LEHNE'S PHARMACOLOGY FOR NURSING
CARE 11TH EDITION 2026 EXAM STUDY GUIDE
FULL QUESTIONS AND ACCURATE ANSWERS
◉ High risk for endocarditis and undergoing surgical or dental
procedures Answer: Amoxicillin
◉ Exposure to gonorrhea Answer: Ceftriaxone
◉ History of recurrent UTIs Answer: TMP-SMX
◉ Exposure to meningococcal infection Answer: Ceftriaxone,
ciproflaxacin, or rifampin
◉ Pregnant woman carrying group B strep Answer: Penicillin G
◉ Prevention of gonococcal conjunctivitis in newborn Answer:
Erythromycin ointment
◉ Prevention of postsurgical infection due to
S. aureus Answer: Cefazolin
,◉ Prophylaxis of strep pharyngitis in child with prior rheumatic
fever Answer: Benzanthine penicillin G or or penicillin V
◉ Exposure to syphili Answer: Benzanthine penicillin G
◉ Prophylaxis in HIV patients Answer:
◉ Treatment of MRSA Answer: Vancomycin, daptomycin, linezolid,
tigecycline, ceftaroline
◉ Treatment of Vancomycin-resistant enterococci (VRE) Answer:
Linezolid and streptogramins (quinupristin, dalfopristin).
◉ Treatment of multidrug-resistant P. aeruginosa, multidrug-
resistant Acinetobacter baumannii Answer: Polymyxins B and E
(colistin).
◉ Antifungal therapy (general overview) Answer:
◉ Amphotericin B MoA Answer: -Binds ergosterol (unique to fungi);
forms membrane pores that allow leakage of electrolytes.
-Amphotericin "tears" holes in the fungal membrane by forming
pores
,◉ Aphotericin B clinical use Answer: -Serious, systemic mycoses.
Cryptococcus (amphotericin B with/without flucytosine for
cryptococcal meningitis), Blastomyces, Coccidioides, Histoplasma,
Candida, Mucor.
-Intrathecally for fungal meningitis.
-Supplement K+ and Mg2+ because of altered renal tubule
permeability
◉ Amphotericin B toxicity Answer: Fever/chills ("shake and bake"),
hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
("amphoterrible"). Hydration nephrotoxicity. Liposomal
amphotericin toxicity.
◉ Nystatin MoA Answer: Same as amphotericin B. Topical use only
as too toxic for systemic use.
◉ Nystatin clinical use Answer: "Swish and swallow" for oral
candidiasis (thrush); topical for diaper rash or vaginal candidiasis.
◉ Flucytosine MoA Answer: Inhibits DNA and RNA biosynthesis by
conversion to 5-fluorouracil by cytosine deaminase.
◉ Flucytosine clinical use Answer: Systemic fungal infections
(especially meningitis caused by Cryptococcus) in combination with
amphotericin B.
, ◉ Flucytosine toxicity Answer: Bone marrow suppression.
◉ Name the -azoles Answer: Clotrimazole, fluconazole, itraconazole,
ketoconazole, miconazole, voriconazole.
◉ Azoles MoA Answer: Inhibit fungal sterol (ergosterol) synthesis
by inhibiting the cytochrome P-450 enzyme that converts lanosterol
to ergosterol.
◉ Azoles clinical use Answer: Local and less serious systemic
mycoses. Fluconazole for chronic suppression of cryptococcal
meningitis in AIDS patients and candidal infections of all types.
Itraconazole for Blastomyces, Coccidioides, Histoplasma.
Clotrimazole and miconazole for topical fungal infections.
◉ Azoles toxicity Answer: Testosterone synthesis inhibition
(gynecomastia, especially with ketoconazole), liver dysfunction
(inhibits cytochrome P-450).
◉ Terbinafine MoA Answer: Inhibits the fungal enzyme squalene
epoxidase.
◉ Terbinafine clinical use Answer: Dermatophytoses (especially
onychomycosis—fungal infection of finger or toe nails).
CARE 11TH EDITION 2026 EXAM STUDY GUIDE
FULL QUESTIONS AND ACCURATE ANSWERS
◉ High risk for endocarditis and undergoing surgical or dental
procedures Answer: Amoxicillin
◉ Exposure to gonorrhea Answer: Ceftriaxone
◉ History of recurrent UTIs Answer: TMP-SMX
◉ Exposure to meningococcal infection Answer: Ceftriaxone,
ciproflaxacin, or rifampin
◉ Pregnant woman carrying group B strep Answer: Penicillin G
◉ Prevention of gonococcal conjunctivitis in newborn Answer:
Erythromycin ointment
◉ Prevention of postsurgical infection due to
S. aureus Answer: Cefazolin
,◉ Prophylaxis of strep pharyngitis in child with prior rheumatic
fever Answer: Benzanthine penicillin G or or penicillin V
◉ Exposure to syphili Answer: Benzanthine penicillin G
◉ Prophylaxis in HIV patients Answer:
◉ Treatment of MRSA Answer: Vancomycin, daptomycin, linezolid,
tigecycline, ceftaroline
◉ Treatment of Vancomycin-resistant enterococci (VRE) Answer:
Linezolid and streptogramins (quinupristin, dalfopristin).
◉ Treatment of multidrug-resistant P. aeruginosa, multidrug-
resistant Acinetobacter baumannii Answer: Polymyxins B and E
(colistin).
◉ Antifungal therapy (general overview) Answer:
◉ Amphotericin B MoA Answer: -Binds ergosterol (unique to fungi);
forms membrane pores that allow leakage of electrolytes.
-Amphotericin "tears" holes in the fungal membrane by forming
pores
,◉ Aphotericin B clinical use Answer: -Serious, systemic mycoses.
Cryptococcus (amphotericin B with/without flucytosine for
cryptococcal meningitis), Blastomyces, Coccidioides, Histoplasma,
Candida, Mucor.
-Intrathecally for fungal meningitis.
-Supplement K+ and Mg2+ because of altered renal tubule
permeability
◉ Amphotericin B toxicity Answer: Fever/chills ("shake and bake"),
hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis
("amphoterrible"). Hydration nephrotoxicity. Liposomal
amphotericin toxicity.
◉ Nystatin MoA Answer: Same as amphotericin B. Topical use only
as too toxic for systemic use.
◉ Nystatin clinical use Answer: "Swish and swallow" for oral
candidiasis (thrush); topical for diaper rash or vaginal candidiasis.
◉ Flucytosine MoA Answer: Inhibits DNA and RNA biosynthesis by
conversion to 5-fluorouracil by cytosine deaminase.
◉ Flucytosine clinical use Answer: Systemic fungal infections
(especially meningitis caused by Cryptococcus) in combination with
amphotericin B.
, ◉ Flucytosine toxicity Answer: Bone marrow suppression.
◉ Name the -azoles Answer: Clotrimazole, fluconazole, itraconazole,
ketoconazole, miconazole, voriconazole.
◉ Azoles MoA Answer: Inhibit fungal sterol (ergosterol) synthesis
by inhibiting the cytochrome P-450 enzyme that converts lanosterol
to ergosterol.
◉ Azoles clinical use Answer: Local and less serious systemic
mycoses. Fluconazole for chronic suppression of cryptococcal
meningitis in AIDS patients and candidal infections of all types.
Itraconazole for Blastomyces, Coccidioides, Histoplasma.
Clotrimazole and miconazole for topical fungal infections.
◉ Azoles toxicity Answer: Testosterone synthesis inhibition
(gynecomastia, especially with ketoconazole), liver dysfunction
(inhibits cytochrome P-450).
◉ Terbinafine MoA Answer: Inhibits the fungal enzyme squalene
epoxidase.
◉ Terbinafine clinical use Answer: Dermatophytoses (especially
onychomycosis—fungal infection of finger or toe nails).
