Karch’s Focus on Nursing
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario A 45-year-old female patient has been
diagnosed with a severe lower respiratory tract infection. The
healthcare provider prescribes an oral cephalosporin. During
the initial assessment, the nurse reviews the patient’s medical
history and allergy profile before administering the first dose.
,Question Which finding in the patient's medical history requires
the nurse to clarify the prescription with the healthcare
provider?
Options A. Documented anaphylactic reaction to amoxicillin B.
History of mild nausea when taking erythromycin C. Current
diagnosis of controlled type 2 diabetes mellitus D. Statement
that she prefers liquid medications over tablets
Correct Answer A. Documented anaphylactic reaction to
amoxicillin
Rationale Cephalosporins are structurally similar to penicillins
(both contain a beta-lactam ring). Due to this structural
similarity, there is a known cross-sensitivity risk (approximately
5% to 10%) where patients allergic to penicillins may also react
to cephalosporins. If a patient has a history of a severe, life-
threatening allergic reaction (anaphylaxis) to a penicillin such as
amoxicillin, cephalosporins are generally contraindicated unless
explicitly cleared by the provider after a risk-benefit analysis.
Why the Other Options Are Incorrect A. (This is the correct
option.) B. Nausea is a common gastrointestinal side effect of
erythromycin (a macrolide) and does not represent an
immunologic allergy or cross-sensitivity risk with
cephalosporins. C. Controlled type 2 diabetes is not a
contraindication to standard oral cephalosporin therapy. D.
Patient preference for liquid medication is a nursing care
,consideration for administration but does not require clarifying
or questioning the safety of the prescribed drug class.
Learning Objective Identify cross-sensitivity risks between
penicillins and cephalosporins to ensure safe medication
administration.
Bloom's Taxonomy Apply
Difficulty Easy
NCLEX Client Needs Category Safety and Infection Control
NCJMM Clinical Judgment Skill Recognize Cues
Question 2
Clinical Scenario A 28-year-old male patient presents to an
urgent care clinic with a localized skin infection. The healthcare
provider diagnoses a skin and soft tissue infection and
prescribes oral cephalexin, a first-generation cephalosporin, 500
mg every 6 hours for 7 days.
Question When providing discharge education about this
medication, which instruction should the nurse include?
Options A. Avoid all dairy products and antacids while taking
this medication. B. Discontinue the medication as soon as the
skin redness resolves. C. Complete the full course of therapy
even if you feel completely better. D. Take this medication only
on an empty stomach 2 hours after meals.
, Correct Answer C. Complete the full course of therapy even if
you feel completely better.
Rationale To prevent the recurrence of infection and discourage
the development of drug-resistant bacteria, patients must be
taught to complete the entire prescribed course of antibiotic
therapy, even if their clinical symptoms improve or resolve
before the medication is finished.
Why the Other Options Are Incorrect A. Dairy products and
antacids interfere significantly with the absorption of
tetracyclines and fluoroquinolones, but they do not cause a
clinically significant interaction with cephalexin. B.
Discontinuing antibiotics prematurely contributes to treatment
failure and bacterial resistance. C. (This is the correct option.) D.
Cephalexin can be taken with food if gastrointestinal upset
occurs, so an absolute empty-stomach restriction is incorrect.
Learning Objective Formulate a patient education plan for an
individual prescribed an oral first-generation cephalosporin.
Bloom's Taxonomy Understand
Difficulty Easy
NCLEX Client Needs Category Health Promotion and
Maintenance
NCJMM Clinical Judgment Skill Generate Solutions
Question 3
Pharmacology
9th Edition
Author(s)Rebecca G. Tucker
TEST BANK
Question 1
Clinical Scenario A 45-year-old female patient has been
diagnosed with a severe lower respiratory tract infection. The
healthcare provider prescribes an oral cephalosporin. During
the initial assessment, the nurse reviews the patient’s medical
history and allergy profile before administering the first dose.
,Question Which finding in the patient's medical history requires
the nurse to clarify the prescription with the healthcare
provider?
Options A. Documented anaphylactic reaction to amoxicillin B.
History of mild nausea when taking erythromycin C. Current
diagnosis of controlled type 2 diabetes mellitus D. Statement
that she prefers liquid medications over tablets
Correct Answer A. Documented anaphylactic reaction to
amoxicillin
Rationale Cephalosporins are structurally similar to penicillins
(both contain a beta-lactam ring). Due to this structural
similarity, there is a known cross-sensitivity risk (approximately
5% to 10%) where patients allergic to penicillins may also react
to cephalosporins. If a patient has a history of a severe, life-
threatening allergic reaction (anaphylaxis) to a penicillin such as
amoxicillin, cephalosporins are generally contraindicated unless
explicitly cleared by the provider after a risk-benefit analysis.
Why the Other Options Are Incorrect A. (This is the correct
option.) B. Nausea is a common gastrointestinal side effect of
erythromycin (a macrolide) and does not represent an
immunologic allergy or cross-sensitivity risk with
cephalosporins. C. Controlled type 2 diabetes is not a
contraindication to standard oral cephalosporin therapy. D.
Patient preference for liquid medication is a nursing care
,consideration for administration but does not require clarifying
or questioning the safety of the prescribed drug class.
Learning Objective Identify cross-sensitivity risks between
penicillins and cephalosporins to ensure safe medication
administration.
Bloom's Taxonomy Apply
Difficulty Easy
NCLEX Client Needs Category Safety and Infection Control
NCJMM Clinical Judgment Skill Recognize Cues
Question 2
Clinical Scenario A 28-year-old male patient presents to an
urgent care clinic with a localized skin infection. The healthcare
provider diagnoses a skin and soft tissue infection and
prescribes oral cephalexin, a first-generation cephalosporin, 500
mg every 6 hours for 7 days.
Question When providing discharge education about this
medication, which instruction should the nurse include?
Options A. Avoid all dairy products and antacids while taking
this medication. B. Discontinue the medication as soon as the
skin redness resolves. C. Complete the full course of therapy
even if you feel completely better. D. Take this medication only
on an empty stomach 2 hours after meals.
, Correct Answer C. Complete the full course of therapy even if
you feel completely better.
Rationale To prevent the recurrence of infection and discourage
the development of drug-resistant bacteria, patients must be
taught to complete the entire prescribed course of antibiotic
therapy, even if their clinical symptoms improve or resolve
before the medication is finished.
Why the Other Options Are Incorrect A. Dairy products and
antacids interfere significantly with the absorption of
tetracyclines and fluoroquinolones, but they do not cause a
clinically significant interaction with cephalexin. B.
Discontinuing antibiotics prematurely contributes to treatment
failure and bacterial resistance. C. (This is the correct option.) D.
Cephalexin can be taken with food if gastrointestinal upset
occurs, so an absolute empty-stomach restriction is incorrect.
Learning Objective Formulate a patient education plan for an
individual prescribed an oral first-generation cephalosporin.
Bloom's Taxonomy Understand
Difficulty Easy
NCLEX Client Needs Category Health Promotion and
Maintenance
NCJMM Clinical Judgment Skill Generate Solutions
Question 3
