Chapter 85: Bacteriostatic Inhibitors of Protein Synthesis: Tetracyclines, Macrolides, and Others

Chapter 85: Bacteriostatic Inhibitors of Protein Synthesis: Tetracyclines, Macrolides, and Others

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. The nurse is providing education about tetracycline (Sumycin). Which statement by the patient best demonstrates understanding of the administration of this medication?

a.	“I will avoid taking my medication with dairy products.”
b.	“I will need to take my antibiotic with grapefruit juice.”
c.	“I should take my antibiotic with a calcium-containing antacid to minimize gastrointestinal distress.”
d.	“I should expect a slight, acne-like rash with this medication.”

 

 

ANS:   A

The patient should avoid taking the medication with dairy products to help prevent chelation; no further teaching is required.

Grapefruit juice should be avoided to prevent unexpected interactions; further teaching is necessary.

Calcium should be avoided, because it also leads to chelation; further teaching is necessary.

An acne-like reaction would indicate an allergic response; further teaching is necessary.

 

DIF:    Cognitive Level: Application             REF:    pp. 1006-1007

TOP:    Nursing Process: Implementation

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

 

2. A pregnant adolescent asks the nurse whether it would be all right to continue to take her prescription for tetracycline (Sumycin) to clear up her acne. What response by the nurse provides the best information?

a.	“Tetracycline is effective in clearing up acne.”
b.	“Tetracycline may cause allergic reactions in pregnant women.”
c.	“Tetracycline will resolve an asymptomatic urinary tract infection.”
d.	“A tetracycline drug could be harmful to the baby’s teeth and should be avoided.”

 

 

ANS:   D

Tetracyclines can cause discoloration of deciduous and permanent teeth. Tooth discoloration can be avoided if the drugs are not taken by pregnant women or by children under 8 years of age.

Tetracycline is effective in clearing up acne; however, it is not appropriate for a pregnant patient.

Pregnancy does not precipitate an allergic response to tetracycline.

Tetracycline may be useful in clearing up a urinary tract infection, but that is not the priority at this time.

 

DIF:    Cognitive Level: Application             REF:    pp. 1006-1007

TOP:    Nursing Process: Implementation

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

 

3. A patient is prescribed azithromycin (Zithromax) as an alternative to penicillin. The patient tells the nurse that he experienced nausea and vomiting when he took erythromycin several months ago and asks if he should expect the same effects with azithromycin. Select the nurse’s best response.

a.	“I need to call your health care provider and ask for a different antibiotic.”
b.	“This drug is like erythromycin but has less severe gastrointestinal side effects.”
c.	“Take the drug with a hearty meal to reduce gastrointestinal side effects.”
d.	“I will get a prescription for an antiemetic in case this drug causes vomiting.”

 

 

ANS:   B

The nurse’s best response is that azithromycin has fewer severe gastrointestinal (GI) side effects than erythromycin.

Calling the health care provider is not necessary, because it is not known whether the patient will experience nausea with the medication.

Azithromycin should not be taken with meals, because absorption is reduced by 50% in the presence of food.

Obtaining a prescription for an antiemetic is not necessary, because it is not known whether the patient will have any GI side effects; they occur in only 3% of those who take the drug.

 

DIF:    Cognitive Level: Application             REF:    p. 1010

TOP:    Nursing Process: Implementation

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

 

4. A patient with an abdominal infection has been prescribed oral clarithromycin (Cleocin). The nurse, who is providing patient education about the drug, should teach the patient to report

a.	headache.
b.	vomiting.
c.	muscle tenderness.
d.	diarrhea.

 

 

ANS:   D

Clarithromycin can promote severe antibiotic-associated pseudomembranous colitis. The patient should report diarrhea, because it may become life-threatening.

Headaches, vomiting, and muscle tenderness are not associated adverse effects of clarithromycin.

 

DIF:    Cognitive Level: Application             REF:    p. 1010

TOP:    Nursing Process: Assessment

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