McCuistion: Pharmacology: A Patient-Centered Nursing Process Approach,
11th Edition
MULTIPLE CHOICE
1. The nurse is teaching a nursing student about the minimal effective concentration (MEC)
of antibiotics. Which statement by the nursing student indicates understanding of this
concept?
a. “A serum drug level greater than the MEC ensures that the drug is bacteriostatic.”
b. “A serum drug level greater than the MEC broadens the spectrum of the drug.”
c. “A serum drug level greater than the MEC is sufficient to halt the growth of the
microorganism.”
d. “A serum drug level greater than the MEC increases the therapeutic index.”
ANS: C
The MEC is the minimum amount of drug needed to halt the growth of a
microorganism. Raising the drug level does not usually broaden the spectrum or
increase the therapeutic index of a drug.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: N/A MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
2. The nurse is caring for a patient who has recurrent urinary tract infections. The patient’s
current infection is not responding to an antibiotic that has been used successfully several
times in the past. The nurse understands that this is most likely due to
a. acquired bacterial resistance.
b. cross-resistance.
c. inherent bacterial resistance.
d. transferred resistance.
ANS: A
Acquired resistance occurs when an organism has been exposed to the antibacterial
drug and becomes resistant over time. Cross-resistance occurs when an organism that
is resistant to one drug is also resistant to another. Inherent resistance occurs without
previous exposure to the drug. Transferred resistance occurs when the resistant genes
of one organism are passed to another organism.
DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing
Process: Evaluation MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
,3. The nurse is preparing to administer amoxicillin to a patient and learns that the patient
previously experienced a severe rash when taking penicillin. Which action will the nurse
take?
a. Administer the amoxicillin and have epinephrine available.
b. Ask the provider to order an antihistamine.
c. Contact the provider to discuss using a different antibiotic.
d. Request an order for a beta-lactamase resistant drug.
ANS: C
Patients who have previously experienced manifestations of allergy to a penicillin
should not use penicillins again unless deemed necessary. The nurse should contact
the provider to discuss using another antibiotic from a different class. Epinephrine and
antihistamines are useful when patients are experiencing allergic reactions, depending
on severity.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
4. The nurse is preparing to administer an antibiotic to a patient who has been receiving the
antibiotic for 2 days after a culture was obtained. The nurse notes increased erythema and
swelling, and the patient has a persistent high fever of 102 F. What is the nurse’s next
best action?
a. Administer the antibiotic as ordered.
b. Contact the provider to request another culture.
c. Discuss the need to add a second antibiotic with the provider.
d. Review the sensitivity results from the patient’s culture.
ANS: D
The sensitivity results from the patient’s culture will reveal whether the organism is
sensitive or resistant to a particular antibiotic. The patient is not responding to the
antibiotic being given, so the antibiotic should be held and the provider notified.
Another culture is not indicated.
Antibiotics should be added only when indicated by the sensitivity.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Evaluation MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer the first dose of an antibiotic to a patient admitted for
a urinary tract infection. Which action is most important prior to administering the
antibiotic?
a. Administering a small test dose to determine whether hypersensitivity exists
b. Having epinephrine available in the event of a severe hypersensitivity reaction
c. Monitoring baseline vital signs, including temperature and blood pressure
, d. Obtaining a urine specimen for culture and sensitivity
ANS: D
To obtain the most accurate culture, the specimen should be obtained before antibiotic
therapy begins. It is important to obtain cultures when possible to correctly identify
the organism and help determine which antibiotic will be most effective.
Administering test doses to determine hypersensitivity is sometimes done when there
is a strong suspicion of allergy when a particular antibiotic is needed. Epinephrine is
kept close at hand when there is a strong suspicion of allergy.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Planning MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
6. A patient is admitted to the hospital for treatment of pneumonia after complaining of high
fever and shortness of breath. The patient was not able to produce sputum for a culture.
The nurse will expect the patient’s provider to order which of the following?
a. A broad-spectrum antibiotic
b. A narrow-spectrum antibiotic
c. Multiple antibiotics
d. The pneumococcal vaccine
ANS: A
Broad-spectrum antibiotics are frequently used to treat infections when the offending
organism has not been identified by culture and sensitivity (C&S). Narrow-spectrum
antibiotics are usually effective against one type of organism and are used when the
C&S indicates sensitivity to that antibiotic. The use of multiple antibiotics, unless
indicated by C&S, can increase resistance. The pneumococcal vaccine is used to
prevent, not treat, an infection.
DIF: Cognitive Level: Applying (Application) TOP: Nursing Process:
Nursing Intervention MSC: NCLEX: Physiological Integrity:
Pharmacological and Parenteral Therapies
7. The nurse is teaching a patient who will be discharged home from the hospital to take
amoxicillin twice daily for 10 days. Which statement by the nurse is correct?
a. “Discontinue the antibiotic when your temperature returns to normal and your
symptoms have improved.”
b. “If diarrhea occurs, stop taking the drug immediately and contact your provider.”
c. “Stop taking the drug and notify your provider if you develop a rash while taking
this drug.”
d. “You may save any unused antibiotic to use if your symptoms recur.”
ANS: C
Patients who develop signs of allergy, such as rash, should notify their provider
before continuing medication therapy. Patients should be counseled to continue taking
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