CHAPTER 23 (3)

Question 1

Factors that place a patient at risk of developing an antimicrobial-resistant organism include:

Answer 1

Inappropriate use of antimicrobials

Question 2

Infants and young children are at higher risk of developing antibiotic-resistant infections due to:

Answer 2

The fact that children this age are more likely to be in daycare and exposed to pathogens from other children

Question 3

Providers should use an antibiogram when prescribing. An antibiogram is:

Answer 3

A chart of the local resistance patterns to antibiotics developed by laboratories

Question 4

There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins because:

Answer 4

Both drug classes contain a beta-lactam ring that is vulnerable to
beta-lactamase-producing organisms.

Question 5

Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the
last time he had penicillin he developed a red, blotchy rash. An appropriate antibiotic to prescribe would be:

Answer 5

Azithromycin

Question 6

Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her?

Answer 6

Amoxicillin (Trimox)

Question 7

Pong-tai is a 12-month-old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to:

Answer 7

Advise the parents that some diarrhea is normal with amoxicillin and recommend probiotics daily.

Question 8

Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate antibiotic to prescribe would be:

Answer 8

None

Question 9

Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according to current American College of Cardiology and American Heart Association guidelines is:

Answer 9

None, no antibiotic is required for dental procedures

Question 10

To prevent further development of antibacterial resistance it is recommended that fluoroquinolones be reserved for treatment of:

Answer 10

Community-acquired pneumonia in patients with comorbidities

Question 11

Fluoroquinolones have a Black Box Warning regarding even months after treatment.

Answer 11

Tendon rupture

Question 12

Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care for her:

Answer 12

Assess her for pseudomembranous colitis

Question 13

Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction?

Answer 13

Erythromycin (E-mycin)

Question 14

Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?

Answer 14

Sulfonamides

Question 15

If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to:

Answer 15

All of the above

Question 16

Tetracyclines such as minocycline are safe to use in

Answer 16

Adolescents

Question 17

Tetracyclines should not be prescribed to children younger than 8 years due to:

Answer 17

Adverse effects on bone growth

Question 18

Nicole is a 16-year-old female who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care?

Answer 18

Evaluate her for pseudotremor cerebri.

Question 19

Patricia has been prescribed doxycycline for a chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include:

Answer 19

Use a back-up method of birth control (condom) until her next menses

Question 20

To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed:

Answer 20

Pyridoxine (vitamin B6)

Question 21

Sadie is an 82-year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need an assessment of:

Answer 21

Renal function

Question 22

When prescribing acyclovir, patients should be educated regarding the:

Answer 22

Need to drink lots of fluids during treatment

Question 23

Nicholas has been diagnosed with type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include:

Answer 23

Starting oseltamivir within the first 48 hours of influenza symptoms

Question 24

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:

Answer 24

AST, ALT, alkaline phosphatase, and bilirubin

Question 25

When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:

Answer 25

Consuming alcohol in any form may cause a severe reaction.

Question 26

Every antibiotic drug class has resistant organisms that influence prescribing decisions (T/F)

Answer 26

True