Chapter 29 Cell Wall Inhibitors
1. A 32-year-old female patient is admitted to the floor with a superinfection. Her orders
read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused
over 30 to 60 minutes for 5 days. What would be important for the nurse to educate this
patient about?
A) Analgesics
B) Antihistamines
C) Contraceptives
D) Decongestants
Ans C
Feedback
Many antibiotics interfere with the effectiveness of oral contraceptives and unplanned
pregnancies can occur. Women should be advised to use a barrier form of
contraceptives when taking this drug. No known serious drugdrug interactions involve
analgesics, antihistamines, or decongestants.
2. A patient with a gram-negative infection is being treated with an aminoglycoside.
What system should the nurse expect to monitor closely while the patient is taking
this medication?
A) Respiratory system B)
Ophthalmic system
C) Renal system
D) Musculoskeletal system
Ans C
Feedback
Renal function should be tested daily because aminoglycosides depend on the kidney for
excretion and if the glomerular filtration rate (GFR) is abnormal it may be toxic to the
kidney. The results of the renal function testing could change the daily dosage.
Aminoglycosides do not usually adversely affect respiratory, hepatic, or musculoskeletal
function, although baseline data concerning these systems is always needed.
3. How would the nurse describe selective toxicity?
, A) Selective toxicity interferes with a biochemical reaction common to many
different organisms.
B) Selective toxicity will decrease invading bacteria by interfering with the
pathogens ability to reproduce.
C) Selective toxicity will eliminate bacteria by interrupting protein synthesis and
damaging the pathogens cell wall.
D) Selective toxicity is the ability of the drug to kill foreign cells without causing
harm to ones own body cells.
Ans D
Feedback
The choice of antibiotics in a clinical situation is determined by assessing which drug
will affect the causative organism and lead to the fewest adverse effects. Selective
toxicity is the ability of the drug to kill foreign cells without causing harm to the human
body cells. How the antibiotic works to kill bacteria varies by drug type and may reduce
the ability to reproduce, damage the cell wall, or interfere with a biochemical reaction,
but this is a description of how the antibiotic works and does not describe selective
toxicity
4. A local bioterrorism medical team is learning about germ warfare. The team is instructed
that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What
fluoroquinolone would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
Ans A
Feedback
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the
prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in
treating acute episodes of chronic bronchitis and community-acquired pneumonia.
Norfloxacin is recommended only for certain types of urinary tract infections.
, 5. A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician
has ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an
oral suspension of 90 mg/5 mL. How many mL will the nurse administer?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Ans C
Feedback
First, using the formula 2.2 lb/1 kg = 66 lb/X kg, determine the childs weight in kg
(66/2.2 = 30 kg). Next, determine the desired dose by using the formula amount of
prescribed drug times weight in kg (9 mg/kg times 30 kg = 270 mg). To determine the
volume of medication to administer, use the formula amount of drug available/volume
available = amount of drug prescribed/volume to administer (90 mg/5 mL = 270 mg/X
mL, 90mg/(X) = 1,350 mg/mL, X = 15 mL).
6. A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health
nurse. In reviewing the patients medication, the nurse discovers that the patient is taking
Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics
for this patient?
A) The half-life of the drug is 3 to 7 hours.
B) It is taken only once a day.
C) It has very few adverse effects.
D) It can be given without consideration to drugdrug interactions.
Ans B
Feedback
Given that the patient is forgetful and lives alone, a daily dose would likely promote
improved compliance. Azithromycin can be administered once daily because the half-life
is 68 hours. Azithromycin is associated with GI adverse effects and can cause
pseudomembranous colitis; neurological symptoms can occur as well. Azithromycin
(Zithromax) may adversely interact with cardiac glycosides, oral anticoagulants,
theophyllines, carbamazepine, and corticosteroids to name a few agents.
7. A 12-year-old patient with a complicated skin infection has been admitted to the
pediatric unit. The physician has ordered Ertapenem (Invanz). What is the nursing priority?
A) Transcribe the order to the medication administration record (MAR).
1. A 32-year-old female patient is admitted to the floor with a superinfection. Her orders
read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused
over 30 to 60 minutes for 5 days. What would be important for the nurse to educate this
patient about?
A) Analgesics
B) Antihistamines
C) Contraceptives
D) Decongestants
Ans C
Feedback
Many antibiotics interfere with the effectiveness of oral contraceptives and unplanned
pregnancies can occur. Women should be advised to use a barrier form of
contraceptives when taking this drug. No known serious drugdrug interactions involve
analgesics, antihistamines, or decongestants.
2. A patient with a gram-negative infection is being treated with an aminoglycoside.
What system should the nurse expect to monitor closely while the patient is taking
this medication?
A) Respiratory system B)
Ophthalmic system
C) Renal system
D) Musculoskeletal system
Ans C
Feedback
Renal function should be tested daily because aminoglycosides depend on the kidney for
excretion and if the glomerular filtration rate (GFR) is abnormal it may be toxic to the
kidney. The results of the renal function testing could change the daily dosage.
Aminoglycosides do not usually adversely affect respiratory, hepatic, or musculoskeletal
function, although baseline data concerning these systems is always needed.
3. How would the nurse describe selective toxicity?
, A) Selective toxicity interferes with a biochemical reaction common to many
different organisms.
B) Selective toxicity will decrease invading bacteria by interfering with the
pathogens ability to reproduce.
C) Selective toxicity will eliminate bacteria by interrupting protein synthesis and
damaging the pathogens cell wall.
D) Selective toxicity is the ability of the drug to kill foreign cells without causing
harm to ones own body cells.
Ans D
Feedback
The choice of antibiotics in a clinical situation is determined by assessing which drug
will affect the causative organism and lead to the fewest adverse effects. Selective
toxicity is the ability of the drug to kill foreign cells without causing harm to the human
body cells. How the antibiotic works to kill bacteria varies by drug type and may reduce
the ability to reproduce, damage the cell wall, or interfere with a biochemical reaction,
but this is a description of how the antibiotic works and does not describe selective
toxicity
4. A local bioterrorism medical team is learning about germ warfare. The team is instructed
that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What
fluoroquinolone would the nurse be most likely to administer for this purpose?
A) Ciprofloxacin (Cipro)
B) Gemifloxacin (Factive)
C) Norfloxacin (Noroxin)
D) Sparfloxacin (Zagam)
Ans A
Feedback
Ciprofloxacin (Cipro) is the most widely used fluoroquinolone and is indicated for the
prevention of anthrax infection. Gemifloxacin and sparfloxacin are most useful in
treating acute episodes of chronic bronchitis and community-acquired pneumonia.
Norfloxacin is recommended only for certain types of urinary tract infections.
, 5. A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician
has ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an
oral suspension of 90 mg/5 mL. How many mL will the nurse administer?
A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
Ans C
Feedback
First, using the formula 2.2 lb/1 kg = 66 lb/X kg, determine the childs weight in kg
(66/2.2 = 30 kg). Next, determine the desired dose by using the formula amount of
prescribed drug times weight in kg (9 mg/kg times 30 kg = 270 mg). To determine the
volume of medication to administer, use the formula amount of drug available/volume
available = amount of drug prescribed/volume to administer (90 mg/5 mL = 270 mg/X
mL, 90mg/(X) = 1,350 mg/mL, X = 15 mL).
6. A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health
nurse. In reviewing the patients medication, the nurse discovers that the patient is taking
Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics
for this patient?
A) The half-life of the drug is 3 to 7 hours.
B) It is taken only once a day.
C) It has very few adverse effects.
D) It can be given without consideration to drugdrug interactions.
Ans B
Feedback
Given that the patient is forgetful and lives alone, a daily dose would likely promote
improved compliance. Azithromycin can be administered once daily because the half-life
is 68 hours. Azithromycin is associated with GI adverse effects and can cause
pseudomembranous colitis; neurological symptoms can occur as well. Azithromycin
(Zithromax) may adversely interact with cardiac glycosides, oral anticoagulants,
theophyllines, carbamazepine, and corticosteroids to name a few agents.
7. A 12-year-old patient with a complicated skin infection has been admitted to the
pediatric unit. The physician has ordered Ertapenem (Invanz). What is the nursing priority?
A) Transcribe the order to the medication administration record (MAR).
