The most frequent side effect of oral ampicillin is : *
- A. Nausea and vomiting
- B. Loose bowel movements
- C. Constipation
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Nausea and vomiting. Oral ampicillin commonly causes gastrointestinal side effects such as nausea and vomiting due to its impact on the gut flora. This side effect is a result of the antibiotic's mechanism of action and is well-documented in clinical practice. Choices B, C, and D are incorrect as loose bowel movements, constipation, and urticaria are not typically associated with oral ampicillin use.
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Clavulanic acid is combined with amoxicillin because:
- A. It inhibits beta lactamases that destroy amoxicillin
- B. It prevents renal excretion of amoxicillin
- C. It destroy bacteria that are not destroyed by amoxicillin
- D. It counteracts the adverse effects of amoxicillin
Correct Answer: A
Rationale: The correct answer is A because clavulanic acid is a beta-lactamase inhibitor that protects amoxicillin from being destroyed by beta-lactamases produced by certain bacteria. This allows amoxicillin to effectively kill the bacteria. Choices B, C, and D are incorrect because clavulanic acid does not affect renal excretion, directly destroy bacteria, or counteract adverse effects of amoxicillin.
Which of the following drug which directly inhibits HIV-reverse transcriptase * without the need for intracellular activation by phosphorylation:
- A. Nelnavir
- B. Nevirapine
- C. Stavudine
- D. Didanosine
Correct Answer: B
Rationale: The correct answer is B: Nevirapine. Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that directly inhibits HIV-reverse transcriptase without needing intracellular activation. It binds directly to the enzyme's active site, preventing the conversion of viral RNA to DNA.
Rationale:
1. Nelnavir (A) is a protease inhibitor that works by blocking the protease enzyme needed for viral replication, not reverse transcriptase inhibition.
2. Stavudine (C) and Didanosine (D) are nucleoside reverse transcriptase inhibitors (NRTIs) that require intracellular phosphorylation to become active, unlike Nevirapine.
In summary, Nevirapine is the correct answer as it directly inhibits HIV-reverse transcriptase without needing intracellular activation, distinguishing it from the other choices which belong to different drug classes or require intracellular phosphorylation.
A 22-year-old woman with a history of chronic pelvic pain is being examined. The nurse suspects endometriosis. Which of the following is the most common symptom of endometriosis?
- A. Pain during menstruation.
- B. Pelvic pain that worsens during menstruation.
- C. Pain during ovulation.
- D. Heavy bleeding during menstruation.
Correct Answer: B
Rationale: The correct answer is B: Pelvic pain that worsens during menstruation. This is because endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation and pain in the pelvic region. The pain typically worsens during menstruation due to the shedding of this tissue, causing irritation and further inflammation.
A: Pain during menstruation is a common symptom, but what distinguishes endometriosis is the worsening of pain during menstruation.
C: Pain during ovulation is not a typical symptom of endometriosis. While some individuals may experience pain during ovulation, it is not the most common symptom.
D: Heavy bleeding during menstruation can occur in endometriosis, but it is not the most common symptom. Pelvic pain that worsens during menstruation is the hallmark symptom of endometriosis.
A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____
- A. 2; 2; 1
- B. 3; 2; 0
- C. 3; 2; 1
- D. 3; 3; 1
Correct Answer: C
Rationale: The correct answer is C: 3; 2; 1. Gravida refers to the total number of pregnancies, including the current one. As the patient has had three pregnancies, the gravida is 3. Para indicates the number of live births, so since the patient has had two live births, the para is 2. AB represents the number of abortions or miscarriages, which is 1 in this case. Therefore, the correct way to record this patient's obstetric history is gravida 3, para 2, AB 1.
Choice A (2; 2; 1) is incorrect because the patient has had three pregnancies, not two. Choice B (3; 2; 0) is incorrect as it does not account for the abortion/miscarriage that occurred. Choice D (3; 3; 1) is also incorrect because the patient has had two live births, not three.
Which of the following diuretics than can cause gynecomastia, hirsutism and menstrual disturbances as adverse reactions?
- A. Hydrochlorothiazide
- B. Bumetanide
- C. Acetazolamide
- D. Spironolactone
Correct Answer: D
Rationale: Step-by-step rationale:
1. Spironolactone is a potassium-sparing diuretic that acts as an aldosterone antagonist.
2. Aldosterone antagonism can lead to anti-androgenic effects, causing gynecomastia and hirsutism in males and menstrual disturbances in females.
3. Hydrochlorothiazide (A) is a thiazide diuretic known for electrolyte imbalances, not these specific side effects.
4. Bumetanide (B) is a loop diuretic that primarily affects electrolytes, not causing hormonal side effects.
5. Acetazolamide (C) is a carbonic anhydrase inhibitor, usually associated with metabolic acidosis, not hormonal disturbances.
Summary:
Spironolactone (D) is the correct answer due to its aldosterone antagonist properties causing hormonal side effects. The other choices do not have the same mechanism of action and are not associated with gynecomastia,