The nurse is caring for a client diagnosed with beta lactam resistant bacteria. The nurse anticipates administering which broad spectrum antibiotic?

Ancef (ciprofloxacin)

Merrem (meropenem)

Flagyl (metronidazole)

Zosyn (piperacillin tazobactam)

Answer and Explanation

The Correct Answer is B

Choice A reason: Ancef (ciprofloxacin) is not the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Ancef is the brand name of cefazolin, which is a firstgeneration cephalosporin, a subclass of beta lactam antibiotics. Cefazolin is effective against gram-positive bacteria, but has limited activity against gram negative bacteria and anaerobes. Cefazolin is also susceptible to beta-lactamase enzymes, which are produced by some bacteria to degrade beta lactam antibiotics and confer resistance. The nurse should avoid using Ancef or any other beta lactam antibiotic for a client with a beta lactam resistant bacteria.

Choice B reason: Merrem (meropenem) is the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Merrem is the brand name of meropenem, which is a carbapenem, a subclass of beta lactam antibiotics. Meropenem is effective against a wide range of bacteria, including gram-positive, gram negative, and anaerobic bacteria. Meropenem is also resistant to most beta-lactamase enzymes, except for metallo-beta-lactamase’s, which are rare and can be detected by laboratory tests. The nurse should consider using Merrem or another carbapenem for a client with a beta lactam resistant bacteria, unless they have a history of allergy or intolerance to beta lactam antibiotics .

Choice C reason: Flagyl (metronidazole) is not the correct answer for the nurse who anticipates administering a broad spectrum antibiotic to a client diagnosed with a beta lactam resistant bacteria. Flagyl is the brand name of metronidazole, which is a nitroimidazole antibiotic. Metronidazole is effective against anaerobic bacteria and some protozoa, but has no activity against aerobic bacteria. Metronidazole is not a beta lactam antibiotic, and it is not affected by beta-lactamase enzymes. However, metronidazole is not a broad spectrum antibiotic, and it is not suitable for treating infections caused by aerobic bacteria, which are more common than anaerobic bacteria. The nurse should use Flagyl only for specific indications, such as bacterial vaginosis, trichomoniasis, or Clostridioides difficile infection .

Choice D reason: Zosyn (piperacillin tazobactam) is not the correct answer for the nurse who anticipates administering a broad-spectrum antibiotic to a client diagnosed with a beta lactam resistant bacterium. Zosyn is the brand name of piperacillin tazobactam, which is a combination of penicillin, a subclass of beta lactam antibiotics, and a beta-lactamase inhibitor. Piperacillin is effective against some gram-positive and gram-negative bacteria, but it is susceptible to beta-lactamase enzymes. Tazobactam is a compound that binds to and inhibits some beta-lactamase enzymes, thereby protecting piperacillin from degradation and extending its spectrum of activity. However, piperacillin tazobactam is not effective against all types of beta-lactamase enzymes, especially those that are encoded by plasmids and can be transferred between bacteria. The nurse should not use Zosyn or any other beta lactam/beta-lactamase inhibitor combination for a client with a beta lactam resistant bacterium unless the specific type of beta-lactamase is known and susceptible to the inhibitor.

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Correct Answer is A

Explanation

Choice A reason: Vasoconstriction is the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. This increases the resistance to blood flow and raises the blood pressure. Phenylephrine is used as a vasopressor to treat hypotension, which is a condition of low blood pressure that can cause dizziness, fainting, or organ damage. The nurse should monitor the blood pressure and the peripheral pulses of the patient after administering phenylephrine.

Choice B reason: Bronchodilation is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has no effect on the beta2 receptors on the bronchial smooth muscle, which are responsible for bronchodilation or widening of the airways. Phenylephrine is not used to treat respiratory conditions, such as asthma or chronic obstructive pulmonary disease, that cause bronchoconstriction or narrowing of the airways. The nurse should assess the respiratory rate and the breath sounds of the patient after administering phenylephrine.

Choice C reason: Diuresis is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has no effect on the kidney function or the urine output. Phenylephrine is not used to treat fluid retention or edema, which are conditions of excess fluid in the body that can cause swelling, weight gain, or heart failure. The nurse should measure the urine output and the specific gravity of the patient after administering phenylephrine.

Choice D reason: Decreased heart rate is not the desired therapeutic effect of phenylephrine in this context. Phenylephrine is a medication that stimulates the alpha1 receptors on the blood vessels, causing them to constrict or narrow. It has little or no effect on the beta1 receptors on the heart, which are responsible for increasing the heart rate and the contractility. Phenylephrine may actually cause a reflex bradycardia, which is a slow heart rate that occurs when the baroreceptors in the blood vessels sense an increase in blood pressure and send signals to the brain to lower the heart rate. Phenylephrine is not used to treat tachycardia, which is a fast heart rate that can cause palpitations, chest pain, or arrhythmias. The nurse should monitor the electrocardiogram and the heart rate of the patient after administering phenylephrine.

A. Dry mouth B. Constricted bronchioles C. Increased heart rate D. Dilated pupils

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

Explanation

Choice A reason: This is correct. Dry mouth is a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that stimulates the secretion of saliva and other fluids in the body. Dry mouth can cause discomfort, bad breath, and increased risk of dental problems¹.

Choice B reason: This is incorrect. Constricted bronchioles are not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: dilated bronchioles. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that causes the smooth muscles of the airways to contract. Dilated bronchioles can improve breathing and reduce wheezing in people with respiratory disorders, such as asthma or COPD.

Choice C reason: This is incorrect. Increased heart rate is not a side effect of anticholinergic drugs. In fact, anticholinergic drugs can cause the opposite effect: decreased heart rate. This is because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that slows down the heart rate and lowers the blood pressure. Decreased heart rate can be beneficial for people with certain heart conditions, such as atrial fibrillation or tachycardia.

Choice D reason: This is correct. Dilated pupils are a common side effect of anticholinergic drugs. It occurs because anticholinergic drugs block the action of acetylcholine, a neurotransmitter that controls the muscles of the iris, which regulate the size of the pupils. Dilated pupils can cause blurred vision, sensitivity to light, and difficulty focusing.

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The nurse is caring for a client diagnosed with beta lactam resistant bacteria. The nurse anticipates administering which broad spectrum antibiotic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer phenylephrine as a vasopressor to treat a patient for hypotension. The desired therapeutic effect of phenylephrine in this context is:

Correct Answer is A

Explanation

A nurse understands that an anticholinergic drug will produce which of the following effects?

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

Explanation

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