A patient with multiple sclerosis is taking baclofen.
Which sign indicates the drug is having the intended outcome?
Obtains relief from muscle spasms.
Increased energy.
Absence of a urinary tract infection.
No longer has double vision.
The Correct Answer is A
Choice A rationale
Baclofen is a gamma-aminobutyric acid (GABA) mimetic that acts as a central nervous system depressant, primarily targeting the spinal cord to reduce spasticity. By activating GABA-B receptors, it hyperpolarizes neurons, decreasing the frequency of neuronal firing and thus alleviating involuntary muscle contractions and spasms often seen in multiple sclerosis.
Choice B rationale
Increased energy is not a direct therapeutic outcome of baclofen. Baclofen is a muscle relaxant that can cause central nervous system depression, potentially leading to sedation or fatigue rather than increased energy. Its primary mechanism is to reduce muscle hypertonicity and spasticity.
Choice C rationale
Baclofen does not have any direct antimicrobial properties or mechanisms to prevent urinary tract infections. UTIs in multiple sclerosis patients are often related to neurogenic bladder dysfunction, urinary retention, and catheterization, and are unrelated to baclofen's pharmacological action on muscle spasms.
Choice D rationale
Double vision, or diplopia, in multiple sclerosis is typically caused by demyelination of cranial nerves responsible for eye movement coordination, such as the oculomotor, trochlear, or abducens nerves. Baclofen's action is primarily on skeletal muscle spasticity and does not directly address neurological visual disturbances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Topical corticosteroids are the mainstay of treatment for contact dermatitis. This inflammatory skin condition is characterized by a delayed hypersensitivity reaction, and corticosteroids reduce inflammation, pruritus, and erythema by suppressing the immune response, inhibiting cytokine release, and stabilizing lysosomal membranes, thus alleviating symptoms locally.
Choice B rationale
Intravenous corticosteroids are generally reserved for severe, widespread, or recalcitrant cases of contact dermatitis, or when there is significant systemic involvement, such as severe angioedema or airway compromise. For typical localized contact dermatitis, topical application is preferred to minimize systemic side effects.
Choice C rationale
Intravenous antibiotics are indicated for bacterial infections. Contact dermatitis is an inflammatory, non-infectious condition caused by exposure to an allergen or irritant. Therefore, antibiotics would not be a primary treatment unless there is a secondary bacterial infection complicating the dermatitis, which is not the typical initial presentation.
Choice D rationale
Oral antibiotics, like intravenous antibiotics, are used to treat bacterial infections. Contact dermatitis is not caused by bacteria but rather by an inflammatory immune response to external agents. Administering oral antibiotics without evidence of secondary bacterial infection would be inappropriate and ineffective for treating the underlying dermatitis.
Correct Answer is B
Explanation
Choice A rationale
Ciprofloxacin absorption can be significantly impaired by antacids containing aluminum, magnesium, or calcium. These antacids bind to ciprofloxacin, forming insoluble complexes that reduce the antibiotic's bioavailability, thus diminishing its effectiveness in treating the infection.
Choice B rationale
Ciprofloxacin, a fluoroquinolone antibiotic, carries a black box warning for increased risk of tendinitis and tendon rupture. Patients should be instructed to monitor for tendon pain, especially in the Achilles tendon, and report it immediately to prevent severe and permanent injury.
Choice C rationale
Limiting fluid intake is contraindicated when taking ciprofloxacin for a UTI. Adequate hydration is crucial to help flush bacteria from the urinary tract and prevent crystalluria, a potential side effect where drug crystals form in the urine, which can lead to kidney damage.
Choice D rationale
Ciprofloxacin does not typically cause urine to turn dark orange. This side effect is more commonly associated with other medications, such as rifampin or phenazopyridine (a urinary analgesic), and is not an expected or normal finding when taking ciprofloxacin.
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