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WorksheetsAntibiotics P2
Total questions: 30
Worksheet time: 15mins
An ED patient with fever and hypotension is started on IV cefepime before cultures. This represents:
Definitive therapy
Empiric therapy
Prophylaxis
Subtherapeutic therapy
A hospitalized patient on day 4 develops new productive cough and fever. Best classification:
Community-acquired pneumonia
Nosocomial pneumonia
Colonization
Viral URI
A patient on warfarin begins TMP-SMX for UTI. Which lab is priority to monitor within 48–72 hours?
Serum potassium
INR
TSH
ALT/AST only
Which cephalosporin has MRSA coverage?
Cefazolin
Ceftriaxone
Ceftaroline
Cefepime
A 6-year-old with cystic fibrosis has Pseudomonas lung infection. Which statement about quinolones is most accurate?
Absolutely contraindicated in all children
May be used judiciously when benefits outweigh risks
Only topical forms are allowed
Safe without monitoring
Patient on imipenem/cilastatin becomes confused and has myoclonic jerks. History includes epilepsy. Priority action:
Administer antiemetic
Check dosing/renal function and notify provider
Give antidiarrheal
Reassure and continue
Patient on azithromycin complains of palpitations. Next best step:
Stop drug and check ECG for QT prolongation
Ignore if BP is normal
Give calcium to offset effect
Start beta-blocker immediately
Post-op patient receiving clindamycin develops profuse watery diarrhea. Initial nursing response:
Administer loperamide
Collect stool for C. difficile testing and notify provider
Encourage dairy products
Hold fluids to rest bowel
Gentamicin plus piperacillin is ordered for suspected enterococcal endocarditis. The rationale is:
Antagonism to reduce toxicity
Synergy to enhance bacterial killing
Coverage duplication only
Prevent QT prolongation
A patient with MRSA pneumonia is being considered for daptomycin. Best nursing statement:
This is appropriate because daptomycin concentrates in the lungs
Daptomycin is inactivated by surfactant and not used for pneumonia
We must give it as an IV push
Oral daptomycin is preferred
Vancomycin trough is ordered. The nurse should draw it:
Any time after infusion
Immediately after infusion
Just before the 4th dose, within 30 minutes prior to next dose
12 hours after dose regardless of frequency
Patient on linezolid is also taking sertraline (SSRI). Major concern?
Serotonin syndrome
Nephrotoxicity
Ototoxicity
Seizure risk
Which instruction is correct for nitrofurantoin therapy?
Crush tablets to improve absorption
Take with food/milk and plenty of fluids
Stop if urine becomes darker immediately
Skip doses if asymptomatic
Patient receiving levofloxacin asks about a daily multivitamin with iron. Best response:
Take together in the morning
Separate the levofloxacin and vitamin by several hours
Stop the vitamin during therapy
Take with milk to help absorption
An older adult on moxifloxacin develops neuropathic symptoms. The nurse recognizes:
This is unrelated
Quinolones can cause peripheral neuropathy that may be permanent
Stop antibiotics altogether
Switch to an aminoglycoside for neuropathy
A patient colonized with MRSA in the nares but asymptomatic requires:
IV vancomycin treatment
Standard precautions and hand hygiene; no systemic antibiotics
Isolation at home
Aminoglycoside prophylaxis
A culture returns ESBL-producing Klebsiella. Which empiric drug should be de-escalated when sensitivities confirm ESBL?
Piperacillin/tazobactam
Meropenem
Ciprofloxacin
Amoxicillin/clavulanate
During vancomycin infusion the patient reports pruritus and facial flushing; BP is stable. Next step:
Stop permanently
Slow the infusion and continue monitoring
Give IV push to finish quickly
Administer epinephrine IM immediately
Which statement about tigecycline is correct?
Oral dosing is standard
Effective for complicated skin/abdominal infections; given IV
Contraindicated in all gram-positive infections
Used for pneumonia only
Which drug is preferred for CRE infection when susceptible?
Colistimethate (colistin)
Ceftriaxone
Azithromycin
Cefazolin
Appropriate steps to reduce antibiotic resistance in the hospital include: (Select all that apply.)
Antimicrobial stewardship involvement
De-escalation to narrow-spectrum agents when possible
Routine use of broad-spectrum agents for all fevers
Hand hygiene and contact precautions
Completing antibiotic courses as ordered
Signs of aminoglycoside toxicity the nurse should report immediately: (Select all that apply.)
Tinnitus
Fullness in the ears
Vertigo/ataxia
Bradycardia
Rising serum creatinine
When teaching a patient taking doxycycline, include: (Select all that apply.)
Use additional contraception
Avoid taking with dairy/antacids
Expect photosensitivity
Safe in pregnancy
Discard if expired
Which statements about macrolides are accurate? (Select all that apply.)
Often cause GI upset (erythromycin)
Active against Chlamydia and Mycoplasma
Always bactericidal
May prolong QT interval
Useful to promote gastric motility
Key nursing points for linezolid include: (Select all that apply.)
Monitor platelets
Avoid tyramine foods
Check for serotonergic co-medications
IV protection from light and timed infusion
Mix IV bag with other medications to reduce line use
Appropriate management of suspected C. difficile includes: (Select all that apply.)
Contact precautions
Stop unnecessary antibiotics
Send stool assay
Give antidiarrheals first
Perform hand hygiene with soap and water
Septic patient: which comes first?
Draw cultures and start antibiotics promptly
Wait for sensitivities
Start probiotics then antibiotics
Obtain chest x-ray before cultures
Patient on gentamicin with new tinnitus and dizziness. First action:
Hold the gentamicin and notify provider
Reassure and continue
Increase infusion rate
Give meclizine and continue
During quinolone education the patient insists on taking antacids simultaneously. Best response:
It's fine with food
Separate by several hours to avoid reduced absorption
Stop quinolone instead
Double the quinolone dose
Vancomycin extravasation suspected at IV site (pain, swelling). First action:
Slow rate
Stop infusion and assess site, follow extravasation protocol
Dilute with NS and continue
Warm compress and continue
