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Art and Science of Advanced Practice Nursing
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Art and Science of Advanced Practice Nursing
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Art and Science of Advanced Practice Nursing
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TEST BANK: Primary Care: Art and Science of Advanced Practice Nursing – An Interprofessional Approach,5th edition (Dunphy) NEW UPDATE 2024
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TEST BANK For Primary Care: Art and Science ofAdvanced Practice Nursing - An Interprofessional
Approach 6th edition Dunphy
Which antibiotics can be used for antibiotic resistance with MRSA -
ANSWER:clindamycin, TMP/SMZ, or doxycycline should be prescribed depending on
local resistance patterns.
Which antibiotics have chemical modifications of penicillin that are stable in the
presence of penicillinase produced by staphylococci. - ANSWER:anti-staphylococcal
penicillin
Nafcillin, oxacillin, and dicloxacillin
Overuse of antibiotics in which populations creates antibiotic resistance -
ANSWER:increasing populations of immunocompromised patients
increases in the number and complexity of invasive medical procedures
increased survival of patients with chronic diseases
Spread of resistant organisms in the community has been associated with -
ANSWER:day care for young children
overcrowding
travel
use of antibiotics in agriculture
The leading risk factors for having a drug-resistant pathogen include -
ANSWER:recent use of antibiotics
age younger than 2 years or older than 65 years
day-care center attendance
exposure to young children
multiple medical comorbidities
recent hospitalization
and immunosuppression
Examples of inappropriate antibiotic use includes - ANSWER:prescribing antibiotics
for viral infections
inadequate dosing
excessive duration of therapy
increased empirical use of broad-spectrum antibiotics
Excessive and inappropriate use of antibiotic agents is a major factor - ANSWER:in
the development of drug resistance
, When is it appropriate to treat an infection empirically? - ANSWER:If antibiotics are
deemed necessary, empirical selection or definitive, culture-derived selection are
both appropriate strategies
Empiric therapy is - ANSWER:medical treatment based on experience and therapy
begun on the basis of a clinical "educated guess" in the absence of complete or
perfect information.
Empiric therapy is based on - ANSWER:clinical presentation (can the patient wait or
do they need treated now)
Before treating an infection empirically, what (if any) tests need to be ordered? -
ANSWER:Obtain cultures and/or specimens
Point of care (POC) testing for group A streptococci, influenza, urine analysis, and
microscopy are widely used and have the advantages of moderate cost and
immediate results
When can you treat an infection empirically without any testing? - ANSWER:treat
empirically if needed, culture results can confirm the diagnosis and allow for
adjustment of therapy.
Before treating an infection empirically - ANSWER:Make clinical diagnosis
Wait it out self-limiting infections using symptomatic and supportive treatment,
rather than antibiotic therapy
Make microbial diagnosis based on results of culture and/or laboratory test or most
likely pathogen
Select drug
Results of sensitivity or usual susceptibility to narrow antibiotic
What is the microbial mechanism for development of antibiotic resistance to
amoxicillin? - ANSWER:inactivation by beta-lactamases
alteration in target PBPs on the bacterial cell wall,
alteration in the outer membrane of cell wall that decreases permeability to the site
of action
How do resistant bacteria render amoxicillin ineffective? - ANSWER:Beta-lactamase
production is the most common mechanism.
Beta-lactamase inhibitors (clavulanate, sulbactam, and tazobactam) - ANSWER:have
minimal antibacterial activity but irreversibly inactivate beta-lactamase enzymes
produced by bacteria by binding to their active site and protecting the antibiotic
from inactivation.
How do you treat a localized skin infection? - ANSWER:Bacitracin (Baciguent), 500
U/g ointment
Apply a small amount to the affected area 1-2×/d
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