A 26-year-old female with a 2-week history of urinary urgency and frequency presents to her primary care physician for evaluation. Urinalysis reveals nitrates, leukocytes, and red blood cells. The physician selects a quinolone antibiotic for treatment of a presumed urinary tract infection. Which of the following organisms would be most sensitive at the lowest drug concentration?

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Question 1 of 5

A 26-year-old female with a 2-week history of urinary urgency and frequency presents to her primary care physician for evaluation. Urinalysis reveals nitrates, leukocytes, and red blood cells. The physician selects a quinolone antibiotic for treatment of a presumed urinary tract infection. Which of the following organisms would be most sensitive at the lowest drug concentration?

Correct Answer: A

Rationale: Escherichia coli is the most common cause of UTIs and is highly sensitive to quinolones like ciprofloxacin, which achieve high urinary concentrations and effectively target gram-negative bacteria.

Question 2 of 5

A 39-year-old female is scheduled to undergo a laparoscopic cholecystectomy. Induction of anesthesia will be undertaken with fospropofol instead of propofol. Advantages of fospropofol over propofol include which of the following?

Correct Answer: D

Rationale: Fospropofol, a prodrug of propofol, causes less pain at the injection site due to its water-soluble nature, unlike propofol’s lipid emulsion, which can irritate veins.

Question 3 of 5

A 24-year-old man complains of night sweats, weight loss, and pruritus over several weeks. Physical exam shows nontender lymphadenopathy. A lymph node biopsy reveals Reed-Sternberg cells. He is started on a chemotherapy regimen including one drug that works primarily by trapping cells in the mitotic (M) phase of the cell cycle. Which drug is this?

Correct Answer: D

Rationale: Vincristine, a vinca alkaloid, inhibits microtubule formation, trapping cells in the mitotic phase (M phase), effective against Hodgkin’s lymphoma with Reed-Sternberg cells.

Question 4 of 5

A 22-year-old sexually active man presents to the ambulatory care clinic with dysuria, penile discharge, and a swollen right knee. A joint aspirate of his right knee reveals many neutrophils as well as some gram-negative diplococci. Which is the best choice to treat his condition?

Correct Answer: A

Rationale: Ceftriaxone is the first-line treatment for disseminated gonococcal infection (caused by Neisseria gonorrhoeae, gram-negative diplococci), effective against both genital and joint involvement.

Question 5 of 5

A 22-year-old African American man who is a college student plans to travel to Africa for a semester of study abroad. A university student health physician prescribes chloroquine for malaria prophylaxis starting 2 weeks before the trip. Soon after starting the regimen, the patient develops scleral icterus. What is the most likely underlying cause for the icterus?

Correct Answer: D

Rationale: Scleral icterus (jaundice) in an African American patient on chloroquine suggests glucose-6-phosphate dehydrogenase (G6PD) deficiency, causing hemolysis and bilirubin elevation.

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