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NR566 MIDTERM EXAM Q&A LATEST
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NR566 MIDTERM EXAM Q&A LATEST
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NR566 MIDTERM EXAM Q&A LATESTCommunity acquired pneumonia (CAP) common pathogens - Answer-S. pneumoniae,
Mycoplasma spp., H. influenzae, and Staphylococcus aureus
First line treatment of CAP for previously healthy adults - Answer-Amoxicillin (PCN),
Doxycycline, and Macrolides (Azithromycin).
What to give if first drug didn't work for CAP - Answer-Levaquin (Fluroquinolones)
Treatment for M. Pneumoniae in pediatric patient (Specific/example antibiotic from drug
class will be provided) - Answer-Macrolides- Erythromycin
Treatment of CAP in pregnancy - Answer-Macrolides-erythromycin, PCN-amoxicillin,
cephalosporins
If someone has been treated with an antibiotic in the previous 90 days of contracting
CAP, a quinolone would be a prudent choice to prescribe such as: - Answer-Floxacin
Treatment of chlamydial pneumonia in infant (options will include dose, but if you know
the correct drug, the dose will come with it on the exam so no need to memorize dose):
- Answer-Macrolide-Erythromycin 12.5mg/kg PO QUID x 14 days
When to use broad-spectrum agents - Answer-Commonly used for empiric therapy
when the pathogen is unknown or infection with multiple types of bacteria is suspected.
When to use narrow-spectrum agents - Answer-Used when infecting pathogen is
unknown.
What are empiric antibiotics - Answer-Starting treatment without cultures or prior to
receiving results.
When to prescribe empiric antibiotics - Answer-Critically ill, hospitalized patients until
culture results return, ambulatory patients, combination therapy.
How to treat c-diff - Answer-10 days of oral vancomycin or metronidazole (flagyl).
Drug class known for ALL drugs in class to promote development of C. Diff - Answer-
2nd and 3rd generation Cephalosporins
PCN cross-sensitivity reactions with which drug classes: - Answer-Cephalosporins or
carbapenems
Prescribing PCN in pregnancy - Answer-Safe throughout pregnancy - safe to use in
breastfeeding, amoxicillin most safe
, Cephalosporins patient education - Answer-Report increase in stool frequency (concern
for c-diff)
Prescribing cephalosporins in pregnancy - Answer-Safe throughout pregnancy
Tetracyclines patient education - Answer-Avoid prolonged exposure to sunlight, wear
protective clothing, apply sunscreen, report promptly any diarrhea.
Prescribing tetracyclines in pregnancy - Answer-Contraindicated
Macrolides patient education - Answer-Avoid exposure to sunlight, wear protective
clothing and apply sunscreen.Report promptly any diarrhea.
Aminoglycosides patient education - Answer-Report symptoms of ototoxicity (H/A,
nausea, tinnitus, vertigo) and toxicity to kidneys.
Sulfaonamides patient education - Answer-Complete the course of treatment even
though symptoms may abate before the full course is over. Drink 8-10 glasses of water
a day to decrease risk of crystal urea.Avoid prolonged exposure to sunlight, wear
protective clothing, apply sunscreen, avoid tanning beds to prevent photosensitivity
reactions. Observe for alterations that may indicate hypersensitivity like a rash and hold
if occur.Inform of early signs of blood dycrasias (sore throat, fever, pallor). Report
promptly if they occur.
Prescribing sulfonamides in pregnancy - Answer-Contraindicated for nursing mothers,
pregnant women in 1st trimester or near term (after 32 weeks)
Gentamicin renal adjustments - Answer-Should be reduced or the dosing interval should
be increased to prevent toxicity.
A patient with an infection caused by Pseudomonas aeruginosa is being treated with
piperacillin. The nurse providing care reviews the patient's laboratory reports and notes
that the patient's blood urea nitrogen and serum creatinine levels are elevated. What
action will the provider take when notified of the elevated lab results?
· Prescribes an aminoglycoside
· Reduces the dosage of piperacillin
· Discontinues the piperacillin and orders penicillin G
· Discontinues the piperacillin and prescribes nafcillin - Answer-Reduces the dosage of
piperacillin
Patients with renal impairment should receive lower doses of piperacillin than patients
with normal renal function. Aminoglycosides are nephrotoxic. Penicillin G and nafcillin
are not effective against Pseudomonas infections.
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