Pa ge |1
NURS 617 Exam 3 Questions and
Answers 100% Verified 2026
Causes of antimicrobial failure
Inadequate efficacy against the offending organisms
Inadequate bioavailability of selected agent
Inadequate host defense mechanisms
Inadequate duration of drug therapy
Superinfection or bacterial resistances
Incorrect identification of the offending organism
Use of a drug to which organisms have previously become resistant
Use of a microbiostatic agent when a microbicidal agent is necessary
Inadequate efficacy against the offending organisms
Use of an incorrect dose
Use of an incorrect route of administration
Use of an incorrect dosing interval
NURS 617
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Use of an incorrect antimicrobial therapeutic plan; one that does not take into
consideration the pharmacokinetic variables that exist in the treated patient
Inadequate bioavailability of selected agent
Failing to recognize that the patient has insufficient immune responses needed to
assist in antimicrobial efficacy; such as those with AIDS, malnutrition,
immunosuppression, cancer, patients on glucocorticoids, patients with large
abscesses, patients with overwhelming sepsis, and patients harboring necrotic
tissues.
Inadequate host defense mechanisms
Changing drugs without evidence of treatment failure
Treating with very expensive drugs (that the patient cannot afford to buy) when
less expensive drugs would have been appropriate
Treating with highly toxic drugs when less toxic drugs would have been
appropriate
Failure to allow for variances in patient compliance for a variety of reasons
Inadequate duration of drug therapy
Use of broad spectrum antibiotics when more targeted, narrow spectrum agents are
more appropriate
Other inappropriate uses of antimicrobial agents
Superinfection or bacterial resistances
NURS 617
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Contraceptive with the longest return to fertility after discontinuing?
Depot medroxyprogesterone acetate (Depo-Provera); return to fertility can take up
to 9-18 months. Contraceptive effect not immediately reversible; suppressive
effects last about three months
Return of fertility after use is terminated may be delayed; possibly as long as a year
How do nucleoside analogues work in herpes infection?
These drugs are activated by several enzyme-controlled mechanisms. The first of
these is by a virus-specific enzyme that is only present in cells infected by the
virus. The second two steps are controlled by enzymes inherently present in the
infected (host) cell. These series of enzyme mechanisms ensure that the drugs are
only active in infected cells and not in non-infected cells. When they become
activated, they block an enzyme in the infected cells (viral DNA polymerase) that
is necessary for the viral particles to replicate themselves.
Block viral DNA polymerase and halt DNA replication (herpes simplex (HSV-1
and HSV-2), varicella zoster virus (VZV); some Epstein-Barr virus [EBV] and
hepatitis B virus [HBV], but less so).
Which PCN is primarily metabolized in the liver?
Nafcillin (Nafcil) (Unipen): Nafcillin administration requires precaution in patients
with liver disease; it is the only penicillin that is metabolized by the liver.
What are the considerations in prescribing and determining dosage of Tamiflu?
Oseltamivir (Tamiflu) can be used prophylactically and therapeutically for
influenza type A, B, and H1N1. May begin empiric treatment without waiting for
NURS 617
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lab results.
When used therapeutically, must be administered within 48 hours of the onset of
symptoms of the flu
Should be used cautiously in patients with renal impairment
Can cause nervousness, insomnia, headache and confusion; caution is advised in
patients with history of seizures or psychosis
May cause orthostatic hypotension
Can cause anticholinergic adverse effects; dry mouth, blurred vision, urinary
retention
MMR vaccine administration contraindications
Cannot be administered prior to 12 mos. of age because protective maternal
antibodies are present until that time
Contraindicated in patients with a past history of anaphylaxis to neomycin [Note:
The vaccine is prepared in chick embryos that have been treated with the antibiotic
neomycin.]
Also contraindicated in pregnancy
Pregnancy should be avoided for 3 months followings the injection
Contraindicated in patients who have received transfusions of blood within the past
3 months or an injection of immune globulin within the prior 6 months. (these
NURS 617
NURS 617 Exam 3 Questions and
Answers 100% Verified 2026
Causes of antimicrobial failure
Inadequate efficacy against the offending organisms
Inadequate bioavailability of selected agent
Inadequate host defense mechanisms
Inadequate duration of drug therapy
Superinfection or bacterial resistances
Incorrect identification of the offending organism
Use of a drug to which organisms have previously become resistant
Use of a microbiostatic agent when a microbicidal agent is necessary
Inadequate efficacy against the offending organisms
Use of an incorrect dose
Use of an incorrect route of administration
Use of an incorrect dosing interval
NURS 617
, Pa ge |2
Use of an incorrect antimicrobial therapeutic plan; one that does not take into
consideration the pharmacokinetic variables that exist in the treated patient
Inadequate bioavailability of selected agent
Failing to recognize that the patient has insufficient immune responses needed to
assist in antimicrobial efficacy; such as those with AIDS, malnutrition,
immunosuppression, cancer, patients on glucocorticoids, patients with large
abscesses, patients with overwhelming sepsis, and patients harboring necrotic
tissues.
Inadequate host defense mechanisms
Changing drugs without evidence of treatment failure
Treating with very expensive drugs (that the patient cannot afford to buy) when
less expensive drugs would have been appropriate
Treating with highly toxic drugs when less toxic drugs would have been
appropriate
Failure to allow for variances in patient compliance for a variety of reasons
Inadequate duration of drug therapy
Use of broad spectrum antibiotics when more targeted, narrow spectrum agents are
more appropriate
Other inappropriate uses of antimicrobial agents
Superinfection or bacterial resistances
NURS 617
, Pa ge |3
Contraceptive with the longest return to fertility after discontinuing?
Depot medroxyprogesterone acetate (Depo-Provera); return to fertility can take up
to 9-18 months. Contraceptive effect not immediately reversible; suppressive
effects last about three months
Return of fertility after use is terminated may be delayed; possibly as long as a year
How do nucleoside analogues work in herpes infection?
These drugs are activated by several enzyme-controlled mechanisms. The first of
these is by a virus-specific enzyme that is only present in cells infected by the
virus. The second two steps are controlled by enzymes inherently present in the
infected (host) cell. These series of enzyme mechanisms ensure that the drugs are
only active in infected cells and not in non-infected cells. When they become
activated, they block an enzyme in the infected cells (viral DNA polymerase) that
is necessary for the viral particles to replicate themselves.
Block viral DNA polymerase and halt DNA replication (herpes simplex (HSV-1
and HSV-2), varicella zoster virus (VZV); some Epstein-Barr virus [EBV] and
hepatitis B virus [HBV], but less so).
Which PCN is primarily metabolized in the liver?
Nafcillin (Nafcil) (Unipen): Nafcillin administration requires precaution in patients
with liver disease; it is the only penicillin that is metabolized by the liver.
What are the considerations in prescribing and determining dosage of Tamiflu?
Oseltamivir (Tamiflu) can be used prophylactically and therapeutically for
influenza type A, B, and H1N1. May begin empiric treatment without waiting for
NURS 617
, Pa ge |4
lab results.
When used therapeutically, must be administered within 48 hours of the onset of
symptoms of the flu
Should be used cautiously in patients with renal impairment
Can cause nervousness, insomnia, headache and confusion; caution is advised in
patients with history of seizures or psychosis
May cause orthostatic hypotension
Can cause anticholinergic adverse effects; dry mouth, blurred vision, urinary
retention
MMR vaccine administration contraindications
Cannot be administered prior to 12 mos. of age because protective maternal
antibodies are present until that time
Contraindicated in patients with a past history of anaphylaxis to neomycin [Note:
The vaccine is prepared in chick embryos that have been treated with the antibiotic
neomycin.]
Also contraindicated in pregnancy
Pregnancy should be avoided for 3 months followings the injection
Contraindicated in patients who have received transfusions of blood within the past
3 months or an injection of immune globulin within the prior 6 months. (these
NURS 617
