Chapter 85: Drugs That Weaken the Bacterial Cell Wall II: Cephalosporins, Carbapenems, Vancomycin, Telavancin, Aztreonam, and Fosfomycin

Chapter 85: Drugs That Weaken the Bacterial Cell Wall II: Cephalosporins, Carbapenems, Vancomycin, Telavancin, Aztreonam, and Fosfomycin

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

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. What is the nurse’s priority action?

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

These signs indicate thrombophlebitis. 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.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1027

TOP:   Nursing Process: Implementation

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

 

2. Which cephalosporin may be used to treat meningitis?

a.	Cefaclor
b.	Cefazolin
c.	Cefoxitin
d.	Cefotaxime

 

 

ANS:  D

Cefotaxime has increased ability to reach the cerebrospinal fluid (CSF) and to treat meningitis. Cefaclor, cefazolin, and cefoxitin do not reach effective concentrations in the CSF.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 1025-1026

TOP:   Nursing Process: Planning

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

 

3. A woman 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 healthcare provider to order:

a.	aztreonam [Azactam].
b.	fosfomycin [Monurol].
c.	trimethoprim/sulfamethoxazole [Bactrim].
d.	vancomycin [Vancocin].

 

 

ANS:  B

Fosfomycin has been approved for single-dose therapy of UTIs in women. Vancomycin and aztreonam are not indicated for UTIs. Bactrim is indicated for UTIs, but administration of a single dose is not therapeutic.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 1034

TOP:   Nursing Process: Planning

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

 

4. A nurse is teaching a nursing student what is meant by “generations” of cephalosporins. Which statement by the student indicates understanding of the teaching?

a.	“Cephalosporins are assigned to generations based on their relative costs to administer.”
b.	“Cephalosporins have increased activity against gram-negative bacteria with each generation.”
c.	“First-generation cephalosporins have better penetration of the cerebrospinal fluid.”
d.	“Later generations of cephalosporins have lower resistance to destruction by beta-lactamases.”

 

 

ANS:  B

With each progression from first-generation agents to fifth-generation agents, the cephalosporins show increased activity against gram-negative organisms, increased resistance to destruction by beta-lactamases, and increased ability to reach the CSF. Cost is not a definitive factor. First-generation drugs have less penetration of the CSF. Resistance to destruction by beta-lactamases increases with increasing generations.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 1025-1026

TOP:   Nursing Process: Assessment

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