NURS 642 Exam 2 Quick Review: Infectious
Disease. Maryville University. UPDATED
ACTUAL Exam Questions and CORRECT
Answers
*CAUTI (catheter associated urinary tract infection) - CORRECT ANSWER - Catheter in
currently or in the past 48 hours.
S/Sx: fever*, suprapubic/CVA tenderness, catheter obstruction.
*Older adults S/sx: falls, change in functional status, or change in mental status.
CT without contrast to check for calculi, hemorrhage, obstruction, and abscesses.
CT w/ contrast to check renal perfusion.
TX: REMOVE CATHETER IF POSSIBLE.
~ Standard: Ceftriaxone, or Zosyn, or Ciprofloxacin.
~ Complicated w/o MDR: Ceftriaxone or Zosyn
~ Complicated w/ MDR: (Merrem, or Imipenem, or Doripenem) + (Vanc, or Dapto, or
Linezolid).
Infection Control Measures in the ICU - CORRECT ANSWER - Contact precautions
Hand hygiene: Soap or Alcohol.
Decolonization/patient bathing: daily chlorhexidine.
Device-specific strategies: Limit invasive procedures.
Oropharyngeal decontamination: Nasal Mupirocin.
Surveillance
Antimicrobial Stewardship - CORRECT ANSWER - To reduce MDR infections.
1st goal: Right Drug, right Dose, De-escalation to pathogen-directed therapy, and right Duration
of therapy.
2nd goal: prevent antimicrobial overuse, misuse, and abuse.
, 3rd goal: minimize the development of resistance.
Front-end approach - restrictive prescriptive authority.
Back-end approach - review orders, give feedback on prescribing patterns.
CDC recommendations for antibiotic stewardship programs - CORRECT ANSWER -
Leadership commitment - Dedicate resources.
Accountability - Appoint single leader.
Drug expertise - Appoint single pharmacist leader.
Action - Take at least 1 action to improve prescribing.
Track - Monitor Abx prescribing and resistance pattern.
Report - Regularly report to staff on Abx prescribing and resistance info.
Educate - Offer education about abx resistance and best prescribing practice.
MDR that are Urgent threats per the CDC - CORRECT ANSWER - carbapenem-resistant
Enterobacteriaceae
Clostridium difficile
Drug-resistant Neisseria gonorrhoeae
Gram Positive Infections: (+) CA-MRSA - CORRECT ANSWER - Community Acquired:
SSTI's
TX: trimethoprim-sulfamethoxazole, tetracyclines, and clindamycin.
Gram Positive Infections: (+) HA-MRSA - CORRECT ANSWER - Hospital Acquired:
bacteremia, pneumonia, complicated SSTI's.
Hospitalization stay over 48 hours or present within 12 months of hospital discharge.
TX: Vancomycin*, Linezolid (pneumonia & SSTI's), Daptomycin (bacteremia but not
pneumonia).
Disease. Maryville University. UPDATED
ACTUAL Exam Questions and CORRECT
Answers
*CAUTI (catheter associated urinary tract infection) - CORRECT ANSWER - Catheter in
currently or in the past 48 hours.
S/Sx: fever*, suprapubic/CVA tenderness, catheter obstruction.
*Older adults S/sx: falls, change in functional status, or change in mental status.
CT without contrast to check for calculi, hemorrhage, obstruction, and abscesses.
CT w/ contrast to check renal perfusion.
TX: REMOVE CATHETER IF POSSIBLE.
~ Standard: Ceftriaxone, or Zosyn, or Ciprofloxacin.
~ Complicated w/o MDR: Ceftriaxone or Zosyn
~ Complicated w/ MDR: (Merrem, or Imipenem, or Doripenem) + (Vanc, or Dapto, or
Linezolid).
Infection Control Measures in the ICU - CORRECT ANSWER - Contact precautions
Hand hygiene: Soap or Alcohol.
Decolonization/patient bathing: daily chlorhexidine.
Device-specific strategies: Limit invasive procedures.
Oropharyngeal decontamination: Nasal Mupirocin.
Surveillance
Antimicrobial Stewardship - CORRECT ANSWER - To reduce MDR infections.
1st goal: Right Drug, right Dose, De-escalation to pathogen-directed therapy, and right Duration
of therapy.
2nd goal: prevent antimicrobial overuse, misuse, and abuse.
, 3rd goal: minimize the development of resistance.
Front-end approach - restrictive prescriptive authority.
Back-end approach - review orders, give feedback on prescribing patterns.
CDC recommendations for antibiotic stewardship programs - CORRECT ANSWER -
Leadership commitment - Dedicate resources.
Accountability - Appoint single leader.
Drug expertise - Appoint single pharmacist leader.
Action - Take at least 1 action to improve prescribing.
Track - Monitor Abx prescribing and resistance pattern.
Report - Regularly report to staff on Abx prescribing and resistance info.
Educate - Offer education about abx resistance and best prescribing practice.
MDR that are Urgent threats per the CDC - CORRECT ANSWER - carbapenem-resistant
Enterobacteriaceae
Clostridium difficile
Drug-resistant Neisseria gonorrhoeae
Gram Positive Infections: (+) CA-MRSA - CORRECT ANSWER - Community Acquired:
SSTI's
TX: trimethoprim-sulfamethoxazole, tetracyclines, and clindamycin.
Gram Positive Infections: (+) HA-MRSA - CORRECT ANSWER - Hospital Acquired:
bacteremia, pneumonia, complicated SSTI's.
Hospitalization stay over 48 hours or present within 12 months of hospital discharge.
TX: Vancomycin*, Linezolid (pneumonia & SSTI's), Daptomycin (bacteremia but not
pneumonia).
