Chapter 58: Treatment of Specific Infections and Miscellaneous Antibiotics

Chapter 58: Treatment of Specific Infections and Miscellaneous Antibiotics

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A primary care nurse practitioner (NP) sees a child who has several honey-colored crusted lesions around the nose and mouth. The NP notes that no other lesions are present. The NP should prescribe:

ANS:  C

Although systemic antibiotics are often required to treat impetigo, mupirocin can be used for topical treatment of mild impetigo. Because this is a localized infection, mupirocin can be ordered empirically. Dicloxacillin and clarithromycin are used when systemic empirical treatment is indicated. TMP-SMX is used to treat cellulitis.

DIF:    Cognitive Level: Applying (Application)                           REF:   658 – 659

2. A patient comes to the clinic several days after an outpatient surgical procedure complaining of swelling and pain at the surgical site. The primary care NP notes a small area of erythema but no abscess or induration. The NP should:

ANS:  A

This patient has cellulitis, so empirical treatment with TMP-SMX is indicated. Topical mupirocin is used for superficial skin infections, not cellulitis. Warm soaks may be used as an adjunct to antimicrobial treatment. Unless the cellulitis becomes worse, it is not necessary to refer the patient to the surgeon.

DIF:    Cognitive Level: Applying (Application)                           REF:   661

3. A 5-year-old child who has no previous history of otitis media is seen in clinic with a temperature of 100° F. The primary care NP visualizes bilateral erythematous, nonbulging, intact tympanic membranes. The child is taking fluids well and is playing with toys in the examination room. The NP should:

ANS:  D

Signs and symptoms of otitis media that indicate a need for antibiotic treatment include otalgia, fever, otorrhea, or a bulging yellow or red tympanic membrane. This child has a low-grade fever, no history of otitis media, a nonbulging tympanic membrane, and no otorrhea, so watchful waiting is appropriate. When an antibiotic is started, amoxicillin is the drug of choice.

DIF:    Cognitive Level: Applying (Application)                           REF:   661

4. A primary care NP sees a patient who reports a 2-week history of nasal congestion and runny nose. The NP performs a history and learns that the nasal discharge has changed from yellow to green in the past few days, accompanied by a fever of 102° F and unilateral facial pain. To treat this patient, the NP should:

ANS:  C

Evidence of a bacterial sinus infection includes prolonged symptoms without improvement for 10 to 14 days, fever greater than 102° F, and unilateral pain. A bacterial infection should be suspected if nasal discharge turns from yellow to green. Amoxicillin-clavulanate is a recommended first-line drug to treat sinusitis.

DIF:    Cognitive Level: Applying (Application)                           REF:   661