ADDRESSED PHARMACOLOGY
TEST BANK TEST
The56nurse56has56been56caring56for56a56patient56who56has56been56taking56antibiotics56for56356weeks.56Upo
n56assessing56the56patient,56the56nurse56notices56the56individual56has56developed56oral56thrush.56What56d
escribes56the56etiology56of56the56thrush?56-56CORRECT56ANSWER-Superinfection
The56nurse56is56caring56for56a56patient56on56a56medical-
surgical56unit56who56has56a56fever56of56unknown56origin.56The56prescriber56has56ordered56a56br
oad-spectrum56antibiotic.56Which56intervention56is56the56priority?56-56CORRECT56ANSWER-
Obtaining56all56cultures56before56the56antibiotic56is56administered
The56nurse56is56teaching56a56nursing56student56about56the56mechanism56by56which56antimicrobial5
6agents56achieve56selective56toxicity.56Which56statement56by56the56student56indicates56a56need56f
or56further56teaching?56-56CORRECT56ANSWER-
"Some56agents56cause56phagocytosis56of56bacterial56cells."
A56child56has56received56amoxicillin56[Amoxil]56for56three56previous56ear56infections,56but56a56current
56otitis56media56episode56is56not56responding56to56treatment.56The56nurse56caring56for56this56child56su
spects56that56resistance56to56the56bacterial56agent56has56occurred56by56which56microbial56mechanism
?56-56CORRECT56ANSWER-Drug56inactivation
A56nursing56student56asks56a56nurse56to56clarify56the56differences56between56the56mechanisms56
of56spontaneous56mutation56and56conjugation56in56acquired56resistance56of56microbes.56What56
will56the56nurse56say?56-56CORRECT56ANSWER-
Spontaneous56mutation56leads56to56resistance56to56only56one56antimicrobial56agent.
A56patient56has56a56viral56sinus56infection,56and56the56provider56tells56the56patient56that56antibiotics5
6will56not56be56prescribed.56The56patient56wants56to56take56an56antibiotic56and56asks56the56nurse56w
hat56possible56harm56could56occur56by56taking56an56antibiotic.56Which56response56by56the56nurse56is56
correct?56-56CORRECT56ANSWER-
"Even56normal56flora56can56develop56resistance56and56transfer56this56to56pathogens."
,A56recent56campaign,56initiated56by56the56Centers56for56Disease56Control56(CDC),56to56delay56the56em
ergence56of56antibiotic56resistance56in56hospitals,56has56what56as56one56of56its56objectives?56-
56CORRECT56ANSWER-Increased56adherence56to56prescribed56antibiotics
A56patient56has56a56localized56skin56infection,56which56is56most56likely56caused56by56a56gram-
positive56cocci.56Until56the56culture56and56sensitivity56results56are56available,56the56nurse56will56expe
ct56the56provider56to56order56a56 -spectrum
agent.56-56CORRECT56ANSWER-narrow;56topical
A56parent56asks56a56nurse56if56the56provider56will56prescribe56an56antibiotic56for56a56child56who56atte
nds56school56with56several56children56who56have56strep56throat.56The56child56is56complaining56of56a56s
ore56throat56and56has56a56fever.56What56will56be56the56nurse's56response56-56CORRECT56ANSWER-
"Your56child56should56come56to56the56clinic56to56have56a56throat56culture56done56today."
n56older56adult56patient56with56chronic56obstructive56pulmonary56disease56(COPD)56develops56bronc
hitis.56The56patient56has56a56temperature56of5639.5°C.56The56nurse56will56expect56the56provider56to:56
-56CORRECT56ANSWER-order56empiric56antibiotics56while56waiting56for56sputum56culture56results.
Which56patients56should56be56given56antibiotics56prophylactically?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-
56Patients56with56certain56congenital56heart56defects56at56risk56for56bacterial56endocarditis
Patients56with56compound56fractures56undergoing56surgical56repair
Which56are56benefits56of56using56a56combination56of56two56or56more56antibiotics?56(Select56all56that56
apply.)56-56CORRECT56ANSWER-Reduced56toxicity
Reduced56resistance
Reduced56risk56in56severe56infection
The56nurse56is56teaching56a56pharmacology56refresher56course56to56a56group56of56nurses.56A56student
56asks56what56host56factors56affect56the56choice56of56agents56in56antimicrobial56therapy.56The56nurse
56will56tell56the56students56that56such56host56factors56include56what?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-Age
Immune56system56statu
s56Infection56site
,A56nurse56transcribes56a56new56prescription56for56potassium56penicillin56G56given56intravenously56(IV)
56every56856hours56and56gentamicin56given56IV56every561256hours.56Which56is56the56best56schedule56f
or56administering56these56drugs?56-56CORRECT56ANSWER-
Give56the56penicillin56at560800,561600,56and562400;56give56the56gentamicin56[Garamycin]56at56180056a
nd560600.
A56nurse56assisting56a56nursing56student56with56medications56asks56the56student56to56describe56how56
penicillins56(PCNs)56work56to56treat56bacterial56infections.56The56student56is56correct56in56responding5
6that56penicillins:56-56CORRECT56ANSWER-disrupt56bacterial56cell56wall56synthesis.
A56child56with56otitis56media56has56had56three56ear56infections56in56the56past56year.56The56child56has56
just56completed56a5610-
56day56course56of56amoxicillin56[Amoxil]56with56no56improvement.56The56parent56asks56the56nurse56w
hy56this56drug56is56not56working,56because56it56has56worked56in56the56past.56What56will56the56nurse56
tell56the56patient?56-56CORRECT56ANSWER-56"The56bacteria56have56synthesized56penicillinase."
A56child56with56an56ear56infection56is56not56responding56to56treatment56with56amoxicillin56[Amoxil].56T
he56nurse56will56expect56the56provider56to56order:56-56CORRECT56ANSWER-amoxicillin-
clavulanic56acid56[Augmentin].
A56patient56is56receiving56intravenous56potassium56penicillin56G,56256million56units56to56be56administer
ed56over56156hour.56At561900,56the56nurse56notes56that56the56dose56hung56at56183056has56infused56c
ompletely.56What56will56the56nurse56do?56-56CORRECT56ANSWER-
Request56an56order56for56serum56electrolytes56and56cardiac56monitoring.
A56patient56is56about56to56receive56penicillin56G56for56an56infection56that56is56highly56sensitive56to56th
is56drug.56While56obtaining56the56patient's56medication56history,56the56nurse56learns56that56the56patie
nt56experienced56a56rash56when56given56amoxicillin56[Amoxil]56as56a56child562056years56earlier.56What
56will56the56nurse56do?56-56CORRECT56ANSWER-
56Request56an56order56for56a56skin56test56to56assess56the56current56risk.
A56patient56with56no56known56drug56allergies56is56receiving56amoxicillin56[Amoxil]56PO56twice56daily.56
Twenty56minutes56after56being56given56a56dose,56the56patient56complains56of56shortness56of56breath.
56The56patient's56blood56pressure56is56100/5856mm56Hg.56What56will56the56nurse56do?56-
56CORRECT56ANSWER-Contact56the56provider56and56prepare56to56administer56epinephrine
, A56patient56has56an56infection56caused56by56Streptococcus56pyogenes.56The56prescriber56has56ordered
56dicloxacillin56PO.56What56will56the56nurse56do?56-56CORRECT56ANSWER-
Question56the56need56for56a56penicillinase-resistant56penicillin.
The56parent56of56an56infant56with56otitis56media56asks56the56nurse56why56the56prescriber56has56ordere
d56amoxicillin56[Amoxil]56and56not56ampicillin56[Unasyn].56What56will56the56nurse56tell56the56parent?56-
56CORRECT56ANSWER-Ampicillin56is56not56as56acid56stable56as56amoxicillin.
A56patient56with56an56infection56caused56by56Pseudomonas56aeruginosa56is56being56treated56with56pi
peracillin.56The56nurse56providing56care56reviews56the56patient's56laboratory56reports56and56notes56th
at56the56patient's56blood56urea56nitrogen56and56serum56creatinine56levels56are56elevated.56The56nurs
e56will56contact56the56provider56to56discuss:56-56CORRECT56ANSWER-
reducing56the56dose56of56piperacillin.
A56nurse56is56discussing56methicillin-
resistant56Staphylococcus56aureus56(MRSA)56with56a56group56of56nursing56students.56Which56statem
ent56by56a56student56correctly56identifies56the56basis56for56MRSA56resistance?56-
56CORRECT56ANSWER-
"MRSA56bacteria56have56developed56PBPs56with56a56low56affinity56for56penicillins."
A56nurse56is56preparing56to56administer56intramuscular56penicillin56to56a56patient56who56is56infected56
with56T.56pallidum56and56notes56that56the56order56is56for56sodium56penicillin56G.56Which56action56is56c
orrect?56-56CORRECT56ANSWER-
Contact56the56provider56to56discuss56changing56the56drug56to56benzathine56penicillin56G.
Which56organisms56can56be56treated56with56penicillin56G56(Benzylpenicillin)?56(Select56all56that56app
ly.)56-56CORRECT56ANSWER-Neisseria56meningitidis
Streptococcus56pyogene
s56Treponema56pallidu
m
A56nursing56student56wants56to56know56the56differences56between56hospital-
associated56methicillin-resistant56Staphylococcus56aureus56(HA-MRSA)56and56community-
associated56methicillin-resistant56Staphylococcus56aureus56(CA-
MRSA).56Which56statements56about56CA-MRSA56are56true?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-20%56to5630%56of56the56general56population56are56colonized56with56CA-
TEST BANK TEST
The56nurse56has56been56caring56for56a56patient56who56has56been56taking56antibiotics56for56356weeks.56Upo
n56assessing56the56patient,56the56nurse56notices56the56individual56has56developed56oral56thrush.56What56d
escribes56the56etiology56of56the56thrush?56-56CORRECT56ANSWER-Superinfection
The56nurse56is56caring56for56a56patient56on56a56medical-
surgical56unit56who56has56a56fever56of56unknown56origin.56The56prescriber56has56ordered56a56br
oad-spectrum56antibiotic.56Which56intervention56is56the56priority?56-56CORRECT56ANSWER-
Obtaining56all56cultures56before56the56antibiotic56is56administered
The56nurse56is56teaching56a56nursing56student56about56the56mechanism56by56which56antimicrobial5
6agents56achieve56selective56toxicity.56Which56statement56by56the56student56indicates56a56need56f
or56further56teaching?56-56CORRECT56ANSWER-
"Some56agents56cause56phagocytosis56of56bacterial56cells."
A56child56has56received56amoxicillin56[Amoxil]56for56three56previous56ear56infections,56but56a56current
56otitis56media56episode56is56not56responding56to56treatment.56The56nurse56caring56for56this56child56su
spects56that56resistance56to56the56bacterial56agent56has56occurred56by56which56microbial56mechanism
?56-56CORRECT56ANSWER-Drug56inactivation
A56nursing56student56asks56a56nurse56to56clarify56the56differences56between56the56mechanisms56
of56spontaneous56mutation56and56conjugation56in56acquired56resistance56of56microbes.56What56
will56the56nurse56say?56-56CORRECT56ANSWER-
Spontaneous56mutation56leads56to56resistance56to56only56one56antimicrobial56agent.
A56patient56has56a56viral56sinus56infection,56and56the56provider56tells56the56patient56that56antibiotics5
6will56not56be56prescribed.56The56patient56wants56to56take56an56antibiotic56and56asks56the56nurse56w
hat56possible56harm56could56occur56by56taking56an56antibiotic.56Which56response56by56the56nurse56is56
correct?56-56CORRECT56ANSWER-
"Even56normal56flora56can56develop56resistance56and56transfer56this56to56pathogens."
,A56recent56campaign,56initiated56by56the56Centers56for56Disease56Control56(CDC),56to56delay56the56em
ergence56of56antibiotic56resistance56in56hospitals,56has56what56as56one56of56its56objectives?56-
56CORRECT56ANSWER-Increased56adherence56to56prescribed56antibiotics
A56patient56has56a56localized56skin56infection,56which56is56most56likely56caused56by56a56gram-
positive56cocci.56Until56the56culture56and56sensitivity56results56are56available,56the56nurse56will56expe
ct56the56provider56to56order56a56 -spectrum
agent.56-56CORRECT56ANSWER-narrow;56topical
A56parent56asks56a56nurse56if56the56provider56will56prescribe56an56antibiotic56for56a56child56who56atte
nds56school56with56several56children56who56have56strep56throat.56The56child56is56complaining56of56a56s
ore56throat56and56has56a56fever.56What56will56be56the56nurse's56response56-56CORRECT56ANSWER-
"Your56child56should56come56to56the56clinic56to56have56a56throat56culture56done56today."
n56older56adult56patient56with56chronic56obstructive56pulmonary56disease56(COPD)56develops56bronc
hitis.56The56patient56has56a56temperature56of5639.5°C.56The56nurse56will56expect56the56provider56to:56
-56CORRECT56ANSWER-order56empiric56antibiotics56while56waiting56for56sputum56culture56results.
Which56patients56should56be56given56antibiotics56prophylactically?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-
56Patients56with56certain56congenital56heart56defects56at56risk56for56bacterial56endocarditis
Patients56with56compound56fractures56undergoing56surgical56repair
Which56are56benefits56of56using56a56combination56of56two56or56more56antibiotics?56(Select56all56that56
apply.)56-56CORRECT56ANSWER-Reduced56toxicity
Reduced56resistance
Reduced56risk56in56severe56infection
The56nurse56is56teaching56a56pharmacology56refresher56course56to56a56group56of56nurses.56A56student
56asks56what56host56factors56affect56the56choice56of56agents56in56antimicrobial56therapy.56The56nurse
56will56tell56the56students56that56such56host56factors56include56what?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-Age
Immune56system56statu
s56Infection56site
,A56nurse56transcribes56a56new56prescription56for56potassium56penicillin56G56given56intravenously56(IV)
56every56856hours56and56gentamicin56given56IV56every561256hours.56Which56is56the56best56schedule56f
or56administering56these56drugs?56-56CORRECT56ANSWER-
Give56the56penicillin56at560800,561600,56and562400;56give56the56gentamicin56[Garamycin]56at56180056a
nd560600.
A56nurse56assisting56a56nursing56student56with56medications56asks56the56student56to56describe56how56
penicillins56(PCNs)56work56to56treat56bacterial56infections.56The56student56is56correct56in56responding5
6that56penicillins:56-56CORRECT56ANSWER-disrupt56bacterial56cell56wall56synthesis.
A56child56with56otitis56media56has56had56three56ear56infections56in56the56past56year.56The56child56has56
just56completed56a5610-
56day56course56of56amoxicillin56[Amoxil]56with56no56improvement.56The56parent56asks56the56nurse56w
hy56this56drug56is56not56working,56because56it56has56worked56in56the56past.56What56will56the56nurse56
tell56the56patient?56-56CORRECT56ANSWER-56"The56bacteria56have56synthesized56penicillinase."
A56child56with56an56ear56infection56is56not56responding56to56treatment56with56amoxicillin56[Amoxil].56T
he56nurse56will56expect56the56provider56to56order:56-56CORRECT56ANSWER-amoxicillin-
clavulanic56acid56[Augmentin].
A56patient56is56receiving56intravenous56potassium56penicillin56G,56256million56units56to56be56administer
ed56over56156hour.56At561900,56the56nurse56notes56that56the56dose56hung56at56183056has56infused56c
ompletely.56What56will56the56nurse56do?56-56CORRECT56ANSWER-
Request56an56order56for56serum56electrolytes56and56cardiac56monitoring.
A56patient56is56about56to56receive56penicillin56G56for56an56infection56that56is56highly56sensitive56to56th
is56drug.56While56obtaining56the56patient's56medication56history,56the56nurse56learns56that56the56patie
nt56experienced56a56rash56when56given56amoxicillin56[Amoxil]56as56a56child562056years56earlier.56What
56will56the56nurse56do?56-56CORRECT56ANSWER-
56Request56an56order56for56a56skin56test56to56assess56the56current56risk.
A56patient56with56no56known56drug56allergies56is56receiving56amoxicillin56[Amoxil]56PO56twice56daily.56
Twenty56minutes56after56being56given56a56dose,56the56patient56complains56of56shortness56of56breath.
56The56patient's56blood56pressure56is56100/5856mm56Hg.56What56will56the56nurse56do?56-
56CORRECT56ANSWER-Contact56the56provider56and56prepare56to56administer56epinephrine
, A56patient56has56an56infection56caused56by56Streptococcus56pyogenes.56The56prescriber56has56ordered
56dicloxacillin56PO.56What56will56the56nurse56do?56-56CORRECT56ANSWER-
Question56the56need56for56a56penicillinase-resistant56penicillin.
The56parent56of56an56infant56with56otitis56media56asks56the56nurse56why56the56prescriber56has56ordere
d56amoxicillin56[Amoxil]56and56not56ampicillin56[Unasyn].56What56will56the56nurse56tell56the56parent?56-
56CORRECT56ANSWER-Ampicillin56is56not56as56acid56stable56as56amoxicillin.
A56patient56with56an56infection56caused56by56Pseudomonas56aeruginosa56is56being56treated56with56pi
peracillin.56The56nurse56providing56care56reviews56the56patient's56laboratory56reports56and56notes56th
at56the56patient's56blood56urea56nitrogen56and56serum56creatinine56levels56are56elevated.56The56nurs
e56will56contact56the56provider56to56discuss:56-56CORRECT56ANSWER-
reducing56the56dose56of56piperacillin.
A56nurse56is56discussing56methicillin-
resistant56Staphylococcus56aureus56(MRSA)56with56a56group56of56nursing56students.56Which56statem
ent56by56a56student56correctly56identifies56the56basis56for56MRSA56resistance?56-
56CORRECT56ANSWER-
"MRSA56bacteria56have56developed56PBPs56with56a56low56affinity56for56penicillins."
A56nurse56is56preparing56to56administer56intramuscular56penicillin56to56a56patient56who56is56infected56
with56T.56pallidum56and56notes56that56the56order56is56for56sodium56penicillin56G.56Which56action56is56c
orrect?56-56CORRECT56ANSWER-
Contact56the56provider56to56discuss56changing56the56drug56to56benzathine56penicillin56G.
Which56organisms56can56be56treated56with56penicillin56G56(Benzylpenicillin)?56(Select56all56that56app
ly.)56-56CORRECT56ANSWER-Neisseria56meningitidis
Streptococcus56pyogene
s56Treponema56pallidu
m
A56nursing56student56wants56to56know56the56differences56between56hospital-
associated56methicillin-resistant56Staphylococcus56aureus56(HA-MRSA)56and56community-
associated56methicillin-resistant56Staphylococcus56aureus56(CA-
MRSA).56Which56statements56about56CA-MRSA56are56true?56(Select56all56that56apply.)56-
56CORRECT56ANSWER-20%56to5630%56of56the56general56population56are56colonized56with56CA-
