If you’re preparing for the NCLEX, answer this 30-item quiz that covers drugs associated with anti-infective therapies (antibiotics, antitubercular agents, etc) and topical agents. Let’s ace that NCLEX!

When antibiotics first came out, nobody could have imagined we’d have the resistance problem we face today. We didn’t give bacteria credit for being able to change and adapt so fast.
—Bonnie Bassler

Topics

Included topics in this exam are:

  • Antibacterial Agents
  • Antitubercular Agents
  • Antifungal Agents
  • Antiviral Agents
  • Ophthalmic and Otic Agents
  • Dermatologic Agents

Guidelines

Follow the guidelines below to make the most out of this exam:

  • Read each question carefully and choose the best answer.
  • You are given one minute per question. Spend your time wisely!
  • Answers and rationales are given below. Be sure to read them.
  • If you need more clarifications, please direct them to the comments section.

Questions

Exam Mode

In Exam Mode: All questions are shown in random and the results, answers and rationales (if any) will only be given after you’ve finished the quiz. You are given 1 minute per question, a total of 30 minutes in this quiz.

Pharmacology: Anti-infective Drugs and Topical Agents (30 Items)

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Practice Mode

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Pharmacology: Anti-infective Drugs and Topical Agents (30 Items)

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Text Mode

In Text Mode: All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.

1. Corinne is experiencing diarrhea after consuming her prescribed antibiotics for the whole week. This is because:

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A. The drugs render food indigestible.
B. Gastric flora is disturbed.
C. Fluid is added into the intestine.
D. Normal intestinal bacteria are destroyed.

2. When a client with chronic obstructive pulmonary disease is taking theophylline also receives ciprofloxacin (Cipro), which of the following interaction could occur?

A. Ciprotoxicity
B. Ineffectiveness of ciprofloxacin
C. Theophylline toxicity
D. Ineffective theophylline

3. The client at highest risk for nephrotoxicity with aminoglycoside use is a:

A. Male with a creatinine of 1.7 and BUN of 52 on a 10-day regimen
B. Female with BUN of 12 and creatinine of 0.8
C. Female with past history of cystitis on 5 days of therapy
D. Male with history of kidney stones on 8 days of therapy

4. When assessing clients for evidence of a penicillin allergy, which of the following symptoms may not be considered to be a true hypersensitivity reaction?

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A. Wheezing
B. Nausea
C. Urticaria
D. Angioneurotic edema

5. All of the following symptoms are evidence of a superinfection except:

A. White oral plaques
B. Creamy vaginal discharge
C. Skin rash
D. Darkened tongue

6. Which of the following statements is true when educating clients about penicillin therapy?

A. The client must take the medication at evenly spaced intervals.
B. The client may save leftover medication for a future illness.
C. If signs of an allergic reaction, continue the medication and notify physician.
D. Clients taking oral contraceptives must be cautioned to use an alternate form of birth control while being treated with penicillin.

7. Antonietta is taking antituberculars, the most common adverse effect she may be experiencing is:

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A. Red-orange discoloration of urine
B. Hypersensitivity
C. Hepatotoxicity
D. CHF

8. In treatment of tuberculosis, the therapeutic rationale for combination drug therapy is to:

A. Decrease cost and improve compliance.
B. Reduce the incidence of cumulative effects.
C. Increase blood dyscrasias.
D. Decrease emergence of drug-resistance strains.

9. Changes in visual acuity and color perception are associated with treatment by which of the following agents?

A. INH (isoniazid)
B. PZA (pyrazinamide)
C. ETH (ethambutol)
D. SM (streptomycin)

10. Which of the following groups of antitubercular agents includes first-line agents?

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A. INH, PZA, RIF
B. SM, PAS, INH
C. EMB, PAS, INH
D. INH, cycloserine, RIF

11. Antitubercular therapy may be determined ineffective when:

A. Sputums are negative.
B. Symptoms resolve.
C. Hepatitis results.
D. Drug-resistant bacteria emerge.

12. Fluconazole (Diflucan) can be administered to a client with:

A. Pneumococcal meningitis
B. Oral thrush
C. Cryptococcal meningitis
D. Pneumococcal pneumonia

13. When administering amphotericin B, which of the following must be used?

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A. A brown bag to protect the infusion from the light
B. A diluent of 5% dextrose with no preservatives
C. A diluent of normal saline with alcohol
D. A micron filter of above l μ

14. Which of the following nursing diagnoses might occur when administering large parenteral doses of amphotericin B with vancomycin (Vancocin)?

A. Decreased cardiac output
B. Ineffective airway clearance
C. Ineffective breathing pattern
D. Fluid volume excess

15. Arvic, a 16-year-old student, has acquired systemic fungal infection, he should be treated with:

A. amphotericin B
B. miconazole (Monistat IV)
C. ketoconazole
D. griseofulvin (Fulvicin)

16. Which of the following must always be present before beginning antifungal therapy?

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A. Coagulation profile
B. Confirmed diagnosis
C. Biopsy of infected site
D. Urinalysis

17. Which choice describes the action of nucleoside analogs?

A. Exert anti-HIV activity at the reverse transcriptase level and cause premature termination of viral DNA chain synthesis
B. Completely stop the replication of HIV virus
C. Allow for a patient to become non-contagious after taking for at least 3 days
D. Are all equally effective and free of side effects

18. Which of the following true about protease inhibitors?

A. Work better when used alone.
B. Are the same as nucleoside analogs.
C. Affect replication of HIV at different stage than nucleoside analogs.
D. Have a high level of toxicity.

19. The human cells specifically affected by HIV are:

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A. Gonadocytes
B. CD4+ T lymphocytes
C. Islet cells
D. Red blood cells

20. Which of the following statements is TRUE about monotherapy for treatment of HIV disease?

A. It is the only FDA-approved treatment for HIV disease
B. It is able to effectively destroy all viral particles of HIV
C. It interferes with the replication of HIV virus without causing any side effects
D. It appears to cause rapid resistance.

21. Which of the following statements is TRUE about combination therapy for treatment of HIV disease?

A. It completely shuts off replication of HIV
B. Is the only FDA-approved treatment for HIV disease
C. It appears to cause a sustained benefit achieved by drug no. 1 preventing the emergence of resistance to drug no. 2 despite resistance to drug no. 1
D. It is only effective if used alternating with periods of monotherapy

22. When administering topical ophthalmic preparations, the nurse must assess:

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A. visual acuity.
B. intraocular movements.
C. color of the sclera.
D. blinking reflex.

23. Which of the following drugs might be given to relieve pain from corneal abrasions?

A. Proparacaine hydrochloride (Alcaine)
B. Timolol maleate (Timoptic)
C. Betaxolol hydrochloride (Betoptic)
D. Levobunolol hydrochloride (Betagan)

24. Drugs that lower intraocular pressure work by increasing:

A. the flow of aqueous humor through the anterior chamber.
B. fluid volume in the eye‘s anterior chamber.
C. pressure in the eye chambers.
D. diameter of the eye chambers.

25. When administering otic preparations, the nurse should observe the tympanic membrane for:

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A. erythema.
B. perforation.
C. fluid.
D. all of the above.

26. Mara Francesca has been diagnosed with scabies. His physician has ordered crotamiton (Eurax). After 1 week of treatment, the client reports that the pruritus has not stopped. You would advise the client to:

A. Stop applying the medication.
B. Continue treatment because pruritus may persist for 4 to 6 weeks.
C. Call the physician.
D. None of the above.

27. Jake has psoriasis of the scalp. The physician has ordered Zetar shampoo. You would advise the client to:

A. Avoid sun exposure to the scalp.
B. Use the shampoo PRN.
C. Report pruritus.
D. None of the above.

28. Topical antibiotics work by:

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A. Inhibiting replication of a virus
B. Blocking histamine-1 and -2 receptors
C. Binding to fungal cell membranes
D. Inhibiting bacterial cell wall synthesis

29. Pediculicides are used to treat which of the following disorders?

A. Scabies
B. Fungal infections
C. Viral infections
D. Head lice

30. Alice is using antiviral creams for her condition. Which of the following is a potential side effect of the medication?

A. Vulvitis
B. Headache
C. Dizziness
D. Staining of the skin

Answers and Rationale

Here are the answers for this exam. Gauge your performance by counter checking your answers to those below. If you have any disputes or clarifications, please direct them to the comments section.

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1. Answer: D. Normal intestinal bacteria are destroyed.

The destruction of normal intestinal flora causes diarrhea. In choice A, a drug that rendered food indigestible could not be given because it would cause severe malnutrition. Choice B is incorrect because there is no gastric flora. Choice C is incorrect because there is no way to add fluid into the intestine.

2. Answer: C. Theophylline toxicity

Theophylline toxicity may occur because the action of theophylline is increased when given with Ciprofloxacin. There is no such thing as ciprotoxicity.

3. Answer: A. Male with a creatinine of 1.7 and BUN of 52 on a 10-day regimen

Choice B is incorrect because a 24-year-old woman with a normal BUN and creatinine would not be at higher risk than others when given aminoglycosides. Choice C is incorrect because recurrent cystitis on limited-time therapy does not present a high risk for nephrotoxicity. The last choice is incorrect because a history of kidney stones on limited-time therapy does not present a high risk for nephrotoxicity.

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4. Answer: B. Nausea

GI disturbances such as nausea are usually caused by direct irritation or overgrowth of gram-positive bacteria or yeasts and are not indicative of a true penicillin allergy.

5. Answer: C. Skin rash

Skin rashes are indicative of hypersensitivity reactions in clients on penicillin therapy.

6. Answer: D. Clients taking oral contraceptives must be cautioned to use an alternate form of birth control while being treated with penicillin.

Penicillin will reduce the effectiveness of birth control pills.

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7. Answer: C. Hepatotoxicity

Hepatotoxicity is the most common side effect associated with antitubercular agents. Orange discoloration is a side effect of rifampin but not with antituberculars in general.

8. Answer: D. Decrease emergence of drug-resistance restraints.

Combination therapy helps decrease the emergence of drug-resistant strains. Multiple drugs usually increase cost and reduce compliance. Multiple drugs increase cumulative effects. Blood dyscrasias would be an untoward effect not a desired effect.

9. Answer: C. ETH (ethambutol)

Ethambutol will cause changes in visual acuity and color perception. Remember “E” for ethambutol and eyes. Peripheral neuropathy is a side effect associated with INH. Gout is a side effect associated with pyrazinamide. Ototoxicity may occur with streptomycin.

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10. Answer: A. INH, PZA, RIF

INH, PZA, and RIF are used as combination first-line agents.

11. Answer: D. Drug-resistant bacteria emerge.

The emergence of drug-resistant bacteria indicates that antitubercular therapy is ineffective because the drug(s) are no longer ending bacterial multiplication.

12. Answer: C. Cryptococcal meningitis

Fluconazole (Diflucan) is a drug given for the treatment of cryptococcal meningitis. A and D are incorrect because pneumococcal meningitis and pneumonia are not caused by fungal infections. Oral thrush is treated with a more mild antifungal, such as nystatin.

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13. Answer: B. A diluent of 5% dextrose with no preservatives

Amphotericin B must be mixed with a solution with no preservatives. The solution is sensitive to light but does not require the infusion to be covered. A micron filter should not be used; if unavoidable, it must be less than 1 μ.

14. Answer: D. Fluid volume excess

These two drugs are both nephrotoxic, so this nursing diagnosis may result from renal problems.

15. Answer: A. amphotericin B

Serious life-threatening fungal infections are treated with amphotericin B.

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16. Answer: B. Confirmed diagnosis

The diagnosis of fungal infection as opposed to infection caused by virus or bacteria is necessary before beginning therapy with antifungal agents.

17. Answer: A. Exert anti-HIV activity at the reverse transcriptase level and cause premature termination of viral DNA chain synthesis

This choice correctly describes the action of nucleoside analogs.

18. Answer: C. Affect replication of HIV at different stage than nucleoside analogs.

Protease inhibitors cleave the viral polyprotein precursors that are essential for the maturation of infectious virus. Nucleosides interfere with replication of HIV by inhibiting reverse transcriptase. Protease inhibitors work best when used in combination with other drugs.

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19. Answer: B. CD4+ T lymphocytes

HIV directly affects CD4+ T lymphocytes.

20. Answer: D. It appears to cause rapid resistance.

With monotherapy, resistance can emerge within a few months.

21. Answer: C. It appears to cause a sustained benefit achieved by drug no. 1 preventing the emergence of resistance to drug no. 2 despite resistance to drug no. 1

Combination therapy is superior to monotherapy at this time for reasons described in this choice.

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22. Answer: A. visual acuity.

The nurse must assess visual acuity, extraocular eye movements, tearing, and discharge when administering topical eye medications.

23. Answer: A. Proparacaine hydrochloride (Alcaine)

This is the only drug listed that is an anesthetic eye preparation.

24. Answer: A. the flow of aqueous humor through the anterior chamber.

Drugs that lower intraocular pressure increase the flow of aqueous humor through the eye’s anterior chamber.

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25. Answer: D. all of the above.

The nurse should assess all of these parameters when administering otic preparations.

26. Answer: B. Continue treatment because pruritus may persist for 4 to 6 weeks.

Many times pruritus is not relieved for 4 to 6 weeks after therapy has been initiated. It is never appropriate to discontinue medication without a physician’s direction.

27. Answer: A. Avoid sun exposure to the scalp.

One of the side effects of Zetar shampoo is photosensitivity.

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28. Answer: D. Inhibiting bacterial cell wall synthesis

Topical antibiotics work by inhibiting bacterial cell wall synthesis. Choice A describes antiviral actions. Choice B describes the action of antipruritics. And choice D describes the action of antifungals.

29. Answer: D. Head lice

Pediculicides are an effective treatment for head lice. Scabicides are used to treat scabies. Antifungals are used to treat fungal infections. Antivirals are used to treat viral infections.

30. Answer: A. Vulvitis

Antiviral creams can cause vulvitis when applied to the genitalia to treat genital herpes.

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