A patient has an infection caused by Streptococcus pyogenes. The prescriber is
considering prescribing dicloxacillin PO.
What should the provider do? - ANSWERQuestion the need for a penicillinase-resistant
penicillin
Provider should consider prescribing another drug
A nurse practitioner is teaching a nursing student about a specific acquired immune
system.
Which statement by the student indicates a need for further teaching? - ANSWER"The
skin is a factor in specific acquired immunity"
Skin is a physical barrier that confers natural immunity
An otherwise healthy child receives a varicella virus vaccine. Three weeks later, the
parent calls to report that the child has a mild case of chickenpox and wonders how this
could happen after the vaccination.
What should the provider tell the parent? - ANSWER"A varicella-like rash can occur
after the vaccine is given"
Children who receive the varicella vaccine may sometimes develop a mild, local
varicella-like rash within a month of receiving the vaccine
A patient has a viral sinus infection, and the provider tells the patient that antibiotics will
not be prescribed. The patient wants to take an antibiotic and asks the provider what
possible harm could occur by taking an antibiotic.
Which response by the provider is correct? - ANSWER"Even normal flora can develop
resistance and transfer this resistance to pathogens"
Antibiotics make conditions favorable for the overgrowth of microbes with acquired
resistance. Normal flora, which are present at all times, can develop resistance and
transfer this resistance to pathogens if they occur. Even when pathogens are not
present, antibiotic use can promote resistance in the future
A patient has a type IV hypersensitivity (delayed-type hypersensitivity) response to an
infection.
Which two types of cells are necessary for this response? - ANSWERInfected
macrophages and CD4 helper T cells
The object of type IV hypersensitivity (delayed-type hypersensitivity) is to rid the body of
bacteria that replicate within macrophages. The macrophage activates the CD4 cell,
which in turn activates the macrophage
, What are penicillins? - ANSWERBroad spectrum bactericidal antibiotics that inhibit cell-
wall synthesis
Treat positive and negative bacteria
What are tetracyclines? - ANSWERBroad spectrum bacteriostatic abx that inhibit
bacterial protein synthesis
Treat positive and negative bacteria
What are fluoroquinolones? - ANSWERMay have bacteriostatic or bactericidal effects
depending on concentration
Inhibit DNA replication and are used to treat urinary, skin, respiratory, and pulmonary
infections
Have strong adverse effects
What are lincosamides? - ANSWERPrimarily bacteriostatic abx that act by inhibiting
protein synthesis
Staphylococcus and other serious infections
What are macrolides? - ANSWERPrimarily bacteriostatic abx that act on the protein
synthesis of gram-positive bacteria
Often used in situations when hypersensitivity to other abx prevents conventional tx and
for respiratory infections
What are sulfonamides? - ANSWERBacteriostatic abx that act on the DNA synthesis of
a wide variety of gram-positive and gram-negative bacteria
Skin infections and burns
What are glycopeptides? - ANSWERBactericidal abx, like vanco, that act on the cell-
wall synthesis of gram-POSITIVE only
Used to treat resistant forms of staphylococcus, c. diff, and other gram-positive
infections
What are amioglycosides? - ANSWERBactericidal abx that act on protein synthesis in
gram-negative bacteria
E. coli and staphylococcus in situations that contraindicate other medication