A 28-year-old man presents to the emergency department with diarrhea for the past 2 days. He went on a camping trip 10 days ago. His loose stools are foul smelling and have been associated with abdominal pain and nausea. Stool analysis shows cysts. What is the most appropriate treatment?

Correct Answer: C

Rationale: The most appropriate treatment for a 28-year-old man presenting with foul-smelling diarrhea, abdominal pain, nausea, and stool analysis positive for cysts after a camping trip is Metronidazole (Option C). Metronidazole is the drug of choice for the treatment of giardiasis, an infection caused by the protozoan Giardia lamblia, which commonly presents with the symptoms described. Metronidazole is effective against anaerobic organisms like Giardia, making it the appropriate choice in this scenario. Clindamycin (Option A) is not indicated for the treatment of giardiasis and can actually worsen the diarrhea. Ivermectin (Option B) is used for parasitic infections like strongyloidiasis and onchocerciasis, not giardiasis. Praziquantel (Option D) is used for parasitic infections like schistosomiasis and tapeworm infections, not giardiasis. In an educational context, understanding the appropriate use of chemotherapy drugs is crucial for healthcare professionals, especially when treating infectious diseases. This case highlights the importance of accurate diagnosis based on symptoms and diagnostic findings to choose the most effective treatment, emphasizing the significance of clinical reasoning and evidence-based practice in patient care.

Correct Answer: C

Rationale: In this scenario, the most appropriate choice for the 21-year-old woman with vaginal discharge, foul odor, and positive whiff test is option C: Metronidazole. Metronidazole is the drug of choice for treating bacterial vaginosis, which is suggested by the presence of clue cells (squamous cells surrounded by bacteria) in the wet prep, foul odor, and positive whiff test (due to the release of volatile amines). Option A, Ceftriaxone, is used for treating gonorrhea or meningitis caused by Neisseria gonorrhoeae, not bacterial vaginosis. Option B, Doxycycline, is typically used for treating sexually transmitted infections like chlamydia or certain types of pneumonia. Option D, Penicillin, is not effective against the anaerobic bacteria associated with bacterial vaginosis. Educationally, understanding the appropriate use of different antibiotics is crucial in clinical practice to ensure effective treatment and prevent antimicrobial resistance. Students should be able to differentiate between different infections and select the most appropriate treatment based on clinical presentation and diagnostic findings. This case highlights the importance of accurate diagnosis and targeted treatment in managing common gynecological infections.

Correct Answer: D

Rationale: The correct answer is D) Inhibits ergosterol synthesis. Clotrimazole is an antifungal medication that belongs to the class of azole antifungals. Its mechanism of action involves inhibiting the synthesis of ergosterol, an essential component of the fungal cell membrane. By disrupting ergosterol synthesis, clotrimazole weakens the fungal cell membrane, leading to cell death. Option A) Binds ergosterol is incorrect because clotrimazole does not bind to ergosterol but rather inhibits its synthesis. Option B) Inhibits cell wall synthesis is incorrect because this is a mechanism of action for antifungal agents like echinocandins, not azole antifungals like clotrimazole. Option C) Inhibits DNA synthesis is incorrect because this is a mechanism of action for antifungal agents like flucytosine, not azole antifungals. Educationally, understanding the mechanism of action of antifungal medications like clotrimazole is crucial for nurses and healthcare professionals when treating fungal infections. Knowing how these drugs work helps in selecting the appropriate treatment and monitoring for effectiveness and potential side effects.

Correct Answer: C

Rationale: The correct answer for this NCLEX question is option C: "All members can be used orally and parenterally." Third generation cephalosporins are a group of antibiotics known for their broad-spectrum activity against gram-negative bacteria and some gram-positive bacteria. However, not all members of this group can be administered both orally and parenterally. Some third generation cephalosporins are only available for parenteral administration, while others can be given orally as well. Option A, "Has an expanded gram-negative & anaerobic antimicrobial effect," is correct as third generation cephalosporins indeed have an extended spectrum of activity compared to earlier generations, covering more gram-negative bacteria and anaerobic organisms. Option B, "Effective against beta-lactamase producing organisms," is also correct. Third generation cephalosporins are designed to combat bacteria that produce beta-lactamase enzyme, which would otherwise render other antibiotics ineffective. Option D, "Used by injection for treatment of severe infections," is a common route of administration for third generation cephalosporins, especially in severe infections where intravenous administration ensures rapid and reliable delivery of the drug to the systemic circulation. In an educational context, understanding the characteristics of different generations of cephalosporins is crucial for nursing and medical students. It helps in selecting the appropriate antibiotic therapy based on the spectrum of activity, route of administration, and efficacy against specific pathogens. Familiarity with these drugs is essential for providing safe and effective patient care, especially in the management of infectious diseases.

Correct Answer: A

Rationale: The correct answer is A) Water soluble used I.V. in an emergency. Benzyl penicillin is advantageous for emergency use because it is water-soluble and can be administered intravenously for rapid onset of action. This is crucial in life-threatening situations where immediate treatment is needed. Option B) Short duration of action is incorrect because benzyl penicillin actually has a longer duration of action compared to other penicillins, allowing for less frequent dosing. Option C) Destroyed by gastric acidity is incorrect as benzyl penicillin is not administered orally, so its effectiveness is not affected by gastric acidity. Option D) Narrow spectrum is incorrect because benzyl penicillin has a broad spectrum of activity against various gram-positive bacteria. In an educational context, understanding the properties of benzyl penicillin is essential for nurses and healthcare professionals who may encounter patients requiring chemotherapy drugs. Knowing the advantages and limitations of different medications is crucial for safe and effective patient care. This knowledge can help in making informed decisions about drug selection, dosing, and monitoring for potential adverse effects.