Test Bank For Microbiology Fundamentals A Clinical Approach 1st Edition Cowan

Test Bank for Microbiology Fundamentals A Clinical Approach, 1st Edition : Cowan
Test Bank for Microbiology Fundamentals A Clinical

Approach, 1st Edition : Cowan
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10
Student: ___________________________________________________________________________
1. Substances that are naturally produced by certain microorganisms that can inhibit or destroy other
microorganisms are called
A. antibiotics.
B. narrow-spectrum drugs.
C. semi-synthetic drugs.
D. synthetic drugs.
E. broad-spectrum drugs.
2. Antimicrobials effective against a wide variety of microbial types are termed

A. antibiotics.
C. semisynthetic drugs.
D. synthetic drugs.
3. Antibiotics are derived from all of the following except

A. Penicillium.
B. Bacillus.
C. Staphylococcus.
D. Streptomyces.
E. Cephalosporium.
4. Important characteristics of antimicrobial drugs include

A. low toxicity for human tissues.
B. high toxicity against microbial cells.
C. do not cause serious side effects in humans.
D. stable and soluble in body tissues and fluids.
E. All of the choices are correct.
5. The use of a drug to prevent imminent infection is called

A. competitive inhibition.
B. synergism.
C. prebiotics.
D. prophylaxis.
E. lantibiotics.
6. The use of any chemical in the treatment, relief, or prophylaxis of a disease is called
A. prophylaxis.
B. chemotherapy.
C. selective toxicity.
D. nephrotoxicity.
E. synergism.
7. Penicillins and cephalosporins

A. interfere with elongation of peptidoglycan.
B. block folic acid synthesis.
C. attach to the 30S ribosomal subunit and disrupt protein synthesis.
D. damage cell membranes.
E. block peptidases that cross-link glycan molecules.
8. Selective toxicity refers to
A. damage to pathogenic organisms.
B. damage to prokaryotic cell membranes.
C. damage to the target organisms but not host cells.
D. damage to nucleic acids.
E. None of the choices is correct.
9. Each of the following effect cell walls except

A. penicillin.
B. cycloserine.
C. vancomycin.
D. erythromycin.
E. cephalosporin.
10. Aminoglycosides
11. Each of the following target prokaryotic ribosomes except

A. streptomycin.
B. gentamycin.
C. polymyxins.
D. tetracycline.
E. erythromycin.
12. Drugs that insert on the _____ ribosomal subunit prevent peptide bond formation or inhibit
translocation of the subunit during translation.
A. 30S
B. 40S
C. 50S
D. 60S
E. 70S
13. Sulfonamides
14. Sulfa drugs work on

A. nucleic acid biosynthesis.
B. ribosome biosynthesis.
C. peptidoglycan biosynthesis.
D. folic acid biosynthesis.
15. Sulfonamides are analogs of PABA and, as a result, they inhibit _____ synthesis.
A. protein
B. DNA
C. RNA
D. folic acid
E. phospholipid
16. Drugs that act by mimicking the normal substrate of an enzyme, thereby blocking its active site,
are called
A. inhibitors.
B. blockers.
C. competitive inhibitors.
D. noncompetitive inhibitors.
17. Ampicillin, amoxicillin, mezlocillin, and penicillin G all have

A. a beta-lactam ring.
B. resistance to the action of penicillinase.
C. a semisynthetic nature.
D. an expanded spectrum of activity.
18. A chemical that inhibits beta-lactamase enzymes is

A. synercid.
B. penicillinase.
C. aztreonam.
D. clavulanic acid.
E. imipenem.
19. What type of chemical will allow some bacteria to be resistant to many penicillins?
A. synercid
B. penicillinase
C. aztreonam
D. clavulanic acid
E. imipenem
20. All of the following pertain to cephalosporins except

A. have a beta-lactam ring.
B. greater resistance to beta-lactamases.
C. newer generations have activity against gram-negatives.
D. many administered by injection, not orally.
E. are synthetic drugs.
21. Which antimicrobial does not inhibit cell wall synthesis?

A. gentamicin
B. vancomycin
C. cephalosporins
D. penicillins
E. clavamox
22. Which drug is used to treat cases of tuberculosis?
A. penicillin G
B. vancomycin
C. tetracycline
D. synercid
E. isoniazid
23. What drug is used in cases of penicillin and methicillin resistance and also used to treat
endocarditis?
A. penicillin G
B. vancomycin
C. tetracycline
D. erythromycin
E. isoniazid
24. Clavulanic acid

A. inhibits B-lactamase activity.
B. inhibits peptidoglycan synthesis.
C. inhibits formation of peptidoglycan cross linkages.
D. inhibits cell membrane synthesis.
25. All _____ consist of a thiazolidine ring, a beta-lactam ring, and an R group.
A. penicillins
B. tetracyclins
C. macrolides
D. cephalosporins
E. aminoglycosides
26. The major source of naturally produced penicillin is the mold

A. Penicillium notatum.
B. Penicilium chrysogenum.
C. Penicilium familiaris.
D. Naturally produced penicillin is no longer used.
27. Gram-negative rods are often treated with

A. penicillin G.
B. vancomycin.
C. aminoglycosides.
D. synercid.
E. isoniazid.
28. Which antimicrobial does not interfere with protein synthesis?

A. aminoglycosides
B. tetracyclines
C. erythromycin
D. trimethroprim
E. gentamicin
29. Which of these drugs has the most narrow spectrum?
A. tetracycline
B. isoniazid
C. erythromycin
D. aminoglycosides
E. cephalosporins
30. Antimicrobials that are macrolides

A. disrupt cell membrane function.
B. include tetracyclines.
C. include azithromycin, clarithromcyin and erythromycin.
D. are very narrow-spectrum drugs.
E. are hepatotoxic.
31. The drug that can cause injury to red blood cells and white blood cells is
A. chloramphenicol.
B. clindamycin.
C. ciprofloxacin.
D. bacitracin.
E. gentamicin.
32. Which of the following antibacterial drug groups does not target protein synthesis?
A. clindamycin
B. erythromycin
C. aminoglycosides
D. sulfonamides
E. tetracycline
33. Which antibiotic is used to treat MRSA and VRE infections?

A. synercid
B. clindamycin
C. linezolid
D. azithromycin
E. clarithromycin
34. Which of the following is not true of polymyxins?

A. disrupt the cell membrane
B. have a narrow-spectrum
C. toxic to kidneys
D. target cell walls
E. can treat severe urinary tract infections
35. The antifungal drug that can be used to treat serious systemic fungal infections is
A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.
36. Ketoconazole, fluconazole, clotrimazole and miconazole are broad-spectrum azoles used to treat
_____ infections.
A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral
37. Which of the following is not a drug group used to treat fungal infections?
A. quinolones
B. macrolide polyene antibiotics
C. griseofulvins
D. synthetic azoles
E. flucytosines
38. The drug used for several protozoan infections is

A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.
39. Mebendazole is a drug used to treat _____ infections.

A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral
40. There are fewer antifungal, anti-protozoan, and anti-helminth drugs compared to antibacterial
drugs because fungi, protozoa, and helminths
A. do not cause many human infections.
B. are not affected by antimicrobials.
C. are so similar to human cells that drug selective toxicity is difficult.
D. are parasites found inside human cells.
E. because their cells have fewer target sites compared to bacteria.
41. Primaquine and chloroquine are drugs used in the treatment of

A. gram-positive infections.
B. gram-negative infections.
C. fungal infections.
D. protozoan infections.
E. viral infections.
42. Which of the following is not a mode of action of antiviral drugs?

A. block penetration
B. block transcription and translation
C. inhibit DNA synthesis
D. block maturation
E. bond to ergosterol in the cell membrane
43. An antiviral that is a guanine analog would have an antiviral mode of action that
A. blocks penetration.
B. blocks transcription and translation.
C. inhibits DNA synthesis.
D. blocks maturation.
E. bonds to ergosterol in the cell membrane.
44. Antiviral drugs that target reverse transcriptase would be used to treat
A. influenza A virus.
B. HIV.
C. herpes zoster virus.
D. respiratory syncytial virus.
E. hepatitis C virus.
45. Acyclovir is used to treat

B. HIV.
C. herpes simplex virus.
46. Which of the following block HIV binding to host cell receptors?
A. AZT
B. acyclovir
C. nevirapine
D. fuzeon
E. amantidine
47. The cellular basis for bacterial resistance to antimicrobials include

A. bacterial chromosomal mutations.
B. synthesis of enzymes that alter drug structure.
C. prevention of drug entry into the cell.
D. alteration of drug receptors on cell targets.
48. The multidrug resistant pumps in many bacterial cell membranes function by
C. removing the drug from the cell when it enters.
49. Microbial resistance resulting from mutation occurs because

A. prokaryotic genomes undergo mutation rapidly.
B. prokaryotic genomes undergo mutation often.
C. short generation times accumulate mutations in populations.
D. mutations are passed between organisms.
50. Each of the following result in drug resistance except

A. drug pumped out of the cell.
B. drug used as a nutrient by the cell.
C. drug binding site altered.
D. drug inactivated.
E. drug blocked from entering cell.
51. Each of the following is a mechanism for drug resistance transfer between microorganisms
except
A. transposons.
B. R-plasmids.
C. conjugation.
D. mutation.
E. All of the choices provide for transfer of drug resistance.
52. Each of the following contributes to emerging drug resistance except

A. overuse of antibiotics.
B. improper use of antibiotics.
C. multiple drug therapy.
D. ingestion of antibiotics with animal feed.
E. addition of antibiotics to common household products.
53. Nutrients that encourage the growth of beneficial microbes in the intestines are known as
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.
54. The use of vaginal inserts of Lactobacillus to restore a healthy acidic environment is an example
of
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.
55. Broad-spectrum drugs that disrupt the body's normal flora often cause
A. nephrotoxicity.
B. superinfections.
C. allergic reactions.
D. drug toxicity.
56. Side effects that occur in patient's tissues while on antimicrobial drugs include all the following
except
A. development of resistance to the drug.
B. hepatotoxicity.
C. nephrotoxicity.
D. diarrhea.
E. deafness.
57. A superinfection results from

A. build up of a drug to toxic levels in the patient.
B. the wrong drug administered to the patient.
C. an immune system reaction to the drug.
D. decrease in most normal flora with overgrowth of an unaffected species.
58. The _____ are drugs that deposit in developing teeth and cause a permanent brown discoloration.
A. streptomycins
B. cephalosporins
C. macrolides
D. tetracyclins
E. penicillins
59. Drug susceptibility testing determines

A. the patient's response to various antimicrobials.
B. the pathogen's response to various antimicrobials.
C. if normal flora will be affected by antimicrobials.
D. if the drug is increasing to toxic levels in a patient.
60. A clinical microbiologist makes serial dilutions of several antimicrobials in broth, and then
incubates each drug dilution series with a standard amount of a patient's isolated pathogen. What
is this microbiologist setting up?
A. Kirby-Bauer
B. antibiogram
C. E-test
D. MIC
E. therapeutic index (TI)
61. A ratio of the dose of the drug that is toxic to humans versus the minimum effective dose for that
pathogen is assessed to predict the potential for toxic drug reactions. This is called the
A. Kirby-Bauer.
B. antibiogram.
C. E-test.
D. MIC.
E. therapeutic index (TI).
62. If pathogen A is more resistant to an erythromycin disc on a Kirby-Bauer plate compared to

pathogen B, then pathogen A will have a(n) _____ zone of inhibition compared to pathogen B.
A. smaller
B. equal
C. larger
D. All of the choices are correct.
63. Which therapeutic index value would be the drug of choice?

A. 20
B. 10
C. 1
D. 0.1
E. Any value would be equally effective.
64. Which two antibiotics affect the DNA and RNA of bacteria?
A. tetracycline and amphotericin B
B. trimethoprim and sulfonamides
C. Rifampin and quinolones
D. tetracycline and bacitracin
65. Antimicrobial drugs that inhibit folic acid synthesis work with no side effects because mammals
must get folic acid from their diet.
True False
66. Species of Bacillus produce bacitracin and the polymyxins.
True False
67. An antibiotic of the penicillin family is penicillin G.
True False
68. The first modern antimicrobial drugs were sulfa drugs.
True False
69. Ciprofloxacin is used to treat viral respiratory infections.
True False
70. Resistance factor plasmids are transferred to other bacterial cells during transformation,
transduction, and conjugation.
True False
71. Bacteria can have a natural resistance to a drug that it has never been exposed to.
True False
72. When a patient's immune system reacts adversely to a drug, this serious side effect is called a
superinfection.
True False
73. Drugs that are hepatotoxic cause damage to a patient's kidneys.
True False
74. The MIC is the smallest concentration of an antimicrobial required to inhibit the growth of the
microbe.
True False
75. The Kirby-Bauer test uses an agar surface, seeded with the test bacterium, to which small discs
containing a specific concentration of several drugs are placed on the surface.
True False
76. An antimicrobial with a low therapeutic index is a safer choice compared to a drug with a high
therapeutic index.
True False
77. It is better to use a broad-spectrum drug instead of a more specific narrow-spectrum drug.
True False
78. Newer, more expensive antimicrobials are always better to use than cheaper, older drugs.
True False
79. Indwelling catheter biofilm infections are more resistant to antibiotics than non-biofilm
infections.
True False
80. Drug toxicity occurs when an antimicrobial drug acts as antigen and stimulates an allergic
response.
True False
NCLEX Prep - Test Bank Question: Please read the clinical scenario, and then answer the questions
that follow to become familiar with the traditional NCLEX question format.
A 76-year-old male visits his primary care physician with complaints of burning with urination and
a frequent urge to void. As the RN, you aid the patient in collecting a urine specimen to be sent
for analysis. While awaiting the final results of drug susceptibility testing in the lab, the patient is
prescribed oral sulfasoxazole.
81. In the lab, the urine specimen is spread on an agar plate with antibiotic discs placed to determine
antimicrobial susceptibility. Following incubation, the clear area around each disc is measured.
What term describes the observed area of antimicrobial action around each disc?
A. zone of inhibition
B. zone of susceptibility
C. zone of resistance
D. antibiogram
82. You provide education to the patient regarding sulfasoxazole, a sulfonamide that targets folic
acid synthesis. The synthesis of which of the following products is affected by inhibition of folate
metabolism?
A. DNA
B. RNA
C. DNA and RNA
D. DNA, RNA, and amino acids
83. Which of the following reactions by the patient would demonstrate an allergic response?
A. anaphylaxis
B. rash
C. difficulty breathing
D. Anaphylaxis, rash development, and difficulty breathing could all indicate allergic response in
a patient.
84. The in vitro susceptibility of the pathogen is established, and the patient is maintained on
sulfasoxazole. If no in vivo effect of the drug is observed by the patient following the first 7 days
of antibiotics, what is the most appropriate action by the medical team?
A. increase the dose of sulfasoxazole
B. discontinue antibiotic therapy
C. discontinue sulfasoxazole and initiate a new antibiotic
D. initiate antiviral therapy
A 12-year-old male is admitted to the pediatric unit due to persistent upper respiratory symptoms
and respiratory distress. The patient has a history of developmental delay, chronic lung disease, and
frequent respiratory infections. Upon assessment, as the RN, you note the patient to have a fever,
moderate respiratory rate, productive cough, and large amount of nasal secretions. Upon report from
the patient’s mother, the patient has been on a 3-week course of antibiotics with no improvement in
symptoms. Upon further work-up, the patient is diagnosed with bacterial pneumonia and methicillin-
resistant Staphylococcus aureus (MRSA) superinfection.
85. You provide education to the patient and his mother regarding the diagnosis. Which of the
following statements, by the mother, demonstrates an understanding of the teaching?
A. "My son has an extremely resistant form of MRSA causing his prolonged illness."
B. "My son developed simultaneous bacterial infections."
C "My son developed a MRSA superinfection, following suppression of normal resident species
. in his lungs due to his initial infection."
D. "My son has pneumonia caused by a virus."
86. Based upon the patient’s history, what is the most likely cause of the superinfection?
A. poor hygiene
B. long-term antibiotic therapy
C. fecal-oral contamination
D. community-acquired MRSA
87. The use of which of the following drugs results in the highest risk of superinfection in a treated
patient?
A. broad-spectrum antibiotics
B. narrow-spectrum antibiotics
C. topical antibiotics
D. antivirals
88. Treatment of urinary tract infections often leads to a superinfection caused by which microbe?
A. Giardia lamblia
B. Lactobacillus acidophilus
C. Escherichia coli
D. Candida albicans
As an RN in a medical intensive care unit, you are participating in a research study regarding
administration of probiotics to critically ill patients receiving antibiotic therapy. You provide
education as part of the consent process to patients, families, and other staff members.
89. Following the teaching to patients and families, you assess understanding of the teaching prior to
obtaining consent. All of the following are accurate statements by a patient regarding probiotics,
except probiotics
A. are live microorganisms.
B. are nutrients to encourage microbe growth.
C. augment the microbes in the intestine.
D. can replace microbes killed during antibiotic therapy.
90. Which of the following is an example of a probiotic?

A. penicillin
B. micafungin
C. yogurt
D. fructans
91. You indicate to the patient that research has demonstrated that probiotics may also be useful in
the management of allergies caused by
A. animal dander.
B. pollen.
C. food.
D. detergents.
10 Key
1. Substances that are naturally produced by certain microorganisms that can inhibit or destroy
other microorganisms are called
A. antibiotics.
C. semi-synthetic drugs.
D. synthetic drugs.
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other.
ASM Topic: Module 05 Systems
Blooms Level: 01. Remember
Cowan - Chapter 10 #1
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials.
Section: 10.01
Topic: Antimicrobial Medications
2. Antimicrobials effective against a wide variety of microbial types are termed
A. antibiotics.
C. semisynthetic drugs.
D. synthetic drugs.
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological methods.
ASM Topic: Module 03 Metabolic Pathways
Learning Objective: 10.08 Distinguish between broad-spectrum and narrow-spectrum antimicrobials, and explain the significance of the distinction.
Section: 10.02
3. Antibiotics are derived from all of the following except
A. Penicillium.
B. Bacillus.
C. Staphylococcus.
D. Streptomyces.
E. Cephalosporium.
Section: 10.01
4. Important characteristics of antimicrobial drugs include
A. low toxicity for human tissues.
B. high toxicity against microbial cells.
C. do not cause serious side effects in humans.
D. stable and soluble in body tissues and fluids.
Blooms Level: 03. Apply
Learning Objective: 10.05 Explain the concept of selective toxicity.
Section: 10.02
5. The use of a drug to prevent imminent infection is called
A. competitive inhibition.
B. synergism.
C. prebiotics.
D. prophylaxis.
E. lantibiotics.
Learning Objective: 10.01 State the main goal of antimicrobial treatment.
Section: 10.01
Topic: Infection and Disease
6. The use of any chemical in the treatment, relief, or prophylaxis of a disease is called
A. prophylaxis.
B. chemotherapy.
C. selective toxicity.
D. nephrotoxicity.
E. synergism.
Learning Objective: 10.01 State the main goal of antimicrobial treatment.
Section: 10.01
7. Penicillins and cephalosporins
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection.
ASM Topic: Module 02 Structure and Function
Learning Objective: 10.06 List the five major targets of antimicrobial agents.
Section: 10.02
Topic: Prokaryotes
8. Selective toxicity refers to
A. damage to pathogenic organisms.
B. damage to prokaryotic cell membranes.
C. damage to the target organisms but not host cells.
D. damage to nucleic acids.
Section: 10.02
9. Each of the following effect cell walls except
A. penicillin.
B. cycloserine.
C. vancomycin.
D. erythromycin.
E. cephalosporin.
Section: 10.02
10. Aminoglycosides
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis.
Section: 10.02
11. Each of the following target prokaryotic ribosomes except
A. streptomycin.
B. gentamycin.
C. polymyxins.
D. tetracycline.
E. erythromycin.
Section: 10.02
Topic: Prokaryotes
12. Drugs that insert on the _____ ribosomal subunit prevent peptide bond formation or inhibit
translocation of the subunit during translation.
A. 30S
B. 40S
C. 50S
D. 60S
E. 70S
Section: 10.02
13. Sulfonamides
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work.
Section: 10.02
14. Sulfa drugs work on
A. nucleic acid biosynthesis.
B. ribosome biosynthesis.
C. peptidoglycan biosynthesis.
D. folic acid biosynthesis.
Section: 10.02
15. Sulfonamides are analogs of PABA and, as a result, they inhibit _____ synthesis.
A. protein
B. DNA
C. RNA
D. folic acid
E. phospholipid
Blooms Level: 02. Understand
Section: 10.02
16. Drugs that act by mimicking the normal substrate of an enzyme, thereby blocking its active
site, are called
A. inhibitors.
B. blockers.
C. competitive inhibitors.
D. noncompetitive inhibitors.
Section: 10.02
17. Ampicillin, amoxicillin, mezlocillin, and penicillin G all have
A. a beta-lactam ring.
B. resistance to the action of penicillinase.
C. a semisynthetic nature.
D. an expanded spectrum of activity.
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective.
Section: 10.02
18. A chemical that inhibits beta-lactamase enzymes is
A. synercid.
B. penicillinase.
C. aztreonam.
D. clavulanic acid.
E. imipenem.
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resistance).
ASM Topic: Module 04 Information Flow
Learning Objective: 10.10 Explain the significance of beta-lactamases.
Section: 10.02
19. What type of chemical will allow some bacteria to be resistant to many penicillins?
A. synercid
B. penicillinase
C. aztreonam
D. clavulanic acid
E. imipenem
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials.
Section: 10.03
20. All of the following pertain to cephalosporins except
A. have a beta-lactam ring.
B. greater resistance to beta-lactamases.
C. newer generations have activity against gram-negatives.
D. many administered by injection, not orally.
E. are synthetic drugs.
Section: 10.02
21. Which antimicrobial does not inhibit cell wall synthesis?
A. gentamicin
B. vancomycin
C. cephalosporins
D. penicillins
E. clavamox
Section: 10.02
22. Which drug is used to treat cases of tuberculosis?
A. penicillin G
B. vancomycin
C. tetracycline
D. synercid
E. isoniazid
Section: 10.02
23. What drug is used in cases of penicillin and methicillin resistance and also used to treat
endocarditis?
A. penicillin G
B. vancomycin
C. tetracycline
D. erythromycin
E. isoniazid
Section: 10.02
24. Clavulanic acid
A. inhibits B-lactamase activity.
B. inhibits peptidoglycan synthesis.
C. inhibits formation of peptidoglycan cross linkages.
D. inhibits cell membrane synthesis.
Section: 10.02
25. All _____ consist of a thiazolidine ring, a beta-lactam ring, and an R group.
A. penicillins
B. tetracyclins
C. macrolides
D. cephalosporins
E. aminoglycosides
Section: 10.02
26. The major source of naturally produced penicillin is the mold
A. Penicillium notatum.
B. Penicilium chrysogenum.
C. Penicilium familiaris.
D. Naturally produced penicillin is no longer used.
Section: 10.01
27. Gram-negative rods are often treated with
A. penicillin G.
B. vancomycin.
C. aminoglycosides.
D. synercid.
E. isoniazid.
Section: 10.02
28. Which antimicrobial does not interfere with protein synthesis?
A. aminoglycosides
B. tetracyclines
C. erythromycin
D. trimethroprim
E. gentamicin
Section: 10.02
29. Which of these drugs has the most narrow spectrum?
A. tetracycline
B. isoniazid
C. erythromycin
D. aminoglycosides
E. cephalosporins
Section: 10.02
30. Antimicrobials that are macrolides
A. disrupt cell membrane function.
B. include tetracyclines.
C. include azithromycin, clarithromcyin and erythromycin.
D. are very narrow-spectrum drugs.
E. are hepatotoxic.
Section: 10.02
31. The drug that can cause injury to red blood cells and white blood cells is
A. chloramphenicol.
B. clindamycin.
C. ciprofloxacin.
D. bacitracin.
E. gentamicin.
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs.
Section: 10.04
32. Which of the following antibacterial drug groups does not target protein synthesis?
A. clindamycin
B. erythromycin
C. aminoglycosides
D. sulfonamides
E. tetracycline
Section: 10.02
33. Which antibiotic is used to treat MRSA and VRE infections?
A. synercid
B. clindamycin
C. linezolid
D. azithromycin
E. clarithromycin
Section: 10.02
34. Which of the following is not true of polymyxins?
A. disrupt the cell membrane
B. have a narrow-spectrum
C. toxic to kidneys
D. target cell walls
E. can treat severe urinary tract infections
Learning Objective: 10.14 Name a drug that targets the cellular membrane.
Section: 10.02
35. The antifungal drug that can be used to treat serious systemic fungal infections is
A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.
Learning Objective: 10.16 Name the four main categories of antifungal agents.
Section: 10.02
36. Ketoconazole, fluconazole, clotrimazole and miconazole are broad-spectrum azoles used to
treat _____ infections.
A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral
Section: 10.02
37. Which of the following is not a drug group used to treat fungal infections?
A. quinolones
B. macrolide polyene antibiotics
C. griseofulvins
D. synthetic azoles
E. flucytosines
Section: 10.02
38. The drug used for several protozoan infections is
A. nystatin.
B. griseofulvin.
C. amphotericin B.
D. sulfa drugs.
E. metronidazole.
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs.
Section: 10.02
39. Mebendazole is a drug used to treat _____ infections.
A. bacterial
B. fungal
C. protozoan
D. helminthic
E. viral
Section: 10.02
40. There are fewer antifungal, anti-protozoan, and anti-helminth drugs compared to antibacterial
drugs because fungi, protozoa, and helminths
A. do not cause many human infections.
B. are not affected by antimicrobials.
C. are so similar to human cells that drug selective toxicity is difficult.
D. are parasites found inside human cells.
E. because their cells have fewer target sites compared to bacteria.
Section: 10.02
Topic: Eukaryotes
Topic: Prokaryotes
41. Primaquine and chloroquine are drugs used in the treatment of
A. gram-positive infections.
B. gram-negative infections.
C. fungal infections.
D. protozoan infections.
E. viral infections.
Section: 10.02
42. Which of the following is not a mode of action of antiviral drugs?
A. block penetration
B. block transcription and translation
C. inhibit DNA synthesis
D. block maturation
E. bond to ergosterol in the cell membrane
Learning Objective: 10.18 List the three major targets of action of antiviral drugs.
Section: 10.02
Topic: Viruses
43. An antiviral that is a guanine analog would have an antiviral mode of action that
A. blocks penetration.
B. blocks transcription and translation.
C. inhibits DNA synthesis.
D. blocks maturation.
E. bonds to ergosterol in the cell membrane.
Section: 10.02
Topic: Viruses
44. Antiviral drugs that target reverse transcriptase would be used to treat
B. HIV.
C. herpes zoster virus.
Section: 10.02
Topic: Viruses
45. Acyclovir is used to treat
B. HIV.
C. herpes simplex virus.
Section: 10.02
Topic: Viruses
46. Which of the following block HIV binding to host cell receptors?
A. AZT
B. acyclovir
C. nevirapine
D. fuzeon
E. amantidine
Section: 10.02
Topic: Viruses
47. The cellular basis for bacterial resistance to antimicrobials include
C. prevention of drug entry into the cell.
Section: 10.03
Topic: Prokaryotes
48. The multidrug resistant pumps in many bacterial cell membranes function by
C. removing the drug from the cell when it enters.
Section: 10.03
Topic: Prokaryotes
49. Microbial resistance resulting from mutation occurs because
A. prokaryotic genomes undergo mutation rapidly.
B. prokaryotic genomes undergo mutation often.
C. short generation times accumulate mutations in populations.
D. mutations are passed between organisms.
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance.
Section: 10.03
50. Each of the following result in drug resistance except
A. drug pumped out of the cell.
B. drug used as a nutrient by the cell.
C. drug binding site altered.
D. drug inactivated.
E. drug blocked from entering cell.
Section: 10.03
51. Each of the following is a mechanism for drug resistance transfer between microorganisms
except
A. transposons.
B. R-plasmids.
C. conjugation.
D. mutation.
E. All of the choices provide for transfer of drug resistance.
Section: 10.03
52. Each of the following contributes to emerging drug resistance except
A. overuse of antibiotics.
B. improper use of antibiotics.
C. multiple drug therapy.
D. ingestion of antibiotics with animal feed.
E. addition of antibiotics to common household products.
ASM Objective: 01.03 Human impact on the environment influences the evolution of microorganisms (e.g, emerging diseases and the selection of antibiotic
resistance).
ASM Topic: Module 01 Evolution
Section: 10.03
53. Nutrients that encourage the growth of beneficial microbes in the intestines are known as
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation.
Section: 10.03
Topic: Prokaryotes
54. The use of vaginal inserts of Lactobacillus to restore a healthy acidic environment is an
example of
A. prebiotics.
B. probiotics.
C. lantibiotics.
D. phytobiotics.
E. riboswitches.
Section: 10.03
Topic: Prokaryotes
55. Broad-spectrum drugs that disrupt the body's normal flora often cause
A. nephrotoxicity.
B. superinfections.
C. allergic reactions.
D. drug toxicity.
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non-human hosts in beneficial, neutral or detrimental ways.
Learning Objective: 10.23 Explain what a superinfection is and how it occurs.
Section: 10.04
56. Side effects that occur in patient's tissues while on antimicrobial drugs include all the
following except
A. development of resistance to the drug.
B. hepatotoxicity.
C. nephrotoxicity.
D. diarrhea.
E. deafness.
Section: 10.04
57. A superinfection results from
A. build up of a drug to toxic levels in the patient.
B. the wrong drug administered to the patient.
C. an immune system reaction to the drug.
D. decrease in most normal flora with overgrowth of an unaffected species.
Section: 10.04
58. The _____ are drugs that deposit in developing teeth and cause a permanent brown
discoloration.
A. streptomycins
B. cephalosporins
C. macrolides
D. tetracyclins
E. penicillins
Section: 10.04
59. Drug susceptibility testing determines
A. the patient's response to various antimicrobials.
B. the pathogen's response to various antimicrobials.
C. if normal flora will be affected by antimicrobials.
D. if the drug is increasing to toxic levels in a patient.
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility.
Section: 10.01
60. A clinical microbiologist makes serial dilutions of several antimicrobials in broth, and then
incubates each drug dilution series with a standard amount of a patient's isolated pathogen.
What is this microbiologist setting up?
A. Kirby-Bauer
B. antibiogram
C. E-test
D. MIC
E. therapeutic index (TI)
ASM Objective: 07.01b Ability to apply the process of science: Analyze and interpret results from a variety of microbiological methods, and apply these methods to
analogous situations.
ASM Topic: Module 07 Scientific Thinking
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable.
Section: 10.01
61. A ratio of the dose of the drug that is toxic to humans versus the minimum effective dose for
that pathogen is assessed to predict the potential for toxic drug reactions. This is called the
A. Kirby-Bauer.
B. antibiogram.
C. E-test.
D. MIC.
E. therapeutic index (TI).
Section: 10.01
62. If pathogen A is more resistant to an erythromycin disc on a Kirby-Bauer plate compared to
pathogen B, then pathogen A will have a(n) _____ zone of inhibition compared to pathogen B.
A. smaller
B. equal
C. larger
D. All of the choices are correct.
Section: 10.01
63. Which therapeutic index value would be the drug of choice?
A. 20
B. 10
C. 1
D. 0.1
E. Any value would be equally effective.
Section: 10.01
64. Which two antibiotics affect the DNA and RNA of bacteria?
A. tetracycline and amphotericin B
B. trimethoprim and sulfonamides
C. Rifampin and quinolones
D. tetracycline and bacitracin
Section: 10.02
65. Antimicrobial drugs that inhibit folic acid synthesis work with no side effects because
mammals must get folic acid from their diet.
TRUE
Section: 10.02
66. Species of Bacillus produce bacitracin and the polymyxins.
TRUE
Section: 10.01
67. An antibiotic of the penicillin family is penicillin G.
TRUE
Section: 10.03
68. The first modern antimicrobial drugs were sulfa drugs.
TRUE
Section: 10.02
69. Ciprofloxacin is used to treat viral respiratory infections.
FALSE
Learning Objective: 10.13 Identify one example of a fluoroquinolone.
Section: 10.02
70. Resistance factor plasmids are transferred to other bacterial cells during transformation,
transduction, and conjugation.
TRUE
Section: 10.03
71. Bacteria can have a natural resistance to a drug that it has never been exposed to.
TRUE
Section: 10.03
72. When a patient's immune system reacts adversely to a drug, this serious side effect is called a
superinfection.
FALSE
Section: 10.04
73. Drugs that are hepatotoxic cause damage to a patient's kidneys.
FALSE
Section: 10.04
74. The MIC is the smallest concentration of an antimicrobial required to inhibit the growth of the
microbe.
TRUE
Section: 10.01
75. The Kirby-Bauer test uses an agar surface, seeded with the test bacterium, to which small
discs containing a specific concentration of several drugs are placed on the surface.
TRUE
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment.
ASM Topic: Module 08 Microbiology Skills
Section: 10.01
76. An antimicrobial with a low therapeutic index is a safer choice compared to a drug with a high
therapeutic index.
FALSE
Section: 10.01
77. It is better to use a broad-spectrum drug instead of a more specific narrow-spectrum drug.
FALSE
Section: 10.02
78. Newer, more expensive antimicrobials are always better to use than cheaper, older drugs.
FALSE
ASM Objective: 01.03 Human impact on the environment influences the evolution of microorganisms (e.g, emerging diseases and the selection of antibiotic
resistance).
ASM Topic: Module 01 Evolution
Section: 10.02
79. Indwelling catheter biofilm infections are more resistant to antibiotics than non-biofilm
infections.
TRUE
Learning Objective: 10.15 Discuss how treatment of biofilm infections differs from that of nonbiofilm infections.
Section: 10.02
80. Drug toxicity occurs when an antimicrobial drug acts as antigen and stimulates an allergic
response.
FALSE
Section: 10.04
A 76-year-old male visits his primary care physician with complaints of burning with urination and
a frequent urge to void. As the RN, you aid the patient in collecting a urine specimen to be sent
for analysis. While awaiting the final results of drug susceptibility testing in the lab, the patient is
prescribed oral sulfasoxazole.
Cowan - Chapter 10
Section: 10.01
Section: 10.02
Section: 10.04
81. In the lab, the urine specimen is spread on an agar plate with antibiotic discs placed to
determine antimicrobial susceptibility. Following incubation, the clear area around each disc
is measured. What term describes the observed area of antimicrobial action around each disc?
A. zone of inhibition
B. zone of susceptibility
C. zone of resistance
D. antibiogram
Section: 10.01
Section: 10.02
82. You provide education to the patient regarding sulfasoxazole, a sulfonamide that targets folic
acid synthesis. The synthesis of which of the following products is affected by inhibition of
folate metabolism?
A. DNA
B. RNA
C. DNA and RNA
D. DNA, RNA, and amino acids
Section: 10.01
Section: 10.02
Section: 10.04
83. Which of the following reactions by the patient would demonstrate an allergic response?
A. anaphylaxis
B. rash
C. difficulty breathing
D. Anaphylaxis, rash development, and difficulty breathing could all indicate allergic response
in a patient.
Section: 10.01
Section: 10.02
Section: 10.04
84. The in vitro susceptibility of the pathogen is established, and the patient is maintained on
sulfasoxazole. If no in vivo effect of the drug is observed by the patient following the first 7
days of antibiotics, what is the most appropriate action by the medical team?
A. increase the dose of sulfasoxazole
B. discontinue antibiotic therapy
C. discontinue sulfasoxazole and initiate a new antibiotic
D. initiate antiviral therapy
Section: 10.01
Section: 10.02
Section: 10.04
A 12-year-old male is admitted to the pediatric unit due to persistent upper respiratory symptoms
and respiratory distress. The patient has a history of developmental delay, chronic lung disease, and
frequent respiratory infections. Upon assessment, as the RN, you note the patient to have a fever,
moderate respiratory rate, productive cough, and large amount of nasal secretions. Upon report from
the patient’s mother, the patient has been on a 3-week course of antibiotics with no improvement in
symptoms. Upon further work-up, the patient is diagnosed with bacterial pneumonia and methicillin-
resistant Staphylococcus aureus (MRSA) superinfection.
Cowan - Chapter 10
Section: 10.04
85. You provide education to the patient and his mother regarding the diagnosis. Which of the
following statements, by the mother, demonstrates an understanding of the teaching?
A. "My son has an extremely resistant form of MRSA causing his prolonged illness."
B. "My son developed simultaneous bacterial infections."
C "My son developed a MRSA superinfection, following suppression of normal resident
. species in his lungs due to his initial infection."
D. "My son has pneumonia caused by a virus."
Section: 10.04
86. Based upon the patient’s history, what is the most likely cause of the superinfection?
A. poor hygiene
B. long-term antibiotic therapy
C. fecal-oral contamination
D. community-acquired MRSA
Section: 10.04
87. The use of which of the following drugs results in the highest risk of superinfection in a
treated patient?
A. broad-spectrum antibiotics
B. narrow-spectrum antibiotics
C. topical antibiotics
D. antivirals
Section: 10.04
88. Treatment of urinary tract infections often leads to a superinfection caused by which microbe?
A. Giardia lamblia
B. Lactobacillus acidophilus
C. Escherichia coli
D. Candida albicans
Section: 10.04
As an RN in a medical intensive care unit, you are participating in a research study regarding
administration of probiotics to critically ill patients receiving antibiotic therapy. You provide
education as part of the consent process to patients, families, and other staff members.
Cowan - Chapter 10
Section: 10.03
89. Following the teaching to patients and families, you assess understanding of the teaching
prior to obtaining consent. All of the following are accurate statements by a patient regarding
probiotics, except probiotics
A. are live microorganisms.
B. are nutrients to encourage microbe growth.
C. augment the microbes in the intestine.
D. can replace microbes killed during antibiotic therapy.
Section: 10.03
90. Which of the following is an example of a probiotic?
A. penicillin
B. micafungin
C. yogurt
D. fructans
Section: 10.03
91. You indicate to the patient that research has demonstrated that probiotics may also be useful in
the management of allergies caused by
A. animal dander.
B. pollen.
C. food.
D. detergents.
Section: 10.03
10 Summary
Category # of Questions
ASM Objective: 01.03 Human impact on the environment influences the evolution of microorganisms (e.g, emerging diseases and 2
the selection of antibiotic resistance).
ASM Objective: 02.01 Bacteria have unique cell structures that can be targets for antibiotics, immunity and phage infection. 11
ASM Objective: 03.04 The growth of microorganisms can be controlled by physical, chemical, mechanical, and biological method 44
s.
ASM Objective: 04.01 Genetic variations can impact microbial functions (e.g. in biofilm formation, pathogenicity and drug resista 11
nce).
ASM Objective: 05.03 Microorganisms and their environment interact with and modify each other. 8
ASM Objective: 05.04 Microorganisms, cellular and viral, interact with both human and non- 19
human hosts in beneficial, neutral or detrimental ways.
ASM Objective: 07.01b Ability to apply the process of science: Analyze and interpret results from a variety of microbiological met 3
hods, and apply these methods to analogous situations.
ASM Objective: 08.05 Use appropriate microbiological and molecular lab equipment. 1
ASM Topic: Module 01 Evolution 2
ASM Topic: Module 02 Structure and Function 11
ASM Topic: Module 03 Metabolic Pathways 44
ASM Topic: Module 04 Information Flow 11
ASM Topic: Module 05 Systems 27
ASM Topic: Module 07 Scientific Thinking 3
ASM Topic: Module 08 Microbiology Skills 1
Blooms Level: 01. Remember 77
Blooms Level: 02. Understand 3
Blooms Level: 03. Apply 15
Cowan - Chapter 10 94
Learning Objective: 10.01 State the main goal of antimicrobial treatment. 2
Learning Objective: 10.02 Identify the sources for most currently used antimicrobials. 4
Learning Objective: 10.03 Describe two methods for testing antimicrobial susceptibility. 9
Learning Objective: 10.04 Define therapeutic index, and identify whether a high or a low index is preferable. 9
Learning Objective: 10.05 Explain the concept of selective toxicity. 3
Learning Objective: 10.06 List the five major targets of antimicrobial agents. 6
Learning Objective: 10.08 Distinguish between broad-spectrum and narrow- 3
spectrum antimicrobials, and explain the significance of the distinction.
Learning Objective: 10.09 Identify the microbes against which the various penicillins are effective. 4
Learning Objective: 10.10 Explain the significance of beta-lactamases. 3
Learning Objective: 10.11 Identify two antimicrobials that act by inhibiting protein synthesis. 8
Learning Objective: 10.12 Explain how drugs targeting folic acid synthesis work. 10
Learning Objective: 10.13 Identify one example of a fluoroquinolone. 1
Learning Objective: 10.14 Name a drug that targets the cellular membrane. 1
Learning Objective: 10.15 Discuss how treatment of biofilm infections differs from that of nonbiofilm infections. 1
Learning Objective: 10.16 Name the four main categories of antifungal agents. 3
Learning Objective: 10.17 Explain why antiprotozoal and antihelminthic drugs are likely to be more toxic than antibacterial drugs. 4
Learning Objective: 10.18 List the three major targets of action of antiviral drugs. 5
Learning Objective: 10.19 Discuss two possible ways that microbes acquire antimicrobial resistance. 5
Learning Objective: 10.20 List five cellular or structural mechanisms that microbes use to resist antimicrobials. 4
Learning Objective: 10.21 Discuss at least two novel antimicrobial strategies that are under investigation. 6
Learning Objective: 10.22 Distinguish between drug toxicity and allergic reactions to drugs. 10
Learning Objective: 10.23 Explain what a superinfection is and how it occurs. 8
Section: 10.01 19
Section: 10.02 51
Section: 10.03 16
Section: 10.04 17
Topic: Antimicrobial Medications 94
Topic: Eukaryotes 1
Topic: Infection and Disease 1
Test Bank for Microbiology Fundamentals A Clinical Approach, 1st Edition : Cowan
Topic: Prokaryotes 7
Topic: Viruses 5
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2. Antimicrobials effective against a wide variety of microbial types are termed

3. Antibiotics are derived from all of the following except

4. Important characteristics of antimicrobial drugs include

5. The use of a drug to prevent imminent infection is called

7. Penicillins and cephalosporins

9. Each of the following effect cell walls except

11. Each of the following target prokaryotic ribosomes except

14. Sulfa drugs work on

17. Ampicillin, amoxicillin, mezlocillin, and penicillin G all have

18. A chemical that inhibits beta-lactamase enzymes is

20. All of the following pertain to cephalosporins except

21. Which antimicrobial does not inhibit cell wall synthesis?

24. Clavulanic acid

26. The major source of naturally produced penicillin is the mold

27. Gram-negative rods are often treated with

28. Which antimicrobial does not interfere with protein synthesis?

30. Antimicrobials that are macrolides

33. Which antibiotic is used to treat MRSA and VRE infections?

34. Which of the following is not true of polymyxins?

38. The drug used for several protozoan infections is

39. Mebendazole is a drug used to treat _____ infections.

41. Primaquine and chloroquine are drugs used in the treatment of

42. Which of the following is not a mode of action of antiviral drugs?

45. Acyclovir is used to treat

47. The cellular basis for bacterial resistance to antimicrobials include

49. Microbial resistance resulting from mutation occurs because

50. Each of the following result in drug resistance except

52. Each of the following contributes to emerging drug resistance except

57. A superinfection results from

59. Drug susceptibility testing determines

62. If pathogen A is more resistant to an erythromycin disc on a Kirby-Bauer plate compared to

63. Which therapeutic index value would be the drug of choice?

90. Which of the following is an example of a probiotic?

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