NUR 521 Exam 4 Blueprint Practice Questions and Answers | 2026 Updated | 100% Correct - University of Alabama.

Exam 4 Blueprint Practice Questions


Section 1: Basic Questions About Antifungals

Question 1 Which of the following is an opportunistic systemic fungal infection?

 A) Sporotrichosis
 B) Aspergillosis
 C) Blastomycosis
 D) Histoplasmosis

Answer: B Rationale: Opportunistic systemic fungal infections occur in immunocompromised
patients and include Aspergillosis, Candidiasis, Cryptococcosis, and Mucormycosis. Non-
opportunistic infections, such as sporotrichosis, blastomycosis, and histoplasmosis, affect healthy
individuals.

Question 2 What is the drug of choice (DOC) for most systemic fungal infections?

 A) Fluconazole
 B) Amphotericin B
 C) Itraconazole
 D) Ketoconazole

Answer: B Rationale: Amphotericin B is the DOC for most systemic fungal infections due to its
broad-spectrum antifungal activity, despite its high toxicity.

Question 3 Which antifungal is effective against both systemic and superficial fungal
infections but has a black box warning for patients with heart failure?

 A) Amphotericin B
 B) Itraconazole
 C) Fluconazole
 D) Terbinafine

Answer: B Rationale: Itraconazole is effective for both systemic and superficial fungal
infections but has a BBW due to its negative inotropic effects, contraindicating its use in patients
with heart failure.

Question 4 Which antifungal is primarily used to treat superficial fungal infections, such as
candidiasis?

 A) Amphotericin B
 B) Fluconazole
 C) Itraconazole
 D) Ketoconazole


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,Answer: B Rationale: Fluconazole is a commonly prescribed antifungal for superficial
infections like candidiasis and cryptococcal meningitis.

Question 5 Which organism is responsible for the majority of cases of superficial fungal
infections?

 A) Candida albicans
 B) Aspergillus spp.
 C) Cryptococcus neoformans
 D) Mucorales spp.

Answer: A Rationale: Candida albicans is a common cause of superficial fungal infections,
particularly involving mucosal surfaces, skin, and nails.

Question 6 What is the primary safety concern associated with Amphotericin B?

 A) Hepatotoxicity
 B) Nephrotoxicity and infusion reactions
 C) Cardiotoxicity
 D) Ototoxicity

Answer: B Rationale: Amphotericin B has significant nephrotoxicity and infusion-related
reactions, limiting its use to life-threatening fungal infections.

Question 7 Which antifungal is the DOC for histoplasmosis and blastomycosis?

 A) Amphotericin B
 B) Fluconazole
 C) Itraconazole
 D) Ketoconazole

Answer: C Rationale: Itraconazole is the preferred agent for non-opportunistic systemic
infections such as histoplasmosis and blastomycosis.

Question 8 What is the recommended antifungal for cryptococcal meningitis?

 A) Amphotericin B
 B) Itraconazole
 C) Fluconazole
 D) Terbinafine

Answer: C Rationale: Fluconazole is effective in treating cryptococcal meningitis, particularly
in immunocompromised patients.

Question 9 Which antifungal carries the highest risk for systemic toxicity and is reserved
for life-threatening infections?


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,  A) Fluconazole
 B) Amphotericin B
 C) Itraconazole
 D) Voriconazole

Answer: B Rationale: Amphotericin B is highly effective but carries a significant risk of
nephrotoxicity and other adverse effects, making it reserved for severe infections.

Question 10 What is the mechanism of action of Azole antifungals like Itraconazole and
Fluconazole?

 A) Inhibit DNA synthesis
 B) Inhibit cell wall synthesis
 C) Inhibit ergosterol synthesis in fungal cell membranes
 D) Disrupt protein synthesis

Answer: C Rationale: Azole antifungals inhibit the synthesis of ergosterol, a critical component
of fungal cell membranes, disrupting fungal growth and survival.

Section 2: Patient Scenarios

Question 11 A 55-year-old construction worker presents with pulmonary infiltrates and weight
loss. A biopsy confirms Histoplasma capsulatum. Which antifungal is the DOC for this systemic
infection?

 A) Amphotericin B
 B) Itraconazole
 C) Fluconazole
 D) Ketoconazole

Answer: B Rationale: Itraconazole is the preferred antifungal for treating systemic infections
like histoplasmosis, offering a less toxic alternative to Amphotericin B.

Question 12 A 65-year-old diabetic man presents with fever, cough, and hemoptysis. Imaging
reveals lung nodules, and culture grows Aspergillus fumigatus. Which antifungal is most
appropriate?

 A) Fluconazole
 B) Amphotericin B
 C) Itraconazole
 D) Ketoconazole

Answer: B Rationale: Amphotericin B is the DOC for systemic aspergillosis due to its broad-
spectrum activity and efficacy in life-threatening infections.




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, Question 13 A 35-year-old woman with HIV presents with headaches and stiff neck. Lumbar
puncture confirms Cryptococcus neoformans. What is the DOC for treatment?

 A) Amphotericin B
 B) Fluconazole
 C) Itraconazole
 D) Ketoconazole

Answer: B Rationale: Fluconazole is effective for treating cryptococcal meningitis and is often
used in immunocompromised patients.

Question 14 A gardener reports developing nodular lesions along her arms after a prick from a
rose bush. A biopsy confirms sporotrichosis. What antifungal should be prescribed?

 A) Amphotericin B
 B) Itraconazole
 C) Fluconazole
 D) Ketoconazole

Answer: B Rationale: Itraconazole is the DOC for systemic infections like sporotrichosis due to
its excellent efficacy profile.

Question 15 A patient presents with superficial white patches in the mouth diagnosed as oral
thrush caused by Candida albicans. Which antifungal is most appropriate?

 A) Amphotericin B
 B) Itraconazole
 C) Fluconazole
 D) Ketoconazole

Answer: C Rationale: Fluconazole is effective for superficial candidiasis, including oral thrush.

Section 1: Basic Questions About Antifungal Use in Pediatric and Elderly
Patients

Question 1 Which antifungal is commonly used to treat oral candidiasis in infants?

 A) Amphotericin B
 B) Nystatin
 C) Fluconazole
 D) Itraconazole

Answer: B Rationale: Nystatin is the preferred antifungal for treating oral candidiasis in
premature and full-term infants due to its safety and efficacy.




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