NCLEX : Antimicrobial Pharmacology

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #49 : Drug Identification

Each of the following antibiotics works by inhibition of the 50S subunit of bacterial ribosomes except __________.

Possible Answers:

macrolides

tetracyclines

clindamycin

streptogramin

Correct answer:

tetracyclines

Explanation:

Macrolides, streptogramins, and clindamycin all work by inhibition of the 50S subunit of bacterial ribosomes. Tetracyclines have a similar mechanism of action, but instead affect the 30S unit of bacterial ribosomes.

Example Question #51 : Drug Identification

Polymyxin antibiotics target what part of the bacterial cellular anatomy?

Possible Answers:

Ribosomes

Cell wall

Nucleic acids

Cell membrane

Correct answer:

Cell membrane

Explanation:

Polymyxin antibiotics function by interfering with phospholipid function in bacterial cell membranes. After binding to lipopolysaccharide (LPS) in the outer membrane, polymyxins' hydrophobic tail causes damage to both the inner and outer membranes of Gram-negative bacteria.

Example Question #52 : Drug Identification

What is the mechanism of action of amoxicillin?

Possible Answers:

Inhibition of bacterial cell wall synthesis

Interference with the 30S subunit of bacterial ribosomes

Interference with the 50S subunit of bacterial ribosomes

Suppression of folate synthesis 

Correct answer:

Inhibition of bacterial cell wall synthesis

Explanation:

Amoxicillin inhibits bacterial cell wall synthesis by interfering with the formation of cross-links between peptidoglycan polymer chains. 

Example Question #53 : Drug Identification

Which of the following class of antibiotics is associated with ototoxicity and hearing loss?

Possible Answers:

Aminoglycosides

Quinolones

Beta-lactam antibiotics

Glycopeptides

Correct answer:

Aminoglycosides

Explanation:

Aminoglycoside antibiotics such as streptomycin and gentamicin have been associated with vestibular toxicity and hearing loss. Aminoglycosides remain in inner ear fluids longer than serum and can have a latent ototoxic effect, causing hearing loss even after the antibiotic has been discontinued. None of the other antibiotics listed are associated with ototoxicity.

Example Question #54 : Drug Identification

Ciprofloxacin belongs to what class of antibiotic?

Possible Answers:

 Fluoroquinolones

Beta lactams

Tetracyclines

Macrolides 

Correct answer:

 Fluoroquinolones

Explanation:

Ciprofloxacin belongs to the fluoroquinolone class of antibiotics. Other antibiotics in this class include norfloxacin, levofloxacin, and nadifloxacin.

Example Question #55 : Drug Identification

What is rifampin's mechanism of action?

Possible Answers:

Inhibition of RNA polymerase

Inhibition of DNA gyrase

Disruption of cell membranes

Inhibition of the 30S subunit of bacterial ribosomes

Correct answer:

Inhibition of RNA polymerase

Explanation:

Rifampin inhibits bacterial RNA synthesis by inhibiting RNA polymerase. This prevents the transcription of proteins within the bacterial cell, leading to cell death.

Example Question #56 : Drug Identification

What is the most serious potential adverse effect of rifampin use?

Possible Answers:

Gastric ulceration or bleeding

Nephrotoxicity

Liver failure

Seizures

Correct answer:

Liver failure

Explanation:

Hepatotoxicity and potential liver failure are the most serious potential adverse effects of rifampin use. Patients on this medication must establish baseline liver function tests and be monitored for liver damage. None of the other conditions listed are associated with rifampin use.

Example Question #57 : Drug Identification

Aminoglycosides are primarily used for infections by what type of pathogen?

Possible Answers:

Gram positive bacteria only

Both Gram negative and Gram positive bacteria

Yeast and fungi

Gram negative bacteria only

Correct answer:

Gram negative bacteria only

Explanation:

Aminoglycoside antibiotics are used to treat Gram negative bacteria. They have not been shown to be effective against Gram positive bacteria and are not antifungal. Recall the major difference between the Gram negative and positive bacteria are their cell wall composition; Gram negative have a small proportion of peptidoglycan and a high proportion of lipopolysaccharide, while Gram negative bacteria have a large proportion of peptidoglycan. 

Example Question #58 : Drug Identification

Which of the following is an example of an aminoglycoside antibiotic?

Possible Answers:

Streptomycin

Azithromycin

Clindamycin

Erythromycin

Correct answer:

Streptomycin

Explanation:

The only aminoglycoside antibiotic among those listed is streptomycin. Other examples of aminoglycosides include tobramycin and gentamicin. All aminoglycosides either end in -mycin or -micin. However, this suffix is not exclusive to aminoglycosides. It is also seen in the macrolides: erythromycin and azithromycin and both macrolides, and in lincosamides such as clindamycin.

Example Question #59 : Drug Identification

Fluoroquinolones such as ciprofloxacin may cause which of the following serious side effects?

Possible Answers:

All of these

Seizures

Sudden tendon rupture

Liver failure

Irreversible peripheral neuropathy

Correct answer:

All of these

Explanation:

Fluoroquinolones (the most commonly prescribed of which is ciprofloxacin) carry a risk of all of the following adverse effects: sudden tendon rupture or tendonitis, hepatotoxicity or liver failure, seizures, and permanent peripheral neuropathy. Other adverse effects include Clostridium difficile associated diarrhea, bone marrow suppression, Steven-Johnson's Syndrome, tremors, and psychosis. The majority of these adverse effects are seen in higher numbers in children and the elderly.

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