NUR 3145 Exam 1 Questions and
Answers
What do S, I, and R mean on a C&S? ✅s: susceptible, i: intermediate, r: resistant
How does a patient develop a superinfection? ✅sometimes an antibiotic can't tell who
is good and who is bad; if the antibiotic kills the host flora, pathogens have room to grow
freely
What are signs and symptoms of a superinfection? ✅diarrhea, bladder pain, painful
urination, abnormal vaginal discharge
What are two examples of a superinfection? ✅clostridium albicans (yeast infection)
and clostridium difficile
How do penicillins, cephalosporins, and carbapenems work? ✅beta-lactam ring lyses
growing bacterial cells that are building cell wells
What can occur that works against penicillins, cephalosporins, and carbapenems?
✅bacteria learns to secrete beta lactamase which breaks up the beta-lactam ring
Do penicillins work better against gram positive or gram negative bacteria? ✅gram
positive; Penicillin=Positive
Should penicillins be given more or less frequently? ✅More because they have short
half-lives
Which drugs are in the penicillin class? ✅penicillin, amoxicillin, ampicillin, piperacillin,
ticarcillin, dicloxacillin, nafcillin, oxacillin
Which drugs are broad-spectrum penicillins? ✅aminopenicillins: amoxicillin and
ampicillin
Which drugs are penicillinase-resistant penicillins? ✅antistaphylococcal: dicloxacillin,
nafcillin, oxacillin; Di-N-O
What is nursing 101 for penicillins? ✅C&S tests before treatment; monitor for
hypersensitivity reactions; evaluate renal, hepatic, and hematologic function at regular
intervals
Why were aminopenicillins developed? ✅they provide some activity against gram
negative bacteria in addition to gram positive bacteria
What is special about amoxicillin-clavulanate? ✅clavulanate is a beta-lactamase
inhibitor
What are penicillinase-resistant penicillins mostly used to treat? ✅staphylococcus
infections
Do you receive more or less coverage from cephalosporins as you move from the first
generation to the fifth generation? ✅more coverage; 5th is most broad spectrum
What are the most common adverse effects of cephalosporins? ✅allergy, rash, GI
complaints
What drugs belong to the cephalosporin class? ✅cefadroxil, cefazolin, cephalexin,
cefalor, cefotetan, cefoxitin, cefprozil, cefuroxime, cefdinir, cefditoren, cefixime,
, cefotaxime, cefpodoxime, ceftazidime, ceftibuten, ceftizoxime, ceftriaxone, cefepime,
ceftaroline
What is the nursing 101 for cephalosporins? ✅monitor for the first 30 min of IV
therapy, obtain and assess C&S, monitor intake and output, monitor for superinfection,
report bleeding, assess IV sites during infusion, report diarrhea
Which beta-lactam ring drug is resistant to beta-lactamase? ✅carbapenems
Which beta-lactam ring drug is the most broad spectrum? ✅carbapenems
What drugs belong to the carbapenem class? ✅doripenem, ertapenem, imipenem-
cilastatin, meropenem
What is a possible side effect of carbapenems? ✅seizures
What is nursing 101 for carbapenems? ✅monitor for hypersensitivity; report focal
tremors/seizures; assess for superinfections; promptly report severe diarrhea with fever;
decrease the rate of IV infusion if nausea is present
Which drug's potential adverse effect is red man syndrome and how does it occur?
✅vancomycin; occurs when drug is given too fast
What adverse effects can result from vancomycin? ✅red man syndrome, ototoxicity,
nephrotoxicity
What is nursing 101 for vancomycin? ✅monitor BP and heart rate during IV
administration, infusion should last at least 60min, monitor for red man syndrome,
monitor urinalysis, monitor renal and hepatic function, assess baseline of hearing,
monitor fluid balance, report changes in input and output ratio, note oliguria or cloudy or
pink urine
What is IV vancomycin used for? ✅pneumonia, meningitis, cellulitis
What is PO vancomycin used for? ✅c. diff
Should you obtain peak and trough levels for PO or IV vancomycin? ✅IV
What drug with a beta-lactam ring can be used on a patient with a penicillin allergy?
✅aztreonam which is a monobactam
What is fosfomycin used for? ✅uncomplicated UTI, it's a single dose powder
Are tetracyclines affective against gram negative or gram positive? ✅both gram
negative and gram positive
Should you give tetracyclines on a full stomach or an empty stomach? ✅give on an
empty stomach because food can drug absorption by 50% or more
What pregnancy class do tetracyclines belong to? ✅Class X, do NOT give to a
pregnant woman
Which drugs belong to the tetracycline class? ✅demeclocycline, doxycycline,
minocycline, tetracycline, tigecycline
What is nursing 101 for tetracyclines? ✅baseline and intermittent C&S; baseline and
intermittent renal, hepatic, and hematopoietic tests, administer with a full glass of water
on an empty stomach, do not give immediately before sleep, report sudden onset of
pain or dysphagia, immediately report severe diarrhea, monitor for signs of a super
infection
What drug is the prototype of macrolides? ✅erythromycin
