Most antibiotic resistance in bacteria is caused by which of the following?

Correct Answer: A

Rationale: Antibiotic resistance in bacteria is commonly caused by genes that are carried on plasmids. Plasmids are small, circular DNA molecules that can be transferred between bacteria, allowing for the rapid spread of antibiotic resistance genes throughout bacterial populations. These resistance genes can encode enzymes that inactivate antibiotics, alter antibiotic targets, or even pump antibiotics out of bacterial cells. Plasmid-mediated resistance is a major concern in the healthcare setting as it can lead to the development of multi-drug resistant bacteria, making infections harder to treat. Therefore, the presence and transfer of genes on plasmids play a significant role in the development of antibiotic resistance in bacteria.

Correct Answer: D

Rationale: Acetazolamide, a carbonic anhydrase inhibitor, promotes diuresis by inhibiting the reabsorption of bicarbonate in the kidneys, leading to increased urine output. This is a common side effect that patients should be informed about. Increased weight (A) is not typically associated with acetazolamide. Light sensitivity (B) and burning or stinging of the eyes (C) are more commonly associated with topical ophthalmic medications, not systemic acetazolamide.

Correct Answer: A

Rationale: Patient education is a critical component of nursing care, especially for elderly patients who may have difficulty understanding complex medication regimens. A realistic outcome for an 86-year-old patient and their caregiver (daughter) is that they can state the proper way to take the drug. This ensures that the medication is taken correctly, reducing the risk of toxicity or underdosing. While teaching about adverse effects and symptoms of toxicity is important, expecting the patient to recall all symptoms may be unrealistic due to age-related cognitive decline. The most practical and achievable goal is ensuring the patient and caregiver understand the proper administration of the medication.

Correct Answer: D

Rationale: Atorvastatin (Lipitor) is a statin medication used to lower cholesterol, but it can cause serious side effects such as myopathy or rhabdomyolysis, which present as muscle pain or weakness. Pain in both legs could indicate a severe adverse reaction. Stopping the medication and seeking immediate medical attention is crucial to prevent complications like kidney damage. Delaying treatment or continuing the medication without evaluation could worsen the condition. Therefore, the correct action is to stop the drug and come to the clinic to be seen today.