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After teaching a group of nursing students about the different generations of cephalosporins, the instructor determines that the teaching was successful when the students identify which of the following as an example of a first-generation cephalosporin? Select all that apply.
- A. Cefepime (Maxipime)
- B. Cefazolin (Ancef)
- C. Cefoxitin (Mefoxin)
- D. Cephalexin (Keflex)
- E. Cefaclor (Raniclor)
Correct Answer: B,D
Rationale: Cefazolin and cephalexin are examples of first-generation cephalosporins. Cefoxitin and cefaclor are examples of second-generation cephalosporins. Cefepime is an example of a fourth-generation cephalosporin.
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The nurse is obtaining a medication history of a 48-year-old patient with an ear infection who is to receive penicillin therapy. The patient reports taking a beta-adrenergic blocker for his hypertension. The nurse would identify that this patient is at increased risk for which of the following if penicillin is administered?
- A. Anaphylactic shock
- B. Higher blood pressure
- C. Excess bleeding
- D. Heart attack
Correct Answer: A
Rationale: Combining penicillins with beta-adrenergic blocking drugs increases the risk of anaphylactic shock. Beta-adrenergic blocking drugs are used to control blood pressure and heart problems, but combining them with penicillins does not increase the risk of high blood pressure or heart attack. Risk of bleeding is maximized if penicillins are combined with anticoagulants.
After teaching a group of nursing students about penicillins, the instructor determines that the teaching was successful when the students identify which of the following as a group? Select all that apply.
- A. Synthetic penicillins
- B. Natural penicillins
- C. Penicillinase-resistant penicillins
- D. Aminopenicillins
- E. Extended-spectrum penicillins
Correct Answer: B,C,D,E
Rationale: Penicillins are categorized into four groups including the natural penicillins, penicillinase-resistant penicillins, aminopenicillins, and extended-spectrum penicillins.
A nurse is reviewing the laboratory test results of a client receiving penicillin therapy. Which of the following would the nurse identify as indicating an adverse hematologic reaction? Select all that apply.
- A. Pancytopenia
- B. Anemia
- C. Thrombocytopenia
- D. Leukopenia
- E. Hemoglobulinemia
Correct Answer: B,C,D
Rationale: Nurses should monitor blood counts of clients taking penicillins for the following hematopoietic changes: anemia, thrombocytopenia, leucopenia, and bone marrow suppression.
A patient is ordered to receive vancomycin IV. When administering the drug, the nurse would infuse the drug over which time frame?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: D
Rationale: Each IV dose of vancomycin is infused over 60 minutes. Too rapid an infusion may result in a sudden and profound fall in blood pressure and shock.
A client develops a mild skin irritation while receiving penicillin therapy. Which of the following would the nurse advise the client to avoid? Select all that apply.
- A. Harsh soaps
- B. Perfumed lotions
- C. Antipyretic creams
- D. Rubbing the irritating area
- E. Wearing rough or irritating clothing
Correct Answer: A,B,D,E
Rationale: When skin irritation is present during the administration of penicillin, the nurse should advise the client to avoid harsh soaps, perfumed lotions, rubbing the irritated area, or wearing rough or irritating clothing.