A 33-year-old woman with nausea, vomiting, and diarrhea after eating a chicken meal at a country picnic presents to the emergency department. Her serum electrolytes are within normal limits. She is placed on amoxicillin and given an antidiarrheal agent. She returns for follow-up in 1 week with worsening of diarrhea and abdominal pain. What is the most likely explanation for these findings?

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Question 1 of 5

A 33-year-old woman with nausea, vomiting, and diarrhea after eating a chicken meal at a country picnic presents to the emergency department. Her serum electrolytes are within normal limits. She is placed on amoxicillin and given an antidiarrheal agent. She returns for follow-up in 1 week with worsening of diarrhea and abdominal pain. What is the most likely explanation for these findings?

Correct Answer: D

Rationale: Worsening diarrhea after amoxicillin suggests Clostridioides difficile infection (a fungal-like overgrowth due to antibiotic disruption of gut flora), not a fungal infection per se, but a common post-antibiotic complication.

Question 2 of 5

A 54-year-old man with a history of recurrent pulmonary tuberculosis is placed on a multidrug regimen, including isoniazid. Despite long-term therapy with this agent, the treating physician has concerns about resistance. The most likely mechanism for this to occur is which of the following?

Correct Answer: B

Rationale: Isoniazid resistance in Mycobacterium tuberculosis is commonly due to mutations in the KatG gene, which encodes catalase-peroxidase needed to activate isoniazid into its active form.

Question 3 of 5

A 54-year-old man with tuberculosis is maintained on a multidrug regimen including cycloserine. He complains of intermittent chest pressure and dyspnea but this does not limit his daily activities. On a cellular level, which of the following amino acids is blocked by this agent?

Correct Answer: A

Rationale: Cycloserine inhibits the incorporation of D-alanine into the peptidoglycan cell wall of Mycobacterium tuberculosis, disrupting cell wall synthesis.

Question 4 of 5

A 34-year-old man is hospitalized with seizures, headache, and vomiting. CT scan of the brain reveals cysticercosis. What is the most appropriate treatment for this patient?

Correct Answer: A

Rationale: Albendazole is the treatment of choice for neurocysticercosis (caused by Taenia solium), penetrating the CNS to kill cysticerci, often combined with steroids to reduce inflammation.

Question 5 of 5

A 45-year-old woman complains of facial wrinkles and lines. She heard of a drug for wrinkles from a friend that is a bacterial toxin and works by paralyzing skeletal muscles. What is the mechanism of action of this drug?

Correct Answer: C

Rationale: Botulinum toxin (e.g., Botox) cleaves SNARE proteins (e.g., SNAP-25), preventing vesicle fusion and acetylcholine release at neuromuscular junctions, paralyzing muscles to reduce wrinkles.

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