Antibiotics, Antifungals, and Antivirals Flashcards

1
Q
  1. Which term describes an invasion by pathogens that reproduce, multiply, and cause infection?

Infection
Immunization
Hypersensitivity
Anaphylaxis

A

Infection

An infection is an invasion by pathogens that reproduce, multiply, and cause disease.

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2
Q
  1. One-celled plants and animals are called:

unicells.
microorganisms.
antibodies.
mycoses.

A

microorganisms.

Microorganisms are tiny, one-celled plants and animals. They are also called microbes.

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3
Q
  1. Which term describes microbes that produce infection and disease?

Penicillinase
Bactericides
Pathogens
Leukocytes

A

Pathogens

Microbes that produce infection and disease are called pathogens.

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4
Q
  1. Which bacteria would cause an infection deep within the body, such as in a joint?

Arthrogenic bacteria
Aerobic bacteria
Anaerobic bacteria
Acidophilic bacteria

A

Anaerobic bacteria

Anaerobic bacteria can survive without oxygen and can grow deep within the body, such as in a joint.

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5
Q
  1. Which is the most important defense mechanism of the external immune system?

Mucous membranes
Tears
Stomach secretions
Skin

A

Skin

The skin is the most important defense mechanism of the external immune system.

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6
Q
  1. Which protein is (are) produced when an unfamiliar microorganism enters the body?

Antibodies
Hemoglobin
Myoglobin
Phagocytes

A

Antibodies

Antibodies are produced when unfamiliar microorganisms enter the body.

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7
Q
  1. Which term describes a way of stimulating the production of antibodies by exposing the body to weakened or killed germs?

Immunization
Infection
Isolation
Administration

A

Immunization

Immunization is a way of stimulating production of antibodies by exposing the body to weakened or killed germs.

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8
Q
  1. The process of placing a small amount of dead or weak disease germs into the body is called:

vaccination.
administration.
injection.
introduction.

A

vaccination.

Vaccination is the process of introducing an infectious agent to the body to establish resistance to an infection.

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9
Q
  1. Thin, less elastic skin, decreased secretion of stomach acid, and weakened muscular structures are all risks factors for infection in a(n):

AIDS patient.
pediatric patient.
older adult patient.
postoperative patient.

A

older adult patient.

Risk factors for infection in the older adult patient include thin, less elastic skin, decreased secretion of stomach acid, and weakened muscular structures.

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10
Q
  1. Which term means an infection that occurs in a hospital or long-term care facility?

Acquired
Nosocomial
Institutional
Staff

A

Nosocomial (you may also see hospital acquired)

Nosocomial infection refers to an infection that occurs in a hospital or long-term care facility.

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11
Q
  1. Handwashing, sterilization of equipment, and the wearing of protective clothing are all examples of:

Bactericidal techniques.
aseptic techniques.
infectant techniques.
immunization techniques.

A

aseptic techniques.

Handwashing, sterilization of equipment, and the wearing of protective clothing when caring for patients are all aseptic techniques.

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12
Q
  1. Which term indicates primary strategies that prevent infections transmitted through blood, body fluid, non-intact skin, and mucous membranes?

Isolation precautions
Infection precautions
Standard precautions
Microorganism precautions

A

Standard precautions

Standards Precautions are primary strategies to prevent infections transmitted through blood, body fluid, non-intact skin, and mucous membranes.

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13
Q
  1. Which term indicates drugs that kill microorganisms directly?

Bacteriocidal
Anticidal
Microbial
Streptocidal

A

Bacteriocidal

Bacteriocidal is a term used to describe drugs that kill microorganisms directly

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14
Q
  1. Which term indicates an altered state of reactivity in which the body reacts with an exaggerated immune response?

Hyper immunity
Hypersensitivity
Hyperreactivity
Hyper Antibiotics

A

Hypersensitivity

Hypersensitivity is an altered state of reactivity in which the body reacts with an exaggerated immune response.

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15
Q
  1. What term indicates a severe, possibly fatal systemic hypersensitivity reaction to a sensitizing agent—that is, a drug, food, or chemical?

Anabolic
Anaphylaxis
Anaerobic
Asepsis

A

Anaphylaxis

Anaphylaxis is a severe, possibly fatal systemic hypersensitivity reaction to a sensitizing agent such as a drug, food, or chemical.

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16
Q
  1. Which term describes a secondary infection that occurs while an antibiotic is destroying the first infection?

Hyperinfection
Massive infection
Superinfection
Broad infection

A

Superinfection

A superinfection is a secondary infection that occurs while the antibiotic is destroying the first infection.

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17
Q
  1. Which statement describes important information that patients must receive while on antibiotic therapy?

Stop taking the medication as soon as symptoms disappear to avoid a superinfection.
Take all of the medication to ensure that the drug does not fail.
Pathogens are usually destroyed with the first few doses; save extra doses for the future.
As soon as you are fever-free, the medication should be discontinued; the therapy has worked.

A

Take all of the medication to ensure that the drug does not fail.

Instruct patients to take all of the medication to ensure that the drug does not fail. An antimicrobial drug often fails because the dose is too small or the drug is taken for too brief a time. Never discontinue antimicrobial drugs until the patients have been fever-free and feeling well for 48 to 72 hours.

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18
Q
  1. Which antibiotic is the most effective and least toxic?

Tetracyclines
Penicillins
Macrolides
Aminoglycosides

A

Penicillins

Penicillin is the most effective antibiotic and the least toxic.

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19
Q
  1. Patients should be educated to take antibiotic doses at the prescribed time to:

avoid hypersensitivity.
increase production of antibodies.
maintain therapeutic blood levels.
decrease the likelihood of superinfections.

A

maintain therapeutic blood levels.

Instruct patients to take doses at prescribed times to maintain therapeutic blood levels.

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20
Q
  1. In patients taking penicillin, rash, fever, or chills may indicate:

a superinfection.
drug resistance.
hypersensitivity.
the presence of penicillinase.

A

hypersensitivity

Hypersensitivity may occur if an individual is having an allergic reaction. Symptoms such as rash, fever, or chills may appear.

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21
Q
  1. Which antibiotic is often prescribed for patients who are allergic to penicillin?

Tetracyclines
Aminoglycosides
Cephalosporins
Quinolones

A

Cephalosporins

Cephalosporins are often prescribed for patients who are allergic to penicillin. They are broad-spectrum, semisynthetic drugs that are chemical modifications of the penicillin structure.

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22
Q
  1. Which should be avoided because they interact with cephalosporins and produce abdominal pain, nausea, vomiting, decreased blood pressure, rapid pulse, and sweating?

Milk and dairy products
Estrogen-containing contraceptives
Alcohol or alcohol-containing medications
Antacids

A

Alcohol or alcohol-containing medications

Alcohol or alcohol-containing medications should be avoided when taking cephalosporins because they can cause abdominal pain, nausea, vomiting, decreased blood pressure, rapid pulse, and sweating.

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23
Q
  1. Which antibiotics pose a greater risk for superinfection than other microbials?

Penicillins
Cephalosporins
Tetracyclines
Aminoglycosides

A

Tetracyclines

Tetracyclines pose a greater risk for superinfection than other microbials.

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24
Q
  1. Which should be avoided by patients taking tetracycline because of a resulting decrease in the absorption of the tetracyclines?

Alcohol
Antacids
Estrogen-containing contraceptives
Full glass of water

A

Antacids

Instruct patients to avoid taking antacids, iron products, or laxatives containing aluminum, calcium, or magnesium because they decrease the absorption of the tetracycline.

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25
Q
  1. Patients should be educated to avoid direct ultraviolet light and sunlight while taking tetracyclines because they can cause a rash due to:

hypersensitivity.
photosensitivity.
solar sensitivity.
radiosensitivity.

A

photosensitivity.

Instruct patients to avoid ultraviolet light and sunlight because tetracyclines can cause a rash due to photosensitivity.

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26
Q
  1. Zithromax, Biaxin, and erythromycin are all examples of:

penicillins.
cephalosporins.
tetracyclines.
macrolides.

A

macrolides.

Zithromax, Biaxin, and erythromycin are three macrolide antibiotics.

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27
Q
  1. Which are potent Bactericidal antibiotics that are generally used to treat only serious or life-threatening conditions?

Tetracyclines
Macrolides
Aminoglycosides
Sulfonamides

A

Aminoglycosides

Aminoglycosides are potent Bactericidal antibiotics that are generally used to treat only serious or life-threatening conditions.

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28
Q
  1. Which body systems may experience toxic effects from the administration of aminoglycosides?

Respiratory; nervous; and cardiovascular
Sensory; renal; and nervous
Integumentary; reproductive; and nervous
Digestive; nervous; and musculoskeletal

A

Sensory; renal; and nervous

The sensory, renal, and nervous systems are body systems that may experience toxic effects with aminoglycoside use. The aminoglycosidess may cause ringing or buzzing in the ears indicating a hearing loss. Instruct patients to report any change in the urinary pattern or blood in the urine indicating a toxic effect on the kidney. Monitor for dizziness, numbness, tingling, or twitching indicating a vestibular or nervous system toxicity.

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29
Q
  1. Patients taking sulfonamides such as Bactrim and Septra must be educated to:

drink at least 3 quarts of fluid per day.
avoid sunlight.
use additional methods of birth control.
take the medication with orange juice to increase absorption.

A

drink at least 3 quarts of fluid per day.

Instruct patients taking Bactrim and Septra to drink at least 3 quarts of fluid a day.

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30
Q
  1. Patients taking which type of antibiotics should be educated to avoid activities that require coordination and alertness because of the possibility of central nervous system symptoms?

Penicillins
Aminoglycosides
Macrolides
Quinolones

A

Quinolones

Instruct patients taking quinolones to avoid activities that require coordination and alertness because of the possibility of central nervous system symptoms.

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31
Q
  1. Which statement correctly applies to the treatment of fungal infections?

Bacterial infections are harder to cure than fungal infections.
Antibiotics are more toxic to human cells than are antifungals.
Antifungal infections are harder to cure than bacterial infections.
Antibiotics are less effective than antifungals.

A

Antifungal infections are harder to cure than bacterial infections.

Antifungal infections are harder to treat than bacterial infections because fungal cell structure resembles the cell structure of human cells. As a result, drugs that are toxic to fungal cells may also be toxic to human cells.

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32
Q
  1. Which causes infections in warm, moist areas of the skin and the mucous membranes of the mouth and vagina?

Bacteria
Viruses
Yeast
Protozoa

A

Yeast

Yeast causes infections in warm, moist areas of the skin and the mucous membranes of the mouth and vagina. Yeast infections are caused by Candida albicans.

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33
Q
  1. Diflucan, Monistat, and Lotrimin are used to treat:

bacterial infections.
viral infections.
fungal infections.
rickettsial infections.

A

fungal infections.

Diflucan, Monistat, and Lotrimin are used to treat fungal infections.

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34
Q
  1. For an antiviral to be most effective, the drug must be given:

as soon as the patient presents with a fever.
after the culture and sensitivity identifies an effective antimicrobial.
before the disease begins.
on an empty stomach to increase absorption.

A

before the disease begins.

For an antiviral to be most effective, the drug must be given before the disease begins because a virus reaches its peak before clinical symptoms appear.

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35
Q
  1. Which forms after a vaccine is administered?

Superinfection
Resistance
Antibodies
Hypersensitivity

A

Antibodies

Antibodies form after a vaccine is administered.

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36
Q
  1. Which is a chronic infection in which there are recurrent periods of active disease followed by latent periods when the patient is asymptomatic?

Tetanus
Common cold
Herpes
Poliomyelitis

A

Herpes

Herpes is a chronic infection in which there are recurrent periods of active disease followed by latent periods when the patient is symptomatic.

37
Q
  1. Which infection is treated using “cocktail” therapy?

Pneumonia
HIV/AIDS
Herpes
Chlamydia

A

HIV/AIDS

HIV/AIDS is an infection treated with a cocktail therapy. A three-drugs-in-one therapy called Atripla combines the active ingredient of three antiretroviral drugs that have already been used for some time as part of the cocktail therapy.

38
Q
  1. Clostridium difficile is a deadly “superbug” that causes:

penicillin-resistant otitis media.
nosocomial diarrhea.
nongonococcal urethritis.
toxoplasmosis.

A

nosocomial diarrhea.

Clostridium difficile is a gram-positive, anaerobic, spore-forming bacterium that is the major cause of nosocomial diarrhea.

39
Q
  1. Which isolation procedure places the patient in a separate room with the door closed, and staff members are required to wear a protective mask only without gloves?

Respiratory
Reverse
Strict
Contact

A

Respiratory

When respiratory isolation is ordered, the patient is kept in a separate room with the door closed, and staff members wear protective masks only without gloves.

40
Q
  1. Which chemicals are used in the sterilization process because they are capable of killing bacteria?

Aseptics
Disinfectants
Soaps
Detergents

A

Disinfectants

Disinfectants are used for sterilization because they can kill bacteria.

41
Q
  1. Which microorganism receives nourishment from undigested food in the colon?

Clostridium perfringens
Escherichia coli
Streptococcus pneumoniae
Candida albicans

A

Escherichia coli

Escherichia coli is a microorganism that needs nutrition. It receives nourishment from undigested food in the colon.

42
Q
  1. Which makes the body immune to many infections?

Antigens
Antibodies
Isolation
Standard Precautions

A

Antibodies

Antibodies make the body immune to many infections.

43
Q
  1. Which is an example of a local infection?

Abscess
Chickenpox
Mumps
Measles

A

Abscess

An abscess is a local infection. Local infections are cuts or surgical wounds, or can be systemic infections and affect the whole body, as in measles.

44
Q
  1. Which is the reason that polio and yellow fever are now rare?

Immunization
Standard Precautions
Antibiotics
Isolation

A

Immunization

Immunization is the reason that polio and yellow fever are now rare. These infections killed thousands of people in the past.

45
Q
  1. Which term refers to pathogen-free techniques used when caring for patients?

Asepsis
Bactericidal
Standard Precautions
Disinfections

A

Asepsis

Asepsis refers to pathogen-free techniques used when caring for patients.

46
Q
  1. What does OSHA stand for?

Overuse of Specific Hospital Antibiotics
Obligatory Standard Healthcare Asepsis
Occupational Safety and Health Administration Organism Syndrome Hospital Acquired

A

Occupational Safety and Health Administration

OSHA stands for Occupational Safety and Health Administration.

47
Q
  1. Tiny, one-celled plants and animals, some of which are pathogenic or disease producing and others that are nonpathogenic are called microbes or _______________________.
A

microorganisms

Explanation: Microorganisms, or microbes, are tiny, one-celled plants and animals, some of which are pathogenic or disease producing and some that are nonpathogenic.

48
Q
  1. Microorganisms that produce infection and disease are labeled ________________.
A

pathogens

Explanation: Pathogens are microorganisms that produce infection and disease.

49
Q
  1. An invasion by pathogens that reproduce, multiply, and cause disease is termed a(n) _______________.
A

infection

Explanation: An infection is an invasion by pathogens that reproduce, multiply, and cause disease.

50
Q
  1. Bacteria that grow in the absence of oxygen are termed ______________.
A

anaerobic

Explanation: Anaerobic refers to bacteria that grow in the absence of oxygen.

51
Q
  1. Diseases caused by the direct or indirect spread of pathogens from one person to another are termed ______________ diseases.
A

infectious

Explanation: Infectious diseases are diseases that are caused by the direct or indirect spread of pathogens from one person to another.

52
Q
  1. The most important component of the external immune system is the __________, which forms a tough physical barrier to microorganisms.
A

skin

Explanation: The skin is the most important component of the external immune system because it forms a tough physical barrier to microorganisms.

53
Q
  1. Microorganisms can enter the body and cause infection when the skin is _____________, as when cut or burned.
A

damaged

Explanation: Microorganisms can enter the body and cause infection when the skin is damaged as when cut or burned.

54
Q
  1. Neutrophils and antibodies make up the ______________ immune system.
A

internal

Explanation: The internal immune system is made up of neutrophils and antibodies. Neutrophils surround and digest microorganisms and antibodies help destroy microorganisms as they enter the body.

55
Q
  1. When a person is able to resist damage from microorganisms, he or she is said to be _______________.
A

immune

Explanation: Immunity means being able to resist damage from microorganisms.

56
Q
  1. The body can be stimulated to produce antibodies against disease-producing microorganisms through ______________________.
A

immunization

Explanation: Immunization is a way of stimulating production of antibodies by exposing the body to weakened or killed germs.

57
Q
  1. A(n) __________________ infection is an infection that occurs in a hospital or long-term care facility.
A

nosocomial

Explanation: Nosocomial infections are infections that occur in hospitals or long-term care facilities.

58
Q
  1. Medical personnel must be trained in __________ or pathogen-free techniques to prevent the spread of infection.
A

aseptic

Explanation: Medical personnel are trained in aseptic or pathogen-free techniques of caring for patients to prevent the spread of infection.

59
Q
  1. When a patient is kept in an environment where pathogens cannot spread from patient to healthcare worker or vice versa, the patient is said to be in ___________________.
A

isolation

Explanation: Isolation refers to an environment where pathogens cannot spread from patient to health care worker or vice versa.

60
Q
  1. The primary strategies for preventing infection transmitted through blood, body fluid, non-intact skin, and mucous membranes are termed ______________________.
A

standard precautions

Explanation: Standard precautions are the primary strategies for preventing infection transmitted through blood, body fluid, non-intact skin, and mucous membranes.

61
Q
  1. Antibiotics that kill microorganisms directly are termed __________________.
A

Bactericidal

Explanation: A bactericide is an agent that kills microorganisms directly. An example is antibiotics.

62
Q
  1. A procedure used to find out which, if any, microbes are present and which antibiotic will be effective against a specific pathogen is the ________________________ test.
A

culture and sensitivity

Explanation: The culture and sensitivity test is a procedure used to find out which, if any, microbes are present and which antibiotics will be effective against a specific pathogen.

63
Q
  1. After exposure to a certain antibiotic for a particular period of time, a pathogen may no longer be sensitive to its action. The pathogen is said to have developed __________________ to the effects of a specific antibiotic.
A

resistance

Explanation: After exposure to an antibiotic for a certain time frame, a specific pathogen may no longer be sensitive to its action. It is said to have developed resistance to the specific antibiotic.

64
Q
  1. An altered state of reactivity in which the body reacts with an exaggerated immune response is termed _____________________.
A

hypersensitivity

Explanation: Hypersensitivity is an exaggerated immune response to a drug or other foreign agent.

65
Q
  1. A secondary infection that occurs while an antibiotic is destroying the first infection is termed a(n) _______________________.
A

superinfection

Explanation: A superinfection occurs while an antibiotic is destroying the first infection.

66
Q
  1. Instructions to “give between meals” mean that the drug is to be given at least 1 hour ____________ or 2 hours ____________ meals when the stomach is assumed to be empty.
A

before, after

Explanation: When the physician writes a medication to be given between meals, the drug should be given 1 hour before or 2 hours after meals, when the stomach is empty.

67
Q
  1. __________________ are a large group of antibiotics that are the most effective and least toxic of all antimicrobials.
A

Penicillins

Explanation: Penicillins are a large group of antibiotics that are the most effective and least toxic of all antimicrobials.

68
Q
  1. A person who is having difficulty breathing, swelling of the throat causing suffocation, and shock symptoms after being administered a medication is said to be in _______________.
A

anaphylaxis

Explanation: Anaphylaxis is a severe, possibly fatal systemic hypersensitivity reaction to a sensitizing agent—that is, a drug, food, or chemical.

69
Q
  1. Because penicillin decreases the effectiveness of estrogen-containing __________________, a patient should be educated to use another form of birth control while taking the drug.
A

contraceptives

Explanation: Instruct patients to use another form of birth control other than estrogen-containing contraceptives when taking penicillin. Penicillin decreases their effectiveness.

70
Q

Cephalosporins are often prescribed for patients who are ________________ to penicillin.

A

allergic

Explanation: Cephalosporins are often prescribed for patients who are allergic to penicillin. They are chemical modifications of the penicillin structure.

71
Q
  1. Patients who are taking cephalosporins should avoid ______________ because it interacts with the drug to produce abdominal pain, nausea, vomiting, decreased blood pressure, rapid pulse, and sweating.
A

alcohol

Explanation: Instruct patients taking cephalosporins to avoid alcohol because it interacts with the drug and causes abdominal pain, nausea, vomiting, decreased blood pressure, rapid pulse, and sweating.

72
Q
  1. Tetracyclines pose a greater risk of ___________________ than other microbials so patients must be monitored for symptoms of secondary infections.
A

superinfection

Explanation: Tetracyclines pose a greater risk of superinfections than other microbials so monitor patients for symptoms of secondary infections.

73
Q
  1. Patients should be educated to avoid taking antacids, iron products, and laxatives containing aluminum, calcium, or magnesium because they decrease the _____________ of tetracyclines.
A

absorption

Explanation: Patients should be educated to avoid taking antacids, iron products, and laxatives containing aluminum, calcium, or magnesium because they decrease the absorption of tetracyclines.

74
Q
  1. Patients should be educated to avoid direct ultraviolet light and sunlight when taking tetracyclines because they can cause a rash due to __________________.
A

photosensitivity

Explanation: Instruct patients to avoid direct ultraviolet light and sunlight when taking tetracyclines because they can cause a rash due to photosensitivity.

75
Q
  1. Aminoglycosides are potent Bactericidal antibiotics that are generally used to treat only serious or _________________________ infections.
A

life-threatening

Explanation: Aminoglycosides are potent bacterial antibiotics that are generally used to treat only serious or life-threatening infections.

76
Q
  1. When taking aminoglycosides, patients should be educated to report any ringing or buzzing in the ears, which may indicate a(n) _________________.
A

hearing loss

Explanation: Instruct patients taking aminoglycosides to report any ringing in the ears because it indicates toxicity and can cause hearing loss.

77
Q
  1. Patients on sulfonamides should be educated to drink 3 quarts of fluids per day to avoid the formation of crystals in the _______________, which can cause urinary complications.
A

urine

Explanation: Instruct patients taking sulfonamides to drink 3 quarts of fluid per day to avoid the formation of crystals in the urine, which can cause urinary complications.

78
Q
  1. Patients taking quinolones should be educated to immediately report dizziness, lightheadedness, blurred vision, or depression to the physician; these symptoms might indicate central nervous system ____________.
A

toxicity

Explanation: Patients taking quinolones should be instructed to report dizziness, lightheadedness, blurred vision, or depression to the physician because the symptoms might indicate central nervous system toxicity.

79
Q
  1. Oral candidiasis, also called _____________, is common in newborns and in immunocompromised patients such as those with cancer or AIDS.
A

thrush

Explanation: Oral candidiasis, also known as thrush, is common in newborns and in immunocompromised patients such as those with AIDS or cancer.

80
Q
  1. Serious infections such as rabies, tetanus, poliomyelitis, and smallpox may be prevented by a(n) _____________.
A

vaccine

Explanation: Vaccines prevent serious infections such as rabies, tetanus, poliomyelitis, and smallpox.

81
Q
  1. Clostridium difficile is a deadly “superbug” that is the major cause of nosocomial _______________.
A

diarrhea

Explanation: Clostridium difficile is a deadly “superbug” that is the major cause of nosocomial diarrhea.

82
Q

101.Meningitis, measles, mumps, and tuberculosis are diseases requiring _______________ isolation.

A

respiratory

Explanation: Respiratory isolation is ordered for meningitis, measles, mumps, and tuberculosis.

83
Q

103.It is important for patients to take prescribed antibiotics until they have ___________________ all the doses.

A

finished

Explanation: Instruct patients taking drugs to finish all doses. Antimicrobials often fail because the dose is too small or the drug is taken too briefly.

84
Q

104.Doses of antimicrobials must be scheduled around mealtimes because oral antibiotics can cause _____________________________.

A

gastric irritation

Explanation: Schedule antimicrobials around mealtimes because oral antibiotics can cause gastric irritation.

85
Q

105.Instructions to “give between meals” means that a drug is to be given at least 1 hour _____________ or 2 hours ___________ meals.

A

before; after

Explanation: Giving a drug “between meals” means the drug is to be given at least 1 hour before or 2 hours after meals.

86
Q

106.______________________ are effective against infections caused by Staphylococci, Streptococci, and E. coli.

A

Penicillins

Explanation: Penicillins are effective against infections caused by Staphylococci, Streptoccocci, and E. coli.

87
Q

107.Persons who have penicillin allergies should wear a(n) ______________________.

A

medical ID

Explanation: Individuals who have penicillin allergies should wear a medical ID to alert medic staff in case emergency treatment is needed.

88
Q

108.The most common side effects of penicillin drugs are _________________, _________________, and _______________.

A

nausea; vomiting; diarrhea

Explanation: The most common side effects of penicillin drugs are nausea, vomiting, and diarrhea.

89
Q

109.When taking penicillin, patients should be educated to notify the physician if a rash, fever, or chills occur because they may indicate a(n) _________________________.

A

allergic reaction

Explanation: Instruct patients to notify the physician if a rash, fever, or chills occur when taking penicillin because they may indicate an allergic reaction.