Factors that place a patient at risk of developing an antimicrobial resistant organism include:

A. Age over 50 years

B. School attendance

C. Travel within the United States

D. Inappropriate use of antimicrobials

D. Inappropriate use of antimicrobials

Infants and young children are at higher risk of developing antibiotic-resistant infections due to:

A. Developmental differences in pharmacokinetics of the antibiotics in children

B. Children this age are more likely to be in daycare and exposed to pathogens from other children

C. Parents of young children insist on preventive antibiotics so they don’t miss work when their child is sick

D. Immunosuppression from the multiple vaccines they receive in the first 2 years of life

B. Children this age are more likely to be in daycare and exposed to pathogens from other children

Providers should use an antibiogram when prescribing. An antibiogram is:

A. The other name for the Centers for Disease Control guidelines for prescribing antibiotics

B. An algorithm used for prescribing antibiotics for certain infections

C. The reference also known as the Pink Book, published by the Centers for Disease Control

D. A chart of the local resistance patterns to antibiotics developed by laboratori

D. A chart of the local resistance patterns to antibiotics developed by laboratori

There is often cross-sensitivity and cross-resistance between penicillins and cephalosporins due to:

A. Similar renal excretion of both classes of drugs

B. When these drug classes are metabolized in the liver they both produce resistant enzymes

C. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase producing organisms

D. There is not an issue with cross-resistance between the penicillins and cephalosporins

C. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase producing organisms

Jonathan has been diagnosed with strep throat and needs a prescription for an antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. The appropriate antibiotic to prescribe would be:

A. Penicillin VK, since his rash does not sound like a serious rash

B. Amoxicillin

C. Cefadroxil (Duricef)

D. Erythromycin

D. Erythromycin

Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection. What would be the appropriate antibiotic to prescribe for her?

A. Ciprofloxacin (Cipro)

B. Amoxicillin (Trimox)

C. Doxycycline

D. Trimethoprim-sulfamethoxazole (Septra)

B. Amoxicillin (Trimox)

Pong-tai is a 12 month old who is being treated with amoxicillin for acute otitis media. His parents

call the clinic and say he has developed diarrhea. The appropriate action would be to:

A. Advise the parents that some diarrhea is normal with amoxicillin and try feeding him yogurt daily

B. Change the antibiotic to one that is less of a gastrointestinal irritant

C. Order stool cultures for suspected viral pathogens not treated by the amoxicillin

D. Recommend increased fluids and fiber in his diet

A. Advise the parents that some diarrhea is normal with amoxicillin and try feeding him yogurt daily

Lauren is a 13 year old who comes to clinic with a 4-day history of cough, low grade fever, and

rhinorrhea. When she blows her nose or coughs the mucous is greenish-yellow. The appropriate

antibiotic to prescribe would be:

A. Amoxicillin

B. Amoxicillin/clavulanate

C. TMP/SMZ (Septra)

D. None

D. None

Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old and has no

residual cardiac problems. She is now 28 and is requesting prophylactic antibiotics for an upcoming

dental visit. The appropriate antibiotic to prescribe according to current American College of

Cardiology and the American Heart Association guidelines is:

A. No antibiotic required for dental procedures

B. Amoxicillin 2 grams 1 hour before the procedure

C. Ampicillin 2 grams IM or IV 30 minutes before the procedure

D. Azithromycin 1 gram 1 hour before the procedure

A. No antibiotic required for dental procedures

To prevent further development of antibacterial resistance it is recommended fluoroquinolones be

reserved for treatment of:

A. Urinary tract infections in young women

B. Upper respiratory infections in adults

C. Skin and soft tissue infections in adults

D. Community-acquired pneumonia in patients with comorbidities

D. Community-acquired pneumonia in patients with comorbidities

Fluoroquinolones have a Black Box warning regarding ____ even months after treatment.

A. Renal dysfunction

B. Hepatic toxicity

C. Tendon rupture

D. Development of glaucoma

C. Tendon rupture

Janet was recently treated with clindamycin for an infection. She calls the advice nurse because she

is having frequent diarrhea that she thinks may have blood in it. What would be the appropriate care

for her?

A. Encourage increased fluids and fiber

B. Assess for pseudomembranous colitis

C. Advise her to eat yogurt daily to help restore her gut bacteria

D. Start her on an antidiarrheal medication

B. Assess for pseudomembranous colitis

Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by a macrolide. Which would be the best choice for a patient with liver dysfunction?

A. Azithromycin (Zithromax)

B. Clarithromycin (Biaxin)

C. Erythromycin (E-mycin)

D. None of the above

C. Erythromycin (E-mycin)

Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?

A. Penicillins

B. Macrolides

C. Cephalosporins

D. Sulfonamides

D. Sulfonamides

If a patient is allergic to sulfonamide antibiotics, he or she will most likely have cross-sensitivity to:

A. Loop diuretics

B. Sulfonylureas

C. Thiazide diuretics

D. All of the above

D. All of the above

Tetracyclines such as minocycline are safe to use in:

A. Pregnant women

B. Adolescents

C. Patients with renal dysfunction

D. Patients with hepatic dysfunction

B. Adolescents

Tetracyclines should not be prescribed to children younger than 8 years due to:

A. Risk of developing cartilage problems

B. Development of significant diarrhea

C. Risk of kernicterus

D. Adverse effects on bone growth

D. Adverse effects on bone growth

Nicole is a 16 year old who is taking minocycline for acne. She comes to the clinic complaining of a headache. What would be the plan of care?

A. Advise acetaminophen or ibuprofen as needed for headaches

B. Prescribe sumatriptan (Imitrex) to be taken at the onset of the headache

C. Evaluate for pseudotremor cerebri

D. Assess her caffeine intake and sleep patterns

C. Evaluate for pseudotremor cerebri

Patricia has been prescribed doxycycline for a Chlamydia infection. She is healthy and her only medication is an oral combined contraceptive. Patricia’s education would include:

A. Use a back-up method of birth control (condom) until her next menses

B. Doxycycline may cause tendonitis and she should report any joint pain

C. Her partner will need treatment if her infection doesn’t clear with the doxycycline

D. Doxycycline is used for one dose treatment of STIs; take the whole prescription at once

A. Use a back-up method of birth control (condom) until her next menses

To prevent the development of peripheral neuropathy in patients taking isoniazid for tuberculosis the patient is also prescribed:

A. Niacin (Vitamin B3)

B. Pyridoxine (Vitamin B6)

C. Riboflavin (Vitamin B2)

D. Thiamine (Vitamin B1)

B. Pyridoxine (Vitamin B6)

Sadie is an 82-year-old patient who has herpes zoster (shingles) and would benefit from an antiviral such as valacyclovir. Prior to prescribing valacyclovir she will need assessment of:

A. Complete blood count to rule out anemia

B. Liver function

C. Renal function

D. Immunocompetence

C. Renal function

When prescribing acyclovir, patients should be educated regarding:

A. High risk of developing diarrhea

B. Need to drink lots of fluids during treatment

C. Risk for life-threatening rash such as Stevens-Johnson

D. Eccentric dosing schedule

B. Need to drink lots of fluids during treatment

Nicholas has been diagnosed with Type A influenza. Appropriate prescribing of oseltamivir (Tamiflu) would include:

A. Starting oseltamivir within the first 48 hours of influenza symptoms

B. Advising the patient he can stop the oseltamivir when his symptoms resolve

C. Educating the patient that oseltamivir will cure influenza

D. Prophylactic treatment of all family members

A. Starting oseltamivir within the first 48 hours of influenza symptoms

Monitoring for patients who are on long-term antifungal therapy with ketoconazole includes:

A. Platelet count

B. BUN and creatinine

C. White blood cell count

D. AST, ALT, alkaline phosphatase, and bilirubin

D. AST, ALT, alkaline phosphatase, and bilirubin

When prescribing metronidazole (Flagyl) to treat bacterial vaginosis, patient education would include:

A. Metronidazole is safe in the first trimester of pregnancy

B. Consuming alcohol in any form may cause a severe reaction

C. Sexual partners need concurrent therapy

D. Headaches are a sign of a serious adverse reaction and need immediate evaluation

B. Consuming alcohol in any form may cause a severe reaction

As of 2011 every antibiotic drug class has resistant organisms which influence prescribing decisions.

True or False

True