NCLEX Exam With Questions And Answers

NCLEX Exam With Questions And Answers

A nurse is preparing to administer the first dose of piperacillin/tazobactam to a patient in an infusion clinic. The nurse should take which of the following precautions?

• Ask the patient about past allergic reactions to penicillins.
• Ask the patient about past allergic reactions to aminoglycosides.
• Mix the piperacillin/tazobactam with lidocaine to reduce pain of infusion.
• Instruct the patient to eat a snack to decrease stomach upset from

piperacillin/tazobactam. - AnswerA A woman is to receive amoxicillin-clavulanate 500 mg PO every 8 hours for bronchitis.The nurse retrieves two 250-mg tablets from the medication cart. This is incorrect for which of the following reasons?

• The amount of sulbactam in amoxicillin-clavulanate 250 mg is 62.5 mg per tablet, twice

the intended amount.

• This provides twice the intended dose of clavulanate.
• The 250-mg tablets have less absorption than the 500-mg tablets.
• Administration of amoxicillin-clavulanate is only intravenous, so selecting tablets

means that the wrong drug is being administered. - AnswerB A cardiac surgeon orders cefazolin 1 g IV "on call" to the operating room for a patient scheduled for a heart valve replacement. The surgery is scheduled for 7:00 am the next morning. What is the rationale for giving the antibiotic at 6:30 am? The last dose was administered more than 8 hours ago.

• The cefazolin must be given 60 minutes before the procedure for legal reasons.
• The cefazolin must be given within 60 minutes before the first skin incision to reach

therapeutic concentrations.

• The cefazolin trough level will be checked at 6:00 am, which would allow the level to

come back before administration of the "on call" dose.

• The last dose was administered yesterday - AnswerB

Which of the following classes of cephalosporins have the best activity against gram-positive organisms?

• first-generation cephalosporins
• second-generation cephalosporins
• third-generation cephalosporins
• fourth-generation cephalosporins - AnswerA

In acute renal failure, doses of which of the following antibiotics must be reduced?(Select all that apply.)

• nafcillin
• cefazolin
• meropenem
• aztreonam - AnswerB, C, D

A nurse working in the neurointensive care unit is caring for a patient with a head injury who has been experiencing seizures and now has pneumonia caused by Pseudomonas aeruginosa. The physician has prescribed imipenem 1 g IV every 6 hours plus gentamicin for the pneumonia. Before administering the antibiotics, the nurse should do which of the following?

• Avoid mixing the imipenem and gentamicin in the same IV bag to prevent inactivation

of the gentamicin.

• Remind the physician of the patient's seizures and inquire whether a different

antibiotic might be safer.

• Suggest to the physician that imipenem is used to treat gram-positive infections and

will not be effective in this patient.

• Set the infusion pump to deliver the imipenem over 15 minutes - AnswerB

A client is prescribed penicillin V orally for a strep throat. What is the mechanism of action of this medication?

• It inhibits protein synthesis.
• It lowers the pH of cellular contents. C. It causes mutations.
• It inhibits cell wall synthesis. - AnswerD

A client has a history of a life-threatening anaphylactic reaction to penicillin G. Which medication should not be administered to this client?

• Lactulose
• Ketoconazole

• Kanamycin
• Cefadroxil - AnswerD

Ampicillin-sulbactam is administered to a client with Staphylococcus aureus. What type of anti-infective is ampicillin-sulbactam?

• Extended-spectrum antipseudomonal penicillin
• Penicillin-beta-lactamase inhibitor combination
• Cephalosporin
• Aminopenicillin - AnswerB

How does adding a beta-lactamase inhibitor agent help achieve a therapeutic effect when prescribed for otitis media?

• It extends the spectrum of antibacterial activity of penicillin.
• It extends the spectrum of the beta-lactamase inhibitor.
• It decreases the side effects of high-dose penicillin.
• It increases the absorption of the penicillin. - AnswerA

A client is administered a third-generation cephalosporin. The broad-spectrum agents like cephalosporins are most effective in treating which type of microorganism?

• Gram positive
• Gram negative
• Fungi
• Virus - AnswerB

What organ system is responsible for the excretion of cefotaxime sodium from the body?

• Respiratory
• Hepatic
• Renal
• Gastrointestinal - AnswerC

Which is the drug of choice for surgical prophylaxis associated with a vaginal hysterectomy?

• Cefadroxil
• Cefazolin sodium
• Cephalexin
• Cephradine - AnswerB

A client is administered probenecid with a penicillin. The client asks why this drug is being administered. What is the best response the nurse can state to the client?

• "Probenecid will increase the serum level of penicillin."
• "Probenecid prevents an anaphylactic reaction."
• "Probenecid will break down the bacterial cell wall."
• "Probenecid decreases the amount of penicillin needed." - AnswerA

A client diagnosed with infective endocarditis would be most effectively treated with which medication?

• Dicloxacillin
• Ampicillin
• Nafcillin
• Oxacillin - AnswerB

An older adult client responded well to treatment with a third-generation cephalosporin.After being largely symptom free for 48 hours, the client has developed a fever of 38.6°C and an elevated white cell count. What phenomenon may account for this client's current clinical presentation?

• The client may be infected with microorganisms that were resistant to the

cephalosporin.

• The client may be experiencing a delayed (type IV) hypersensitivity reaction to the

cephalosporin.

• The client may be developing glomerulonephritis secondary to the nephrotoxic

cephalosporin.