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: D
Rationale: The correct answer is D: Procaine penicillin. Procaine penicillin is a long-acting penicillin formulation due to the addition of procaine, which slows down the release of penicillin into the bloodstream. This results in a prolonged duration of action compared to benzathine, sodium, and potassium penicillin. Benzathine penicillin is also long-acting but primarily used for prevention, not treatment. Sodium and potassium penicillin are not formulated for extended action, making them less suitable for long-term treatment. Therefore, D is the best choice for long-lasting penicillin therapy.
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During the examination of a full-term newborn male, a finding requiring investigation would be:
- A. Absent testes
- B. Meatus centered at the tip of the penis
- C. Wrinkled scrotum
- D. Penis 2 to 3 cm in length
Correct Answer: A
Rationale: The correct answer is A: Absent testes. In a full-term newborn male, the absence of testes is a concerning finding that requires immediate investigation to rule out conditions like undescended testes or any underlying genetic abnormalities. This is crucial for ensuring normal development and future fertility.
The other choices are incorrect because:
B: Meatus centered at the tip of the penis is a normal finding in a full-term newborn.
C: Wrinkled scrotum is a common and normal variation in newborns and does not typically require immediate investigation.
D: Penis 2 to 3 cm in length is within the expected range for a full-term newborn and is not a cause for concern.
Which antibiotic is primarily bacteriostatic but becomes bactericidal at higher * concentrations?:
- A. Erythromycin
- B. Tetracycline
- C. Chloramphenicol
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Chloramphenicol. At lower concentrations, Chloramphenicol is primarily bacteriostatic, inhibiting bacterial protein synthesis. However, at higher concentrations, it can disrupt the bacterial ribosome, leading to bacterial cell death, making it bactericidal. Erythromycin (A) and Tetracycline (B) are primarily bacteriostatic by inhibiting protein synthesis. Ampicillin (D) interferes with bacterial cell wall synthesis but does not exhibit a concentration-dependent shift to bactericidal activity like Chloramphenicol.
You are providing care for a patient with reflex urinary incontinence. Which action is appropriately delegated to the new LPN/LVN?
- A. Teach the patient bladder emptying by the Credé method.
- B. Demonstrate how to perform intermittent self-catheterization.
- C. Discuss the side effects of bethanechol chloride (Urecholine).
- D. Reinforce the importance of proper handwashing to prevent infection.
Correct Answer: B
Rationale: The correct answer is B because demonstrating how to perform intermittent self-catheterization is within the scope of practice for an LPN/LVN. This task involves a specific skill set that can be taught and supervised by the LPN/LVN. It is essential for managing reflex urinary incontinence and maintaining bladder function. Choices A, C, and D are incorrect because teaching the patient bladder emptying by the Credé method (A) and discussing the side effects of bethanechol chloride (C) are tasks that require a higher level of nursing education and knowledge. Reinforcing the importance of proper handwashing (D) is a basic nursing task that can be performed by a nursing assistant or other unlicensed assistive personnel.
During a physical examination, the nurse finds that a male patients foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:
- A. Phimosis.
- B. Epispadias.
- C. Urethral strictur
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis is the condition where the foreskin is tight and cannot retract over the glans. This is a common condition in males and can lead to issues such as difficulty urinating and increased risk of infections. Epispadias (B) is a congenital condition where the urethra opens on the upper side of the penis. Urethral stricture (C) is a narrowing of the urethra that can cause difficulty with urination, but it is not related to tight foreskin.
The drug of choice for monilial diarrhea is:
- A. Amphothericin B
- B. Nystatin
- C. Ketoconazole
- D. Itraconazole
Correct Answer: B
Rationale: Step-by-step rationale for why Nystatin is the correct choice for monilial diarrhea:
1. Nystatin is an antifungal medication specifically effective against Candida species causing monilial infections.
2. It works by binding to ergosterol in fungal cell membranes, disrupting membrane integrity and causing cell death.
3. Nystatin is not absorbed systemically, making it suitable for gastrointestinal infections.
4. Amphothericin B is reserved for severe systemic fungal infections due to its significant toxicity. Ketoconazole and Itraconazole are not typically used for gastrointestinal Candida infections, as they are more commonly used for systemic fungal infections.