And Answers SNHU
Q1. A Pseudomonas aeruginosa isolate is susceptible to several
aminoglycosides, but local resistance to gentamicin and tobramycin
is high. Which aminoglycoside may retain activity against resistant
organisms?
A) Amikacin
B) Paromomycin
C) Neomycin
D) Streptomycin
Correct Answer: A) Amikacin
Rationale: Amikacin is relatively resistant to many aminoglycoside-
inactivating enzymes and may retain activity when resistance to gentamicin
or tobramycin is common.
Q2. Which toxicity requires particularly close monitoring during
systemic aminoglycoside therapy?
A) Hyperthyroidism
B) Nephrotoxicity and ototoxicity
C) Severe hyperglycemia
D) Gingival hyperplasia
Correct Answer: B) Nephrotoxicity and ototoxicity
Rationale: Aminoglycosides can accumulate in renal and inner-ear tissues,
producing potentially serious renal and auditory or vestibular toxicity.
Q3. Which new symptom in a patient receiving gentamicin should
raise concern for ototoxicity?
A) Mild constipation
B) Increased appetite
C) Nasal congestion
D) Tinnitus, hearing change, or new balance disturbance
Correct Answer: D) Tinnitus, hearing change, or new balance disturbance
Rationale: Cochlear and vestibular injury can present with tinnitus, hearing
impairment, dizziness, or disequilibrium.
Q4. Which patient factor substantially increases aminoglycoside
toxicity risk?
A) Seasonal allergic rhinitis
B) Controlled dyslipidemia
C) Reduced renal function
D) Mild iron deficiency
, Correct Answer: C) Reduced renal function
Rationale: Aminoglycosides are eliminated primarily through the kidneys, so
impaired clearance can increase drug accumulation and toxicity.
Q5. Neomycin is commonly limited to topical or local use because of
what property?
A) Significant toxicity with systemic exposure
B) Complete lack of antibacterial activity
C) Rapid hepatic destruction
D) Inability to affect gram-negative organisms
Correct Answer: A) Significant toxicity with systemic exposure
Rationale: Neomycin has substantial nephrotoxic and ototoxic potential and
is generally used for topical or selected gastrointestinal applications.
Q6. Trimethoprim can produce which clinically important electrolyte
abnormality?
A) Hypocalcemia
B) Hyperkalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: B) Hyperkalemia
Rationale: Trimethoprim reduces renal potassium excretion and can
increase serum potassium, particularly with kidney disease or other
potassium-raising medications.
Q7. Which combination creates increased concern for clinically
significant hyperkalemia?
A) Trimethoprim plus acetaminophen
B) Amoxicillin plus an antihistamine
C) Azithromycin plus topical steroid
D) Trimethoprim plus an ACE inhibitor in a patient with chronic kidney
disease
Correct Answer: D) Trimethoprim plus an ACE inhibitor in a patient with
chronic kidney disease
Rationale: Trimethoprim and ACE inhibitors can both increase potassium,
while renal impairment further limits potassium elimination.
Q8. Which prescribing principle best supports antimicrobial
stewardship?
A) Use broad-spectrum antibiotics for every respiratory illness
B) Continue antibiotics indefinitely after improvement
C) Use culture information, likely pathogens, local resistance, and the