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NR 566 MIDTERM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR 566 MIDTERM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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NR 566 MIDTERM QUESTIONS ANDANSWERS WITH SOLUTIONS 2024
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
no tanning beds
monitor for hypersensitivity symptoms
sulfonamides renal dosing - ANSWER Avoid in older adults for
For patients with creatinine clearance <30mL/min:
For patients concurrently prescribed warfarin, avoid trimethoprim/sulfamethoxazole, macrolides, and
ciprofloxacin
do not give if creatine is under 15
Gentamicin (aminoglycoside) - ANSWER monitor Cr cl in elderly
renal adjustments
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