Deck 18: Therapy of Infectious and Parasitic Diseases

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?

A) Cefaclor
B) Cefazolin
C) Cefotaxime
D) Ceftaroline

Answer 1

Ceftaroline

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?

A) Reassure the patient that this is a harmless side effect of this drug.
B) Tell the patient that blindness rarely occurs with this drug.
C) Tell the patient that this symptom is reversible when the drug is discontinued.
D) Suggest the patient take tyramine supplements to minimize this effect.

Answer 2

Tell the patient that this symptom is reversible when the drug is discontinued.

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?

A) Adding an additional antibiotic to the patient's regimen
B) Discontinuing the cephalosporin and beginning metronidazole
C) Discontinuing all antibiotics and providing fluid replacement
D) Increasing the dose of the cephalosporin and providing isolation measures

Answer 3

Discontinuing the cephalosporin and beginning metronidazole

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?

A) Order a cephalosporin.
B) Reassure the patient that allergic responses diminish over time.
C) Request an order for a skin test to assess the current risk.
D) Order a desensitization schedule to be used to administer the drug safely.

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.

A) broad; systemic
B) broad; topical
C) narrow; systemic
D) narrow; topical

Question 6

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

A) Amoxicillin-clavulanic acid
B) Ampicillin
C) Nafcillin
D) Penicillin G

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?

A) Order a sputum culture and prescribe an antibiotic based on the results.
B) Order an empiric antibiotic while waiting for sputum culture results.
C) Treat symptomatically, because antibiotics are usually ineffective against bronchitis.
D) Treat the patient with more than one antibiotic without obtaining cultures.

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?

A) 250 mg at 2000 the same day
B) 500 mg at 2000 the same day
C) 250 mg at 0800 the next day
D) 500 mg at 0800 the next day

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?

A) Prescribes an aminoglycoside
B) Discontinues the piperacillin and orders penicillin G
C) Reduces the dosage of piperacillin
D) Discontinues the piperacillin and prescribes nafcillin

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?

A) Take one pill twice daily.
B) Take a daily dose for 28 days.
C) Inhale the powdered drug as ordered three times each day.
D) Use the nebulizer to administer the drug three times daily.

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?

A) Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1800 and 0600.
B) Give the penicillin at 0800, 1600, and 2400; give the gentamicin [Garamycin] at 1200 and 2400.
C) Give the penicillin at 0600, 1400, and 2200; give the gentamicin [Garamycin] at 0600 and 1800.
D) Give the penicillin every 8 hours; give the gentamicin [Garamycin] simultaneously with two of the penicillin doses.

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?

A) Clindamycin
B) Doxycycline
C) Erythromycin ethylsuccinate
D) Penicillin G

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?

A) Abstain from alcohol consumption during therapy.
B) Avoid dairy products while taking this drug.
C) Take an antihistamine if a rash occurs.
D) Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.

Question 14

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

A) Diarrhea
B) Headache
C) Nausea
D) Vomiting

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?

A) Aztreonam
B) Fosfomycin
C) Trimethoprim/sulfamethoxazole
D) Vancomycin

Question 16

Which cephalosporin may the prescriber order to treat meningitis?

A) Cefaclor
B) Cefazolin
C) Cefoxitin
D) Cefotaxime

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?

A) Order an immediate assessment of the skin at the infusion site for signs of tissue necrosis.
B) Order that the patient be closely observed for confusion and other neurotoxic effects.
C) Order a serum electrolyte test and cardiac monitoring STAT.
D) Request immediate notification of any bizarre behaviors demonstrated by the patient.

Question 18

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

A) Prescribing an antihistamine to the patient's existing drug regimen
B) Ordering liver function tests to test for hepatotoxicity
C) Prescribing an antifungal drug to treat a superinfection
D) Testing the patient for a C. difficile secondary infection

Question 19

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

A) Chloramphenicol
B) Clindamycin
C) Linezolid
D) Vancomycin

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?

A) First
B) Second
C) Third
D) Fourth

Question 21

A patient recently began receiving clindamycin to treat an infection. After 8 days of treatment, the patient reports having 10 to 15 watery stools per day. What action will the provider take to address the patient's diarrhea?

A) Increase the clindamycin dose to aggressively treat this infection.
B) Assure the patient this is known side effect of clindamycin, and suggest consuming extra fluids.
C) Discontinue the clindamycin immediately.
D) Prescribe Lomotil or a bulk laxative to minimize the diarrheal symptoms.

Question 22

A patient with a history of renal calculi has fever, flank pain, and bacteriuria. What action will the provider take?

A) Prescribe antibiotic therapy after urine culture and sensitivity results are available.
B) Order an prophylactic antibiotic for 6 weeks after the acute infection has cleared.
C) Initiate immediate treatment with a prescription for a broad-spectrum antibiotic.
D) Refer the patient for intravenous antibiotics and hospitalization.

Question 23

The provider is reviewing the culture results of a patient receiving an aminoglycoside. The report reveals an anaerobic organism as the cause of infection. What action will the provider take?

A) Discuss an increased risk of aminoglycoside toxicity with the patient.
B) Continue the aminoglycoside as ordered.
C) Prescribe a different class of antibiotic.
D) Add a penicillin to the patient's drug regimen.

Question 24

A provider has ordered intravenous gentamicin at a dose that is half the usual dose for an adult patient. What factor noted in the patient's medical history would be a likely reason for this action?

A) Antibiotic resistance
B) Interpatient variation
C) Liver disease
D) Renal disease

Question 25

A patient who takes an ACE inhibitor and an angiotensin receptor blocker (ARB) medication will begin taking TMP/SMZ to treat a urinary tract infection. Which serum electrolyte will the provider monitor closely?

A) Calcium
B) Chloride
C) Potassium
D) Sodium

Question 26

A patient who has been receiving intravenous gentamicin for several days reports having had a headache for 2 days. What action will the provider take?

A) Discontinue the gentamicin.
B) Order a gentamicin trough before the next dose is given.
C) Prescribe an analgesic to control headache discomfort.
D) Order renal function tests to evaluate for potential nephrotoxicity.

Question 27

A patient shows signs and symptoms of conjunctivitis. Which aminoglycoside will the provider order?

A) Amikacin
B) Kanamycin
C) Neomycin
D) Paromomycin

Question 28

A 20-year-old female patient presents with suprapubic discomfort, pyuria, dysuria, and bacteriuria greater than 100,000/mL of urine. Which are the most likely diagnosis and treatment?

A) Uncomplicated lower urinary tract infection treatable with short-course therapy
B) Complicated lower urinary tract infection treatable with single-dose therapy
C) Uncomplicated upper urinary tract infection requiring 14 days of oral antibiotics
D) Complicated upper urinary tract infection requiring parenteral antibiotics

Question 29

A patient is to begin taking doxycycline to treat a rickettsial infection. Which statement by the patient indicates a need for further teaching by the provider about this drug?

A) "I should consult my provider before using laxatives or antacids while taking this drug."
B) "I should not take a calcium supplement or consume dairy products with this drug."
C) "I should take this drug with food to ensure more complete absorption."
D) "If I get diarrhea, I should stop taking the drug and let my provider know immediately."

Question 30

A patient with a urinary tract infection is given a prescription for TMP/SMZ. When reviewing the drug with the patient, the provider learns that the patient has type 1 diabetes mellitus and consumes alcohol heavily. What action will the provider take?

A) Prescribe a different antibiotic for this patient.
B) Order daily blood glucose determinations while giving TMP/SMZ.
C) Suggest that the patient take a potassium supplement while taking TMP/SMZ.
D) Suggest that the patient avoid excessive fluid intake while taking TMP/SMZ.

Question 31

Which patient diagnosed with a urinary tract infection will be hospitalization and prescribed intravenous antibiotics?

A) A 5-year-old child with a fever of 100.5 $\degree$ F, dysuria, and bacteriuria
B) A pregnant woman with bacteriuria, suprapubic pain, and fever
C) A young man with dysuria, flank pain, and a previous urinary tract infection
D) An older adult man with a low-grade fever, flank pain, and an indwelling catheter

Question 32

A patient has a positive urine culture 1 week after completion of a 3-day course of antibiotics. What action will the prescriber take?

A) Prescribe a 2-week course of antibiotics.
B) Order tests to evaluate for a structural abnormality of the urinary tract.
C) Prescribe long-term prophylaxis with low-dose antibiotics.
D) Treat the patient with intravenous antibiotics.

Question 33

A drug history from a patient about to receive sulfadiazine identifies that the patient takes warfarin, glipizide, and a thiazide diuretic. Based on this information, what action will the provider take?

A) Change the antibiotic to TMP/SMZ.
B) Increase the dose of the glipizide.
C) Order daily lab testing of the patient's electrolytes.
D) Order daily coagulation levels to be drawn.

Question 34

A patient presents to the emergency department with chills, severe flank pain, dysuria, and urinary frequency. The patient has a temperature of 102.9 $\degree$ F, a pulse of 92 beats/minute, respirations of 24 breaths/minute, and a blood pressure of 119/58 mm Hg. The provider suspects that the patient is showing signs and symptoms of what pathology?

A) Acute cystitis
B) Urinary tract infection
C) Pyelonephritis
D) Prostatitis

Question 35

An older male patient comes to the clinic with reports of chills, malaise, myalgia, localized pain, dysuria, nocturia, and urinary retention. The provider will suspect what cause for the patient's symptomology?

A) Acute cystitis
B) Urinary tract infection
C) Pyelonephritis
D) Prostatitis

Question 36

A patient will be discharged from the hospital with a prescription for TMP/SMZ. When providing teaching for this patient, the provider will discuss the importance of what action while taking this medication?

A) Drinking 8 to 10 glasses of water every day
B) Eating foods that are high in potassium
C) Taking the medication with food
D) Taking a folic acid supplement

Question 37

A pregnant female patient diagnosed with bacteriuria, suprapubic pain, urinary urgency and frequency, and a low-grade fever is allergic to sulfa, ciprofloxacin, and amoxicillin. The provider will prescribe which alternative medication to treat this patient?

A) Cephalexin
B) Fosfomycin
C) Methenamine
D) Nitrofurantoin

Question 38

A patient is receiving tobramycin three times daily. The provider has ordered a trough level with the 8:00 AM dose and will expect the level to be drawn at what time?

A) 4:00 AM
B) 7:00 AM
C) 7:45 AM
D) 8:45 AM

Question 39

A patient is diagnosed with a lung infection caused by P. aeruginosa. The culture and sensitivity report shows sensitivity to all aminoglycosides. The provider knows that the rate of resistance to gentamicin is common in this hospital. What provider will order which medication?

A) Amikacin
B) Gentamicin
C) Paromomycin
D) Tobramycin

Question 40

A young, nonpregnant female patient with a history of a previous urinary tract infection is experiencing dysuria, urinary urgency and frequency, and suprapubic pain of 3 days' duration. She is afebrile. A urine culture is positive for more than 100,000/mL of urine. The provider orders which treatment to assure the most effective treatment for this patient?

A) A 14-day course of amoxicillin with clavulanic acid
B) A 7-day course of ciprofloxacin
C) A single dose of fosfomycin
D) A 3-day course of trimethoprim/sulfamethoxazole

Question 41

A patient comes to a clinic for tuberculosis medications 2 weeks after beginning treatment with a four-drug induction phase. The patient's sputum culture remains positive, and no drug resistance is noted. At this point, the provider will take what action?

A) Change the regimen to a two-drug continuation phase.
B) Continue the four-drug regimen and recheck the sputum in 2 weeks.
C) Obtain a chest radiograph and consider adding another drug to the regimen.
D) Question the patient about adherence to the drug regimen.

Question 42

A provider has ordered oral voriconazole for a patient who has a systemic fungal infection. The nurse obtains a medication history and learns that the patient takes phenobarbital for seizures. When the nurse contacts the provider what action will the provider take?

A) Confirm the intravenous voriconazole order.
B) Reduce the dose of phenobarbital.
C) Reduce the dose of voriconazole.
D) Prescribe a different antifungal agent.

Question 43

A patient is about to begin treatment with isoniazid. When the provider learns that the patient also takes phenytoin for seizures what action will be taken?

A) Increasing the phenytoin dose
B) Reducing the isoniazid dose
C) Monitoring isoniazid levels
D) Monitoring phenytoin levels

Question 44

Before prescribing methenamine, it is important for the provider to review the patient's history for evidence of which problem?

A) Elevated blood urea nitrogen and creatinine
B) History of reactions to antibiotic agents
C) Possibility of pregnancy
D) Previous resistance to antiseptic agents

Question 45

Which condition is generally treated with oral antifungal agents?

A) Tinea capitis
B) Tinea corporis
C) Tinea cruris
D) Tinea pedis

Question 46

The nurse is preparing to administer amphotericin B intravenously. The provider will pretreat the patient with which medications?

A) Acetaminophen and diphenhydramine
B) Aspirin and diphenhydramine
C) Ibuprofen and diphenhydramine
D) Morphine sulfate and acetaminophen

Question 47

A patient is beginning treatment for active tuberculosis (TB) in a region with little drug-resistant TB. Which treatment regimen will the provider prescribe initially?

A) Isoniazid and pyrazinamide
B) Isoniazid, pyrazinamide, and ethambutol
C) Rifampin, pyrazinamide, and ethambutol
D) Isoniazid, rifampin, pyrazinamide, and ethambutol

Question 48

A patient with HIV who takes protease inhibitors develops tuberculosis and will begin treatment. Which drug regimen will the provider prescribe for this patient?

A) Isoniazid, pyrazinamide, ethambutol + rifabutin
B) Isoniazid, pyrazinamide, ethambutol
C) Isoniazid, rifampin, pyrazinamide, ethambutol
D) Isoniazid + rifabutin

Question 49

Which patient will the provider determine should begin treatment for tuberculosis?

A) A patient with HIV and a tuberculin skin test result of a 4-mm region of induration
B) A recent immigrant from a country with a high prevalence of TB with a 10-mm region of induration
C) A patient with no known risk factors who has a job-related tuberculin skin test result of a 12-mm area of induration
D) An intravenous drug abuser with a tuberculin skin test result of a 5-mm region of induration

Question 50

A patient taking isoniazid for 4 months for latent tuberculosis reports bilateral tingling and numbness of the hands and feet, as well as feeling clumsy. What action will the provider take?

A) Discontinue the isoniazid.
B) Lower the isoniazid dose and order rifampin.
C) Order pyridoxine 100 mg per day.
D) Order another tuberculin skin test to monitor disease status.

Question 51

A patient has an invasive aspergillosis infection. Which antifungal agent will the prescriber consider the drug of choice for this infection?

A) Amphotericin B
B) Fluconazole
C) Posaconazole
D) Voriconazole

Question 52

A patient who is receiving intravenous ciprofloxacin for pneumonia develops diarrhea. A stool culture is positive for Clostridium difficile. What action will the provider take?

A) Prescribe metronidazole.
B) Increase the dose of ciprofloxacin.
C) Restrict dairy products.
D) Switch to gemifloxacin.

Question 53

A patient will begin taking an immunosuppressant medication. The provider learns that a patient about to begin immunosuppressant medication has a history of frequent candidal infections. The provider will order which drug as prophylaxis?

A) Fluconazole
B) Ketoconazole
C) Posaconazole
D) Voriconazole

Question 54

A patient is about to begin therapy with ethambutol. Before initiating treatment with this drug, the provider orders which test(s) to determine an accurate baseline?

A) Color vision and visual acuity
B) Complete blood cell (CBC) count
C) Hearing testing and a tympanogram
D) Hepatic function tests

Question 55

A provider would prescribe which antibiotic to a patient diagnosed with methicillin-resistant Staphylococcus aureus (MRSA)?

A) Daptomycin
B) Levofloxacin
C) Norfloxacin
D) Ciprofloxacin

Question 56

A nurse is preparing to administer oral ofloxacin to a patient. While taking the patient's medication history, the nurse learns that the patient takes warfarin and theophylline. Upon learning this information, what action will the provider take?

A) Reduce the dose of ofloxacin.
B) Increase the dose of ofloxacin.
C) Increase the dose of theophylline.
D) Order daily coagulation levels.

Question 57

A patient comes to the clinic and receives valacyclovir for a herpes-zoster virus. When will the provider instruct the patient to take the medication?

A) Without regard to meals
B) Without any dairy products
C) Each morning
D) On an empty stomach

Question 58

A patient who is being treated for HIV infection has a 5-mm area of induration after a routine TB skin test. The patient's chest radiograph is normal, and there are no other physical findings. The provider will prescribe which medications to begin treatment?

A) Isoniazid and rifabutin
B) Isoniazid and rifampin
C) Isoniazid and rifapentine
D) Isoniazid and pyrazinamide

Question 59

A patient who is being treated with medication for both HIV and tuberculosis but a four-drug regimen taken for 3 months has shown no improvement in symptoms. Which drug will the provider add to this patient's regimen?

A) Bedaquiline
B) Capreomycin
C) Ethionamide
D) Pyridoxine

Question 60

A patient who is taking nitrofurantoin reports experiencing several side effects. Which side effect would cause the provider the most concern and would require discontinuation of the medication?

A) Anorexia, nausea, and vomiting
B) Brown-colored urine
C) Drowsiness
D) Tingling of the fingers

Question 61

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. What action will the provider take?

A) Extend this patient's drug therapy to twice daily for 12 months.
B) Order intravenous foscarnet every 8 hours for 2 to 3 weeks.
C) Increase the acyclovir dose to 800 mg PO five times daily.
D) Order intravenous valacyclovir [Valtrex] 1 g PO twice daily for 10 days.

Question 62

A provider determines that a patient requires a prescription for a narrow spectrum antibacterial drug to treat a gram-positive cocci-related infection. What option will the provider consider? (Select all that apply.)

A) Erythromycin
B) Penicillin G
C) Tetracycline
D) Vancomycin
E) Trimethoprin

Question 63

A female patient who has hepatitis C is being treated with pegylated interferon $\alpha$ and ribavirin. It will be important for the provider to discuss what topic with the patient?

A) If she gets pregnant, she should use the inhaled form of ribavirin.
B) If she is taking oral contraceptives, she should also take a protease inhibitor.
C) She should use a hormonal contraceptive to avoid pregnancy.
D) She will need a monthly pregnancy test during her treatment.

Question 64

A young female patient is seen in a rural clinic after complaining of abdominal pain. The patient is wearing dirty clothing and is barefoot. The provider orders a complete blood count, which shows that the patient is anemic. The provider suspects that this patient has which of the following infestations?

A) Ancylostomiasis (hookworm)
B) Ascariasis (giant roundworm)
C) Enterobiasis (pinworm)
D) Trichuriasis (whipworm)

Question 65

A patient diagnosed with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What action will the provider take?

A) Order a serum calcium level.
B) Treat for a potential foscarnet overdose.
C) Order a creatinine clearance level.
D) Order IV saline to be given before the next dose.

Question 66

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The provider will order which drug?

A) Azithromycin
B) Doxycycline
C) Erythromycin ethylsuccinate
D) Sulfisoxazole

Question 67

A patient is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine. Which laboratory findings would most concern the provider?

A) Increased serum amylase and triglycerides and decreased serum calcium
B) Decreased serum amylase and serum triglycerides and increased serum calcium
C) Decreased hemoglobin and hematocrit
D) Increased serum amylase, decreased triglycerides, and increased platelets

Question 68

A patient starting therapy with efavirenz asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the prescriber provide?

A) The drug must be taken within 30 minutes after a meal.
B) The drug is best taken with a high-fat meal.
C) The drug can be taken anytime without regard to meals.
D) The drug should be taken once daily on an empty stomach.

Question 69

A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?

A) Azithromycin, 1 g PO once, and cefoxitin, 2 g IM once in the clinic
B) Ceftriaxone, 250 mg IM once, with doxycycline, 100 mg PO twice daily for 14 days as an outpatient
C) Doxycycline, 100 mg IV twice daily, and cefoxitin, 2 g IV every 6 hours in the hospital
D) Doxycycline, 100 mg PO twice daily for 14 days, and metronidazole, 500 mg PO twice daily for 14 days in the hospital

Question 70

A patient with a history of congestive heart failure and renal impairment is diagnosed with esophageal candidiasis. Which antifungal agent will the provider prescribe this patient?

A) Amphotericin B
B) Fluconazole
C) Itraconazole
D) Voriconazole

Question 71

A patient who is taking nelfinavir reports moderate to severe diarrhea. What action will the provider recommend?

A) An over-the-counter antidiarrheal drug
B) Immediate discontinuation of the nelfinavir
C) Reducing the dose of nelfinavir by half
D) Taking the nelfinavir with food to avoid side effects

Question 72

A patient diagnosed with hepatitis B begins treatment with adefovir and asks how long the drug therapy will last. What time frame will the prescriber give the patient?

A) A lifetime
B) An indefinite, prolonged period of time
C) 48 weeks
D) Until nephrotoxicity occurs

Question 73

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. Which medication will the provider prescribe?

A) Acyclovir
B) Azithromycin
C) Metronidazole
D) Tinidazole

Question 74

What medication will the provider prescribe for a patient with an Enterococcus faecium associated infection who has proven to be ampicillin resistant? (Select all that apply.)

A) Linezolid
B) Vancomycin
C) Tigecycline
D) Carbapenems

Question 75

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. Upon being notified of the test results, what action will the provider take?

A) Prescribe lovastatin.
B) Prescribe simvastatin.
C) Discuss diet modification and exercise.
D) Prescribe pancrease.

Question 76

A patient who is taking didanosine reports nausea, vomiting, and abdominal pain. What will the provider recommend to this patient?

A) "Take the drug with food to minimize these side effects."
B) "Stop taking the drug immediately and resume taking it once your symptoms subside."
C) "Take the medication in the evening to avoid experiencing these kinds of symptoms."
D) "You will need laboratory tests to determine if these are serious effects of the drug."

Question 77

A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking omeprazole for reflux disease. What instructions will the provider give the patient to maximize medication effectiveness?

A) Take the omeprazole 1 hour before the ketoconazole.
B) Take the omeprazole at least 2 hours after the ketoconazole.
C) Restrict intake of dairy products.
D) Wear sun glasses when outdoors to manage photosensitivity.

Question 78

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The provider will order which treatment regimen?

A) Azithromycin, 1 g PO once, and doxycycline, 100 mg PO twice daily for 7 days
B) Ceftriaxone, 250 mg IM once, and azithromycin, 1 g PO once
C) Ceftriaxone, 125 mg IM once
D) Doxycycline, 100 mg IV twice daily for 12 days

Question 79

A patient diagnosed with histoplasmosis is being treated with itraconazole. The provider will teach this patient to report which symptoms?

A) Gynecomastia and decreased libido
B) Headache and rash
C) Nausea, vomiting, and anorexia
D) Visual disturbances

Question 80

A patient is HIV positive and the provider is about to prescribe zidovudine. Before the medication therapy is initialed the provider will review which of the patient's latest laboratory values?

A) Ketones in the urine and blood
B) Serum immunoglobulin levels
C) Serum lactate dehydrogenase
D) Complete blood count (CBC)