Deck 58: Treatment of Specific Infections and Miscellaneous Antibiotics

Question 1

A primary care NP sees a patient who reports a 2-week history of nasal congestion and runny nose.The NP performs a history and learns that the nasal discharge has changed from yellow to green in the past few days,accompanied by a fever of 102° F and unilateral facial pain.To treat this patient,the NP should:

A) order azithromycin daily for 5 days.
B) prescribe cefdinir twice daily for 10 days.
C) prescribe amoxicillin-clavulanate twice daily for 10 days.
D) recommend symptomatic treatment because this is probably a viral infection.

Answer 1

prescribe amoxicillin-clavulanate twice daily for 10 days.

Question 2

A primary care nurse practitioner (NP)sees a child who has several honey-colored crusted lesions around the nose and mouth.The NP notes that no other lesions are present.The NP should prescribe:

A) dicloxacillin.
B) clarithromycin.
C) mupirocin topical.
D) trimethoprim-sulfamethoxazole (TMP-SMX).

Answer 2

mupirocin topical.

Question 3

A female patient presents with grayish,odorous vaginal discharge.The primary care NP performs a gynecologic examination and notes vulvar and vaginal erythema.Testing of the discharge reveals a pH of 5.2 and a fishy odor when mixed with a solution of 10% potassium hydroxide.The NP should:

A) order topical fluconazole.
B) order metronidazole 500 mg twice daily for 7 days.
C) withhold treatment until culture results are available.
D) prescribe a clotrimazole vaginal suppository for 7 days.

Answer 3

order metronidazole 500 mg twice daily for 7 days.

Question 4

A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site.The primary care NP notes a small area of erythema but no abscess or induration.The NP should:

A) prescribe TMP-SMX.
B) prescribe topical mupirocin four times daily.
C) suggest that the patient apply warm soaks three times daily.
D) refer the patient to the surgeon for further evaluation.

Question 5

A patient has recently returned from travel in Central America and reports having seven to eight liquid stools each day with severe tenesmus.The primary care NP notes a temperature of 102° F.A stool specimen is Hemoccult positive with leukocytes present.The NP will:

A) order tests for Clostridium difficile.
B) prescribe tinidazole 2000 mg for 3 days.
C) give 750 mg of ciprofloxacin one time only.
D) order a stool culture and begin therapy with a fluoroquinolone.

Question 6

During a gynecologic examination of a sexually active adolescent girl,the primary care NP notes mucopurulent cervicitis.A culture is positive for Neisseria gonorrhoeae.The NP should:

A) give a single dose of 2 g of oral azithromycin.
B) administer benzathine penicillin G 2.4 million units intramuscularly.
C) prescribe oral doxycycline 100 mg daily for 7 days.
D) give intramuscular ceftriaxone and a single dose of 1 g of azithromycin.

Question 7

A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F.The primary care NP visualizes bilateral erythematous,nonbulging,intact tympanic membranes.The child is taking fluids well and is playing with toys in the examination room.The NP should:

A) prescribe azithromycin once daily for 5 days.
B) prescribe amoxicillin twice daily for 10 days.
C) prescribe amoxicillin-clavulanate twice daily for 10 days.
D) initiate antibiotic therapy if the child's condition worsens.

Question 8

A patient has confirmed Rocky Mountain spotted fever,and the infectious disease specialist is treating the patient with doxycycline 100 mg orally for 7 days.The patient comes to the clinic for follow-up care with the primary care NP at the end of therapy and reports continued fever,headache,and myalgia.The NP will consult with the infectious disease specialist and order:

A) 7 more days of doxycycline.
B) erythromycin 250 mg four times daily for 7 days.
C) amoxicillin 500 mg three times daily for 10 to 14 days.
D) hospital admission for intravenous chloramphenicol.

Question 9

A woman has a urinary tract infection (UTI)and has been taking TMP-SMX for 3 days along with increased fluids.She reports continued dysuria and urinary frequency and has a consistent,low-grade fever.The primary care NP should:

A) prescribe ciprofloxacin twice daily for 3 days.
B) order doxycycline twice daily for 7 to 14 days.
C) prescribe amoxicillin-clavulanate twice daily for 7 days.
D) order TMP-SMX DS twice daily for 7 days.

Question 10

A school-age child comes to the clinic with a 5-day history of cough and low-grade fever.The primary care NP auscultates crackles and diminished breath sounds bilaterally.The NP should:

A) order azithromycin.
B) prescribe doxycycline.
C) obtain a sputum culture.
D) recommend symptomatic treatment.