HESI RN · Drugs and the immune system
Question 1 of 37
Ciprofloxacin inhibits the bacterial enzyme
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HESI RN · Drugs and the immune system
Question 2 of 37
The most suitable tetracycline for use in a patient with impaired renal function is
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HESI RN · Drugs and the immune system
Question 3 of 37
If a patient gives history of urticaria, itching and swelling of lips following injection of penicillin G, then
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HESI RN · Drugs and the immune system
Question 4 of 37
Which one of the following statements about cefotetan is accurate?
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HESI RN · Drugs and the immune system
Question 5 of 37
The semisynthetic penicillin which is destroyed by acid is
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HESI RN · Drugs and the immune system
Question 6 of 37
The plasma half-life of penicillin-G is longer in the newborn because their
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HESI RN · Drugs and the immune system
Question 7 of 37
A man has an Escherichia coli bacteremia with a low-grade fever (101.6°F). Appropriate management of his fever would be
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HESI RN · Drugs and the immune system
Question 8 of 37
Prolonged oral therapy with the following antibiotic can damage intestinal villi resulting in steatorrhea and loose motions
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HESI RN · Drugs and the immune system
Question 9 of 37
The appearance of markedly vacuolated, nucleated red cells in the marrow, anemia, and reticulocytopenia are characteristic dose-dependent side effects of
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HESI RN · Drugs and the immune system
Question 10 of 37
Drug of choice for Brucella infection is
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HESI RN · Drugs and the immune system
Question 11 of 37
Which of the following is not true of sulfonamides?
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HESI RN · Drugs and the immune system
Question 12 of 37
Drug which interfere with the bacterial cell wall synthesis is
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HESI RN · Drugs and the immune system
Question 13 of 37
Fexofenadine:
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HESI RN · Drugs and the immune system
Question 14 of 37
Which aminoglycoside antibiotic causes more hearing loss than vestibular disturbance as toxic effect?
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HESI RN · Drugs and the immune system
Question 15 of 37
Select the fourth generation cephalosporin among the following
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HESI RN · Drugs and the immune system
Question 16 of 37
Probenecid increases the plasma concentration of penicillin because
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HESI RN · Drugs and the immune system
Question 17 of 37
Highest incidence of antibiotic-associated pseudomembranous enterocolitis has been noted with the use of
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HESI RN · Drugs and the immune system
Question 18 of 37
Antiviral agents that are active against cytomegalovirus (CMV) include which of the following? I. Ganciclovir II. Foscarnet III. Acyclovir
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HESI RN · Drugs and the immune system
Question 19 of 37
Clavulanic acid is combined with amoxicillin because
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HESI RN · Drugs and the immune system
Question 20 of 37
Cloxacillin is indicated in infections caused by the following organism(s)
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HESI RN · Drugs and the immune system
Question 21 of 37
The following agents inhibit the metabolism of ciclosporin:
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HESI RN · Drugs and the immune system
Question 22 of 37
Which one of the following statements about ampicillin is false?
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HESI RN · Drugs and the immune system
Question 23 of 37
The persistent suppression of bacterial growth that may occur following limited exposure to some antimicrobial drugs is called
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HESI RN · Drugs and the immune system
Question 24 of 37
Chloramphenicol is the drug of choice in
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Option B: Chloramphenicol is the drug of choice in Salmonella infections due to its broad-spectrum activity against various bacteria, including Salmonella species. It is particularly effective in treating typhoid fever and other serious infections caused by this organism, especially in cases where other antibiotics may not be suitable due to resistance or patient allergies.
Option A: Staphylococcal infections are typically treated with antibiotics such as methicillin or vancomycin, as these are more effective against Staphylococcus species, which are resistant to chloramphenicol.
Option C: Viral infections do not respond to chloramphenicol, as it is an antibiotic designed to target bacterial infections. Antiviral medications are required for effective treatment of viral pathogens.
Option D: Amoebic dysentery is primarily treated with metronidazole or tinidazole, not chloramphenicol, as these medications specifically target the protozoan organisms responsible for the condition.
Takeaways: Chloramphenicol is specifically indicated for treating Salmonella infections due to its effectiveness against this type of bacteria, while other infections require different antibiotic therapies. Understanding the specific indications for antibiotics is crucial for effective patient management, especially in cases of Salmonella infection treatment.
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HESI RN · Drugs and the immune system
Question 25 of 37
A 19-year-old woman with recurrent sinusitis has been treated with different antibiotics on several occasions. During the course of one such treatment she developed a severe diarrhea and was hospitalized. Sigmoidoscopy revealed colitis, and pseudomembranes were confirmed histologically. Which of the following drugs, administered orally, is most likely to be effective in the treatment of colitis due to C difficile?
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Option D: Metronidazole is the first-line treatment for colitis caused by Clostridium difficile. It effectively targets the anaerobic bacteria responsible for the infection and is administered orally to ensure adequate absorption and therapeutic effect in the gastrointestinal tract.
Option A: Ampicillin is a penicillin antibiotic that is not effective against C. difficile and may even contribute to its overgrowth due to disruption of normal gut flora.
Option B: Cefazolin is a cephalosporin antibiotic that does not have activity against C. difficile and is not indicated for treating this type of colitis.
Option C: Clindamycin is known to be a common cause of C. difficile infection and is not effective for treating colitis caused by this organism, as it can exacerbate the condition.
Takeaways: Metronidazole is the preferred oral treatment for C. difficile colitis, as it specifically targets the pathogen responsible for the infection and helps restore gut health, which requires appropriate antibiotic stewardship to prevent recurrence.
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HESI RN · Drugs and the immune system
Question 26 of 37
Streptomycin sulfate is not absorbed orally because it is
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Option C: Highly ionized at a wide range of pH values explains why streptomycin sulfate is not absorbed orally. Its ionization prevents it from crossing cell membranes effectively, leading to poor gastrointestinal absorption. This characteristic is crucial for understanding the pharmacokinetics of aminoglycosides like streptomycin.
Option A: Degraded by gastrointestinal enzymes does not apply to streptomycin sulfate, as it is not significantly affected by these enzymes, which primarily impact other types of medications.
Option B: Destroyed by gastric acid is inaccurate; streptomycin is stable in acidic environments, which allows it to remain intact in the stomach.
Option D: Insoluble in water is misleading; streptomycin sulfate is actually soluble in water, which is essential for its formulation and administration.
Takeaways: Understanding that streptomycin sulfate is highly ionized at a wide range of pH values is essential for recognizing its poor oral absorption, which requires knowledge of pharmacokinetics in drug administration for effective therapeutic use.
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HESI RN · Drugs and the immune system
Question 27 of 37
What is break point concentration of an antibiotic?
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Option B: Concentration of the antibiotic which demarks between sensitive and resistant bacteria defines the break point concentration. This measurement is crucial in determining the effectiveness of an antibiotic against specific bacterial strains, guiding treatment decisions and ensuring appropriate antibiotic use.
Option A: Concentration at which the antibiotic lyses the bacteria does not accurately describe the break point concentration, as this term specifically refers to the sensitivity and resistance classification rather than the lytic action of the antibiotic.
Option C: Concentration of the antibiotic which overcomes bacterial resistance misrepresents the concept, as break point concentration does not imply overcoming resistance but rather indicates the threshold for sensitivity.
Option D: Concentration at which a bacteriostatic antibiotic becomes bactericidal is not relevant to break point concentration, which focuses on the classification of bacterial susceptibility rather than the mode of action of the antibiotic.
Takeaways: Understanding the break point concentration is essential for determining bacterial sensitivity and resistance, which requires accurate interpretation of susceptibility testing to guide effective antibiotic therapy.
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HESI RN · Drugs and the immune system
Question 28 of 37
Which of the following organisms is notorious for developing antimicrobial resistance rapidly?
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Option D: Escherichia coli is notorious for developing antimicrobial resistance rapidly due to its ability to acquire resistance genes through horizontal gene transfer and its high mutation rate. This organism is a common cause of urinary tract infections and can become resistant to multiple antibiotic classes, complicating treatment options.
Option A: Streptococcus pyogenes typically shows slower rates of resistance development compared to other organisms, as it is less prone to genetic mutations and horizontal gene transfer.
Option B: Meningococcus, while it can develop resistance, does not do so at the same rapid pace as Escherichia coli, and its resistance patterns are less common in clinical practice.
Option C: Treponema pallidum, the causative agent of syphilis, has remained largely susceptible to penicillin and has not shown significant resistance development, making it less of a concern in this context.
Takeaways: Understanding the rapid development of antimicrobial resistance in organisms like Escherichia coli is crucial for effective treatment strategies, as it requires ongoing surveillance and appropriate antibiotic stewardship to manage infections effectively.
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HESI RN · Drugs and the immune system
Question 29 of 37
Which out of the following antibiotics penetrates blood-CSF barrier the best
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Option D: Chloramphenicol penetrates the blood-CSF barrier effectively due to its small size and lipid solubility, making it a preferred choice for treating central nervous system infections such as meningitis. Its ability to achieve therapeutic concentrations in the cerebrospinal fluid is crucial for effective treatment.
Option A: Erythromycin does not penetrate the blood-CSF barrier well, limiting its use in treating CNS infections. Its larger molecular size and hydrophilicity hinder its ability to cross this barrier effectively.
Option B: Gentamicin is an aminoglycoside antibiotic that poorly penetrates the blood-CSF barrier due to its hydrophilic nature and larger molecular weight, making it ineffective for CNS infections.
Option C: Tetracycline has limited ability to penetrate the blood-CSF barrier compared to chloramphenicol, which restricts its effectiveness in treating infections within the central nervous system.
Takeaways: Chloramphenicol's unique properties allow it to effectively penetrate the blood-CSF barrier, making it suitable for treating CNS infections, while other antibiotics like erythromycin, gentamicin, and tetracycline do not achieve adequate CNS concentrations. Understanding these pharmacokinetic properties is essential for appropriate antibiotic selection in clinical practice, especially for treating bacterial meningitis.
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HESI RN · Drugs and the immune system
Question 30 of 37
Penicillins interfere with bacterial cell wall synthesis by
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Option C: Inhibiting transpeptidases and carboxy peptidases which cross-link the peptidoglycan residues accurately describes the mechanism of action of penicillins. These enzymes are crucial for forming the structural integrity of the bacterial cell wall, and their inhibition leads to cell lysis and death of the bacteria.
Option A: Inhibiting synthesis of N-acetyl muramic acid pentapeptide does not accurately reflect the primary action of penicillins, as they do not directly inhibit the synthesis of this component but rather the enzymes that facilitate its incorporation into the cell wall.
Option B: Inhibiting conjugation between N-acetyl muramic acid and N-acetyl glucosamine is not the mechanism of action for penicillins. Instead, penicillins target the enzymes that cross-link these components rather than the conjugation process itself.
Option D: Counterfeiting for D-alanine in the bacterial cell wall is a mechanism associated with some other antibiotics, such as vancomycin, but does not apply to penicillins, which primarily inhibit transpeptidation.
Takeaways: Understanding the mechanism of action of penicillins, specifically their role in inhibiting transpeptidases and carboxy peptidases, is essential for effective antibiotic therapy and requires knowledge of bacterial cell wall synthesis to optimize treatment strategies.
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HESI RN · Drugs and the immune system
Question 31 of 37
In the empiric treatment of severe bacterial infections of unidentified etiology, this drug, often used in combination with an aminoglycoside, provides coverage against many staphylococci
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Option D: Nafcillin is a penicillinase-resistant penicillin that provides effective coverage against many staphylococci, making it a suitable choice in the empiric treatment of severe bacterial infections, especially when combined with an aminoglycoside for broader coverage.
Option A: Amoxicillin does not provide adequate coverage against methicillin-resistant Staphylococcus aureus (MRSA) and is not the preferred choice for severe infections requiring staphylococcal coverage.
Option B: Clavulanic acid is a beta-lactamase inhibitor that enhances the efficacy of certain antibiotics but does not have direct antibacterial activity against staphylococci on its own.
Option C: Erythromycin is a macrolide antibiotic that is not typically effective against staphylococci, particularly in severe infections, and is not used in combination with aminoglycosides for this purpose.
Takeaways: Nafcillin is essential for empiric treatment of severe bacterial infections due to its effectiveness against staphylococci, particularly when combined with an aminoglycoside for broader coverage, as outlined in CDC guidelines on antibiotic use.
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HESI RN · Drugs and the immune system
Question 32 of 37
Drugs usually active against penicillinase-producing Staphylococcus aureus include which of the following? I. Timentin (ticarcillin-clavulanate) II. Augmentin (amoxicillin-clavulanate) III. Oxacillin
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Option A: Drugs usually active against penicillinase-producing Staphylococcus aureus include Timentin (ticarcillin-clavulanate), Augmentin (amoxicillin-clavulanate), and Oxacillin. Timentin and Augmentin contain a beta-lactamase inhibitor, which enhances their efficacy against resistant strains, while Oxacillin is a penicillinase-resistant penicillin specifically designed for this purpose.
Option B: Only Oxacillin is correct. While Oxacillin is effective against penicillinase-producing Staphylococcus aureus, Timentin and Augmentin also provide coverage due to their beta-lactamase inhibitors, making this option incomplete.
Option C: I and II are correct. This option overlooks the fact that Oxacillin is also effective against penicillinase-producing Staphylococcus aureus, thus failing to recognize all three agents' roles in treatment.
Option D: II and III are correct. This option neglects Timentin's effectiveness against penicillinase-producing Staphylococcus aureus, which diminishes the completeness of the treatment options presented.
Takeaways: Understanding the effectiveness of various antibiotics against resistant bacteria, including penicillinase-producing Staphylococcus aureus, is crucial for appropriate treatment; beta-lactamase inhibitors enhance the efficacy of certain drugs, as seen with Timentin and Augmentin.
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HESI RN · Drugs and the immune system
Question 33 of 37
A 23-year-old male with a history of influenza A infection. An outbreak of influenza A has just been reported in his community and he is exhibiting initial symptoms of influenza A. Which agent would be the most useful to treat him?
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Option C: Rimantadine is an antiviral medication specifically indicated for the treatment and prevention of influenza A virus infections. It works by inhibiting the viral M2 protein, which is essential for viral replication. Given the patient's history of influenza A and current symptoms, rimantadine is the most appropriate choice for effective management.
Option A: Cidofovir is an antiviral agent primarily used for cytomegalovirus infections and is not effective against influenza A. Its mechanism does not target the influenza virus, making it unsuitable for this case.
Option B: Famciclovir is an antiviral medication effective against herpes viruses, such as herpes simplex and varicella-zoster virus, but it does not have activity against influenza A. Therefore, it is not appropriate for treating influenza.
Option D: Foscarnet is an antiviral used mainly for resistant herpes virus infections and cytomegalovirus retinitis. It does not have efficacy against influenza A, rendering it ineffective for this patient's condition.
Takeaways: Rimantadine is the preferred antiviral for treating influenza A due to its specific action against the virus, which requires appropriate antiviral therapy to mitigate symptoms and prevent complications.
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HESI RN · Drugs and the immune system
Question 34 of 37
Regarding the antibacterial action of gentamicin, which one of the following statements is most accurate?
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HESI RN · Drugs and the immune system
Question 35 of 37
An advantage of bleomycin over most antineoplastic drugs is its
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HESI RN · Drugs and the immune system
Question 36 of 37
Adverse effects associated with ciclosporin include all the following EXCEPT:
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HESI RN · Drugs and the immune system
Question 37 of 37
A woman has an upper respiratory infection. Six years ago, she experienced an episode of bronchospasm following penicillin V therapy. The cultures now reveal a strain of Streptococcus pneumoniae that is sensitive to all of the following drugs. Which of these drugs would be the best choice for this patient?
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HESI RN · Drugs and the immune system
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