A nurse is caring for a patient with a confirmed Gram-negative bacterial infection. The healthcare provider has prescribed an antibiotic regimen. Which of the following considerations is most important when treating Gram-negative organisms compared to Gram-positive organisms?

A Gram-negative bacteria have a thicker peptidoglycan (cell wall), making them more susceptible to antibiotics

Gram-negative bacteria possess a multi-layered cell wall that can impede antibiotic penetration more skillfully, requiring specific antibiotic selection

Gram-negative bacteria are less likely to develop antibiotic resistance, simplifying treatment choices

Gram-negative bacteria have a thinner cell wall, making them more susceptible to antibiotic therapy.

Answer and Explanation

The Correct Answer is B

A. Gram-negative bacteria have a thinner peptidoglycan layer compared to Gram-positive bacteria. The thicker peptidoglycan of Gram-positive bacteria is more easily targeted by certain antibiotics like penicillin.

B. Gram-negative bacteria have an outer membrane with lipopolysaccharides, which acts as a barrier to many antibiotics. This structural complexity often necessitates the use of antibiotics that can penetrate the outer membrane or have mechanisms to bypass this barrier.

C. Gram-negative bacteria are more prone to developing antibiotic resistance due to their outer membrane and efflux pumps. This complicates treatment decisions rather than simplifying them, requiring vigilance in antibiotic selection and monitoring.

D. While Gram-negative bacteria do have a thinner peptidoglycan layer, their outer membrane protects them from many antibiotics, so they are not inherently more susceptible. Treatment must consider this additional barrier to ensure efficacy.

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Correct Answer is C

Explanation

A. A candida fungal infection.: Candida infections are treated with antifungal medications such as fluconazole or nystatin, not acyclovir. Acyclovir is ineffective against fungi because it specifically targets viral DNA synthesis.

B. An MRSA bacterial infection.: Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterial infection treated with antibiotics such as vancomycin or linezolid. Acyclovir has no antibacterial properties and would not be effective for MRSA.

C. A herpes viral infection.: Acyclovir is an antiviral drug primarily used to treat infections caused by the herpes simplex virus (HSV-1 and HSV-2) and varicella-zoster virus. It works by inhibiting viral DNA replication, helping reduce symptom severity and frequency of outbreaks.

D. A giardia protozoal infection.: Giardia infections are caused by protozoa and are typically treated with antiprotozoal medications such as metronidazole. Acyclovir has no activity against protozoa and would not treat this type of infection.

A. 30 to 60 minutes before the first meal of the day. B. At bedtime to reduce nighttime heartburn symptoms. C. With the first bite of the largest meal of the day. D. As needed for episodes of severe heartburn.

Correct Answer is A

Explanation

A. 30 to 60 minutes before the first meal of the day.: Pantoprazole, a proton pump inhibitor (PPI), is most effective when taken before eating because it inhibits active proton pumps in the stomach that are stimulated by food intake, ensuring maximal acid suppression throughout the day.

B. At bedtime to reduce nighttime heartburn symptoms.: Although GERD symptoms can occur at night, pantoprazole is not designed for immediate relief. Taking it at bedtime reduces its effectiveness because fewer proton pumps are active overnight compared to after morning dosing.

C. With the first bite of the largest meal of the day.: Taking pantoprazole with food can delay absorption and decrease its acid-suppressing effect. It should be given on an empty stomach to ensure that sufficient drug levels are present when acid secretion begins.

D. As needed for episodes of severe heartburn.: Pantoprazole is a maintenance medication that requires consistent daily dosing to achieve full therapeutic benefit. It does not act rapidly enough to relieve acute heartburn episodes, which are better managed with antacids.

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A nurse is caring for a patient with a confirmed Gram-negative bacterial infection. The healthcare provider has prescribed an antibiotic regimen. Which of the following considerations is most important when treating Gram-negative organisms compared to Gram-positive organisms?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse knows that acyclovir would most likely be prescribed for which type of infection?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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