The nurse identifies which host factor as the most important when choosing an antimicrobial drug?

Age

Competent immune function

Genetic heritage

Previous medication reactions.

Answer and Explanation

The Correct Answer is B

This is because antibiotics act synergistically with the immune system to subdue infection, and it is critical for success that the host defenses are adequate.

Choice A is wrong because Age is wrong because age is a general factor that must be considered when choosing any medication, not just antimicrobials.

Choice C is wrong because Genetic heritage is wrong because genetic heritage is also a general factor that may affect the metabolism and excretion of medications, not the selection of antimicrobials.

Choice D is wrong because Previous medication reactions is wrong because previous medication reactions are also a general factor that may indicate allergies or intolerances to certain medications, not the selection of antimicrobials.

Normal ranges for immune function vary depending on the type and level of immunity measured, such as innate, adaptive, humoral or cellular immunity. Some common tests for immune function include complete blood count (CBC), immunoglobulin levels, complement levels, antibody titers and skin tests.

Normal ranges for these tests depend on the laboratory and the method used, but some examples are:

• CBC: white blood cell count 4.5-11 x 10^9/L; neutrophils 40-75%; lymphocytes 20-50%; monocytes 2-10%; eosinophils 1-6%; basophils 0-2%.

• Immunoglobulin levels: IgG 7-16 g/L; IgA 0.7-4 g/L; IgM 0.4-2.3 g/L; IgE 0-0.4 g/L.

• Complement levels: C3 0.9-1.8 g

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Correct Answer is C

Explanation

Azithromycin is a macrolide antibiotic that can cause a rare but serious side effect calledQT prolongation, which affects the electrical activity of the heart and can lead toirregular heartbeats, chest pain, and sudden cardiac death. The patient should report any signs of chest pain or palpitations to the doctor immediately.

Choice A is wrong because diarrhea is a common side effect of azithromycin that usually does not require medical attention unless it is severe or bloody.

Choice B is wrong because headache is also a common side effect of azithromycin that usually does not require medical attention unless it is severe or persistent.

Choice D is wrong because nausea is another common side effect of azithromycin that usually does not require medical attention unless it is severe or accompanied by vomiting.

A. Development of medication resistance in the host B. Over-riding of the minimum bactericidal concentration C. Incorrect dosing, which contributes to ribosome mutations D. Transfer of DNA coding to other bacteria E. Spontaneous mutation in the microbial genome.

Correct Answer is ["D","E"]

Explanation

A microbe acquires antibiotic resistance by transferring DNA coding to other bacteria or by spontaneous mutation in the microbial genome.

These genetic changes allow the microbe to survive the effects of the antibiotic and pass on the resistance to its offspring.

ChoiceAis wrong because the host does not develop medication resistance, but the microbe does.

ChoiceBis wrong because the minimum bactericidal concentration (MBC) is the lowest concentration of an antibiotic needed to kill 99.9% of bacteria, not a mechanism of resistance.

ChoiceCis wrong because incorrect dosing does not cause ribosome mutations, but may promote the emergence of drug-resistant microbes by exposing them to suboptimal levels of the antibiotic.

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The nurse identifies which host factor as the most important when choosing an antimicrobial drug?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient has been prescribed azithromycin, a macrolide antibiotic, for a respiratory infection. The nurse should instruct the patient to report which of the following signs or symptoms of a potential adverse effect?

Correct Answer is C

Explanation

(Select all that apply) A microbe acquires antibiotic resistance by which means?

Correct Answer is ["D","E"]

Explanation

A nurse is reviewing laboratory results for a client who has a fungal infection and is receiving itraconazole therapy. Which of the following findings should alert the nurse to a potential adverse effect of this medication?

A nurse is preparing to administer flucytosine to a client who has a systemic fungal infection. Which of the following assessments should the nurse perform before giving this medication? (Select all that apply.).

A nurse is caring for a client who has oral candidiasis and is prescribed nystatin suspension. Which of the following actions should the nurse take?

The nurse is caring for a patient receiving vancomycin (Vancocin) for treatment of an infection caused by methicillin-resistant Staphylococcus aureus (MRSA). Which assessment finding would indicate a potentially serious adverse reaction to this drug?

A nurse is caring for a patient who is receiving gentamicin IV for treatment of endocarditis caused by gram-negative bacteria. Which laboratory value should be monitored closely during gentamicin therapy?

Which statement is true regarding antimicrobial stewardship?

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