Test Bank For Abrams’ Clinical Drug Therapy:

Rationales for Nursing Practice, Tenth edition:

Geralyn Frandsen

To download the complete and accurate content document, go to:

https://testbankbell.com/download/test-bank-for-abrams-clinical-drug-therapy-rational
es-for-nursing-practice-tenth-edition-geralyn-frandsen/
Test Bank For Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, Tenth editio

Import Settings:
Base Settings: Brownstone Default
Information Field: Chapter
Information Field: Client Needs
Information Field: Cognitive Level
Information Field: Difficulty
Information Field: Integrated Process
Information Field: Objective
Information Field: Page and Header
Highest Answer Letter: E
Multiple Keywords in Same Paragraph: No

Chapter: Chapter 13: Inflammation, Infection, and the Use of Antimicrobial Agents

Multiple Choice

1. A female patient has been treated for strep throat with ampicillin by mouth. She visits the
occupational health nurse and states she has vaginal itching. What organism is the cause of the
vaginal itching?
A) Klebsiella
B) Enterobacter
C) Candida albicans
D) Proteus

Ans: C
Chapter: 13
Client Needs: D-4
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 4
Page and Header: 231, Normal Flora
Feedback: The yeast Candida albicans is a normal resident of the vagina and the intestinal
tract. An antibacterial drug may destroy the normal bacterial flora without affecting the fungal
organism. Klebsiella, Enterobacter, and Proteus will not contribute to the development of a yeast
infection.

Visit TestBankBell.com to get complete for all chapters

2. An elderly patient is treated for pneumonia with clindamycin (Cleocin). One week after the
completion of the medication, she develops diarrhea. What is the most probable cause of the
diarrhea?
A) Change in normal flora
B) Food-borne illness
C) Crohn's disease
D) Incontinence

Ans: A
Chapter: 13
Client Needs: D-2
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 239, Nursing Diagnoses
Feedback: Much of the normal flora can cause disease under certain conditions, especially in
the elderly, debilitated, or immunosuppressed people. The development of infectious diarrhea is
related to the change in the normal flora of the bowel. Food-borne illness, Crohn's disease, and
incontinence do not contribute to this particular development of diarrhea.

3. A patient with burns has developed a wound infection. This patient is experiencing what type
of wound infection?
A) Fungal infection
B) Opportunistic infection
C) Nosocomial infection
D) Food-borne infection

Ans: B
Chapter: 13
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 232, Opportunistic Pathogens
Feedback: Opportunistic infections are likely to occur in people with severe burns, cancer,
human immunodeficiency virus, and indwelling catheters and are often caused by drug-resistant
microorganisms, are usually serious, and may be life threatening. The patient may be at risk for a
fungal, nosocomial, or food-borne infection, but the risk for all infections is high due to the
patient's opportunistic nature of the burn.

4. An elderly man who is a resident of a skilled nursing facility develops methicillin-resistant

Staphylococcus aureus. What type of infection has this man developed?
A) Community acquired
B) Postoperative
C) Sustained infection
D) Nosocomial infection

Ans: D
Chapter: 13
Client Needs: A-2
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 5
Page and Header: 234, Community-Acquired Versus Nosocomial Infections
Feedback: Nosocomial infections are infections acquired from microorganisms in hospitals and
other health care facilities. The patient's infection is not community acquired, postoperative, or
sustained.

5. A nurse is instructing a patient on the antibiotic regimen for the treatment of pneumonia.
Which of the following is most important to teach the patient?
A) Take the medication with orange juice.
B) Supplement the medication with multivitamins.
C) Complete the entire prescription of medication.
D) Administer the medication with dairy products.

Ans: C
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 6, 8
Page and Header: 237, Box 13.3
Feedback: Interruption or inadequate antimicrobial treatment of infections may also contribute
to the emergences of antibiotic-resistant organisms. The administration of an antibiotic with
orange juice is not recommended in all instances. The medication does not need to be
supplemented with vitamins. Antibiotics need not be administered with dairy products.

6. A patient is to be started on an antibiotic. Which of the following is most important to take

into consideration before beginning the antibiotic regimen?
A) Duration of symptoms
B) Culture and sensitivity
C) The patient's hydration status
D) The patient's age and weight

Ans: B
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 7
Page and Header: 237, Culture and Sensitivity Studies
Feedback: Culture identifies the causative organism, and susceptibility tests determine which
drugs are likely to be effective against the organism. The duration of symptoms and the patient's
hydration status, age, and weight are important, but not imperative, in determining the antibiotic
of choice.

7. A patient has presented to the emergency department after suffering a severe laceration to his
hand in a workplace accident. During the subsequent process of acute inflammation, what
physiological event took place first?
A) The patient's B cells produced antibodies.
B) The patient's blood vessels constricted.
C) Neutrophils migrated to the injury site.
D) Opsonization occurred.

Ans: B
Chapter: 13
Client Needs: D-4
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 1, 2
Page and Header: 229, Acute Inflammation
Feedback: The process of acute inflammation occurs in three stages. The first stage is the
vascular stage; notable changes occur in the small blood vessels at the site of the cellular and
tissue injury. At the time of the injury, vasoconstriction results, followed by vasodilation of the
capillaries and venules to increase capillary blood flow, increasing temperature and redness at
the site. Opsonization, neutrophil migration, and antibody production take place in later stages of
inflammation.

8. A 12-year-old boy was bitten by a dog, and inflammation took place at the site of the injury.
During the process of opsonization, what physiological event occurred?
A) The boy's blood vessels dilated, allowing rapid peripheral blood flow.
B) Viscosity of the boy's blood decreased, facilitating the migration of neutrophils.
C) Antigens were coated, marking them for phagocytosis.
D) T cells were released from the boy's thymus gland.

Ans: C
Chapter: 13
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 2
Page and Header: 229, Acute Inflammation
Feedback: The third stage of inflammation involves opsonization, which facilitates
phagocytosis. During opsonization, a substance coats the foreign antigens, producing
inflammation. This inflammation makes the antigens more susceptible to the macrophages and
leukocytes, thus increasing phagocytic activity. Opsonization is not characterized by T-cell
activity or changes in blood flow and viscosity.

9. An adult patient with an autoimmune disorder regularly takes oral corticosteroids. The nurse
knows that corticosteroids can be used in the successful treatment of inflammation but that they
also create a risk for
A) bleeding.
B) leukocytosis.
C) infection.
D) electrolyte imbalances.

Ans: C
Chapter: 13
Client Needs: D-2
Cognitive Level: Comprehension
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 3
Page and Header: 229, Drug Therapy
Feedback: Corticosteroids impair phagocytosis by preventing phagocytic cells from leaving the
bloodstream. They decrease the amount of lymphocytes, fibroblasts, and collagen needed for
tissue repair. This causes a reduction in inflammation but a commensurate increase in the
patient's risk for infection.

10. The family members of a geriatric patient are angered that she has been colonized with
methicillin-resistant Staphylococcus aureus during her stay in the hospital. The nurse should
explain what characteristic of colonization to the members of the family?
A) The bacteria are present but are not causing infection.
B) The bacteria are causing an infection, but the infection is not spreading.
C) The bacteria are causing tissue injury at the site of colonization.
D) The bacteria are spreading within a clearly defined body region.

Ans: A
Chapter: 13
Client Needs: A-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Teaching/Learning
Objective: 4
Page and Header: 231, Normal Flora
Feedback: Colonization is the presence and growth of microorganisms. The microorganisms do
not necessarily cause tissue injury or elicit an immune response in the human body.

11. An adult female patient has been living with human immunodeficiency virus (HIV) for
several years but has recently been admitted to the hospital after being diagnosed with herpes
simplex. How would this patient's herpes infection most likely be characterized?
A) Community-acquired infection
B) Opportunistic infection
C) Secondary infection
D) Nosocomial infection

Ans: B
Chapter: 13
Client Needs: D-4
Cognitive Level: Analysis
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 5
Page and Header: 232, Opportunistic Pathogens
Feedback: Microorganisms may become pathogens in hosts whose defense mechanisms are
impaired. Opportunistic infections are likely to occur in people whose defenses are compromised
due to human immunodeficiency virus (HIV) infection. This is not characterized as a nosocomial
infection (hospital-acquired infection) or a secondary infection. The infection was likely to have
been acquired in the community, but the patient's HIV diagnosis means that it would be
considered to be an opportunistic infection.

12. A group of nursing students are learning about the factors that underlie recent increases in
the incidence and prevalence of antibiotic-resistant microorganisms. What factor is known to
contribute to antibiotic resistance?
A) Increased survival rates from acute infections
B) Increased population density
C) Use of antibiotics that are ineffective against the infectious microorganism
D) Overuse of antibiotics

Ans: D
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 6
Page and Header: 234, Antibiotic-Resistant Microorganisms
Feedback: Antibiotic overuse can contribute to antibiotic resistance. Resistance is not typically
attributable to increased age of patients, increased population density, or the use of ineffective
antibiotics.

13. A 4-month-old baby has been brought to the emergency department by her parents, and
initial assessment is highly suggestive of bacterial meningitis. Consequently, the baby has been
admitted, and empiric antibiotic therapy has been ordered. The nurse should understand what
characteristic of this infant's current treatment plan?
A) Success or failure of treatment will not be apparent for several weeks.
B) The infant will receive aggressive treatment with a narrow-spectrum antibiotic.
C) Culture and sensitivity results of the infant's cerebrospinal fluid are still pending.
D) The infant is suspected of having an antibiotic-resistant infection.

Ans: C
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Diffcult
Integrated Process: Nursing Process
Objective: 7
Page and Header: 237, Empiric Therapy
Feedback: Empiric therapy is based on an informed estimate of the most likely pathogen(s)
given the patient's signs and symptoms and the site of infection, as well as knowledge of
communicable diseases currently infecting other people in the community. Because laboratory
tests used to definitively identify causative organisms and to determine susceptibility to
antibiotics usually require 48 to 72 hours, the prescriber usually initiates treatment with an
antimicrobial drug that is likely to be effective. The other listed statements are not true of
empiric therapy.

14. A patient with an infection has not responded appreciably to antibiotic therapy, and the
nurse suspects antibiotic resistance. What phenomenon is known to contribute to acquired
antibiotic resistance?
A) Bacteria take on genetic material from healthy body cells, reducing antigen recognition.
B) Microorganisms remain in resting (G0) phase during antibiotic treatment.
C) Distribution of an antibiotic is insufficient to cause resolution of the infection.
D) The strongest microorganisms survive antibiotic treatment while the weakest are eradicated.

Ans: D
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Diffcult
Integrated Process: Nursing Process
Objective: 6
Page and Header: 236, Mechanisms of Antibiotic Resistance in Bacteria
Feedback: Selective pressure, or natural selection, refers to the survival of the fittest bacteria.
When antibiotic therapy is initially begun, the weakest bacteria are killed first while the strongest
bacteria, which are best able to withstand the effects of antibiotic therapy, remain. This
contributes to antibiotic resistance. Resistance is not the result of an extended G0 phase, impaired
distribution, or bacterial appropriation of human genetic material.

15. When participating in the care of a patient who is being treated with antimicrobials, the
nurse can promote the appropriate use of these medications in which of the following ways?
A) Encouraging the use of narrow-spectrum, rather than broad-spectrum, antibiotics
B) Promoting the use of prophylactic antibiotics for patients possessing risk factors for
infection
C) Initiating empiric therapy for all older adult patients admitted to a health care facility
D) Promoting the use of herbal treatment for infection rather than antimicrobial drugs

Ans: A
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 7
Page and Header: 236, Drug Therapy
Feedback: Guidelines to promote more appropriate use of antimicrobial drugs include using a
narrow-spectrum antibacterial drug instead of a broad-spectrum drug, whenever possible, in
order to decrease the risk of a superinfection. Herbal alternatives are frequently not available.
Antibiotics should not normally be administered in the absence of a diagnosed infection.

16. A critically ill patient has developed a fever of 38.9°C, and blood cultures have been drawn
and sent to the laboratory for culture and sensitivity testing. Determination of the culture will tell
the care team
A) whether the infection is antibiotic resistant.
B) the exact identity of the infectious microorganism.
C) the most likely location of the infection.
D) the most likely origin of the infection.

Ans: B
Chapter: 13
Client Needs: D-1
Cognitive Level: Comprehension
Difficulty: Moderate
Integrated Process: Nursing Process
Objective: 7
Page and Header: 237, Culture and Sensitivity Studies
Feedback: Culture identifies the causative microorganism. It does not necessarily indicate the
presence of antibiotic resistance. The origin or location of the infection may often been indirectly
determined by the culture, but this is not always the case.

17. A medical nurse on a night shift is reviewing a patient's medication administration record
for the following day. The nurse notes that a combination antimicrobial drug is ordered. What is
implied by the fact that the patient has been ordered a combination drug?
A) The patient's infection likely has a fungal or protozoal etiology.
B) The patient likely has a history of recurrent, multisystemic infections.
C) The patient may be unable to tolerate treatment with a single antimicrobial.
D) The patient may have an infection caused by multiple microorganisms.

Ans: D
Chapter: 13
Client Needs: D-2
Cognitive Level: Application
Difficulty: Diffcult
Integrated Process: Nursing Process
Objective: 7, 8
Page and Header: 239, Combination Therapy
Feedback: Indications for combination therapy may include infections caused by multiple
microorganisms. A fungal or protozoal infection is not implied, and the patient may or may not
have a history of recurrent infections. Intolerance of single antibiotics is not normally an
indication for combination therapy.

18. A hospital nurse is aware that nosocomial infections pose a significant threat to many
patients' health status. In order to reduce the spread of nosocomial infections, the nurse should
prioritize which of the following actions?
A) Increased use of empiric antibiotic therapy
B) Use of disinfectants when providing patient hygiene
C) Vigilant and thorough hand hygiene
D) Patient education on the causes of infection

Ans: C
Chapter: 13
Client Needs: A-2
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 8
Page and Header: 239, Nursing Interventions
Feedback: Good hand hygiene is probably the most effective method of preventing infections.
This supersedes the importance of education regarding the causes of infection or the use of
disinfectants. Antibiotic therapy should only be used on patients who clearly need this treatment.

Multiple Selection
19. An 81-year-old female patient has been admitted to the hospital after a urinary tract
infection developed into urosepsis. What assessments should the nurse prioritize when
monitoring the course of this patient's infection? Select all that apply.
A) Blood urea nitrogen and creatinine
B) White blood cell count
C) Heart rhythm
D) Temperature
E) Liver panel

Ans: B, D
Chapter: 13
Client Needs: D-1
Cognitive Level: Application
Difficulty: Easy
Integrated Process: Nursing Process
Objective: 8
Page and Header: 239, Nursing Interventions
Feedback: For patients with an infection, the nurse should prioritize assessment of WBCs and
temperature. Cardiac, renal, and liver function are important measures of health, but these are
less directly affected by the presence of infection.

Multiple Choice

20. Mr. Garcia has been taking antibiotics at home for the treatment of a respiratory infection
for the past 6 days, and there is no evident improvement in his infection. Which of the following
nursing assessments is most appropriate?
A) Assess Mr. Garcia's adherence to his medication regimen.
B) Assess Mr. Garcia's home hygiene.
C) Assess Mr. Garcia's understanding of his illness.
D) Assess Mr. Garcia's use of herbal or alternative remedies.

Ans: A
Chapter: 13
Client Needs: D-1
Cognitive Level: Application
Difficulty: Moderate
Integrated Process: Nursing Process
Test Bank For Abrams’ Clinical Drug Therapy: Rationales for Nursing Practice, Tenth editio

Objective: 8
Page and Header: 240, Evaluation
Feedback: Nonadherence to antibiotic therapy can result in a continuation or exacerbation of
the infection. Poor hygiene is a risk factor for the development of infection but is less likely to
perpetuate an existing infection that is being treated appropriately with antibiotics. Herbs may be
contraindicated but are unlikely to negate the therapeutic effects of an antibiotic. The nurse
should gauge the patient's understanding of his illness, but this does not have a bearing on his
lack of improvement.

Visit TestBankBell.com to get complete for all chapters