Nokea
Which of the following semisynthetic penicillins which has an extended * spectrum of activity against many gram negative bacilli, is acid resistant but not penicillinase resistant?:
- A. Cloxacillin
- B. Amoxicillin
- C. Phenoxymethyl penicillin
- D. Piperacillin
Correct Answer: D
Rationale: Step 1: Piperacillin is a semisynthetic penicillin with extended spectrum against gram-negative bacilli.
Step 2: It is acid-resistant, meaning it can withstand acidic environments in the stomach.
Step 3: However, it is not penicillinase-resistant, making it susceptible to penicillinase enzymes.
Step 4: Cloxacillin (A) and Amoxicillin (B) are penicillinase-resistant but do not have extended gram-negative activity.
Step 5: Phenoxymethyl penicillin (C) is neither acid-resistant nor penicillinase-resistant.
In summary, Piperacillin is the correct choice due to its extended spectrum against gram-negative bacilli and acid resistance, despite not being penicillinase-resistant.
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What would be the best nursing action for the female client admitted following a nephrolithotomy with a urinary tract infection?
- A. Administer IV fluids and blood transfusions.
- B. Administer narcotic analgesics as prescribed.
- C. Encourage fluid intake of 3000 mL/day.
- D. Suggest taking herbs or spices to increase food palatability.
Correct Answer: C
Rationale: The correct answer is C: Encourage fluid intake of 3000 mL/day. This is important post-nephrolithotomy to prevent urinary stasis and aid in flushing out potential stone fragments. Adequate hydration also helps in preventing urinary tract infections. Administering IV fluids and blood transfusions (A) may be necessary in certain cases, but not specifically indicated for this scenario. Administering narcotic analgesics (B) may be required for pain management, but it does not address the underlying issue of preventing complications. Suggesting herbs or spices (D) is unrelated and may not be recommended due to potential interactions with medications.
Acetazolamide is not frequently used as diuretic but the current indication is in the treatment of:
- A. Liver cirrhosis
- B. CHF
- C. Glaucoma
- D. Kidney failure
Correct Answer: C
Rationale: Acetazolamide is a carbonic anhydrase inhibitor that reduces intraocular pressure by decreasing aqueous humor production, making it effective in treating glaucoma. It is not commonly used as a diuretic due to its short duration of action and side effects. Therefore, choice C is correct. Choices A, B, and D are incorrect as acetazolamide is not indicated for liver cirrhosis, CHF, or kidney failure. Liver cirrhosis typically requires diuretics to manage ascites, CHF is managed with loop diuretics, and kidney failure may require different types of diuretics based on the underlying cause.
One of the primary functions of the kidney is to filter blood in order to remove substances that have no useful function in the body. Which of the following is the correct path of blood from the abdominal aorta to the inferior vena cava (IVC)?
- A. abdominal aorta – renal arteries – segmental arteries – interlobar arteries – arcuate arteries – interlobular arteries – efferent arteries – glomerulus – afferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- B. abdominal aorta – renal arteries – interlobar arteries – segmental arteries – arcuate arteries – interlobular arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- C. abdominal aorta – renal arteries – segmental arteries – interlobar arteries – arcuate arteries – interlobular arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
- D. abdominal aorta – renal arteries – interlobar arteries – interlobular arteries – segmental arteries – arcuate arteries – afferent arteries – glomerulus – efferent arteries – peritubular capillaries – interlobular veins – arcuate veins – interlobar veins – renal veins – inferior vena cava
Correct Answer: C
Rationale: The correct path of blood flow in the kidney is from the abdominal aorta to the renal arteries, then to the segmental arteries, followed by interlobar arteries, arcuate arteries, interlobular arteries, afferent arteries, glomerulus, efferent arteries, peritubular capillaries, interlobular veins, arcuate veins, interlobar veins, renal veins, and finally to the inferior vena cava. Choice C accurately follows this sequential flow of blood, making it the correct answer.
Explanation for why other choices are incorrect:
- Choice A has the incorrect sequence of interlobar and interlobular arteries, which disrupts the correct flow.
- Choice B also has an incorrect sequence of interlobar and interlobular arteries, leading to an inaccurate path.
- Choice D has the interlobar and interlobular arteries in the wrong order, deviating from the correct blood flow pathway.
Which of the following cephalosporins has activity against gram negative anaerobic bacteria like Bacteroides fragilis, and the only cephalosporins that cross the blood brain barrier and enter the brain?
- A. Ceftriaxone
- B. Cefoxitin
- C. Cephalexin
- D. Cefixime
Correct Answer: A
Rationale: Rationale:
1. Ceftriaxone is a third-generation cephalosporin known for broad-spectrum coverage.
2. It has excellent activity against gram-negative anaerobes such as Bacteroides fragilis.
3. It is also one of the cephalosporins that can penetrate the blood-brain barrier.
4. The other choices do not have the same anaerobic coverage or BBB penetration.
Summary:
- B: Cefoxitin is a second-generation cephalosporin with anaerobic coverage but does not cross the BBB.
- C: Cephalexin is a first-generation cephalosporin with limited anaerobic activity and no BBB penetration.
- D: Cefixime is a third-generation cephalosporin with no anaerobic activity or BBB penetration.
Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?
- A. Do you need to get up at night to urinate?
- B. Do you experience nocturnal emissions, or wet dreams?
- C. Do you know how to perform a testicular self-examination?
- D. Has anyone ever touched your genitals when you did not want them to?
Correct Answer: A
Rationale: The correct answer is A because it pertains to a common genitourinary issue in older men, nocturia. Nocturnal emissions (choice B) are not typically relevant in this context. Testicular self-examination (choice C) is more appropriate for younger men, and asking about unwanted touching (choice D) is not relevant to obtaining a genitourinary history. Asking about nocturia can provide valuable information about potential prostate issues, urinary tract infections, or other conditions commonly affecting older men.