Updated 2025/2026 test bank for the APEA
3P Exam Final Version, featuring
comprehensive 100 questions and verified
answers covering Pathophysiology,
Pharmacology, and Physical Assessment for
advanced practice nursing
β-lactam antibiotic MOA - All antibiotics in class share the same mechanism of
action: disruption of the bacterial cell wall.
Inhibition of cell wall synthesis
Empiric Therapy - start treatment without cultures or prior to receiving the
results of a culture
immediate empiric antibiotics - Critically ill patients receive (Fill in the Answer)
after the first set of cultures obtained; do not wait for results.
Bactericidal antibiotics - Directly kill bacteria: Agents include aminoglycosides,
beta-lactams, fluoroquinolones, metronidazole, most antimycobacterial agents,
streptogramins, and vancomycin.
preferred for immunocompromised patients such as those with diabetes, HIV,
or cancer and for those who have overwhelming infections
1
,Bacteriostatic agents - inhibit bacterial proliferation while the host's immune
system does the killing. Agents include clindamycin, macrolides, sulfonamides,
and tetracyclines
β-lactam Antibiotics - Penicillins, Cephalosporins, Carbapenems, Monobactams
Penicillins MOA - Weaken bacterial cell wall by two actions:
(1) inhibition of transpeptidases
(2) disinhibition (activation) of autolysins.
PBPs (Penicillin Binding Proteins) - Transpeptidases, Autolysins, and other
bacterial enzymes are collectively named as because antibiotic class must bind
to them to produce antibacterial effects.
gram-positive bacteria - two layers: the cytoplasmic membrane and a relatively
thick cell wall; penicillins are generally very active against these organisms.
gram-negative bacteria - three layers: the cytoplasmic membrane, a relatively
thin cell wall, and an additional outer membrane; only certain penicillins (e.g.,
ampicillin) are able to cross and reach penicillin binding proteins (PBPs)
Four Major Groups of Penicillins - (1) narrow-spectrum penicillins that are
penicillinase sensitive
(2) narrow-spectrum penicillins that are penicillinase resistant
(antistaphylococcal penicillins)
(3) broad-spectrum penicillins (aminopenicillins)
2
,(4) extended-spectrum penicillins (antipseudomonal penicillins).
narrow-spectrum penicillins: Penicillinase sensitive penicillins - Penicillin G,
Penicillin V
narrow-spectrum penicillinase sensitive susceptible pathogens - Streptococci,
Neisseria, anaerobes
very narrow antimicrobial spectrum and are used only against penicillinase-
producing strains of staphylococci (S. aureus and S. epidermidis). - narrow-
spectrum penicillins: penicillinase resistant penicillins
narrow-spectrum penicillins: penicillinase resistant penicillins - Nafcillin, Oxacillin,
Dicloxacillin
narrow-spectrum- penicillinase resistant susceptible pathogens - S. Aureus, S.
Epidermidis
Drugs of choice for most staphylococcal infections - penicillinase-resistant
penicillins (Nafcillin, Oxacillin, Dicloxacillin)
Broad spectrum Penicillin: Aminopenicillins - Ampicillin, Amoxicillin
Broad spectrum Aminopenicillin susceptible pathogens - Haemophilus influenzae,
Escherichia coli, Proteus mirabilis, enterococci, Neisseria gonorrhoeae
Extended spectrum penicillins (antipseudomonal penicillin) - Piperacillin
3
, Has the same antimicrobial spectrum as penicillin G, plus increased activity
against certain gram-negative bacilli, including Haemophilus influenzae,
Escherichia coli, and Salmonella and Shigella - Broad spectrum Penicillin:
Aminopenicillins
First line for acute otitis media and sinusitis - Amoxicillin
Extended spectrum penicillins suceptible pathogens - Haemophilus influenzae,
Escherichia coli, Proteus mirabilis, enterococci, Neisseria gonorrhoeae,
pseudomonas, enterobactor, klebsiella
Principle pathogenic target of Piperacillin - Pseudomonas aeruginosa
beta-lactamase inhibitors to broaden penicillin spectrum - clavulanate,
sulbactam, tazobactam
Penicillin/Beta-Lactamase Combinations - Ampicillin/sulbactam (Unasyn)
Amoxicillin/clavulanate (Augmentin)
Piperacillin/tazobactam (Zosyn)
MRSA Drug of Choice - Vancomycin
Most Important AE of Penicillins - Hypersensitivity Reaction
4
3P Exam Final Version, featuring
comprehensive 100 questions and verified
answers covering Pathophysiology,
Pharmacology, and Physical Assessment for
advanced practice nursing
β-lactam antibiotic MOA - All antibiotics in class share the same mechanism of
action: disruption of the bacterial cell wall.
Inhibition of cell wall synthesis
Empiric Therapy - start treatment without cultures or prior to receiving the
results of a culture
immediate empiric antibiotics - Critically ill patients receive (Fill in the Answer)
after the first set of cultures obtained; do not wait for results.
Bactericidal antibiotics - Directly kill bacteria: Agents include aminoglycosides,
beta-lactams, fluoroquinolones, metronidazole, most antimycobacterial agents,
streptogramins, and vancomycin.
preferred for immunocompromised patients such as those with diabetes, HIV,
or cancer and for those who have overwhelming infections
1
,Bacteriostatic agents - inhibit bacterial proliferation while the host's immune
system does the killing. Agents include clindamycin, macrolides, sulfonamides,
and tetracyclines
β-lactam Antibiotics - Penicillins, Cephalosporins, Carbapenems, Monobactams
Penicillins MOA - Weaken bacterial cell wall by two actions:
(1) inhibition of transpeptidases
(2) disinhibition (activation) of autolysins.
PBPs (Penicillin Binding Proteins) - Transpeptidases, Autolysins, and other
bacterial enzymes are collectively named as because antibiotic class must bind
to them to produce antibacterial effects.
gram-positive bacteria - two layers: the cytoplasmic membrane and a relatively
thick cell wall; penicillins are generally very active against these organisms.
gram-negative bacteria - three layers: the cytoplasmic membrane, a relatively
thin cell wall, and an additional outer membrane; only certain penicillins (e.g.,
ampicillin) are able to cross and reach penicillin binding proteins (PBPs)
Four Major Groups of Penicillins - (1) narrow-spectrum penicillins that are
penicillinase sensitive
(2) narrow-spectrum penicillins that are penicillinase resistant
(antistaphylococcal penicillins)
(3) broad-spectrum penicillins (aminopenicillins)
2
,(4) extended-spectrum penicillins (antipseudomonal penicillins).
narrow-spectrum penicillins: Penicillinase sensitive penicillins - Penicillin G,
Penicillin V
narrow-spectrum penicillinase sensitive susceptible pathogens - Streptococci,
Neisseria, anaerobes
very narrow antimicrobial spectrum and are used only against penicillinase-
producing strains of staphylococci (S. aureus and S. epidermidis). - narrow-
spectrum penicillins: penicillinase resistant penicillins
narrow-spectrum penicillins: penicillinase resistant penicillins - Nafcillin, Oxacillin,
Dicloxacillin
narrow-spectrum- penicillinase resistant susceptible pathogens - S. Aureus, S.
Epidermidis
Drugs of choice for most staphylococcal infections - penicillinase-resistant
penicillins (Nafcillin, Oxacillin, Dicloxacillin)
Broad spectrum Penicillin: Aminopenicillins - Ampicillin, Amoxicillin
Broad spectrum Aminopenicillin susceptible pathogens - Haemophilus influenzae,
Escherichia coli, Proteus mirabilis, enterococci, Neisseria gonorrhoeae
Extended spectrum penicillins (antipseudomonal penicillin) - Piperacillin
3
, Has the same antimicrobial spectrum as penicillin G, plus increased activity
against certain gram-negative bacilli, including Haemophilus influenzae,
Escherichia coli, and Salmonella and Shigella - Broad spectrum Penicillin:
Aminopenicillins
First line for acute otitis media and sinusitis - Amoxicillin
Extended spectrum penicillins suceptible pathogens - Haemophilus influenzae,
Escherichia coli, Proteus mirabilis, enterococci, Neisseria gonorrhoeae,
pseudomonas, enterobactor, klebsiella
Principle pathogenic target of Piperacillin - Pseudomonas aeruginosa
beta-lactamase inhibitors to broaden penicillin spectrum - clavulanate,
sulbactam, tazobactam
Penicillin/Beta-Lactamase Combinations - Ampicillin/sulbactam (Unasyn)
Amoxicillin/clavulanate (Augmentin)
Piperacillin/tazobactam (Zosyn)
MRSA Drug of Choice - Vancomycin
Most Important AE of Penicillins - Hypersensitivity Reaction
4
