A 62-year-old man states that his physician told him that he has an “inguinal hernia.” He asks the nurse to explain what a hernia is. The nurse should:

Correct Answer: D

Rationale: Step 1: Define hernia as a condition where an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue. Step 2: Emphasize the relevance to the patient's situation. Step 3: Clarify that an inguinal hernia specifically involves the intestines protruding through the inguinal canal in the groin area. Step 4: Explain that surgery may be needed to repair the hernia. Step 5: Stress the importance of seeking medical attention for proper evaluation and treatment. Summary: A: Incorrect - Dismissing the patient's concerns is not appropriate. B: Incorrect - Hernias are not typically related to prenatal growth abnormalities. C: Incorrect - The nurse can provide basic information about hernias without needing the physician to explain further.

Correct Answer: D

Rationale: Mycolic acid synthesis is inhibited by Ethambutol by targeting the enzyme arabinosyltransferase, essential for cell wall synthesis in mycobacteria. Resistance develops slowly with Ethambutol, unlike other choices which target different pathways (A: Isoniazid - inhibits mycolic acid synthesis by targeting InhA enzyme, B: Rifampicin - inhibits RNA polymerase, C: Pyrazinamide - disrupts membrane potential). Ethambutol is essential in combination therapy to prevent resistance.

Correct Answer: C

Rationale: The correct answer is C, Minocycline. Minocycline has a higher potential for vestibular toxicity compared to other tetracyclines due to its greater lipid solubility, leading to increased penetration of the blood-brain barrier and inner ear. This can result in dizziness, vertigo, and imbalance. Choice A, Doxycycline, is less likely to cause vestibular toxicity since it has lower lipid solubility and reduced penetration into the inner ear. Choice B, Oxytetracycline, and Choice D, Demeclocycline, also have lower potential for vestibular toxicity compared to Minocycline due to similar reasons. Overall, Minocycline stands out as the correct answer due to its unique pharmacokinetic properties that predispose it to vestibular toxicity.

Correct Answer: D

Rationale: The correct answer is D: Cefepime. Cefepime is a fourth-generation cephalosporin that has broad-spectrum activity, including against anaerobic gram-negative bacteria like Bacteroides fragilis. Its extended spectrum of activity is due to its increased stability against beta-lactamases produced by many bacteria. Choices A, B, and C (Cefdinir, Cefuroxime, Cefazolin) are not typically effective against anaerobic gram-negative bacteria. Cefdinir is primarily active against respiratory pathogens, Cefuroxime has limited anaerobic coverage, and Cefazolin is more effective against gram-positive bacteria.

Correct Answer: A

Rationale: Step-by-step rationale for choice A (Ganciclovir) being the correct answer: 1. Ganciclovir is a nucleoside analog that inhibits CMV DNA synthesis. 2. It is specifically approved for the treatment of CMV retinitis in immunocompromised patients. 3. Ganciclovir has a high specificity for CMV, making it an effective antiviral agent against CMV. Summary of why the other choices are incorrect: - Choice B (Foscarnet) is also active against CMV but is not as commonly used as Ganciclovir. - Choice C (Acyclovir) is not effective against CMV as it primarily targets herpes simplex virus and varicella-zoster virus. - Choice D ( ) is an incomplete choice and does not correspond to any known antiviral agent.