Nokea
Imipenem has the broadest spectrum of activity currently available to beta-lactams. This include antimicrobial activity against the following organisms EXCEPT:
- A. Staphylococcus aureus
- B. Staphylococcus epidermidis
- C. Pseudomonas aeruginosa
- D. Mycoplasma pneumoniae
Correct Answer: D
Rationale: The correct answer is D: Mycoplasma pneumoniae. Imipenem, a carbapenem antibiotic, has broad-spectrum activity against Gram-positive, Gram-negative, anaerobic, and some atypical bacteria. Mycoplasma pneumoniae is an atypical bacteria lacking a cell wall, making it resistant to beta-lactam antibiotics like imipenem. Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa are all susceptible to imipenem due to their cell wall composition.
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The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia.
- A. Scrotal.
- B. Femoral.
- C. Direct inguinal.
- D. Indirect inguinal.
Correct Answer: C
Rationale: The correct answer is C: Direct inguinal hernia. In this scenario, the key clues are the painless round swelling close to the pubis, easily reduced when supine, and in the area of the internal inguinal ring. Direct inguinal hernias occur due to weakness in the abdominal wall muscles, often seen in older males with increased intra-abdominal pressure. The hernia protrudes directly through the abdominal wall, typically in the area of the internal inguinal ring. Scrotal hernias (Choice A) present in the scrotum, not close to the pubis. Femoral hernias (Choice B) occur below the inguinal ligament and are more common in females. Indirect inguinal hernias (Choice D) pass through the internal inguinal ring and are more common in young males.
The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?
- A. Skin on the scrotum is taut.
- B. Left testicle hangs lower than the right testicl
- D. Scrotal skin has yellowish 1-cm nodules that are firm and nontender.
Correct Answer: D
Rationale: The correct answer is D because the presence of yellowish 1-cm nodules that are firm and nontender on the scrotal skin could indicate a serious issue such as testicular cancer or a benign condition like sebaceous cysts. Further evaluation is necessary to rule out malignancy or infection.
A: Skin on the scrotum being taut is a normal finding.
B: Left testicle hanging lower than the right is a common anatomical variation, not a cause for concern.
C: The absence of information makes it impossible to determine if this finding requires follow-up.
Superinfections are more common with: *
- A. Use of narrow spectrum antibiotics
- B. Short courses of antibiotics
- C. Use of antibiotics that are completely absorbed from the small intestines
- D. Use of antibiotic combinations covering both gram positive and gram negative bacteria
Correct Answer: D
Rationale: The correct answer is D because using antibiotic combinations covering both gram positive and gram negative bacteria can disrupt the balance of normal flora in the body, leading to superinfections. This is due to the broad spectrum of activity of these antibiotics, which can kill off a wider range of bacteria, including the beneficial ones.
Choice A is incorrect because narrow spectrum antibiotics target specific types of bacteria, reducing the likelihood of disrupting the normal flora and causing superinfections. Choice B is incorrect because longer courses of antibiotics increase the risk of superinfections as they continue to disrupt the normal flora over a longer period. Choice C is incorrect because antibiotics that are completely absorbed from the small intestines do not necessarily increase the risk of superinfections; it is more about the spectrum of activity and the impact on normal flora.
Thiazide diuretics may produce an increase in blood levels of uric acid and:
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: D
Rationale: Thiazide diuretics can lead to hyperglycemia by reducing insulin sensitivity. This can result in increased blood glucose levels. Thiazides also elevate uric acid levels by reducing its excretion. Therefore, the correct answer is D (Glucose).
Incorrect choices:
A (Potassium) - Thiazides typically cause hypokalemia, not hyperkalemia.
B (BUN) and C (Urea) - Thiazides may cause a slight increase in BUN and serum creatinine levels due to reduced kidney function, but not as significantly as glucose levels.
Which macrolide antibiotic that can be given once a day for 3 days for empirical treatment of ENT, respiratory and genital infections?
- A. Erythromycin
- B. Azithromycin
- C. Clarithromycin
- D. Roxithromycin
Correct Answer: B
Rationale: The correct answer is B: Azithromycin. It is preferred for short-term treatment due to its long half-life allowing once-daily dosing. Azithromycin has a broad spectrum of activity against many pathogens causing ENT, respiratory, and genital infections. It is well-tolerated and has fewer drug interactions. Other choices like A: Erythromycin have a higher frequency of dosing and more side effects. C: Clarithromycin and D: Roxithromycin are not typically given once daily for 3 days.