Nokea
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. Gram positive and gram negative bacteria have different susceptibility patterns, so using a combination of antibiotics increases the likelihood of killing off a wider range of bacteria, including the beneficial ones. This disruption paves the way for opportunistic pathogens to overgrow and cause superinfections. Choices A, B, and C are incorrect because narrow spectrum antibiotics target specific bacteria, short courses of antibiotics reduce the risk of resistance and overgrowth, and antibiotics completely absorbed from the small intestines have minimal impact on gut flora compared to systemic antibiotics.
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The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.
A patient with severe infectious disease is being treated with aminoglycoside * antibiotics. Which of the following diuretic should be avoided for this patient because of the serious side effect shared by both drugs?
- A. Furosemide
- B. Hydrochlorothiazide
- C. Spironolactone
- D. Acetazolamide
Correct Answer: A
Rationale: The correct answer is A: Furosemide. Aminoglycoside antibiotics can cause ototoxicity and nephrotoxicity. Furosemide, a loop diuretic, also has the potential to cause ototoxicity and nephrotoxicity, leading to a serious side effect when combined with aminoglycosides. On the other hand, choices B, C, and D (Hydrochlorothiazide, Spironolactone, and Acetazolamide) do not share the same serious side effects with aminoglycosides. Hydrochlorothiazide is a thiazide diuretic that acts on the distal convoluted tubule, Spironolactone is a potassium-sparing diuretic that acts on the collecting duct, and Acetazolamide is a carbonic anhydrase inhibitor diuretic that works in the proximal tubule. Therefore, Furosemide should
Which of the following antifungal agent act as fungicidal by inhibiting the * synthesis of β1,3 glucan used for the disseminated mucocutaneous Candida infections?
- A. Caspofungin
- B. Amphoterecin B
- C. Flucytosine
- D. Ketoconazole resistance rapidly?:
Correct Answer: A
Rationale: Rationale:
Caspofungin is a echinocandin antifungal that inhibits the synthesis of β1,3 glucan in the fungal cell wall, leading to cell death. This mechanism makes it fungicidal against Candida infections. Amphotericin B disrupts fungal cell membranes, while Flucytosine interferes with DNA/RNA synthesis. Ketoconazole inhibits ergosterol synthesis. Therefore, A is correct as it targets the specific mechanism for Candida infections.
A 62-year-old man states that his physician told him that he has an “inguinal hernia.†He asks the nurse to explain what a hernia is. The nurse should:
- A. Tell him not to worry and that most men his age develop hernias.
- B. Explain that a hernia is often the result of prenatal growth abnormalities.
- C. Refer him to his physician for additional consultation because the physician made the initial diagnosis.
- D. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
Correct Answer: D
Rationale: Step 1: Define hernia as a condition where an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue.
Step 2: Emphasize the relevance to the patient's situation.
Step 3: Clarify that an inguinal hernia specifically involves the intestines protruding through the inguinal canal in the groin area.
Step 4: Explain that surgery may be needed to repair the hernia.
Step 5: Stress the importance of seeking medical attention for proper evaluation and treatment.
Summary:
A: Incorrect - Dismissing the patient's concerns is not appropriate.
B: Incorrect - Hernias are not typically related to prenatal growth abnormalities.
C: Incorrect - The nurse can provide basic information about hernias without needing the physician to explain further.
The renin-angiotensin-aldosterone system (RAAS) is essential in regulating blood pressure. Which of the following hormones involved in RAAS is produced by the kidney?
- A. Renin
- B. Angiotensin I
- C. Angiotensin II
- D. Aldosterone
Correct Answer: A
Rationale: Rationale: Renin is produced and released by the kidney in response to low blood pressure or low sodium levels. Renin initiates the RAAS cascade by converting angiotensinogen to angiotensin I. Angiotensin I is then converted to angiotensin II, leading to vasoconstriction and aldosterone release. Aldosterone, produced by the adrenal glands, promotes sodium and water retention. Therefore, choice A is correct as renin is the hormone produced by the kidney to regulate blood pressure. Choices B, C, and D are incorrect as they are downstream products of the RAAS cascade and are not directly produced by the kidney.