NUR 521 Exam 4 Blueprint Practice Questions and Answers | 2026 Updated | 100% Correct - University of Alabama.

NUR 521 Exam 4 Blueprint Practice Questions
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and Answers | 2026 Updated | 100% Correct -
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University of Alabama.
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Exam 4 Blueprint Practice Questions
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Section 1: Basic Questions About Antifungals
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Question 1 Which of the following is an opportunistic systemic fungal infection?
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• A) Sporotrichosis
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• B) Aspergillosis
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• C) Blastomycosis
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• D) Histoplasmosis
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Answer: B Rationale: Opportunistic systemic fungal infections occur in immunocompromised
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patients and include Aspergillosis, Candidiasis, Cryptococcosis, and Mucormycosis. Non-
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opportunistic infections, such as sporotrichosis, blastomycosis, and histoplasmosis, affect healthy
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individuals.
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Question 2 What is the drug of choice (DOC) for most systemic fungal infections?
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• A) Fluconazole m8




• B) Amphotericin B
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• C) Itraconazolem8




• D) Ketoconazolem8




Answer: B Rationale: Amphotericin B is the DOC for most systemic fungal infections due to its
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broad-spectrum antifungal activity, despite its high toxicity.
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Question 3 Which antifungal is effective against both systemic and superficial fungal
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infections but has a black box warning for patients with heart failure?
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• A) Amphotericin B
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• B) Itraconazolem8




• C) Fluconazole m8




• D) Terbinafine m8




Answer: B Rationale: Itraconazole is effective for both systemic and superficial fungal
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infections but has a BBW due to its negative inotropic effects, contraindicating its use in patients
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with heart failure.
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Question 4 Which antifungal is primarily used to treat superficial fungal infections, such as
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candidiasis?
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,• A) Amphotericin B
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• B) Fluconazole
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• C) Itraconazole
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• D) Ketoconazole
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2

,Answer: B Rationale: Fluconazole is a commonly prescribed antifungal for superficial
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infections like candidiasis and cryptococcal meningitis.
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Question 5 Which organism is responsible for the majority of cases of superficial fungal
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infections?
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• A) Candida albicans
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• B) Aspergillus spp.
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• C) Cryptococcus neoformans
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• D) Mucorales spp.
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Answer: A Rationale: Candida albicans is a common cause of superficial fungal infections,
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particularly involving mucosal surfaces, skin, and nails.
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Question 6 What is the primary safety concern associated with Amphotericin B?
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• A) m8 g Hepatotoxicity
• B) m8 g Nephrotoxicity and infusion reactions g
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• C) m8 g Cardiotoxicity
• D) m8 g Ototoxicity

Answer: B Rationale: Amphotericin B has significant nephrotoxicity and infusion-related
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reactions, limiting its use to life-threatening fungal infections.
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Question 7 Which antifungal is the DOC for histoplasmosis and blastomycosis?
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• A) m8 gAmphotericin B m8 g


• B) m8 gFluconazole
• C) m8 gItraconazole
• D) m8 gKetoconazole

Answer: C Rationale: Itraconazole is the preferred agent for non-opportunistic systemic
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infections such as histoplasmosis and blastomycosis.
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Question 8 What is the recommended antifungal for cryptococcal meningitis?
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• A) m8 gAmphotericin B m8 g


• B) m8 gItraconazole
• C) m8 gFluconazole
• D) m8 gTerbinafine

Answer: C Rationale: Fluconazole is effective in treating cryptococcal meningitis,
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particularly in immunocompromised patients.
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Question 9 Which antifungal carries the highest risk for systemic toxicity and is
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reserved for life-threatening infections?
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3

, • A) m8 g Fluconazole
• B) m8 g Amphotericin B m8g


• C) m8 g Itraconazole
• D) m8 Voriconazole
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Answer: B Rationale: Amphotericin B is highly effective but carries a significant risk of
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nephrotoxicity and other adverse effects, making it reserved for severe infections.
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Question 10 What is the mechanism of action of Azole antifungals like Itraconazole and
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Fluconazole?
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• A) Inhibit DNA synthesis
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• B) Inhibit cell wall synthesis
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• C) Inhibit ergosterol synthesis in fungal cell membranes
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• D) Disrupt protein synthesis
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Answer: C Rationale: Azole antifungals inhibit the synthesis of ergosterol, a critical component
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of fungal cell membranes, disrupting fungal growth and survival.
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Section 2: Patient Scenarios
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Question 11 A 55-year-old construction worker presents with pulmonary infiltrates and
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weight loss. A biopsy confirms Histoplasma capsulatum. Which antifungal is the DOC for this
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systemic infection?
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• A) m8 g Amphotericin B m8 g


• B) m8 g Itraconazole
• C) m8 g Fluconazole
• D) m8 Ketoconazole
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Answer: B Rationale: Itraconazole is the preferred antifungal for treating systemic infections
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like histoplasmosis, offering a less toxic alternative to Amphotericin B.
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Question 12 A 65-year-old diabetic man presents with fever, cough, and hemoptysis. Imaging
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reveals lung nodules, and culture grows Aspergillus fumigatus. Which antifungal is most
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appropriate?
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• A) m8 g Fluconazole
• B) m8 g Amphotericin B m8g


• C) m8 g Itraconazole
• D) m8 Ketoconazole
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Answer: B Rationale: Amphotericin B is the DOC for systemic aspergillosis due to its
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broad-spectrum activity and efficacy in life-threatening infections.
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