Chapter 9: Antibiotics

Chapter 9
1. b 2. c 3. c 4. c 5. b 6. d 7. b 8. c 9. d 10. c 11. b 12. a

1. If culture and sensitivity testing cannot be performed on a patient, a drug chosen to treat
the infection will have
a. a narrow spectrum of activity
b. a broad spectrum of activity
c. few toxic effects
d. a prolonged duration of action

2. A patient receiving injections of streptomycin for resistant tuberculosis should be

monitored closely for
a. yeast infections
b. photosensitivity
c. hearing loss or eighth cranial nerve damage
d. blurring of vision

3. A cephalosporin would not be the drug of choice for a patient with

a. elevated AST levels
b. high serum triglyceride levels
c. elevated blood, urea, nitrogen, and creatinine levels
d. type 2 diabetes

4. Ciprofloxacin is a drug of choice for

a. tuberculosis
b. leprosy
c. anthrax exposure
d. sexually transmitted diseases

5. A patient who is taking a fluoroquinolone antibiotic should be advised of the risk of

photosensitivity and cautioned not to combine the drug with
a. kava
b. St. John’s wort
c. ginseng
d. aloe

6. A macrolide antibiotic, such as azithromycin, may be a good drug to try in a patient

who is allergic to
a. cephalosporins
b. tetracycline
c. aspirin
d. penicillin
7. A penicillin would be the first drug of choice for
a. a bladder infection
b. a child with otitis media
c. an adult with duodenal ulcers
d. a teenager with an abscessed tooth

8. A patient taking a prolonged course of sulfasalazine would most likely have

a. tuberculosis
b. recurrent otitis media
c. ulcerative colitis
d. recurrent bladder infections

9. A patient going home on tetracycline therapy should be advised not to take his pill with
a. water
b. ginger ale
c. apple sauce
d. milk

10. Gram-negative bacteria

a. are found mostly in the respiratory tract
b. are associated mostly with soft-tissue infections
c. are found primarily in the gastrointestinal and genitourinary tracts
d. accept a positive stain when testing

11. A woman being treated with antibiotics should be advised

a. to double up on the oral contraceptives during the days the antibiotic is taken
b. to use a barrier form of contraception during antibiotic therapy because the oral
contraceptives may be ineffective
c. to stop taking her oral contraceptives because serious adverse effects could occur
d. to restart her oral contraceptive cycle when the antibiotic therapy is finished

12. New drugs have been developed to specifically treat certain resistant strains of bacteria.
It is important to
a. limit their use to situations when a culture has shown that they are the drug of
choice
b. use them as frequently as possible to get rid of these resistant strains of bacteria
c. include these drugs as a first line of treatment for severe infections with no known
cause to eradicate resistant strains
d. stock them for ready access so they may be used quickly

Chapter 11: Antifungal Agents

Chapter 11
1. c 2. d 3. b 4. b 5. c 6. a 7. d 8. c 9. d 10. a
1. Fungal infections are on the increase because fungi are found in abundance in the
environment and can cause infection readily in patients who
a. have been taking antibiotics
b. have poor hygiene and nutrition
c. are immunocompromised for any reason
d. have been traveling to areas where fungal infections are endemic

2. A fungus will not be affected by drugs that affect bacteria because

a. there are many forms of resistant fungi
b. the fungus is found normally in the environment and is not affected by drugs
c. bacteria are more abundant than fungi and are affected by the drugs first
d. fungi have a rigid cell wall that contains ergosterol and are not affected by the same
drugs that can affect a bacterial cell wall

3. A patient with a serious systemic fungal infection who is expected to recover well and
progress from intravenous to oral antifungal treatment would best be treated with
a. ketoconazole
b. fluconazole
c. itraconazole
d. amphotericin B

4. Candida is not responsible for the common infection

a. jock itch
b. Rocky Mountain spotted fever
c. athlete’s foot
d. vaginal yeast infection

5. A patient with an oral Candida infection is to be treated with a troche. Teaching

instructions for this patient should include
a. warm the troche in your hands before using
b. chew the troche quickly to reduce the bad taste
c. dissolve the troche slowly in your mouth
d. rub the troche around your mouth to touch all of the white spots

6. Because antifungal drugs tend to be very toxic to the host, it is important to

a. get a culture of the causative organism to make sure that the appropriate drug is
being used
b. use the smallest dose available to prevent adverse effects
c. switch drugs every few days to continue to kill the fungus and decrease adverse
effects
d. withhold treatment until the patient cannot survive without it
7. A person has a severe case of athlete’s foot. He is advised to use Tinactin, a topical
drug. It is important to teach the patient
a. to avoid washing the feet or abrading the areas that are oozing
b. to cover the area tightly with a bandage or plastic bag to keep the drug in close
contact with the affected area
c. to apply extra layers of cream if there are open lesions on the feet
d. that clean, dry socks are important for eradicating the infection

8. A patient using a topical antifungal agent should be taught to call the health care
provider and stop using the drug if
a. a red rash appears in the area
b. the area appears to be oozing
c. local irritation, burning, and pain occurs when the drug is used
d. the area being treated starts to flake skin

9. A patient receiving itraconazole must be monitored for possible liver toxicity. Early
signs for which to watch include
a. elevated blood, urea, nitrogen levels
b. hypertension
c. edema and swelling of the extremities
d. changes in the color of urine or stools

10. A woman with a vaginal yeast infection should be advised

a. to insert the cream, suppository, or tablet high into the vagina
b. to stop using the treatment if she is having her menstrual period
c. to use the drug only when she can stay in bed for several hours after insertion
d. to avoid inserting the cream, suppository, or tablet high into the vagina

Chapter 13: Anthelmintic Agents

Chapter 13
1. c 2. d 3. b 4. a 5. c 6. c 7. a 8. c 9. c 10. a

1. The only way to diagnose a helminthic infection properly in humans is by

a. blood culture
b. culture swab of the throat
c. stool specimen for ova and parasites
d. rectal exam with smear

2. The most common worm infection that will be encountered in American school-age
children is infection by
a. whip worms
b. threadworms
c. roundworms
d. pinworms
3. A patient went on a dream vacation to see the pyramids and took a tour that included
swimming in the Nile. A few weeks after returning home, the patient was complaining
of fever, chills, abdominal pain, and nausea. After ruling out the flu or other common
problems, it may be appropriate to consider
a. tapeworm
b. schistosomiasis
c. ringworm
d. African sleeping sickness

4. In trying to decide whether to treat the student with a pinworm infection with pyrantel
or mebendazole, a key consideration may be
a. pyrantel is given as a single dose and the patient will not need to remember to take
it
b. mebendazole has no adverse effects and thus would be safer
c. the pinworm is not infectious if the patient is treated with mebendazole
d. pyrantel can be taken safely during pregnancy, which could be an issue

5. Teaching information that is necessary to ensure the therapeutic effectiveness of an

anthelmintic drug would include
a. the infected person should be isolated
b. any person exposed to the patient should also be treated
c. strict handwashing and hygiene measures are important in eradicating the worm
d. the drugs should never be taken with food

6. Ascaris infections are the most prevalent, worldwide helminthic infections and may
cause
a. cough, fever, and signs of pulmonary infestation
b. cardiac arrhythmias
c. seizures and disorientation
d. bloody diarrhea

7. Mebendazole is the most commonly used antihelmintic. It is effective against

a. pinworms, roundworms, whip worms, and hookworms
b. trichinosis and flukes
c. pork tapeworm and threadworms
d. all stages of schistosomal infections

8. Parents of a child who has been diagnosed with pinworm disease may feel very anxious
and stressed. Teaching should include
a. criticism of their personal hygiene practices
b. evaluation of their kitchen and cooking area
c. an explanation of what they may see and experience as the worms are passed from
the body
 d. a description of the proper isolation techniques for the child

9. The parents of the child with a pinworm infection would also be told that effective
treatment of pinworm infections would involve all of the following except
a. keeping nails cut short and hands well scrubbed
b. laundering undergarments, bed linens, and pajamas every day
c. boiling all drinking water
d. disinfecting toilet seats and bathroom floors daily

10. Helminths can

a. invade body tissues and can seriously damage lymphatic tissue, lungs, the central
nervous system, heart, and liver
b. irritate the anal area but not cause any real problems
c. spread rapidly within a schoolroom
d. disrupt normal cellular function in humans and cause disease

Chapter 8: Anti-infective Agents

Chapter 8
1. b 2. a 3. c 4. d 5. d 6. a 7. a 8. c 9. c 10. b

1. Penicillins are anti-infectives that work by

a. preventing bacterial cell division
b. interfering with biosynthesis of the bacterial cell wall
c. altering the protein synthesis within the bacterial cell
d. providing the bacteria with false nutrients, causing their death

2. An antibiotic with a broad spectrum of activity could be used

a. to treat many different bacterial infections
b. to treat only a very small group of select bacterial infections
c. to treat bacterial and viral infections
d. to treat infections with no known cause

3. The basic goal of anti-infective therapy is to

a. destroy all traces of the invading organisms
b. prevent invading organisms from multiplying so they will die off
c. reduce the population of the invading organism to a point at which the human
immune response can take care of the infection
d. wipe out the invading organisms within a short period of time so the body can heal

4. Microorganisms can develop resistance to anti-infective drugs by doing all of the

following except
a. changing cellular permeability to prevent the drug from entering the cell
 b. altering binding sites on the membranes or ribosomes that then no longer accept the
drug
c. producing an enzyme that deactivates the antimicrobial drug
d. rearranging their DNA to produce membranes that are impermeable to the drug

5. The emergence of resistant strains of microorganisms is a serious public health problem

that can be decreased by
a. using antibiotics quickly to treat colds and other infections, before the invading
organism has a chance to multiply
b. using antibiotics for shorter periods of time, just until the signs and symptoms of
infection have passed
c. providing patients with prescriptions for antibiotics that they can have filled as soon
as they suspect that they have an infection
d. teaching patients the importance of taking the full course of an antibiotic that has
been prescribed and not saving the remaining drugs for future infections

6. It is important to get a culture of an area that is infected to

a. identify correctly the invading organism and to arrange treatment
b. increase the cost of a health care visit
c. track the emergence of resistant strains of bacteria
d. isolate mutant viruses

7. Sensitivity testing of a culture done on an infected area of the body shows

a. the drugs that are capable of controlling that particular microorganism
b. the patient’s potential for allergic reactions to a drug
c. the offending microorganism
d. an immune reaction to the infecting organism

8. Gastrointestinal toxicity is a very common adverse effect seen with anti-infective

therapy. A patient experiencing gastrointestinal toxicity might complain of
a. elevated blood, urea, nitrogen
b. difficulty breathing
c. nausea, vomiting, or diarrhea
d. a red, itchy rash

9. Some anti-infectives are used as a means of prophylaxis. An example of this would be

a. use of amoxicillin to treat tonsillitis
b. use of penicillin to treat an abscess
c. use of an antibiotic before dental surgery
d. use of norfloxacin to treat a bladder infection

10. Superinfections may occur when anti-infective agents destroy the normal flora of the
body. Candida infections are associated commonly with antibiotic use. A patient with
this type of superinfection would exhibit
 a. difficulty breathing
b. vaginal discharge or white patches in the mouth
c. elevated blood, urea, nitrogen levels
d. dark, circular lesions on the skin

Chapter 14: Antineoplastic Agents

Chapter 14
1. a 2. a 3. c 4. b 5. b 6. c 7. d 8. b 9. b 10. c

1. The goal of traditional antineoplastic drug therapy is to

a. reduce the size of the mass of abnormal cells so the immune system can take care of
destroying them
b. eradicate all the abnormal cells that have developed
c. destroy all cells of the originating type
d. stimulate the immune system to destroy the neoplastic cells

2. Cell properties that are not specific characteristics of cancer cells would include
a. mitosis
b. anaplasia
c. metastasis
d. autonomy

3. Alkylating agents disrupt cellular DNA and cause cell death. This will also affect
noncancer cells and has most effect on those cells
a. with a long dormant phase
b. with membrane abnormalities
c. that are turning over rapidly
d. with a good oxygen supply

4. Antineoplastic agents are often given in combination and in repeated cycles. In

teaching the patient about this regimen, the need to do this would be best explained by
a. telling the patient that the drugs would make him too sick if given all at once
b. outlining the cell cycle and the importance of destroying the mutant cells in all
stages of the cell cycle
c. telling the patient the costs of the drugs and the importance of administering them
in small batches
d. telling the patient that no one understands the actual effect of the drugs and they are
best given this way

5. Patients who are receiving antineoplastic drugs need to have regular blood tests to
a. evaluate drug serum levels
b. monitor bone marrow activity and determine the next appropriate dose
 c. screen for neoplastic cells
d. monitor blood glucose levels

6. The use of hormones or hormone modulators to treat a cancer is contraindicated in

a. men
b. postmenopausal women
c. pregnant women
d. patients who use birth control pills

7. A patient is receiving a combination of antineoplastic agents and will most likely lose
her hair. Pretreatment education may include the suggestion to get a wig or other
appropriate head cover because
a. other people may be uncomfortable seeing her bald head
b. the hair is most likely to grow back if the head is covered at all times
c. her self-esteem will be better if the head is covered
d. most of the heat is lost through the head and it is important to cover it during
extremes in temperature

8. Chemotherapeutic agents should not be used during pregnancy because

a. the tendency to cause nausea and vomiting will be increased
b. potentially serious adverse effects on the rapidly multiplying cells of the fetus
c. bone marrow toxicity could alter hormone levels
d. patients may be weakened by the drug regimen

9. A patient has been prescribed Gleevec for treatment of leukemia. When the patient goes
to pick up the drug at the pharmacy, he is shocked by the price. The patient
a. would benefit from a support group
b. could petition the drug company for special funding benefits to cover the cost of the
drug
c. should refuse to take the drug because of cost
d. should ask the health care provider for another drug just like this one that might be
cheaper

10. Nausea and vomiting are frequent adverse effects associated with antineoplastic
therapy. Patients who are experiencing this unpleasant effect should be advised
a. to avoid eating any food during chemotherapy
b. that there is nothing that can be done for this effect and it will pass with time
c. to try to maintain hydration and nutrition, which are very important during
treatment
d. to use antacids to relieve the irritation to the stomach, which should stop the nausea

Chapter 10: Antiviral Agents

Chapter 10
1. c 2. d 3. c 4. a 5. b 6. c 7. b 8. d 9. c 10. b
1. A patient receiving Tamiflu should have
a. access to other antiviral agents
b. symptoms of the flu for at least 5 days
c. symptoms of the flu for as long as or less than 2 days
d. a pregnancy test before using the drug

2. A virus is a parasite because

a. it uses up all of a host’s nutrition
b. it drains a host’s oxygen supply
c. it can only multiply by using the host’s blood supply
d. it cannot survive on its own but must take over host cells

3. Relenza is designed to affect the influenza virus to lessen the length of time a person
has the flu. This drug must be administered by
a. intramuscular injection
b. crushed oral tablets
c. inhalation
d. intradermal injection

4. A college student taking valacyclovir to treat recurrent genital herpes should be taught
a. to avoid sexual intercourse because these drugs do not cure the disease
b. to monitor and limit daily fluid intake to prevent fluid retention
c. that sexual intercourse is fine; as long as you are on the drug, you are not
contagious
d. to stop taking the drug as soon as the lesions disappear

5. A patient being treated for human immunodeficiency virus (HIV) comes in for a blood
pressure check. When taking her history, she reports that she is only taking retinovir for
the treatment of her HIV. This causes you to check further because
a. retinovir is not used to treat HIV states
b. the antivirals used to treat HIV are used only in combination with other antiviral
drugs
c. retinovir is contraindicated in people with hypertension
d. retinovir has been discontinued and she should not have access to it

6. Nursing interventions for the patient receiving antiviral drugs for the treatment of HIV
probably would not include
a. monitoring renal and hepatic function periodically during therapy
b. administering the drugs around the clock to increase drug effectiveness
c. encouraging the patient to avoid eating if gastrointestinal upset is severe
d. stopping the drugs and notifying the prescriber if a severe rash occurs

7. Viral infections have proved difficult to treat because

 a. viruses have a protein coating that is hard to penetrate
b. viruses inject themselves into human cells to survive and to reproduce, and they
cannot be affected while in the human cell
c. viruses are bits of ribonucleic acid or DNA
d. viruses resist drug therapy easily by altering their cell membrane

8. A patient who is taking a combination regimen of lamivudine, zidovudine, ritonavir,

and zalcitabine to treat HIV should be cautioned to avoid
a. direct sunlight
b. using saw palmetto
c. taking over-the-counter vitamin products
d. taking St. John’s wort

9. A pregnant woman with acquired immune deficiency syndrome would probably be

trying to prevent maternal transmission of the acquired immune deficiency syndrome
virus to the baby by taking
a. efavirenz
b. nevirapine
c. zidovudine
d. stavudine

10. A patient with cold sores may benefit from the topical application of
a. valacyclovir
b. penciclovir
c. fomivirsen
d. imiquimod