Exam 4 V2: NUR 210/ NUR210– Principles of Pharmacology Guide | Galen (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A

Exam 4 V2: NUR 210/ NUR210– Principles of Pharmacology Guide | Galen (Latest 2026/ 2027 Update) 100% Verified Questions & Answers | Grade A Q: What is bacteriostatic? Answer inhibits bacterial growth Q: what is bactericidal? Answer kills bacteria Q: What is a broad spectrum antibiotic? Answer - able to control a variety of organisms (gram - or +) - used when you cannot identify what the organism causing the disease is - targets many bacteria ("shotgun approach) Q: when are broad spectrum antibiotics used? Answer when you do not know what organism is causing the problem Q: What are narrow spectrum antibiotics? Answer - effective against few organisms (either Gram positive OR Gram negative) - used when you know which organism is causing the problems and which drug that it is sensitive to - targets one organism ("bb gun approach) Q: When are narrow spectrum antibiotics used? Answer Whenever the bacteria causing the disease is known Q: what does selective toxicity mean? Answer toxic to a specific cell (bacteria/microorganism) while sparing other normal cells Q: is bacterial resistance innate or acquired? Answer both- can be either Q: what is meant by bacterial resistance? Answer ability of an organism to survive against an antimicrobial or to render the antimicrobial ineffective Q: What is a super infection? Answer when an infection arises in addition to one that is already present; an infection that occurs because of treatment for a primary infection Q: what is meant by prophylactic antibiotic use? Answer antibiotics that are used to PREVENT infection Q: what are three surgical procedures that increase the risk for infection? what is often given with/after the procedures to decrease the risk of infection? Answer 1. orthopedic 2. cardiac 3. abdominal prophylactic antibiotics given to reduce the risk of infection Q: why is there a risk for endocarditis with a patient who has an artificial valve, having dental surgery? Answer in the gums are cut bacteria can get into the bloodstream and travel to the heart and infect the artificial valve Q: how can chemotherapy increase the risk for infection? what can be given with it to reduce the risk for infection? Answer affects the bone marrow; prophylactic antibiotics Q: what are the 5 stages of infection? Answer 1. incubation 2. prodromal 3. acute 4. convalescent 5. resolution Q: what do bacteria change nitrate into? what does this indicate? Answer nitrite; indicates bacteria in the urine Q: what is one body fluid that you dont take gram stains on? Answer blood Q: how fast does a gram stain come back? Answer within hours Q: how long does a culture and sensitivity test take to come back? Answer 24-72 hours Q: why should you get a urinalysis before a C & S (culture and sensitivity test)? Answer sometimes there is normally bacteria in urine that is not causing an infection so you can rule out an infection if you do a urinalysis first Q: what is leukocyte esterase? what does it indicate? Answer enzyme produced by WBCs; indicates leukocytes in the urine Q: greater than what amount of erythrocytes is significant? Answer greater than 5 cells/hpf Q: greater than what amount of leukocytes indicates significant pyuria? Answer greater than 5 cells/hpf Q: What is a nosocomial infection? Answer hospital acquired infection Q: what happens to the virulence of a microorganism with a nosocomial infection? Answer increases Q: what are the two exceptions for getting a culture BEFORE starting antibiotics? Answer bacterial meningitis and severe sepsis Q: why can giving an antibiotic/antimicrobial before identifying the organism cause issues? Answer giving antimicrobials before getting a culture might prevent organisms from growing in culture What is the minimum inhibitory concentration (MIC)? what does it not do? Answer lowest amount of drug that inhibits bacterial growth; does not kill organism What is the minimum bactericidal concentration? Answer Lowest concentration that decreases size of bacterial colonies by 99.99%; basically lowest amount that kills that organism What is anaphylaxis? Answer Severe allergic reaction people with a penicillin allergy may also react to ______? Answer Cephalosporins people with sulfa allergies cannot take _________? Answer Bactrim: trimehoprim/sulfamethoxazole (sulfonamide) What is the peak level? Answer highest blood level of a drug; related to the amount of drug that they take what is the trough level? Answer drawn immediately before a certain dose; looks at how well the body eliminates the drug that is supposed to; *related to the time between doses* how does C. diff happen? Answer caused by antibiotics that kill normal flora C. diff is able to grow without this _____ factor Answer growth why should you not give anti-diarrheals to a patient with C. diff? Answer can cause toxic megacolon (psuedomembrane colitis) what are some signs/symptoms of C. diff? Answer orange, watery diarrhea, abdominal cramping + tenderness why should you not send C. diff for a culture? takes way too long what is an important intervention to teach family members and anyone who goes in to a patient with C.diff's room? wash hands with soap and water what are the two drugs used to treat C. diff? PO/IV metronidazole or PO vancomycin PO/IV metronidazole or PO vancomycin are used to treat which bacterial infection? C. diff what happens to cause Candidas? antimicrobial agents kill pathogens as well as normal flora is candidas a bacterial or fungal infection? fungal what 3 places in the body can candidas grow? mouth, esophagus, vagina what two drugs can be used to treat candidas? Mycostatin and Nystatin Mycostatin and Nystatin are used to treat which fungal infection? candidas what are 3 ways that microorganisms can live and grow in an environment where antimicrobial drugs are present? 1. innate resistance 2. sharing of genetic material between organisms 3. mutations what color stain is gram negative? pink/red what color gram stain is positive? purple lymphadenopathy, hepatitis, and splenomagly are symptoms of what chronic infection caused by the Epstein-Barr virus? Infectious Mononucleosis is acute lymphocytic leukemia (ALL) more common in adults or children? children is chronic lymphocytic leukemia (CLL) more common in adults or children? adults Is acute myelotic leukemia (AML) more common in adults or children? adults High granulocyte count and splenomegaly (fatigue, weight loss, diaphoresis, bleeding, abdominal discomfort) are symptoms of which form of leukemia? AML CML ALL CLL CML an issue with Reed-Sternberg cells is found with which type of lymphoma? Hodgkin's disease/lymphoma what is the difference in the spreading of Hodgkins vs. Non-Hodgkin's disease? spreading is predictable with Hodgkins disease but it is unpredictable and fast with non Hodgkins bone fractures and increased osteoclasts are factors of what type of cancer? Multiple myeloma; cancer of the plasma cells what is the main difference between Hodgkins and Non-Hodgkins Disease? Reed-Sternberg cells in Hodgkins Disease is Non-Hodgkins disease insidious or abrupt onset? more abrupt than Hodgkins disease; spreads early is Hodgkins disease insidious or abrupt onset? insidious (slow) with an acute bacterial infection or trauma, which leukocyte would you expect to see an increase in? neutrophils with a chronic bacterial infection or an (acute) viral infection, which leukocyte would you expect to see a rise in? lymphocytes what is dimorphic fungi? It may grow as mycelia or yeast and are often associated with disease in humans and are temperature dependent which spreads faster, Hodgkins or Non-Hodgkins disease? Non-Hodgkins Where is aspergillis commonly found? ventilation systems, unfiltered air, contaminated dust during hospital construction and rennovation crytpococcus infection is usually seen as what? meningitis which fungal infection presents with chronic, granulomatous lesions and skin lesions? how does it get into the body? Blastomycosis; inhalation Where is blastomycosis endemic? eastern US Histoplasmosis has an effect on what major organ? lungs How does histoplasmosis enter the body? inhalation Bird and bat droppings, contaminated soil, caves, and chicken coops are all ways in which what fungal infection can spread? Histoplasmosis can histoplasmosis be spread from person to person? NO- must have contact with contaminated soil flu-like cough, chest pain, fever, dyspnea, and HEMOPTYSIS are symptoms of which fungal infection? histoplasmosis How is Cryptococcus transmitted? Bird poop in soil; inhalation are Blastomycosis and Histoplasmosis opportunistic or non-opportunistic fungal infections? non-opportunistic which azole can treat Blastomycosis and Histoplasmosis? Itraconazole CMV (CytomegaloVirus) is only a real problem with which group of patients? immunocompromised neutropenia is usually seen with what type of patients? cancer patients What is a CBC with differential? measures the amount of each type of leukocyte in a sample of 100 cells with a bacterial infection (acute), most of the increase in WBCs will be _____? neutrophils what is the difference between segs and bands? segs (segmented) neutrophils are mature, bands are immature neutrophils what is meant by a "shift to the left"? what is it indicative of? increase in band neutrophils- indicates that the body is overwhelmed by the infection because the neutrophils don't have time to mature what does dermatophyte mean? cant grow at body temp which white blood cells are the first to arrive at the site of inflammation? neutrophils which white blood cells are the primary cells of immune response? lymphocytes you see an increase of monocytes with which type of infection? when do they arrive? bacterial; arrive after neutrophils What is agranulocytosis? decrease in # of granulocytes Bacteriostatic inhibits bacterial growth Bactericidal kills bacteria Drugs with narrow therapeutic window need peak/trough Factors to consider (antibiotics) Age, nutrition, WBC's, immune system, organ function Narrow spectrum antibiotics Effective against specific bacteria Example of narrow spectrum antibiotics Penicillin and erythromycin Broad spectrum antibiotics affect a broad range of gram-positive or gram-negative bacteria example of broad spectrum antibiotic Tetracycline and cephalosporin Adverse reactions of antibiotics Allergic reactions: -rash, pruritus, hives (treat with antihistamine, vascular collapse, laryngeal edema, bronchospasm, cardiac arrest (treat with epinephrine, bronchodilators, antihistamine) Superinfection: secondary infection due to disturbed normal flora (in mouth, GI, respiratory tract, GU, skin; frequently fungal infections Oran toxicity:liver and kidneys Penicillin broad spectrum Ampicillin Amoxicillin Use if penicillin broad spectrum (amoxicillin) Upper respiratory infection, gi, gu, skin infections, h. pylori/e. coli Action of amoxicillin binds to bacterial cell wall causing cell death (bactericidal) Side effects of amoxicillin nausea, vomiting, diarrhea, abdominal pain, stomatitis, headache, crystalluria, dermatitis, confusion, rash amoxicillin patient teaching -to take as prescribed -finish entire course of meds -report sore throat, fever and fatigue (sign of superinfection) -take in equal intervals to maintain blood serum levels -do not take with acidic food (decreases effect) Amoxicillin Nursing Considerations -IV or PO -Use cautiously in renal patients -monitor I&O -Nephrotoxicity at high doses -signs of anaphylaxis: rash, itching, dyspnea -monitor stool for blood: pseudomembranous Amoxicillin contraindications Contraindicated for clients who have a severe allergy to penicillin and cephalosporins -IBD, UC, asthma, mono, renal failure Cephalosporins inhibit cell wall synthesis (bactericidal) Cephalosporin example Ceftriaxone Side effects of ceftriaxone anorexia, nausea, vomiting, abdominal cramps, headache, stomatitis nursing considerations for ceftriaxone assess allergies, vital signs, urine output, renal/liver function, infuse over 30 minutes, watch for bleeding, culture sensitivity adverse reactions ceftriaxone superinfection (mouth ulcers), bleeding, seizures ceftriaxone contraindicated in gallbladder disease, c-diff, renal impairment, hepatic dysfunction patient teaching ceftriaxone no alcohol ceftriaxone is used to treat meningitis, gonorrhea, many infections Macrolides erythromycin, clarithromycin, azithromycin (-mycin) uses of azithromycin respiratory tract, sinuses, GI, skin, STI action of azithromycin inhibits protein synthesis, both bacteriostatic/bactericidal azithromycin side effects blurred vision, PHOTOSENSITIVITY, headaches, tinnitus, drowsy, dizzy, nausea, vomiting, abdominal cramps, anorexis, diarrhea azithromycin is an alternative if the pt is allergic to what penicillin adverse effects of azithromycin hearing loss, angioedema, seizures, superinfection, hepatotoxicity nursing considerations: azithromycin assess allergies, VS, ursine output, liver/renal function, culture sensitivity do not give azithromycin with this antacids when do you give azithromycin 1 hour before, or 2 hours after meals, with full glass of water can azithromycin be given with food? yes azithromycin increases the effects of what drugs? digoxin, warfarin glycopeptide vancomycin use of vancomycin staph infection, c-diff, septicemia action of vancomycin bactericidal antibiotic side effects of vancomycin chills, dizzy, nausea, vomiting, headache, if given too quick... RED MAN SYNDROME adverse reactions of vancomycin nephrotoxicity, ototoxicity, severe hypotension, tachycardia nursing considerations of vancomycin assess allergies, vital signs, renal function, and c/s vancomycin dosage dilute 100/200 mL and give over 60-90 minutes what do you have to do for vancomycin? draw peak/trough tetracycline broad spectrum doxycycline use of doxycycline acne, sti's, respiratory, urinary, skin, h. pylori, MRSA action of doxycycline bacteriostatic/bactericidal side effects of doxycycline nausea, vomiting, abdominal pain, diarrhea, headache, glossitis, TOOTH/NAIL DISCOLORATION, PHOTOSENSITIVITY, vision changes doxycycline may cause superinfection, nephrotoxicity teaching for doxycycline avoid sunlight avoid dairy products teach birth control store away from light, expiration date for toxicity, take full dose, do not give during pregnancy or children under 8 Aminoglycosides Gentamicin use of gentamycin respiratory infections, MRSA, septicemia, bacteremia-serious infections action of gentamycin bactericidal side effects of gentamycin anorexia, nausea, vomiting, rash, dizzy, tinnitus, weak, photosensitivity, vision changes do not give gentamycin to.. pregnant patients adverse of gentamycin nephrotoxicity, ototoxicity, superinfection, peripheral neuropathy, decreased electrolytes nursing considerations of gentamycin assess allergies, vital signs, c/s, renal/liver function, assess for decreased potassium/magnesium levels, assess hearing gentamycin administration given IM, IV- dilute in 200mL, and 30-60 gentamycin causes ototoxicity when mixed with loop diuretics nephrotoxicity with gentamycin when combined with NSAIDS, furosemide, vancomycin fluoroquinolones ciprofloxacin use of ciprofloxacin sinusitis, cellulitis, respiratory/urinary/skin infections action of ciprofloxacin bactericidal side effects of ciprofloxacin anorexia, nausea, vomiting, diarrhea, abdominal cramping, blurred vision, restless, confusion, nightmare, tremors, photosensitivity, TENDON RUPTURE adverse effects of ciprofloxacin superinfection, stevens-johnson syndrome, anaphylaxis, angioedema nursing considerations of ciprofloxacin assess allergy, vital signs, urine output what do antacids do regarding ciprofloxacin antacids and iron decrease absorption give BEFORE meals - not with food watch blood sugar level if diabetic, no caffiene, increase fluid intake ciprofloxacin administration IV- dilute, give over 60 minutes, monitor theophylline level if taking, wear sunscreen, report superinfection side effects sulfonamides trimethoprim-sulfamethoxazole (TMP-SMZ) use of TMP-SMZ otitis media, resp/urinary infections, e-cole, meningitis, gastroenteritis, MRSA action of TMP-SMZ bactericidal s/e of TMP-SMZ anorexia, stomatitis, n/v, diarrhea, abd pain, headache, vertigo, weakness, insomnia, photosensitivity, tinnitus, crystalluria serious adverse effects of TMP-SMZ myocarditis, arganulocytosis superinfection (not serious) nursing consideration TMP-SMZ assess allergies, vital signs, urine OUTPUT, renal/liver function, give with full glass of water to prevent crystalluria TMP-SMZ monitor... blood sugar with sulfonureas TMP-SMZ watch for... bleeding with warfarin do not take antacids with TMP-SMZ pt. teaching for TMP-SMZ report bruising/bleeding, sun block (no sun exposure), full glass of water, 1hr before or 2 hr after meals antifungal nystatin action of nystatin kills fungus side effects of nystatin diarrhea, n/v, dyspepsia (heart burn), skin irritation if topical adverse effects of nystatin pruritus, urticaria, hyperglycemia, angioedema, bronchospasm, sinus tachycardia nystatin admin swish in mouth QID, dont eat or drink afterwards for 20 minutes fluconazole antifungal fluconazole use treat candida, meningitis, for systemic fungal infection s/e fluconazole abd pain, diarrhea, ha, rash, hypokalemia fluconazole adverse elevated liver enzymes, liver failure, fatal cardiac arrythmias, toxic epidermal necrolysis fluconazole teach take as ordered, renal function, contraindicated in pregnancy, cardiac, renal or hepatic fluconazole many drug interaction/watch caffiene acyclovir antiviral acyclovir use HSV, varicella s/e acyclovir tremors, agitation, lethargy, rash, pruriris, increased bleeding time acyclovir adverse crystalluria, neuropathy, nephrotoxicity, seizures nursing considerations acyclovir administer over 60 min, never iv push, safe sex, pap smears, milk proteins interact acyclovir decreases phenytoin effect so seizures can occur metronidazole antibacterial peptide antiprotozoal metronidazole uses h. pylori, rosacea, trichomonas, c. diff metronidazole causes metallic taste in mouth metronidazole adverse seizures, optic and peripheral neuropathy, pruritis, urticaria nitrofurantion urinary anti infective use of nitrifurantoin uti nitrofurantoin considerations do not crush, rinse mouth after to prevent staining of teeth avoid what with nitrofurantion antacids phenAZOpyridine urinary analgesic use of phenazypyridine uti symptoms, burning phenazopyridine nsg considerations can alter urine glucose so blood test is used promethazine antiemetic promethazine use treat/prevent motin sickness, sedation adverse rxn promethazine cns depression, extrapyramidal syndrome, seizures, agranulocytosis, resp. depression nsg considerations promethazine assess dehydration, bowel sounds, no 1st trimester pregnancy, no driving, increased risk of seizures with phenytoin do not give promethazine to GI obstruction, glaucoma, htn, older adults