Antibiotics and Antimicrobial Agents > Pharmacology
Exam Review
Antimicrobial classifications
Total Questions : 11
Showing 11 questions, Sign in for moreA nurse is caring for a client who has a viral infection. Which of the following antiviral groups inhibits viral DNA polymerase or reverse transcriptase enzymes that are essential for viral DNA or RNA synthesis?
Explanation
This is because nucleoside analogs inhibit viral DNA polymerase or reverse transcriptase enzymes that are essential for viral DNA or RNA synthesis.
Some possible explanations for the other choices are:
Choice B is wrong becauseNon-nucleoside reverse transcriptase inhibitors (NNRTIs) are wrong because they do not inhibit viral DNA polymerase, but rather bind directly to reverse transcriptase and block its activity.
Choice C is wrong becauseNucleotide reverse transcriptase inhibitors (NRTIs) are wrong because they are not nucleosides, but nucleotides that need to be phosphorylated before they can inhibit reverse transcriptase.
Choice D is wrong becauseProtease inhibitors (PIs) are wrong because they do not inhibit viral DNA polymerase or reverse transcriptase, but rather block the protease enzyme that cleaves viral proteins into functional units.
A nurse is caring for a client who has a viral infection. Which of the following antiviral groups bind to and inhibit viral reverse transcriptase enzyme that is essential for viral RNA synthesis? (Select all that apply)
Explanation
These are examples ofnon-nucleoside reverse transcriptase inhibitors (NNRTIs), which bind to and inhibit viral reverse transcriptase enzyme that is essential for viral RNA synthesis.NNRTIs block reverse transcriptase by binding directly to the enzyme and prevent the completion of DNA synthesis.
Choice D is wrong because rilpivirine (Edurant) is also an NNRTI, but it does not bind to the same site as efavirenz, nevirapine and etravirine.
Therefore, it is not part of the same antiviral group.
Choice E is wrong because nucleotide reverse transcriptase inhibitors (NRTIs) are different from NNRTIs.
NRTIs are analogues of the natural deoxynucleotides that compete with them for incorporation into the viral DNA chain.However, NRTIs lack a 3′-hydroxyl group on the deoxyribose moiety, which results in chain termination.
NRTIs do not bind to reverse transcriptase enzyme directly like NNRTIs do.
A nurse is caring for a client who has a viral infection. The client asks the nurse how nucleoside analogs work to treat viral infections. Which of the following statements by the nurse is correct?
Explanation
Nucleoside analogs are antiviral agents that resemble natural nucleosides and act by causing termination of the nascent DNA chain.They are used to treat various viral infections such as HIV, HBV, HCV, CMV, HSV and VZV.
Choice A is wrong because it describes the mechanism of action of non-nucleoside reverse transcriptase inhibitors (NNRTIs), which are another class of antiviral drugs that bind to and inhibit viral reverse transcriptase enzyme.
Choice B is wrong because it describes the mechanism of action of protease inhibitors (PIs), which are another class of antiviral drugs that inhibit viral protease enzyme that is essential for viral protein maturation and assembly.
Choice D is wrong because it describes the mechanism of action of fusion inhibitors (FIs), which are another class of antiviral drugs that prevent viral fusion with host cell membrane.
A nurse is caring for a client who has a viral infection and is taking an antiviral medication that inhibits the integrase enzyme that is essential for viral DNA integration into host cell genome. Which of the following antiviral groups does this medication belong to?
Explanation
Integrase strand transfer inhibitors (INSTIs) are a class of antiviral drugs that block the action of integrase, a viral enzyme that inserts the viral genome into the DNA of the host cell. This prevents the virus from replicating and infecting new cells.
Choice A is wrong because nucleotide reverse transcriptase inhibitors (NRTIs) are a class of antiviral drugs that block the action of reverse transcriptase, a viral enzyme that converts the viral RNA into DNA.
Choice B is wrong because non-nucleoside reverse transcriptase inhibitors (NNRTIs) are a class of antiviral drugs that also block the action of reverse transcriptase, but in a different way than NRTIs.They bind to a different site on the enzyme and cause it to change shape.
Choice D is wrong because protease inhibitors (PIs) are a class of antiviral drugs that block the action of protease, a viral enzyme that cleaves the viral polyprotein into functional units.This prevents the virus from assembling and maturing.
A nurse is caring for a client who has a fungal infection and is prescribed amphotericin. What adverse effects should the nurse monitor for in this client?
Explanation
Amphotericin B is a drug used to treat fungal infections, but it can cause kidney damage and electrolyte imbalance as a common side effect. The nurse should monitor the client’s urine output, creatinine, potassium, and magnesium levels.
Choice B is wrong because Ototoxicity is wrong because amphotericin B does not affect the ears or hearing.
Ototoxicity is more common with aminoglycosides, another class of antibiotics.
Choice C is wrong because Hepatotoxicity is wrong because amphotericin B does not cause liver damage.
Hepatotoxicity is more common with azoles, another class of antifungals.
Choice D is wrong because Thrombocytopenia is wrong because amphotericin B does not cause low platelet count.
Thrombocytopenia is more common with heparin, an anticoagulant drug.
A nurse is teaching a client who has a vaginal candidiasis infection about the use of miconazole cream. Which of the following instructions should the nurse include? (Select all that apply.).
Explanation
The nurse should instruct the client to avoid sexual intercourse until the infection is cleared, as it can cause irritation and inflammation of the vaginal mucosa and potentially transmit the infection to the partner.The nurse should also instruct the client to use a backup method of contraception if using oral contraceptives, as miconazole cream can reduce the effectiveness of hormonal contraceptives.
Choice A is wrong because the client should apply the cream twice a day for 7 days, not once a day.
Choice B is wrong because the client should not wash the applicator with soap and water after each use, as it can alter the pH of the vagina and promote fungal growth.
Choice E is wrong because bleeding or bruising are not common side effects of miconazole cream and are not related to vaginal candidiasis infection.
A nurse is reviewing the medication history of a client who has a fungal infection and is prescribed caspofungin. The nurse should identify that which of the following medications can interact with caspofungin?
Explanation
Cyclosporine can interact with caspofungin and increase its plasma concentration and risk of liver toxicity.Cyclosporine is a drug used to prevent organ rejection or suppress the immune system.
Choice B is wrong because warfarin does not have a significant interaction with caspofungin.Warfarin is a blood thinner that prevents blood clots.
Choice C is wrong because metformin does not have a significant interaction with caspofungin.Metformin is a drug used to lower blood sugar levels in diabetes.
Choice D is wrong because digoxin does not have a significant interaction with caspofungin.Digoxin is a drug used to treat heart failure and irregular heartbeat.
Caspofungin is an antifungal drug that belongs to the echinocandin class.It works by inhibiting the synthesis of a component of the fungal cell wall called beta-glucan.
It is used to treat various fungal infections such as candidemia, esophageal candidiasis, invasive aspergillosis, and febrile neutropenia
A nurse is educating a client who has tinea pedis about the use of terbinafine cream. Which of the following statements by the client indicates an understanding of the teaching?
Explanation
This statement indicates that the client understands the proper use of terbinafine cream for tinea pedis, which is a fungal infection of the feet.Terbinafine cream is an antifungal agent that works by killing the fungus or preventing its growth.According to a study, terbinafine 1% cream applied once daily for 7 days is effective in treating interdigital tinea pedis, but some sources recommend applying it twice daily for 2 weeks.
Choice B is wrong because washing the feet with soap and water before applying the cream is not necessary and may cause irritation or dryness of the skin.
Choice C is wrong because covering the affected area with a bandage after applying the cream is not advised and may create a moist environment that favors fungal growth.
Choice D is wrong because itching or burning are common side effects of terbinafine cream and do not indicate an allergic reaction or a need to stop using the cream.However, if the symptoms are severe or persist, the client should contact their health care provider.
A nurse is caring for a client who has malaria and is prescribed chloroquine. What is the mechanism of action of this drug?
Explanation
Chloroquine inhibits heme polymerization in the parasite, which causes the accumulation of toxic heme and kills the parasite.
Choice B is wrong because chloroquine does not disrupt mitochondrial function in the parasite.
Choice C is wrong because chloroquine does not interfere with DNA synthesis in the parasite.
Choice D is wrong because chloroquine does not block calcium influx in the parasite.
Heme polymerization is the process of converting heme, a toxic byproduct of hemoglobin digestion, into hemozoin, a nontoxic pigment that can be stored by the parasite.Chloroquine forms a complex with heme and prevents it from polymerizing, thus disrupting the parasite’s metabolism and survival.
A nurse is administering albendazole to a client who has a tapeworm infection. The client asks how the drug works. Which of the following responses should the nurse give?
Explanation
Albendazole prevents the worm from absorbing glucose, which is its main source of energy.This leads to the worm’s death
Choice B is wrong because albendazole does not paralyze the worm’s muscles.It inhibits the formation of microtubules, which are important for cell division and movement
Choice C is wrong because albendazole does not dissolve the worm’s cuticle.
The cuticle is a protective layer that covers the worm’s body.Albendazole affects the internal cells of the worm, not the external ones
Choice D is wrong because albendazole does not stimulate the worm’s nervous system.It has the opposite effect of blocking the transmission of nerve impulses by interfering with tubulin, a protein that forms part of the nerve cells
A nurse is reviewing the medication history of a client who is prescribed atovaquone-proguanil for malaria prophylaxis.
Which of the following medications should the nurse identify as a potential interaction with atovaquone-proguanil?
Explanation
Rifampin is a drug that can interact with atovaquone-proguanil and reduce its effectiveness in preventing or treating malaria.Rifampin can lower the blood levels of atovaquone and proguanil by increasing their metabolism in the liver. Therefore, rifampin should be avoided or used with caution when taking atovaquone-proguanil.
Choice A is wrong because warfarin is not a known interaction with atovaquone-proguanil.
Warfarin is a blood thinner that can interact with many other drugs, but atovaquone-proguanil is not one of them.
Choice B is wrong because metformin is not a known interaction with atovaquone-proguanil.
Metformin is a drug that lowers blood sugar levels in people with diabetes.
It does not affect the metabolism or efficacy of atovaquone-proguanil.
Choice C is wrong because omeprazole is not a known interaction with atovaquone-proguanil.
Omeprazole is a drug that reduces stomach acid production and treats ulcers and reflux.
It does not interfere with the absorption or action of atovaquone-proguanil.
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