NURS 5334 Antimicrobial Recall
,NURS 5334 Antimicrobial Recall
NURS 5334 Antimicrobial Recall LATEST
Question 1:
A 72-year-old patient with reduced renal function is prescribed
ciprofloxacin for a complicated UTI. What adjustment should the NP
consider?
A. Increase the dose due to reduced clearance
B. Decrease the dose or extend the dosing interval
C. No dose adjustment is needed because ciprofloxacin is hepatically
metabolized
D. Switch to a different antibiotic because ciprofloxacin is contraindicated in
the elderly
Answer: B. Decrease the dose or extend the dosing interval
Rationale: Ciprofloxacin is primarily renally excreted. In elderly patients with
reduced renal function, dose reduction or extended dosing intervals are
necessary to prevent accumulation and toxicity .
Question 2:
A patient on warfarin is prescribed cephalexin for a skin infection. The NP
should:
A. Monitor INR closely as cephalexin may potentiate warfarin effects
B. Increase the warfarin dose
C. Stop the warfarin while on cephalexin
D. No monitoring is needed
Answer: A. Monitor INR closely as cephalexin may potentiate warfarin
effects
Rationale: Cephalexin can displace warfarin from protein-binding sites and
alter gut flora, potentially increasing the INR and bleeding risk. Close
monitoring is essential .
,NURS 5334 Antimicrobial Recall
Question 3:
Which antibiotic is associated with the highest risk of Clostridium difficile
infection?
A. Penicillin
B. Cephalexin
C. Clindamycin
D. Doxycycline
Answer: C. Clindamycin
Rationale: Clindamycin is strongly associated with C. difficile infection due to
its disruption of normal gut flora. Patients should be counseled to report any
diarrhea immediately .
Question 4:
A 5-year-old child with acute otitis media has a documented allergy to
penicillin with a non-anaphylactic rash. Which antibiotic is most
appropriate?
A. Amoxicillin
B. Cefdinir (third-generation cephalosporin)
C. Clindamycin
D. Doxycycline
Answer: B. Cefdinir (third-generation cephalosporin)
Rationale: Third-generation cephalosporins such as cefdinir have a low cross-
reactivity risk (<1-2%) with penicillin allergies and are appropriate for non-
anaphylactic reactions. Doxycycline is contraindicated in children under 8
years .
, NURS 5334 Antimicrobial Recall
Question 5:
A 28-year-old female is diagnosed with uncomplicated cystitis. She is
allergic to sulfa and penicillin. Which antibiotic is appropriate?
A. Nitrofurantoin
B. Trimethoprim-sulfamethoxazole
C. Amoxicillin-clavulanate
D. Cephalexin
Answer: A. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis. It is
safe for patients with sulfa and penicillin allergies and achieves high
concentrations in urine .
Question 6:
What is the mechanism of action of metronidazole?
A. Inhibition of cell wall synthesis
B. Inhibition of protein synthesis
C. Disruption of DNA and inhibition of nucleic acid synthesis
D. Blockade of folic acid synthesis
Answer: C. Disruption of DNA and inhibition of nucleic acid synthesis
Rationale: Metronidazole is a prodrug activated in anaerobic bacteria,
causing DNA strand breakage and inhibition of nucleic acid synthesis. It is
effective against anaerobes and protozoa .
Question 7:
A 45-year-old male with a history of seizures is being treated for a sinus
infection. Which antibiotic should be avoided?
A. Amoxicillin
B. Azithromycin
,NURS 5334 Antimicrobial Recall
NURS 5334 Antimicrobial Recall LATEST
Question 1:
A 72-year-old patient with reduced renal function is prescribed
ciprofloxacin for a complicated UTI. What adjustment should the NP
consider?
A. Increase the dose due to reduced clearance
B. Decrease the dose or extend the dosing interval
C. No dose adjustment is needed because ciprofloxacin is hepatically
metabolized
D. Switch to a different antibiotic because ciprofloxacin is contraindicated in
the elderly
Answer: B. Decrease the dose or extend the dosing interval
Rationale: Ciprofloxacin is primarily renally excreted. In elderly patients with
reduced renal function, dose reduction or extended dosing intervals are
necessary to prevent accumulation and toxicity .
Question 2:
A patient on warfarin is prescribed cephalexin for a skin infection. The NP
should:
A. Monitor INR closely as cephalexin may potentiate warfarin effects
B. Increase the warfarin dose
C. Stop the warfarin while on cephalexin
D. No monitoring is needed
Answer: A. Monitor INR closely as cephalexin may potentiate warfarin
effects
Rationale: Cephalexin can displace warfarin from protein-binding sites and
alter gut flora, potentially increasing the INR and bleeding risk. Close
monitoring is essential .
,NURS 5334 Antimicrobial Recall
Question 3:
Which antibiotic is associated with the highest risk of Clostridium difficile
infection?
A. Penicillin
B. Cephalexin
C. Clindamycin
D. Doxycycline
Answer: C. Clindamycin
Rationale: Clindamycin is strongly associated with C. difficile infection due to
its disruption of normal gut flora. Patients should be counseled to report any
diarrhea immediately .
Question 4:
A 5-year-old child with acute otitis media has a documented allergy to
penicillin with a non-anaphylactic rash. Which antibiotic is most
appropriate?
A. Amoxicillin
B. Cefdinir (third-generation cephalosporin)
C. Clindamycin
D. Doxycycline
Answer: B. Cefdinir (third-generation cephalosporin)
Rationale: Third-generation cephalosporins such as cefdinir have a low cross-
reactivity risk (<1-2%) with penicillin allergies and are appropriate for non-
anaphylactic reactions. Doxycycline is contraindicated in children under 8
years .
, NURS 5334 Antimicrobial Recall
Question 5:
A 28-year-old female is diagnosed with uncomplicated cystitis. She is
allergic to sulfa and penicillin. Which antibiotic is appropriate?
A. Nitrofurantoin
B. Trimethoprim-sulfamethoxazole
C. Amoxicillin-clavulanate
D. Cephalexin
Answer: A. Nitrofurantoin
Rationale: Nitrofurantoin is a first-line agent for uncomplicated cystitis. It is
safe for patients with sulfa and penicillin allergies and achieves high
concentrations in urine .
Question 6:
What is the mechanism of action of metronidazole?
A. Inhibition of cell wall synthesis
B. Inhibition of protein synthesis
C. Disruption of DNA and inhibition of nucleic acid synthesis
D. Blockade of folic acid synthesis
Answer: C. Disruption of DNA and inhibition of nucleic acid synthesis
Rationale: Metronidazole is a prodrug activated in anaerobic bacteria,
causing DNA strand breakage and inhibition of nucleic acid synthesis. It is
effective against anaerobes and protozoa .
Question 7:
A 45-year-old male with a history of seizures is being treated for a sinus
infection. Which antibiotic should be avoided?
A. Amoxicillin
B. Azithromycin
