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)
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is incorrect. Miosis is the constriction of the pupils, which can also be caused by morphine, but it is not a life-threatening side effect. Miosis occurs because morphine stimulates the parasympathetic nervous system, which controls the muscles that constrict the pupils¹.
Choice B reason: This is incorrect. Sedation is the state of being calm, relaxed, and sleepy, which can also be caused by morphine, but it is not a life-threatening side effect. Sedation occurs because morphine depresses the central nervous system, which reduces the activity of the brain and the body.
Choice C reason: This is correct. Respiratory depression is the slowing down of breathing, which can be a life-threatening side effect of morphine. Respiratory depression occurs because morphine depresses the respiratory center in the brainstem, which regulates the rate and depth of breathing. If the breathing becomes too slow or shallow, the patient may not get enough oxygen and may lose consciousness or die.
Choice D reason: This is incorrect. Euphoria is the feeling of intense happiness, pleasure, or wellbeing, which can also be caused by morphine, but it is not a life-threatening side effect. Euphoria occurs because morphine stimulates the reward system in the brain, which releases dopamine, a neurotransmitter that causes positive emotions.
Correct Answer is B
Explanation
Choice A reason: Bradycardia is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the heart rate or blood pressure significantly, and it is not associated with bradycardia, which is a slow heart rate that can cause dizziness, fatigue, or fainting. The nurse should monitor the vital signs of the client after administering diphenhydramine, but bradycardia is not a common or expected outcome.
Choice B reason: Sedation is an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine can cross the bloodbrain barrier and block the histamine receptors in the brain, which are involved in regulating the sleepwake cycle and alertness. Diphenhydramine can cause sedation, sleepiness, drowsiness, dizziness, and impaired coordination, which can affect the performance and safety of the client. The nurse should instruct the client to avoid driving, operating machinery, or performing other tasks that require mental alertness after taking diphenhydramine, and to take the medication at bedtime or as needed for sleep.
Choice C reason: Constipation is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the gastrointestinal motility or secretion significantly, and it is not associated with constipation, which is a condition of infrequent or difficult bowel movements. The nurse should encourage the client to eat a balanced and highfiber diet, drink plenty of fluids, and exercise regularly to prevent or treat constipation, but diphenhydramine is not a contributing factor.
Choice D reason: Hypertension is not an adverse effect of diphenhydramine. Diphenhydramine is a medication that blocks the action of histamine, a chemical that causes allergic reactions and inflammation. Diphenhydramine can also block the action of acetylcholine, a neurotransmitter that stimulates the parasympathetic nervous system. Diphenhydramine does not affect the blood pressure or the vascular tone significantly, and it is not associated with hypertension, which is a condition of high blood pressure that can cause headaches, chest pain, or stroke. The nurse should monitor the blood pressure of the client after administering diphenhydramine, but hypertension is not a common or expected outcome.
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