NRS 2020 FINAL EXAM 2026/2027
LATEST COMPLETE 2 VERSION OAKLAND
UNIVERSITY 300 QUESTIONS CORRECTLY
ANSWERED
What are examples of a superinfection?
- C. diff
- Oral candida
- Vaginal yeast infection
What causes C. diff?
Toxin Clostridium difficile growth following antibiotic treatment
What are the s/s of C. diff?
- Fever
- Abdominal cramping
- Watery diarrhea
- Blood or mucus in stool
- > 10-15 stools/day
What is the treatment for C. diff?
- metronidazole (Flagyl)
- vancomycin (Vancocin)
What increases risk for C. diff?
Concurrent use of proton pump inhibitors
What are the different antibiotic classes?
- Sulfonamides
- Penicillins
- Cephalosporins
- Macrolides
- Fluoroquinolones (aka quinolones)
- Aminogycosides
- Tetracyclines
What are the MoAs of antibiotic therapy?
Interference w/:
- Cell wall synthesis
- Protein synthesis
- DNA replication
- Acting as a metabolite disrupt metabolic rxns inside the cell
What does bactericidal mean?
Kills bacteria
What does bacteriostatic mean?
Inhibits bacterial growth
What causes antibiotic resistance?
,- Overuse
- Inappropriate use
- Mutation, conjugation
- Food and animal industry
What are examples of bacteria that have developed antibiotic resistance?
- Methicillin-resistant S. aureus (MRSA)
- Methicillin-resistant S. epidermis (MRSE)
What is the treatment for antibiotic resistance?
vancomycin (Vancocin)
What does delaying emergence of antibiotic resistance involve?
- Vaccination
- Removal of catheters
- Targeting the pathogen
- Practice antimicrobial control
- Treat infection, not contamination or colonization
- Know when to say NO to vanco
- Stop treatment when infection is cured or unlikely
What are examples of antimicrobial misuses?
Untreatable infection
- Don't use antibiotics for fungal infections
Fever of unknown origin
- Fever doesn't ALWAYS mean infection
- Improper dosage
- Lacking organism identity
What are the principal factors in choosing an antibiotic?
- Identify organism
- Drug sensitivity
- Host factors (immune system)
What are the excluding factors in choosing an antibiotic?
- Allergy
- Penetration to site of infection/concentration
Patient variables
- Age
- Pregnancy
- Hx of allergic rxn
- Genetics
What are the nursing implications for antibiotic treatment?
- Assess s/s of infection
- Obtain Hx of allergy
- Observe for anaphylaxis
- Culture and sensitivity before first dose
- Administer around the clock as ordered
What are the s/s of anaphylaxis?
- Trouble breathing
- Hives
- Throat tightness
, - N/V
- Dizziness
- Tachycardia
- Hypotension
What should be included in patient education of antibiotic therapy?
Instruct the patient to take ATB as directed
- Finish the whole Rx, even if feeling better
- Don't share meds
Report s/s of superinfection or C. diff
- Do not treat/suppress diarrhea
Describe beta-lactam antibiotics.
Have a beta-lactam ring in their structure
Includes:
- Penicillins
- Cephalosporins
- Carbapenems
What is the MoA of penicillins?
- Bactericidal
- Weaken the cell wall, causing bacteria to take up excessive water and rupture
What does bacterial resistance to penicillins mean?
- Inability to reach target
- Inactivation of penicillins by bacterial enzymes
What are the indications for penicillins?
Prevention and treatment of infections caused by susceptible bacteria such as Gram-
positive bacteria such as:
- Streptococcus
- Enterococcus
- Staphylococcus
What are penicillinases?
Enzymes that render penicillins and other beta-lactam ATBs ineffective
What are penicillins combined with to prevent breakdown by penicillinases?
Beta-lactamase inhibitors
What are examples of beta-lactamase inhibitors?
- Clavulanic acid
- Tazobactam
- Sulbactam
What are examples of narrow-spectrum, penicillinase sensitive penicillins?
- penicillin G (Benzylpenicllin)
- procaine penicillin (Wycillin)
- benzathine penicillin (Bicillin L-A)
What are the adverse effects r/t narrow-spectrum, penicillinase sensitive
penicillins?
- Allergy
- Cross-sensitivity to cephalosporins
What are examples of narrow-spectrum, penicillinase resistant penicillins?
LATEST COMPLETE 2 VERSION OAKLAND
UNIVERSITY 300 QUESTIONS CORRECTLY
ANSWERED
What are examples of a superinfection?
- C. diff
- Oral candida
- Vaginal yeast infection
What causes C. diff?
Toxin Clostridium difficile growth following antibiotic treatment
What are the s/s of C. diff?
- Fever
- Abdominal cramping
- Watery diarrhea
- Blood or mucus in stool
- > 10-15 stools/day
What is the treatment for C. diff?
- metronidazole (Flagyl)
- vancomycin (Vancocin)
What increases risk for C. diff?
Concurrent use of proton pump inhibitors
What are the different antibiotic classes?
- Sulfonamides
- Penicillins
- Cephalosporins
- Macrolides
- Fluoroquinolones (aka quinolones)
- Aminogycosides
- Tetracyclines
What are the MoAs of antibiotic therapy?
Interference w/:
- Cell wall synthesis
- Protein synthesis
- DNA replication
- Acting as a metabolite disrupt metabolic rxns inside the cell
What does bactericidal mean?
Kills bacteria
What does bacteriostatic mean?
Inhibits bacterial growth
What causes antibiotic resistance?
,- Overuse
- Inappropriate use
- Mutation, conjugation
- Food and animal industry
What are examples of bacteria that have developed antibiotic resistance?
- Methicillin-resistant S. aureus (MRSA)
- Methicillin-resistant S. epidermis (MRSE)
What is the treatment for antibiotic resistance?
vancomycin (Vancocin)
What does delaying emergence of antibiotic resistance involve?
- Vaccination
- Removal of catheters
- Targeting the pathogen
- Practice antimicrobial control
- Treat infection, not contamination or colonization
- Know when to say NO to vanco
- Stop treatment when infection is cured or unlikely
What are examples of antimicrobial misuses?
Untreatable infection
- Don't use antibiotics for fungal infections
Fever of unknown origin
- Fever doesn't ALWAYS mean infection
- Improper dosage
- Lacking organism identity
What are the principal factors in choosing an antibiotic?
- Identify organism
- Drug sensitivity
- Host factors (immune system)
What are the excluding factors in choosing an antibiotic?
- Allergy
- Penetration to site of infection/concentration
Patient variables
- Age
- Pregnancy
- Hx of allergic rxn
- Genetics
What are the nursing implications for antibiotic treatment?
- Assess s/s of infection
- Obtain Hx of allergy
- Observe for anaphylaxis
- Culture and sensitivity before first dose
- Administer around the clock as ordered
What are the s/s of anaphylaxis?
- Trouble breathing
- Hives
- Throat tightness
, - N/V
- Dizziness
- Tachycardia
- Hypotension
What should be included in patient education of antibiotic therapy?
Instruct the patient to take ATB as directed
- Finish the whole Rx, even if feeling better
- Don't share meds
Report s/s of superinfection or C. diff
- Do not treat/suppress diarrhea
Describe beta-lactam antibiotics.
Have a beta-lactam ring in their structure
Includes:
- Penicillins
- Cephalosporins
- Carbapenems
What is the MoA of penicillins?
- Bactericidal
- Weaken the cell wall, causing bacteria to take up excessive water and rupture
What does bacterial resistance to penicillins mean?
- Inability to reach target
- Inactivation of penicillins by bacterial enzymes
What are the indications for penicillins?
Prevention and treatment of infections caused by susceptible bacteria such as Gram-
positive bacteria such as:
- Streptococcus
- Enterococcus
- Staphylococcus
What are penicillinases?
Enzymes that render penicillins and other beta-lactam ATBs ineffective
What are penicillins combined with to prevent breakdown by penicillinases?
Beta-lactamase inhibitors
What are examples of beta-lactamase inhibitors?
- Clavulanic acid
- Tazobactam
- Sulbactam
What are examples of narrow-spectrum, penicillinase sensitive penicillins?
- penicillin G (Benzylpenicllin)
- procaine penicillin (Wycillin)
- benzathine penicillin (Bicillin L-A)
What are the adverse effects r/t narrow-spectrum, penicillinase sensitive
penicillins?
- Allergy
- Cross-sensitivity to cephalosporins
What are examples of narrow-spectrum, penicillinase resistant penicillins?
