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When reviewing the allergy history of a patient, the nurse notes that the patient is allergic to penicillin. Based on this finding, the nurse would question an order for which class of antibiotics?
- A. Tetracyclines
- B. Sulfonamides
- C. Cephalosporins
- D. Quinolones
Correct Answer: C
Rationale: Allergy to penicillin may also result in hypersensitivity to cephalosporins. Patients reporting penicillin allergy need to describe their prior allergic reaction. It is very important to document the type of reaction.
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The nurse is reviewing the medication history of a patient who will be taking a sulfonamide antibiotic. During sulfonamide therapy, a significant drug interaction may occur with which of these drugs or drug classes? (Select all that apply.)
- A. Opioids
- B. Oral contraceptives
- C. Sulfonylureas
- D. Antihistamines
- E. Phenytoin
- F. Warfarin
Correct Answer: B,C,E,F
Rationale: Sulfonamides may potentiate the hypoglycemic effects of sulfonylureas in diabetes treatment and the toxic effects of phenytoin. They also enhance the anticoagulant effects of warfarin, which can lead to hemorrhage. Sulfonamides may also reduce the efficacy of oral contraceptives. Opioids and antihistamines are not typically associated with significant interactions with sulfonamides.
The nurse is monitoring for therapeutic results of antibiotic therapy in a patient with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy?
- A. Increased red blood cell count
- B. Increased hemoglobin level
- C. Decreased white blood cell count
- D. Decreased platelet count
Correct Answer: C
Rationale: Decreased white blood cell counts are an indication of reduction of infection and are a therapeutic effect of antibiotic therapy.
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.
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.
A patient has a urinary tract infection. The nurse knows that which class of drugs is especially useful for such infections?
- A. Macrolides
- B. Carbapenems
- C. Sulfonamides
- D. Tetracyclines
Correct Answer: C
Rationale: Sulfonamides achieve very high concentrations in the kidneys, through which they are eliminated. Therefore, they are often used in the treatment of urinary tract infections.