Overview
Which of the following types of antiinfectives treat bacterial infections?
A. antibacterial
B. antiviral
C. antibiotic
D. A and B
E. A and C
E
Many forms of antibiotics can cause allergic reactions. Which of the following would you see the highest rate of allergic reactions?
A. Penicillin
B. Vancomycin
C. Cephalosporin
D. Carbapenems
In addition to being an alternative for a penicillin allergy, what other benefit does macrolide have over penicillin?
A. longer half life
B. less adverse effects
C. treats both gram positive and gram negative infections
A. longer half life (so you have to give less doses but it stays in the body just as long)
At what point is a patient the most at risk for hypersensitivity reaction when taking Fluoroquinolones antibiotics?
A. after the first dose
B. later on toward the end of treatment
C. hypersensitivity reactions are not usually associated with this medication
A
A patient who is prescribed INH, an antituberculosis agent / antimycobacterial, cannot drink at all because they are at a huge risk for which of the following (black box warning)?
A. neurotoxicity
B. bleeding
C. hepatotoxicity
D. GI upset
C
(will see jaundice, fatigue, increased liver enzymes, appetite loss)
A patient presents symptoms of a possible respiratory infection. You collect a culture and sensitivity and send it down to lab and are waiting on the results. In the meantime, you want to get the patient started on an antibiotic to prevent the development or spread of anything the patient might have. What kind of antibiotic would you expect to see ordered?
A. broad-spectrum antibiotic
B. narrow spectrum antibiotic
C. prophylactic anti-infectives
A (antibiotic is effective against a wide variety of different microbes; can specify once testing is complete)
Cephalosporin, although it treats gram negative infections, can be used as an alternative to which other medication because of its similar structure? In other words, if a patient has an allergy to which antibiotic could you administer cephalosporin instead?
A. Vancomycin
B. Tetracyclines
C. Penicillin
D. Aminoglycosides
C. Penicillin
A patient with whooping cough is prescribed a Macrolide antibiotic due to their allergy to penicillin. Despite it being a nice alternative, what are some teaching points of this medication you would want to inform your patient about? Select all that apply (3)
A. its expensive
B. is contraindicated with anticoagulants (ex warfarin)
C. it has adverse effects such as epigastric burning and discoloration of teeth
D. need to take on an empty stomach
A B D
(Answer C are the adverse effects of tetracyclines - macrolides are N/V, abdominal cramping, diarrhea)
Fluoroquinolones are antibiotics that treat infections of the respiratory, GU, and some skin/soft tissue organisms. What type of infection is it especially used for?
A. UTI
B. laryngitis
C. cellulitis
D. pylonephritis
A. UTI
Viruses are non living and infect bacteria, plants, and animals by entering the host cell to cause infection. One thing we know about viruses as opposed to bacterial infections is:
A. they are mainly self-limiting and do not require drugs most of the time
B. they are much bigger than bacteria
C. they dont need a host cell to replicate, they can cause alot of damage on their own
A.
many are self-limiting - 7-10 days
A patient is being sent home on Flagyl, an antibiotic, for a respiratory infection he was hospitalized with. Which statement made by the patient indicates that they understand the purpose of taking the entire course of the medication?
A. "I will stop taking my antibiotic once my symptoms go away so I dont acquire resistance"
B. "I will take my medication as needed depending on the severity of my symptoms"
C. "I will take the antibiotic for the full length of therapy to decrease the chance of resistance"
D "I will stop taking the antibiotic when I see fit and notify the physician if my symptoms come back and I need a refill"
C.
(the more an antibiotic is prescribed, the larger the percent of resistant strains)
Which of the following types of medications, due to its potential for side effects, do you need to monitor the peak and trough levels of very closely?
A. Carbapenems
B. Cephalosporin
C. Vancomycin
D. Penicillin
C. Vancomycin
Aminoglycosides are bactericidal, meaning they can kill bacteria. However, they have potential to cause several serious side effects similar to Vancomycin. These side effects include:
A. hepatotoxicity and nephrotoxicity
B. Nephrotoxicity and anaphylactic reaction
C. Cardiovascular collapse or edema of tongue, pharynx, larynx
D. ototoxicity and nephrotoxicity
D
Because Fluoroquinolones treat infections of multiple body systems, they cause toxicity to many systems. One toxicity in particular is phototoxicity. Which other type of antibiotic will have the same adverse effect?
A. Flagyl
B. Tetracyclines
C. cephalosporin
B. tetracyclines
A 45 year old post op patient who had an appendectomy starts to develop a fever and other signs of infection, indicating an abscess has formed. The provider orders Flagyl, an anti-infective. When the patient recovers and is discharged, what is the main teaching point you want to tell them?
A. "You can discontinue this medication once your symptoms of infection clear"
B. "Do not double up on doses, it could cause nephrotoxicity"
C. "Avoid taking this medication with alcohol - you will see signs of severe flushing, tachycardia, and hypotension"
C.
this is a disulfiram-like reaction (disulfiram is used to help people stop drinking and causes an unpleasant reaction that reduces their desire to drink)
A patient is having severe diarrhea and presenting signs of clostridium albicans, a super infection. Based on your knowledge, you know that a super infection is which of the following? (select 3)
A. caused by broad spectrum antibiotics
B. tends to have few side effectsC. happens when an anti-infective antibiotic kills host flora
D. are most commonly found in the GI tract
A C D
Carbapenems, an antibiotic that inhibits cell wall synthesis, is a broad spectrum alternative to Penicillin. Which is the only route this medication can be administered?
A. IV
B. PO
C. Sublingual/buccal
D. nasal
A. IV
Like many antibiotics, aminoglycosides can cause resistance to the patient over the course of treatment. As the nurse administering the medication, you know that which of the following "strategies" would decrease the chance of resistance of this medication?
A. monotherapy
B. giving in one large dose rather than frequent smaller doses
C. giving it concurrently with penicillin
B.
Fluoroquinolones have a few drug/food interactions, including antacids and vitamin/mineral supplements. When teaching your patient which minerals exactly to avoid, which ones should you include? (3)
A. calcium
B. aluminum
C. magnesium
D. potassium
A, B, C
(zinc and iron too - ABC are the main ones)
these will delay the absorption of the antibiotic by 90%!
An anti-infective, Bactrim, is useful for UTI's, diarrhea, etc. You would want to give the patient plenty of fluids to prevent which of the following adverse effects?
A. urinary retention and flushing
B. Steven Johnson Syndrome and crystalluria
C. yeast infection and constipation
B.
Which of the following high risk patients would you expect to administer prophylactic antibiotics to? Select all that apply (2)
A. a 39 year old admitted to the hospital for pneumonia
B. a 50 year old receiving a liver transplant
C. a 21 year old recovering from abdominal surgery
D. a 64 year old with a healed wound from a dog bite
B and C
(A - virus; D - has to be a deep puncture wound)
You are administering Vancomycin for a patient with c diff. When teaching a patient about the abundance of side effects of Vancomycin, you tell them that it can cause flushing, hypotension, tachycardia, rash, etc. If given to quickly, what is the name of the ailment it can cause?
A. Irritable bowel syndrome
B. Red Mans syndrome
C. Hepatitis
D. Nephrotoxicity
Red Mans Syndrome - person turns red from head to toe
Because antibiotics, tetracycline in particular, has the ability to kill not only bad but also good bacteria, what are some common side effects you would expect to see with tetracycline medication? (select all that apply - 2)
A. diarrhea (c diff)
B. vaginal candidiasis (yeast infection)
C. liver toxicity
D. rash
A and B
A. achilles tendon rupture
B. unexplained joint pain
C. tendonitis of shoulder and hand
D. rheumatoid arthritis
A B C
TB, a microbacterial respiratory infection, has a more extensive treatment regimen than other infections. About how long would you tell a patient they can expect to be treated for?
A. 2 months
B. 4 months
C. 6 months
D. 12 months
C. 6 months
initial phase: 2 months of daily meds - rifampin, isoniazid, pyrazinamide, ethambutol; RIPE
continuation phase: 4 months just RI 2-3x/week