NSG 3320 Exam 4 Practice Questions with Correct Answers and Rationales
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Course
NSG 3320
Institution
NSG 3320
A nurse assisting a nursing student with medications asks the student to describe how penicillin (PCNs) works to treat bacterial infections. The student is correct in responding that penicillin:
•A. disinhibit transpeptidases. •B. disrupt bacterial cell wall synthesis. •C. inhibit autolysins...
NSG 3320 Exam 4 Practice Questions
with Correct Answers and Rationales
A nurse assisting a nursing student with medications asks the student to describe how
penicillin (PCNs) works to treat bacterial infections. The student is correct in responding
that penicillin:
Rationale:
•PCNs weaken the cell wall, causing bacteria to take up excessive amounts of water
and subsequently rupture.
•PCNs inhibit transpeptidases and disinhibit autolysins.
•PCNs do not affect the cell walls of the host.
A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has
ordered piperacillin and amikacin, both to be given intravenously. What will the nurse
do?
•A. Make sure to administer the drugs at different times using different IV tubing.
•B. Make sure to administer the drugs at different times using different IV tubing.
•C. Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be
used.
•D. Watch the patient closely for allergic reactions, because this risk is increased with
this combination. ✅Answer: A
Rationale:
•When penicillins are present in high concentrations, they interact with aminoglycosides
and inactivate the aminoglycoside; therefore, these two drugs should never be mixed in
the same IV solution.
•The drugs should be given at different times. because PCN inactivates gentamicin;
therefore, the nurse should give one first, flush the line, and then give the other.
•In the treatment of Pseudomonas infections, extended-spectrum penicillins, such as
piperacillin, usually are given in conjunction with an antipseudomonal aminoglycoside,
such as amikacin; therefore, suggesting a larger dose of piperacillin and discontinuation
of the amikacin is incorrect.
•Zosyn is not recommended.
•The risk of allergic reactions does not increase with this combination of drugs.
✅Answer:
,Rationale:
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?
•A. Contact the provider and prepare to administer epinephrine.
•B. Notify the provider if the patient develops a rash.
•C. Request an order for a skin test to evaluate possible PCN allergy.
•D. Withhold the next dose until symptoms subside. ✅Answer: A
Rationale:
•A. Contact the provider and prepare to administer epinephrine.
•B. Notify the provider if the patient develops a rash.
•C. Request an order for a skin test to evaluate possible PCN allergy.
•D. Withhold the next dose until symptoms subside.
✅Answer:
Rationale:
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 vein. What is the nurse's priority action?
•A. Apply warm packs to the arm, and infuse the medication at a slower rate.
•B. Continue the infusion while elevating the arm.
•C. Select an alternate intravenous site and administer the infusion more slowly.
•D. Request central venous access. ✅Answer: C
Rationale:
•These signs indicate thrombophlebitis. The nurse should select an alternative IV site
and administer the infusion more slowly.
•The IV should not be continued in the same site, because necrosis may occur.
•A central line would be indicated only for long-term administration of antibiotics.
A patient receiving a cephalosporin develops a secondary intestinal infection caused by
Clostridium difficile. What is an appropriate treatment for this patient?
•A. Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen
•B. Discontinuing the cephalosporin and beginning metronidazole (Flagyl)
•C. Discontinuing all antibiotics and providing fluid replacement
•D. Increasing the dose of the cephalosporin and providing isolation measures
✅Answer: B
, Rationale:
•Patients who develop C. difficile infection (CDI) as a result of taking cephalosporins or
other antibiotics need to stop taking the antibiotic in question and begin taking either
metronidazole or vancomycin.
•Adding one of these antibiotics without withdrawing the cephalosporin is not indicated.
•CDI must be treated with an appropriate antibiotic, so stopping all antibiotics is
incorrect.
•Increasing the cephalosporin dose would only aggravate the CDI.
The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse
notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's
heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse
understands that these findings are consistent with:
•A. allergic reaction.
•B. rhabdomyolysis.
•C. Stevens-Johnson syndrome.
•D. red man syndrome. ✅Answer: D
Rationale:
•Rapid infusion of vancomycin can cause flushing, rash, pruritus, urticaria, tachycardia,
and hypotension, a collection of symptoms known as red man syndrome.
•Rhabdomyolysis is not associated with the administration of vancomycin.
•The patient's symptoms may seem to indicate an allergic reaction, but this is
specifically red man syndrome.
•The symptoms are not those of Stevens-Johnson syndrome, which manifests as
blisters or sores (or both) on the lips and mucous membranes after exposure to the sun.
A pregnant adolescent patient asks the nurse whether she should continue to take her
prescription for tetracycline (Sumycin) to clear up her acne. Which response by the
nurse is correct?
•A. "Tetracycline is safe to take during pregnancy."
•B. "Tetracycline may cause allergic reactions in pregnant women."
•C. "Tetracycline can be harmful to the baby's teeth and should be avoided."
•D. "Tetracycline will prevent asymptomatic urinary tract infections." ✅Answer: C
Rationale:
•Tetracyclines can cause discoloration of deciduous and permanent teeth. Tooth
discoloration can be prevented if the drugs are not taken by pregnant women or by
children under 8 years of age.
•Tetracycline is not appropriate for a pregnant patient.
•Pregnancy does not precipitate an allergic response to tetracycline.
•Tetracycline should not be used to prevent urinary tract infections (UTIs), especially in
pregnant women.
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