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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Refers to an infection that is resistant to conventional antibiotics:
This statement is partially correct. Acquired resistance does indeed refer to bacteria becoming resistant to antibiotics, but it is not specific to conventional antibiotics. Bacteria can develop resistance to various types of antibiotics, including conventional antibiotics and newer antimicrobial agents.
B. Superinfection that has significant antifungal resistance:
This statement is incorrect. Acquired resistance specifically pertains to bacteria and their ability to resist antibiotics. It does not involve antifungal resistance or superinfections.
C. Refers to a term used for antibiotic coverage:
This statement is incorrect. Acquired resistance is not a term used to describe antibiotic coverage. It describes the phenomenon of bacteria becoming resistant to antibiotics.
D. There is no such phenomenon of acquired resistance:
This statement is incorrect. Acquired resistance is a well-documented phenomenon in microbiology and is a significant challenge in the treatment of bacterial infections. Ignoring or denying the existence of acquired resistance would overlook a critical aspect of antibiotic stewardship and management of bacterial infections.
Correct Answer is B
Explanation
A. Changes in mental status:
Changes in mental status are not typically associated with ototoxicity caused by gentamicin. Mental status changes may indicate other systemic effects or adverse reactions, but they are not specific to ototoxicity.
B. Complaints that he is unable to hear the television:
This complaint is highly indicative of ototoxicity. Hearing loss, particularly high-frequency hearing loss, is a common symptom of ototoxicity caused by drugs like gentamicin. Difficulty hearing sounds such as the television, especially at typical volume levels, suggests a potential problem with hearing function.
C. An increase in the BUN and creatinine:
An increase in blood urea nitrogen (BUN) and creatinine levels may indicate kidney damage, which can occur as a result of nephrotoxicity associated with gentamicin use. While nephrotoxicity is a known adverse effect of gentamicin, it is not specific to ototoxicity.
D. Tingling of the extremities:
Tingling of the extremities is not typically associated with ototoxicity caused by gentamicin. This symptom may suggest other neurological or systemic effects but is not specific to ototoxicity.
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