prep u 13

Question 1:
(see full question) The pathophysiology class is learning how microorganisms develop resistance to anti-infective drugs. What is one way the students would learn that microorganisms develop resistance to anti-infective drugs?
You selected: By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
Correct
Explanation:
Microorganisms have developed resistance by changing cellular permeability to prevent the drug from entering the cell by altering binding sites on the membranes or on ribosomes so … (more)

Question 2:
(see full question) Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture?
You selected: To identify the drugs that might be effective in treatment
Incorrect
Correct response: To identify the organism causing the infection
Explanation:
Culture identifies the infection’s causative organism. Susceptibility tests determine which drugs are likely to be effective against the organism.

Question 3:
(see full question) A patient at high risk for infection is admitted to your unit. Which of the following factors might predispose the patient to infection?
You selected: All the above
Correct
Explanation:
Factors that suppress the host defense mechanisms and predispose the patient to infection include impaired blood supply, diabetes and other chronic disease, advanced age, immunosup … (more)

Question 4:
(see full question)
A male client is diagnosed with a drug-resistant infection in his wound. What should the home care nurse teach the client and his family?
You selected: To use gloves when handling drainage from the wound
Correct
Explanation:
General infection-control practices include frequent and thorough hand hygiene, use of gloves when indicated, and appropriate handling and disposal of body substances (e.g., … (more)

Question 5:
(see full question) A female client comes to the clinic reporting vaginal discharge with itching. When obtaining the client’s medication history, what would the nurse consider as significant?
You selected: oral contraceptive use
Incorrect
Correct response: broad spectrum anti-infective for recent infection
Explanation:
The use of broad-spectrum anti-infectives may result in superinfections, which are infections occurring when opportunistic pathogens kept in check by normal flora invade the tissue … (more)

Question 6:
(see full question) You are working as a nurse educator in the hospital setting. Part of your responsibility includes developing a plan to prevent antibiotic resistance. What is the most important part of your plan?
You selected: An education campaign that focuses on handwashing between patients
Correct
Explanation:
Handwashing is one of the most effective ways to prevent antibiotic resistance, by preventing diseases from being spread from one person to another.

Question 7:
(see full question) A client is informed of a need for extensive dental surgery. The dentist prescribes a course of antibiotic therapy before beginning the procedure and continuing for 5 days after the procedure. What is this is an example of?
You selected: prophylaxis
Correct
Explanation:
In a situation where an infection is likely to occur, antibiotics can be used as a means of preventing an infection; this is called prophylaxis. Synergism is using two antibiotics … (more)

Question 8:
(see full question) You are speaking to a group of clients in a public meeting. They ask you to explain the difference between community-acquired infections and nosocomial infections. Your best response is:
You selected: Usually, nosocomial infections are less severe and easier to treat. Community-acquired infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.
Incorrect
Correct response: Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.
Explanation:
Infections are often categorized as community-acquired or nosocomial. Because the microbial environments differ, the two types of infections often have different causes and require … (more)

Question 9:
(see full question) Like many other classes of drugs, anti-infective drugs can have a variety of adverse effects. What is the most common, potentially serious, adverse effect of antimicrobial drugs?
You selected: Skin rash
Incorrect
Correct response: Toxic effects on the kidney
Explanation:
The most commonly encountered adverse effects associated with the use of anti-infective agents are direct toxic effects on the kidney, gastrointestinal (GI) tract, and nervous syst … (more)

Question 10:
(see full question) The pharmacology instructor is discussing ways to decrease the incidence and severity of adverse effects among children taking anti-infective agents. What would the instructor mention is one way to do this in children?
You selected: Keep clients well hydrated.
Correct
Explanation:
Because children can have increased susceptibility to the gastrointestinal and nervous system effects of anti-infectives, monitor hydration and nutritional status carefully. Client … (more)

Question 11:
(see full question) What occurs when the normal flora is destroyed by the use of anti-infectives?
You selected: hypersensitivity
Incorrect
Correct response: superinfection
Explanation:
Destruction of the normal flora by anti-infectives commonly leads to superinfection, an infection that occurs when opportunistic pathogens that were kept in check by the norma … (more)

Question 12:
(see full question) The nursing instructor and her students are discussing ways to prevent the spread of infection. Which of the following measures should the instructor identify as the most important?
You selected: Maintaining reverse isolation protocols
Incorrect
Correct response: Rigorously and consistently applying recommended precautions
Explanation:
Rigorous and consistent use of recommended precautions helps to protect health care providers and patients regardless of the type of infection. These basic precautions include usin … (more)

Question 14:
(see full question) A client has been receiving an antibiotic for the past 36 hours for treatment of a bacterial infection, and the infection has shown no signs of improving. What does the nurse suspect is the most likely reason for a lack of improvement?
You selected: The client isn’t taking the medication
Incorrect
Correct response: The client’s infection is resistant to the medication
Explanation:
When a client hasn’t responded to an antibiotic after 24 to 36 hours, it is a possible sign that the infectious agent is resistant to the antibiotic. Though it is possi … (more)

Question 15:
(see full question) To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?
You selected: Obtaining sensitivity testing
Correct
Explanation:
Performing sensitivity testing on cultured microbes is important to evaluate the bacteria and determine which drugs are capable of controlling the particular organism. Once the sen … (more)

Question 16:
(see full question) The pharmacology instructor is discussing ways of minimizing the emergence of drug-resistant microbial agents. Which of the following measures could the instructor suggest?
You selected: All the above
Correct
Explanation:
Combating the proliferation of drug-resistant pathogens relies, in part, on responsible use of antibacterial drugs. Responsible use includes avoiding the use of broad-spectrum anti … (more)

Question 17:
(see full question) A nurse provides client teaching for someone being discharged home on an anti-infective. What statement by the client indicates to the nurse that additional teaching concerning the use of anti-infectives is needed?
You selected: “I will stop the antibiotic as soon as I feel better.”
Correct
Explanation:
Compliance with anti-infective therapy is a concern. Clients tend to stop taking the drugs when they begin to “feel better.” A nurse should instruct the client to take … (more)

Question 18:
(see full question) A nurse is caring for a child weighing 30 kg. The physician orders gentamicin (Garamycin) tid for the client. The recommended dosage range is 6 to 7.5 mg/kg/day. Why is it important to give a dosage within this recommended range? (Select all that apply.)
You selected: • To eradicate the bacteria
• Give a safe dose for this size child.
• Prevent overdose in the child.
• So the child gets too much medication
Incorrect
Correct response: • Prevent overdose in the child.
• Give a safe dose for this size child.
• To eradicate the bacteria
Explanation:
Drug dosage is important in preventing the development of resistance. Doses should be high enough and the duration of drug therapy should be long enough to eradicate even slightly … (more)

Question 19:
(see full question) The nurse caring for a 24-year-old woman admitted with pneumonia explains how antibiotics work to help cure her pneumonia. Which statement would be correct about how antibiotic therapy works?
You selected: Antibiotics work by inhibiting cell wall synthesis.
Correct
Explanation:
Antimicrobial drugs work in a variety of ways: inhibition of bacterial cell wall synthesis, inhibition of protein synthesis, inhibition of nucleic acid synthesis, inhibition of met … (more)

Question 20:
(see full question) A client is admitted to the unit. The nurse knows that the client is at high risk for infection. What factors predispose the ckient to infection? (Mark all that apply.)
You selected: • Impaired blood supply
• Suppression of immune system
• Advanced age
Correct
Explanation:
Factors that suppress the host defense mechanisms include impaired blood supply, suppression of immune system, and advanced age. Hypertension does not predispose a person to infect … (more)

Question 1:
(see full question) Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is:
You selected: the number of effective drugs available for serious or antibiotic-resistant infections.
Incorrect
Correct response: the host’s ability to defend itself against the would-be invaders.
Explanation:
The human body and the environment contain many microorganisms, most of which do not cause disease and live in a state of balance with the human host. When the balance is upset and … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231.
Question 2:
(see full question) A client who is receiving anti-infective therapy is experiencing gastrointestinal toxicity. What would the nurse expect to assess?
You selected: diarrhea
Correct
Explanation:
Gastrointestinal toxicity would be manifested by diarrhea, nausea, vomiting, or stomach upset. Dizziness and vertigo would reflect neurotoxicity. Rash may suggest a hypersensi … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 323.
Question 3:
(see full question) The nurse is assessing a client who has recently been given the first dose of a new anti-infective. What finding should lead the nurse to suspect that the client is experiencing a hypersensitivity reaction?
You selected: The client recently had an episode of diarrhea.
Incorrect
Correct response: The client has a facial and trunk rash.
Explanation:
Rash suggests a hypersensitivity reaction. Vertigo may suggest a neurotoxic adverse effect. Diarrhea may occur over time as a result of gastrointestinal adverse effects. A blood pr … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 4:
(see full question) A 6-year-old client is prescribed a narrow-spectrum antibiotic. What is meant by “narrow-spectrum antibiotic”?
You selected: The antibiotic is effective against only a select few pathogens.
Correct
Explanation:
Antibacterial drugs are subdivided into narrow-spectrum, broad-spectrum, and antimycobacterial classifications. As the name implies, a narrow-spectrum drug is effective against a f … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 5:
(see full question) Successful treatment with bacteriostatic antibiotics depends upon:
You selected: the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy.
Correct
Explanation:
Successful treatment with bacteriostatic antibiotics depends on the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 6:
(see full question) The nurse is preparing to administer an anti-infective agent that is prescribed for an older adult. The nurse should prioritize what action?
You selected: Encourage fluid intake for the duration of treatment
Incorrect
Correct response: Monitor the client closely for signs of adverse effects
Explanation:
The older adult is more susceptible to severe adverse effects. For this reason, close monitoring is necessary and is a priority over education that addresses culture testing and th … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 240.
Question 7:
(see full question) A nurse has questioned why a client’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?
You selected: The use of broad-spectrum antibiotics can create a risk for a superinfection.
Correct
Explanation:
The benefit of a narrow-spectrum antimicrobial agent is that it limits the potential for adverse effects, such as superinfection. In a superinfection, an antibiotic suppresses all … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 8:
(see full question) A client comes to the clinic reporting mouth sores that appear consistent with an oral yeast infection. The nurse should question the client about recent use of:
You selected: antibiotics.
Correct
Explanation:
The client is exhibiting signs of a superinfection, which can occur with the use of antibiotics. Superinfections are not associated with oral contraceptives, multivitamins, or anti … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 9:
(see full question) A female client calls the pediatrician’s office because her child reports a sore throat. The nurse anticipates the physician will take what action?
You selected: Request a throat culture.
Correct
Explanation:
For sore throat, a throat culture for streptococcal organisms should be performed and the results obtained before an antibiotic is prescribed.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 232.
Question 10:
(see full question) A client with acne has been receiving an anti-infective agent for a prolonged period. Initially, the drug was effective, but over time its effectiveness as decreased. What is the nurse’s best action?
You selected: Assess the client for additional signs of superinfection.
Incorrect
Correct response: Refer the client to the health care provider because the client may be experiencing resistance.
Explanation:
Resistance refers to the organism’s ability to adapt over time to an antibiotic and produce cells that are no longer affected by a particular drug. Destruction of the normal flor … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 235.
Question 11:
(see full question) Which of the following scenarios depicts someone using antibacterial medications appropriately?
You selected: A patient refuses to share her medication with her husband, who believes that he has the same illness.
Correct
Explanation:
Patients can use antibacterial drugs responsibly by taking all prescribed doses and by not taking medications prescribed for another person or another illness. Clinicians should av … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 12:
(see full question) A client is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of:
You selected: prophylaxis.
Correct
Explanation:
In a situation where an infection is likely to occur, antibiotics can be used as a means of prophylaxis to prevent an infection before it occurs. Synergism is using two antibiotics … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 13:
(see full question) A nurse is writing a care plan for a client on an anti-infective drug. What would be an appropriate intervention to reduce the accumulation of the drug in the kidney?
You selected: Increase fluids.
Correct
Explanation:
To prevent the accumulation of anti-infective drugs in the kidneys, which can cause kidney damage, clients taking anti-infective drugs should be well hydrated. Decreasing the dosag … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 14:
(see full question)
Which client is most at risk for an opportunistic infection?
You selected: A 14-year-old client with HIV infection
Correct
Explanation:
The client most at risk for an opportunistic infection is the one with the HIV infection because the immune system is compromised with this disease.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231.
Question 15:
(see full question)
The nurse is aware that which areas of the body are difficult to treat with antimicrobial drugs? (Select all that apply.)
You selected: • Prostate gland
• Brain
Incorrect
Correct response: • Prostate gland
• Brain
• Eyes
Explanation:
Certain areas of the body are difficult to treat with antibiotics because antibacterials don’t reach adequate levels of concentration in these areas such as the prosta … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 238.
Question 16:
(see full question) When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is aware that when compared with doses for young and middle-aged adults, these clients may require:
You selected: a lower dose.
Correct
Explanation:
Infants and the elderly are the populations most vulnerable to drug toxicity. In the infant, the liver and kidneys are still immature and may have difficulty metabolizing or excret … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 17:
(see full question) A female client takes an antibiotic, left over from her last bout with bronchitis, when she discovers that her child has developed strep throat. She takes the antibiotic as a preventive measure. What effects might this practice have? (Select all that apply.)
You selected: • Increasing adverse drug effects
• Increasing the risk of infections with drug-resistant microorganisms
Correct
Explanation:
Inappropriate use of antibiotics increases adverse drug effects, infections with drug resistant microorganisms, and health care costs as well as reduce the number of available … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 18:
(see full question)
The physician orders an antibiotic for a female client, who states that she cannot take antibiotics on an empty stomach because they make her nauseous. What instructions should the nurse give her?
You selected: Take the medication with food to reduce nausea.
Correct
Explanation:
Check specific recommendations with regard to the administration of the antibiotic with food and other medications to decrease binding to food and drugs and prevent inactivat … (more)

Question 19:
(see full question) People taking antimicrobial drugs should be instructed to report any problem that could indicate adverse drug effects, lack of therapeutic response, or emergence of another infection. One such problem is:
You selected: skin rash.
Correct
Explanation:
Clients should be instructed to report nausea, vomiting, diarrhea, skin rash, recurrence of symptoms for which the antimicrobial drug was prescribed, or signs of new infection (e.g … (more)

Question 20:
(see full question) A 32-year-old patient is taking an antibacterial medication for treatment of a urinary tract infection. Two days after starting the medication, she develops a cough and a fever of 101.5 °F. What should this patient do?
You selected: Call her health care provider
Correct
Explanation:
Patients should immediately report any problem that could indicate adverse drug effects, lack of therapeutic effect, or another infection. Potential signs include nausea, vomiting, … (more)

Question 1:
(see full question) Like many other classes of drugs, anti-infective drugs can have a variety of adverse effects. What is the most common, potentially serious, adverse effect of antimicrobial drugs?
You selected: Toxic effects on the kidney
Correct
Explanation:
The most commonly encountered adverse effects associated with the use of anti-infective agents are direct toxic effects on the kidney, gastrointestinal (GI) tract, and nervous syst … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 2:
(see full question) A client has been receiving an antibiotic for the past 36 hours for treatment of a bacterial infection, and the infection has shown no signs of improving. What does the nurse suspect is the most likely reason for a lack of improvement?
You selected: The client’s infection is resistant to the medication
Correct
Explanation:
When a client hasn’t responded to an antibiotic after 24 to 36 hours, it is a possible sign that the infectious agent is resistant to the antibiotic. Though it is possi … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 235.
Question 3:
(see full question) The nursing instructor and her students are discussing ways to prevent the spread of infection. Which of the following measures should the instructor identify as the most important?
You selected: Rigorously and consistently applying recommended precautions
Correct
Explanation:
Rigorous and consistent use of recommended precautions helps to protect health care providers and patients regardless of the type of infection. These basic precautions include usin … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 240.
Question 4:
(see full question)
A client is diagnosed with bacterial pneumonia. Pending culture results, what would the nurse expect the physician to order?
You selected: Broad-spectrum antibiotics
Correct
Explanation:
Bacterial pneumonia is usually treated with a broad-spectrum antibiotic until culture and susceptibility reports become available.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 5:
(see full question) A nurse is instructing a colleague on how an antimicrobial produces a therapeutic effect. What should be included in the nurse’s teaching?
You selected: Penicillin interferes with synthesis of the bacteria cell wall.
Correct
Explanation:
The action of antimicrobials is to interfere with the normal function of the invading organism to prevent it from reproducing and to cause cell death without affecting host cells. … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 6:
(see full question) Inappropriate use of antibiotics does all of the following except increase:
You selected: health care costs.
Incorrect
Correct response: the number of available effective drugs for serious or antibiotic-resistant infections.
Explanation:
Antimicrobials are among the most frequently used drugs worldwide. Their success in saving lives and decreasing severity and duration of infectious diseases has encouraged their ex … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 7:
(see full question)
The nursing instructor is discussing normal body defense against infection. The nursing students answer correctly when they identify what as defense factors? (Select all that apply.)
You selected: • Stomach acid
• Coughing
Incorrect
Correct response: • Coughing
• Stomach acid
• Swallowing
Explanation:
Normal body defenses against infection include coughing, sneezing, swallowing, and normal amounts of stomach acid. Risk factors include an impaired blood supply and any impai … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231.
Question 8:
(see full question) Antimicrobials work by several different mechanisms of action. How do the penicillins work?
You selected: Inhibiting cell wall synthesis
Correct
Explanation:
Some anti-infectives interfere with biosynthesis of the bacterial cell wall. Because bacterial cells have a slightly different composition than human cells, this is an effective wa … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 9:
(see full question) What is critical to helping prevent development of resistant strains of microbes?
You selected: Maintain the maximum safe frequency of antimicrobial drug ingestion.
Incorrect
Correct response: Maintain the optimum duration of the antimicrobial agent.
Explanation:
Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of these agents to the treatments of specific pathogens known to be s … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 10:
(see full question) A nurse is caring for a child weighing 30 kg. The physician orders gentamicin (Garamycin) tid for the client. The recommended dosage range is 6 to 7.5 mg/kg/day. Why is it important to give a dosage within this recommended range? (Select all that apply.)
You selected: • To eradicate the bacteria
• Give a safe dose for this size child.
• Prevent overdose in the child.
Correct
Explanation:
Drug dosage is important in preventing the development of resistance. Doses should be high enough and the duration of drug therapy should be long enough to eradicate even slightly … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 11:
(see full question) What occurs when the normal flora is destroyed by the use of anti-infectives?
You selected: superinfection
Correct
Explanation:
Destruction of the normal flora by anti-infectives commonly leads to superinfection, an infection that occurs when opportunistic pathogens that were kept in check by the norma … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 232.
Question 12:
(see full question) A nurse is required to administer an antibiotic to a client. What preadministration assessment steps should the nurse perform before the first dose of antibiotic is given? Select all that apply.
You selected: • Identify and record symptoms of infection
• Take and record vital signs of the patient
• Obtain thorough allergy history of the patient
Correct
Explanation:
It is important for the nurse to identify and record symptoms of infection, take and record vital signs of the patient, and obtain a thorough allergy history of the patient before … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 13:
(see full question) You are speaking to a group of clients in a public meeting. They ask you to explain the difference between community-acquired infections and nosocomial infections. Your best response is:
You selected: Usually, community-acquired infections are less severe and easier to treat. Nosocomial infections may be more severe and difficult to manage because they often result from drug-resistant microorganisms and occur in people whose immunity is impaired.
Correct
Explanation:
Infections are often categorized as community-acquired or nosocomial. Because the microbial environments differ, the two types of infections often have different causes and require … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 234.
Question 14:
(see full question)
The nurse is aware that a client is at risk for the development of an infection because of what factors? (Select all that apply.)
You selected: • Client is 35 pounds underweight
• Client has diabetes mellitus
• Client is taking chemotherapy for a malignancy
Correct
Explanation:
Risk factors for infection include malnutrition, presence of chronic illness such as diabetes mellitus and renal disease, or a depressed immune system because of chemotherapy … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231..
Question 15:
(see full question) A group of students are reviewing information about anti-infective agents. The students demonstrate a need for additional review when they identify what as an anti-infective agent?
You selected: anticoagulant
Correct
Explanation:
An anticoagulant interferes with blood clotting and is not an anti-infective agent. Antibiotics, anthelmintics, antiprotozoals, antivirals, and antifungals are all anti-infective a … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 16:
(see full question) A client is admitted to the hospital with elevated temperature, chills, cough, and fatigue. The physician orders a chest x-ray, which indicates pneumonia. The blood cultures also come back positive for a Gram-negative bacillus. The physician orders two antibiotics to be given to the client, one for Gram-negative organisms and one for Gram-positive organisms. Why does the physician not prescribe just one antibiotic for both types of bacteria?
You selected: There are not any antibiotics available in the United States that treat both bacteria.
Incorrect
Correct response: Broad-spectrum antibiotics can cause antibiotic resistance.
Explanation:
All antimicrobials have the ability to promote the emergence of drug-resistant microbes. However, resistance is more likely to occur in organisms exposed to broad-spectrum drugs. A … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 235-236.
Question 17:
(see full question) A client is to receive penicillin. The nurse understands that this drug achieves its effect by which action?
You selected: Interfering with the pathogen cell wall
Correct
Explanation:
Penicillins interfere with the biosynthesis of the pathogen cell wall. Sulfonamides, antimycobacterial drugs, and trimethoprim-sulfamethoxazole prevent the cells of the invading or … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 293.
Question 18:
(see full question) Bactericidal compounds fight infection and destroy microorganisms by inhibiting what?
You selected: Cell wall synthesis
Incorrect
Correct response: Protein synthesis
Explanation:
Some anti-infectives are so active against the infective microorganisms that they actually cause the death of the cells they affect. These drugs are said to be bactericidal. Bacter … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 19:
(see full question) When reviewing the medication orders, a nurse notes that combination therapy with two anti-infective agents has been ordered. What is the nurse’s best interpretation of this order?
You selected: The client has an infection that is a result of antibiotic resistance.
Incorrect
Correct response: The client has an infection that may be caused by more than one organism.
Explanation:
Combination therapy may be used when an infection is caused by more than one organism and each pathogen may react to a different anti-infective agent. Combined effects of different … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 20:
(see full question) A female client comes to the clinic reporting vaginal discharge with itching. When obtaining the client’s medication history, what would the nurse consider as significant?
You selected: broad spectrum anti-infective for recent infection
Correct
Explanation:
The use of broad-spectrum anti-infectives may result in superinfections, which are infections occurring when opportunistic pathogens kept in check by normal flora invade the tissue … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 232, 234.

Question 1:
(see full question) Your client asks about the difference between viruses and bacterial infection. When explaining about the origin of viruses, you would include:
You selected: They are officially classified according to their structure but are more commonly described according to origin and the disorders or symptoms they produce.
Correct
Explanation:
Viruses are intracellular parasites that survive only in living tissues. They are officially classified according to their structure, but are more commonly described according to o … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 230-231.
Question 2:
(see full question)
On his second day in the critical care unit, a client develops a left lower lobe infiltrate and is diagnosed with nosocomial pneumonia. What does the nurse expect is the cause of the pneumonia?
You selected: Streptococcus
Incorrect
Correct response: Staphylococcus aureus
Explanation:
Clients in critical care units are at high risk for acquiring nosocomial pneumonia because of the severity of their illness, duration of hospitalization, and antimicrobial dr … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 232.
Question 3:
(see full question) Indications for combination therapy may include all of the following EXCEPT:
You selected: A postmenopausal female with a urinary tract infection.
Correct
Explanation:
Antimicrobial drugs are often used in combination. Indications for combination therapy may include the following: Infections caused by multiple microorganisms; nosocomial infection … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 4:
(see full question) A nurse is preparing a teaching plan for a client who is receiving trimethoprim/sulfamethoxazole. What would the nurse need to keep in mind when describing how this drug works?
You selected: Alters the permeability of the cell membrane
Incorrect
Correct response: Prevents the organism’s cells from using substances
Explanation:
Trimethoprim-sulfamethoxazole prevents the cells of the invading organism from using substances essential to their growth and development, leading to an inability to divide an … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 326.
Question 5:
(see full question) You are a home care nurse caring for a patient on IV vancomycin for cellulitis of the left calf. Your responsibilities could include
You selected: all the above actions.
Correct
Explanation:
Responsibilities of the home care nurse may include teaching family members how to administer antibiotics, how to care for the person with an infection, and how to protect other pe … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 6:
(see full question) A nurse is caring for a client who is receiving a broad spectrum anti-infective agent. What is one unwanted effect of taking a broad spectrum anti-infective agent?
You selected: destruction of the normal flora
Correct
Explanation:
One offshoot of the use of anti-infectives, especially broad-spectrum anti-infectives, is destruction of the normal flora.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 7:
(see full question) When describing an anti-infective agent with a narrow spectrum of activity, what would the nurse include?
You selected: The drug is selective in its action on organisms.
Correct
Explanation:
An anti-infective with a narrow spectrum of activity is selective in its action; thus, it is effective against only a few microorganisms with a very specific metabolic pathway … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 8:
(see full question) It is common practice to draw culture and sensitivity tests to determine the most effective antibiotic that will treat the causative agent of the client’s infection. What does “culture” determine?
You selected: Specifically what organism is causing the infection
Correct
Explanation:
In some cases of severe infection, a broad-spectrum antibiotic is started after a culture is taken, but before the exact causative organism has been identified. Culture identifies … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 9:
(see full question) The nurse is preparing to administer a drug that is bactericidal. The nurse should explain what characteristic of this drug?
You selected: It is effective in interfering with cell reproduction.
Incorrect
Correct response: It will directly cause the death of pathogenic cells.
Explanation:
Bactericidal refers to a highly aggressive drug that causes cell death. An anti-infective with a narrow spectrum of activity is selective in its action so that it is effective agai … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 10:
(see full question) The nurse is assessing a client who has recently been given the first dose of a new anti-infective. What finding should lead the nurse to suspect that the client is experiencing a hypersensitivity reaction?
You selected: The client has a facial and trunk rash.
Correct
Explanation:
Rash suggests a hypersensitivity reaction. Vertigo may suggest a neurotoxic adverse effect. Diarrhea may occur over time as a result of gastrointestinal adverse effects. A blood pr … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 11:
(see full question) Which of the following is the most important nursing action to help prevent antimicrobial resistance in health care settings?
You selected: Good hand-washing between each patient contact
Correct
Explanation:
Antimicrobial resistance is a major concern worldwide because hospitals are most likely to harbor resistant bacteria, it is important that nurses use aseptic technique for all proc … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 12:
(see full question) Some patients expect a prescription for antibiotics when they see a physician for nearly any illness. Why is excessive use of antibiotics a problem?
You selected: It contributes to the proliferation of antibiotic-resistant organisms.
Correct
Explanation:
Inappropriate and excessive use of antibiotics increases adverse drug effects, infections with drug-resistant microorganisms, and health care costs. It also reduces the number of d … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 234-235.
Question 13:
(see full question)
The nurse is aware that which areas of the body are difficult to treat with antimicrobial drugs? (Select all that apply.)
You selected: • Brain
• Eyes
• Prostate gland
Correct
Explanation:
Certain areas of the body are difficult to treat with antibiotics because antibacterials don’t reach adequate levels of concentration in these areas such as the prosta … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 238.
Question 14:
(see full question) A group of nursing students are giving a report on the emergence of drug-resistant microbial agents. What could the students cite as a good way to minimize the emergence of drug-resistant microbial agents? (Mark all that apply.)
You selected: • Use narrow-spectrum agents if they are thought to be effective.
• Avoid the use of broad-spectrum antibacterial drugs when treating trivial or viral infections.
• Do not use vancomycin unnecessarily.
Correct
Explanation:
Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of antimicrobial agents to the treatment of specific pathogens known … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 235-236.
Question 15:
(see full question) A female client is treated with antibiotics for bacterial pneumonia. When obtaining a drug history, the nurse finds that the client ceased her medication regimen when she no longer experienced symptoms during the first round of antibiotics. The nurse is responsible for the client’s education plan. In order to effectively treat the pneumonia, what must the client do?
You selected: Complete a full course of antibiotics as prescribed.
Correct
Explanation:
Client education related to antibiotic therapy should stress the importance of completing a full course of antibiotics as prescribed.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 16:
(see full question) An immunocompromised patient in a critical care setting has developed a respiratory infection that has been attributed to methicillin-resistant Staphylococcus aureus (MRSA). The nurse should anticipate that the patient will require treatment with
You selected: vancomycin.
Correct
Explanation:
Vancomycin is the drug of choice to manage infections caused by MRSA. MRSA is resistant to all of the antistaphylococcic penicillins, as well as to ciprofloxacin and clindamycin.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 234.
Question 17:
(see full question) The nursing instructor is talking with students about anti-infective medications. Drugs that are very selective in their actions are said to be:
You selected: narrow spectrum.
Correct
Explanation:
Some anti-infectives are so selective in their action that they are effective against only a few microorganisms with a very specific metabolic pathway or enzyme. These drugs are sa … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 18:
(see full question) The nursing instructor is discussing the signs and symptoms of infection. Which of the following is a local sign of infection?
You selected: Edema
Correct
Explanation:
Local signs of infection include redness, heat, edema, and pain; systemic signs include fever and leukocytosis. Specific manifestations depend on the site of infection.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 19:
(see full question) Which statement by a client indicates to the nurse that additional teaching concerning the use of antimicrobials is needed?
You selected: “I will stop the antibiotic as soon as I feel better.”
Correct
Explanation:
Compliance with antimicrobial therapy is a concern. Clients tend to stop taking the drugs when they begin to feel better. A nurse should instruct the client to take the entire cour … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 20:
(see full question) Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is:
You selected: the host’s ability to defend itself against the would-be invaders.
Correct
Explanation:
The human body and the environment contain many microorganisms, most of which do not cause disease and live in a state of balance with the human host. When the balance is upset and … (more)

Question 1:
(see full question) What would contribute to drug resistance?
You selected: Antibiotic prescription for viral illness
Correct
Explanation:
The use of antibiotic prescription for viral illnesses or infections is a contributing factor to the development of resistance. A high enough drug dosage and long enough duration o … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 2:
(see full question) Of the clients with a bacterial infection requiring antibacterial drug therapy, which client will likely require the most long-term follow-up care by the nurse?
You selected: An adolescent with weakened immunity
Incorrect
Correct response: An elderly woman with a recent pacemaker insertion
Explanation:
The elderly woman with a pacemaker will be the most difficult to treat; therefore, she will require the most follow-up care. It is difficult to treat infections that occur because … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 3:
(see full question) The pathophysiology class is learning how microorganisms develop resistance to anti-infective drugs. What is one way the students would learn that microorganisms develop resistance to anti-infective drugs?
You selected: By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
Correct
Explanation:
Microorganisms have developed resistance by changing cellular permeability to prevent the drug from entering the cell by altering binding sites on the membranes or on ribosomes so … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 4:
(see full question) After teaching a group of students about resistance, the instructor determines that the students need additional teaching when they identify what as a way that microorganisms develop resistance?
You selected: Production of an enzyme that deactivates the drug
Incorrect
Correct response: Production of a chemical to act as an antagonist
Explanation:
Microorganisms develop resistance by producing a chemical that acts as an antagonist to the drug. In addition, the microorganism can produce an enzyme that deactivates the drug, ch … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 5:
(see full question) To ensure that the most appropriate drug is being used to treat a pathogen, which would need to be done first?
You selected: Obtaining sensitivity testing
Correct
Explanation:
Performing sensitivity testing on cultured microbes is important to evaluate the bacteria and determine which drugs are capable of controlling the particular organism. Once the sen … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237-238.
Question 6:
(see full question) A client is admitted to the hospital with elevated temperature, chills, cough, and fatigue. The physician orders a chest x-ray, which indicates pneumonia. The blood cultures also come back positive for a Gram-negative bacillus. The physician orders two antibiotics to be given to the client, one for Gram-negative organisms and one for Gram-positive organisms. Why does the physician not prescribe just one antibiotic for both types of bacteria?
You selected: Broad-spectrum antibiotics can cause antibiotic resistance.
Correct
Explanation:
All antimicrobials have the ability to promote the emergence of drug-resistant microbes. However, resistance is more likely to occur in organisms exposed to broad-spectrum drugs. A … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 235-236.
Question 7:
(see full question) Bactericidal compounds fight infection and destroy microorganisms by inhibiting what?
You selected: Protein synthesis
Correct
Explanation:
Some anti-infectives are so active against the infective microorganisms that they actually cause the death of the cells they affect. These drugs are said to be bactericidal. Bacter … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 8:
(see full question) In teaching about using antibiotic medications, what is it critical to include to help stop the development of resistant strains of microorganisms?
You selected: It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.
Correct
Explanation:
Teaching clients to take the full course of their antibiotic as prescribed can help to decrease the number of resistant strains. Antibiotics should only be used to treat bacterial … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 9:
(see full question) Inappropriate use of antibiotics does all of the following except increase:
You selected: the number of available effective drugs for serious or antibiotic-resistant infections.
Correct
Explanation:
Antimicrobials are among the most frequently used drugs worldwide. Their success in saving lives and decreasing severity and duration of infectious diseases has encouraged their ex … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 10:
(see full question) The pharmacology instructor is discussing ways to decrease the incidence and severity of adverse effects among children taking anti-infective agents. What would the instructor mention is one way to do this in children?
You selected: Keep clients well hydrated.
Correct
Explanation:
Because children can have increased susceptibility to the gastrointestinal and nervous system effects of anti-infectives, monitor hydration and nutritional status carefully. Client … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.

Question 1:
(see full question)
The physician orders an antibiotic for a female client, who states that she cannot take antibiotics on an empty stomach because they make her nauseous. What instructions should the nurse give her?
You selected: Take the medication with food to reduce nausea.
Correct
Explanation:
Check specific recommendations with regard to the administration of the antibiotic with food and other medications to decrease binding to food and drugs and prevent inactivat … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 2:
(see full question) Which would be the most significant factor in the selection of an antibiotic drug for treatment of a client’s infection?
You selected: culture and susceptibility test results
Correct
Explanation:
Antibiotic selection can be based on a variety of factors, including culture and susceptibility tests and empiric therapy. Other factors that may play a role in selection are the c … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 237-238.
Question 3:
(see full question) A client with an upper respiratory tract infection was prescribed roxithromycin, an antibiotic. To what should the nurse tell the client that irregular administration of this medication could lead?
You selected: Development of drug resistance
Correct
Explanation:
When there is irregular or indiscriminate use of antibiotics, certain pathogens may mutate or build a tolerance to the drug. The antibiotic then becomes ineffective against that or … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 234.
Question 4:
(see full question) A client taking trimethoprim-sulfamethoxazole for a urinary tract infection asks how the medicine works to destroy the pathogen. What would be the nurse’s best answer?
You selected: Destroys proteins in the cell wall
Incorrect
Correct response: Prevents the pathogen from dividing
Explanation:
Some anti-infectives prevent the cells of the invading organism from using substances essential to their growth and development, leading to an inability to divide and eventually to … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 326.
Question 5:
(see full question) When caring for infants and the elderly who are in need of an antimicrobial agent, the nurse is aware that when compared with doses for young and middle-aged adults, these clients may require:
You selected: a lower dose.
Correct
Explanation:
Infants and the elderly are the populations most vulnerable to drug toxicity. In the infant, the liver and kidneys are still immature and may have difficulty metabolizing or excret … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 6:
(see full question) A nurse has questioned why a client’s physician has prescribed a narrow-spectrum antibiotic rather than a broad-spectrum drug in the treatment of an infection. Which facts provide the best rationale for the use of narrow-spectrum antibiotics whenever possible?
You selected: The use of broad-spectrum antibiotics can create a risk for a superinfection.
Correct
Explanation:
The benefit of a narrow-spectrum antimicrobial agent is that it limits the potential for adverse effects, such as superinfection. In a superinfection, an antibiotic suppresses all … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 7:
(see full question) Major defense mechanisms of the human body include all of the following EXCEPT:
You selected: Increased platelet cells.
Correct
Explanation:
Although the numbers and virulence of microorganisms help determine whether a person acquires an infection, another major factor is the host’s ability to defend itself against the … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231.
Question 8:
(see full question) Successful treatment with bacteriostatic antibiotics depends upon:
You selected: the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy.
Correct
Explanation:
Successful treatment with bacteriostatic antibiotics depends on the ability of the host’s immune system to eliminate the inhibited bacteria and an adequate duration of drug therapy … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 9:
(see full question) Culture and susceptibility tests are performed prior to the prescription of antimicrobial drugs. What is the specific purpose of the culture?
You selected: To identify the organism causing the infection
Correct
Explanation:
Culture identifies the infection’s causative organism. Susceptibility tests determine which drugs are likely to be effective against the organism.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 237-238.
Question 10:
(see full question) It is the duty of all health care providers to prevent antibiotic resistance. As a nurse, how can you play an active role in preventing antibiotic resistance? (Select all that apply.)
You selected: • Report culture results to the physician.
• Use proper isolation procedures.
Incorrect
Correct response: • Obtain culture specimens prior to administration of antibiotic therapy.
• Use proper isolation procedures.
• Report culture results to the physician.
Explanation:
In the United States, the Centers for Disease Control and Prevention (CDC) initiated the Campaign to Prevent Antimicrobial Resistance in Healthcare Settings. The campaign focuses o … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 239.
Question 11:
(see full question) A client is to undergo extensive dental surgery. The dentist prescribes a course of antibiotics before beginning the procedure and continuing for 5 days after the procedure. This is an example of:
You selected: prophylaxis.
Correct
Explanation:
In a situation where an infection is likely to occur, antibiotics can be used as a means of prophylaxis to prevent an infection before it occurs. Synergism is using two antibiotics … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237.
Question 12:
(see full question) The client has been taking a fluoroquinolone and calls the physician’s office to report that she is experiencing redness and is excoriated in her groin area. What is the best response of the nurse?
You selected: Explain to client that this is an adverse reaction.
Incorrect
Correct response: Notify the physician.
Explanation:
The client is most likely experiencing a superinfection related to the antibiotic use. The nurse needs to communicate the client’s concerns with the physician. It is outside the s … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 17: Drug Therapy with Aminoglycosides and Fluoroquinolones, p. 319.
Question 13:
(see full question) A client who is receiving anti-infective therapy is experiencing gastrointestinal toxicity. What would the nurse expect to assess?
You selected: diarrhea
Correct
Explanation:
Gastrointestinal toxicity would be manifested by diarrhea, nausea, vomiting, or stomach upset. Dizziness and vertigo would reflect neurotoxicity. Rash may suggest a hypersensi … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 323.
Question 14:
(see full question) People taking antimicrobial drugs should be instructed to report any problem that could indicate adverse drug effects, lack of therapeutic response, or emergence of another infection. One such problem is:
You selected: skin rash.
Correct
Explanation:
Clients should be instructed to report nausea, vomiting, diarrhea, skin rash, recurrence of symptoms for which the antimicrobial drug was prescribed, or signs of new infection (e.g … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 237, box 13.3.
Question 15:
(see full question) You are a critical care nurse caring for a 66-year-old male patient who requires mechanical ventilation. What type of infection is this patient particularly susceptible to acquiring?
You selected: Nosocomial pneumonia
Correct
Explanation:
A patient in the critical care environment is at high risk for acquiring nosocomial pneumonia because of the severity of illness, duration of hospitalization, and antimicrobial dru … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 232.
Question 16:
(see full question) Most anti-infective agents achieve their effectiveness by acting in similar ways.
You selected: False
Correct
Explanation:
Anti-infective agents work by altering the cell membrane of the pathogen, by interfering with protein synthesis, or by interfering with the ability of the pathogen to obtain needed … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 236.
Question 17:
(see full question) A post-operative patient acquires a bladder infection while in the hospital. What term refers to an infection acquired in the hospital setting?
You selected: Nosocomial
Correct
Explanation:
Infections are frequently categorized as community acquired or nosocomial. Nosocomial infections are acquired in the health care setting and are often more difficult to treat.

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 234.
Question 18:
(see full question) A client is admitted to the unit. The nurse knows that the client is at high risk for infection. What factors predispose the ckient to infection? (Mark all that apply.)
You selected: • Impaired blood supply
• Advanced age
• Suppression of immune system
Correct
Explanation:
Factors that suppress the host defense mechanisms include impaired blood supply, suppression of immune system, and advanced age. Hypertension does not predispose a person to infect … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, p. 231.
Question 19:
(see full question) A nurse is caring for a client in the intensive care unit. The client was admitted 2 hours ago with a severe infection and was started on empiric therapy. Which test will be done to identify drug susceptibility?
You selected: Culture and sensitivity
Correct
Explanation:
The most common test to identify drug susceptibility is called a culture and sensitivity. A sample of the exudates, body fluids, or serum is sent to the laboratory. The culture det … (more)

Reference:
Frandsen, G., & Pennington, S.S. Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, 10th ed., Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2014, Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents, pp. 237-238.
Question 20:
(see full question) What is critical to helping prevent development of resistant strains of microbes?
You selected: Maintain the optimum duration of the antimicrobial agent.
Correct
Explanation:
Exposure to an antimicrobial agent leads to the development of resistance, so it is important to limit the use of these agents to the treatments of specific pathogens known to be s … (more)

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