Final Exam: NR 566 / NR566 (Latest
Update ) Advanced
Pharmacology for Care of the Family |
Questions & Answers | with rationales.
**Q1. A 22-year-old female presents with lower abdominal pain, fever,
and cervical motion tenderness. She is diagnosed with Pelvic
Inflammatory Disease (PID). According to CDC guidelines, which
outpatient regimen is appropriate?**
A. Azithromycin 1 gram PO once + Metronidazole 2 grams PO once
B. Ciprofloxacin 500 mg BID for 14 days
C. Doxycycline 100 mg BID for 7 days alone
D. Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 14 days ±
Metronidazole
**Correct Answer: D**
*Rationale:* The recommended outpatient regimen for PID is a single
IM dose of ceftriaxone (to cover *N. gonorrhoeae*) plus oral
doxycycline for 14 days (to cover *C. trachomatis*). The addition of
metronidazole is recommended to cover anaerobic organisms.
**Q2. A patient has just been diagnosed with uncomplicated
gonorrhea. Which intramuscular (IM) antibiotic is the recommended
first-line treatment?**
,A. Penicillin G 2.4 million units IM
B. Ceftriaxone 500 mg IM
C. Gentamicin 240 mg IM
D. Spectinomycin 2 grams IM
**Correct Answer: B**
*Rationale:* Due to rising resistance to fluoroquinolones and other
antibiotics, a single 500 mg IM dose of ceftriaxone is the standard of
care for uncomplicated gonorrhea per CDC guidelines.
**Q3. In addition to IM ceftriaxone for gonorrhea, why is it
recommended to also treat the patient with oral doxycycline 100mg
BID for 7 days?**
A. To prevent the development of fungal superinfections
B. To treat possible coexisting chlamydial infection
C. To reduce the pain of the IM injection
D. To enhance the efficacy of the ceftriaxone against gonorrhea
**Correct Answer: B**
*Rationale:* Co-infection with *Chlamydia trachomatis* is common in
patients with gonorrhea. Dual therapy is required to ensure eradication
of both organisms, as ceftriaxone does not reliably treat chlamydia.
,**Q4. A 25-year-old male has a purulent urethral discharge. A Gram
stain shows Gram-negative diplococci. Besides ceftriaxone IM, what
oral antibiotic should be prescribed empirically?**
A. Metronidazole
B. Doxycycline
C. Azithromycin
D. Penicillin VK
**Correct Answer: B**
*Rationale:* While the Gram stain suggests gonorrhea, high rates of co-
infection with chlamydia necessitate treatment for both. The current
CDC recommendation for gonorrhea is ceftriaxone IM plus oral
doxycycline.
**Q5. A patient is treated for trichomoniasis with a 2-gram single dose
of metronidazole. What is essential teaching for this patient?**
A. She may experience joint pain for a few days
B. She should avoid sexual intercourse for 3 months
C. She must avoid alcohol for at least 24 hours (up to 48-72 hours)
D. She needs to return for a follow-up urine test in one week
**Correct Answer: C**
*Rationale:* Metronidazole can cause a severe disulfiram-like reaction
(nausea, vomiting, flushing, headache) when combined with alcohol.
, Patients must be instructed to avoid alcohol during treatment and for
at least 24 hours (or longer, up to 3 days, to be safe) after the last dose.
**Q6. First-line treatment for primary, secondary, or early latent
syphilis (less than 1 year) is:**
A. Doxycycline 100 mg BID for 14 days
B. Ceftriaxone 1 gram IM daily for 10 days
C. Penicillin G benzathine 2.4 million units IM once
D. Azithromycin 2 grams PO once
**Correct Answer: C**
*Rationale:* A single dose of Penicillin G benzathine 2.4 million units IM
is the standard of care for early syphilis. Doxycycline is an alternative
for non-pregnant patients with penicillin allergy.
**Q7. A pregnant patient is diagnosed with primary syphilis and reports
a penicillin allergy. What is the appropriate management?**
A. Prescribe doxycycline 100 mg BID for 14 days
B. Prescribe azithromycin 2 grams PO once
C. Desensitize the patient to penicillin and then treat with penicillin G
benzathine
D. Prescribe cephalexin 500 mg QID for 14 days
**Correct Answer: C**
Update ) Advanced
Pharmacology for Care of the Family |
Questions & Answers | with rationales.
**Q1. A 22-year-old female presents with lower abdominal pain, fever,
and cervical motion tenderness. She is diagnosed with Pelvic
Inflammatory Disease (PID). According to CDC guidelines, which
outpatient regimen is appropriate?**
A. Azithromycin 1 gram PO once + Metronidazole 2 grams PO once
B. Ciprofloxacin 500 mg BID for 14 days
C. Doxycycline 100 mg BID for 7 days alone
D. Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 14 days ±
Metronidazole
**Correct Answer: D**
*Rationale:* The recommended outpatient regimen for PID is a single
IM dose of ceftriaxone (to cover *N. gonorrhoeae*) plus oral
doxycycline for 14 days (to cover *C. trachomatis*). The addition of
metronidazole is recommended to cover anaerobic organisms.
**Q2. A patient has just been diagnosed with uncomplicated
gonorrhea. Which intramuscular (IM) antibiotic is the recommended
first-line treatment?**
,A. Penicillin G 2.4 million units IM
B. Ceftriaxone 500 mg IM
C. Gentamicin 240 mg IM
D. Spectinomycin 2 grams IM
**Correct Answer: B**
*Rationale:* Due to rising resistance to fluoroquinolones and other
antibiotics, a single 500 mg IM dose of ceftriaxone is the standard of
care for uncomplicated gonorrhea per CDC guidelines.
**Q3. In addition to IM ceftriaxone for gonorrhea, why is it
recommended to also treat the patient with oral doxycycline 100mg
BID for 7 days?**
A. To prevent the development of fungal superinfections
B. To treat possible coexisting chlamydial infection
C. To reduce the pain of the IM injection
D. To enhance the efficacy of the ceftriaxone against gonorrhea
**Correct Answer: B**
*Rationale:* Co-infection with *Chlamydia trachomatis* is common in
patients with gonorrhea. Dual therapy is required to ensure eradication
of both organisms, as ceftriaxone does not reliably treat chlamydia.
,**Q4. A 25-year-old male has a purulent urethral discharge. A Gram
stain shows Gram-negative diplococci. Besides ceftriaxone IM, what
oral antibiotic should be prescribed empirically?**
A. Metronidazole
B. Doxycycline
C. Azithromycin
D. Penicillin VK
**Correct Answer: B**
*Rationale:* While the Gram stain suggests gonorrhea, high rates of co-
infection with chlamydia necessitate treatment for both. The current
CDC recommendation for gonorrhea is ceftriaxone IM plus oral
doxycycline.
**Q5. A patient is treated for trichomoniasis with a 2-gram single dose
of metronidazole. What is essential teaching for this patient?**
A. She may experience joint pain for a few days
B. She should avoid sexual intercourse for 3 months
C. She must avoid alcohol for at least 24 hours (up to 48-72 hours)
D. She needs to return for a follow-up urine test in one week
**Correct Answer: C**
*Rationale:* Metronidazole can cause a severe disulfiram-like reaction
(nausea, vomiting, flushing, headache) when combined with alcohol.
, Patients must be instructed to avoid alcohol during treatment and for
at least 24 hours (or longer, up to 3 days, to be safe) after the last dose.
**Q6. First-line treatment for primary, secondary, or early latent
syphilis (less than 1 year) is:**
A. Doxycycline 100 mg BID for 14 days
B. Ceftriaxone 1 gram IM daily for 10 days
C. Penicillin G benzathine 2.4 million units IM once
D. Azithromycin 2 grams PO once
**Correct Answer: C**
*Rationale:* A single dose of Penicillin G benzathine 2.4 million units IM
is the standard of care for early syphilis. Doxycycline is an alternative
for non-pregnant patients with penicillin allergy.
**Q7. A pregnant patient is diagnosed with primary syphilis and reports
a penicillin allergy. What is the appropriate management?**
A. Prescribe doxycycline 100 mg BID for 14 days
B. Prescribe azithromycin 2 grams PO once
C. Desensitize the patient to penicillin and then treat with penicillin G
benzathine
D. Prescribe cephalexin 500 mg QID for 14 days
**Correct Answer: C**
