A nurse is preparing to administer the first dose of piperacillin/tazobactam to a patient in
an infusion clinic. The nurse should take which of the following precautions?
A. Ask the patient about past allergic reactions to penicillins.
B. Ask the patient about past allergic reactions to aminoglycosides.
C. Mix the piperacillin/tazobactam with lidocaine to reduce pain of infusion.
D. Instruct the patient to eat a snack to decrease stomach upset from
piperacillin/tazobactam. - AnswerA
A woman is to receive amoxicillin-clavulanate 500 mg PO every 8 hours for bronchitis.
The nurse retrieves two 250-mg tablets from the medication cart. This is incorrect for
which of the following reasons?
A. The amount of sulbactam in amoxicillin-clavulanate 250 mg is 62.5 mg per tablet, twice
the intended amount.
B. This provides twice the intended dose of clavulanate.
C. The 250-mg tablets have less absorption than the 500-mg tablets.
D. Administration of amoxicillin-clavulanate is only intravenous, so selecting tablets
means that the wrong drug is being administered. - AnswerB
A cardiac surgeon orders cefazolin 1 g IV "on call" to the operating room for a patient
scheduled for a heart valve replacement. The surgery is scheduled for 7:00 am the next
morning. What is the rationale for giving the antibiotic at 6:30 am? The last dose was
administered more than 8 hours ago.
A. The cefazolin must be given 60 minutes before the procedure for legal reasons.
B. The cefazolin must be given within 60 minutes before the first skin incision to reach
therapeutic concentrations.
C. The cefazolin trough level will be checked at 6:00 am, which would allow the level to
come back before administration of the "on call" dose.
D. The last dose was administered yesterday - AnswerB
Which of the following classes of cephalosporins have the best activity against
gram-positive organisms?
,A. first-generation cephalosporins
B. second-generation cephalosporins
C. third-generation cephalosporins
D. fourth-generation cephalosporins - AnswerA
In acute renal failure, doses of which of the following antibiotics must be reduced?
(Select all that apply.)
A. nafcillin
B. cefazolin
C. meropenem
D. aztreonam - AnswerB, C, D
A nurse working in the neurointensive care unit is caring for a patient with a head injury
who has been experiencing seizures and now has pneumonia caused by Pseudomonas
aeruginosa. The physician has prescribed imipenem 1 g IV every 6 hours plus gentamicin
for the pneumonia. Before administering the antibiotics, the nurse should do which of the
following?
A. Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation
of the gentamicin.
B. Remind the physician of the patient's seizures and inquire whether a different
antibiotic might be safer.
C. Suggest to the physician that imipenem is used to treat gram-positive infections and
will not be effective in this patient.
D. Set the infusion pump to deliver the imipenem over 15 minutes - AnswerB
A client is prescribed penicillin V orally for a strep throat. What is the mechanism of
action of this medication?
A. It inhibits protein synthesis.
B. It lowers the pH of cellular contents. C. It causes mutations.
D. It inhibits cell wall synthesis. - AnswerD
A client has a history of a life-threatening anaphylactic reaction to penicillin G. Which
medication should not be administered to this client?
A. Lactulose
B. Ketoconazole
, C. Kanamycin
D. Cefadroxil - AnswerD
Ampicillin-sulbactam is administered to a client with Staphylococcus aureus. What type
of anti-infective is ampicillin-sulbactam?
A. Extended-spectrum antipseudomonal penicillin
B. Penicillin-beta-lactamase inhibitor combination
C. Cephalosporin
D. Aminopenicillin - AnswerB
How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when
prescribed for otitis media?
A. It extends the spectrum of antibacterial activity of penicillin.
B. It extends the spectrum of the beta-lactamase inhibitor.
C. It decreases the side effects of high-dose penicillin.
D. It increases the absorption of the penicillin. - AnswerA
A client is administered a third-generation cephalosporin. The broad-spectrum agents
like cephalosporins are most effective in treating which type of microorganism?
A. Gram positive
B. Gram negative
C. Fungi
D. Virus - AnswerB
What organ system is responsible for the excretion of cefotaxime sodium from the body?
A. Respiratory
B. Hepatic
C. Renal
D. Gastrointestinal - AnswerC
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