C HAPTER 39: A NTIBIOTICS P ART 2
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing the m edication orders for a patient who will be
receiving aminogl ycoside therapy. Which other medication or medication
class, if ordered, would be a potential interaction concern?
a. Calcium channel blockers
b. Phenytoin
c. Proton pump inhibitors
d. Loop diuretics
ANS: D
Concurrent use of aminogl ycosides with loop diuretics increases the
risk for ototoxicit y. The other drugs and drug classes do not cause
interactions.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Assessment
MSC: NC LEX: Physiological In tegrit y: Pharmacological and
Parenteral Therapies
2. The nurse checks the patient ’s laboratory work prior to administering a
dose of vancom ycin and finds that the trough vancom ycin level is 15
mcg/m L. What will the nurse do next?
a. Administer the vancom ycin as ordered.
b. Hold the drug, and administer 4 hours later.
c. Hold the drug, and notify the prescriber.
, d. Repeat the test to verify results.
ANS: A
Optimal blood levels of vancom ycin are a trough level of 10 to 20
mcg/m L. Measurement of peak levels is no longer ro utinel y
recommended, and onl y trough levels are commonl y monitored. Blood
samples for measurement of trough levels are drawn immediatel y
before administration of the next dose. Because of the increase in
resistant organisms, many clinicians use a trough le vel of 15 to 20
mcg/m L as their goal. These trough levels mean that even just before
the next dose is due, when drug levels should be low, the drug levels
are actuall y too high.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Evaluation
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
3. A patient has been diagnosed with carbapenem -resistant
Enterobacteriaceae (CRE). The nurse expects to see orders for which
drug?
a. Dapsone, a miscellaneous antibiotic
b. Ciprofloxacin, a quinolone
c. Linezolid, an oxazolidinone
d. Colistimethate sodium, a pol ypeptide antibiotic
ANS: D
Colistimethate sodium (Col y-Mycin), commonl y referred to as colistin,
is now being used again, often as one of the onl y drugs available to
treat CRE. The other options are incorrect.
DIF: Cognitive Level: Appl ying (Application)
Lilley: Pharmacology and the Nursing Process, 10th Edition
MULTIPLE CHOICE
1. The nurse is reviewing the m edication orders for a patient who will be
receiving aminogl ycoside therapy. Which other medication or medication
class, if ordered, would be a potential interaction concern?
a. Calcium channel blockers
b. Phenytoin
c. Proton pump inhibitors
d. Loop diuretics
ANS: D
Concurrent use of aminogl ycosides with loop diuretics increases the
risk for ototoxicit y. The other drugs and drug classes do not cause
interactions.
DIF: Cognitive Level: Appl ying (Application)
TOP: Nursing Process: Assessment
MSC: NC LEX: Physiological In tegrit y: Pharmacological and
Parenteral Therapies
2. The nurse checks the patient ’s laboratory work prior to administering a
dose of vancom ycin and finds that the trough vancom ycin level is 15
mcg/m L. What will the nurse do next?
a. Administer the vancom ycin as ordered.
b. Hold the drug, and administer 4 hours later.
c. Hold the drug, and notify the prescriber.
, d. Repeat the test to verify results.
ANS: A
Optimal blood levels of vancom ycin are a trough level of 10 to 20
mcg/m L. Measurement of peak levels is no longer ro utinel y
recommended, and onl y trough levels are commonl y monitored. Blood
samples for measurement of trough levels are drawn immediatel y
before administration of the next dose. Because of the increase in
resistant organisms, many clinicians use a trough le vel of 15 to 20
mcg/m L as their goal. These trough levels mean that even just before
the next dose is due, when drug levels should be low, the drug levels
are actuall y too high.
DIF: Cognitive Level: Anal yzing (Anal ysis)
TOP: Nursing Process: Evaluation
MSC: NC LEX: Physiological Integrit y: Reduction of Risk
Potential
3. A patient has been diagnosed with carbapenem -resistant
Enterobacteriaceae (CRE). The nurse expects to see orders for which
drug?
a. Dapsone, a miscellaneous antibiotic
b. Ciprofloxacin, a quinolone
c. Linezolid, an oxazolidinone
d. Colistimethate sodium, a pol ypeptide antibiotic
ANS: D
Colistimethate sodium (Col y-Mycin), commonl y referred to as colistin,
is now being used again, often as one of the onl y drugs available to
treat CRE. The other options are incorrect.
DIF: Cognitive Level: Appl ying (Application)
