ATI RN
NCLEX questions on chemotherapy drugs Questions
Question 1 of 5
A 26-year-old sexually active man presents to his primary care physician with a nonpruritic maculopapular rash on his palms. He reports that about 6 weeks ago, he developed a nonpainful ulcer on his penis that healed spontaneously. Benzathine penicillin G is administered. Twelve hours later, he begins to have myalgia, fever, and chills. What is the most likely cause of this new onset of symptoms?
Correct Answer: D
Rationale: This is a Jarisch-Herxheimer reaction, caused by rapid release of endotoxins from dying Treponema pallidum (syphilis) after penicillin treatment, leading to fever, myalgia, and chills.
Question 2 of 5
A 73-year-old man with overwhelming sepsis requiring intravenous fluid support, pressors, and antibiotics is now beginning to improve clinically. The rationale against the use of a bacteriostatic antibiotic in this patient includes which of the following?
Correct Answer: C
Rationale: In severe sepsis, bactericidal antibiotics are preferred to kill bacteria rapidly and remove viable organisms, as bacteriostatic drugs only inhibit growth, relying on the immune system, which may be compromised.
Question 3 of 5
An 8-month-old female infant is brought to the emergency department by her parents. She is febrile, tachycardic, and hypotensive. Sepsis is suspected and the physician wants to give chloramphenicol but is worried about gray baby syndrome. Why does chloramphenicol sometimes cause gray baby syndrome in infants?
Correct Answer: D
Rationale: Gray baby syndrome occurs in infants due to immature liver function, reducing conjugation (glucuronidation) of chloramphenicol, leading to toxic accumulation, cyanosis, and cardiovascular collapse.
Question 4 of 5
A 35-year-old female patient has just received a bone marrow transplant and is taking immunosuppressants. Two days after starting her immunosuppression regimen, she develops dyspnea, chest pain, and hemoptysis. A galactomannan test confirms a diagnosis of aspergillosis. She is given multiple drugs to combat this new infection, one of which is caspofungin. How does caspofungin work?
Correct Answer: B
Rationale: Caspofungin inhibits β-1,3-glucan synthesis, a key component of the fungal cell wall, leading to cell lysis, effective against Aspergillus in immunocompromised patients.
Question 5 of 5
A 71-year-old man with osteomyelitis is treated with aminoglycosides. Blood cultures are drawn and reveal resistance to this antibiotic class. What is the most likely reason for this to occur?
Correct Answer: C
Rationale: Aminoglycoside resistance often occurs via plasmid-encoded acetyltransferases, which modify the drug, preventing it from binding to bacterial ribosomes.