a patient who will begin taking trimethoprim sulfamethoxazole tmp smx asks the nurse why the combination drug is necessary the nurse will explain that
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HESI RN

HESI RN Medical Surgical Practice Exam

1. Why is the combination drug trimethoprim-sulfamethoxazole (TMP-SMX) necessary?

Correct answer: B

Rationale: The correct answer is B: To decrease bacterial resistance. Trimethoprim-sulfamethoxazole (TMP-SMX) is a combination drug used to prevent bacterial resistance to sulfonamides. It works by targeting different steps in the bacterial metabolic pathway, making it harder for bacteria to develop resistance. Choice A is incorrect because the combination does not broaden the antibacterial spectrum; instead, it enhances effectiveness against specific bacteria. Choice C is incorrect as taste improvement is not the primary reason for combining these drugs. Choice D is incorrect because while combination therapy can sometimes help minimize toxic effects, the primary purpose in this case is to address bacterial resistance.

2. Which is a characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections?

Correct answer: B

Rationale: The characteristic that distinguishes sulfonamides from other drugs used to treat bacterial infections is that sulfonamides are synthetic compounds, not derived from biologic substances. Choice A is incorrect because sulfonamides are bacteriostatic, not bactericidal. Choice C is incorrect because sulfonamides do not have antifungal and antiviral properties. Choice D is incorrect because sulfonamides act by inhibiting bacterial synthesis of folic acid, not increasing it.

3. The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs?

Correct answer: D

Rationale: Medications with a narrow therapeutic index have a limited range between the therapeutic dose and a toxic dose. It is important to monitor these medications closely by evaluating regular serum peak and trough levels. Drugs with a narrow spectrum (Choice B) are antibiotics that target only a limited group of bacteria, not related to the need for peak and trough monitoring. Drugs with a broad spectrum (Choice A) cover a wide range of bacteria, but this characteristic does not determine the need for peak and trough monitoring. Drugs with a broad therapeutic index (Choice C) have a wide safety margin between therapeutic and toxic doses, so they typically do not require peak and trough level monitoring.

4. Which of the following is a key symptom of appendicitis?

Correct answer: A

Rationale: Corrected Choice A: Right lower quadrant pain is a classic and key symptom of appendicitis. Pain in the right lower quadrant is typically the initial symptom and is a result of inflammation and irritation of the appendix. This pain can start around the umbilicus and then migrate to the right lower quadrant. It is important to note that appendicitis rarely presents with pain in the left lower quadrant or generalized abdominal pain. Rebound tenderness, indicated in Choice D, is a sign of peritoneal irritation and is associated with appendicitis, but it is not as characteristic as the right lower quadrant pain in the initial presentation of appendicitis.

5. A client with chronic renal failure is on a low-protein diet. Which of the following is the best response by the nurse when the client asks why this diet is necessary?

Correct answer: B

Rationale: A low-protein diet is necessary for clients with chronic renal failure because it helps prevent the buildup of waste products, such as urea, in the body. Excess protein can lead to the accumulation of waste products that the compromised kidneys may not effectively filter out, further burdening the already impaired renal function. Choices A, C, and D are incorrect because the primary reason for a low-protein diet in chronic renal failure is to reduce the workload on the kidneys by minimizing the production of waste products that can exacerbate the condition, not specifically to reduce kidney workload, maintain electrolyte balance, or prevent dehydration.

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