NURS 5433 FNP II Final Exam Questions and Answers Graded A+
1. gram positive bacteria: staph
strep
enterococcus
- everything else is gram negative
2. penicillins: MOA: inhibit bacterial wall synthesis by binding to and activating
enzymes that are essential for cell wall function
effective against gram positive bacteria
- strep throat
- ear infections
- syphillis
3. cephalosporins: MOA: inhibit cell wall synthesis
broad spectrum, effective against pos and neg bacteria, later generations are more
effective against gram neg
treat respiratory infections, UTIs, skin infections, bacterial meningitis, pneumonia
4. cephalosporin generations: 1 - cephalexin
2 - cefuroxime
3 - ceftriaxone
4 - cefepime
5. macrolides: MOA: inhibit bacterial protein synthesis
effective against primarily gram pos but some gram neg
erythromycin, azithromycin, clarithromycin
treat respiratory infections, bronchitis, pna, skin infections, STIs
6. flouroquinolones: MOA: inhibit bacterial DNA synthesis
broad spectrum +/-
ciprofloxacin, levofloxacin, moxifloxacin
UTIs, GI infections, respiratory infections, skin infections
Risk of tendon rupture! Last resort abx
7. tetracyclines: MOA: inhibit bacterial synthesis
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
broad spectrum +/-
tetracycline, doxycycline, minocycline
acne, respiratory infections, lyme, rocky mountain spotted fever, STIs
don't use in kids <8 y.o. unless RMSF
8. aminoglycosides: MOA: inhibit bacterial protein synthesis
gram negative bacteria
tobramicin, gentamicin, amikacin
treat sepsis, pna, UTIs, often in combo with another med
risk of ototoxicity, nephrotoxicity, neuromuscular blockade
9. sulfonamides: MOA: inhibits synthesis of folic acid in bacteria
gram + and some gram neg
bactrim, sulfamethoxazole
UTIs, ear infections, PNA
10. Live attenuated vaccines: MMR, varicella, nasal flu, rotavirus, yellow fever,
smallpox
can cause fever and rash - normal!
must be given on the same day or at least 4 weeks apart, too close together can
interfere with effectiveness
AVOID in pregnancy and immunocompromised
do not give before 1 year old
11. When do you start giving flu vaccine?: 6 months old
12. Do you vaccinate if the child is ill or febrile?: Yes
13. kawasaki disease: acute inflammatory condition that affects kids <5 y.o, inflam-
mation of blood vessels, can lead to heart problems
s/s:
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
fever >5 days
conjunctivitis
strawberry tongue
cracked lips, erythema in oral cavity
rash
edema and erythema of hands, feet
peeling fingertips
cervical lymphadenopathy
irritability
Tx: IVIG 2g/kg and high dose aspirin
Refer to Cardiology
14. diagnostic criteria of kawasakis: 5 days of fever plus 4 of the following:
- bilateral conjunctival injection
- polymorphic rash
- cervical lymphadenopathy
- extremity changes
- oral changes, strawberry tongue
Diagnose with echocardiogram and CXR
Tx: IVIG and aspirin
15. Influenza Vaccine: can give 6 months and older, any trimester of pregnancy
contraindicated in Guillian Barre syndrome, otherwise can get even with egg allergy
Antivirals: oseltamivir, zanamivir, baloxavir, peramivir
16. Fifth Disease: viral illness caused by parvovirus B19 that primarily effects kids
(5-15 y.o)
prodrome: low grade fever, headache, fatigue, cold like symptoms
Rash: "slapped cheek" rash and reticular lacy rash on trunks, arms, legs, pink/red,
lasts 1-3 weeks, irritated by warmth, friction, and sun
transmission: respiratory droplets and direct contact with secretions, vertical trans-
mission from mother to fetus
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
management: supportive care - rest, hydration, infection control, monitor blood cell
counts
Immunocompromised may get IVIG
adults may get arthritis, more severe in adults, self-limiting
can also cause anemia
17. pregnant woman exposed to fifth disease: Can cause fetal complications
(hydrops fetalis, stillbirth, miscarriage)
Check:
vaccinated or previous infection?
serologic testing IgG and IgM
fetal monitoring
B19 assay and IgM to confirm diagnosis
consult specialist
NAAT or PCR for immunocompromised
18. Rocky Mountain Spotted Fever: caused by rickettsia recketsii (tick borne) from
dog ticks or wood ticks
Can cause organ failure
s/s: high fever, malaise, headache, muscle aches, N/V, petechial rash (small, flat,
red/purple spots on wrists/ankles that spread to palms, trunk, arms and appears
2-5 days after onset)
Tx: Doxycycline 100 mg BID x 5-7 days in adults, 2.2mg/kg in children BID x5-7 days
or Chloramphenicol in pregnancy
19. Diagnostics for RMSF: Indirect fluorescent antibody (IFA)
ELISA, PCR
CBC and liver enzymes (increased WBCs and thrombocytopenia)
20. Lyme Disease: borrelia burgdorferi (tickborne)
black legged deer tick, tick attached >36 hours
incubation 3-30 days after bite
Prophylactic tx: >36 hours attached, 200mg single dose or 4.4mg/kg in kids given
within 72 hours of tick removal
s/s: fever, HA, muscle/join pain, fatigue, bulls eye rash with central clearing, lym-
1. gram positive bacteria: staph
strep
enterococcus
- everything else is gram negative
2. penicillins: MOA: inhibit bacterial wall synthesis by binding to and activating
enzymes that are essential for cell wall function
effective against gram positive bacteria
- strep throat
- ear infections
- syphillis
3. cephalosporins: MOA: inhibit cell wall synthesis
broad spectrum, effective against pos and neg bacteria, later generations are more
effective against gram neg
treat respiratory infections, UTIs, skin infections, bacterial meningitis, pneumonia
4. cephalosporin generations: 1 - cephalexin
2 - cefuroxime
3 - ceftriaxone
4 - cefepime
5. macrolides: MOA: inhibit bacterial protein synthesis
effective against primarily gram pos but some gram neg
erythromycin, azithromycin, clarithromycin
treat respiratory infections, bronchitis, pna, skin infections, STIs
6. flouroquinolones: MOA: inhibit bacterial DNA synthesis
broad spectrum +/-
ciprofloxacin, levofloxacin, moxifloxacin
UTIs, GI infections, respiratory infections, skin infections
Risk of tendon rupture! Last resort abx
7. tetracyclines: MOA: inhibit bacterial synthesis
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
broad spectrum +/-
tetracycline, doxycycline, minocycline
acne, respiratory infections, lyme, rocky mountain spotted fever, STIs
don't use in kids <8 y.o. unless RMSF
8. aminoglycosides: MOA: inhibit bacterial protein synthesis
gram negative bacteria
tobramicin, gentamicin, amikacin
treat sepsis, pna, UTIs, often in combo with another med
risk of ototoxicity, nephrotoxicity, neuromuscular blockade
9. sulfonamides: MOA: inhibits synthesis of folic acid in bacteria
gram + and some gram neg
bactrim, sulfamethoxazole
UTIs, ear infections, PNA
10. Live attenuated vaccines: MMR, varicella, nasal flu, rotavirus, yellow fever,
smallpox
can cause fever and rash - normal!
must be given on the same day or at least 4 weeks apart, too close together can
interfere with effectiveness
AVOID in pregnancy and immunocompromised
do not give before 1 year old
11. When do you start giving flu vaccine?: 6 months old
12. Do you vaccinate if the child is ill or febrile?: Yes
13. kawasaki disease: acute inflammatory condition that affects kids <5 y.o, inflam-
mation of blood vessels, can lead to heart problems
s/s:
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
fever >5 days
conjunctivitis
strawberry tongue
cracked lips, erythema in oral cavity
rash
edema and erythema of hands, feet
peeling fingertips
cervical lymphadenopathy
irritability
Tx: IVIG 2g/kg and high dose aspirin
Refer to Cardiology
14. diagnostic criteria of kawasakis: 5 days of fever plus 4 of the following:
- bilateral conjunctival injection
- polymorphic rash
- cervical lymphadenopathy
- extremity changes
- oral changes, strawberry tongue
Diagnose with echocardiogram and CXR
Tx: IVIG and aspirin
15. Influenza Vaccine: can give 6 months and older, any trimester of pregnancy
contraindicated in Guillian Barre syndrome, otherwise can get even with egg allergy
Antivirals: oseltamivir, zanamivir, baloxavir, peramivir
16. Fifth Disease: viral illness caused by parvovirus B19 that primarily effects kids
(5-15 y.o)
prodrome: low grade fever, headache, fatigue, cold like symptoms
Rash: "slapped cheek" rash and reticular lacy rash on trunks, arms, legs, pink/red,
lasts 1-3 weeks, irritated by warmth, friction, and sun
transmission: respiratory droplets and direct contact with secretions, vertical trans-
mission from mother to fetus
, NURS 5433 FNP II Final Exam Questions and Answers Graded A+
management: supportive care - rest, hydration, infection control, monitor blood cell
counts
Immunocompromised may get IVIG
adults may get arthritis, more severe in adults, self-limiting
can also cause anemia
17. pregnant woman exposed to fifth disease: Can cause fetal complications
(hydrops fetalis, stillbirth, miscarriage)
Check:
vaccinated or previous infection?
serologic testing IgG and IgM
fetal monitoring
B19 assay and IgM to confirm diagnosis
consult specialist
NAAT or PCR for immunocompromised
18. Rocky Mountain Spotted Fever: caused by rickettsia recketsii (tick borne) from
dog ticks or wood ticks
Can cause organ failure
s/s: high fever, malaise, headache, muscle aches, N/V, petechial rash (small, flat,
red/purple spots on wrists/ankles that spread to palms, trunk, arms and appears
2-5 days after onset)
Tx: Doxycycline 100 mg BID x 5-7 days in adults, 2.2mg/kg in children BID x5-7 days
or Chloramphenicol in pregnancy
19. Diagnostics for RMSF: Indirect fluorescent antibody (IFA)
ELISA, PCR
CBC and liver enzymes (increased WBCs and thrombocytopenia)
20. Lyme Disease: borrelia burgdorferi (tickborne)
black legged deer tick, tick attached >36 hours
incubation 3-30 days after bite
Prophylactic tx: >36 hours attached, 200mg single dose or 4.4mg/kg in kids given
within 72 hours of tick removal
s/s: fever, HA, muscle/join pain, fatigue, bulls eye rash with central clearing, lym-
