Microbiology for Nursing Practice Exam
Course Introduction
This course introduces nursing students to the fundamental principles of microbiology, emphasizing the role of microorganisms in human health and disease. Students will explore the structure, function, classification, and growth of bacteria, viruses, fungi, and parasites, with a focus on medically significant organisms. Topics include infection control, immunology, disease transmission, antimicrobial agents, and the nurses responsibilities in preventing and managing infections. Through lectures, laboratory exercises, and case studies, students will develop a foundational understanding of microbiology necessary for effective patient care and infection prevention in clinical settings.
Recommended Textbook
Microbiology The Human Experience Preliminary Edition by John W. Foster
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Chapter 1: Microbes Shape Our History
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Q1) What is the causative agent of the infectious disease used to establish Koch's postulates?
A) Streptococcus pyogenes
B) Bacillus anthracis
C) Helicobacter pylori
D) Chlamydia trachomatis
Answer: B
Q2) Which of the following was an unexpected benefit of the bubonic plague?
A) There was no benefit to the bubonic plague.
B) The population of Europe experienced a baby boom.
C) It resulted in a better understanding of aseptic practices and how to prevent the spread of infection.
D) The population decline enabled the cultural advancement of the Renaissance. Answer: D
Q3) In 1884,the Gram stain was devised to distinguish bacteria from ________ cells. Answer: human
Q4) Why did agar offer an improvement over gelatin for the growth of microorganisms?
Answer: Agar remains more solid at higher temperatures than does gelatin.
Q5) Bacteria and archaea are classified as ________. Answer: prokaryotes
Page 3
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Chapter 2: Basic Concepts of Infectious Disease
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Q1) What kind of relationship exists between microbiota and their human hosts?
A) mutualistic
B) pathogenic
C) endoparasitic
D) ectoparasitic
Answer: B
Q2) An infectious disease that rapidly increases in incidence throughout the world is known as a ________.
Answer: pandemic
Q3) Giardia lamblia,a cause of diarrhea and other gastrointestinal symptoms,is acquired from contaminated drinking water.It can be treated with several different antimicrobial drugs.Into what risk level does G.lamblia fall?
A) risk group I
B) risk group II
C) risk group III
D) risk group IV
Answer: B
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Chapter 3: Observing Microbes
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Q1) Assume you stain Bacillus with malachite green with heat and then counterstain with safranin.Through the microscope,the green structures are
A) cell walls.
B) capsules.
C) endospores.
D) bacteria.
Answer: C
Q2) A(n)________ microscopy microscope produces halos of bright lights against a dark field.
A) compound light
B) electron
C) fluorescence
D) darkfield
Answer: D
Q3) Why is the presence of a capsule clinically significant?
A) It protects the bacterial cell from lack of nutrients.
B) It protects the bacterial cell from engulfment by white blood cells.
C) It protects the bacterial cell from heat.
D) It protects the bacterial cell from the staining regents.
Answer: B
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Chapter 4: Living Chemistry: From Atoms to Cells
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Q1) Bacteria within a phagosome may be destroyed by the fusing of the phagosome with which acidic eukaryotic organelle?
A) endoplasmic reticulum
B) pseudopod
C) lysosome
D) vesicle
Q2) Molecules that are soluble in water are ________ and molecules that are insoluble in water are ________.
A) endergonic;exergonic
B) nonpolar;polar
C) hydrophobic;hydrophilic
D) hydrophilic;hydrophobic
Q3) A reaction with a positive DG and low activation energy will be
A) spontaneous and slow.
B) exergonic and fast.
C) endergonic and fast.
D) endergonic and slow.
Q4) Redox reactions involve the movement of ________ from one molecule or atom to another.
Q5) What are some structural differences between cellular DNA and RNA?
Page 6
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Chapter 5: Cell Biology of Bacteria and Eukaryotes
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Q1) The cell wall is part of the A) cell membrane.
B) cytoplasm.
C) cell envelope.
D) proteome.
Q2) Which organelle houses a eukaryotic cell's genome?
A) rough endoplasmic reticulum
B) contractile vacuole
C) ribosome
D) nucleus
Q3) Flagella are required for bacterial
A) chemotaxis.
B) growth.
C) adherence.
D) buoyancy.
Q4) Which of the following is FALSE of teichoic acids?
A) They reinforce the cell wall.
B) They may help pathogens attach to host cells.
C) They are recognized by the host immune system.
D) They repel the Gram stain.
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Chapter 6: Bacterial Growth, Nutrition, and Differentiation
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Q1) Which of the following is NOT required for microorganisms to grow and divide?
A) DNA replication
B) binary fission
C) equatorial septum formation
D) conjugation
Q2) Which of the following could describe the relationship between the cyanobacterium Nostoc and E.coli related to the carbon cycle?
A) Nostoc produces carbohydrates from lithotrophy,and E.coli breaks down the carbohydrates to generate CO .
B) Nostoc produces carbohydrates from phototrophy,and E.coli breaks down the carbohydrates to generate CO .
C) Nostoc produces CO that E.coli turns into carbohydrates.
D) E.coli produces carbohydrates that Nostoc uses as energy to produce more carbohydrates.
Q3) The production of ________ mechanisms in a biofilm helps maintain the viability of a biofilm during an infection.
Q4) Aerobic bacteria are capable of using ________ as a terminal electron acceptor in the electron transport chain.
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Chapter 7: Bacterial Metabolism
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Q1) CASE HISTORY
Tonya,age 32,was spending a warm June weekend at a beach in Massachusetts.The water near shore looked clear,although farther offshore the water had a reddish tint.Tonya dug up a pailful of clams and cooked them thoroughly.After dinner,her lips grew numb and her fingers tingled.She felt nauseated and had difficulty walking across the room.Her speech became slurred,but she managed to dial 911.The ambulance got her to the hospital in time for Tonya to have her stomach pumped and receive assistance breathing.The physician explained to Tonya that she had contracted paralytic shellfish poisoning from consumption of clams contaminated by an algal toxin.The toxin,called saxitoxin,accumulates in the clams as they feed on the algae;cooking does not affect the toxin.At that time,Massachusetts had a ban on shellfish because of a high population density of saxitoxin-producing algae,Alexandrium tamarense,a cause of "red tide."
Though Tonya suffered from consumption of saxitoxin,the organisms that produced it are valuable to humans as well.Explain how these myxotrophic organisms produce a product necessary to our respiration.
Q2) The metabolic pathway used by cyanobacteria and plants to fix carbon dioxide into sugar is known as the ________ cycle.
Q3) The Embden-Myerhof-Parnas (EMP)pathway is also known as ________.
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Chapter 8: Bacterial Genetics and Biotechnology
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Q1) What enzyme is used to produce cDNA?
A) DNA polymerase III
B) DNA ligase
C) RNA polymerase
D) reverse transcriptase
Q2) Which repair process leads to an abasic site as part of the repair pathway?
A) base excision repair
B) methyl mismatch repair
C) recombination
D) SOS repair
Q3) Transcription of genes starts at regions of the genome called ________.
Q4) Except for the initiating fMet tRNA,what is the order of sites that tRNAs take through a ribosome?
A) first E,then P,and finally A
B) first A,then P,and finally E
C) first E,then A,and finally P
D) first P,then A,and finally E
Q5) If DNA polymerase misincorporates a base,leading to a mismatch,how do repair enzymes distinguish the parental and daughter DNA strands to specifically fix the daughter strand?
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Chapter 9: Bacterial Genomes and Evolution
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Q1) Renaming Pasteurella pestis to Yersinia pestis alters the ________ of the organism.
A) classification
B) nomenclature
C) identification
D) homology
Q2) Wolbachia appears to be developing into a(n)________ of its host.
A) mitochondria
B) chloroplast
C) organelle
D) endosymbiont
Q3) Which of the following is NOT a step in the transduction process?
A) The DNA phage enters a bacterial cell by endocytosis.
B) The phage DNA commandeers host protein synthesis machinery.
C) The phage uses host cell DNA replication machinery.
D) Completed phage particles are released into the environment by lysing.
Q4) A ________ relationship develops between endosymbionts and their hosts.
Q5) The ________ gene was used as a molecular clock to reveal the divergence of three domains of life.
Q6) Explain how natural selection quickly leads to antibiotic resistance.
Page 11
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Chapter 10: Bacterial Diversity
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Q1) Which of the following does NOT accurately describe Pseudomonas aeruginosa?
A) causes opportunist infections in human surgical wounds
B) may form biofilms on pulmonary lining of cystic fibrosis patients
C) commonly grows in soil as a decomposer
D) may infect fleas,which transmit P.aeruginosa to humans
Q2) Autoclaves use high temperatures and steam to sterilize surgical instruments.When instruments are sterilized they do not contain any bacteria.Explain how Bacillus stearothermophilus,a bacterium within the phylum Firmicutes,can be used to test sterilization within autoclaves.
Q3) Which of the following is considered metabolically INACTIVE?
A) an elementary body of Chlamydia trachomatis
B) a reticulate body of Chlamydophila pneumonia
C) a vegetative Bacillus anthracis cell
D) a biofilm containing Bacteroides
Q4) Structures found in some Gram-positive bacteria that resist desiccation,radiation,freezing,and chemical disinfectants are ________.
Q5) The major group of bacteria that causes sexually transmitted infections and the eye disease trachoma and are obligate intracellular pathogens is ________.
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Chapter 11: Eukaryotic Microbes and Invertebrate Infectious Agents
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Q1) The ability of fungi to digest lignin is important in the A) production of bread.
B) production of beer.
C) decomposition of wood.
D) decomposition of animal bodies.
Q2) Filamentous amebas
A) form inorganic shells made of calcium carbonate.
B) contain large,bulky pseudopods.
C) move using cytoplasmic streaming.
D) utilize chloroplasts for photosynthesis.
Q3) Aspergillus and histoplasmosis infections are both caused by
A) opportunistic skin contact with fungi.
B) smoking tobacco contaminated with fungal spores.
C) swimming in contaminated water.
D) inhalation of fungal spores.
Q4) Giardias and trichomonads are both examples of ________.
Q5) You are looking at a group of unicellular organisms under a microscope and are asked to determine whether the organisms are fungi or algae.Name one visible feature that would allow you to make this determination and explain the significance of that feature in the lifestyle of the organism.
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Chapter 12: Viruses
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Q1) ________ is an example of a virus with a large double-stranded DNA viral genome.
Q2) A small subset of the human population does not express the CD4 and CCR5 receptors.To what virus are these individuals naturally immune?
A) HIV
B) HPV
C) influenza
D) hepatitis
Q3) A phage genome integrated into the DNA of the bacterial host cell is known as a ________.
Q4) Influenza contains a ________ genome.
Q5) Which of the following is NOT caused by an aberrant protein?
A) Creutzfeldt-Jakob disease
B) scrapie
C) hepatitis
D) kuru
Q6) Why must influenza have highly efficient host-to-host transmission?
A) because of its rapid infection
B) because of its slow infection
C) because of genetic reassortment
D) because of latent infection
Page 14
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Chapter 13: Sterilization, Disinfection, and Antibiotic Therapy
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Q1) Describe how avoiding the use of antibiotics for viral infections can prevent the spread of antibiotic resistance.
Q2) ________ is the process of heating foods to a moderately high temperature long enough to kill most heat-resistant,non-spore-forming pathogens known.
Q3) Explain how DNA chain-terminating analog antivirals are selectively toxic despite the fact that the viruses they target and the host cell both contain DNA genomes.
Q4) Which antibiotic inhibits the formation of the peptide side chain of NAM?
A) vancomycin
B) cycloserine
C) bacitracin
D) cephalexin
Q5) Drug sensitivity occurs when a(n)
A) drug is broken down by a pathogenic organism.
B) organism is inhibited by a drug.
C) individual develops an allergic reaction to a drug he or she is taking.
D) drug that is used to inhibit the growth of an organism is no longer capable.
Q6) ________ is the process by which all living cells,spores,and viruses are destroyed on an object.
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Chapter 14: Normal Human Microbiota: a Delicate Balance of Power
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Q1) A noninfectious disease that can be linked to changes in the microbiota is
A) yeast infection.
B) C.difficile infection.
C) irritable bowel syndrome.
D) stomach flu.
Q2) How has the development of clean water NEGATIVELY affected modern civilization?
A) reduced fecal transmission of bacteria resulting in missing microbiota
B) altered immunological environment
C) increased transmission of hormone-activating compounds
D) decreased amounts of important trace minerals
Q3) Which of the following would NOT be a good organism choice for a vaccine delivery system?
A) Streptococcus salivarius
B) Lactobacillus acidophilus
C) Staphylococcus epidermidis
D) Staphylococcus aureus
Q4) Describe the positive and negative side of enterotoxins.
Q5) Explain two potential negative effects of using phage therapy to treat bacterial infections.
Q6) The presence of a core ________ is most important for a healthy microbiome. Page 16
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Chapter 15: The Immune System: Inflammation and Innate Immunity
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Q1) The complement cascade produces all of the following outcomes EXCEPT A) creating pores in bacterial membranes.
B) increasing phagocytosis.
C) attracting white blood cells.
D) decreasing inflammation.
Q2) All of the following is true regarding a fever EXCEPT that A) the use of fever reducers helps to speed recovery.
B) a fever creates an unfavorable environment for microbial growth.
C) substances that cause a fever are known as pyrogens.
D) thermoregulation is maintained by the hypothalamus.
Q3) An example of oxygen-dependent killing is A) lactoferrin.
B) superoxide ion.
C) lysozyme.
D) defensins.
Q4) A clinical that counts the total number of white blood cells and identifies their various cell types is called a ________.
Q5) There are two general types of interferons,type I and type II.Describe how type I interferons work to prevent the host from infection.
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Chapter 16: The Immune System: Adaptive Immunity
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Q1) Cells that become activated when they bind to intracellular antigen bound to class I MHC on antigen-presenting cells are known as ________ cells.
Q2) Describe the two-step molecular process required to activate T<sub>H</sub>0 cells.
Q3) One health risk associated with excessive cytokine release is the chance of
A) severe tissue damage.
B) cytokines destroying antibodies.
C) damage to virally infected cells.
D) inactivating mitosis.
Q4) Small molecules that do not elicit an immune response unless they are attached to immunogens are referred to as ________.
Q5) What is the function of class II MHC molecules?
A) Class II MHC is used to present intracellular antigen to CD8 cells.
B) Class II MHC is used to present intracellular antigen to CD4 cells.
C) Class II MHC is used to present extracellular antigen to CD8 cells.
D) Class II MHC is used to present extracellular antigen to CD4 cells.
Q6) A humoral immune response involves the production of ________.
Q7) The small peptides released by various cells that influence the direction and intensity of an immune response are known as ________.
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Chapter 17: Immune Disorders, Tools, and Vaccines
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Q1) An example of a primary immunodeficiency would be
A) DiGeorge syndrome.
B) HIV.
C) severe combined immunodeficiency syndrome.
D) IgA deficiency.
Q2)
CASE HISTORY
The patient,Asuncion,is an eight-year-old girl from Argentina.She received the BCG vaccine for tuberculosis about one year before coming to the United States.Upon entering school in the United States,she must take a skin test for tuberculosis (TB).Asuncion tries to refuse but is told it is a requirement.She allows the nurse to apply the test to her arm.Three days later,the test site has a large red lesion and the skin is starting to slough (peel off).
From the information given in the case study,we cannot tell whether Asuncion could potentially pose a TB infection risk to her classmates.Why was this test an inappropriate one for Asuncion and what would be a more useful alternative?
Q3) The process that detects and eliminates cancer cells as they arise is called a(n)________.
Q4) Antigens that possess structures similar in shape to host structures are called ________.
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Chapter 18: Microbial Pathogenesis
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Q1) Which statement about horizontal gene transfer is correct?
A) Few pathogenicity islands are generated by horizontal transmission.
B) Horizontal gene transfers move whole blocks of DNA from one organism to another.
C) Horizontal gene transfer helps pathogens evolve.
D) All genes code for toxins.
Q2) All of the following are true about bacterial capsules EXCEPT
A) they are produced by intracellular pathogens to avoid the host immune system.
B) they coat bacterial cell wall components inhibiting phagocytosis.
C) the slippery nature of capsules make "grabbing" the bacterial cell difficult.
D) the immune system attacks encapsulated organisms with opsonizing antibodies.
Q3) Which of the following protozoans uses antigenic variation to circumvent the host immune system?
A) plasmodium
B) entamoeba
C) leishmania
D) trypanosome
Q4) Draw and label an AB toxin.List two diseases that are caused by AB toxins.
Q5) Toxins made and secreted by bacterial cells are called ________ while toxins contained within the bacterial cell wall are called ________.
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Chapter 19: Infections of the Skin and Eye
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Q1) All of the following are used to treat chickenpox EXCEPT A) aspirin.
B) calamine lotion.
C) antihistamines.
D) oatmeal baths.
Q2) Topical retinoids and antibiotics are commonly used to treat A) cellulitis.
B) acne.
C) erysipelas.
D) impetigo.
Q3) All of the following are virulence factors associated with S.pyogenes EXCEPT A) lipopolysaccharide.
B) capsule.
C) M protein.
D) lipoteichoic acid.
Q4) All of the following are classified as dermatophytic fungi EXCEPT A) Malassezia.
B) Epidermophyton.
C) Trichophyton.
D) Microsporum.
Page 22
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Chapter 20: Infections of the Respiratory Tract
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Q1) Close contact with respiratory droplets from which of the following individuals is most likely to cause disease?
A) an individual with histoplasmosis
B) an individual with blastomycosis
C) an individual with cryptococcosis
D) an individual with tuberculosis
Q2) An AIDS patient with a fungal infection develops meningoencephalitis,which is the most prevalent form of A) histoplasmosis.
B) coccidioidomycosis.
C) cryptococcosis.
D) blastomycosis.
Q3) Croup is most frequently seen in A) the elderly.
B) middle-aged adults.
C) adolescents.
D) young children.
Q4) The ciliated epithelium in the respiratory tract that traps inhaled particles and microorganisms is referred to as the ________.
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Chapter 21: Systemic Infections
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Q1) Atherosclerosis is associated with infection of
A) endothelial cells.
B) mast cells.
C) macrophages.
D) lymphocytes.
Q2) Two major systemic bacterial diseases associated with septicemia are
A) vibriosis and Lyme disease.
B) typhoid fever and salmonellosis.
C) tularemia and leptospirosis.
D) brucellosis and epidemic typhus.
Q3) Carlos is experiencing a systemic infection caused by a bacterium in the genus Leptospira.The signs and symptoms associated with his illness are fever,general malaise,muscle aches,abdominal pain,and jaundice.Explain the role his circulatory and lymphatic systems played in the development of the signs and symptoms he is experiencing.
Q4) Which of the following pairs of diseases are transmitted by mosquitoes?
A) malaria and toxoplasmosis
B) babesiosis and Chagas' disease
C) leishmaniasis and schistosomiasis
D) lymphatic filariasis and malaria
Page 24
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Chapter 22: Infections of the Digestive System
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Q1) ________ can result from overcrowding/bad hygiene as well as eating undercooked seafood.
Q2) When does dental caries become painful?
A) when the biofilm forms on the tooth
B) when the enamel breaks down
C) when the decay penetrates the nerve
D) Dental caries is never painful.
Q3) Orchitis can result in ________ infected with mumps.
A) prepubescent males
B) postpubescent males
C) prepubescent females
D) postpubescent females
Q4) Which of the following organisms is NOT transmitted by direct fecal-oral contact?
A) Entamoeba
B) Giardia
C) Cyclospora
D) Cryptosporidium
Q5) Lactobacillus species are a major type of probiotic.Describe one positive aspect of Lactobacillus and one negative aspect.
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Chapter 23: Infections of the Urinary and Reproductive
Tracts
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Q1) Highly active antiretroviral therapy,or HAART,is used to treat ________.
Q2) There are two types of urinary tract infections: bladder infections,or ________,and kidney infections,or ________.
Q3) All of the following cause UTIs EXCEPT A) E.coli.
B) S.aureus.
C) S.pyogenes.
D) C.trichomatis.
Q4) The normal microbiota of the adult vagina consist primarily of A) Lactobacillus.
B) Streptococcus.
C) Mycobacterium.
D) Candida.
Q5) All of the following are risk behaviors that lead to the acquisition of an STI EXCEPT A) abstinence.
B) unprotected sex.
C) multiple sex partners.
D) drug abuse.
26
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Chapter 24: Infections of the Central Nervous System
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Q1) A small proteinaceous infectious particle is known as a ________.
Q2) CASE HISTORY
In June,Mitch,a 47-year-old resident of Oklahoma,was admitted to the hospital with rapid onset of progressive dizziness,blurred vision,slurred speech,difficulty swallowing,and nausea.Findings on examination included absence of fever,drooping eyelids,facial paralysis,and impaired gag reflex.He developed breathing difficulties and required mechanical ventilation.The patient reported that during the 24 hours before onset of symptoms,he had eaten home-canned green beans and a stew containing roast beef and potatoes.Analysis of the patient's stool detected botulinum type a toxin,but no Clostridium botulinum organisms were found.The patient was hospitalized for 49 days,including 42 days on mechanical ventilation,before being discharged. Briefly describe the likely progress of Mitch's disease from exposure to hospitalization.Is antibiotic therapy likely to be useful in the treatment of Mitch's disease? Why or why not?
Q3) All of the following are true regarding African trypanosomiasis EXCEPT that
A) it is also known as "sleeping sickness."
B) all subspecies of Trypanosoma brucei have multiple hosts.
C) it is transmitted by the tsetse fly.
D) death occurs without proper treatment.
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Chapter 25: Diagnostic Clinical Microbiology
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Q1) A point-of-care (POC)assay that fails to identify 50% of individuals with a disease has low ________.
Q2) Lumbar puncture is the most common method for obtaining a sample of A) blood.
B) cerebrospinal fluid.
C) synovial fluid.
D) peritoneal fluid.
Q3) If your goal is to isolate Gram-negative bacteria from Gram-positive bacteria and you are not interested in biochemical differences between the Gram-negative bacteria,it would be best to use a growth media that is A) selective.
B) differential.
C) selective and differential.
D) nonselective.
Q4) Body sites that contain no microorganisms are considered to be ________.
Q5) Mannitol salt agar (MSA)contains a high concentration of salt that restricts the growth of most bacterial species.MSA also changes from pink to yellow when mannitol is fermented by some organisms.Describe the characteristics that make MSA both selective and differential.
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Chapter 26: Epidemiology: Tracking Infectious Diseases
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Q1) An infectious agent with a high mortality rate that is highly contagious and lacks a vaccine and effective treatment is known as a ______.
Q2) An investigator is collecting data identifying the time of year and locations of measles outbreaks within the United States over a ten-year period from 2000 to 2010.This investigator is most likely involved in
A) descriptive epidemiology.
B) cohort studies.
C) analytical epidemiology.
D) experimental studies.
Q3) A disease transmitted from animals to humans is called a _______ disease.
Q4) Mary,an elderly woman with an indwelling catheter,is admitted to a local hospital for treatment of pneumonia.Three days after her admission,Mary's husband receives a call from the hospital.He is informed that Mary has a nosocomial infection.Which of the following statements is true?
A) The nosocomial infection referred to is pneumonia.
B) Mary has most likely developed a urinary tract infection.
C) Of all hospital patients,25-30% develop nosocomial infections.
D) Mary's nosocomial infection could have been prevented with improved ventilation.
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Page 29
Chapter 27: Environmental and Food Microbiology
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62 Verified Questions
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Sample Questions
Q1) One benefit of food fermentation is the generation of vitamin A) A.
B) C.
C) B .
D) D.
Q2) Historically,N only entered the atmosphere as a result of nitrogen fixation by bacteria and archaea.How has human technology affected nitrogen cycling?
A) Humans genetically modified plants to allow them to fix nitrogen.
B) Humans developed a method for artificially fixing nitrogen to generate fertilizers.
C) Humans use nitrogen as a source of renewable energy. D) Human technology has had no effect on nitrogen cycling.
Q3) An end result of mixed-acid fermentation products being converted into a gas in cattle is production of the greenhouse gas ________.
Q4) Describe any differences between the primary producers in the ocean versus the primary producers on land.
Q5) Using organisms such as bacteria to neutralize pollutants from a contaminated site is referred to as ________.
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