Overview of Drugs for Bacterial Infections

Question 1 of 38

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Which response would the nurse provide when asked to explain how an anti-infective works?

• • “It works against antimicrobial drugs.”The term anti-infective is used synonymously with the term antimicrobial. The two terms mean the same thing.
• • “It is a drug that is used to kill bacteria.”A drug used to specifically kill bacteria is an antibacterial drug.
• • “It is less effective than an antibacterial drug.”Anti-infective agents are effective against all types of pathogens. An antibacterial is effective against bacteria only.
• Correct
  • “It is a drug that can kill or stop the spread of all types of pathogens.”Anti-infective agents are drugs that can kill or inhibit the spread of infectious agents such as bacteria, viruses, fungi, or protozoans

Question 2 of 38

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Which response would the nurse provide when asked to explain how a pathogen is susceptible to anti-infective therapy?

• Correct
  • “It means that the pathogen can be killed by the drug.”Organisms or pathogens that can be killed or have the ability to reproduce suppressed by anti-infective drugs are considered susceptible.
• • “It means that the drug has no effect on the pathogen.”Susceptibility does not mean that the drug has no effect on the pathogen. Having no effect indicates that the organism is resistant to the drug.
• • “It means that the pathogen will proliferate when exposed to the drug.”Susceptibility does not mean that the drug causes the organism to proliferate. Withholding anti-infective therapy would cause the organism to proliferate.
• • “It means that there is no way of knowing if the drug will be effective against the pathogen.”Sensitivity testing is done to determine if an anti-infective agent will be effective against a pathogen. This information will be used by the healthcare provider before prescribing the drug.

Question 3 of 38

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Which information indicates that a pathogen has become a multidrug-resistant organism?

• • Mutates into a superbugSuperbug is another term for a multidrug-resistant organism.
• • Is killed when exposed to an anti-infective drugOrganisms that can be killed by anti-infective drugs are considered susceptible.
• • Unable to be killed or suppressed by an anti-infective drugPathogens that are neither killed nor suppressed by anti-infective drugs are resistant organisms.
• Correct
  • Resistant to at least three different drugs that once were effectiveAn organism that is resistant to three or more different types of drugs to which it was once susceptible is termed a superbug or a multidrug-resistant (MDR) organism.

Question 4 of 38

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Which threat is caused by a drug resistant pathogen? Select all that apply. One, some, or all responses may be correct.

• • Staphylococcus aureusStaphylococcus aureus is not considered a drug-resistant organism.
• Correct
  • Neisseria gonorrhoeaeDrug resistance has developed in many pathogens. Even though 18 drug-resistant threats exist in the United States, Neisseria gonorrhoeae is one that is considered urgent.
• Correct
  • Clostridium difficile (C-diff)Drug resistance has developed in many pathogens. Clostridium difficile is one that is considered urgent within the United States.
• • Gram-negative beta-hemolytic streptococcusEven though gram-negative bacteria are more difficult to treat, gram-negative beta-hemolytic streptococcus is not identified as a drug-resistant organism.
• Correct
  • Carbapenem-resistant Enterobacteriaceae (CRE)Drug resistance means that an organism is resistant to three or more different types of drugs. Carbapenem-resistant Enterobacteriaceae is one that is considered urgent in the United States.

Question 5 of 38

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In which way does an antimicrobial drug kill a pathogen? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Modifies protein synthesisAntibiotics work in different ways to affect pathogenic bacteria. One of these ways is to modify protein synthesis within the cell.
• Correct
  • Damages the cell membraneAntibiotics work in different ways to affect pathogenic bacteria. One of these ways is to destroy the cell membrane.
• Correct
  • Modifies nucleic acid synthesisAntibiotics work in different ways to affect pathogenic bacteria. One of these ways is to modify nucleic acid synthesis which is a vital process to the bacteria’s existence.
• Correct
  • Inhibits synthesis of the cell wallAntibiotics work in different ways to affect pathogenic bacteria. One of these ways is to destroy the external cell wall, making it weaker or unable to reproduce.
• Correct
  • Modifies metabolism in the cytoplasmAntibiotics work in different ways to affect pathogenic bacteria. One of these ways is to modify the metabolism in the cytoplasm, destroying cellular processes.

Question 6 of 38

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Which outcome indicates that an anti-infective is bacteriostatic?

• • Bacteria are killed.Bactericidal is the term used to describe a drug that kills bacteria.
• • Bacteria mutate.A superbug is one that is no longer susceptible to antimicrobials through mutation.
• Correct
  • Bacteria reproduce slowly.Bacteriostatic is the term used to describe a drug that only limits or slows the growth of bacteria.
• • Bacteria are rendered harmless to the body.No foreign pathogen is considered harmless in the body. A drug that is a bacteriostatic agent limits or slows the growth of the bacteria and relies on the patient’s immune system to kill the organism.

Question 7 of 38

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Which part of the bacteria cell is affected by penicillin?

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  • Cell wallPenicillins are one type of a class of drugs known as cell wall synthesis inhibitors. They interfere with the creation and repair of bacterial cell walls.
• • Cell membraneDrugs such as polymyxins and daptomycin work on the bacterial cell membrane
• • Protein synthesisDrugs such as mupirocin and linezolid affect protein synthesis within the bacterial cell.
• • Nucleic acid synthesisDrugs such as tetracycline and aminoglycosides affect nucleic acid synthesis within the bacterial cell.

Question 8 of 38

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For which infection would the nurse anticipate penicillin to be prescribed?

• • AcneTetracycline is the first drug of choice to treat acne.
• Correct
  • SyphilisPenicillin remains the drug of choice for many infections including syphilis.
• • Legionnaires’ diseaseMacrolides are used to treat Legionnaires’ disease. This drug can also be used to treat infections in patients who are allergic to penicillin.
• • Lower respiratory tract infectionCephalosporins are used to treat lower respiratory tract infections

Question 9 of 38

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Which response would the nurse provide when a patient states, “I experience diarrhea every time I take penicillin?”

• • “That means you are allergic to penicillin.”Diarrhea is not a symptom of a penicillin allergy. An allergy to penicillin causes erythema, urticaria, angioedema, laryngeal edema, and anaphylaxis.
• Correct
  • “Diarrhea is the most common side effect of penicillin.”The most common side effect of penicillin is simple diarrhea of two to four loose stools daily.
• • “It means you have infectious diarrhea from antibiotic use.”C-diff is an infectious form of diarrhea caused by antibiotic use however penicillin is not one drug that causes it.
• • “That is how the bacteria killed by the penicillin is removed from your body.”Diarrhea does not occur as a mechanism to remove killed bacteria from the body. It occurs because normal flora in the gastrointestinal tract is killed by the penicillin and alters the digestion of food.

Question 10 of 38

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Which recommendation would the nurse provide to a patient taking birth control pills who is prescribed penicillin?

• • “Take the birth control pill at bedtime.”Changing the time of taking the birth control pill will not alter the effectiveness when it is taken while penicillin is being used.
• • “Stop taking the birth control pills while taking the penicillin.”Stopping birth control pills during penicillin therapy increases the patient’s risk of an unplanned pregnancy.
• • “Take the birth control pill 1 hour after the morning penicillin dose.”Taking the birth control pill an hour after the morning dose of penicillin will not alter the impact penicillin has on the effects of the birth control pill.
• Correct
  • “Use another type of birth control while taking this medication and for 1 month afterwards.”Female patients who are taking oral birth control pills should be instructed to use another reliable method of pregnancy protection while taking penicillin and for 1 month after completing penicillin therapy to prevent an unplanned pregnancy.

Question 11 of 38

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Which method or route would the nurse use to administer penicillin G procaine?

• • SubcutaneousPenicillin G is not given through a subcutaneous injection.
• Correct
  • Z-track methodWith penicillin G, the Z-track method is to be used for an IM injection deep into the muscle to prevent the drug from leaking through the tissues and causing pain or damage.
• • Intravenous infusionPenicillin G procaine is never injected into a blood vessel because the procaine it contains can cause severe neurovascular complications.
• • Into the deltoid muscleThe deltoid muscle is not used for a penicillin G injection.

Question 12 of 38

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Which cephalosporin would the nurse anticipate providing to a patient with methicillin-resistant staphylococcus aureus (MRSA)?

• • CefazolinCefazolin is a first-generation cephalosporin that is used for gram-positive bacteria and limited gram-negative bacteria.
• • CefoxitinCefoxitin is a second-generation cephalosporin that is more effective against gram-negative and anaerobic organisms.
• Correct
  • CeftarolineCeftaroline is a fifth-generation cephalosporin that is the only cephalosporin that can treat MRSA.
• • CeftriaxoneCeftriaxone is a third-generation cephalosporin that is more potent against gram-negative bacteria but less active against gram-positive bacteria.

Question 13 of 38

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For which reason would the nurse question giving a patient a dose of a prescribed cephalosporin?

• Correct
  • Documented allergy to penicillinPatients who are allergic to penicillins have a risk of allergic reactions to cephalosporins because cephalosporins are structurally similar to penicillins. This is known as cross-sensitivity.
• • Developed diarrhea the last time it was takenSince diarrhea is a common side effect of cephalosporin, it is not necessary to question giving the medication to the patient.
• • Experienced nausea when taken for a skin infectionNausea is a common side effect of cephalosporin. The medication does not need to be questioned before giving it to the patient.
• • Reported vomiting when taken for a urinary tract infectionVomiting is a common side effect of cephalosporin. It is not necessary to question giving the medication to the patient.

Question 14 of 38

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Which question would the nurse ask when a patient taking a cephalosporin develops a throbbing headache, tachycardia, and chest pain?

• • “Did you skip taking doses of the medication?”The patient is experiencing a disulfiram reaction. This does not occur when doses of the medication are skipped.
• • “Did you take the medication in an empty stomach?”Taking the medication on an empty stomach does not cause a disulfiram reaction.
• Correct
  • “Did you drink alcohol while taking this medication?”Alcohol taken with cephalosporins may produce a disulfiram reaction. Disulfiram is a drug used to prevent alcohol use by producing a severe sensitivity to alcohol. The reaction results in severe flushing, copious vomiting, throbbing headache, dyspnea, tachycardia, hypotension, and chest pain.
• • “Did you take the medication after eating a high-fat diet?”Taking the medication with foods high in fat will not cause a disulfiram reaction.

Question 15 of 38

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For which adverse effect would the nurse monitor a patient who is receiving carbapenem? Select all that apply. One, some, or all responses may be correct.

• Correct
  • SeizuresPatients receiving carbapenem must be monitored closely for seizures because this drug can cause central nervous system changes.
• • BleedingBleeding is not an adverse effect of carbapenem.
• Correct
  • ConfusionPatients receiving carbapenem must be monitored closely for confusion because this drug can cause central nervous system changes.
• • Chest painChest pain is not an adverse effect of carbapenem.
• • Shortness of breathShortness of breath is not an adverse effect of carbapenem.

Question 16 of 38

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Which assessment finding indicates the patient is experiencing an adverse effect to vancomycin?

• • OtotoxicityOtotoxicity can occur from either vancomycin or carbapenem.
• • AngioedemaAngioedema is a clinical manifestation of an allergic reaction to penicillin.
• • NephrotoxicityNephrotoxicity is an adverse reaction to either vancomycin or carbapenem.
• Correct
  • Deep red rash on the upper bodyVancomycin often causes flushing and hypotension. An unusual response is a deep red rash on the upper body known as red man syndrome. The reaction is a response to histamine release.

Question 17 of 38

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Which medication would the nurse withhold when also giving the patient a dose of carbapenem?

• • ColestipolColestipol decreases the absorption of the oral form of vancomycin.
• Correct
  • ProbenecidCarbapenem drugs compete with probenecid, and these drugs should not be given at the same time.
• • AminoglycosideVancomycin adds to the toxicity of antibiotics such as the aminoglycosides.
• • CholestyramineCholestyramine decreases the absorption of the oral form of the drug.

Question 18 of 38

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For which condition is tetracycline prescribed? Select all that apply. One, some, or all responses may be correct.

• Correct
  • AcneBecause many other drugs are more effective against gram-negative and gram-positive organisms, tetracyclines are therefore the first choice for treating only a few diseases such as acne.
• Correct
  • ChlamydiaTetracycline is effective in the treatment of chlamydia.
• Correct
  • Lyme diseaseTetracycline is used to treat Lyme disease.
• Correct
  • Typhoid feverTetracycline is a drug used to treat typhoid fever.
• Correct
  • Helicobacter pyloriTetracycline is effective in the treatment of stomach ulcers caused by Helicobacter pylori.

Question 19 of 38

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Which instruction would the nurse provide to a patient who is prescribed tetracycline?

• • “Take the doses with milk.”Tetracycline should be taken 1 hour before drinking milk or 2 hours after drinking milk because milk inhibits intestinal absorption.
• • “Take doses after eating a full meal.”Tetracycline should be taken 1 hour before eating a meal or 2 hours after eating a meal because milk inhibits intestinal absorption.
• Correct
  • “Use sunscreen while taking this medication.”The patient should be remined to wear sun-protective clothing and sunscreen when going outdoors because tetracycline increases skin sun sensitivity and can cause severe sunburns.
• • “Take a dose before applying retinoid to treat acne.”Using retinoid with tetracycline can cause a severe rise in intracranial pressure and is contraindicated.

Question 20 of 38

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Which question would the nurse ask a female patient before giving a prescribed dose of tetracycline?

• Correct
  • “Are you pregnant?”Tetracycline is not given to pregnant patients because it interferes with the development of bone and tooth enamel. Exposure to tetracycline during gestation can cause permanent tooth staining.
• • “Are you allergic to penicillin?”There is not a cross-sensitivity between tetracycline and penicillin.
• • “Have you ever had a yeast infection?”A yeast infection may occur while taking tetracycline long-term however a history of yeast infections is not a contraindication for the drug.
• • “Have you been diagnosed with diabetes?”Diabetes is not a contraindication for taking tetracycline.

Question 21 of 38

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Which response would the nurse provide when a patient who is prescribed azithromycin asks, “Why am I only given a few pills to take?”

• • “The pills are expensive.”The patient is not prescribed a small number of pills because the medication is expensive.
• Correct
  • “Blood levels of this drug remain higher for longer periods of time.”Azithromycin is an advanced-generation macrolide which has a longer duration of action. Because blood levels of the drug remain higher for longer periods of time, the number of required doses and the duration of therapy is reduced.
• • “The healthcare provider wants to see if you have any side effects first.”The patient is not prescribed a small number of azithromycin doses because of potential side effects.
• • “The healthcare provider wants to see if the medication helps your infection first.”The patient is not prescribed a small number of azithromycin doses to evaluate the effectiveness of the drug on the infection.

Question 22 of 38

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Which assessment finding indicates that a patient is experiencing an adverse effect from a macrolide?

• • NauseaNausea is a common side effect of macrolides.
• • FlatulenceFlatulence is a common side effect of macrolides.
• Correct
  • Yellow scleraMacrolides can impair the liver and cause jaundice. Yellow sclera indicates the presence of jaundice.
• • Abdominal painAbdominal pain is a common side effect of macrolides.

Question 23 of 38

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Which instruction would the nurse provide to a patient who is prescribed erythromycin?

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  • “Take the medication with food or milk.”Erythromycin should be taken with food or milk because stomach acid inactivates the drug.
• • “Take the medication on an empty stomach.”Taking the medication on an empty stomach will not be as effective because stomach acid inactivates the drug.
• • “Crush each dose of the medication and mix it with food.”Erythromycin tablets are enteric coated. Medications that are enteric coated should not be crushed before taking.
• • “Remain upright for at least 30 minutes after taking a dose.”There is no reason for the patient to remain upright for 30 minutes after taking a dose of the medication.

Question 24 of 38

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Which action would the nurse take when a patient receiving streptomycin reports blurred vision?

• • Turn off the room lights.Turning off the room lights would be appropriate if the patient is experiencing photophobia.
• • Elevate the head of the bed.There is no therapeutic reason to elevate the head of the bed.
• Correct
  • Notify the healthcare provider.A patient receiving streptomycin should be assessed for eye disorders because this drug can induce nervous system toxicities.
• • Encourage the patient to drink more fluids.Increasing oral fluids will not help with the patient’s blurred vision.

Question 25 of 38

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At which time would the nurse schedule a trough level to be drawn on a patient receiving an aminoglycoside?

• • At the hour of sleepDrawing the sample at the hour of sleep is not the correct time to measure the trough level.
• • First thing in the morningDrawing the sample first thing in the morning is not the correct time to measure the trough level.
• • An hour after the last doseDrawing the sample an hour after the last dose would evaluate the peak level.
• Correct
  • Before the next scheduled doseAminoglycosides have a narrow therapeutic range. This requires that the sample for the antibiotic blood level be drawn just before the next scheduled dose is given. This sample shows the lowest blood level of the antibiotic or the trough.

Question 26 of 38

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Which medication increases a patient’s risk of developing ototoxicity when taken with an aminoglycoside? Select all that apply. One, some, or all responses may be correct.

• Correct
  • AspirinTaking aminoglycosides with some drugs can increase the risk of developing ototoxicity. Aspirin is one of these drugs.
• • DigoxinDigoxin is not identified as a drug that causes ototoxicity when taken with an aminoglycoside.
• • MetoprololMetoprolol is not identified as a drug that causes ototoxicity when taken with an aminoglycoside.
• Correct
  • FurosemideTaking furosemide with an aminoglycoside increases the risk of developing ototoxicity.
• Correct
  • Ethacrynic acidTaking ethacrynic acid with an aminoglycoside increases the risk of developing ototoxicity.

Question 27 of 38

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Which instruction would the nurse provide to a patient who is prescribed linezolid (Zyvox)? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Avoid alcohol while taking this drug.There is a risk of developing hypertension when alcohol is ingested while taking linezolid.
• • Take each dose with a full glass of water.A full glass of water needs to be given with clindamycin to minimize GI irritation.
• Correct
  • Report bruising to the healthcare provider.The healthcare provider should be notified if bruising occurs as this medication can alter the platelet count.
• Correct
  • Report bleeding to the healthcare provider.The healthcare provider should be notified if bleeding occurs as this medication can alter the platelet count.
• Correct
  • Avoid foods with tyramine while taking this drug.The patient should be instructed to avoid foods with tyramine while taking this drug as this could cause severe hypertension.

Question 28 of 38

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For which condition would a patient be prescribed a sulfonamide? Select all that apply. One, some, or all responses may be correct.

• Correct
  • CystitisSulfonamides are a good choice for treating kidney problems because the drug concentrates and is eliminated by the kidney. It would be appropriate to use this drug for cystitis.
• Correct
  • PyelitisSulfonamides concentrate and are eliminated by the kidneys. This drug would be appropriate to treat pyelitis.
• Correct
  • PyelonephritisA sulfonamide is a good drug to treat pyelonephritis because it concentrates and is eliminated by the kidneys.
• Correct
  • ToxoplasmosisSulfonamides are effective to treat toxoplasmosis.
• Correct
  • Pneumocystis pneumoniaSulfonamides have been used to treat pneumocystis pneumonia.

Question 29 of 38

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Which assessment finding is a possible side effect of a sulfonamide? Select all that apply. One, some, or all responses may be correct.

• Correct
  • VertigoVertigo is a more problematic side effect of sulfonamides.
• Correct
  • TinnitusA problematic side effect of sulfonamides is tinnitus.
• Correct
  • AnorexiaAnorexia is a common side effect of sulfonamides.
• Correct
  • InsomniaCommon side effects of sulfonamides include minor but irritating problems such as insomnia.
• Correct
  • StomatitisThe side effect of stomatitis is more problematic and can occur when taking a sulfonamide.

Question 30 of 38

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Which statement indicates that the instruction provided to the patient receiving a sulfonamide was effective? Select all that apply. One, some, or all responses may be correct.

• Correct
  • “I will avoid sun exposure.”Sulfonamides cause skin reactions and increase sun sensitivity.
• Correct
  • “I will take each dose with a full glass of water.”Sulfonamides should be taken with food, milk, or a full glass of water to minimize stomach irritation.
• Correct
  • “I will drink at least 1.5 liters of fluid each day.”To prevent formation of crystals in the urine, the patient must drink at least 1.5 L/day unless this is contraindicated.
• Correct
  • “I will report bleeding to the healthcare provider.”Because sulfonamides can suppress bone marrow function, there is a risk of bleeding which should be reported to the healthcare provider.
• • “I will stop the medication when my symptoms subside.”The patient should be instructed to take the full course of the medication as prescribed.

Question 31 of 38

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Which medication would be the drug of choice for a patient suspected of being exposed to anthrax?

• • GentamicinGentamicin is an aminoglycoside and is not used to treat anthrax.
• Correct
  • CiprofloxacinCiprofloxacin is a fluoroquinolone that is effective in the treatment of many infections. It is the drug of choice for anthrax exposure in a bioterrorist attack.
• • ClarithromycinClarithromycin is a macrolide and is not used to treat anthrax.
• • Sulfamethoxazole/trimethoprimSulfamethoxazole/trimethoprim is a sulfonamide and is not used to treat anthrax.

Question 32 of 38

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Which patient is at risk for a ruptured tendon when taking a fluoroquinolone? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Patient with renal failureFluoroquinolones have been associated with an increased risk of tendon rupture that may result in disability and/or require surgical repair. Rupture of the tendon can occur in patients with decreased renal function.
• Correct
  • Patient who is 85 years oldFluoroquinolones have been associated with tendon rupture. The risk of this occurring is increased in older patients.
• Correct
  • Patient who takes prednisoneFluoroquinolones have been associated with rupture of a tendon in the shoulder, hand, arm, wrist, legs, or heel. This risk is increased in patients taking prednisone.
• • Patient recovering from a strokeThe risk of tendon rupture when taking a fluoroquinolone not increased in a patient recovering from a stroke.
• • Patient with a urinary tract infectionThe risk of tendon rupture when taking a fluoroquinolone is not increased in a patient with a urinary tract infection.

Question 33 of 38

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Which instruction would the nurse provide to a patient who is prescribed a fluoroquinolone? Select all that apply. One, some, or all responses may be correct.

• Correct
  • “Increase your intake of fluids.”Fluids should be increased with taking a fluoroquinolone to dilute the urine and prevent crystallization of urine.
• • “Avoid eating foods with tyramine.”Tyramine is to be avoided with protein synthesis inhibitors.
• Correct
  • “Avoid exposure to direct sunlight.”The patient should be instructed to avoid direct sunlight to prevent a severe sunburn.
• Correct
  • “Report any development of joint pain.”The patient should be instructed to report joint pain as this could indicate a developing ruptured tendon.
• Correct
  • “Report any numbness or tingling of the hands or feet.”The patient should be instructed to report numbness or tingling of the hands or feet as this could indicate the development of peripheral neuropathy from the drug.

Question 34 of 38

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Which item would the nurse have available for a patient receiving the first dose of a newly prescribed antibiotic? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Crash cartBecause a patient can have an allergic reaction to any anti-infective drug, emergency equipment should be available to treat the reaction or anaphylaxis.
• Correct
  • EpinephrineBecause a patient can have an allergic reaction to any anti-infective drug, epinephrine should be available to treat the reaction or anaphylaxis.
• • Heparin flushA heparin flush would be used to ensure the patency of an intravenous angiocatheter that is capped and is not used in the emergency treatment of a reaction to an antibiotic.
• Correct
  • DiphenhydramineBecause a patient can have an allergic reaction to any anti-infective drug, diphenhydramine should be available to treat the reaction or anaphylaxis.
• • Sterile normal salineSterile normal saline has many uses in patient care however is not used in the emergency treatment of a reaction to an antibiotic.

Question 35 of 38

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Which assessment finding indicates that a patient is developing pseudomembranous colitis from antibiotic therapy? Select all that apply. One, some, or all responses may be correct.

• • ThrushWhite patches in the mouth, or thrush, indicates an overgrowth of yeast because of a reduction of the normal flora in the mouth.
• Correct
  • Low-grade feverSome antibiotics can cause severe and damaging inflammation of the colon caused pseudomembranous colitis. A low-grade fever is a symptom of this adverse effect.
• • Vaginal dischargeAn itchy vaginal discharge indicates an overgrowth of yeast because of a reduction of the normal flora in the vagina.
• Correct
  • Abdominal crampsSome antibiotics can cause severe and damaging inflammation of the colon caused pseudomembranous colitis. Abdominal cramping is a symptom of this adverse effect.
• Correct
  • Excessive watery bloody diarrheaSome antibiotics can cause severe and damaging inflammation of the colon caused pseudomembranous colitis. Excessive watery bloody diarrhea is a symptom of this adverse effect.

Question 36 of 38

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At which time would the nurse give an anti-infective that is prescribed three times a day?

• • 6:00 a.m.; 12 noon; 6:00 p.m.Antimicrobials work best against infection when blood drug levels remain consistent, and it is best to give them on an even, around-the-clock schedule. This schedule would not keep an even drug level.
• • 8:00 a.m.; 12 noon; 4:00 p.m.This schedule would mean that the drug level would drop between 4:00 p.m. and 8:00 a.m. permitting the organism to grow again.
• • 7:00 a.m.; 1:00 p.m.; 7:00 p.m.This schedule would mean that the drug level would drop between 7:00 p.m. and 7:00 a.m. permitting the organism to grow again.
• Correct
  • 6:00 a.m.; 2:00 p.m.; 10:00 p.m.This schedule would ensure a consistent blood level of the medication and reduce the risk of the organism growing again between doses.

Question 37 of 38

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Which question would the nurse ask when a patient develops another urinary tract infection after receiving treatment for the same infection a month ago?

• • “How many meals a day do you eat?”The number of meals the patient eats per day has no impact on the development of the same infection that was treated a month ago.
• • “How much water do you drink every day?”The amount of water the patient drinks per day has no impact on the development of the same infection that was treated a month ago.
• • “What type of exercise do you do every day?”The type of exercise the patient performs each day has no impact on the development of the same infection that was treated a month ago.
• Correct
  • “Did you take the full course of the drug to treat the other infection?Whatever duration is prescribed, it is important for the patient to receive all of the therapy. Stopping antimicrobial therapy after infection symptoms are no longer present but before the prescribed duration of treatment is completed increases the risk of infection recurrence and development of drug-resistant organisms.

Question 38 of 38

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Which patient statement indicates to the nurse that teaching provided about antimicrobial therapy was effective? Select all that apply. One, some, or all responses may be correct.

• • “I will take the medication only as needed.”Teaching a patient regarding antimicrobial therapy includes instructing the patient to take the medication around the clock to maintain a blood level, instead of only as needed.
• Correct
  • “I will call 911 if I develop difficulty breathing.”The patient should be instructed to call 911 if difficulty breathing occurs as this could indicate the development of an anaphylactic reaction.
• Correct
  • “I will stop taking the drug if I develop a rash or hives.”The patient should be instructed to stop taking the drug if a rash or hives develop as this could indicate an allergic reaction.
• Correct
  • “I will report new symptoms to the healthcare provider.”The patient should notify the healthcare provider with any new symptoms as these could indicate an adverse reaction.
• Correct
  • “I will take all of the doses and not save any for later use.”The patient should take all doses of the prescribed antimicrobial because expired drugs deteriorate and become less effective. Also the full course of the medication is required to effectively kill the offending organism.