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NURS 5334 - Antimicrobial Recall 5HP Questions Practice Quizzes Pearls With Complete Solutions 1st line antibiotic for patient with comorbidities [immunosuppression] who has pneumonia and can be treated as an outpatient would be Correct Answers Levofloxacin 20 year comes in with UTI. Based on symptoms and UA, diagnosed with UTI. Cultures reveal Enterococcus faecalis that is sensitive to all antibiotics usually tested for potential treatment. Which of the following is an appropriate oral option to treat the UTI Correct Answers Amoxicillin 24 year old woman returned from vacation abroad suffering from traveler's diarrhea, and her problem has not responded to antidiarrheal drugs. A pathogenic gram-negative bacillus is suspected. Which drug is most likely to be effective in the treatment of this patient Correct Answers Ciprofloxacin 55 year old man has been on anticoagulant treatment for many years and is newly diagnosed with TB. Which of the following antimycobacterial agents would MOST LIKELY induce cytochrome P450 enzymes in the patient's liver thereby modifying the effects of his anticoagulant treatment Correct Answers Rifampin A group of college students are traveling to a chloroquine- resistant malaria area for a mission trip. Which of the following medications can be used for both prevention and treatment of malaria in these students Correct Answers Atoraquone- proguanil
A patient on long term Clindamycin therapy should be warned of which side effect Correct Answers Clostridium Difficile Diarrhea All antiviral drugs used to treat HIV Correct Answers Are inducers or inhibitors of one or more CYP450 isoenzymes Altered absorption of drugs in the elderly may result in _______ drug response Correct Answers Delayed An 80 year old patient will be taking Cefdinir [Omnicef]. Before initiating therapy, the NP should order Correct Answers Creatinine clearance Antibiogram Correct Answers Chart of local resistance patterns to antibiotics developed by laboratories Antibiotics contraindicated in pregnancy Correct Answers Chloramphenicol-gray baby syndrome Erythromycin estolate- cholestatic hepatitis in mother Tetracycline- limb abnormalities, dental staining, decrease in bone growth Fluoroquinolones- abnormalities in cartilage TMP/SMX- hemolysis, increased risk of kernicterus -Dose on TMP portion of the drug in children(4mg/Kg q 12hr)
- Do NOT use in pts with G6PD Avoid as many meds as possible during lactation Antibiotics excreted hepatically Correct Answers Cefoperazone
Bactericidal Correct Answers Very Finely Proficient At Cell Murder: Vancomycin Fluoroquinolones Penicillin Aminoglycosides Cephalosporins Metronidazole Bactericidal drugs are Correct Answers are directly lethal to bacteria at achievable concentrations Bacteriostatic Correct Answers ECSTaTic Erythromycin Clindamycin Sulfamethoxazole Trimethroprim Tetracycline Chloramphenicol Brittany is a 23 year old female and culture Correct Answers Metronidazole gel 0.75%, one full applicator intravaginally once daily for 5 days Cefepime is eliminated via Correct Answers Tubular secretion and or glomerular filtration Diarrhea Correct Answers Salmonella, Shigella, Campylobacter, E. Coli, C. Diff, Bacteroides fragilis
Disadvantages of combo thearpy Correct Answers Risk of allergies Risk of superinfection Risk of drug interactions Increased cost Empiric antibiotic use Correct Answers Based on clinical presentation Covering most likely organisms Cultures obtained prior to inititation Re-evaluated upon results First generation cephalosporins are best against which organism Correct Answers Gram positive cocci Fluoroquinolones work by Correct Answers disrupting DNA replication and cell division Fourth generation cephalosporins are good to treat Correct Answers Pneumonia Gram positive organisms Correct Answers Staph, Strep, Enterococcus Other than atypicals How do penicillins and cephalosporins work Correct Answers By weaking the cell wall and promoting lysis and death How do you help prevent medication errors Correct Answers Write out the term daily
Jackson 22 has community acquired pneumonia. Mycoplasma pneumoniae is suspected. Which of the following is the best choice for treatment Correct Answers Doxycycline Jade comes in with Vaginal Candidiasis. What is the NP going to prescribe Correct Answers Fluconazole 150mg by mouth once Jake a 34 year old male has primary syphilis. What is appropriate treatment Correct Answers Benzathine penicillin G (Bicillin LA) IM Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotic should be AVOIDED in this patient Correct Answers Sulfonamides John has HIV and has just been diagnosed with TB. What is the MINIMUM amount of time he will need therapy Correct Answers 6 months John is 4 week old infant who has been diagnosed with Chlamydial pneumonia. An appropriate treatment for his pneumonia would be Correct Answers Erythromycin John is an alcoholic, Which of the following antibiotics should not be prescribed Correct Answers Cefazolin
Lauren a 22 year old female comes into the clinic and is diagnosed with Trichomoniasis. The NP can prescribe Correct Answers Metronidazole 500mg by mouth twice daily for 7 days Tinidazole 2 grams by mouth in a single dose List that identifies drugs with high likelihood of cause adverse effects in elderly Correct Answers Beers list Madeline is a 29 year old with genital herpes and would like suppressive therapy. Which of the following is the appropriate treatment Correct Answers Valacyclovir 500mg by mouth daily for 1 year Mark is a 40 year old male with bacterial prostatitis. Which of the following is the most appropriate antibiotic regimen Correct Answers Levofloxacin for 2-4 weeks Mary is a 20 year old female you have diagnosed her with strep throat. She has had an anaphylactic reaction to penicillin. Which of the following antibiotics is appropriate for Mary Correct Answers Azithromycin Max is a 70 year old diabetic with shingles. What lab test would you want to order prior to starting an antiviral Correct Answers BUN/Cr Mechanism of action of aminoglycosides Correct Answers Causes misreading of the code on the mRNA template to inhibit protein synthesis
Primary reason for the use of drug combinations in treatment of TB is to Correct Answers Delay or prevent emergence of resistance Prophylactic antibiotic use Correct Answers Surgical -clean surgery: single dose -dirty surgery: early therapy, not true prevention Antibiotics NOT indicated in uncomplicated viral URIs or uncomplicated influenza Can often be withheld in midly ill patients until cultures are available Randy is a 19 year old male and has diagnosed with chlamydia. Which of the following is the appropriate treatment Correct Answers Doxycycline 100mg PO twice daily for 7 days Sarah is a 25 year old female who is 8 weeks pregnant and has a urinary tract infection. What would be appropriate antibiotic to prescribe for her Correct Answers Amoxicillin Sinusitis Correct Answers Strep pneumoniae, M. catarrhalis, H. flu, viral Skin Correct Answers Strep and Staph The mechanism of action of the tetracyclines involves Correct Answers Inhibiting protein synthesis Third generation cephalosporins are good to treat Correct Answers Meningitis
Treating one infection interferes with treatment of the other in patients with both TB and HIV Correct Answers True Treatment for an 18 year old non pregnant female with uncomplicated cervix infection with gonorrhea and chlamydial infection has not been excluded is Correct Answers Ceftriaxone 500mg IM plus Doxycycline 100mg PO twice daily for 7 days UTI Correct Answers E. coli, proteus mirabilis, Klebsiella, staph saprophyticus (Gram +) Vancomycin works Correct Answers By inhibiting cell wall synthesis What are penicillinases Correct Answers Beta lactamases that act selectively on penicillins What do you tell the patient taking metronidazole about drinking alcohol Correct Answers Metronidazole can cause a disulfiram-like reaction if taken with alcohol Alcohol must be avoided completely during treatment and for 72 hours after treatment What is extremely resistant TB resistant to Correct Answers All fluoroquinolones, Isoniazid [INH] and rifampin, and at least one of the injectable second line drugs What is multidrug resistant TB Correct Answers Resistant to both isoniazid [INH] and Rifampin
Which information should be included when teaching about rifampin Correct Answers Rifampin can change the color of body fluids to reddish orange Which information should the nurse include when teaching a patient about INH therapy Correct Answers An adverse effect of isoniazid therapy is peripheral neuropathy, which can be reversed with pyridoxine Which is accurate about fluoroquinolones Correct Answers Fluoroquinolones have different therapeutic applications depending on the generation Which is primary method of B-lactamase resistance with streptococcus pneumoniae Correct Answers Modification of target site Which is true about ciprofloxacin Correct Answers During treatment, tendonitis and even tendon rupture may occur Which is true about fluconazole Correct Answers Primary route of excretion is renal Which macrolide is LEAST likely to cause QT prolongation Correct Answers Azithromycin Which medications create problematic interactions with other HIV antiviral drugs Correct Answers Rifampin and Rifabutin Which of the Cephalosporins are rarely used for active infections Correct Answers First generation
Which of the following antibiotics are beta-lactamase inhibitors Correct Answers Clavulanic Acid Sulbactam Tazobactam Which of the following antivirals does the CDC no longer recommend for flu due to resistance Correct Answers Amantadine Which of the following are broad spectrum penicillins (aminopenicillins) Correct Answers Amoxicillin Ampicillin Which of the following are extended-spectrum penicillins (antipseudomonal) Correct Answers Piperacillin Which of the following are penicillinase resistant penicillins Correct Answers Nafcillin Dicloxacillin Oxacillin Which of the following are side effects of aminoglycosides Correct Answers Ototoxicity and nephrotoxicity Which of the following are the most common causative organisms for UTIs Correct Answers Proteus Mirabilis Klebsiella E. Coli
Which statement about vancomycin is accurate Correct Answers Increases bacterial cell wall permeability and inhibits RNA synthesis Which statement is accurate regarding the antibacterial action of gentamicin Correct Answers Gentamicin continues to exert antibacterial effects even after plasma level decrease below detectable levels Which TB medication can cause decrease in vision Correct Answers Ethambutol Why are narrow spectrum antibiotics preferred over broad spectrum antibiotics Correct Answers Broad spectrum antibiotics do the most to facilitate emergence of resistance Why are neonates at greater risk for toxicity with highly protein- bound drugs Correct Answers Protein binding is decreased in neonates increasing the amount of free drug available Why do many medications lack pediatric dosing information in their drug labeling Correct Answers There is lack of evidence- based literature on the safe and effective use of medications in children You have an elderly patient taking warfarin. You add another protein binding drug. Which of the following statements is correct? Correct Answers You will need to decrease dose of warfarin
