Chapter 46: Antimicrobial Agents

Chapter 46: Antimicrobial Agents

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient allergic to penicillin is being evaluated for a gram-negative infection. Which antimicrobial drug class would the health care provider be cautious in prescribing because of a possible cross sensitivity and/or allergic reaction?

ANS:  A

Cephalosporins may be used with caution as alternatives when patients are allergic to the penicillins, but cephalosporins are chemically similar in structure to penicillins and may produce a cross sensitivity and/or allergic reaction. Aminoglycosides, sulfonamides, and quinolones do not tend to produce cross sensitivities.

DIF:    Cognitive Level: Comprehension     REF:   p. 736             OBJ:   7 | 8

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

2. The health care provider has prescribed penicillin and probenecid for a patient with a sexually transmitted disease. What is the purpose of combining these medications?

ANS:  C

The combination therapy of penicillin and probenecid allows the penicillin to remain in the body longer, which enhances drug availability and action. The combination may be used advantageously in treating serious or resistant infections. Probenecid inhibits the excretion of penicillin, slows down the excretion of penicillin, and does not affect absorption or toxic effects.

DIF:    Cognitive Level: Comprehension     REF:   p. 730             OBJ:   6

TOP:   Nursing Process Step: Implementation

MSC:  NCLEX Client Needs Category: Physiological Integrity

3. An older adult who has septicemia is receiving IV aminoglycoside therapy. Which symptom is most important for the nurse to monitor?

ANS:  B

Eighth cranial nerve damage can result from aminoglycoside therapy. Patients should be monitored during therapy and after therapy has been discontinued for signs and symptoms of ototoxicity, including dizziness, tinnitus, and progressive hearing loss. Aminoglycosides do not produce bone marrow depression; this is characteristic of treatment with chloramphenicol. Aminoglycosides do not typically produce GI distress. Aminogylcosides do not produce photosensitivity; this is characteristic of treatment with glycylcyclines.

DIF:    Cognitive Level: Application           REF:   p. 729             OBJ:   7 | 8

TOP:   Nursing Process Step: Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity

4. On what is the selection of an antimicrobial agent based?

ANS:  A

The selection of the antimicrobial agent must be based on the sensitivity of the pathogen and the possible toxicity to the patient. The half life of the drug is not a concern with selection in comparison to sensitivity. Therapeutic levels of the drug are not criteria for selection. Bioavailability is a lesser concern than sensitivity.

DIF:    Cognitive Level: Comprehension     REF:   p. 727             OBJ:   6

TOP:   Nursing Process Step: Evaluation

MSC:  NCLEX Client Needs Category: Safe, Effective Care Environment