Macrolides (Antibiotics) Nursing NCLEX Quiz Questions

Macrolides nursing pharmacology NCLEX quiz questions for students!

Macrolides are a group of antibiotics used to treat various infections. The nurse should know what type of microorganisms this group of medications treat, how they work, side effects, and the nursing considerations for this antibiotic group.

Before taking the quiz, don’t forget to watch the Macrolides lecture and review the lecture notes.

Macrolides (Antibiotics) Nursing NCLEX Questions Quiz

1. Select the microorganism below that is NOT targeted by the antibiotic group known as Macrolides:

A. Streptococcal

B. Chlamydia

C. Enterococcus

D. Corynebacterium diptheriae

The answer is C: Enterococcus. Macrolides are mainly effective against gram-positive bacterium like Streptococcal, Corynebacterium diphtheriae, and Staphylococcal infection etc. but NOT Enterococcus. In addition, they can target some gram-negative like Salmonella, chlamydia, H. pylori, Legionella, Gonorrhea, H. influenzae etc.

2. True or False: Macrolides can be prescribed to help treat a stomach infection caused by Helicobacter pylori.

The answer is TRUE. Clarithromycin is a macrolide used to treat H. pylori.

3. The nurse is assessing a patient’s medication history. The patient has been prescribed a Macrolide for the treatment of otitis media. Which medication below is a Macrolide?

A. Streptomycin

B. Neomycin

C. Azithromycin

D. Levofloxacin

The answer is C. Azithromycin is a Macrolide that can be prescribed in children to treatment a middle ear infection (otitis media). Streptomycin and Neomycin are Aminoglycosides, and Levofloxacin is a Fluoroquinolones “quinolones”.

4. Your patient is diagnosed with C. diff. The physician has ordered a Macrolide for treatment. Which medication below will the nurse prepare to administer to the patient?

A. Clarithromycin

B. Streptomycin

C. Fidaxomicin

D. Erythromycin

The answer is C: Fidaxomicin. This Macrolide is relatively new to the group and is used to treat cases of C. diff (Clostridioides difficile). This is a superinfection of the GI system that causes profuse diarrhea.

5. Select all the statements that are true about how Macrolides work to treat a bacterial infection:

A. “Macrolides are known to be bacteriostatic.”

B. “Macrolides inhibit folic acid synthesis.”

C. “Macrolides target subunit 50S on the ribosome.”

D. “Macrolides affect the creation of proteins by the bacteria.” 

The answers are A, C, and D. Macrolides are generally known as having bacteriostatic properties, meaning they inhibit the growth/reproduction of the bacteria. To do this, they affect the bacteria’s creation of proteins (hence inhibit protein synthesis) by targeting the larger subunit of the ribosome known as 50S. Due to this, they affect translocation of messenger RNA and transfer RNA, which inhibits protein synthesis.

6. Your patient is prescribed to take Erythromycin for treatment of a respiratory infection. On the ECG monitor you see that the patient develops the rhythm above. What other medication, if taken by the patient while prescribed Erythromycin, could lead to this type of abnormal rhythm?

A. Lisinopril

B. Amiodarone

C. Cyanocobalamin

D. Levothyroxine

The answer is B: Amiodarone. The rhythm above is known as Torsades de Pointes (which is deadly) and most commonly occurs due to a medication that can prolong the QT interval. Macrolides, such as Erythromycin, can lead to a prolonged QT interval, especially if taken with other medications that do this as well. Antiarrhythmics, like Amiodarone and Quinidine, can do this along with Quinolones (another type of antibiotic… example Moxifloxacin), Antidepressants: Doxepin, Antipsychotics: Haloperidol etc.

7. A patient is prescribed Erythromycin. Which finding can occur as an adverse side effect of this medication if the patient develops cholestatic jaundice? Select all that apply:

A. Prolonged QT interval

B. Tinnitus

C. Elevated Bilirubin

D. Decreased ALT

E. Dark colored urine

G. Yellowing of the sclera

The answers are C, E, and G. Cholestatic jaundice is a liver problem that can develop with Macrolides, especially Erythromycin. Findings of this would be elevated liver enzymes (ALT, AST, ALP, bilirubin), jaundice (yellowing or orange hue to the white of the eyes or skin), abdominal pain, fatigue, dark urine, light color stool.

8. True or False: A patient who is allergic to Penicillin should avoid taking Macrolides.

The answer is FALSE: The statement should say: “A patient who is allergic to Penicillin may be prescribed a Macrolide as a safer alternative.”

9. The nurse is educating the patient about how to take a Macrolide. Which statement verbalized by the patient requires re-education about this topic?

A. “It is best to take this medication without food.”

B. “I plan on taking it in the morning 1 hour before breakfast or 2 hours after breakfast with a glass of juice.”

C. “It’s recommended to take the medication with at least 8 ounces of water.”

D. “If I develop GI symptoms while taking this medication, I can take it with some food. “

The answer is B. GI upset can develop with this group of medications because they increase GI motility (mainly erythromycin). Educate the patient to take it with food if GI upset develops because this may help, but it’s best to take this group without food to encourage high absorption because food can interfere with absorption. Therefore, the patient can take it 1 hour before or 2 hour after meals with only water (8 oz). It’s best to avoid acidic drinks like fruit juice or milk with administration because it can alter absorption.

10. True or False: Some patients can develop reversible ototoxicity was taking a Macrolide.

The answer is TRUE. While some patients could develop hearing loss, dizziness, full feeling in the ears, and tinnitus, this tends to be reversible.

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