Mr. Thomas, who is receiving oral penicillin, reports that he has a sore mouth. On inspection, the nurse notes bright red oral mucous membranes with some white patches. The primary care provider is notified immediately because these symptoms may be caused by:

a Vitamin C deficiency

dehydration

poor oral hygiene

a superinfection

Answer and Explanation

The Correct Answer is D

A. A Vitamin C deficiency:

While a Vitamin C deficiency can lead to oral health issues such as bleeding gums or scurvy, it is less likely to present with bright red oral mucous membranes and white patches. Vitamin C deficiency typically manifests with other symptoms such as fatigue, weakness, and joint pain.

B. Dehydration:

Dehydration can cause dry mouth and oral discomfort, but it is less likely to present with bright red oral mucous membranes and white patches. Dehydration may also result in a dry, sticky feeling in the mouth rather than soreness with white patches.

C. Poor oral hygiene:

Poor oral hygiene can lead to various oral health problems, including gingivitis and dental caries, but it is less likely to cause bright red oral mucous membranes with white patches. Poor oral hygiene typically results in plaque accumulation, gum inflammation, and dental decay rather than the specific symptoms described.

D. A superinfection:

This is the correct option. A superinfection occurs when opportunistic microorganisms, such as fungi or resistant bacteria, proliferate and cause infection following antibiotic therapy. Penicillin, like other antibiotics, can disrupt the normal balance of microorganisms in the mouth, allowing opportunistic pathogens to flourish and lead to conditions such as oral thrush (caused by Candida albicans) or oral candidiasis. The presence of bright red oral mucous membranes with white patches suggests the possibility of a superinfection, which warrants immediate attention from the primary care provider for further evaluation and management.

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Correct Answer is A

Explanation

A. She only has one functioning kidney:

This choice is the most significant consideration when prescribing vancomycin to Mrs. Oza. Vancomycin is primarily eliminated from the body through the kidneys. Individuals with reduced kidney function, such as Mrs. Oza with only one functioning kidney, have a higher risk of vancomycin-associated nephrotoxicity (kidney damage). Therefore, her renal status is crucial information for determining the appropriate dosage of vancomycin and monitoring for any signs of kidney impairment during treatment.

B. She remains outdoors for long periods of time:

While spending time outdoors for long periods may have implications for Mrs. Oza's overall health, it is not directly relevant to the prescription of vancomycin. This information may be important for considering sun exposure, hydration, and other factors related to her arthritis and general well-being, but it does not specifically impact the pharmacokinetics or pharmacodynamics of vancomycin.

C. She has hypertension:

Mrs. Oza's hypertension is a relevant medical condition to consider in her overall health management. However, hypertension alone does not directly affect the prescription of vancomycin. Hypertension may influence the choice of antihypertensive medications or other aspects of her medical care, but it does not have a direct impact on the renal clearance or potential nephrotoxicity of vancomycin.

D. She enjoys an alcoholic beverage twice a week:

While alcohol consumption can interact with certain medications and impact overall health, it is not the most significant consideration when prescribing vancomycin to Mrs. Oza. Moderate alcohol consumption is unlikely to directly affect the pharmacokinetics or pharmacodynamics of vancomycin. However, excessive alcohol intake may contribute to liver dysfunction, which could indirectly influence drug metabolism. Nonetheless, in Mrs. Oza's case, her reduced renal function is a more critical factor to consider when prescribing vancomycin.

A. penicillin will be effective in treating the infection B. penicillin will not be effective in treating the infection C. the test must be repeated to obtain accurate results D. Ms. Robertson is allergic to penicillin

Correct Answer is A

Explanation

A. Penicillin will be effective in treating the infection:

This interpretation is correct. When the culture and sensitivity test results show that the bacteria causing the infection are sensitive to penicillin, it means that penicillin will effectively inhibit the growth of these bacteria, leading to the resolution of the infection. This sensitivity indicates that penicillin is an appropriate and effective choice for treating the infection.

B. Penicillin will not be effective in treating the infection:

This interpretation is incorrect. If the bacteria are sensitive to penicillin, it means that penicillin will be effective in treating the infection. Sensitivity to penicillin indicates that the bacteria are susceptible to the antimicrobial activity of penicillin, and therefore, penicillin is expected to be effective in eradicating the infection.

C. The test must be repeated to obtain accurate results:

This interpretation is not warranted based on the information provided. If the culture and sensitivity test results indicate that the bacteria causing the infection are sensitive to penicillin, there is no need to repeat the test for accuracy. Sensitivity testing provides valuable information about the susceptibility of bacteria to specific antibiotics, helping healthcare providers make informed decisions about appropriate treatment.

D. Ms. Robertson is allergic to penicillin:

This interpretation is unrelated to the information provided in the scenario. The culture and sensitivity test results indicate the susceptibility of bacteria to penicillin, not whether the patient has an allergy to penicillin. Allergy testing is a separate diagnostic process used to determine if a patient is allergic to penicillin or other medications. Sensitivity testing does not provide information about the patient's allergy status.

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Mr. Thomas, who is receiving oral penicillin, reports that he has a sore mouth. On inspection, the nurse notes bright red oral mucous membranes with some white patches. The primary care provider is notified immediately because these symptoms may be caused by:

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

When reviewing Ms. Robertson's culture and sensitivity test results, the nurse learns that the bacteria causing Ms. Robertson's infection are sensitive to penicillin. The nurse interprets this result to mean:

Correct Answer is A

Explanation

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