Chapter 84: Drugs That Weaken the Bacterial Cell Wall II: Cephalosporins, Car-bapenems, Vancomycin, Aztreonam, Teicoplanin and Fosfomycin

Chapter 84: Drugs That Weaken the Bacterial Cell Wall II: Cephalosporins, Carbapenems, Vancomycin, Aztreonam, Teicoplanin and Fosfomycin

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. 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. The nurse’s priority action is to

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.

 

 

ANS:   C

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.

 

DIF:    Cognitive Level: Application             REF:    p. 998

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

2. A patient being treated with cefmetazole (Zefazone) complains of a headache. Which analgesic would be the best choice for this patient?

a.	Acetaminophen
b.	Aspirin
c.	Ibuprofen
d.	Excedrin

 

 

ANS:   A

Because cephalosporins have drug-drug interactions with nonsteroidal anti-inflammatory drugs (NSAIDs), the safest medication for a headache in this patient would be acetaminophen.

Aspirin, ibuprofen, and Excedrin pose a greater risk of prolonging bleeding time when administered with cephalosporins.

 

DIF:    Cognitive Level: Application             REF:    p. 998

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

3. A patient complains of burning on urination and increased frequency. The patient has a history of frequent urinary tract infections (UTIs) and is going out of town in 2 days. To treat the infection quickly, the nurse would expect the health care provider to order

a.	vancomycin (Vancocin).
b.	fosfomycin (Monurol).
c.	aztreonam (Azactam).
d.	trimethoprim/sulfamethoxazole (Bactrim).

 

 

ANS:   B

Fosfomycin has been approved for single-dose therapy of UTIs.

Vancomycin and aztreonam are not indicated for UTIs.

Bactrim is indicated for UTIs, but it cannot be administered in a single dose and be therapeutic.

 

DIF:    Cognitive Level: Application             REF:    p. 1002

TOP:    Nursing Process: Planning

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. A patient is receiving intravenous vancomycin (Vancocin). A unique complication of rapid IV infusion of vancomycin is

a.	pleural effusion.
b.	angioedema.
c.	red man syndrome.
d.	neurotoxicity.

 

 

ANS:   C

Rapid infusion of vancomycin can cause flushing, rash, pruritus, urticaria, tachycardia, and hypotension, known collectively as red man syndrome.

Pleural infusion is unlikely with IV vancomycin.

Angioedema is not associated with vancomycin administration.

Neurotoxicity is not associated with rapid infusion of IV vancomycin.

 

DIF:    Cognitive Level: Application             REF:    p. 1001

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies