The Infectious Diseases Society of America released new guidelines advising providers against routine antibiotic treatment of sinusitis, because most cases are caused by viruses. When antibiotics are used, the guidelines suggest:
Question 1The Infectious Diseases Society of America released new guidelines advising providers against routine antibiotic treatment of sinusitis, because most cases are caused by viruses. When antibiotics are used, the guidelines suggest:
Select one:
a.amoxicillin alone.
b.amoxicillin-clavulanate instead of amoxicillin alone.
c.amoxicillin for one week followed by amoxicillin-clavulanate for one week
d.Either b or c.
Question 2Among the statements below, select the one which provides the best rationale for treatment with group A β-hemolytic streptococci:
Select one:
a.It is extremely easy to accurately diagnose a bacterial pharyngitis by history and physical alone. A throat culture is not necessary before treatment with group A β-hemolytic streptococci.
b.It is extremely difficult to accurately diagnose a bacterial pharyngitis by history and physical alone. A throat culture is optional but highly recommended before treatment with group A β-hemolytic streptococci.
c.It is extremely easy to accurately diagnose a bacterial pharyngitis by history and physical alone. A throat culture is optional before treatment with group A β-hemolytic streptococci.
d.It is extremely difficult to accurately diagnose a bacterial pharyngitis by history and physical alone. A throat culture is necessary before treatment with group A β-hemolytic streptococci.
Question 3 C. difficile is often associated with copious liquid diarrhea and is a consequence of treatment with all antibiotics. Among the following which are most likely to cause C. difficile infection:
Select one:
a.ampicillin
b.amoxicillin
c.cephalosporin
d.All of the above
Question 4Nonpharmacologic interventions for an uncomplicated UTI may include rest, hydration to flush the urinary tract, and short-term use of urinary analgesics with agents such as:
Select one:
a.Phenazopyridine
b.Urised
c.Both a and b
d.Neither a nor b
Question 5For patients with uncomplicated genital, rectal, and pharyngeal gonorrhea, the CDC recommendations call for combination therapy using:
Select one:
a.ceftriaxone 100 mg as a single IM dose, plus azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days.
b.ceftriaxone 250 mg as a single IM dose, plus either azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days.
c.ceftriaxone 250 mg as a single IM dose, plus azithromycin 1 g orally in a single dose or doxycycline 200 mg orally twice daily for 7 days.
d.ceftriaxone 50 mg as a single IM dose, plus azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days.
Question 6Because fluoroquinolones have:
Select one:
a.good tissue penetration, they provide effective treatment for skin, bone, and genital infections; however, their CNS penetration is poor.
b.poor tissue penetration, they provide ineffective treatment for skin, bone, and genital infections; however, their CNS penetration is excellent.
c.poor tissue and CNS penetration.
d.good tissue penetration, they provide effective treatment for skin, bone, and genital infections; however, their CNS penetration is excellent.
Question 7Sulfonamides are:
Select one:
a.not metabolized by the cytochrome P450 enzyme system in liver nor via conjugation and acetylation; therefore, patients who are slow acetylators have a decreased risk of toxicity.
b.not metabolized by the cytochrome P450 enzyme system in the liver but are metabolized in the liver via conjugation and acetylation; therefore, patients who are slow acetylators have an increased risk of toxicity.
c.not metabolized by the cytochrome P450 enzyme system in the liver but are metabolized in the liver via conjugation and acetylation; therefore, patients who are rapid acetylators have an increased risk of toxicity.
d.metabolized by the cytochrome P450 enzyme system in the liver and via conjugation and acetylation; therefore, patients who are slow acetylators have an increased risk of toxicity.
Question 8The CNP prescribes her patient efavirenz (Sustiva) for HIV infection, telling her that:
Select one:
a.Efavirenz ( Sustiva) will prevent the transmission of the disease.
b.Efavirenz ( Sustiva) will not cure the disease but may significantly extend her life expectancy.
c.Efavirenz ( Sustiva) will be used prior to vaccines.
d.Efavirenz ( Sustiva) will cure the disease over time.
Question 9A patient with HIV infection has been taking lopinavir with ritonavir (Kaletra) for the past 8 years as prescribed by his CNP, who must continually evaluate his patient for the following adverse effects associated with this drug?
Select one:
a.Fever
b.Elevated triglycerides
c.Pancreatitis
d.Both b and c
Question 10Which of the following findings would suggest that myelosuppression is occurring in a client who is taking zidovudine (Retrovir)?
Select one:
a.Decrease in blood pressure
b.Decrease in WBC count
c.Increase in BUN levels
d.Increase in WBC count
Question 11The following patients should have antiretroviral therapy initiated for treatment of HIV infection.
Select one:
a.AIDS patients with rapidly declining CD4 counts
b.AIDS Patients with early HIV infection
c.All of the above
d.Patients with AIDS-defining illnesses
Question 12Women taking ketoconazole, fluconazole, itraconazole, or griseofulvin should use contraception:
Select one:
a.during and for 2 months after therapy because of possible teratogenic effects
b.during and for 6 months after therapy because of possible teratogenic effects
c.during and for 4 months after therapy because of possible teratogenic effects
d.during and for 9 months after therapy because of possible teratogenic effects
Question 13A patient is scheduled to begin abacavir for HIV and his physician ordered a HLA-B*5701 test. The result is positive therefore:
Select one:
a.a. treatment may be initiated and CD4 counts monitored
b.treatment should not be initiated but CD4 counts and viral load should be monitored
c.treatment may be initiated and viral load trended
d.treatment should not be initiated but CD8 counts should be monitored
Question 14What is the main reason for administering a progestational medication to perimenopausal women who use estrogen?
Select one:
a.Preventing osteoporosis.
b.Decrease the risk of endometrial hyperplasia.
c.Promoting growth of the uterine lining.
d.Preventing hot flashes.
Question 15Routine immunization guidelines recommend administering the hepatitis B vaccine at birth and repeating doses at:
Select one:
a.six months and 12 months.
b.one month and two months.
c.four months and two years.
d.one month and six months.
Question 16Treatment of viral conjunctivitis includes the use of:
Select one:
a.antihistamine/decongestant drops.
b.steroid eyedrops.
c.cold compresses.
d.antihistamine/mast cell stabilizer drops.
Question 17An infant who receives a drug that does not produce CNS side effects in adults exhibits drowsiness and sedation. The nurse understands that this is because of differences in which physiologic system in infants and adults?
Select one:
a.Renal filtration
b.Gastrointestinal absorption
c.Blood-brain barrier
d.First-pass effect
Question 18An older adult patient has confusion, memory loss, and disorientation in familiar surroundings. The patient has been taking donepezil [Aricept] 10 mg once daily for 6 months. The patient’s symptoms have begun to worsen, and the patient’s spouse asks if the medication dose can be increased. What will the nurse practitioner tell the spouse?
Select one:
a.The increase in symptoms is the result of hepatotoxicity from the medication’s side effects.
b.The dose can be increased, because the patient has been taking the drug for longer than 3 months.
c.The patient must take the drug for longer than 1 year before the dose can be increased.
d.The dose can be increased to twice daily dosing instead of once daily dosing.
Question 19A patient has been diagnosed with Parkinson disease (PD) and begins treatment with levodopa/carbidopa [Sinemet]. After several months of therapy, the patient reports no change in symptoms. The nurse will expect the provider to:
Select one:
a.add a dopamine agonist.
b.reevaluate the diagnosis.
c.discuss the “on-off” phenomenon.
d.increase the dose of Sinemet.
Question 20 A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse practitioner enters the patient’s room during morning rounds and finds the patient having facial spasms. The patient’s head is thrust back, and the patient is unable to speak. What will the nurse practitioner do?
Select one:
a.Increase the haloperidol dose.
b.Order diphenhydramine.
c.Order haloperidol.
d.Order levodopa.
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