Question 1

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA). What medication treatment should the provider prescribe for this patient?

Accepted Answer

Ceftaroline is effective against MRSA, unlike the other cephalosporins listed (Cefaclor, Cefazolin, and Cefotaxime), which are not effective against MRSA.

Question 2

A patient who has been taking linezolid for 6 months develops vision problems and is worried about blindness. What response will the provider give to address the patient's concern?

Accepted Answer

Linezolid can cause optic neuropathy, which may lead to vision problems, but this condition is usually reversible upon discontinuation of the drug.

Question 3

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What action will the provider take to provide effective care for this patient?

Accepted Answer

Discontinuing the cephalosporin and starting metronidazole is the appropriate action because cephalosporins can disrupt normal gut flora, leading to overgrowth of Clostridium difficile. Metronidazole or oral vancomycin are the treatments of choice for C. difficile infection.

Question 4

A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin as a child 20 years earlier. What action will the provider take when made aware of the patient's past reaction to amoxicillin?

Accepted Answer

Requesting an order for a skin test to assess the current risk of allergic reaction to penicillin is the appropriate action. Since the patient had a previous allergic reaction to amoxicillin, which is in the same beta-lactam antibiotic family as penicillin, it's important to assess the current risk of allergy before administering penicillin G.

Question 5

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 provider will order a ____-spectrum ____ agent.

Accepted Answer

The answer of A patient has a localized skin infection,...

Question 6

A child with an ear infection is not responding to treatment with amoxicillin. What alternative medication will the provider order?

Accepted Answer

Amoxicillin-clavulanic acid is often chosen as an alternative when a patient does not respond to amoxicillin alone, as the clavulanic acid component inhibits beta-lactamase enzymes produced by some bacteria, making the amoxicillin component more effective.

Question 7

An older adult patient with a history of chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5 $\degree$C. What action will the provider initially take to assure effective care for this patient?

Accepted Answer

Antibiotics can be started empirically in patients with COPD who develop bronchitis, especially if there's a suspicion of bacterial infection, while waiting for sputum culture results to tailor the antibiotic therapy more precisely.

Question 8

A patient received 500 mg of azithromycin at 0800 as a first dose. What order will the provider write for the amount and time of the second dose of azithromycin?

Accepted Answer

The standard dosing regimen for azithromycin when treating many infections starts with a higher dose on the first day, followed by lower doses on the subsequent days. The correct choice is 250 mg at 0800 the next day, as it follows the typical dosing pattern of a "loading dose" followed by smaller "maintenance doses."

Question 9

A patient with an infection caused by Pseudomonas aeruginosa is being treated with piperacillin. The nurse providing care reviews the patient's laboratory reports and notes that the patient's blood urea nitrogen and serum creatinine levels are elevated. What action will the provider take when notified of the elevated lab results?

Accepted Answer

Elevated blood urea nitrogen and serum creatinine levels indicate impaired kidney function. Reducing the dosage of piperacillin can help to mitigate the risk of further kidney damage while still treating the Pseudomonas aeruginosa infection.

Question 10

A patient diagnosed with cystic fibrosis has a Pseudomonas aeruginosa infection and the provider has ordered aztreonam. What instruction will the provider give the patient regarding the administration of this drug?

Accepted Answer

Aztreonam is administered via inhalation using a nebulizer for patients with cystic fibrosis to treat Pseudomonas aeruginosa infections.

Question 11

A patient is given a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs?

Accepted Answer

The best schedule is to administer the penicillin G every 8 hours (0800, 1600, 2400) and the gentamicin every 12 hours (1800 and 0600), ensuring that each medication is given at the correct interval without overlap in administration times, which could potentially cause confusion or errors in dosing.

Question 12

A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the provider will prescribe which antibiotic?

Accepted Answer

Erythromycin ethylsuccinate is the antibiotic of choice for treating pertussis (whooping cough) in infants, including those who have not yet received immunizations.

Question 13

A patient will be discharged home to complete treatment with intravenous cefotetan. The prescriber will include which instruction when teaching the patient about this drug treatment?

Accepted Answer

Cefotetan, a cephalosporin antibiotic, can cause a disulfiram-like reaction when combined with alcohol, leading to unpleasant symptoms such as nausea, vomiting, and palpitations. Therefore, patients are advised to abstain from alcohol consumption during therapy.

Question 14

Which side effect of clindamycin causes the provider the most concern and may warrant discontinuation of the drug?

Accepted Answer

Diarrhea caused by clindamycin can be a symptom of Clostridium difficile-associated diarrhea (CDAD), which can range from mild to life-threatening colitis. This is a significant concern and may require discontinuation of the drug.

Question 15

A patient reporting burning on urination and increased frequency has a history of frequent urinary tract infections (UTIs). The patient is going out of town in 2 days and the provider wants to treat the infection quickly. What medication will the provider order?

Accepted Answer

Fosfomycin is a single-dose antibiotic that is effective for the treatment of uncomplicated urinary tract infections (UTIs), making it a quick and convenient option for a patient who is going out of town.

Question 16

Which cephalosporin may the prescriber order to treat meningitis?

Accepted Answer

Cefotaxime is a third-generation cephalosporin that has good penetration into the cerebrospinal fluid, making it an appropriate choice for treating meningitis.

Question 17

A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What action will the provider take when notified of this medication error?

Accepted Answer

The rapid infusion of potassium penicillin G can lead to electrolyte imbalances and cardiac issues, so monitoring electrolytes and cardiac function is crucial.

Question 18

A patient who is taking doxycycline for a serious infection reports anal itching. What action will the provider take?

Accepted Answer

Doxycycline, like other antibiotics, can disrupt the normal flora of the body, leading to overgrowth of fungi. This can result in fungal infections, such as candidiasis, which can cause symptoms like anal itching. Prescribing an antifungal drug can help treat this superinfection.

Question 19

A patient develops Clostridium difficile-associated diarrhea (CDAD). Which antibiotic will the prescriber order to treat this infection?

Accepted Answer

Vancomycin is commonly used to treat Clostridium difficile-associated diarrhea (CDAD) due to its effectiveness against this specific type of bacteria.

Question 20

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. Which generation of cephalosporin will the provider order?

Accepted Answer

First-generation cephalosporins, such as cefazolin, are commonly used for preoperative prophylaxis in orthopedic surgeries due to their effectiveness against the bacteria most likely to cause surgical site infections, including Staphylococcus and Streptococcus species.

Quiz 18: Therapy of Infectious and Parasitic Diseases

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA) . What medication treatment should the provider prescribe for this patient?

A patient who has been taking linezolid for 6 months develops vision problems and is worried about blindness. What response will the provider give to address the patient's concern?

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What action will the provider take to provide effective care for this patient?

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 provider will order a -spectrum agent.

A child with an ear infection is not responding to treatment with amoxicillin. What alternative medication will the provider order?

An older adult patient with a history of chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5 $\degree$ C. What action will the provider initially take to assure effective care for this patient?

A patient received 500 mg of azithromycin at 0800 as a first dose. What order will the provider write for the amount and time of the second dose of azithromycin?

A patient diagnosed with cystic fibrosis has a Pseudomonas aeruginosa infection and the provider has ordered aztreonam. What instruction will the provider give the patient regarding the administration of this drug?

A patient is given a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs?

A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the provider will prescribe which antibiotic?

A patient will be discharged home to complete treatment with intravenous cefotetan. The prescriber will include which instruction when teaching the patient about this drug treatment?

Which side effect of clindamycin causes the provider the most concern and may warrant discontinuation of the drug?

A patient reporting burning on urination and increased frequency has a history of frequent urinary tract infections (UTIs) . The patient is going out of town in 2 days and the provider wants to treat the infection quickly. What medication will the provider order?

Which cephalosporin may the prescriber order to treat meningitis?

A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What action will the provider take when notified of this medication error?

A patient who is taking doxycycline for a serious infection reports anal itching. What action will the provider take?

A patient develops Clostridium difficile-associated diarrhea (CDAD) . Which antibiotic will the prescriber order to treat this infection?

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. Which generation of cephalosporin will the provider order?

Quiz 18: Therapy of Infectious and Parasitic Diseases

A patient has a skin infection and the culture reveals methicillin-resistant Staphylococcus aureus (MRSA) . What medication treatment should the provider prescribe for this patient?

A patient who has been taking linezolid for 6 months develops vision problems and is worried about blindness. What response will the provider give to address the patient's concern?

A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What action will the provider take to provide effective care for this patient?

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 provider will order a ____-spectrum ____ agent.

A child with an ear infection is not responding to treatment with amoxicillin. What alternative medication will the provider order?

An older adult patient with a history of chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5 °\degree° C. What action will the provider initially take to assure effective care for this patient?

A patient received 500 mg of azithromycin at 0800 as a first dose. What order will the provider write for the amount and time of the second dose of azithromycin?

A patient diagnosed with cystic fibrosis has a Pseudomonas aeruginosa infection and the provider has ordered aztreonam. What instruction will the provider give the patient regarding the administration of this drug?

A patient is given a new prescription for potassium penicillin G given intravenously (IV) every 8 hours and gentamicin given IV every 12 hours. Which is the best schedule for administering these drugs?

A 6-week-old infant who has not yet received immunizations develops a severe cough. While awaiting nasopharyngeal culture results, the provider will prescribe which antibiotic?

A patient will be discharged home to complete treatment with intravenous cefotetan. The prescriber will include which instruction when teaching the patient about this drug treatment?

Which side effect of clindamycin causes the provider the most concern and may warrant discontinuation of the drug?

A patient reporting burning on urination and increased frequency has a history of frequent urinary tract infections (UTIs) . The patient is going out of town in 2 days and the provider wants to treat the infection quickly. What medication will the provider order?

Which cephalosporin may the prescriber order to treat meningitis?

A patient is receiving intravenous potassium penicillin G, 2 million units to be administered over 1 hour. At 1900, the nurse notes that the dose hung at 1830 has infused completely. What action will the provider take when notified of this medication error?

A patient who is taking doxycycline for a serious infection reports anal itching. What action will the provider take?

A patient develops Clostridium difficile-associated diarrhea (CDAD) . Which antibiotic will the prescriber order to treat this infection?

A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. Which generation of cephalosporin will the provider order?

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 provider will order a -spectrum agent.

An older adult patient with a history of chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5 $\degree$ C. What action will the provider initially take to assure effective care for this patient?