AGNP BOARD EXAM QUESTIONS Prescription (82 Questions)
Question:
Which of the following is NOT recommended as an alternative treatment for bacterial vaginosis?
Intramuscular ceftriaxone (Rocephin) Correct
Clindamycin (Cleocin) vaginal cream
Metronidazole (Flagyl) vaginal cream
Tinidazole (Tindamax) orally
Explanation:
Intramuscular ceftriaxone (Rocephin) is not indicated in the treatment of bacterial vaginosis.
Metronidazole (Flagyl) vaginal cream may be used if metronidazole oral is ineffective or not well tolerated.
Alternative regimens include several tinidazole regimens or clindamycin (oral or intravaginal).
Question:
The recommended empiric treatment of pelvic inflammatory disease is:
penicillin G benzathine (Bicillin) intramuscularly plus ceftriaxone (Rocephin) intramuscularly.
azithromycin (Zithromax) orally plus ceftriaxone (Rocephin) intramuscularly.
ceftriaxone (Rocephin) intramuscularly plus doxycycline (Vibramycin). Correct
metronidazole (Flagyl) plus ofloxacin (Floxin).
Explanation:
The recommended empiric treatment for mild to moderate symptoms of pelvic inflammatory disease (PID)
is ceftriaxone (Rocephin) 250 mg intramuscularly plus doxycycline (Vibramycin) 100 mg twice daily x 14
days with or without metronidazole (Flagyl) 500 mg PO twice daily x 14 days. All regimens used to treat PID
should also be effective against Neisseria gonorrhoeae and Chlamydia trachomatis because negative
endocervical screening for these organisms does not rule out upper-reproductive tract infection.
Question:
For the treatment of chlamydia, azithromycin (Zithromax) should be given:
as one-time dose. Correct
daily for 3 days.
daily for 5 days.
daily for 7 days.
Explanation:
For the treatment of chlamydia, azithromycin (Zithromax) should be given as a single dose, 1 gram orally.
Azithromycin (Zithromax) is classified as a macrolide. It is active against most isolates of Chlamydia
trachomatis, Neisseria gonorrhoeae, and Streptococcus pneumoniae.
Question:
Clindamycin (Cleocin) to treat bacterial vaginosis should NOT be used in combination with:
atorvastatin.
prednisone.
, estradiol. Correct
ibuprofen.
Explanation:
Clindamycin (Cleocin) may decrease hormonal contraceptive efficacy and should not be coadministered
with estradiol. The other choices are not known to cause drug-drug interactions when administered with
clindamycin.
Question:
When treating latent syphilis, treatment outcomes do NOT include the prevention of:
asymptomatic progression of the disease.
neurosyphilis.
sexual transmission. Correct
transfer to a fetus in pregnancy.
Explanation:
Because latent syphilis is not transmitted sexually, the objective of treating patients in this stage of disease
is to prevent complications (neurosyphilis and progression of disease) and transmission from a pregnant
woman to her fetus.
Question:
The most commonly reported side effects of azithromycin (Zithromax) for treatment of chlamydia are:
alopecia and headache.
blurred vision and tinnitus.
diarrhea and nausea. Correct
dry mouth and tachycardia.
Explanation:
The most common treatment-related side effects of azithromycin (Zithromax) are related to the
gastrointestinal system with diarrhea/loose stools, nausea, and abdominal pain. Most of the adverse
reactions leading to discontinuation were related to the gastrointestinal tract. Potentially serious adverse
reactions of angioedema and cholestatic jaundice have been reported.
Question:
The most common reason for persistent gonococcal infections is:
inappropriate prescribing of the correct treatment regimen.
treatment failure due to high resistance rates.
failure of the patient to abstain from unprotected sexual intercourse. Correct
lack of test-of-cure and follow-up after treatment.
Explanation:
A high prevalence of Neisseria gonorrhoeae infection has been observed among men and women
previously treated for gonorrhea. Rather than signaling treatment failure, most of these infections result
from reinfection caused by failure of sex partners to receive treatment or the initiation of sexual activity
with a new infected partner. This indicates a need for improved patient education and treatment of sex
partners. If the patient’s last potential sexual exposure was >60 days before onset of symptoms or
, diagnosis, the most recent sex partner should be treated. To avoid reinfection, sex partners should be
instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s)
have completed treatment and after resolution of symptoms.
Question:
The recommended treatment for chlamydia infection when azithromycin (Zithromax) or doxycycline
(Doryx) is contraindicated is:
clindamycin (Cleocin).
erythromycin (Ery-Tab). Correct
metronidazole (Flagyl).
tetracycline (Sumycin).
Explanation:
First-line therapies for the treatment of chlamydia infection include azithromycin (Zithromax) or
doxycycline (Doryx). Alternative therapies include levofloxacin (Levaquin), erythromycin base,
erythromycin ethylsuccinate, or ofloxacin (Floxin).
Question:
An alternative intramuscular medication for ceftriaxone (Rocephin) in the treatment of pelvic inflammatory
disease is:
cefoxitin. Correct
penicillin G benzathine (Bicillin).
gentamicin.
streptomycin.
Explanation:
Cefoxitin, a second-generation cephalosporin, has better anaerobic coverage than ceftriaxone (Rocephin),
and in combination with probenecid and doxycycline is effective in achieving short-term clinical response
in women with pelvic inflammatory disease. Ceftriaxone has better coverage against Neisseria
gonorrhoeae. The addition of metronidazole (Flagyl) will also effectively treat bacterial vaginosis, which is
frequently associated with PID.
Question:
The generic name for Flagyl is:
fluconazole.
methazolamide.
metronidazole. Correct
tinidazole.
Explanation:
The generic name for Flagyl is metronidazole. Flagyl is classified as a nitroimidazole. In addition to the
treatment of bacterial vaginosis, it is used in the treatment of parasite infections, Clostridium difficile, and
Helicobacter pylori. The brand name for fluconazole is Diflucan (an antifungal); methazolamide is
Neptazane (a diuretic); tinidazole is Tindamax (an antiparasitic, antibacterial).
Question:
Which of the following is NOT recommended as an alternative treatment for bacterial vaginosis?
Intramuscular ceftriaxone (Rocephin) Correct
Clindamycin (Cleocin) vaginal cream
Metronidazole (Flagyl) vaginal cream
Tinidazole (Tindamax) orally
Explanation:
Intramuscular ceftriaxone (Rocephin) is not indicated in the treatment of bacterial vaginosis.
Metronidazole (Flagyl) vaginal cream may be used if metronidazole oral is ineffective or not well tolerated.
Alternative regimens include several tinidazole regimens or clindamycin (oral or intravaginal).
Question:
The recommended empiric treatment of pelvic inflammatory disease is:
penicillin G benzathine (Bicillin) intramuscularly plus ceftriaxone (Rocephin) intramuscularly.
azithromycin (Zithromax) orally plus ceftriaxone (Rocephin) intramuscularly.
ceftriaxone (Rocephin) intramuscularly plus doxycycline (Vibramycin). Correct
metronidazole (Flagyl) plus ofloxacin (Floxin).
Explanation:
The recommended empiric treatment for mild to moderate symptoms of pelvic inflammatory disease (PID)
is ceftriaxone (Rocephin) 250 mg intramuscularly plus doxycycline (Vibramycin) 100 mg twice daily x 14
days with or without metronidazole (Flagyl) 500 mg PO twice daily x 14 days. All regimens used to treat PID
should also be effective against Neisseria gonorrhoeae and Chlamydia trachomatis because negative
endocervical screening for these organisms does not rule out upper-reproductive tract infection.
Question:
For the treatment of chlamydia, azithromycin (Zithromax) should be given:
as one-time dose. Correct
daily for 3 days.
daily for 5 days.
daily for 7 days.
Explanation:
For the treatment of chlamydia, azithromycin (Zithromax) should be given as a single dose, 1 gram orally.
Azithromycin (Zithromax) is classified as a macrolide. It is active against most isolates of Chlamydia
trachomatis, Neisseria gonorrhoeae, and Streptococcus pneumoniae.
Question:
Clindamycin (Cleocin) to treat bacterial vaginosis should NOT be used in combination with:
atorvastatin.
prednisone.
, estradiol. Correct
ibuprofen.
Explanation:
Clindamycin (Cleocin) may decrease hormonal contraceptive efficacy and should not be coadministered
with estradiol. The other choices are not known to cause drug-drug interactions when administered with
clindamycin.
Question:
When treating latent syphilis, treatment outcomes do NOT include the prevention of:
asymptomatic progression of the disease.
neurosyphilis.
sexual transmission. Correct
transfer to a fetus in pregnancy.
Explanation:
Because latent syphilis is not transmitted sexually, the objective of treating patients in this stage of disease
is to prevent complications (neurosyphilis and progression of disease) and transmission from a pregnant
woman to her fetus.
Question:
The most commonly reported side effects of azithromycin (Zithromax) for treatment of chlamydia are:
alopecia and headache.
blurred vision and tinnitus.
diarrhea and nausea. Correct
dry mouth and tachycardia.
Explanation:
The most common treatment-related side effects of azithromycin (Zithromax) are related to the
gastrointestinal system with diarrhea/loose stools, nausea, and abdominal pain. Most of the adverse
reactions leading to discontinuation were related to the gastrointestinal tract. Potentially serious adverse
reactions of angioedema and cholestatic jaundice have been reported.
Question:
The most common reason for persistent gonococcal infections is:
inappropriate prescribing of the correct treatment regimen.
treatment failure due to high resistance rates.
failure of the patient to abstain from unprotected sexual intercourse. Correct
lack of test-of-cure and follow-up after treatment.
Explanation:
A high prevalence of Neisseria gonorrhoeae infection has been observed among men and women
previously treated for gonorrhea. Rather than signaling treatment failure, most of these infections result
from reinfection caused by failure of sex partners to receive treatment or the initiation of sexual activity
with a new infected partner. This indicates a need for improved patient education and treatment of sex
partners. If the patient’s last potential sexual exposure was >60 days before onset of symptoms or
, diagnosis, the most recent sex partner should be treated. To avoid reinfection, sex partners should be
instructed to abstain from unprotected sexual intercourse for 7 days after they and their sexual partner(s)
have completed treatment and after resolution of symptoms.
Question:
The recommended treatment for chlamydia infection when azithromycin (Zithromax) or doxycycline
(Doryx) is contraindicated is:
clindamycin (Cleocin).
erythromycin (Ery-Tab). Correct
metronidazole (Flagyl).
tetracycline (Sumycin).
Explanation:
First-line therapies for the treatment of chlamydia infection include azithromycin (Zithromax) or
doxycycline (Doryx). Alternative therapies include levofloxacin (Levaquin), erythromycin base,
erythromycin ethylsuccinate, or ofloxacin (Floxin).
Question:
An alternative intramuscular medication for ceftriaxone (Rocephin) in the treatment of pelvic inflammatory
disease is:
cefoxitin. Correct
penicillin G benzathine (Bicillin).
gentamicin.
streptomycin.
Explanation:
Cefoxitin, a second-generation cephalosporin, has better anaerobic coverage than ceftriaxone (Rocephin),
and in combination with probenecid and doxycycline is effective in achieving short-term clinical response
in women with pelvic inflammatory disease. Ceftriaxone has better coverage against Neisseria
gonorrhoeae. The addition of metronidazole (Flagyl) will also effectively treat bacterial vaginosis, which is
frequently associated with PID.
Question:
The generic name for Flagyl is:
fluconazole.
methazolamide.
metronidazole. Correct
tinidazole.
Explanation:
The generic name for Flagyl is metronidazole. Flagyl is classified as a nitroimidazole. In addition to the
treatment of bacterial vaginosis, it is used in the treatment of parasite infections, Clostridium difficile, and
Helicobacter pylori. The brand name for fluconazole is Diflucan (an antifungal); methazolamide is
Neptazane (a diuretic); tinidazole is Tindamax (an antiparasitic, antibacterial).
