The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?

Third-generation

First-generation

Fourth-generation

Second-generation

Answer and Explanation

The Correct Answer is B

Choice A reason: Third-generation cephalosporins, like ceftriaxone, are effective against gram-negative bacteria and some gram-positive organisms but are not the primary choice for gram-positive infections. Their broader spectrum targets complex infections, while gram-positive organisms like Staphylococcus are better treated with first-generation cephalosporins, which are more specific.

Choice B reason: First-generation cephalosporins, like cefazolin, are most effective against gram-positive organisms, such as Staphylococcus and Streptococcus. They inhibit cell wall synthesis by binding to penicillin-binding proteins, providing excellent coverage for skin and soft tissue infections caused by gram-positive bacteria, making them the preferred choice.

Choice C reason: Fourth-generation cephalosporins, like cefepime, have a broad spectrum, including gram-negative and some gram-positive organisms. They are reserved for multidrug-resistant infections, not routine gram-positive infections, where first-generation cephalosporins are more targeted and sufficient, reducing the risk of resistance development.

Choice D reason: Second-generation cephalosporins, like cefuroxime, have balanced activity against gram-positive and gram-negative bacteria. They are less effective against gram-positive organisms compared to first-generation cephalosporins and are typically used for respiratory or mixed infections, not primarily for gram-positive infections.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

Choice A reason: Theophylline, a methylxanthine, causes palpitations by increasing cyclic AMP through phosphodiesterase inhibition, stimulating cardiac beta-1 receptors. This can lead to tachycardia or arrhythmias, especially at high levels. Monitoring heart rate is critical due to theophylline’s narrow therapeutic index and potential for cardiovascular toxicity.

Choice B reason: Diarrhea is not a primary adverse effect of theophylline. Gastrointestinal upset, like nausea or vomiting, may occur due to gastric irritation, but diarrhea is less common. Theophylline’s main toxicities involve the cardiovascular and nervous systems, making palpitations a more significant concern.

Choice C reason: Drowsiness is not associated with theophylline, which acts as a CNS stimulant, potentially causing nervousness or insomnia. Its phosphodiesterase inhibition increases cyclic AMP, enhancing alertness, not sedation. Drowsiness is more linked to antihistamines, making this incorrect for theophylline monitoring.

Choice D reason: Bradycardia is not a typical theophylline effect. Theophylline stimulates the heart via beta-1 receptor activation, causing tachycardia or palpitations. Bradycardia may occur with other drugs, like beta-blockers, but theophylline’s sympathomimetic effects make palpitations a more relevant adverse effect to monitor.

A. The combination of heparin and an oral anticoagulant results in fewer adverse effects than heparin alone. B. Heparin provides anticoagulation while we wait for your blood level of warfarin to reach adequate levels. C. These medications work synergistically. D. The warfarin is used to obtain an adequate level of anticoagulation when heparin alone is unable to do so.

Correct Answer is B

Explanation

Choice A reason: Combining heparin and warfarin does not reduce adverse effects. Heparin risks bleeding and thrombocytopenia, while warfarin adds bleeding risk. The combination is used to bridge therapy until warfarin’s anticoagulant effect is therapeutic, not to minimize side effects, making this statement incorrect.

Choice B reason: Heparin provides immediate anticoagulation by enhancing antithrombin activity, inhibiting thrombin and factor Xa. Warfarin takes 3-5 days to achieve therapeutic INR by inhibiting vitamin K-dependent clotting factors. Heparin bridges this delay, ensuring continuous anticoagulation during warfarin initiation, making this the correct response.

Choice C reason: Heparin and warfarin do not work synergistically. Heparin acts rapidly via antithrombin, while warfarin slowly inhibits clotting factor synthesis. Their effects are independent, used together to maintain anticoagulation during warfarin’s delayed onset, not to enhance each other’s mechanisms, making this inaccurate.

Choice D reason: Warfarin is not used because heparin is insufficient but to provide long-term oral anticoagulation. Heparin is effective but requires IV administration, while warfarin allows outpatient management. The combination ensures anticoagulation during warfarin’s onset, not to compensate for heparin’s inadequacy.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is reviewing the culture results of a patient with an infection, and notes that the culture indicates a gram-positive organism. Which generation of cephalosporin is most appropriate for this type of infection?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient is taking theophylline. The nurse will monitor for which adverse effects associated with the use of this medication?

Correct Answer is A

Explanation

The nurse is caring for a client receiving an intravenous heparin infusion. The client has a new prescription for warfarin and asks the nurse why he has to be on two medications. What response by the nurse is appropriate?

Correct Answer is B

Explanation

The prescriber has changed the patient’s medication regimen to include the leukotriene receptor antagonist (LTRA) montelukast to treat asthma. The nurse will emphasize which point about this medication?

Which antifungal drug is used to treat systemic fungal infections and can cause nephrotoxicity?

What body system will the nurse assess for common adverse effects of traditional antihistamines?

Bacterial resistance to antibiotics can occur with which situations? (Select all that apply)

A patient who has been taking isoniazid has a new prescription for pyridoxine. She is wondering why she needs this medication. The nurse explains that pyridoxine is often given concurrently with isoniazid to prevent which condition?

Which drug has a quick onset of action and is recommended for use during an acute asthma attack or chronic obstructive pulmonary disease (COPD) exacerbation?

A patient with elevated lipid levels has a new prescription for niacin. The nurse informs the patient that which adverse effects may occur with this medication?

When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?