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After teaching a group of students about antibacterial drugs that disrupt the bacterial cell wall, the instructor determines that the teaching was successful when the students identify which of the following as an example of a carbapenem? Select all that apply.
- A. Vancomycin
- B. Imipenem-cilastatin
- C. Meropenem
- D. Aztreonam
- E. Ceftriaxone
Correct Answer: B,C
Rationale: Carbapenems include imipenem-cilastatin and meropenem. Vancomycin and aztreonam are classified as miscellaneous drugs that disrupt the bacterial cell wall. Ceftriaxone is a third-generation cephalosporin.
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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.
The nurse is providing care to a patient who is receiving an aminoglycoside for a wound infection. The patient is also ordered to receive a cephalosporin. The nurse would carefully assess the patient for which of the following?
- A. Nausea
- B. Nephrotoxicity
- C. Increased bleeding
- D. Respiratory difficulty
Correct Answer: B
Rationale: When cephalosporin is administered with aminoglycosides, it increases the risk for nephrotoxicity and should be closely monitored. Nausea is an adverse reaction of cephalosporins in patients with gastrointestinal tract infection. The risk of bleeding increases when cephalosporin is administered with oral anticoagulants. The risk for respiratory difficulty and a disulfiram-like reaction increases if alcohol is consumed within 72 hours after administration of certain cephalosporins.
A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform?
- A. Inspect mouth and gums regularly.
- B. Instruct patient to avoid brushing teeth.
- C. Offer patient a liquid diet.
- D. Instruct the patient to gargle every 2 hours.
Correct Answer: A
Rationale: The nurse should regularly inspect the patient's mouth and gums to assess the patient's progress. The nurse should instruct the patient to use a soft-bristled toothbrush. The patient need not follow a liquid diet; a nonirritating soft diet can be recommended. Gargling every 2 hours may not help relieve the symptoms and may even aggravate the existing condition.
A group of nursing students are reviewing information about administering penicillins. The students demonstrate an understanding of the information when they identify which drugs as being given without regard to meals? Select all that apply.
- A. Amoxicillin (Amoxil)
- B. Ampicillin (Principen)
- C. Penicillin V (Veetids)
- D. Amoxicillin/clavulanate (Augmentin)
- E. Carbenicillin indanyl (Geocillin)
Correct Answer: A,C
Rationale: Amoxicillin and penicillin V can be administered without regard to meals, unlike the rest of the penicillins, such as ampicillin, amoxicillin/clavulanate, or carbenicillin indanyl, which should be given on an empty stomach.
A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions would be most appropriate for the nurse to do when preparing penicillin in parenteral form?
- A. Extract penicillin from vial and then reconstitute.
- B. Save excess antibiotic after reconstitution for later use.
- C. Use any available diluent for reconstitution.
- D. Shake the vial well to distribute the drug evenly.
Correct Answer: D
Rationale: When preparing a parenteral form of penicillin, the nurse should shake the vial thoroughly before withdrawing the drug to ensure its even distribution in the solution. Penicillins in powder or crystalline form must be reconstituted before being withdrawn from the vial. Excess antibiotic after reconstitution should never be saved, as the drug loses its potency when stored. Reconstitution should be done only with the diluent prescribed on the manufacturer's label.