Chapter 86: Bacteriostatic Inhibitors of Protein Synthesis: Tetracyclines, Macrolides, and Others

Chapter 86: Bacteriostatic Inhibitors of Protein Synthesis: Tetracyclines, Macrolides, and Others

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication?

a.	“I should not take this medication with milk or other dairy products.”
b.	“I should not worry if I experience an acnelike rash with this medication.”
c.	“I should take an antacid, such as Tums, if I experience gastrointestinal distress.”
d.	“I should take this antibiotic with a calcium supplement to improve absorption.”

 

 

ANS:  A

The patient should avoid taking the medication with dairy products to help prevent chelation. An acnelike reaction would indicate an allergic response. Taking the medication with calcium-containing antacids or supplements should be avoided, because this also leads to chelation.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1038-1039

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. 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 can be harmful to the baby’s teeth and should be avoided.”
b.	“Tetracycline is safe to take during pregnancy.”
c.	“Tetracycline may cause allergic reactions in pregnant women.”
d.	“Tetracycline will prevent asymptomatic urinary tract infections.”

 

 

ANS:  A

Tetracyclines can cause discoloration of deciduous teeth of infants if taken by the mother after the fourth month of gestation. Tetracyclines should not be given to pregnant women. 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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1038-1039

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient?

a.	The provider may increase the clindamycin dose to treat this infection.
b.	This is a known side effect of clindamycin, and the patient should consume extra fluids.
c.	The patient should stop taking the clindamycin now and contact the provider immediately.
d.	The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms.

 

 

ANS:  C

Clostridium difficile–associated diarrhea (CDAD) is the most severe toxicity of clindamycin; if severe diarrhea occurs, the patient should be told to stop taking clindamycin immediately and to contact the provider so that treatment with vancomycin or metronidazole can be initiated. Increasing the dose of clindamycin will not treat this infection. Consuming extra fluids while still taking the clindamycin is not correct, because CDAD can be fatal if not treated. Taking Lomotil or bulk laxatives only slows the transit of the stools and does not treat the cause.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 1042-1043

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A patient is diagnosed with periodontal disease, and the provider orders oral doxycycline [Periostat]. The patient asks the purpose of the drug. What is the nurse’s response?

a.	“It is used because of its anti-inflammatory effects.”
b.	“It inhibits collagenase to protect connective tissue in the gums.”
c.	“It reduces bleeding and the pocket depth of oral lesions.”
d.	“It suppresses bacterial growth in the oral mucosa.”

 

 

ANS:  B

Two tetracyclines are used for periodontal disease. Doxycycline inhibits collagenase, which destroys connective tissue in the gums. It is not used for anti-inflammatory effects. Minocycline is used to reduce bleeding and pocket depth and to inhibit bacterial growth.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1038

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies