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NURS 621 exam 1 Updated 2024 with complete solution; Maryville University
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NURS 621 exam 1 Updated 2024 with complete solution; Maryville University
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NURS 621 exam 1 Updated 2024 with complete solution;Maryville University
Those with granulocytopenia (neutropenia) have a higher risk for infection when the
absolute neutrophil count (ANC) falls below ______ and a dramatic increase in
frequency and severity when the ANC falls below ______ - ANSWERbelow 1000/mcL
and more severe when below 100/mcl
For Hematopoietic cell transplant recipients who are Early post-transplant period pre-
engraftment (day 1-21) are at risk for what type of infections? - ANSWERat risk for
gram-positive, gram-negative, HSV, RSV, and fungal infections.
For Hematopoietic cell transplant recipients between 3 weeks-3 months at risk for -
ANSWERCMV, Aspergillus, Adenovirus,Candida, PJP
For Hematopoietic cell transplant recipients beyond 3 months post-transplant are at risk
for - ANSWERAspergillus, CMV, Varicella, and viraland bacterial infections
for solid organ transplantation immediate post-operative infections involves -
ANSWERtransplant organ area (lung transplant= pneumonia
for solid organ transplantation 2-4 weeks post transplant, infection relates to operative
procedure and hospitalization are related to - ANSWERoperative procedure and
hospitalizaiton (catheter, wounds, pna)
for solid organ transplantation infection between 1-6 months is usually related to -
ANSWERimmunosuppression, such as viruses, fungal infections
what meds do we add to an immunocompromised patient if they remain febrile after 5-7
days of abx therapy? - ANSWERantifungal therapy such as voriconazole or micafungin
Med used for prophylaxis opportunistic development in those who are
immunocompromised with HSV - ANSWERacyclovir
Med used for prophylaxis opportunistic development in those who are
immunocompromised with PJP (pneumocystis jiroveci pneumonia) - ANSWERBactrim
Med used for prophylaxis opportunistic development in those who are
immunocompromised cytomegalovirus - ANSWERValcyte
,Med used for prophylaxis opportunistic development in those who immunocompromised
with aspergillus - ANSWERvoriconazole
Acute Endocarditis:• Staph Aureus, Enterococcus Faecalis, Strep Viridans should be
treated with - ANSWERIV vancomycin for 4-6 weeks
Osteomyelitis:• Staph Aureus, secondary Gram-negative aerobes should be treated with
- ANSWERIV Vancomycin PLUS Ceftriaxone for 4-6 weeks
Brain Abscess:• Staph Aureus, Gram-negative bacilli, Strep, mixed Anaerobes should
be treated with - ANSWERCeftriaxone PLUS Metronidazole PLUS Vancomycin for 6
weeks
Neutropenic Fever in those with cancer receiving chemotherapy:• Staph Aureus,
Pseudomonas, Klebsiella, E.Coli should be treated with - ANSWERCefepime or Zosyn
for gram-negative/Pseudomonas coverage and ifconcerned for MRSA, then add
Vancomycin.Infectious Diseases and Antimicrobial Therapy 10
Intra-abdominal sepsis (Peritonitis, Cholecystitis):• Gram-negative bacteria, anaerobic
bacteria, Enterococcus treated with - ANSWERZosyn, Cefepime PLUS Flagyl,
Ertapenem, Meropenem
Bacterial meningitis that is community-acquired in those >50 years old:• Strep
pneumoniae (Pneumococcus), Neisseria meningitides (Meningococcus), Listeria, gram-
negative bacilli, Group B Strep treated with - ANSWERAmpicillin PLUS Rocephin PLUS
Vancomycin• Add Acyclovir until HSV is ruled out from CSF fluid cultures.
Community-acquired Bacterial Meningitis in those 18-50 years old:• Pneumococcus,
Meningococcus treated with - ANSWERRocephin PLUS Vancomycin• Add Acyclovir
until HSV is ruled out from CSF fluid cultures.
Postoperative Meningitis:• Staph Aureus, Gram-negative bacilli, Coag-negative Staph,
Diphtheroids (Cutibacterium) treated with - ANSWERvancomycin PLUS cefepime
Impaired Cellular Immunity with Meningitis:• L. monocytogenes, Gram-negative bacilli,
Strep Pneumoniae is treated with - ANSWERVanc PLUS Ampicillin PLUS Cefepime•
Add Acyclovir until HSV is ruled out from CSF fluid cultures
Community-acquired PNA and non-ICU hospital admission:• Pneumococci, H.
influenzae, Mycoplasma, Legionella, Chlamydia is treated with - ANSWERRocephin OR
Ampicillin-Sulbactam PLUS Azithromycin OR a respiratory Fluoroquinolonealone
Postoperative or Nosocomial PNA:• Staph Aureus, gram-negative bacilli, Pseudmonas
is treated with - ANSWERCefepime OR Ceftazidime OR Zosyn OR Imipenem OR
Meropenem PLUS Vancomycin• Secondary agents: Cipro, Tobramycin
, Pyelonephritis with flank pain and fever:• E. Coli, Klebsiella, Proteus is treated with -
ANSWERRocephin OR if culture results confirm susceptibility then Cipro OR Levaquin
(Moxifloxacindoesn't penetrate the urine)
Septic Arthritis• Staph Aureus, Neisseria gonorrhoeae is treated with -
ANSWERRocephin PLUS Vancomycin
Septic Thrombophlebitis Staph Aureus, Gram-negative aerobic bacteria is treated with -
ANSWERVancomycin PLUS Rocephin
with infections in IV drug use, if fever is present but xray is clear treat for
ENDOCARDITIS with.... - ANSWERtreat with empiric IV vanc while waiting for blood
cultures
with infections in IV drug use, if chest xray shows PNA treat with - ANSWERrocephin
AND azithro or doxy
with infections in IV drug use, if evidence of septic emboli present (nodular infiltrates)
treat for presumed endocarditis with - ANSWERIV vanc (has MRSA and Enterococcus
coverage)
why should cephalexin, macrolides and clindamycin not be used alone in animal bite
treatment - ANSWERThey will not treat pasurella
What is the fastest way to deliver a medication to an action site in the elderly? -
ANSWERInhalation
Patients with brain, oral, and abdominal abscesses need ________ coverage -
ANSWERanaerobic coverage
Gram positive stain is the color - ANSWERpurple
gram negative stain is the color - ANSWERpink
How can you differentiate the membranes of gram positive and gram negative bacteria -
ANSWERGram-positive is thicker
Gram negative is thinner
The gram positive Cocci, Strep- pyogenes, pneumonia, viridans, bovis can be treated
with - ANSWERPCN, Vanc, Clindamycin, Cephalosporin
The gram positive cocci enterococcus faecalis can be treated with what? (VAC) -
ANSWERVanc, Ampicillin, ceftriaxone (VAC)
Gram positive cocci enterococcus faecium is treated with? - ANSWERVanc, linezolid,
daptomycin, tigecycline
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