A patient diagnosed with otitis externa and taking fluoroquinolone/glucocorticoid combination medication asks the NP what benefit is to taking the medications together. You reply?

Correct Answer: B

Rationale: The correct answer is B because the glucocorticoid helps reduce swelling and pain caused by inflammation in otitis externa, while the fluoroquinolone effectively treats the infection. Combining both medications addresses both aspects of the condition, providing comprehensive treatment. Choice A is incorrect because there is no contraindication for using these medications together in this context. Choice C is incorrect as glucocorticoids do not specifically decrease adverse effects of fluoroquinolones. Choice D is also incorrect as glucocorticoids do not directly impact the development of antibiotic resistance to fluoroquinolones.

Correct Answer: B

Rationale: The correct answer is B: Therapeutic index. The therapeutic index is the ratio between the drug's desired therapeutic effects and its toxic effects. It indicates the margin of safety of a drug. A: Cumulative effect refers to the increased potency or adverse effects of a drug when taken repeatedly. C: Tolerance is the decreasing response to a drug over time, requiring higher doses for the same effect. D: Affinity is the strength of binding between a drug and its target receptor, not directly related to the drug's therapeutic and toxic effects. Therefore, the correct choice is B as it specifically addresses the ratio between therapeutic and toxic effects.

Correct Answer: A

Rationale: The correct answer is A: A thiazide diuretic. Thiazide diuretics are recommended as the initial medication for managing hypertension in patients without compelling indications. They are effective in lowering blood pressure by reducing the volume of circulating blood. In this case, the patient's blood pressure readings are consistently elevated, indicating the need for pharmacological management. Thiazide diuretics have been shown to reduce cardiovascular events and mortality in hypertensive patients. Loop diuretics and Spironolactone (Choice B) are not first-line treatments for hypertension and are typically used in specific cases like heart failure. Beta blockers (Choice C) are not the preferred initial treatment for hypertension in the absence of other compelling indications. Thus, the most appropriate choice for managing this patient's hypertension would be a thiazide diuretic.

Correct Answer: B

Rationale: The correct answer is B: Macrolides. Macrolides bind to the 50S subunit of the bacterial ribosome, inhibiting protein synthesis. Erythromycin and azithromycin are examples of macrolide antibiotics. The other choices are incorrect because: A: Fluoroquinolones inhibit bacterial DNA gyrase and topoisomerase IV. C: Aminoglycosides bind to the 30S subunit of the bacterial ribosome. D: Tetracyclines inhibit protein synthesis by binding to the 30S subunit of the bacterial ribosome.

Correct Answer: C

Rationale: The correct answer is C (Streptococcus pneumoniae, Moraxella catarrhalis, Haemophilus influenzae) because these are the most common bacterial pathogens causing ABRS. Streptococcus pneumoniae is the most common, followed by Haemophilus influenzae and Moraxella catarrhalis. These bacteria are typically found in the upper respiratory tract and can cause infection when there is inflammation or blockage of the sinuses. The other choices are incorrect because they are not commonly associated with ABRS. Choice A includes bacteria commonly found in urinary tract infections. Choice B includes bacteria associated with hospital-acquired infections. Choice D includes bacteria that are more commonly associated with atypical pneumonia rather than sinus infections.