NU 372 - Exam 1 Questions With Complete
Solutions
Actions to fight antibiotic resistant infections
Correct Answers Resistant organisms, such as
methicillin-resistant Staphylococcus aureus
(MRSA), vancomycin-resistant Staphylococcus
aureus (VRSA), and carbapenem-resistant
Enterobacteriaceae (CRE) have emerged. Antibiotic
resistant strains of C. difficile also occur (primarily
associated with the use of broad spectrum
antibiotics in a hospital setting.) The CDC lists four
core actions to fight resistant strains: (1)
Preventing infections, thereby preventing the
spread of resistance, (2) Tracking, (3) Improving
antibiotic prescribing/stewardship, and (4)
Developing new drugs and diagnostic tests.
Acute otitis media (AOM) - clinical manifestations
and complications Correct Answers Clinical
manifestations: fever (often high) and pain
(otalgia), hearing loss, bulging tympanic
membrane, perforation of tympanic membrane.
Often follows upper respiratory infection.
Complications: hearing loss, expressive speech
delay, tympanosclerosis (scarring of the tympanic
membrane).
,Acute otitis media (AOM) - general description
Correct Answers Most frequently seen in children.
Pathogens are most commonly bacterial or viral.
Acute otitis media (AOM) - treatment Correct
Answers Viral: symptom management. Bacterial:
antibiotic administration (e.g. amoxicillin, Bactrim,
azithromycin) (usually a 5-10 day course). Pain
management. May use analgesics, antihistamines,
antipyretics, etc. May apply heat to the area, which
sometimes helps with symptom relief. Treatment
may also involve myringotomy (incision in ear
drum to relieve pressure / remove fluid) or
tympanotomy (which involves a myringotomy
followed by placement of tubes to continue to drain
fluid).
Acute stage Correct Answers The acute stage is
the period during which the host experiences the
maximum impact of the infectious process
corresponding to rapid proliferation and
dissemination of the pathogen. During this phase,
toxic by-products of microbial metabolism, cell
lysis, and the immune response mounted by the
host combine to produce tissue damage and
inflammation. The symptoms of the host are
pronounced and more specific than in the
prodromal stage, usually typifying the pathogen
and sites of involvement.
,Aerobic vs nonaerobic bacteria Correct Answers
Aerobic bacteria depend on oxygen for survival,
whereas anaerobic bacteria (e.g., those bacteria
associated with gangrene) do not use oxygen.
Agent Correct Answers The microorganism that
can cause disease (i.e. bacteria, viruses, fungi,
parasites, protozoa)
Airborne precautions Correct Answers Used for
patients who have infections that spread through
the air. Place patient in a private room that has
monitored negative air pressure in relation to
surrounding areas, 6 to 12 air changes per hour,
and appropriate discharge of air outside, or
monitored filtration if air is recirculated. Keep door
closed and patient in room. Wear a respirator (N95
or >) when entering room of patient with known or
suspected tuberculosis. If patient has known or
suspected rubeola (measles) or varicella (chicken
pox), respiratory protection should be worn unless
the person entering room is immune to these
diseases. Transport patient out of room only when
necessary and place a surgical mask on the patient
if possible. Wash hands with sanitizer foam/gel or
soap/water.
Aminoglycoside antibiotics Correct Answers The
aminoglycosides are a group of powerful antibiotics
used to treat serious infections caused by Gram-
, negative aerobic bacilli. Because most of these
drugs have potentially serious adverse effects,
newer, less-toxic drugs have replaced
aminoglycosides in the treatment of less serious
infections. Aminoglycosides include amikacin
(generic), gentamicin (generic), neomycin
(generic), streptomycin (generic), and tobramycin
(Bethkis, TOBI, Tobrex Ophthalmic). The
aminoglycosides are bactericidal. They inhibit
protein synthesis in susceptible strains of Gram-
negative bacteria. They irreversibly bind to a unit
of the bacteria ribosomes, leading to misreading of
the genetic code and cell death. Many have very
serious side effects.
Antibiotic peak and trough levels Correct Answers
Antibiotic peak and trough levels are taken during
treatment of infection to ensure that the levels of
these drugs in a patient's system are in a
therapeutic range (which indicates that the drug
levels are appropriate for treatment and that the
patient is excreting the drug appropriately). If
outside of therapeutic range, antibiotics can cause
toxicity and tissue damage. Peak levels are
typically taken 1-2 hr after oral administration or
30 min after IV administration. Trough levels are
taken a few minutes before the next scheduled
dose. If a trough level is low, this indicates that the
patient is excreting the drug properly and is ready
for the next dose. If the trough level is elevated,
Solutions
Actions to fight antibiotic resistant infections
Correct Answers Resistant organisms, such as
methicillin-resistant Staphylococcus aureus
(MRSA), vancomycin-resistant Staphylococcus
aureus (VRSA), and carbapenem-resistant
Enterobacteriaceae (CRE) have emerged. Antibiotic
resistant strains of C. difficile also occur (primarily
associated with the use of broad spectrum
antibiotics in a hospital setting.) The CDC lists four
core actions to fight resistant strains: (1)
Preventing infections, thereby preventing the
spread of resistance, (2) Tracking, (3) Improving
antibiotic prescribing/stewardship, and (4)
Developing new drugs and diagnostic tests.
Acute otitis media (AOM) - clinical manifestations
and complications Correct Answers Clinical
manifestations: fever (often high) and pain
(otalgia), hearing loss, bulging tympanic
membrane, perforation of tympanic membrane.
Often follows upper respiratory infection.
Complications: hearing loss, expressive speech
delay, tympanosclerosis (scarring of the tympanic
membrane).
,Acute otitis media (AOM) - general description
Correct Answers Most frequently seen in children.
Pathogens are most commonly bacterial or viral.
Acute otitis media (AOM) - treatment Correct
Answers Viral: symptom management. Bacterial:
antibiotic administration (e.g. amoxicillin, Bactrim,
azithromycin) (usually a 5-10 day course). Pain
management. May use analgesics, antihistamines,
antipyretics, etc. May apply heat to the area, which
sometimes helps with symptom relief. Treatment
may also involve myringotomy (incision in ear
drum to relieve pressure / remove fluid) or
tympanotomy (which involves a myringotomy
followed by placement of tubes to continue to drain
fluid).
Acute stage Correct Answers The acute stage is
the period during which the host experiences the
maximum impact of the infectious process
corresponding to rapid proliferation and
dissemination of the pathogen. During this phase,
toxic by-products of microbial metabolism, cell
lysis, and the immune response mounted by the
host combine to produce tissue damage and
inflammation. The symptoms of the host are
pronounced and more specific than in the
prodromal stage, usually typifying the pathogen
and sites of involvement.
,Aerobic vs nonaerobic bacteria Correct Answers
Aerobic bacteria depend on oxygen for survival,
whereas anaerobic bacteria (e.g., those bacteria
associated with gangrene) do not use oxygen.
Agent Correct Answers The microorganism that
can cause disease (i.e. bacteria, viruses, fungi,
parasites, protozoa)
Airborne precautions Correct Answers Used for
patients who have infections that spread through
the air. Place patient in a private room that has
monitored negative air pressure in relation to
surrounding areas, 6 to 12 air changes per hour,
and appropriate discharge of air outside, or
monitored filtration if air is recirculated. Keep door
closed and patient in room. Wear a respirator (N95
or >) when entering room of patient with known or
suspected tuberculosis. If patient has known or
suspected rubeola (measles) or varicella (chicken
pox), respiratory protection should be worn unless
the person entering room is immune to these
diseases. Transport patient out of room only when
necessary and place a surgical mask on the patient
if possible. Wash hands with sanitizer foam/gel or
soap/water.
Aminoglycoside antibiotics Correct Answers The
aminoglycosides are a group of powerful antibiotics
used to treat serious infections caused by Gram-
, negative aerobic bacilli. Because most of these
drugs have potentially serious adverse effects,
newer, less-toxic drugs have replaced
aminoglycosides in the treatment of less serious
infections. Aminoglycosides include amikacin
(generic), gentamicin (generic), neomycin
(generic), streptomycin (generic), and tobramycin
(Bethkis, TOBI, Tobrex Ophthalmic). The
aminoglycosides are bactericidal. They inhibit
protein synthesis in susceptible strains of Gram-
negative bacteria. They irreversibly bind to a unit
of the bacteria ribosomes, leading to misreading of
the genetic code and cell death. Many have very
serious side effects.
Antibiotic peak and trough levels Correct Answers
Antibiotic peak and trough levels are taken during
treatment of infection to ensure that the levels of
these drugs in a patient's system are in a
therapeutic range (which indicates that the drug
levels are appropriate for treatment and that the
patient is excreting the drug appropriately). If
outside of therapeutic range, antibiotics can cause
toxicity and tissue damage. Peak levels are
typically taken 1-2 hr after oral administration or
30 min after IV administration. Trough levels are
taken a few minutes before the next scheduled
dose. If a trough level is low, this indicates that the
patient is excreting the drug properly and is ready
for the next dose. If the trough level is elevated,
