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Antibiotics and Antimicrobial Agents > Pharmacology

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Total Questions : 5

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Question 1:

A nurse is reviewing the mechanism of action of different antibiotic groups.

The nurse understands that which of the following antibiotics bind to the 30S ribosomal subunit of bacteria and interfere with protein synthesis?

A. Cefazolin (Zolicef) B. Amikacin (Amikin) C. Ciprofloxacin (Cipro) D. Penicillin G (Pfizerpen)

Answer and Explanation

Choice A:

Choice A is wrong because cefazolin (Zolicef) is a cephalosporin antibiotic that binds to the penicillin-binding proteins of bacteria and interferes with cell wall synthesis by inhibiting peptidoglycan cross-linking.

Choice B:

Amikacin (Amikin) is an aminoglycoside antibiotic that binds to the 30S ribosomal subunit of bacteria and interferes with protein synthesis by causing mRNA misreading and inhibiting 30S subunit assembly.

Choice C:

Choice C is wrong because ciprofloxacin (Cipro) is a fluoroquinolone antibiotic that binds to the DNA gyrase and topoisomerase IV of bacteria and interferes with DNA replication by inhibiting DNA supercoiling.

Choice D:

Choice D is wrong because penicillin G (Pfizerpen) is a beta-lactam antibiotic that binds to the penicillin-binding proteins of bacteria and interferes with cell wall synthesis by inhibiting peptidoglycan cross-linking.

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Question 2:

A nurse is caring for a client who has a urinary tract infection caused by Escherichia coli. The provider has ordered sulfamethoxazole-trimethoprim (Bactrim) for the client. Which of the following actions should the nurse take? (Select all that apply).

A. Monitor the client’s blood glucose level B. Instruct the client to drink plenty of fluids C. Advise the client to avoid sunlight exposure D. Teach the client to take the medication with food E. Check the client’s platelet count.

Answer and Explanation

Choice A:

Choice A is wrong because sulfamethoxazole-trimethoprim does not affect blood glucose levels. This is a possible side effect of some other antibiotics, such as fluoroquinolones.

Choice B:

The nurse should instruct the client to drink plenty of fluids and advise the client to avoid sunlight exposure when taking sulfamethoxazole-trimethoprim (Bactrim). Drinking fluids can help prevent crystalluria and kidney damage caused by the medication. Avoiding sunlight exposure can prevent photosensitivity reactions that can cause skin rash, itching, or burning.

Choice C:

Choice D:

Choice D is wrong because sulfamethoxazole-trimethoprim can be taken with or without food. Taking it with food may help reduce nausea or stomach upset, but it is not necessary.

Choice E:

Choice E is wrong because sulfamethoxazole-trimethoprim does not affect platelet count. This is a possible side effect of some other antibiotics, such as penicillins or cephalosporins.

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Question 3:

A nurse is administering imipenem-cilastatin (Primaxin) to a client who has a severe infection. The client asks the nurse why this medication is given in combination. The nurse should respond with which of the following statements?

A. “The combination enhances the antimicrobial activity of imipenem.” B. “The combination reduces the risk of allergic reactions to imipenem.” C. “The combination prevents the degradation of imipenem by renal enzymes.” D. “The combination lowers the dosage requirement of imipenem.”.

Answer and Explanation

Choice A:

Choice A is wrong because the combination does not enhance the antimicrobial activity of imipenem, but rather preserves its activity by preventing its breakdown.

Choice B:

Choice B is wrong because the combination does not reduce the risk of allergic reactions to imipenem, but rather increases the risk of side effects such as diarrhea, rash, fever, and seizures.

Choice C:

The combination of imipenem and cilastatin prevents the degradation of imipenem by renal enzymes. Imipenem is a carbapenem antibiotic that works by interfering with the bacteria’s cell wall. Cilastatin is a dehydropeptidase inhibitor that inhibits the metabolism of imipenem by renal brush-border enzymes, thus increasing imipenem concentrations in urine.

Choice D:

Choice D is wrong because the combination does not lower the dosage requirement of imipenem, but rather allows for higher dosages to be administered depending on the organism sensitivity and the severity of infection.

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Question 4:

A nurse is teaching a client who has a sinus infection about amoxicillin (Amoxil). Which of the following statements by the client indicates an understanding of the teaching?

A. “I should stop taking this medication if I develop a rash.” B. “I should take this medication until I feel better.” C. “I should use a backup method of birth control while taking this medication.” D. “I should take this medication with an antacid to prevent stomach upset.”.

Answer and Explanation

Choice A:

Choice A is wrong because a rash can indicate an allergic reaction to amoxicillin, which can be life-threatening. The client should stop taking the medication and seek medical attention if a rash develops.

Choice B:

Choice B is wrong because the client should complete the full course of amoxicillin as prescribed, even if they feel better. Stopping the medication too soon can lead to bacterial resistance and recurrence of infection.

Choice C:

This statement indicates that the client understands that amoxicillin can reduce the effectiveness of oral contraceptives and increase the risk of unintended pregnancy.

Choice D:

Choice D is wrong because amoxicillin does not cause stomach upset and does not need to be taken with an antacid. In fact, some antacids can interfere with the absorption of amoxicillin and reduce its effectiveness.

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Question 5:

A nurse is caring for a client who has endocarditis and is receiving gentamicin (Garamycin) intravenously. Which of the following laboratory tests should the nurse monitor to assess for adverse effects of this medication?

A. Serum creatinine B. Serum potassium C. Serum albumin D. Serum bilirubin.

Answer and Explanation

Choice A:

The nurse should monitor the serum creatinine level of the client who is receiving gentamicin because this medication can cause nephrotoxicity, which is damage to the kidneys.Serum creatinine is a marker of kidney function and it should be within the normal range of 0.6 to 1.2 mg/dL for adults. If the serum creatinine level increases, it indicates that the kidneys are not filtering the waste products properly and the dose of gentamicin may need to be adjusted or discontinued.

Choice B:

Serum potassium is wrong because gentamicin does not affect the potassium level in the blood.Potassium is an electrolyte that regulates the nerve and muscle function and it should be within the normal range of 3.5 to 5.0 mEq/L for adults.Abnormal potassium levels can be caused by other factors such as dehydration, kidney disease, diuretics, or acid-base imbalance.

Choice C:

Serum albumin is wrong because gentamicin does not affect the albumin level in the blood.Albumin is a protein that helps maintain fluid balance and transport substances in the blood and it should be within the normal range of 3.5 to 5.0 g/dL for adults.Low albumin levels can be caused by other factors such as malnutrition, liver disease, inflammation, or blood loss.

Choice D:

Serum bilirubin is wrong because gentamicin does not affect the bilirubin level in the blood.Bilirubin is a waste product of red blood cell breakdown and it should be within the normal range of 0.1 to 1.2 mg/dL for adults.

High bilirubin levels can be caused by other factors such as hemolysis, liver.

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