NR566 Week 4 Midterm Exam
Advanced Pharmacology – Care of the Family
Question 1
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A 72-year-old patient presents to the emergency department with sudden, severe right-eye pain,
headache, blurred vision, and halos around lights. Examination reveals conjunctival injection, a
mid-dilated fixed pupil, and markedly elevated intraocular pressure (IOP). What is the MOST
appropriate next step in management?
A. Initiate prostaglandin analog therapy for long-term IOP reduction
B. Reassure the patient and schedule outpatient follow-up in one week
C. Administer osmotic agents, miotics, or carbonic anhydrase inhibitors ✓
D. Schedule elective laser trabeculoplasty
Correct Answer: C
Rationale: This presentation is acute angle-closure glaucoma, an ophthalmic emergency. Immediate
IOP-lowering treatment (osmotic agents, miotics, or carbonic anhydrase inhibitors) is required, followed
by definitive laser iridotomy. Prostaglandins and elective laser trabeculoplasty are used for chronic
open-angle glaucoma and are far too slow for this emergency. Reassurance and delayed follow-up risk
permanent vision loss within hours.
NR566 – Week 4 Midterm Exam Review
,Question 2
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Which BEST describes the action of a bacteriostatic agent?
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A. Inhibits bacterial growth and replication, relying on host immunity ✓
B. Alters host immune function to increase bacterial clearance
C. Neutralizes bacterial toxins without affecting bacterial survival
D. Directly kills bacteria by disrupting cell wall integrity
Correct Answer: A
Rationale: Bacteriostatic drugs (e.g., tetracyclines, macrolides) halt bacterial growth and replication so
the host's own immune system can clear the infection. Option D describes bactericidal action (e.g.,
penicillins, which disrupt the cell wall). Options B and C do not describe the mechanism of either drug
class.
NR566 – Week 4 Midterm Exam Review
,Question 3
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When selecting between a bactericidal and bacteriostatic antibiotic, which of the following is the
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MOST important consideration?
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A. The site, severity, and the client's immune status ✓
B. The patient's dietary folic acid intake
C. The color change observed during Gram staining
D. Whether the bacteria are Gram-positive or Gram-negative
Correct Answer: A
Rationale: Bactericidal drugs are generally preferred for severe infections (e.g., endocarditis, meningitis)
and in immunocompromised patients, since bacteriostatic agents depend on a functioning immune
system to fully clear the infection. Gram stain results (D) guide the choice of antibiotic spectrum, not the
cidal vs. static decision. B and C are not relevant considerations.
NR566 – Week 4 Midterm Exam Review
, Question 4
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A 55-year-old hospitalized patient develops severe diarrhea after broad-spectrum antibiotic therapy.
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The nurse practitioner suspects Clostridioides difficile. Which is the MOST appropriate treatment?
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A. Oral Vancomycin ✓
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B. Oral Clarithromycin
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C. Oral Amoxicillin
D. IV Cefotaxime
Correct Answer: A
Rationale: Oral vancomycin (or oral fidaxomicin) is first-line therapy for C. difficile infection. Because it
remains in the gut lumen, it achieves high local concentrations against C. difficile without significant
systemic absorption. IV vancomycin is ineffective because it does not reach adequate colonic
concentrations. Additional broad-spectrum antibiotics (C, D) can worsen C. difficile infection, and
clarithromycin (B) has no role in treatment.
NR566 – Week 4 Midterm Exam Review
Advanced Pharmacology – Care of the Family
Question 1
i a
uv
St
x-
fe
ht
rig
:B
m
ro
yF
nl
yO
Bu
A 72-year-old patient presents to the emergency department with sudden, severe right-eye pain,
headache, blurred vision, and halos around lights. Examination reveals conjunctival injection, a
mid-dilated fixed pupil, and markedly elevated intraocular pressure (IOP). What is the MOST
appropriate next step in management?
A. Initiate prostaglandin analog therapy for long-term IOP reduction
B. Reassure the patient and schedule outpatient follow-up in one week
C. Administer osmotic agents, miotics, or carbonic anhydrase inhibitors ✓
D. Schedule elective laser trabeculoplasty
Correct Answer: C
Rationale: This presentation is acute angle-closure glaucoma, an ophthalmic emergency. Immediate
IOP-lowering treatment (osmotic agents, miotics, or carbonic anhydrase inhibitors) is required, followed
by definitive laser iridotomy. Prostaglandins and elective laser trabeculoplasty are used for chronic
open-angle glaucoma and are far too slow for this emergency. Reassurance and delayed follow-up risk
permanent vision loss within hours.
NR566 – Week 4 Midterm Exam Review
,Question 2
i a
uv
St
x-
fe
ht
rig
:B
m
ro
yF
nl
Which BEST describes the action of a bacteriostatic agent?
yO
Bu
A. Inhibits bacterial growth and replication, relying on host immunity ✓
B. Alters host immune function to increase bacterial clearance
C. Neutralizes bacterial toxins without affecting bacterial survival
D. Directly kills bacteria by disrupting cell wall integrity
Correct Answer: A
Rationale: Bacteriostatic drugs (e.g., tetracyclines, macrolides) halt bacterial growth and replication so
the host's own immune system can clear the infection. Option D describes bactericidal action (e.g.,
penicillins, which disrupt the cell wall). Options B and C do not describe the mechanism of either drug
class.
NR566 – Week 4 Midterm Exam Review
,Question 3
i a
uv
St
x-
fe
ht
rig
:B
m
ro
yF
nl
When selecting between a bactericidal and bacteriostatic antibiotic, which of the following is the
yO
MOST important consideration?
Bu
A. The site, severity, and the client's immune status ✓
B. The patient's dietary folic acid intake
C. The color change observed during Gram staining
D. Whether the bacteria are Gram-positive or Gram-negative
Correct Answer: A
Rationale: Bactericidal drugs are generally preferred for severe infections (e.g., endocarditis, meningitis)
and in immunocompromised patients, since bacteriostatic agents depend on a functioning immune
system to fully clear the infection. Gram stain results (D) guide the choice of antibiotic spectrum, not the
cidal vs. static decision. B and C are not relevant considerations.
NR566 – Week 4 Midterm Exam Review
, Question 4
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A 55-year-old hospitalized patient develops severe diarrhea after broad-spectrum antibiotic therapy.
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The nurse practitioner suspects Clostridioides difficile. Which is the MOST appropriate treatment?
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A. Oral Vancomycin ✓
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B. Oral Clarithromycin
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C. Oral Amoxicillin
D. IV Cefotaxime
Correct Answer: A
Rationale: Oral vancomycin (or oral fidaxomicin) is first-line therapy for C. difficile infection. Because it
remains in the gut lumen, it achieves high local concentrations against C. difficile without significant
systemic absorption. IV vancomycin is ineffective because it does not reach adequate colonic
concentrations. Additional broad-spectrum antibiotics (C, D) can worsen C. difficile infection, and
clarithromycin (B) has no role in treatment.
NR566 – Week 4 Midterm Exam Review
