NURS 5663 PHARMACOLOGY WEEK 5:
ANTI-INFECTIVE THERAPY
QUESTIONS WITH CORRECT ANSWERS
1. A patient is prescribed Penicillin G for a severe streptococcal infection. Which mechanism
best describes how this medication works?
A. Inhibition of protein synthesis by binding to the 50S ribosomal subunit
B. Interference with bacterial cell wall synthesis by binding to penicillin-binding proteins
(PBPs)
C. Disruption of DNA replication by inhibiting DNA gyrase
D. Antagonism of folate synthesis via inhibition of dihydropteroate synthase
Answer: B
Conceptual Explanation: Penicillins are beta-lactam antibiotics that work by inhibiting
the final step of bacterial cell wall synthesis. They bind to PBPs, which are enzymes
involved in cross-linking peptidoglycan strands, leading to cell lysis and death.
2. Which cephalosporin generation is most effective against MRSA (Methicillin-resistant
Staphylococcus aureus)?
A. First generation (e.g., Cefazolin)
B. Third generation (e.g., Ceftriaxone)
,C. Fourth generation (e.g., Cefepime)
D. Fifth generation (e.g., Ceftaroline)
Answer: D
Conceptual Explanation: Ceftaroline is a fifth-generation cephalosporin and is currently
the only beta-lactam antibiotic with clinical activity against MRSA due to its high affinity for
PBP2a.
3. A patient on Vancomycin therapy develops a rapid onset of flushing, rash, and pruritus on
the face and neck. What is the most likely cause and appropriate intervention?
A. Red Man Syndrome; slow the infusion rate and consider antihistamines
B. Anaphylaxis; stop the infusion and administer epinephrine
C. Stevens-Johnson Syndrome; discontinue drug and admit to burn unit
D. Drug-Induced Hypersensitivity Syndrome; monitor for eosinophilia
Answer: A
Conceptual Explanation: Red Man Syndrome is a rate-related infusion reaction caused by
histamine release, not a true IgE-mediated allergy. It is managed by slowing the infusion
rate (e.g., over 60-120 minutes) and potentially pre-treating with antihistamines.
4. Tetracyclines are contraindicated in children under the age of 8 and pregnant women
primarily because of:
A. Increased risk of tendon rupture
, B. Permanent discoloration of teeth and inhibition of bone growth
C. High risk of ototoxicity and vestibular damage
D. Potential for severe nephrotoxicity and Fanconi syndrome
Answer: B
Conceptual Explanation: Tetracyclines bind to calcium in developing teeth and bones,
leading to permanent yellow-brown discoloration of the teeth and potential suppression of
long bone growth in fetuses and young children.
5. A patient is taking Ciprofloxacin for a urinary tract infection. Which Black Box Warning
should the nurse include in the patient education?
A. Risk of fatal hepatic failure
B. Severe QT prolongation and cardiac arrest
C. Profound myelosuppression and anemia
D. Tendinitis and tendon rupture
Answer: D
Conceptual Explanation: Fluoroquinolones, including ciprofloxacin, carry a Black Box
Warning regarding the increased risk of tendinitis and tendon rupture, particularly the
Achilles tendon, especially in older adults and those taking corticosteroids.
ANTI-INFECTIVE THERAPY
QUESTIONS WITH CORRECT ANSWERS
1. A patient is prescribed Penicillin G for a severe streptococcal infection. Which mechanism
best describes how this medication works?
A. Inhibition of protein synthesis by binding to the 50S ribosomal subunit
B. Interference with bacterial cell wall synthesis by binding to penicillin-binding proteins
(PBPs)
C. Disruption of DNA replication by inhibiting DNA gyrase
D. Antagonism of folate synthesis via inhibition of dihydropteroate synthase
Answer: B
Conceptual Explanation: Penicillins are beta-lactam antibiotics that work by inhibiting
the final step of bacterial cell wall synthesis. They bind to PBPs, which are enzymes
involved in cross-linking peptidoglycan strands, leading to cell lysis and death.
2. Which cephalosporin generation is most effective against MRSA (Methicillin-resistant
Staphylococcus aureus)?
A. First generation (e.g., Cefazolin)
B. Third generation (e.g., Ceftriaxone)
,C. Fourth generation (e.g., Cefepime)
D. Fifth generation (e.g., Ceftaroline)
Answer: D
Conceptual Explanation: Ceftaroline is a fifth-generation cephalosporin and is currently
the only beta-lactam antibiotic with clinical activity against MRSA due to its high affinity for
PBP2a.
3. A patient on Vancomycin therapy develops a rapid onset of flushing, rash, and pruritus on
the face and neck. What is the most likely cause and appropriate intervention?
A. Red Man Syndrome; slow the infusion rate and consider antihistamines
B. Anaphylaxis; stop the infusion and administer epinephrine
C. Stevens-Johnson Syndrome; discontinue drug and admit to burn unit
D. Drug-Induced Hypersensitivity Syndrome; monitor for eosinophilia
Answer: A
Conceptual Explanation: Red Man Syndrome is a rate-related infusion reaction caused by
histamine release, not a true IgE-mediated allergy. It is managed by slowing the infusion
rate (e.g., over 60-120 minutes) and potentially pre-treating with antihistamines.
4. Tetracyclines are contraindicated in children under the age of 8 and pregnant women
primarily because of:
A. Increased risk of tendon rupture
, B. Permanent discoloration of teeth and inhibition of bone growth
C. High risk of ototoxicity and vestibular damage
D. Potential for severe nephrotoxicity and Fanconi syndrome
Answer: B
Conceptual Explanation: Tetracyclines bind to calcium in developing teeth and bones,
leading to permanent yellow-brown discoloration of the teeth and potential suppression of
long bone growth in fetuses and young children.
5. A patient is taking Ciprofloxacin for a urinary tract infection. Which Black Box Warning
should the nurse include in the patient education?
A. Risk of fatal hepatic failure
B. Severe QT prolongation and cardiac arrest
C. Profound myelosuppression and anemia
D. Tendinitis and tendon rupture
Answer: D
Conceptual Explanation: Fluoroquinolones, including ciprofloxacin, carry a Black Box
Warning regarding the increased risk of tendinitis and tendon rupture, particularly the
Achilles tendon, especially in older adults and those taking corticosteroids.
