Chapter 30 Protein Synthesis Inhibitors
1. Which is a characteristic that distinguishes sulfonamides from other drugs used to treat
bacterial infection?
a. Sulfonamides are bactericidal.
b. Sulfonamides are derived from biologic substances.
c. Sulfonamides have antifungal and antiviral properties.
d. Sulfonamides increase bacterial synthesis of folic acid.
ANS B
Sulfonamides are bacteriostatic, not bactericidal. They are not derived from biologic
substances. They are not antifungals or antivirals. They act by decreasing bacterial synthesis of
folic acid.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 429
TOP NURSING PROCESS N/A MSC NCLEX Physiological Integrity
Pharmacological and Parenteral Therapies
2. The nurse is counseling a patient who will begin taking a sulfonamide drug to treat a
urinary tract infection. What information will the nurse include in teaching? a. Drink several
quarts of water daily.
b. If stomach upset occurs, take an antacid.
c. Limit sun exposure to no more than 1 hour each day.
d. Sore throat is a common, harmless side effect.
ANS A
Patients should drink several quarts of water daily while taking sulfonamides to prevent
crystalluria. Patients should not take antacids with sulfonamides. Patients should not go out
into the sun. Sore throat should be reported.
DIF COGNITIVE LEVEL Applying (Application) REF dm 430
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim,
Septra) to treat a urinary tract infection reports vaginal itching and discharge. The nurse will
perform which action?
a. Ask the patient if she might be pregnant.
b. Reassure the patient that this is a normal side effect.
c. Report a possible superinfection to the provider.
d. Suspect that the patient is having a hematologic reaction.
ANS C
, Superinfection can occur with a secondary infection. Vaginal itching and discharge is a sign of
superinfection. This is not symptomatic of pregnancy. These are not common side effects and
do not indicate a hematologic reaction.
DIF COGNITIVE LEVEL Applying (Application) REF dm 432 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient who will begin taking trimethoprim-sulfamethoxazole (TMP-SMX) asks the
nurse why the combination drug is necessary. The nurse will explain that the combination is
used to a. broaden the antibacterial spectrum.
b. decrease bacterial resistance.
c. improve the taste.
d. minimize toxic effects.
ANS B
The combination drug is used to decrease bacterial resistance to sulfonamides. It does not
broaden the spectrum, improve the taste, or decrease toxicity.
DIF COGNITIVE LEVEL Applying (Application) REF dm 429
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer trimethoprim-sulfamethoxazole (TMP-SMX) to a
patient who is being treated for a urinary tract infection. The nurse learns that the patient has
type 2 diabetes mellitus and takes a sulfonylurea oral antidiabetic drug. The nurse will monitor
this patient closely for which effect? a. Headaches
b. Hypertension
c. Hypoglycemia
d. Superinfection
ANS C
Taking oral antidiabetic agents (sulfonylurea) with sulfonamides increases the hypoglycemic
effect. Sulfonylureas do not increase the incidence of headaches, hypertension, or
superinfection when taken with sulfonamides. Examples of antidiabetic sulfonylurea
medications are glipizide, glimepride, glyburide, tolaamide, and tolbutamide.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 431 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX)
and learns that the patient takes warfarin (Coumadin). The nurse will request an order for
a. a decreased dose of TMP-SMX.
b. a different antibiotic.
c. an increased dose of warfarin.
d. coagulation studies.
1. Which is a characteristic that distinguishes sulfonamides from other drugs used to treat
bacterial infection?
a. Sulfonamides are bactericidal.
b. Sulfonamides are derived from biologic substances.
c. Sulfonamides have antifungal and antiviral properties.
d. Sulfonamides increase bacterial synthesis of folic acid.
ANS B
Sulfonamides are bacteriostatic, not bactericidal. They are not derived from biologic
substances. They are not antifungals or antivirals. They act by decreasing bacterial synthesis of
folic acid.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 429
TOP NURSING PROCESS N/A MSC NCLEX Physiological Integrity
Pharmacological and Parenteral Therapies
2. The nurse is counseling a patient who will begin taking a sulfonamide drug to treat a
urinary tract infection. What information will the nurse include in teaching? a. Drink several
quarts of water daily.
b. If stomach upset occurs, take an antacid.
c. Limit sun exposure to no more than 1 hour each day.
d. Sore throat is a common, harmless side effect.
ANS A
Patients should drink several quarts of water daily while taking sulfonamides to prevent
crystalluria. Patients should not take antacids with sulfonamides. Patients should not go out
into the sun. Sore throat should be reported.
DIF COGNITIVE LEVEL Applying (Application) REF dm 430
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
3. A female patient who is taking trimethoprim-sulfamethoxazole (TMP-SMZ) (Bactrim,
Septra) to treat a urinary tract infection reports vaginal itching and discharge. The nurse will
perform which action?
a. Ask the patient if she might be pregnant.
b. Reassure the patient that this is a normal side effect.
c. Report a possible superinfection to the provider.
d. Suspect that the patient is having a hematologic reaction.
ANS C
, Superinfection can occur with a secondary infection. Vaginal itching and discharge is a sign of
superinfection. This is not symptomatic of pregnancy. These are not common side effects and
do not indicate a hematologic reaction.
DIF COGNITIVE LEVEL Applying (Application) REF dm 432 TOP
NURSING PROCESS Nursing Intervention
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
4. A patient who will begin taking trimethoprim-sulfamethoxazole (TMP-SMX) asks the
nurse why the combination drug is necessary. The nurse will explain that the combination is
used to a. broaden the antibacterial spectrum.
b. decrease bacterial resistance.
c. improve the taste.
d. minimize toxic effects.
ANS B
The combination drug is used to decrease bacterial resistance to sulfonamides. It does not
broaden the spectrum, improve the taste, or decrease toxicity.
DIF COGNITIVE LEVEL Applying (Application) REF dm 429
TOP NURSING PROCESS Nursing Intervention Patient Teaching
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
5. The nurse is preparing to administer trimethoprim-sulfamethoxazole (TMP-SMX) to a
patient who is being treated for a urinary tract infection. The nurse learns that the patient has
type 2 diabetes mellitus and takes a sulfonylurea oral antidiabetic drug. The nurse will monitor
this patient closely for which effect? a. Headaches
b. Hypertension
c. Hypoglycemia
d. Superinfection
ANS C
Taking oral antidiabetic agents (sulfonylurea) with sulfonamides increases the hypoglycemic
effect. Sulfonylureas do not increase the incidence of headaches, hypertension, or
superinfection when taken with sulfonamides. Examples of antidiabetic sulfonylurea
medications are glipizide, glimepride, glyburide, tolaamide, and tolbutamide.
DIF COGNITIVE LEVEL Understanding (Comprehension) REF dm 431 TOP
NURSING PROCESS Assessment
MSC NCLEX Physiological Integrity Pharmacological and Parenteral Therapies
6. The nurse is preparing to give a dose of trimethoprim-sulfamethoxazole (TMP-SMX)
and learns that the patient takes warfarin (Coumadin). The nurse will request an order for
a. a decreased dose of TMP-SMX.
b. a different antibiotic.
c. an increased dose of warfarin.
d. coagulation studies.
