Deck 83: Basic Principles of Antimicrobial Therapy

Question 1

A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism?

A) Alteration of drug target molecules
B) Antagonist production
C) Drug inactivation
D) Reduction of drug concentration at the site of action

Answer 1

Drug inactivation

Question 2

Which are benefits of using a combination of two or more antibiotics?

A) Reduced cost
B) Reduced risk of superinfection
C) Reduced toxicity
D) Reduced resistance
E) Reduced risk in severe infection

Answer 2

Reduced toxicity
Reduced resistance
Reduced risk in severe infection

Question 3

A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response?

A) "Because strep throat is likely, your child should be treated empirically."
B) "With good hand washing, your child should not get strep throat."
C) "Your child probably has strep throat, so your provider will order an antibiotic."
D) "Your child should come to the clinic to have a throat culture done today."

Answer 3

"Your child should come to the clinic to have a throat culture done today."

Question 4

A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives?

A) Allowing patients to stop antibiotics when symptoms subside
B) Allowing prescribers to develop their own prescribing guidelines
C) Increased adherence to prescribed antibiotics
D) Increased use of antibiotics among parents of young children

Question 5

Which patients should be given antibiotics prophylactically?

A) Children who attend day care with other children who have strep throat
B) Children undergoing chemotherapy who have mild neutropenia
C) Patients with certain congenital heart defects at risk for bacterial endocarditis
D) Patients with compound fractures undergoing surgical repair
E) Postoperative patients who have undergone emergency cesarean sections

Question 6

A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say?

A) Conjugation results in a gradual increase in resistance.
B) Conjugation results in random changes in the microbe's DNA.
C) Spontaneous mutation leads to resistance to only one antimicrobial agent.
D) Spontaneous mutation can transfer DNA from one organism to another.

Question 7

An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to:

A) obtain a sputum culture and wait for the results before prescribing an antibiotic.
B) order empiric antibiotics while waiting for sputum culture results.
C) treat symptomatically, because antibiotics are usually ineffective against bronchitis.
D) treat the patient with more than one antibiotic without obtaining cultures.

Question 8

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum ____ agent.

A) broad; systemic
B) broad; topical
C) narrow; systemic
D) narrow; topical

Question 9

The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such host factors include what?

A) Age
B) Gender
C) Immune system status
D) Infection site
E) Weight

Question 10

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush?

A) Antibiotic resistance
B) Community-acquired infection
C) Nosocomial infection
D) Superinfection

Question 11

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority?

A) Administering the antibiotic immediately
B) Administering antipyretics as soon as possible
C) Delaying administration of the antibiotic until the culture results are available
D) Obtaining all cultures before the antibiotic is administered

Question 12

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct?

A) "Antibiotics are mutagenic and can produce changes that cause resistance."
B) "Even normal flora can develop resistance and transfer this to pathogens."
C) "Host cells become resistant to antibiotics with repeated use."
D) "Patients who overuse antibiotics are more likely to have nosocomial infections."

Question 13

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching?

A) "Some agents disrupt the bacterial cell wall."
B) "Some agents act to block the conversion of para-aminobenzoic acid (PABA) to folic acid."
C) "Some agents cause phagocytosis of bacterial cells."
D) "Some agents weaken the cell wall, causing cell wall lysis."