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midterm nr568 Exam Questions With Complete Solutions, Exams of Nursing

Southern Utah University (SUU)Nursing

midterm nr568 Exam Questions With Complete Solutions

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2024/2025

Available from 07/08/2025

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midterm nr568 Exam Questions With Complete Solutions

Amoxicillin

1.  adults  Dosage forms:

1b.  Pediatrics:  dosage:

Indications

2. infections, bacterial-dose, duration vary by infection

type/severity

3.  pharyngitis, streptococcal

4.  otitis media, acute

5. sinusitis, acute bacterial

6. H. pylori infection

7. pneumonia, community-acquired

1. CAP: 250 mg, 500 mg; TAB: 500 mg, 875 mg; ER TAB: 775

mg; CHEWABLE: 125 mg, 250 mg; SUSP: 125 mg per 5 mL

1b.  20-90mg/kg/day

2. [500-875 mg PO q12h]

3. [immediate-release form] Dose:  1000 mg PO q24h  x10 days;

[extended-release form] Dose: 775 mg ER PO q24h x10 days;

Info: give w/ in 1h of a meal; do not cut/crush/chew ER tab

4.  [1 g PO q8h x5-10 days] Max: 4 g/day;

5.  [1 g PO q8h x5-10 days] Max: 4 g/day;

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midterm nr568 Exam Questions With Complete Solutions Amoxicillin

adults Dosage forms: 1b. Pediatrics: dosage: Indications
infections, bacterial-dose, duration vary by infection type/severity
pharyngitis, streptococcal
otitis media, acute
sinusitis, acute bacterial
H. pylori infection
pneumonia, community-acquired
CAP: 250 mg, 500 mg; TAB: 500 mg, 875 mg; ER TAB: 775 mg; CHEWABLE: 125 mg, 250 mg; SUSP: 125 mg per 5 mL 1b. 20-90mg/kg/day
[500-875 mg PO q12h]
[immediate-release form] Dose: 1000 mg PO q24h x10 days; [extended-release form] Dose: 775 mg ER PO q24h x10 days; Info: give w/ in 1h of a meal; do not cut/crush/chew ER tab
[1 g PO q8h x5-10 days] Max: 4 g/day;
[1 g PO q8h x5-10 days] Max: 4 g/day;

[triple/quadruple tx] Dose: 1 g PO bid x5-14 days; Info: part of multi-drug regimen; search H. pylori Tx Regimens for guidelines; not 1st-line tx,
[1 g PO q8h for at least 5 days] Acyclovir:
Availability: Topical:
Availability: Oral Injection: Various Dosing Interval: Orolabial HSV: 200mg five times daily or 400mg TID for 7- days Varicella- children under 40mg: 20 mg/kg per dose 4 times per day for 5 days Varicella- children over 40 mg and adults: 800mg 4 times per day for 5 days Herpes Zoster: 800mg 5 times daily for 7-10 days Indications: HSV -genital & Orolabial Varicella (Chicken Pox) Herpes Zoster (Shingles)

[250 mg PO qid x7 days] give w/ quinine sulfate; give at least 1h before or 2h after meals; to avoid relapse in acute P. vivax or P. ovale infection, follow up tx w/ primaquine;
[if usual regimen bid] renal impairment: consider decr. usual frequency Benzoyl Peroxide Cr.
Availability:
Dosing Interval:
Daily Dosage:
Indications:
Cream: 5%, 6.5%, 8.5%, 10%
Apply QD-BID
Apply to affected area, wash, rinse, dry before applying; may bleach hair, fabric
Acne Vulgaris Community-Acquired Pneumonia (CAP)

pneumonia acquired outside hospital or healthcare facilities
most often seen in primary care. Causative agents

Most common bacteria is
What other pathogens can cause CAP in the General population

What causes CAP in Smokers and those with COPD
What causes CAP in those with cystic fibrosis (CF)
What is the Gold Standard for CAP dx
What pathogen is usually transmitted by inhaling mist or aspiration liquid that comes from a water source
Streptococcus Pneumoniae (aka pneumococcus); gram positive; also most deadly
Atypical bacteria (Mycoplasma pneumoniae)-often seen in people of close proximity (correctional facilities, college dormitories, SNFs) or Viruses (influenza, RSV)
Haemophilus influenzae (gram-neg)
Pseudomonas aeruginosa (gram neg)
Chest x-ray
Legionella sp Community-Acquired Pneumonia (CAP) Treatment options for Typical pneumonia
If pt has NO comorbidities:
What other class can be used for penicillin-sensitive S. pneumoniae
If those therapies FAIL and a resistant organism is suspected
First-line agents: Beta-lactam or doxycycline ○ Amoxicillin 1,000 mg PO TID x 5-7 days OR

Ceph-cefuroxime + azithromycin (Z-pack) or clarithromycin

Respiratory fluoroquinolone; duration 5-7 days ○ Moxifloxacin ○ Gemifloxacin

Treatment of chlamydial pneumonia:

C. pneumoniae (atypical pneumonia) is more commonly seen in
1st line Treatment is
children and young adults 2a. Macrolides Azithromycin (5 days total) 2b. Tetracycline

250 mg orally every 6 hours for 14-21 days 2c. Doxycyclines for 10 days
Do not use doxy in pregnant women 2d. Fluoroquinolones-Levofloxacin for 7-14 days Week 2-Fungal Fungal infections
Mycoses (fungal infections) can be categorized as either systemic or superficial.
Understanding the appropriate drug choice for each type of fungal infection is an essential element of safe prescribing

Systemic mycoses can be subdivided into two categories:
The opportunistic mycoses include—
nonopportunistic infections include.

Treating systemic mycoses can be difficult; may require prolonged therapy with drugs that frequently prove toxic.

opportunistic infections and nonopportunistic infections.
candidiasis, aspergillosis, cryptococcosis, and mucormycosis —are seen primarily in debilitated or immunocompromised hosts
sporotrichosis, blastomycosis, histoplasmosis, and coccidioidomycosis; can occur in any host & are relatively uncommon Treatment Overview

List drugs for systemic infections
List drugs for superficial (local infections) Clotrimazole is not active against onychomycosis (nail fungus) Fluconazole [Diflucan] is active against all three Treatment for Systemic Fungal Infections List the two main types Amphotericin B
Broad-spectrum antifungal
Highly toxic medication
Black box warning: Use in life-threatening infections only
Administered IV only: refusion reactions are common
Premedicate: acetaminophen plus diphenhydramine Azoles ie, Ketoconazole
Broad-spectrum antifungals

Know how to treat Different types of ○ tinea cruris (ringworm of the groin),

responds well to
Treatment should continue for
If the infection is severely inflamed
topical allylamine/azole therapy. ■ Terbinafine, Butenafine, Clotrimazole - if severe
at least 1 week after symptoms have cleared.
a systemic antifungal drug (e.g. Clotrimazole) may be needed; topical or systemic glucocorticoids may be needed as well. Know how to treat Different types of ○ tinea capitis (ringworm of the scalp),
Is difficult to treat and (blank) drugs don't typically work
Usually responds well to
Topical
Oral griseofulvin, taken for 6 to 8 weeks, is considered standard therapy.

However, oral terbinafine, taken for only 2 to 4 weeks, may be more effective. ■ Griseofulvin, terbinafine Know how to treat Different types of Oral candidiasis , also known as thrush , is seen often.

Topical agents—nystatin, clotrimazole, and miconazole—are generally effective.
In the immunocompromised host, oral therapy with fluconazole or ketoconazole is usually required. Know how to treat Different types of Vagina - candida (vaginal yeast infection). Topical miconazole. Oral fluconazole Onychomycosis (infection of toenails)

Onychomycosis is difficult to eradicate and requires prolonged treatment. Infections may be caused by (blank) or (blank)
Onychomycosis may be treated with
by dermatophytes or Candida species.
oral allylamine/azole (terbinafine and itraconazole both are active against Candida species and dermatophytes) OR with topical ciclopirox-only active against dermatophyte Itraconazole-Azole ○ clinical uses ○ MOA Clinical Uses ○ is an alternative to amphotericin B for systemic mycoses and is the prototype for azole family. ○ also used in the oral tx of Onychomycosis-nail fungus MOA

Patient Teaching Summary of Key Prescribing Considerations-Azoles
Baseline
Monitoring
Minimizing Adverse Effects: Avoid use with drugs metabolized by CYP3A
Patient Teaching ○ Instruct patients to report signs of liver dysfunction.
tests of liver function.
AST/ALT, alkaline phosphate, bilirubin: Initially and then monthly.
(warfarin, cyclosporine, digoxin, quinidine)

Voriconazole and Phenobarbital should not be combined due to CYP450 induction Explain: ● Phenobarbital is a cytochrome P450 hepatic enzyme inducer - if given with Voriconazole -plasma levels of Voriconazole are extremely lowered by phenobarbital Patient-Centered Care Across the Life Span-Antifungal Agents Infants
Nystatin is used to treat oral candidiasis in Children/adolescents
Many antifungal agents are used safely in children, Pregnant women

Risks and benefits must be considered for administration during Breastfeeding women
(blank) are lacking regarding most antifungals and breastfeeding. Older adults
Older adults have a higher risk for Infants
premature and full-term infants. Fluconazole is also used safely to treat systemic candidiasis in newborn infants. Children/adolescents
in lower doses. Side-effect profiles are similar to those of adults. Pregnant women
pregnancy. Breastfeeding women
Data; Most antifungals are considered safe in lower doses. The exception to this is ketoconazole-has high potential for hepatotoxicity-avoid in breastfeeding Older adults
achlorhydria (HCl acid in gastric secretions) than do younger individuals and may not predictably absorb some antifungal agents. In addition, common drugs prescribed to older adults,

undercooked beef or pork undercooked fish that is infested with tapeworm larvae.
snails, which take up residence in the vascular system, primarily in veins of the intestines and liver. Diagnostics and monitoring for Anthelmintics see diagram

Identifying High-Risk Patients with the following drugs Mebendazole

The most concerning adverse effects are
Baseline tests include 3.. The WHO allows mebendazole to be used in the (blank) and (blank) trimesters
This is the drug of choice for most intestinal Nematodes/roundworms. This agent clears
bone marrow suppression and liver impairment; however, these are typically only a problem with high doses or prolonged treatment

Because bone marrow suppression and liver impairment may occur, patients with liver disease, anemia, bleeding disorders, and infections are at increased risk

Liver fxn, CBC and renal fxn
in the second and third trimesters, but not the first trimester,
infestation with pinworms, hookworms, and giant roundworms

Identifying High-Risk Patients with the following drugs Albendazole (pg. 774) -

Albendazole may cause
Baseline line tests include
Who's at increased risk
In the USA, the drug is approved only for
albendazole is used off-label for
Mild to moderate liver impairment & bone marrow Suppression causing agranulocytosis and pancytopenia. Liver impairment may increase risk.
Liver function/CBC- before each cycle of tx and 14 days later.
Patients with liver, kidney disease, anemia-bleeding disorders & infections are at increased risk
pork tapeworms and disease of the liver, lung, and peritoneum by dog tapeworms
Nematodes: (hookworms, pinworms, giant roundworms, whipworms, and pork roundworms-cause of trichinosis) & Chinese liver flukes

Identifying High-Risk Patients with the following drugs Pyrantel pamoate

Neonates should NOT be given formulations with
Most adverse effects are

for onchocerciasis (River Blindness) and ivermectin is DOC for intestinal strongyloidiasis & kills mites such as Scabies in immunocompromised patients.
It's safer in pregnancy; low risk of teratogenicity Patient-Cenetered Care Across The Life Span-Anthelmintics Children

There are inadequate studies in children taking most of these drugs. Pyrantel pamoate Pregnant Women
Praziquantel appears to be the safest Breast-Feeding Women
The WHO advises women taking Older Adults
There are no current Children
formulations containing benzyl alcohol or its derivatives should not be prescribed for neonates (causes gasping syndrome). Pregnant Women
of the anthelmintics. Moxidectin has also demonstrated apparent safety; however, it was only approved recently. Breast-Feeding Women

mebendazole and pyrantel pamoate to continue breastfeeding but advises caution with albendazole and ivermectin. The manufacturer of praziquantel advises women not to nurse on the day of tx and 72 hours after. Older Adults
contraindications for older adults taking these drugs; but this is due to insufficient data to determine safety Week 2 Antiviral Agents Non-HIV Ch 80
Unlike bacteria, viruses require a host cell in order to replicate. Medications used to treat viral infections work by interrupting the viral replication process inside host cells Herpes Simplex Viruses and Varicella-Zoster
Herpes Simplex Virus (HSV) family; a group that includes
HSV causes infection of
VZV is the cause of
HSV, varicella-zoster virus (VZV), and cytomegalovirus (CMV).
the genitalia, mouth, face, and other sites.
chickenpox and herpes zoster (shingles) Acyclovir (Zovirax)

Oral: is used to tx
Topical: is used to tx
IV: is used to tx
HSV infection and suppression, VZV infection
orolabial HSV (cold sores)

midterm nr568 Exam Questions With Complete Solutions, Exams of Nursing

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