Nokea
The penicillin G preparation with the longest duration of action is:
- A. Benzathine penicillin
- B. Sodium penicillin
- C. Potassium penicillin
- D. Procaine penicillin
Correct Answer: A
Rationale: The correct answer is A: Benzathine penicillin. Benzathine penicillin has the longest duration of action among the choices because it is formulated as a salt that releases the active drug slowly over an extended period. The benzathine salt forms a depot at the injection site, leading to a sustained release of penicillin into the bloodstream. This results in a prolonged therapeutic effect and less frequent dosing compared to other penicillin preparations.
Summary:
- Choice B: Sodium penicillin has a shorter duration of action as it gets rapidly absorbed and eliminated from the body.
- Choice C: Potassium penicillin is not a standard form of penicillin and does not exist as a distinct preparation.
- Choice D: Procaine penicillin has an intermediate duration of action compared to benzathine penicillin due to the addition of procaine for local anesthesia, but it is not as long-acting.
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Cloxacillin is indicated in infections caused by the following organism(s) * a Staphylococci
- A. Streptococci
- B. Gonococci
- C. All of the above
Correct Answer: A
Rationale: Step-by-step rationale:
1. Cloxacillin is a beta-lactam antibiotic effective against Staphylococci.
2. Streptococci are not within the spectrum of activity for Cloxacillin.
3. Gonococci are also not susceptible to Cloxacillin.
4. Therefore, the correct answer is A (Streptococci), as Cloxacillin is indicated only for Staphylococcal infections.
Summary:
Choice A is correct because Cloxacillin is effective against Staphylococci. Choices B and C are incorrect because Cloxacillin is not indicated for Gonococci or all of the organisms mentioned.
A patient with HIV-AIDS being treated with combined antiviral drugs and * immunosuppressive agents, develops an opportunistic infection caused by Pneumocystis caranii. Which of the following drugs most likely be used in the treatment of pulmonary infection caused by P, caranii?
- A. Metronidazole
- B. Carbenicillin
- C. Trimthoprim /Sulfametoxazole
- D. Penicillin G
Correct Answer: C
Rationale: The correct answer is C: Trimethoprim/Sulfamethoxazole. This combination is the first-line treatment for Pneumocystis carinii pneumonia in patients with HIV-AIDS due to its efficacy against the organism. Trimethoprim inhibits bacterial folic acid synthesis, while sulfamethoxazole inhibits bacterial dihydrofolic acid formation. These drugs work synergistically to target different steps in the folic acid synthesis pathway of Pneumocystis carinii, leading to its effective eradication. Metronidazole (A) is used for anaerobic bacterial infections, Carbenicillin (B) is a penicillin derivative mainly used for Gram-negative bacteria, and Penicillin G (D) is not effective against Pneumocystis carinii.
During an examination, the nurse observes a female patient's vestibule and expects to see the:
- A. Urethral meatus and vaginal orifice.
- B. Vaginal orifice and vestibular (Bartholin) glands.
- C. Urethral meatus and paraurethral (Skene) glands.
- D. Paraurethral (Skene) and vestibular (Bartholin) glands.
Correct Answer: A
Rationale: The correct answer is A: Urethral meatus and vaginal orifice. The vestibule is the area between the labia minora where the urethral meatus and vaginal orifice are located. This is important for the nurse to observe during an examination to assess the patient's genital health.
Choice B is incorrect because the vestibular (Bartholin) glands are not typically visible in the vestibule during an examination. Choice C is incorrect because the paraurethral (Skene) glands are not typically visible in the vestibule either. Choice D is incorrect because it combines the paraurethral (Skene) and vestibular (Bartholin) glands, which are not typically visible in the vestibule during examination.
Thirty percent of patients with kidney cancer have metastasis at the time of diagnosis. Why does this occur?
- A. The only treatment modalities for the disease are palliative.
- B. Diagnostic tests are not available to detect tumors before they metastasize.
- C. Classic symptoms of hematuria and palpable mass do not occur until the disease is advanced.
- D. Early metastasis to the brain impairs the patient’s ability to recognize the seriousness of symptoms.
Correct Answer: D
Rationale: The correct answer is D because early metastasis to the brain can impair the patient's ability to recognize the seriousness of symptoms. This can delay diagnosis and treatment, leading to a higher percentage of patients having metastasis at the time of diagnosis.
A is incorrect because there are treatment modalities for kidney cancer beyond palliative care. B is incorrect as diagnostic tests like imaging studies can detect tumors before they metastasize. C is incorrect because while classic symptoms may not always be present, other symptoms and diagnostic tests can still lead to an earlier diagnosis.
Which of the following anti-HIV regimen that is generally reserved for * advanced cases of AIDS or for repeated treatment failures?:
- A. Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI)
- B. Three NRTIs
- C. Two NRTIs + one non-NRTI
- D. One NRTI + one non-NRTI + one PI
Correct Answer: A
Rationale: The correct answer is A: Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI). This regimen is typically reserved for advanced cases of AIDS or repeated treatment failures due to its potent antiviral effects. NRTIs inhibit viral replication by interfering with the HIV enzyme reverse transcriptase, while PIs inhibit the enzyme protease, essential for viral maturation. Combining these two classes of drugs provides a strong barrier against HIV resistance. Other choices (B, C, D) are less effective in advanced cases as they do not provide the same level of dual inhibition necessary to combat resistant strains and advanced disease progression.