Drugs Used in Treating Bacterial, Viral, Fungal, and Protozoal Infections Quiz: Answered + Rationales 2025-26. | NURS 3310 - Hunter College - CUNY.

Drugs Used in Treating Bacterial, Viral, Fungal, and Protozoal Infections Quiz: Answered + Rationales 2025-26. Question 1. Oral ribavirin, combined with interferon, is used to treat infection of which virus? 1.Influenza A 2.HIV-1 3.Respiratory syncytial virus (RSV) 4.Hepatitis C virus (HCV) Option 1:Ribavirin is active against influenza A, but its oral form combined with interferon is not used to treat it. Option 2:Ribavirin is active against H1V-1, but its oral form combined with interferon is not used to treat it. Option 3:Ribavirin is active against RSV, but its oral form combined with interferon is not used to treat it. Option 4:Oral ribavirin plays a key role when combined with interferon for the treatment of HCV. Question 2. A 23-year-old female patient presents to the clinic with a 24-hour history of zoster outbreak. When would therapy with a nucleoside analog be initiated for greatest effect? 1.Within 3 days 2.Within 4 days 3.Within 2 days 4.Within 5 days Option 1:Therapy with nucleoside analogues should be initiated within 3 days of the outbreak of the rash in herpes zoster. Option 2:Therapy would be losing effect after 4 days following outbreak of rash. Option 3:Therapy is most effective if initiated within 48 hours of the outbreak of the rash. Option 4:Therapy would be losing effect after 5 days following outbreak of rash. Question 3. Which statement from a newly diagnosed HIV positive adult patient indicates understanding of the ART treatment regimen? 1."I will be taking medications for the rest of my life." 2."There is no advantage to starting early therapy." 3."There are few side effects from the medications." 4."There is no way to find out whether the therapy is working." Option 1:Patients initiating ART should be willing and able to commit to lifelong treatment and should understand the benefits and risks of therapy and the importance of adherence. Option 2:Initiating early therapy can help to prevent complications associated with the disease along with decreasing viral load levels. Option 3:The ART treatment regimen consists of several medications taken concurrently, each with the potential for side effects. Option 4:Monitoring of a patient's viral load will help to assess the treatment regimen. Question 4. Which treatment regimen is recommended for adult or pediatric patients who have community acquired pneumonia? 1.5 days of antibiotic therapy 2.7 days of antibiotic therapy 3.3 days of antibiotic therapy 4.10 days of antibiotic therapy Option 1:Five days of high-dose amoxicillin for pediatrics and combination antibiotic therapy choices for adults with co-morbidities is recommended. Option 2:This timeframe of antibiotic therapy is not recommended for either the adult or pediatric patient. Option 3:This timeframe of antibiotic therapy is not recommended for either the adult or pediatric patient. Option 4:This timeframe of antibiotic therapy is not recommended for either the adult or pediatric patient. Question 5. Which statement describes the third step that enables a viral pathogen to become infectious? 1.Infect a target cell within a host 2.Able to pass the host's immunity defenses 3.Ability to reproduce within the host 4.Transmission of the virus to others Option 1:This is the first step that a viral pathogen must take to become infectious. Option 2:This is the third step - evading the host's immunity defenses to become infectious. Option 3:This is the second step that a viral pathogen must take to become infectious. Option 4:This is the fourth step that a viral pathogen must take to become infectious. Question 6. The radiograph of an adult patient indicates tuberculosis (TB). Which action should the APN take to confirm the diagnosis? 1.Order pulmonary function tests (PFTs) 2.Obtain serial sputum cultures for confirmation 3.Obtain pulse oximetry reading 4.Complete Blood Count (CBC) with differential Option 1:PFTs are not indicated for confirmation of a clinical diagnosis of TB. Option 2:In patients with radiographic abnormalities consistent with TB, an effort should be made to establish a diagnosis via sputum culture. The ATS/CDC/ISDA and the Canadian guidelines recommend that three sputum specimens should be obtained 8 to 24 hours apart if pulmonary involvement is suspected (Public Health Agency of Canada, 2023b; Nahid et al, 2016). Option 3:A pulse oximetry reading will not confirm a clinical diagnosis of TB. Option 4:CBC with differential will not confirm a clinical diagnosis of TB. Question 7. Which statement is accurate about incidence of antimicrobial resistance with regard to treatment of otitis media (OM)? 1.The benefit of antibiotic therapy outweighs the disadvantages 2.Antibiotic therapy should be shortened to prevent development of resistance 3.The provider should verify whether antibiotic therapy is needed rather than dispense per protocol 4.Treatment of OM with antibiotic therapy is successful Option 1:The provider needs to decide carefully whether an antibiotic is necessary, and in the case of treatment failure, consider the possibility of resistant bacterial strains. Option 2:For antibiotic therapy to be effective, it must be completed as ordered. Option 3:The emergence of antimicrobial resistance among respiratory pathogens has caused primary care providers to reevaluate their routine use of antibiotics for all illnesses, especially OM (Hullegie et al., 2021). Option 4:There have been reported treatment failures of OM with antibiotic therapy. Question 8. Which is the purpose of anti-retroviral therapy (ART)? 1.Decrease viral load to undetectable level 2.Prevent maternal-fetal transmission 3.Prevent complications 4.Decreasing the incidence of syphilis Option 1:The purpose of ART is to stop replication of HIV and decrease viral load to an undetectable level of fewer than 50 copies/mL. Option 2:While one wants to prevent maternal-fetal transmission, the purpose of ART focuses on stopping replication of the viral and decreasing the viral load. Option 3:While one wants to prevent complications associated with HIV, the purpose of ART focuses on stopping replication of the viral and decreasing the viral load. Option 4:ART therapy is focused on HIV, not syphilis. Question 9. Which diagnostic test should the APN order to diagnose pneumonia? 1.Chest x-ray 2.Pulse oximetry 3.Incentive spirometry (IS) 4.EKG Option 1:The American Thoracic Society (ATS) and the Infectious Disease Society of America (IDSA) emphasize the need for an initial chest radiograph to evaluate for a new or progressive infiltrate because of the variability of clinical presentations (Esden, 2020). Option 2:Pulse oximetry will provide information relative to oxygen perfusion/saturation, but it does not diagnose pneumonia. Option 3:IS provides information about the patient's lung function but it does not diagnose pneumonia. Option 4:EKG provides information about the patient's heart rate and rhythm; it does not diagnose pneumonia. Question 10. Which practice setting would best serve to care for a patient in a health pandemic? 1.Hospital outpatient clinic 2.Emergency Room setting 3.Telehealth 4.Urgent care setting Option 1:For the majority of patients, illness does not require medical intervention with hospitalization, and outpatient care via remote platforms is preferred as this reduces inperson evaluation in medical settings that can further expose other patients and health-care workers to SARS-CoV-2 (Stokes, et al., 2020; NIH, 2021). Option 2:Telehealth has been used in previous pandemics to help deliver care to patients, while limiting exposure of highly transmissible illnesses. Option 3:For the majority of patients, illness does not require medical intervention with hospitalization, and outpatient care via remote platforms is preferred as this reduces in person evaluation in medical settings that can further expose other patients and health-care workers to SARS-CoV-2 (Stokes, et al., 2020; NIH, 2021). Option 4:Telehealth has been used in previous pandemics to help deliver care to patients, while limiting exposure of highly transmissible illnesses. Question 11. Which parameter is used to monitor for potential cases of tuberculosis (TB) in the clinical setting as it relates to health-care workers? 1.Administer risk assessment on a yearly basis 2.Annual PPD testing 3.Perform risk assessment at initial hire 4.Perform risk assessment only if exposed Option 1:Risk assessment is used to guide interpretation of screening, with health-care personnel deemed at increased risk of TB if they answer "yes" to (1) residence for more than 1 month in a country with a high TB rate; (2) current or planned immunosuppression, including HIV or transplant recipients; or (3) close contact with someone with infectious TB disease since last TB testing (Sosa et al, 2019). Option 2:Routine annual testing is no longer recommended, although annual TB education and information about TB exposure risks should be provided for all health-care providers (Sosa et al, 2019). Option 3:Health-care facilities with low risk of TB exposure should test at baseline and if TB exposure occurs. Option 4:Risk assessment performed on an annual basis regardless of exposure should be performed. Question 12. Which lab tests should the APN monitor for a patient who has been receiving long term treatment with a first-generation cephalosporin? 1.BUN and CrCl 2.Serum potassium level 3.Hemoglobin A1c 4.Serum sodium level Option 1:During prolonged therapy, periodic BUN and CrCl should be determined to evaluate renal function. Option 2:Unless there is a comorbidity, serum potassium levels would not need to be monitored. Option 3:Hemoglobin A1c is indicated for monitoring of glycemic control. Option 4:Unless there is a comorbidity, serum sodium levels would not need to be monitored. Question 13. The APN is reviewing a patient's history as they have been treated for a bacterial infection with antibiotic therapy with no improvement. Which finding might account for this outcome? 1.History of hypertension (HTN) controlled with ACE inhibitor 2.Patient is 48 years old 3.Recently discharged from a skilled nursing unit (SNU) 4.Allergic to penicillin (PCN) Option 1:Although the patient has HTN, it is controlled by an ACE inhibitor so it would not impact the patient's outcome. Option 2:The patient's age, by itself should not account for this outcome Option 3:The leading risk factors for having a drug-resistant pathogen include recent use of antimicrobials, multiple medical comorbidities, recent hospitalization or other skilled healthcare contact, and immunosuppression (Chow et al, 2012). Option 4:Although the patient is allergic to PCN, it would account for this outcome. Question 14. Which information should the APN provide to a patient who has been exposed to COVID but is not up to date on current vaccinations? 1.No quarantine is needed 2.Wear a mask only if symptomatic 3.Watch for symptoms for 2 weeks 4.Quarantine for 5 days Option 1:This information should be given to a patient who was exposed to SARS-CoV-2 and is up to date on vaccinations. Option 2:Patients who were exposed to SARS-CoV-2 and are not up-to date on vaccinations should receive the following instructions: Wear a well-fitting mask for 10 full days if around others (avoid going to places you are unable to wear a mask) Option 3:Patients who were exposed to SARS-CoV-2 and are not up-to date on vaccinations should receive the following instructions: • Watch for symptoms up until day 10. Option 4:Patients who were exposed to SARS-CoV-2 and are not up-to date on vaccinations should receive the following instructions: • Quarantine for 5 days. • Watch for symptoms up until day 10. • Wear a well-fitting mask for 10 full days if around others (avoid going to places you are unable to wear a mask). • Get tested, even if asymptomatic, at least 5 days after you contact someone who is COVID-19 positive. • If you develop symptoms, get tested and remain home until you have results. Question 15. Which clinical sign indicates improvement of pneumonia? 1.Heart rate trend 100 to 82 bpm 2.Temperature remains at 101 degrees Fahrenheit 3.Oxygen saturation 92% to 95% on room air 4.Blood pressure trend 100/72 to 90/60 Option 1:Improvement is defined as a reduction in fever; normalization of vital signs including heart rate, respiratory rate, and blood pressure; normalization of oxygen saturations; improvement in mentation; and normalization of appetite (Metlay et al., 2019). Option 2:Finding indicates fever with increased metabolic demand which does not indicate improvement of pneumonia. Option 3:Oxygen saturation indicates hypoxemia, requiring oxygen supplementation. This does not indicate improvement of pneumonia. Option 4:BP indicates hypotension which does not indicate improvement of pneumonia. Question 16. The 53-year-old patient just completed a 14-day course of antibiotic and developed Clostridium difficile infection (CDI). Which clinical symptom should the APN suspect to be present? 1.99.2 degrees Fahrenheit 2.Heart rate 60 bpm 3.Watery or bloody diarrhea 4.Hepatomegaly Option 1:A fever is typically associated with CDI. Option 2:A HR of 60 bpm (bradycardia) is typically not associated with CDI. Option 3:CDI may present with watery or bloody diarrhea, accompanied by severe abdominal cramps and pain, fever, and pseudomembranous colitis. Option 4:Hepatomegaly is not typically associated with CDI. Question 17. Which clinical finding should the APN monitor for in a patient who is receiving long-term treatment for HIV? 1.Appendicitis 2.Hepatitis B and C 3.Concussion 4.Hypotension Option 1:Appendicitis is not correlated with treatment for HIV. Option 2:It is important to monitor the HIV positive patient for Hepatitis B and C co-infection. Option 3:Although the HIV positive patient should be monitored for cognitive function, concussions are not correlated with treatment for HIV. Option 4:Although the HIV positive patient should be monitored for cardiovascular disease, it would be more likely to see hypertension then hypotension. Question 18. The APN is assessing a 42-year-old adult patient who has been receiving treatment for tuberculosis (TB) for 6 months. Which phase of treatment is the patient in? 1.Continuation phase 2.Intensive phase 3.Initiation phase 4.Bactericidal phase Option 1:Treatment for TB has two phases: the first phase or initiation phase (bactericidal or intensive phase), which lasts for 2 months, and the continuation phase (sterilizing phase), which lasts for 4 to 7 months (Johnston et al., 2022; Nahid et al, 2016). Option 2:Intensive phase refers to the first phase or initiation phase which lasts for 2 months. Option 3:Initiation phase refers to the first phase or intensive phase which lasts for 2 months. Option 4:Bactericidal phase refers to the first phase or intensive phase which lasts for 2 months. Question 19. An adult patient has an upper respiratory infection (URI) for 2 days and is taking OTC medications as needed but asks the APN to prescribe an antibiotic. What is the APN's response? 1."There is no need for antibiotic therapy at this time." 2."What is the name of your pharmacy?" 3."Continue with OTC medications for 2 more days, then if symptoms haven’t resolved, I will prescribe an antibiotic." 4."Do you need cough medicine?" Option 1:Antibiotics are not necessary for viral infections, and education regarding the signs and symptoms of a secondary bacterial infection needs to be provided. Option 2:Unless the patient presents with signs of a secondary bacterial infection, antibiotic therapy is not indicated for viral infections. Option 3:The patient has only been symptomatic for 2 days. Patients need to be assured that most URIs resolve in 7 to 10 days and that little can be done to shorten the course of the disease. Option 4:There is no clinical data provided to indicate that cough medicine is needed. Question 20. A 42-year-old pregnant female patient comes to the clinic with an outbreak of herpes simplex to the lips. Which medication would be most appropriate for the patient? 1.Famciclovir 2.Acyclovir 3.Famvir 4.Valganciclovir Option 1:There is inadequate human data on famciclovir to justify prescribing to a pregnant patient. Option 2:Acyclovir is preferred in pregnancy due to reported clinical research data. Option 3:There is inadequate human data on Famvir to justify prescribing to a pregnant patient. Option 4:Valganciclovir is Pregnancy Category C and is most often used in treating cytomegalovirus disease in HIV patients. Question 1. Which medication is U.S. Federal Drug Administration (FDA)- approved for pre-exposure prophylaxis (PrEP) in patients who are at high risk for contracting HIV? 1.Truvada 2.Atripla 3.Emtriva 4.Stribild Option 1:Truvada is a combination of tenofovir disoproxil fumarate and emtricitabine for PrEP in patients who have high-risk behavior. Option 2:Tenofovir disoproxil fumarate (Atripla) is one of the drugs included in PrEP. Option 3:Emtricitabine (Emtriva) is one of the drugs included in PrEP. Option 4:Stribild is not FDA-approved for PrEP in patients who are at high risk for contracting HIV. Question 2. Which action represents the hallmark of primary preventive care relative to SARS-CoV-2? 1.Short-term hospitalization 2.Current on vaccinations 3.Quarantine 4.Taking a screening test for COVID Option 1:Hospitalization would be an example of tertiary preventive care. Option 2:Vaccinations are a hallmark of primary, preventive care and are highly effective in reducing morbidity and mortality in patients who become ill with SARS-CoV-2. Option 3:Quarantine methods would be an example of tertiary preventive care. Option 4:Screening tests would be an example of secondary preventive care. Question 3. Which medications are included in the 6-month regimen to effectively treat tuberculosis? 1.Isoniazid, rifampin, pyrazinamide, and ethambutol 2.Isoniazid, rifampin, cycloserine, and ethionamide 3.Levofloxacin, moxifloxacin, pyrazinamide, and ethambutol 4.Levofloxacin, moxifloxacin, cycloserine, and ethionamide Option 1:A 6-month regimen is recommended for patients who adhere to treatment and have fully susceptible organisms. The preferred regimen for patients with newly diagnosed pulmonary tuberculosis consists of 2 months of four-drug therapy administered daily: isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB), followed by 4 months of INH and RIF daily. Option 2:Isoniazid and rifampin are included in the regimen, but cycloserine and ethionamide are second-line drugs for treating tuberculosis. Option 3:Pyrazinamide and ethambutol are included in the regimen, but levofloxacin and moxifloxacin are second-line drugs for treating tuberculosis. Option 4:Levofloxacin, moxifloxacin, cycloserine, and ethionamide are all second-line drugs for treating tuberculosis. Question 4. Which basic principle must the APN apply when treating tuberculosis (TB)? 1.Treatment regimens must contain multiple drugs. 2.Failing treatment regimens must be bolstered with the addition of a single drug at a time. 3.Treatment for tuberculosis must include three phases: bactericidal, intensive, and sterilizing. 4.Treatment must be ceased at 6 months to avoid severe adverse drug reactions. Option 1:There are three basic principles that must be applied when treating tuberculosis: (1) treatment regimens must contain multiple drugs to which the organisms are susceptible; (2) the drugs must be taken regularly; and (3) drug therapy must continue for a sufficient period of time. Option 2:A fundamental principle of managing TB patients is never to add a single drug to a failing treatment regimen. Option 3:Treatment for TB has two phases: (1) the first phase or initiation phase (bactericidal or intensive phase), which lasts for 2 months, and (2) the continuation phase (sterilizing phase), which lasts for 4 to 7 months. Option 4:There is no basic principle that treatment must be ceased at 6 months. Question 5. A 33-year-old female patient is diagnosed with vaginal candidiasis. Which medication and dosage are most appropriate for the APN to prescribe? 1.Itraconazole 100 mg as single PO dose 2.Fluconazole 150 mg as single PO dose 3.Fluconazole 100 mg as single PO dose 4.Itraconazole 150 mg as single PO dose Option 1:Itraconazole 100 mg as single PO dose is appropriate treatment for esophageal candidiasis but not vaginal candidiasis. Option 2:Fluconazole 150 mg as single PO dose is the medication and dosage. Option 3:This dose of fluconazole is too low. Option 4:Itraconazole 150 mg as single PO dose is appropriate treatment for esophageal candidiasis but not vaginal candidiasis. Question 6. Which action should the APN recommend for a 48-year-old male patient who has flu-like symptoms but has tested negative for SARS-CoV-2? 1.Prescribe antibiotic therapy 2.Perform repeat testing in a few days 3.Have the patient return to the office in 10 days for re-evaluation 4.Obtain a throat culture to rule out a Strep infection Option 1:Antibiotics are not effective against viral infections. Option 2:Note that patients who may initially test negative are encouraged to undergo repeat testing when other disease states have been ruled out and symptoms consistent with SARSCoV-2 persist (Cohen, Gebo, & Bloom, 2022). Option 3:Asking the patient to return in 10 days does not address any specific concerns or information in the delivery of care. Option 4:There is no provided clinical data to indicate that the patient has a sore throat. Question 7. Which factor has contributed to the increased incidence of antimicrobial resistance? 1.Increase in immunocompromised patients 2.Non-compliance with antibiotic therapy 3.Use of masks during the pandemic 4.Use of OTC medication to treat symptoms Option 1:Factors that contribute to antimicrobial resistance may include increases in populations of immunocompromised patients, the number and complexity of invasive medical procedures, use (appropriate or inappropriate) of antimicrobials, and survival of patients with chronic diseases. Spread of resistant organisms in the community and health-care settings can be extremely prevalent. Option 2:Non-compliance with antibiotic therapy has not led to an increased incidence of antimicrobial resistance. Option 3:Use of masks during the pandemic is not associated with an increased incidence of microbial resistance. Option 4:Use of OTC medications for symptom management has not led to an increased incidence of antimicrobial resistance. Question 8. Which serious complication is caused by tuberculosis (TB) in children younger than 5 years of age and usually occurs within 6 months of primary infection? 1.TB meningitis 2.Extrapulmonary TB 3.Hepatitis 4.Peripheral neuropathy Option 1:TB meningitis is the most serious complication of TB. It usually occurs in young children (younger than 5 years) within 6 months of primary infection. The disease has three stages: prodromal (lasts 1 week), neurological involvement, and then increasing neurological involvement resulting from increasing intracranial pressure. Option 2:Extrapulmonary TB is not commonly seen in pediatric patients. Option 3:Isoniazid has a Black Box Warning regarding the development of severe and sometimes fatal hepatitis, even after many months of treatment. The risk is age-related, with the highest incidence in persons ages 50 to 64 years. Option 4:Adult patients treated for TB are at risk for peripheral neuropathy associated with isoniazid therapy. Question 9. The APN has diagnosed S. pneumoniae in an adolescent. Which antibiotic is most appropriate for the APN to prescribe? 1.High-dose amoxicillin (90 mg/kg daily, divided into two doses) 2.Low-dose amoxicillin (45 mg/kg daily, divided into two doses) 3.High-dose azithromycin (90 mg/kg daily, divided into two doses) 4.Low-dose azithromycin (45 mg/kg daily, divided into two doses Option 1:If S. pneumoniae is the suspected organism based on the clinical picture in previously healthy, appropriately immunized infants, preschool, school-aged, and adolescent children, high-dose amoxicillin (90 mg/kg daily, divided in two doses) is the drug of choice for 7 to 10 days of outpatient treatment. Option 2:If S. pneumoniae is the suspected organism based on the clinical picture in previously healthy, appropriately immunized infants, preschool, school-aged, and adolescent children should be given a higher dose of amoxicillin. Option 3:If S. pneumoniae is the suspected organism based on the clinical picture in previously healthy, appropriately immunized infants, preschool, school-aged, and adolescent children, azithromycin is not the drug of choice. Option 4:If S. pneumoniae is the suspected organism based on the clinical picture in previously healthy, appropriately immunized infants, preschool, school-aged, and adolescent children, azithromycin is not the drug of choice. Question 10. The APN diagnosed a 54-year-old patient with onychomycosis. Which medication regimen is most appropriate for this patient? 1.Itraconazole 100 mg PO once daily with meal for 12 consecutive weeks 2.Itraconazole 200 mg PO once daily with meal for 12 consecutive weeks 3.Terbinafine 200 mg PO once daily with meal for 12 consecutive weeks 4.Terbinafine 100 mg PO once daily with meal for 12 consecutive weeks Option 1:Itraconazole 100 mg PO once daily is too low a dosage for this patient. Option 2:Itraconazole 200 mg PO once daily with meal for 12 consecutive weeks is the appropriate medication and dosage. Option 3:Terbinafine 250 mg PO once daily for 6 weeks may be prescribed for onychomycosis. Option 4:Terbinafine 250 mg PO once daily for 6 weeks may be prescribed for onychomycosis. Question 11. Based on IDSA/ATS CAP severity criteria, which finding would indicate major criteria? 1.Increased lactate levels 2.Decreased white blood cell count 3.Decreased platelets 4.Decreased blood pressure in response to fluids Option 1:Major criteria include (1) septic shock with the need for vasopressor support and (2) respiratory failure requiring mechanical ventilation. Increased lactate levels are associated with septic shock. Option 2:Minor criteria include leukopenia (white blood cell count < 4000) (Metlay et al., 2019). Option 3: Minor criteria include thrombocytopenia (platelet count < 100,000/μL) (Metlay et al., 2019). Option 4:Minor criteria hypotension requiring aggressive fluid resuscitation (Metlay et al., 2019). Question 12. An infant is diagnosed with chlamydial pneumonia. Which medication regimen adheres to the standard of treatment for this patient? 1.Clarithromycin 50 mg/kg daily for 14 days 2.Erythromycin 50 mg/kg daily for 14 days 3.Azithromycin 50 mg/kg daily for 14 days 4.Clindamycin 20 mg/kg daily for 14 days Option 1:Clarithromycin is not the recommended medication for this patient. Option 2:The standard treatment for infants with confirmed chlamydial pneumonia is erythromycin (EryPed) 50 mg/kg daily for 14 days or oral azithromycin (Zithromax) 20 mg/kg/d for 3 days. Option 3:Azithromycin can be used with infants; however, the standard treatment for infants with confirmed chlamydial pneumonia is oral azithromycin 20 mg/kg/d for 3 days. Option 4:Clindamycin is not the recommended medication for this patient. Question 13. Which medication should the APN not prescribe for a 38-year-old male athlete who runs marathons and has a skin abscess? 1.Levaquin 2.Clindamycin 3.Trimethoprim-sulfamethoxazole (TMP-SMX) 4.Doxycycline Option 1:All of the fluoroquinolones have a boxed warning regarding the risk of tendon rupture and tendonitis. It would not be advised to prescribe this medication for a long-distance runner. Option 2:Clindamycin would be an appropriate choice. Option 3:TMP-SMX would be an appropriate choice. Option 4:Doxycycline would be an appropriate choice. Question 14. Which is the difference between empirical therapy and definitive therapy? 1.Definitive therapy is based on lab testing, whereas empirical therapy is based on clinical research studies. 2.Empirical therapy is based on preliminary culture results, whereas definitive therapy is based on actual cultural results. 3.Definitive therapy is based on reported clinical symptoms of the patient, whereas empirical therapy is based on protocols. 4.Empirical therapy is based on pharmacological principles, whereas definitive therapy is based on imaging studies. Option 1:In definitive therapy, the microbial diagnosis is based on valid and reliable tests such as culture or antigen assays, and drug selection is based on laboratory and susceptibility results. In empirical testing, the microbial diagnosis and drug regimen are determined with epidemiological studies. Option 2:Definitive therapy is based on laboratory results, empirical therapy is based on epidemiological research. Option 3:Definitive therapy is based on laboratory results, not patient symptoms and empirical therapy is based on research studies. Option 4:Empirical therapy is based on research findings and definitive therapy is based on laboratory findings relative to organism identification. Question 15. The APN understands that a pregnant female who has tuberculosis can be treated with which medication regimen? 1.Isoniazid, rifampin, pyrazinamide, and ethambutol 2.Isoniazid, rifampin, cycloserine, and ethionamide 3.Levofloxacin, moxifloxacin, pyrazinamide, and ethambutol 4.Levofloxacin, moxifloxacin, cycloserine, and ethionamide Option 1:The initial treatment regimen for pregnant women is isoniazid, rifampin, and ethambutol. Pyrazinamide is used worldwide in pregnant women. Option 2:Isoniazid and rifampin are included in the regimen, but cycloserine and ethionamide are not. Option 3:Pyrazinamide and ethambutol are included in the regimen, but levofloxacin and moxifloxacin are fluoroquinolones that are contraindicated in pregnancy. Option 4:Levofloxacin, moxifloxacin, cycloserine, and ethionamide are not the treatment regimen for pregnant women with tuberculosis. Question 16. Which characteristics of the patient with HIV must be known prior to starting abacavir specifically? 1.HLA B *5701 testing 2.Pretreatment CD4+ T cell count 3.Pregnancy potential 4.Cardiovascular disease Option 1:HLA B *5701 must be completed prior to starting abacavir because if the patient has a positive test, anaphylaxis can occur if the patient takes abacavir. Option 2:The patient must complete pretreatment CD4+ T cell count if considering nevirapine. Option 3:Knowledge of pregnancy potential is not specific to abacavir. Option 4:Knowledge of comorbid conditions (e.g., cardiovascular disease, chemical dependency, liver disease, psychiatric disease, pregnancy, renal diseases, or tuberculosis) is not specific to abacavir. Question 17. Which clinical sign indicates improvement of pneumonia? 1.Heart rate trend 100 to 82 bpm 2.Temperature remains at 101 degrees Fahrenheit 3.Oxygen saturation 92% to 95% on room air 4.Blood pressure trend 100/72 to 90/60 Option 1:Improvement is defined as a reduction in fever; normalization of vital signs including heart rate, respiratory rate, and blood pressure; normalization of oxygen saturations; improvement in mentation; and normalization of appetite (Metlay et al., 2019). Option 2:Finding indicates fever with increased metabolic demand which does not indicate improvement of pneumonia. Option 3:Oxygen saturation indicates hypoxemia, requiring oxygen supplementation. This does not indicate improvement of pneumonia. Option 4:BP indicates hypotension which does not indicate improvement of pneumonia. Question 18. A 36-year-old patient is diagnosed with oral candidiasis. Which regimen of fluconazole is most appropriate for this patient? 1.Fluconazole 300 mg PO on first day, followed by 50 mg once daily for 2 weeks 2.Fluconazole 300 mg PO on first day, followed by 100 mg once daily for 2 weeks 3.Fluconazole 200 mg PO on first day, followed by 50 mg once daily for 2 weeks 4.Fluconazole 200 mg PO on first day, followed by 100 mg once daily for 2 weeks Option 1:Fluconazole 300 mg PO on first day is too high for an initial dose. Fluconazole 50 mg once daily for 2 weeks is too low of a continuing dose. Option 2:Fluconazole 300 mg PO on first day is too high for an initial dose. Option 3:Fluconazole 50 mg once daily for 2 weeks is too low of a continuing dose. Option 4:Fluconazole 200 mg PO on first day, followed by 100 mg once daily for 2 weeks is the proper medication and dosage to be prescribed with a patient with oral candidiasis. Question 19. A 24-year-old pregnant female is diagnosed with a urinary tract infection (UTI) at 32 weeks gestation. Which antibiotic would be most appropriate for this patient? 1.Levaquin 2.Cephalexin 3.Doxycycline 4.Cipro Option 1:Pregnancy contraindicates several classes of antibiotics, such as tetracyclines and fluoroquinolones. Levaquin is a fluroquinolone. Option 2:Pregnancy contraindicates several classes of antibiotics, such as tetracyclines and fluoroquinolones, so aminopenicillins may be used for gravid women, even though another agent is the drug of choice for non-pregnant patients. Option 3:Pregnancy contraindicates several classes of antibiotics, such as tetracyclines and fluoroquinolones. Doxycycline is a tetracycline. Option 4:Pregnancy contraindicates several classes of antibiotics, such as tetracyclines and fluoroquinolones. Cipro is a fluroquinolone. Question 20. An APN is prescribing oseltamivir for the onset of flu-like symptoms to a 44-year-old patient. Which dosage is appropriate for this patient? 1.75 mg PO bid for 5 days and start within 48 hours of symptoms 2.75 mg PO bid for 4 days and start within 48 hours of symptoms 3.75 mg PO bid for 3 days and start within 48 hours of symptoms 4.75 mg PO bid for 2 days and start within 48 hours of symptoms Option 1:75 mg PO bid for 5 days and start within 48 hours of symptoms is the dosage and time frame. Option 2:Four days is not the time frame. Option 3:Three days is not the time frame. Option 4:Two days is not the time frame.