Nokea
Which laboratory result is of most concern for a patient with cystitis?
- A. Serum WBC 9000/mm?
- B. Urinalysis with 1-2 WBCs present
- C. Urine bacteria 100,000 colonies/mL
- D. Serum hematocrit 36%
Correct Answer: C
Rationale: The correct answer is C because a urine bacteria count of 100,000 colonies/mL indicates a significant bacterial infection, which is concerning for cystitis. This result suggests an active infection in the urinary tract, requiring prompt treatment.
A: Serum WBC of 9000/mm³ is within the normal range and may not necessarily indicate an active infection.
B: Urinalysis with 1-2 WBCs present is also within the normal range and may not be indicative of an acute infection.
D: Serum hematocrit of 36% is a measure of the proportion of red blood cells in the blood and is not directly related to cystitis.
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A 20 year old patient presented to the ER with headache, stiff neck and fever for 3 days and is diagnosed with bacterial meningitis. Which one of the following antibiotics is the best choice to treat meningitis?
- A. Cefuroxime
- B. Cephalexin
- C. Cefotaxime
- D. Cefdinir
Correct Answer: C
Rationale: The correct answer is Cefotaxime (C) because it is a third-generation cephalosporin with excellent penetration into the cerebrospinal fluid, making it effective against bacterial meningitis pathogens. Cefotaxime covers a broad spectrum of bacteria commonly causing meningitis, including Streptococcus pneumoniae and Neisseria meningitidis.
A: Cefuroxime (A) is not the best choice as it has limited activity against some of the common pathogens causing meningitis.
B: Cephalexin (B) is a first-generation cephalosporin with poor central nervous system penetration and limited activity against meningitis pathogens.
D: Cefdinir (D) is a third-generation cephalosporin but is not the preferred choice for treating bacterial meningitis due to its inferior CNS penetration compared to cefotaxime.
A 5 year old child has been brought with intestinal obstruction due to clumping of roundworms. Which of the following anthelmintic which administered by orogastric tube can relax the balls of ascaris and relieve the obstruction?
- A. Levamisole
- B. Mebendazole
- C. Pyrantel pamoate
- D. Piperazine
Correct Answer: D
Rationale: The correct answer is D: Piperazine. Piperazine is a paralytic agent that causes relaxation of the muscles of the roundworm (Ascaris), allowing it to be easily expelled from the intestine. By administering piperazine via orogastric tube, the clumped roundworms causing intestinal obstruction can be relaxed, relieving the obstruction. Levamisole, Mebendazole, and Pyrantel pamoate are not effective in relaxing the muscles of the roundworms, making them incorrect choices for this specific scenario.
Mary Jane develops edema after the birth of her first child and will be treated by peritoneal dialysis. The nurse will have the patient void before the catheter is introduced into the peritoneal space to
- A. determine the effectiveness of the treatment
- B. prevent accidental puncture of the bladder
- C. get an accurate output record
- D. prevent incontinence
Correct Answer: B
Rationale: The correct answer is B: prevent accidental puncture of the bladder. Voiding before catheter insertion ensures the bladder is empty, reducing the risk of bladder puncture during peritoneal dialysis. Choice A is incorrect as voiding does not determine treatment effectiveness. Choice C is incorrect as output recording is not the primary reason for voiding. Choice D is incorrect as voiding does not directly prevent incontinence during peritoneal dialysis.
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.
A patient has experienced excessive losses of the kidneys
- A. The left kidneys connection to the common bile duct
- B. How will this lost bicarbonate be replaced?
Correct Answer: B
Rationale: The correct answer is B because excessive losses of the kidneys can lead to metabolic acidosis due to bicarbonate loss. Bicarbonate is essential for maintaining acid-base balance in the body. Replacement of lost bicarbonate is crucial to prevent acidosis. Choice A is incorrect as the kidneys are not connected to the common bile duct. Choices C and D are not applicable to the scenario provided.