Nokea
The nurse is monitoring a patient who has been on antibiotic therapy for 2 weeks. Today the patient tells the nurse that he has had watery diarrhea since the day before and is having abdominal cramps. His oral temperature is 101?°F (38.3?°C). Based on these findings, which conclusion will the nurse draw?
- A. The patient's original infection has not responded to the antibiotic therapy.
- B. The patient is showing typical adverse effects of antibiotic therapy.
- C. The patient needs to be tested for Clostridium difficile infection.
- D. The patient will need to take a different antibiotic.
Correct Answer: C
Rationale: Antibiotic-associated diarrhea is a common adverse effect of antibiotics. However, it becomes a serious superinfection when it causes antibiotic-associated colitis, also known as pseudomembranous colitis or simply C. difficile infection. This happens because antibiotics disrupt the normal gut flora and can cause an overgrowth of Clostridium difficile. The most common symptoms of C. difficile colitis are watery diarrhea, abdominal pain, and fever.
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A patient tells the nurse that he is having nausea and decreased appetite during drug therapy with a tetracycline antibiotic. Which statement is the nurse's best advice to the patient?
- A. Take it with cheese and crackers or yogurt.
- B. Take each dose with a glass of milk.
- C. Take an antacid with each dose as needed.
- D. Drink a full glass of water with each dose.
Correct Answer: D
Rationale: Oral doses should be given with at least 8 ounces of fluids and food to minimize gastrointestinal upset. Antacids and dairy products will bind with the tetracycline and make it inactive.
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?
- A. First-generation
- B. Second-generation
- C. Third-generation
- D. Fourth-generation
Correct Answer: A
Rationale: First-generation cephalosporins provide excellent coverage against gram-positive bacteria but limited coverage against gram-negative bacteria.
The nurse is preparing to use an antiseptic. Which statement is correct regarding how antiseptics differ from disinfectants?
- A. Antiseptics are used to sterilize surgical equipment.
- B. Disinfectants are used as preoperative skin preparation.
- C. Antiseptics are used only on living tissue to kill microorganisms.
- D. Disinfectants are used only on nonliving objects to destroy organisms.
Correct Answer: D
Rationale: Antiseptics primarily inhibit microorganisms but do not necessarily kill them. They are applied exclusively to living tissue. Disinfectants are able to kill organisms and are used only on nonliving objects.
During drug therapy for pneumonia, a female patient develops a vaginal superinfection. The nurse explains that this infection is caused by which of these?
- A. Large doses of antibiotics that kill normal flora
- B. The infection spreading from the lungs to the new site of infection
- C. Resistance of the pneumonia-causing bacteria to the drugs
- D. An allergic reaction to the antibiotics
Correct Answer: A
Rationale: Normally occurring bacteria are killed during antibiotic therapy, allowing other flora to take over and resulting in superinfections.
A patient will be receiving amoxicillin suspension 300 mg via a gastrostomy tube every 8 hours. The medication comes in a bottle that contains 400 mg/5 mL. Identify how many milliliters the nurse will administer with each dose. (record answer using one decimal place)
Correct Answer: 3.8 mL
Rationale: 400 mg:5 mL::300 mg:x mL. Solve for x: (400 ?? x) = (5 ?? 300); 400x = 1500; x = 3.75, rounding to 3.8; administer 3.8 mL.