MOA
A nursing student is developing a study guide on antibiotics that achieve their therapeutic effect by inhibiting bacterial cell wall synthesis. Which of the following medications should the student include in this category? (Select all that apply.)
a) levofloxacin (Levaquin)
b) piperacillin-tazobactam (Zosyn)
c) imipenem-cilastatin (Primaxin)
d) gentamicin (Garamycin)
e) cefazolin (Ancef)
B,C,E
A nurse is caring for a client receiving IV gentamicin (Garamycin). Due to the black box warnings associated with this medication, which of the following assessments should the nurse prioritize?
a) Monitoring for constipation and abdominal distention
b) Observing for signs of photosensitivity
c) Assessing for tinnitus and monitoring urine output
d) Checking for a disulfiram-like reaction with alcohol
c) Assessing for tinnitus and monitoring urine output
A nurse is caring for a client with a confirmed bloodstream infection caused by Methicillin-resistant Staphylococcus aureus (MRSA). The nurse would anticipate an order for which of the following antibiotics?
a) Cefazolin (Kefzol)
b) Piperacillin-tazobactam (Zosyn)
c) Vancomycin (Vancocin)
d) Aztreonam (Azactam)
c) Vancomycin (Vancocin)
A patient is prescribed a loop diuretic for hypertension. Which of the following potential side effects should the nurse monitor for?
Hypokalemia
A nurse is reviewing the medical history of a patient who is about to receive a prescription for levofloxacin (Levaquin). Which of the following conditions in the patient's history would require the nurse to question the prescription?
A. Hypertension
B. Type 2 Diabetes
C. Myasthenia gravis
D. History of a penicillin allergy
C. Myasthenia Gravis
A client is receiving the combination antibiotic imipenem-cilastatin (Primaxin). The nurse recognizes that the purpose of the cilastatin component is to perform which of the following actions?
a) Directly inhibit bacterial wall synthesis
b) Reduce the potential for nephrotoxicity
c) Prevent the destruction of the imipenem component
d) Decrease the severity of gastrointestinal side effects
c) Prevent the destruction of the imipenem component
A nurse is administering an IV infusion of vancomycin (Vancocin). Partway through the infusion, the client develops flushing, a rash on the upper body, and hypotension. The nurse recognizes these symptoms are most likely caused by which of the following?
a) The infusion being administered too rapidly
b) A concurrent reaction with a penicillin antibiotic
c) The development of C. difficile superinfection
d) An expected narrow-spectrum antibacterial effect
a) The infusion being administered too rapidly
A client is scheduled for a surgical procedure. The nurse knows that which of the following first-generation cephalosporins is frequently administered for surgical prophylaxis?
a) Ceftriaxone (Rocephin)
b) Imipenem-cilastatin (Primaxin)
c) Cefazolin (Ancef)
d) Levofloxacin (Levaquin)
c) Cefazolin (Ancef)
A nurse is administering a beta-blocker to a patient with a history of asthma. Which of the following is the most important assessment for the nurse to perform before giving the medication?
A. Heart Rate
B. Blood Pressure
C. Urine Output
D. Breath Sounds
D. Breath Sounds
- Beta Blockers can cause Bronchoconstriction which can exacerbate asthma
A patient with a serious infection is prescribed gentamicin (Garamycin). During the initial assessment, the patient states, "I have some hearing loss in my right ear from my time in the military." Which action should the nurse take first?
A. Administer the medication as prescribed.
B. Ensure the patient is well-hydrated.
C. Document the hearing loss in the patient's chart.
D. Hold the medication and notify the healthcare provider.
C. Document the hearing loss in the patient's chart.
A nurse is preparing to administer levofloxacin (Levaquin). The nurse understands that this fluoroquinolone antibiotic class is effective against a broad spectrum of pathogens because its mechanism of action involves what process?
a) Inhibiting bacterial wall synthesis
b) Affecting bacterial DNA synthesis
c) Inhibiting bacterial protein synthesis
d) Damaging the fungal cell membrane
b) Affecting bacterial DNA synthesis
A nurse is providing discharge instructions to a client with a new prescription for levofloxacin (Levaquin). Which client statement indicates an understanding of a serious potential adverse effect?
a) "I will report any sudden pain or swelling in my ankle or heel immediately."
b) "I should expect this medication to cause a harmless red color in my urine."
c) "If I get a headache, I should stop taking the medication right away."
d) "This medication is known to cause severe constipation."
a) "I will report any sudden pain or swelling in my ankle or heel immediately."
A client in the intensive care unit is diagnosed with a ventilator-associated pneumonia caused by Pseudomonas aeruginosa. The nurse would anticipate the administration of which extended-spectrum penicillin that was specifically developed to combat this pathogen?
a) Vancomycin (Vancocin)
b) Piperacillin-tazobactam (Zosyn)
c) Cefazolin (Ancef)
d) Linezolid (Zyvox)
b) Piperacillin-tazobactam (Zosyn)
A nurse is administering an intravenous infusion of vancomycin (Vancocin). The nurse notes the patient is developing flushing of the face and neck, and a rash on their upper body. The patient's blood pressure has also dropped. Which action should the nurse take first?
A. Administer an antihistamine as ordered.
B. Slow the rate of the vancomycin infusion.
C. Document the findings as a minor reaction.
D. Check the patient's peak and trough levels.
B. Slow the rate of the vanco
A healthcare provider orders imipenem-cilastatin (Primaxin) for a patient. Which of the following statements by the patient would prompt the nurse to seek clarification from the provider before administration?
A. "I am allergic to sulfa drugs."
B. "I have a history of seizures."
C. "I take metformin for my diabetes."
D. "I have a family history of heart disease."
B. "I have a history of seizures."
A client with a severe Clostridium difficile (C. diff) infection is prescribed oral vancomycin (Vancocin). The nurse understands that vancomycin's mechanism of action is effective against this pathogen because it targets which of the following?
a) Protein synthesis in gram-negative bacteria
b) The cell wall synthesis of gram-positive organisms
c) DNA synthesis in anaerobic bacteria d) The cell wall synthesis of a broad spectrum of organisms
b) The cell wall synthesis of gram-positive organisms
A client with a history of a seizure disorder is prescribed imipenem-cilastatin (Primaxin). The nurse should monitor this client closely for which potential adverse effect?
a) Hypoglycemia
b) Ototoxicity
c) Confusion or hallucinations
d) Vancomycin Flushing Syndrome
c) Confusion or hallucinations
An adult client is diagnosed with a severe and complicated urinary tract infection (UTI). The provider prescribes levofloxacin (Levaquin). The nurse recognizes this fluoroquinolone is an appropriate choice based on which of the following indications?
a) It is used for infections in hard-to-treat areas like the GU tract.
b) It is the primary treatment for gram-positive resistant organisms.
c) It is exclusively indicated for infections caused by Pseudomonas aeruginosa.
d) It is a narrow-spectrum antibiotic used only for skin infections.
a) It is used for infections in hard-to-treat areas like the GU tract.
A patient is prescribed gentamicin (Garamycin) for a serious gram-negative infection. Which assessment finding would be of the greatest concern to the nurse?
A. Nausea and vomiting
B. Tinnitus and dizziness
C. A rash on the trunk
D. Diarrhea
B. Tinnitus and dizziness
A nurse is preparing to administer vancomycin (Vancocin). A review of the patient's medical record reveals impaired renal function. The nurse should recognize that this patient is at an increased risk for which of the following?
A. Vancomycin Flushing Syndrome (VFS)
B. C. difficile-associated diarrhea
C. Lactic acidosis
D. Nephrotoxicity
D. Nephrotoxicity
A client with a multidrug-resistant Pseudomonas aeruginosa infection is prescribed aztreonam (Azactam). The nurse understands that this monobactam antibiotic's mechanism of action is effective against this specific pathogen because it does which of the following?
a) Inhibits protein synthesis in gram-positive bacteria
b) Inhibits cell wall synthesis in gram-negative microbes
c) Affects DNA synthesis in a broad spectrum of organisms
d) Inhibits cell wall synthesis in gram-positive microbes
b) Inhibits cell wall synthesis in gram-negative microbes
A client receiving piperacillin-tazobactam (Zosyn) reports bleeding gums while brushing their teeth. A review of the client's lab work shows a new, low platelet count. The nurse recognizes this as which potential adverse effect of the medication?
a) Superinfection
b) Hypokalemia
c) Thrombocytopenia
d) Hyperglycemia
c) Thrombocytopenia
A client with a severe, intra-abdominal infection that is resistant to multiple other antibiotics is admitted to the ICU. The nurse would anticipate an order for which carbapenem antibiotic that is reserved for serious infections?
a) Ceftriaxone (Rocephin)
b) Aztreonam (Azactam)
c) Imipenem-cilastatin (Primaxin)
d) Gentamicin (Garamycin)
c) Imipenem-cilastatin (Primaxin)
A patient being treated with levofloxacin (Levaquin) calls the clinic to complain of new-onset ankle pain and swelling. What is the best instruction for the nurse to provide?
A. "Elevate the affected leg and apply a warm compress."
B. "Take over-the-counter ibuprofen for the pain."
C. "This is an expected side effect that should resolve on its own."
D. "Stop taking the medication and contact your healthcare provider immediately."
D. "Stop taking the medication and contact your healthcare provider immediately
A patient is prescribed linezolid (Zyvox). The nurse notes the patient is also taking a sympathomimetic medication for asthma. The nurse should prioritize monitoring for which of the following adverse effects?
A. Hypoglycemia
B. Hypertension
C. Myelosuppression
D. Diarrhea
B. Hypertension