pharm test bank test 3
The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the
patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the
thrush? - ANS Superinfection
The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The
prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? - ANS Obtaining
all cultures before the antibiotic is administered
The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve
selective toxicity. Which statement by the student indicates a need for further teaching? - ANS "Some
agents cause phagocytosis of bacterial cells."
A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media
episode is not responding to treatment. The nurse caring for this child suspects that resistance to the
bacterial agent has occurred by which microbial mechanism? - ANS Drug inactivation
A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous
mutation and conjugation in acquired resistance of microbes. What will the nurse say? - ANS
Spontaneous mutation leads to resistance to only one antimicrobial agent.
A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be
prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur
by taking an antibiotic. Which response by the nurse is correct? - ANS "Even normal flora can develop
resistance and transfer this to pathogens."
A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of
antibiotic resistance in hospitals, has what as one of its objectives? - ANS Increased adherence to
prescribed antibiotics
,A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the
culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum
____ agent. - ANS narrow; topical
A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with
several children who have strep throat. The child is complaining of a sore throat and has a fever. What
will be the nurse's response - ANS "Your child should come to the clinic to have a throat culture done
today."
n older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The
patient has a temperature of 39.5°C. The nurse will expect the provider to: - ANS order empiric
antibiotics while waiting for sputum culture results.
Which patients should be given antibiotics prophylactically? (Select all that apply.) - ANS Patients with
certain congenital heart defects at risk for bacterial endocarditis
Patients with compound fractures undergoing surgical repair
Which are benefits of using a combination of two or more antibiotics? (Select all that apply.) - ANS
Reduced toxicity
Reduced resistance
Reduced risk in severe infection
The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host
factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such
host factors include what? (Select all that apply.) - ANS Age
Immune system status
Infection site
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours
and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? - ANS
Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600.
,A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs)
work to treat bacterial infections. The student is correct in responding that penicillins: - ANS disrupt
bacterial cell wall synthesis.
A child with otitis media has had three ear infections in the past year. The child has just completed a 10-
day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not
working, because it has worked in the past. What will the nurse tell the patient? - ANS "The bacteria
have synthesized penicillinase."
A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will
expect the provider to order: - ANS amoxicillin-clavulanic acid [Augmentin].
A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour.
At 1900, the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do? -
ANS Request an order for serum electrolytes and cardiac monitoring.
A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While
obtaining the patient's medication history, the nurse learns that the patient experienced a rash when
given amoxicillin [Amoxil] as a child 20 years earlier. What will the nurse do? - ANS Request an order for
a skin test to assess the current risk.
A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes
after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is
100/58 mm Hg. What will the nurse do? - ANS Contact the provider and prepare to administer
epinephrine
A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin
PO. What will the nurse do? - ANS Question the need for a penicillinase-resistant penicillin.
, The parent of an infant with otitis media asks the nurse why the prescriber has ordered amoxicillin
[Amoxil] and not ampicillin [Unasyn]. What will the nurse tell the parent? - ANS Ampicillin is not as acid
stable as amoxicillin.
A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The
nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea
nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: - ANS
reducing the dose of piperacillin.
A nurse is discussing methicillin-resistant Staphylococcus aureus (MRSA) with a group of nursing
students. Which statement by a student correctly identifies the basis for MRSA resistance? - ANS "MRSA
bacteria have developed PBPs with a low affinity for penicillins."
A nurse is preparing to administer intramuscular penicillin to a patient who is infected with T. pallidum
and notes that the order is for sodium penicillin G. Which action is correct? - ANS Contact the provider
to discuss changing the drug to benzathine penicillin G.
Which organisms can be treated with penicillin G (Benzylpenicillin)? (Select all that apply.) - ANS
Neisseria meningitidis
Streptococcus pyogenes
Treponema pallidum
A nursing student wants to know the differences between hospital-associated methicillin-resistant
Staphylococcus aureus (HA-MRSA) and community-associated methicillin-resistant Staphylococcus
aureus (CA-MRSA). Which statements about CA-MRSA are true? (Select all that apply.) - ANS 20% to
30% of the general population are colonized with CA-MRSA.
Boils caused by CA-MRSA can be treated without antibiotics.
CA-MRSA is less dangerous than HA-MRSA.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and
irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the
The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the
patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the
thrush? - ANS Superinfection
The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The
prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority? - ANS Obtaining
all cultures before the antibiotic is administered
The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve
selective toxicity. Which statement by the student indicates a need for further teaching? - ANS "Some
agents cause phagocytosis of bacterial cells."
A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media
episode is not responding to treatment. The nurse caring for this child suspects that resistance to the
bacterial agent has occurred by which microbial mechanism? - ANS Drug inactivation
A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous
mutation and conjugation in acquired resistance of microbes. What will the nurse say? - ANS
Spontaneous mutation leads to resistance to only one antimicrobial agent.
A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be
prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur
by taking an antibiotic. Which response by the nurse is correct? - ANS "Even normal flora can develop
resistance and transfer this to pathogens."
A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of
antibiotic resistance in hospitals, has what as one of its objectives? - ANS Increased adherence to
prescribed antibiotics
,A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the
culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum
____ agent. - ANS narrow; topical
A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with
several children who have strep throat. The child is complaining of a sore throat and has a fever. What
will be the nurse's response - ANS "Your child should come to the clinic to have a throat culture done
today."
n older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The
patient has a temperature of 39.5°C. The nurse will expect the provider to: - ANS order empiric
antibiotics while waiting for sputum culture results.
Which patients should be given antibiotics prophylactically? (Select all that apply.) - ANS Patients with
certain congenital heart defects at risk for bacterial endocarditis
Patients with compound fractures undergoing surgical repair
Which are benefits of using a combination of two or more antibiotics? (Select all that apply.) - ANS
Reduced toxicity
Reduced resistance
Reduced risk in severe infection
The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host
factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such
host factors include what? (Select all that apply.) - ANS Age
Immune system status
Infection site
A nurse transcribes a new prescription for potassium penicillin G given intravenously (IV) every 8 hours
and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs? - ANS
Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600.
,A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs)
work to treat bacterial infections. The student is correct in responding that penicillins: - ANS disrupt
bacterial cell wall synthesis.
A child with otitis media has had three ear infections in the past year. The child has just completed a 10-
day course of amoxicillin [Amoxil] with no improvement. The parent asks the nurse why this drug is not
working, because it has worked in the past. What will the nurse tell the patient? - ANS "The bacteria
have synthesized penicillinase."
A child with an ear infection is not responding to treatment with amoxicillin [Amoxil]. The nurse will
expect the provider to order: - ANS amoxicillin-clavulanic acid [Augmentin].
A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour.
At 1900, the nurse notes that the dose hung at 1830 has infused completely. What will the nurse do? -
ANS Request an order for serum electrolytes and cardiac monitoring.
A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While
obtaining the patient's medication history, the nurse learns that the patient experienced a rash when
given amoxicillin [Amoxil] as a child 20 years earlier. What will the nurse do? - ANS Request an order for
a skin test to assess the current risk.
A patient with no known drug allergies is receiving amoxicillin [Amoxil] PO twice daily. Twenty minutes
after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is
100/58 mm Hg. What will the nurse do? - ANS Contact the provider and prepare to administer
epinephrine
A patient has an infection caused by Streptococcus pyogenes. The prescriber has ordered dicloxacillin
PO. What will the nurse do? - ANS Question the need for a penicillinase-resistant penicillin.
, The parent of an infant with otitis media asks the nurse why the prescriber has ordered amoxicillin
[Amoxil] and not ampicillin [Unasyn]. What will the nurse tell the parent? - ANS Ampicillin is not as acid
stable as amoxicillin.
A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The
nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea
nitrogen and serum creatinine levels are elevated. The nurse will contact the provider to discuss: - ANS
reducing the dose of piperacillin.
A nurse is discussing methicillin-resistant Staphylococcus aureus (MRSA) with a group of nursing
students. Which statement by a student correctly identifies the basis for MRSA resistance? - ANS "MRSA
bacteria have developed PBPs with a low affinity for penicillins."
A nurse is preparing to administer intramuscular penicillin to a patient who is infected with T. pallidum
and notes that the order is for sodium penicillin G. Which action is correct? - ANS Contact the provider
to discuss changing the drug to benzathine penicillin G.
Which organisms can be treated with penicillin G (Benzylpenicillin)? (Select all that apply.) - ANS
Neisseria meningitidis
Streptococcus pyogenes
Treponema pallidum
A nursing student wants to know the differences between hospital-associated methicillin-resistant
Staphylococcus aureus (HA-MRSA) and community-associated methicillin-resistant Staphylococcus
aureus (CA-MRSA). Which statements about CA-MRSA are true? (Select all that apply.) - ANS 20% to
30% of the general population are colonized with CA-MRSA.
Boils caused by CA-MRSA can be treated without antibiotics.
CA-MRSA is less dangerous than HA-MRSA.
A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and
irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the
