Exam 4:NUR 521:(Exam 4 Blueprint)|Practice Questions & Answers:Latest Updated: Guaranteed A+ Score Guide

NUR 521 Exam 4 Blueprint Practice Questions & Answers

Section 1: Basic Questions About Antifungals
Question 1 Which of the following is an opportunistic systemic fungal infection?

• A) Sporotrichosis B) Aspergillosis
• C) Blastomycosis
• D) Histoplasmosis

Answer: B Rationale: Opportunistic systemic fungal infections occur in immunocompromised
patients and include Aspergillosis, Candidiasis, Cryptococcosis, and Mucormycosis.
Nonopportunistic infections, such as sporotrichosis, blastomycosis, and histoplasmosis, affect
healthy individuals.

Question 2 What is the drug of choice (DOC) for most systemic fungal infections?

• A) Fluconazole
• B) Amphotericin B
• C) Itraconazole
• D) Ketoconazole

Answer: B Rationale: Amphotericin B is the DOC for most systemic fungal infections due to its
broad-spectrum antifungal activity, despite its high toxicity.

Question 3 Which antifungal is effective against both systemic and superficial fungal
infections but has a black box warning for patients with heart failure?

• A) Amphotericin B
• B) Itraconazole
• C) Fluconazole
• D) Terbinafine

Answer: B Rationale: Itraconazole is effective for both systemic and superficial fungal infections
but has a BBW due to its negative inotropic effects, contraindicating its use in patients with
heart failure.

Question 4 Which antifungal is primarily used to treat superficial fungal infections, such as
candidiasis?

• A) Amphotericin B



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, • B) Fluconazole
• C) Itraconazole
• D) Ketoconazole
Answer: B Rationale: Fluconazole is a commonly prescribed antifungal for superficial infections
like candidiasis and cryptococcal meningitis.

Question 5 Which organism is responsible for the majority of cases of superficial fungal
infections?

• A) Candida albicans B) Aspergillus spp. C) Cryptococcus neoformans D)
Mucorales spp.

Answer: A Rationale: Candida albicans is a common cause of superficial fungal infections,
particularly involving mucosal surfaces, skin, and nails.

Question 6 What is the primary safety concern associated with Amphotericin B?

• A) Hepatotoxicity
• B) Nephrotoxicity and infusion reactions
• C) Cardiotoxicity
• D) Ototoxicity

Answer: B Rationale: Amphotericin B has significant nephrotoxicity and infusion-related
reactions, limiting its use to life-threatening fungal infections.

Question 7 Which antifungal is the DOC for histoplasmosis and blastomycosis?

• A) Amphotericin B
• B) Fluconazole
• C) Itraconazole
• D) Ketoconazole

Answer: C Rationale: Itraconazole is the preferred agent for non-opportunistic systemic
infections such as histoplasmosis and blastomycosis.

Question 8 What is the recommended antifungal for cryptococcal meningitis?

• A) Amphotericin B
• B) Itraconazole
• C) Fluconazole
• D) Terbinafine




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,Answer: C Rationale: Fluconazole is effective in treating cryptococcal meningitis, particularly in
immunocompromised patients.

Question 9 Which antifungal carries the highest risk for systemic toxicity and is reserved for
life-threatening infections?

• A) Fluconazole
• B) Amphotericin B
• C) Itraconazole
• D) Voriconazole

Answer: B Rationale: Amphotericin B is highly effective but carries a significant risk of
nephrotoxicity and other adverse effects, making it reserved for severe infections.

Question 10 What is the mechanism of action of Azole antifungals like Itraconazole and
Fluconazole?

• A) Inhibit DNA synthesis
• B) Inhibit cell wall synthesis
• C) Inhibit ergosterol synthesis in fungal cell membranes
• D) Disrupt protein synthesis

Answer: C Rationale: Azole antifungals inhibit the synthesis of ergosterol, a critical component
of fungal cell membranes, disrupting fungal growth and survival.

Section 2: Patient Scenarios
Question 11 A 55-year-old construction worker presents with pulmonary infiltrates and weight
loss. A biopsy confirms Histoplasma capsulatum. Which antifungal is the DOC for this systemic
infection?

• A) Amphotericin B
• B) Itraconazole
• C) Fluconazole
• D) Ketoconazole

Answer: B Rationale: Itraconazole is the preferred antifungal for treating systemic infections
like histoplasmosis, offering a less toxic alternative to Amphotericin B.

Question 12 A 65-year-old diabetic man presents with fever, cough, and hemoptysis. Imaging
reveals lung nodules, and culture grows Aspergillus fumigatus. Which antifungal is most
appropriate?



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, • A) Fluconazole
• B) Amphotericin B
• C) Itraconazole
• D) Ketoconazole

Answer: B Rationale: Amphotericin B is the DOC for systemic aspergillosis due to its
broadspectrum activity and efficacy in life-threatening infections.
Question 13 A 35-year-old woman with HIV presents with headaches and stiff neck. Lumbar
puncture confirms Cryptococcus neoformans. What is the DOC for treatment?

• A) Amphotericin B
• B) Fluconazole
• C) Itraconazole
• D) Ketoconazole

Answer: B Rationale: Fluconazole is effective for treating cryptococcal meningitis and is often
used in immunocompromised patients.

Question 14 A gardener reports developing nodular lesions along her arms after a prick from a
rose bush. A biopsy confirms sporotrichosis. What antifungal should be prescribed?

• A) Amphotericin B
• B) Itraconazole
• C) Fluconazole
• D) Ketoconazole

Answer: B Rationale: Itraconazole is the DOC for systemic infections like sporotrichosis due to
its excellent efficacy profile.

Question 15 A patient presents with superficial white patches in the mouth diagnosed as oral
thrush caused by Candida albicans. Which antifungal is most appropriate?

• A) Amphotericin B
• B) Itraconazole
• C) Fluconazole
• D) Ketoconazole

Answer: C Rationale: Fluconazole is effective for superficial candidiasis, including oral thrush.

Section 1: Basic Questions About Antifungal Use in Pediatric and Elderly Patients
Question 1 Which antifungal is commonly used to treat oral candidiasis in infants?



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