NUR 521 Exam 4 Blueprint Practice Questions and Answers 2026 Updated 100- Correct - University of Alabama..

NUR 521 Exam 4 Blueprint Practice Questions
and Answers | 2026 Updated | 100% Correct -
University of Alabama.
Exam 4 Blueprint Practice Questions


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. Non-
opportunistic 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?
1

,• A) Amphotericin B
• B) Fluconazole
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• C) Itraconazole
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• D) Ketoconazole
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2

,Answer: B Rationale: Fluconazole is a commonly prescribed antifungal for superficial
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infections like candidiasis and cryptococcal meningitis.
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Question 5 Which organism is responsible for the majority of cases of superficial fungal
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infections?
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• A) Candida albicans
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• B) Aspergillus spp.
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• C) Cryptococcus neoformans
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• D) Mucorales spp.
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Answer: A Rationale: Candida albicans is a common cause of superficial fungal infections,
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particularly involving mucosal surfaces, skin, and nails.
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Question 6 What is the primary safety concern associated with Amphotericin B?
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• A) Hepatotoxicity
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• B) Nephrotoxicity and infusion reactions
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• C) Cardiotoxicity
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• D) Ototoxicity
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Answer: B Rationale: Amphotericin B has significant nephrotoxicity and infusion-related
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reactions, limiting its use to life-threatening fungal infections.
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Question 7 Which antifungal is the DOC for histoplasmosis and blastomycosis?
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• A) Amphotericin B
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• B) Fluconazole
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• C) Itraconazole
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• D) Ketoconazole
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Answer: C Rationale: Itraconazole is the preferred agent for non-opportunistic systemic
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infections such as histoplasmosis and blastomycosis.
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Question 8 What is the recommended antifungal for cryptococcal meningitis?
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• A) Amphotericin B
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• B) Itraconazole
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• C) Fluconazole
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• D) Terbinafine
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Answer: C Rationale: Fluconazole is effective in treating cryptococcal meningitis, particularly
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in immunocompromised patients.
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Question 9 Which antifungal carries the highest risk for systemic toxicity and is reserved
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for life-threatening infections?
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, • A) Fluconazole g


• B) Amphotericin B
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• C) Itraconazole g


• D) Voriconazole g




Answer: B Rationale: Amphotericin B is highly effective but carries a significant risk of
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nephrotoxicity and other adverse effects, making it reserved for severe infections.
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Question 10 What is the mechanism of action of Azole antifungals like Itraconazole and
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Fluconazole?
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• A) Inhibit DNA synthesis
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• B) Inhibit cell wall synthesis
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• C) Inhibit ergosterol synthesis in fungal cell membranes
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• D) Disrupt protein synthesis
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Answer: C Rationale: Azole antifungals inhibit the synthesis of ergosterol, a critical component of
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fungal cell membranes, disrupting fungal growth and survival.
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Section 2: Patient Scenarios
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Question 11 A 55-year-old construction worker presents with pulmonary infiltrates and weight
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loss. A biopsy confirms Histoplasma capsulatum. Which antifungal is the DOC for this systemic
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infection?
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• A) Amphotericin B g g


• B) Itraconazole g


• C) Fluconazole g


• D) Ketoconazole g




Answer: B Rationale: Itraconazole is the preferred antifungal for treating systemic infections
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like histoplasmosis, offering a less toxic alternative to Amphotericin B.
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Question 12 A 65-year-old diabetic man presents with fever, cough, and hemoptysis. Imaging
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reveals lung nodules, and culture grows Aspergillus fumigatus. Which antifungal is most
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appropriate?
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• A) Fluconazole g


• B) Amphotericin B
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• C) Itraconazole g


• D) Ketoconazole g




Answer: B Rationale: Amphotericin B is the DOC for systemic aspergillosis due to its broad-
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spectrum activity and efficacy in life-threatening infections.
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