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Chapter 59: Penicillins Test Bank

Chapter 59: Penicillins Test Bank

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Chapter 59: Penicillins
Test Bank
MULTIPLE CHOICE
1.   A primary care nurse practitioner (NP) sees a 3-year-old child who has a history of recurrent otitis media. The child’s parent tells the NP that the child is allergic to penicillin. The NP learns that the child developed an all-over rash 2 days after starting amoxicillin at age 2 years. The NP should:
a.

order a penicillin skin test.

b.

use cephalosporins when treating otitis media.

c.

order penicillin desensitization so the child can take penicillin when needed.

d.

use amoxicillin when needed because actual allergy correlates poorly with patient report.

2.   A patient with group A â-hemolytic streptococcal pharyngitis is treated with penicillin V. At a follow-up visit 2 weeks later, the patient presents with edema of the hands and feet, blood pressure of 140/85 mm Hg, and cola-colored urine. A urine dipstick shows proteinuria. The primary care NP should:
a.

perform a repeat throat culture.

b.

prescribe 10 more days of penicillin V.

c.

obtain an ASO titer and creatinine clearance.

d.

order oral amoxicillin-clavulanate for 14 days.

3.   A patient is taking dicloxacillin (Dynapen) 500 mg every 6 hours to treat a severe penicillinase-resistant infection. At a 1-week follow-up appointment, the patient reports nausea, vomiting, and epigastric discomfort. The primary care NP should:
a.

change the medication to a cephalosporin.

b.

decrease the dose to 250 mg every 6 hours.

c.

reassure the patient that these are normal adverse effects of this drug.

d.

order blood cultures, a white blood cell (WBC) count with differential, and liver function tests (LFTs).

4.   The primary care NP administers penicillin G (Bicillin) to a 75-year-old patient who has COPD and heart failure. The patient takes digoxin, warfarin, and spironolactone. To help prevent drug interactions, the NP should order:
a.

serum electrolytes.

b.

coagulation studies.

c.

creatinine clearance.

d.

liver transaminases aspartate aminotransferase and alanine aminotransferase.

5.   A sexually active woman is being treated for streptococcal pharyngitis. The patient takes oral contraceptive pills (OCPs). Which penicillin should the primary care NP prescribe for this patient?
a.

Ampicillin

b.

Penicillin V

c.

Penicillin G

d.

Dicloxacillin

6.   A patient was seen in a local emergency department and was treated empirically for pharyngitis with ampicillin and comes to the clinic 2 days later with an urticarial rash. The patient has no previous history of atopy and does not have respiratory symptoms. The primary care NP should suspect:
a.

scarlatina.

b.

mononucleosis.

c.

serum sickness.

d.

penicillin allergy.

7.   A patient with otitis media is treated for 10 days with amoxicillin. At the follow-up visit, the primary care NP notes bilateral erythematous, bulging tympanic membranes. The NP should prescribe:
a.

intramuscular injection of penicillin G (Bicillin).

b.

amoxicillin for 10 more days.

c.

oral dicloxacillin (Dynapen) for 10 days.

d.

oral amoxicillin-clavulanate (Augmentin) for 10 days.


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