Chapter 63: Fluoroquinolones

Chapter 63: Fluoroquinolones

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient has been taking ciprofloxacin for 3 days and calls the primary care nurse practitioner (NP) to report having headaches and dizziness. The NP should:

ANS:  D

Headaches and dizziness are common side effects of fluoroquinolones. It is not necessary to change to another fluoroquinolone, decrease the dose, or change to another antibiotic class.

DIF:    Cognitive Level: Understanding (Comprehension)             REF:   694

2. A primary care NP sees a patient who has fever, flank pain, and dysuria. The patient has a history of recurrent urinary tract infections (UTIs) and completed a course of trimethoprim-sulfamethoxazole (TMP/SMX) the week before. A urine test is positive for leukocyte esterase. The NP sends the urine for culture and should treat this patient empirically with:

ANS:  B

Fluoroquinolones are effective in treatment of UTIs that are resistant to other antibiotics. Because this patient recently completed a course of TMP/SMX, the NP can assume that the bacterium causing the infection is resistant to TMP/SMX. Gemifloxacin is not indicated for UTI, but ciprofloxacin is. Azithromycin is not a fluoroquinolone.

DIF:    Cognitive Level: Applying (Application)                           REF:   693

3. A patient is taking levofloxacin to treat sinusitis. The patient calls the primary care NP to report pain just above the heel of the right foot. The NP should:

ANS:  C

Warnings have been issued for the fluoroquinolone antibiotics for the increased risk of tendon ruptures. Ruptures have occurred unilaterally and bilaterally, and have involved the Achilles tendon; however, ruptures in the shoulder joint, hand, biceps, thumb, and other tendon sites have been reported. The risk of tendon rupture is further increased in those over age 60, those receiving concomitant steroid therapy, and in kidney, heart, and lung transplant recipients. Reasons for tendon ruptures also include physical activity or exercise, kidney failure, and tendon problems in the past. These ruptures may occur during therapy or up to several months after discontinuation of drugs.

DIF:    Cognitive Level: Applying (Application)                           REF:   693

4. A patient who is taking a fluoroquinolone antibiotic for pyelonephritis develops Clostridium difficile–associated disease (CDAD). The primary care NP should treat for C. difficile and _____ fluoroquinolone.

ANS:  B

Patients who develop CDAD while taking fluoroquinolones should stop taking the drug immediately

DIF:    Cognitive Level: Applying (Application)                           REF:   694