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NUR 909 Final Exam Questions And Correct Answers
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NUR 909 Final Exam Questions And Correct AnswersEYE DOs
True or False. All eye drops must be sterile to be considered safe for use. - Answer True;
ear drops are generally more acidic than eye drops, so eye drops can be used in the ear
but not vice versa (PPT)
Name 3 bacteria that are most commonly associated with bacterial conjunctivitis. -
Answer Staph aureus, Strep pneumoniae, H. influenzae (PPT)
How many gtts = approx 1 mL? - Answer 20 gtts = approx 1 mL (PPT)
Centers for Disease Control recommends all newborn infants receive prophylactic
administration of __________________ within 1 hour of birth to prevent ______________. -
Answer Erythromycin ointment; gonococcal conjunctivitis (can cx blindness) (PPT)
Describe the mechanism of action of prostaglandin analogs utilized for glaucoma. -
Answer Decreases the IOP by increasing the outflow of aqueous humor (PPT)
What is the distinctive indication that bimatroprost is FDA-approved for? - Answer
Hypotrichosis of eyelashes, may increase % & duration of hairs in the growth phase
resulting in eyelash growth; brand name Latisse (PPT); need rx (Google)
Put the following glaucoma medications in order from greatest reduction in intraocular
pressure to least. Timolol, acetazolamide, latanoprost, brinzolamide - Answer MOST
timolol (BB) reduces IOP by 20-25%, acetazolamide & brinzolamide (carbonic
anhydrase) reduce IOP by 15-20% topical, 20-25% PO, lantoprost LEAST
Oral beta blockers should be avoided in patients who use ophthalmic beta blockers
,because - Answer The additive effects may include bradycardia
Naphazoline-containing eye drops should not be used for >72hrs due to concern for
what? - Answer Potential rebound redness; less likely w/this & tetrahydrozoline
compared to other ocular vasoconstrictors (PPT)
Which 2 classes of medications should only be prescribed by an ophthalmologist? -
Answer Ocular NSAIDs d/t risk for permanent damage if used in wrong pt & steroids
(PPT)
EAR DOs - Answer
Which bacteria is most commonly the cause of acute otitis externa and to which class of
otic antibiotics are they most susceptible? ANS Pseudomonas; most susceptible to
fluoroquinolones (PPT)
In instances of a ruptured tympanic membrane, which dosing form is preferred in the
treatment of acute otitis externa? ANS Suspension, solutions can be very irritating to
ruptured TMs (PPT)
What is the role of otic steroids in the treatment of acute otitis externa? - Answer Use of
a topical abx w/a corticosteroid may shorten time to sx resolution; PO abx are
INEFFECTIVE
-Ciprodex (ciprofloxacin + dexamethasone)
-Cortisporin (neomycin, polymyxin B, hydrocortisone) (PPT)
Describe the mechanism of action of carbamide peroxide. - Answer Releases hydrogen
peroxide, which softens impacted cerumen d/t foaming axn (PPT)
ABX RESISTANCE - Answer
,What contribute to antibiotic resistance? -Answer -Prophylaxis (surgery, dental
procedures, daily use in immunosuppressed pts [HIV/AIDS, CF], recurrent UTI) (PPT)
-Increasing populations of immunocompromised pts, increases in the # & complexity of
invasive medical procedures, & increased survival of pts w/chronic diseases; spread of
resistant organisms assoc w/day care for young children, overcrowding, travel & use of
abx in agriculture (pg 714)
-Overuse & inappropriate use of abx; examples: providing abx for viral infections, poor
dosing, too long of therapy duration, & increased empirical use of broad-spectrum abx
when not needed (714)
Name a few of the most common risk factors for having a drug resistant pathogen. -
Answer Very recent use of abx, less than 2 yo or greater than 65 yo, daycare
attendance, exposure to young children, numerous medical comorbidities, recent
hospitalization, immunosuppression (714)
True or False. Resistance has developed in every class of antibiotics. - Answer T (714)
BETA-LACTAMS - Answer
Name the classes of antibiotics that fall under beta-lactams. - Answer Penicillins,
cephalosporins, carbapenems & monobactams (715)
Explain the mode of action of penicillin antibiotics. - Answer Interfere with bac growth by
inhibiting the biosynthesis of a bacterial cell wall mucopeptide (also referred to as
murein or peptidoglycan) (715)
Name the class of antibiotics and their spectrum of activity. Penicillins have activity
primarily against gram-________ organisms. - Answer + anaerobic (PPT)
Explain how the activity of aminopenicillins are different than that of penicillins. What
causes this difference? - Answer -Cover gram + & - organisms; 1st group of penicillins
w/activity against gram - bac (PPT)
-Aminopenicillins have greater activity against gram - bac bc of their enhanced ability to
, penetrate these organisms' outer membrane (715)
How does the addition of a beta-lactamase inhibitor improve the activity of an
aminopenicillin? -Answer -BLIs protect hydrolysable penicillins form inactivation by
beta-lactamases (PPT)
-BLIs prevent the destruction of beta-lactam abx by serving as a competitive inhibitor of
beta-lactamase; BLIs also contain a beta-lactam ring but have poor antimicrobial
activity alone (715)
Amoxicillin is dosed for children with acute otitis media at 80 to 90 mg/kg/day. How does
that compare to dosing for other indications? What is the rationale for this dosing
regimen? - Answer Cost - affordable, high efficacy & long hx of safe use; taste &
convenience
-amoxicillin requires 2-3 doses/day, penicillin V requires 2-4 doses/day (723)
What % of pts are truly allergic to penicillins? - Ans 10% (PL)
Describe the major difference btwn the generations of cephalosporins: 1st gen - Ans
gram + (cocci & most streptococci)
Describe the major difference between the generations of cephalosporins: 2nd gen
-Answer as same 1st gen w/ increased activity against H. influenzae, limited activity
against anaerobes, each 2nd generation cephalosporin has a slightly diff spectrum of
activity so don't assume & do a C&S
Describe the major difference between the generations of cephalosporins: 3rd gen -
Answer have activity against streptococcal species, active against uncommon gram -
pathogens (use discouraged d/t poor ability to detect inducible beta-lactamases that
can inactivate this rx class)
Describe the major difference between the generations of cephalosporins: 4th gen -
Answer broader spectrum of activity, more resistant to beta-lactamases that may
inactivate 3rd gen; active against gram + & - organisms
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