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 C

Explanation

A. "Expect your urine to turn pink or red while taking this medication."

This statement is incorrect. Vancomycin does not typically cause urine discoloration. However, red man syndrome, characterized by flushing of the skin, particularly on the face and upper body, can occur with rapid infusion of vancomycin. This is not related to urine color change.

B. "Discontinue the medication once your symptoms subside."

This statement is incorrect. It's crucial for the client to complete the full course of antibiotics as prescribed, even if symptoms improve before completing the treatment course. Discontinuing the medication prematurely can lead to the development of antibiotic resistance and recurrence of the infection.

C. "Notify your provider if you experience any changes in your hearing."

This statement is correct. Vancomycin can potentially cause ototoxicity, which may manifest as changes in hearing, including ringing in the ears (tinnitus) or hearing loss. Clients should be instructed to report any such symptoms to their healthcare provider promptly.

D. "Decrease your fluid intake to 1000ml per day."

This statement is incorrect. Adequate hydration is essential, especially when taking medications like vancomycin, to help prevent kidney damage and promote drug elimination. Restricting fluid intake is not advisable unless specifically instructed by the healthcare provider for a particular medical reason.

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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about vancomycin with a client who has an infection. Which of the following information should the nurse include in the teaching?

Correct Answer is C

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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