Deck 86: Bacteriostatic Inhibitors of Protein Synthesis: Tetracyclines, Macrolides, and Others

Question 1

A patient is to begin taking doxycycline to treat a rickettsial infection. Which statement by the patient indicates a need for teaching about this drug?

A) "I should consult my provider before using laxatives or antacids while taking this drug."
B) "I should not take a calcium supplement or consume dairy products with this drug."
C) "I should take this drug with food to ensure more complete absorption."
D) "If I get diarrhea, I should stop taking the drug and let my provider know immediately."

Answer 1

"I should take this drug with food to ensure more complete absorption."

Question 2

Tetracyclines are considered first-line drugs for which disorders?

A) Chlamydia trachomatis cervicitis
B) Clostridium difficile diarrhea
C) Lyme disease
D) Methicillin-resistant Staphylococus aureus skin infections
E) Typhus fever

Answer 2

Chlamydia trachomatis cervicitis
Lyme disease
Typhus fever

Question 3

A child has been receiving chloramphenicol for a Neisseria meningitidis central nervous system (CNS) infection. The nurse administers the dose and subsequently notes that the child has vomited and appears dusky and gray in color. The child's abdomen is distended. What will the nurse do?

A) Contact the provider for an order to obtain a chloramphenicol level.
B) Notify the provider that the child's meningitis is worsening.
C) Recognize this as initial signs of a C. difficile infection.
D) Stop the infusion immediately and notify the provider.

Answer 3

Stop the infusion immediately and notify the provider.

Question 4

To prevent yellow or brown discoloration of teeth in children, tetracyclines should not be given:

A) to children once the permanent teeth have developed.
B) to patients taking calcium supplements.
C) to pregnant patients after the fourth month of gestation.
D) with dairy products or antacids.

Question 5

A patient recently began receiving clindamycin [Cleocin] to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What will the nurse tell this patient?

A) The provider may increase the clindamycin dose to treat this infection.
B) This is a known side effect of clindamycin, and the patient should consume extra fluids.
C) The patient should stop taking the clindamycin now and contact the provider immediately.
D) The patient should try taking Lomotil or a bulk laxative to minimize the diarrheal symptoms.

Question 6

A nurse is providing education about tetracycline [Sumycin]. Which statement by the patient best demonstrates understanding of the administration of this medication?

A) "I should not take this medication with milk or other dairy products."
B) "I should not worry if I experience an acnelike rash with this medication."
C) "I should take an antacid, such as Tums, if I experience gastrointestinal distress."
D) "I should take this antibiotic with a calcium supplement to improve absorption."

Question 7

A patient received 500 mg of azithromycin [Zithromax] at 0800 as a first dose. What are the usual amount and time of the second dose of azithromycin?

A) 250 mg at 2000 the same day
B) 500 mg at 2000 the same day
C) 250 mg at 0800 the next day
D) 500 mg at 0800 the next day

Question 8

A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the nurse will expect to administer which antibiotic?

A) Clindamycin [Cleocin]
B) Doxycycline [Vibramycin]
C) Erythromycin ethylsuccinate
D) Penicillin G

Question 9

A patient who is taking doxycycline for a serious infection contacts the nurse to report anal itching. The nurse will contact the provider to discuss:

A) adding an antihistamine to the patient's drug regimen.
B) ordering liver function tests to test for hepatotoxicity.
C) prescribing an antifungal drug to treat a superinfection.
D) testing the patient for a C. difficile secondary infection.

Question 10

A patient is diagnosed with periodontal disease, and the provider orders oral doxycycline [Periostat]. The patient asks the purpose of the drug. What is the nurse's response?

A) "It is used because of its anti-inflammatory effects."
B) "It inhibits collagenase to protect connective tissue in the gums."
C) "It reduces bleeding and the pocket depth of oral lesions."
D) "It suppresses bacterial growth in the oral mucosa."

Question 11

A child with an upper respiratory infection caused by B. pertussis is receiving erythromycin ethylsuccinate. After 2 days of treatment, the parent asks the nurse why the child's symptoms have not improved. Which response by the nurse is correct?

A) "Erythromycin eliminates the bacteria that causes the infection, but not the toxin that causes the symptoms."
B) "We may need to add penicillin or another antibiotic to increase the antimicrobial spectrum."
C) "We will need to review the culture sensitivity information to see whether a different antibiotic is indicated."
D) "Your child may have developed a suprainfection that we need to culture and treat."

Question 12

A patient develops CDAD. Which antibiotic is recommended for treating this infection?

A) Chloramphenicol
B) Clindamycin [Cleocin]
C) Linezolid [Zyvox]
D) Vancomycin

Question 13

A pregnant adolescent patient asks the nurse whether she should continue to take her prescription for tetracycline [Sumycin] to clear up her acne. Which response by the nurse is correct?

A) "Tetracycline can be harmful to the baby's teeth and should be avoided."
B) "Tetracycline is safe to take during pregnancy."
C) "Tetracycline may cause allergic reactions in pregnant women."
D) "Tetracycline will prevent asymptomatic urinary tract infections."

Question 14

Which side effect of clindamycin [Cleocin] causes the most concern and may warrant discontinuation of the drug?

A) Diarrhea
B) Headache
C) Nausea
D) Vomiting

Question 15

A patient with severe community-acquired pneumonia has been prescribed telithromycin [Ketek]. Which aspect of the patient's medical history is of concern to the nurse?

A) Anemia
B) Myasthenia gravis
C) Renal disease
D) Streptococcus pneumoniae infection

Question 16

A patient is taking erythromycin ethylsuccinate for a chlamydial infection and develops vaginal candidiasis. The prescriber orders ketoconazole to treat the superinfection. What will the nurse do?

A) Administer the erythromycin and the ketoconazole as ordered.
B) Contact the provider to discuss changing to a different antifungal medication.
C) Contact the provider to discuss increasing the dose of erythromycin.
D) Contact the provider to suggest using erythromycin stearate.

Question 17

A hospitalized patient who is taking demeclocycline [Declomycin] reports increased urination, fatigue, and thirst. What will the nurse do?

A) Contact the provider to report potential toxic side effects.
B) Notify the provider to discuss changing the medication to doxycycline.
C) Perform bedside glucometer testing to evaluate the serum glucose level.
D) Provide extra fluids and reassure the patient that these are expected side effects.

Question 18

A patient who has been taking linezolid [Zyvox] for 6 months develops vision problems. What will the nurse do?

A) Reassure the patient that this is a harmless side effect of this drug.
B) Tell the patient that blindness is likely to occur with this drug.
C) Tell the patient that this symptom is reversible when the drug is discontinued.
D) Tell the patient to take tyramine supplements to minimize this effect.

Question 19

A nurse is teaching a nursing student about dalfopristin/quinupristin [Synercid]. Which statement by the student indicates an understanding of the teaching?

A) "Patients should stop taking the drug if they experience joint and muscle pain."
B) "Patients taking this drug should have blood tests performed frequently."
C) "Patients who are allergic to penicillin should not take this drug."
D) "This drug will be administered intravenously over a 30- to 60-minute period."

Question 20

A nurse is providing teaching for a patient who will begin taking clarithromycin ER [Biaxin XL] to treat an Helicobacter pylori infection. Which statement by the patient indicates understanding of the teaching?

A) "I may experience distorted taste when taking this medication."
B) "I should take 1 tablet twice daily for 10 days."
C) "I should take this medication on an empty stomach."
D) "This medication does not interact with other drugs."

Question 21

Which infections may be treated with linezolid [Zyvox])?

A) Community-acquired pneumonia (CAP) that is penicillin sensitive
B) Nosocomial pneumonia caused by methicillin-sensitive Staphylococcus aureus (MSSA)
C) Pneumonias caused by Mycoplasma avium
D) Superficial methicillin-resistant S. aureus skin infections (MRSA)
E) Vancomycin-resistant infections