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NRNP 6566 Week 9 Knowledge Check

1. A 32-year-old preschool teacher complains of difficulty swallowing, sore throat, and chills. She is febrile with a temperature of 101.6 along with white patches on her tonsils. Her rapid strep test is positive. Her past medical history is positive for an anaphylactic reaction to cefaclor two years ago. What antibiotic could be safely utilized in this patient?
2. A 20-year old woman was seen by her primary care provider last week and diagnosed with a lower track UTI. Her complaints at that time included burning on urination, frequent urination of a small amount, and suprapubic pain. She was prescribed a 3-day course of Bactrim which she completed. She is admitted to the step-down unit today with complaints of fever (102.6 and above) for the past 24 hours and CVA tenderness. She appears very ill and is somewhat confused today. Her BP is 100/62. Her family indicates that she has been vomiting for the last 24 hours and been unable to keep food or fluids down. What would your initial plan for this patient include?
3. A 26-year-old male is scheduled for a lumbar laminectomy tomorrow. Penicillin causes a rash in this patient. His preoperative orders include cefazolin 2 gm IV to be given on call to the OR. The NP is called to change the antibiotic order due to the patient’s allergy. What is the best action for the NP to take?
4. What factors are considered when making empiric antibiotic decisions? Apply those factors to a patient with suspected acute otitis media.
5. A 42-year-old female has a severe bacterial infection. She is being treated with a broach spectrum IV drug. The drug is administered too rapidly causing hypotension, flushing and itching over the upper portion of her chest, neck, and face. What antibiotic is likely responsible for these symptoms?
6. A 72 year old male is admitted to the hospital from his long term can facility after complaints of dyspnea and cough for 1 week. He was diagnosed with a COPD exacerbate and started on azithromycin. He has had little improvement after 3 days on this antibiotic. His past medical history includes hypertension, COPD, and hyperlipidemia. Current medications include lisinopril, atorvastatin, salmeterol, and albuterol inhaler. Current symptoms include fever, chills, productive cough, and worsening dyspnea. 
7. A 54-year-old women is 7 days post-op following a breast lump removal. She complains of pain, redness, and swelling around her left breast incision. She has a low grade temperature (99.6). The NP determines that she has a post-operative wound infection. What antibiotics would be indicated to treat her infection?
8. A 16-year-old male is admitted to the step-down unit following laparotomy for appendicitis. It was determined during surgery that the appendix had ruptured causing a peritonitis. What antibiotics would be indicated to treat peritonitis?
9. A 19-year-old female presents with complaints of crampy abdominal pain. The pain has been present for about 7 days. She verifies unprotected sexual activity with multiple partners over the past 6 months. The pain is worse with movement and exercise. She has purulent vaginal discharge and a low-grade temperature (99.6). PID is suspected and cultures have been sent off. What are the most common bacteria in this patient and how are they treated?
10. A 42-year-old man is evaluated for redness, pain, swelling, and tenderness on the anterior right thigh. His symptoms started about 4 days ago with a small 1 cm blister on his thigh. The area has gotten bigger over the past 4 days and is now 4 cm x 6 cm. He indicates that has been having fever and chills over the past couple of days. The NP diagnoses him with cellulitis. What would your treatment for this be?