion of acid, it has fewer systemic effects.
812. A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for
further teaching?
a. "I need to drink extra fluids while taking this medication."
b. "I need to use sunscreen when taking this drug."
c. "I should call my provider if I develop a rash while taking this drug."
d. "I should stop taking this drug when my symptoms are gone." - correct answers ✔✔ANS: D
Patients should always be advised to complete the prescribed course of the antibiotic even when
symptoms subside. Patients should also understand the need to drink 8 to 10 glasses of water a day, to
use sunscreen, and to notify the provider if they develop a rash.
813. A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When
providing teaching for this patient, the nurse will tell the patient that it will be important to:
a. drink 8 to 10 glasses of water every day.
b. eat foods that are high in potassium.
, c. take the medication with food.
d. take folic acid supplements. - correct answers ✔✔ANS: A
TMP/SMZ can injure the kidneys, because it causes deposition of sulfonamide crystals in the kidneys.
Patients should be advised to drink 8 to 10 glasses of water a day to maintain a urine flow of 1200 mL in
adults. Trimethoprim can cause hyperkalemia, so consuming extra potassium is unnecessary. The
medication should be taken on an empty stomach. It is not necessary to consume extra folic acid,
because mammalian cells use dietary folate and do not have to synthesize it; it is the process of folic acid
synthesis that is altered by sulfonamides.
814. A nurse is caring for an African-American patient who has been admitted to the unit for long-term
antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would
be correct to suspect that the patient has developed:
a. Stevens-Johnson syndrome.
b. kernicterus.
c. hepatotoxicity.
d. hemolytic anemia. - correct answers ✔✔ANS: D
Sulfonamides can cause hemolytic anemia in patients of African-American and Mediterranean origin,
usually because of a genetic deficiency. Red cell lysis can produce fever, pallor, and jaundice, and patients
should be observed for these signs. The patient's signs and symptoms are not characteristics of Stevens-
Johnson syndrome or hepatotoxicity. The patient's signs and symptoms are not characteristic of
kernicterus, which occurs in newborns.
815. A pregnant patient is treated with trimethoprim/ sulfamethoxazole (TMP/SMZ) [Bactrim] for a
urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely.
The nurse will expect to monitor the infant for:
a. birth defects.
b. hypoglycemia.
c. rash.
d. kernicterus. - correct answers ✔✔ANS: D
Kernicterus is a disorder in newborns caused by deposition of bilirubin in the brain. Sulfonamides
promote kernicterus by displacing bilirubin from plasma proteins. Sulfonamides should not be given to
infants under 2 months of age or to pregnant women after 32 weeks' gestation. Sulfonamides do not
cause birth defects or hypoglycemia. Serious rashes may occur but are not the primary concern in the
newborn.
Trimethoprim Exam 2025 With 100%
Correct Answers
811. A patient with second-degree burns is treated with silver sulfadiazine [Silvadene]. A nursing student
asks the nurse about the differences between silver sulfadiazine and mafenide [Sulfamylon], because the
two are similar products, and both contain sulfonamides. What does the nurse tell the student about
silver sulfadiazine?
a. It causes increased pain when the medication is applied.
b. It has a broader spectrum of antimicrobial sensitivity.
c. It has antibacterial effects related to release of free silver.
d. It suppresses renal excretion of acid, causing acido - correct answers ✔✔ANS: C
Silver sulfadiazine has antibacterial effects primarily related to the release of free silver and not to the
sulfonamide portion of the molecule. Unlike mafenide, silver sulfadiazine reduces pain when applied.
Silver sulfadiazine and mafenide have similar antibacterial effects. Because silver sulfadiazine does not
suppress renal excretion of acid, it has fewer systemic effects.
812. A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for
further teaching?
a. "I need to drink extra fluids while taking this medication."
b. "I need to use sunscreen when taking this drug."
c. "I should call my provider if I develop a rash while taking this drug."
d. "I should stop taking this drug when my symptoms are gone." - correct answers ✔✔ANS: D
Patients should always be advised to complete the prescribed course of the antibiotic even when
symptoms subside. Patients should also understand the need to drink 8 to 10 glasses of water a day, to
use sunscreen, and to notify the provider if they develop a rash.
813. A patient will be discharged from the hospital with a prescription for TMP/SMZ [Bactrim]. When
providing teaching for this patient, the nurse will tell the patient that it will be important to:
a. drink 8 to 10 glasses of water every day.
b. eat foods that are high in potassium.
, c. take the medication with food.
d. take folic acid supplements. - correct answers ✔✔ANS: A
TMP/SMZ can injure the kidneys, because it causes deposition of sulfonamide crystals in the kidneys.
Patients should be advised to drink 8 to 10 glasses of water a day to maintain a urine flow of 1200 mL in
adults. Trimethoprim can cause hyperkalemia, so consuming extra potassium is unnecessary. The
medication should be taken on an empty stomach. It is not necessary to consume extra folic acid,
because mammalian cells use dietary folate and do not have to synthesize it; it is the process of folic acid
synthesis that is altered by sulfonamides.
814. A nurse is caring for an African-American patient who has been admitted to the unit for long-term
antibiotic therapy with sulfonamides. The patient develops fever, pallor, and jaundice. The nurse would
be correct to suspect that the patient has developed:
a. Stevens-Johnson syndrome.
b. kernicterus.
c. hepatotoxicity.
d. hemolytic anemia. - correct answers ✔✔ANS: D
Sulfonamides can cause hemolytic anemia in patients of African-American and Mediterranean origin,
usually because of a genetic deficiency. Red cell lysis can produce fever, pallor, and jaundice, and patients
should be observed for these signs. The patient's signs and symptoms are not characteristics of Stevens-
Johnson syndrome or hepatotoxicity. The patient's signs and symptoms are not characteristic of
kernicterus, which occurs in newborns.
815. A pregnant patient is treated with trimethoprim/ sulfamethoxazole (TMP/SMZ) [Bactrim] for a
urinary tract infection at 32 weeks' gestation. A week later, the woman delivers her infant prematurely.
The nurse will expect to monitor the infant for:
a. birth defects.
b. hypoglycemia.
c. rash.
d. kernicterus. - correct answers ✔✔ANS: D
Kernicterus is a disorder in newborns caused by deposition of bilirubin in the brain. Sulfonamides
promote kernicterus by displacing bilirubin from plasma proteins. Sulfonamides should not be given to
infants under 2 months of age or to pregnant women after 32 weeks' gestation. Sulfonamides do not
cause birth defects or hypoglycemia. Serious rashes may occur but are not the primary concern in the
newborn.
