NR566 MIDTERM EXAM Q&A
What pathogen is highly associated with CAP in general population? - Answer-
streptococcus pneumoniae
Other common pathogens with CAP - Answer-atypical bacteria (mycoplasma
pneumonia)
viruses (influenza, respiratory syncytial virus)
First line treatment CAP in previous healthy adults - Answer-Amoxicillin, doxycycline,
macrolides (DAM)
Treatment of CAP in pregnancy - Answer-amoxicillin, cephalosporins, erythromycin
(ACE)
Treatment for mycoplasma pneumonia in the pediatric patient - Answer-Macrolides
(erythromycin, clarithromycin, azithromycin)
treatment of chlamydial pneumonia in infant - Answer-Erythromycin base/ethylsuccinate
Broad spectrum antibiotics - when to use? - Answer-empiric therapy
When you don't know which bacteria it is
more likely to facilitate emergence of drug-resistant organisms and superinfections
prescribe these before culture results back
suspects patient has UTI
Narrow spectrum antibiotics - when to use? - Answer-When the pathogen is known
Preferred
What are empiric antibiotics? - Answer-Broad Spectrum antibiotics that are given
BEFORE the results are in for certain circumstances.
Also can be prescribed when the NP believes it is a certain disease.
A)Prescription for an antibiotic for severe infection based on knowledge
B)Prescription of an antibiotic for severe infection based on clinical evaluation
C)Prescription of antibiotic for severe infection based on most likely causative agent
When to prescribe empiric antibiotics? - Answer-E for Emergency
E for enticpation
Embulatory patients
Pt has severe infxn, initiate treatment before test results available
How to treat C Diff - Answer-Stop taking the abx that caused it
, flagyl and vancomycin
Drug class known for all drugs in class to promote development of C diff - Answer-
cephalosporins (especially second or third generations)
Penicillin's have cross-sensitivity with which drug class? - Answer-cephalosporins
Can you take penicillin's if pregnant? - Answer-Yes
Can you prescribe cephalosporins if pregnant? - Answer-yes
Patient education needed for cephalosporins - Answer-Can promote C diff, instruct
patients to report increase in stool frequency
Can you prescribe tetracyclines in pregnant patients - Answer-No - can cause tooth
staining
Patient education for tetracyclines - Answer-Photosensitivity. Advise patients to avoid
prolonged exposure to sunlight, to wear protective clothing, and to apply sunscreen to
exposed skin/avoid tanning beds.
Instruct patients not to take this medication together with calcium supplements, milk
products, iron supplements, magnesium-containing laxatives, and most antacids.
Advise patients to notify the provider if diarrhea occurs, as this is an indication of
potentially life-threatening superinfection of the bowel.
Macrolides patient education - Answer-increased risk of Torsades due to prolonged QT
Which macrolide is ok for pregnancy? - Answer-erythromycin
Aminoglycosides patient education (ex. gentamicin, tobramycin, amikacin) - Answer-use
is associated with ototoxicity and nephrotoxicity
Prescribing sulfonamides during pregnancy - Answer-not safe (especially in first
trimester)- causes birth defects
if taken near term, infant can develop kernicterus (brain damage caused by too much
bilirubin)
Which cephalosporins may induce a disulfiram-like reaction if alcohol is ingested? -
Answer-Cefazolin and cefotetan
sulfonamides patient education - Answer-complete full course even if symptoms
resolved
take with 8-10 glasses of water or noncaffeinated beverages per day to decrease risk of
crystalluria
protect skin from sun
What pathogen is highly associated with CAP in general population? - Answer-
streptococcus pneumoniae
Other common pathogens with CAP - Answer-atypical bacteria (mycoplasma
pneumonia)
viruses (influenza, respiratory syncytial virus)
First line treatment CAP in previous healthy adults - Answer-Amoxicillin, doxycycline,
macrolides (DAM)
Treatment of CAP in pregnancy - Answer-amoxicillin, cephalosporins, erythromycin
(ACE)
Treatment for mycoplasma pneumonia in the pediatric patient - Answer-Macrolides
(erythromycin, clarithromycin, azithromycin)
treatment of chlamydial pneumonia in infant - Answer-Erythromycin base/ethylsuccinate
Broad spectrum antibiotics - when to use? - Answer-empiric therapy
When you don't know which bacteria it is
more likely to facilitate emergence of drug-resistant organisms and superinfections
prescribe these before culture results back
suspects patient has UTI
Narrow spectrum antibiotics - when to use? - Answer-When the pathogen is known
Preferred
What are empiric antibiotics? - Answer-Broad Spectrum antibiotics that are given
BEFORE the results are in for certain circumstances.
Also can be prescribed when the NP believes it is a certain disease.
A)Prescription for an antibiotic for severe infection based on knowledge
B)Prescription of an antibiotic for severe infection based on clinical evaluation
C)Prescription of antibiotic for severe infection based on most likely causative agent
When to prescribe empiric antibiotics? - Answer-E for Emergency
E for enticpation
Embulatory patients
Pt has severe infxn, initiate treatment before test results available
How to treat C Diff - Answer-Stop taking the abx that caused it
, flagyl and vancomycin
Drug class known for all drugs in class to promote development of C diff - Answer-
cephalosporins (especially second or third generations)
Penicillin's have cross-sensitivity with which drug class? - Answer-cephalosporins
Can you take penicillin's if pregnant? - Answer-Yes
Can you prescribe cephalosporins if pregnant? - Answer-yes
Patient education needed for cephalosporins - Answer-Can promote C diff, instruct
patients to report increase in stool frequency
Can you prescribe tetracyclines in pregnant patients - Answer-No - can cause tooth
staining
Patient education for tetracyclines - Answer-Photosensitivity. Advise patients to avoid
prolonged exposure to sunlight, to wear protective clothing, and to apply sunscreen to
exposed skin/avoid tanning beds.
Instruct patients not to take this medication together with calcium supplements, milk
products, iron supplements, magnesium-containing laxatives, and most antacids.
Advise patients to notify the provider if diarrhea occurs, as this is an indication of
potentially life-threatening superinfection of the bowel.
Macrolides patient education - Answer-increased risk of Torsades due to prolonged QT
Which macrolide is ok for pregnancy? - Answer-erythromycin
Aminoglycosides patient education (ex. gentamicin, tobramycin, amikacin) - Answer-use
is associated with ototoxicity and nephrotoxicity
Prescribing sulfonamides during pregnancy - Answer-not safe (especially in first
trimester)- causes birth defects
if taken near term, infant can develop kernicterus (brain damage caused by too much
bilirubin)
Which cephalosporins may induce a disulfiram-like reaction if alcohol is ingested? -
Answer-Cefazolin and cefotetan
sulfonamides patient education - Answer-complete full course even if symptoms
resolved
take with 8-10 glasses of water or noncaffeinated beverages per day to decrease risk of
crystalluria
protect skin from sun
