Question 1

Which patients should be given antibiotics prophylactically?

Accepted Answer

A)  Children who attend day care with other children who have strep throat 
B)  Children undergoing chemotherapy who have mild neutropenia 
C)  Patients with certain congenital heart defects at risk for bacterial endocarditis 
D)  Patients with compound fractures undergoing surgical repair 
E)  Postoperative patients who have undergone emergency cesarean sections 
A)  Children who attend day care with other children who have strep throat 
B)  Children undergoing chemotherapy who have mild neutropenia 
C)  Patients with certain congenital heart defects at risk for bacterial endocarditis 
D)  Patients with compound fractures undergoing surgical repair 
E)  Postoperative patients who have undergone emergency cesarean sections C, D

Question 2

A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives?

Accepted Answer

A)  Allowing patients to stop antibiotics when symptoms subside 
B)  Allowing prescribers to develop their own prescribing guidelines 
C)  Increased adherence to prescribed antibiotics 
D)  Increased use of antibiotics among parents of young children 
A)  Allowing patients to stop antibiotics when symptoms subside 
B)  Allowing prescribers to develop their own prescribing guidelines 
C)  Increased adherence to prescribed antibiotics 
D)  Increased use of antibiotics among parents of young children C

Question 3

The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such host factors include what?

Accepted Answer

A)  Age 
B)  Gender 
C)  Immune system status 
D)  Infection site 
E)  Weight 
A)  Age 
B)  Gender 
C)  Immune system status 
D)  Infection site 
E)  Weight A, C, D

Question 4

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching?

Accepted Answer

A)  "Some agents disrupt the bacterial cell wall." 
B)  "Some agents act to block the conversion of para-aminobenzoic acid (PAB
A)  to folic acid." 
C)  "Some agents cause phagocytosis of bacterial cells." 
D)  "Some agents weaken the cell wall, causing cell wall lysis." 
A)  "Some agents disrupt the bacterial cell wall." 
B)  "Some agents act to block the conversion of para-aminobenzoic acid (PAB
A)  to folic acid." 
C)  "Some agents cause phagocytosis of bacterial cells." 
D)  "Some agents weaken the cell wall, causing cell wall lysis."

Question 5

A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response?

Accepted Answer

A)  "Because strep throat is likely, your child should be treated empirically." 
B)  "With good hand washing, your child should not get strep throat." 
C)  "Your child probably has strep throat, so your provider will order an antibiotic." 
D)  "Your child should come to the clinic to have a throat culture done today." 
A)  "Because strep throat is likely, your child should be treated empirically." 
B)  "With good hand washing, your child should not get strep throat." 
C)  "Your child probably has strep throat, so your provider will order an antibiotic." 
D)  "Your child should come to the clinic to have a throat culture done today."

Question 6

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority?

Accepted Answer

A)  Administering the antibiotic immediately 
B)  Administering antipyretics as soon as possible 
C)  Delaying administration of the antibiotic until the culture results are available 
D)  Obtaining all cultures before the antibiotic is administered 
A)  Administering the antibiotic immediately 
B)  Administering antipyretics as soon as possible 
C)  Delaying administration of the antibiotic until the culture results are available 
D)  Obtaining all cultures before the antibiotic is administered

Question 7

Which are benefits of using a combination of two or more antibiotics?

Accepted Answer

A)  Reduced cost 
B)  Reduced risk of superinfection 
C)  Reduced toxicity 
D)  Reduced resistance 
E)  Reduced risk in severe infection 
A)  Reduced cost 
B)  Reduced risk of superinfection 
C)  Reduced toxicity 
D)  Reduced resistance 
E)  Reduced risk in severe infection

Question 8

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush?

Accepted Answer

A)  Antibiotic resistance 
B)  Community-acquired infection 
C)  Nosocomial infection 
D)  Superinfection 
A)  Antibiotic resistance 
B)  Community-acquired infection 
C)  Nosocomial infection 
D)  Superinfection

Question 9

A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism?

Accepted Answer

A)  Alteration of drug target molecules 
B)  Antagonist production 
C)  Drug inactivation 
D)  Reduction of drug concentration at the site of action 
A)  Alteration of drug target molecules 
B)  Antagonist production 
C)  Drug inactivation 
D)  Reduction of drug concentration at the site of action

Question 10

An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to:

Accepted Answer

A)  obtain a sputum culture and wait for the results before prescribing an antibiotic. 
B)  order empiric antibiotics while waiting for sputum culture results. 
C)  treat symptomatically, because antibiotics are usually ineffective against bronchitis. 
D)  treat the patient with more than one antibiotic without obtaining cultures. 
A)  obtain a sputum culture and wait for the results before prescribing an antibiotic. 
B)  order empiric antibiotics while waiting for sputum culture results. 
C)  treat symptomatically, because antibiotics are usually ineffective against bronchitis. 
D)  treat the patient with more than one antibiotic without obtaining cultures.

Question 11

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum ____ agent.

Accepted Answer

A)  broad; systemic 
B)  broad; topical 
C)  narrow; systemic 
D)  narrow; topical 
A)  broad; systemic 
B)  broad; topical 
C)  narrow; systemic 
D)  narrow; topical

Question 12

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct?

Accepted Answer

A)  "Antibiotics are mutagenic and can produce changes that cause resistance." 
B)  "Even normal flora can develop resistance and transfer this to pathogens." 
C)  "Host cells become resistant to antibiotics with repeated use." 
D)  "Patients who overuse antibiotics are more likely to have nosocomial infections." 
A)  "Antibiotics are mutagenic and can produce changes that cause resistance." 
B)  "Even normal flora can develop resistance and transfer this to pathogens." 
C)  "Host cells become resistant to antibiotics with repeated use." 
D)  "Patients who overuse antibiotics are more likely to have nosocomial infections."

Question 13

A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say?

Accepted Answer

A)  Conjugation results in a gradual increase in resistance. 
B)  Conjugation results in random changes in the microbe's DNA. 
C)  Spontaneous mutation leads to resistance to only one antimicrobial agent. 
D)  Spontaneous mutation can transfer DNA from one organism to another. 
A)  Conjugation results in a gradual increase in resistance. 
B)  Conjugation results in random changes in the microbe's DNA. 
C)  Spontaneous mutation leads to resistance to only one antimicrobial agent. 
D)  Spontaneous mutation can transfer DNA from one organism to another.

Exam 83: Basic Principles of Antimicrobial Therapy

Which patients should be given antibiotics prophylactically?

A recent campaign, initiated by the Centers for Disease Control (CDC), to delay the emergence of antibiotic resistance in hospitals, has what as one of its objectives?

The nurse is teaching a pharmacology refresher course to a group of nurses. A student asks what host factors affect the choice of agents in antimicrobial therapy. The nurse will tell the students that such host factors include what?

The nurse is teaching a nursing student about the mechanism by which antimicrobial agents achieve selective toxicity. Which statement by the student indicates a need for further teaching?

A parent asks a nurse if the provider will prescribe an antibiotic for a child who attends school with several children who have strep throat. The child is complaining of a sore throat and has a fever. What will be the nurse's response?

The nurse is caring for a patient on a medical-surgical unit who has a fever of unknown origin. The prescriber has ordered a broad-spectrum antibiotic. Which intervention is the priority?

Which are benefits of using a combination of two or more antibiotics?

The nurse has been caring for a patient who has been taking antibiotics for 3 weeks. Upon assessing the patient, the nurse notices the individual has developed oral thrush. What describes the etiology of the thrush?

A child has received amoxicillin [Amoxil] for three previous ear infections, but a current otitis media episode is not responding to treatment. The nurse caring for this child suspects that resistance to the bacterial agent has occurred by which microbial mechanism?

An older adult patient with chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. The nurse will expect the provider to:

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a ____-spectrum ____ agent.

A patient has a viral sinus infection, and the provider tells the patient that antibiotics will not be prescribed. The patient wants to take an antibiotic and asks the nurse what possible harm could occur by taking an antibiotic. Which response by the nurse is correct?

A nursing student asks a nurse to clarify the differences between the mechanisms of spontaneous mutation and conjugation in acquired resistance of microbes. What will the nurse say?

Orientation to Pharmacology

Application of Pharmacology in Nursing Practice

Drug Regulation, Development, Names, and Information

Pharmacokinetics

Pharmacodynamics

Drug Interactions

Adverse Drug Reactions and Medication Errors

Individual Variation in Drug Responses

Drug Therapy During Pregnancy and Breast-Feeding

Drug Therapy in Pediatric Patients

Drug Therapy in Geriatric Patients

Basic Principles of Neuropharmacology

Physiology of the Peripheral Nervous System

Muscarinic Agonists and Antagonists

Cholinesterase Inhibitors and Their Use in Myasthenia Gravis

Drugs That Block Nicotinic Cholinergic Transmission: Neuromuscular Blocking Agents

Adrenergic Agonists

Adrenergic Antagonists

Indirect-Acting Antiadrenergic Agents

Introduction to Central Nervous System Pharmacology

Drugs for Parkinson Disease

Drugs for Alzheimers Disease

Drugs for Multiple Sclerosis

Drugs for Seizure Disorders

Drugs for Muscle Spasm and Spasticity

Local Anesthetics

General Anesthetics

Opioid Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics

Pain Management in Patients With Cancer

Drugs for Headache

Antipsychotic Agents and Their Use in Schizophrenia

Antidepressants

Drugs for Bipolar Disorder

Sedative-Hypnotic Drugs

Management of Anxiety Disorders

Central Nervous System Stimulants and Attention-Deficithyperactivity Disorder

Drug Abuse I: Basic Considerations

Drug Abuse II: Alcohol

Drug Abuse III: Nicotine and Smoking

Drug Abuse IV: Major Drugs of Abuse Other Than Alcohol and Nicotine

Diuretics

Agents Affecting the Volume and Ion Content of Body Fluids

Review of Hemodynamics

Drugs Acting on the Renin-Angiotensin-Aldosterone System

Calcium Channel Blockers

Vasodilators

Drugs for Hypertension

Drugs for Heart Failure

Antidysrhythmic Drugs

Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels

Drugs for Angina Pectoris

Anticoagulant, Antiplatelet, and Thrombolytic Drugs

Management of St-Elevation Myocardial Infarction

Drugs for Hemophilia

Drugs for Deficiency Anemias

Hematopoietic Agents

Drugs for Diabetes Mellitus

Drugs for Thyroid Disorders

Drugs Related to Hypothalamic and Pituitary Function

Drugs for Disorders of the Adrenal Cortex

Estrogens and Progestins: Basic Pharmacology and Noncontraceptive Applications

Birth Control

Drug Therapy of Infertility

Drugs That Affect Uterine Function

Androgens

Drugs for Erectile Dysfunction and Benign Prostatic Hyperplasia

A patient has a localized skin infection, which is most likely caused by a gram-positive cocci. Until the culture and sensitivity results are available, the nurse will expect the provider to order a -spectrum agent.