All NCLEX Resources
Example Questions
Example Question #191 : Nclex
You are the nurse in a primary care clinic taking care of a patient with spastic bladder. Her physician prescribes oxybutynin for symptom relief. Which of the following best describes the mechanism of action of oxybutynin?
Antagonism of M1, M2, and M3 muscarinic acetylcholine receptors
Alpha-adrenergic blockade
Beta-adrenergic blockade
Direct thrombin inhibition
Calcium-channel blockade
Antagonism of M1, M2, and M3 muscarinic acetylcholine receptors
The correct answer is "Antagonism of M1, M2, and M3 muscarinic acetylcholine receptors."
This is the correct answer because it accurately describes the way in which oxybutynin exhibits its anticholinergic properties, which help to relieve urinary frequency/urgency and bladder spasm. In patients with spastic bladder, oxybutynin exhibits its anticholinergic effects most significantly on the smooth muscle of the bladder detrusor muscle, which helps to treat the patients' symptoms associated with spasm of the muscle, which often manifests as urinary frequency or urgency, with or without urinary incontinence.
Calcium-channel blockade does not describe the mechanism of action of oxybutynin. Verapamil and amlodipine are examples of calcium-channel blockers.
Beta-adrenergic blockade does not describe the mechanism of action of oxybutynin. Propranolol and esmolol are examples of beta-adrenergic blockers.
Alpha-adrenergic blockade does not describe the mechanism of action of oxybutynin. Tamsulosin and doxazosin are examples of alpha-adrenergic blockers.
Direct thrombin inhibition does not describe the mechanism of action of oxybutynin. Argatroban and lepirudin are examples of direct thrombin inhibitors.
Example Question #1 : Microbiology
What is the primary effect of botulism toxin?
Ascending paralysis
Nausea and vomiting
Tonic paralysis
Flaccid paralysis
Flaccid paralysis
Botulism toxin inhibits acetylcholine release from the presynaptic nerve terminal, causing flaccid paralysis. Death in botulism exposure is generally due to respiratry failure. Tonic paralysis is the cause of respiratory arrest in other toxicity exposures, such as exposure to tetanus toxin.
Example Question #1 : Bacteria
What organism causes Rocky Mountain spotted fever?
Borrelia burgdorferi
Rickettsia helvetica
Rickettsia rickettsii
Ehrlichia chaffeensis
Rickettsia rickettsii
Rickettsia rickettsii causes Rocky Mountain Spotted Fever, and is spread by dermacentor ticks. It causes fever, headache, muscle pain, and a rash. Borrelia burgdorferi is associated with Lyme disease, ehrlichia chaffeensis is associated with human monocytotropic ehrlichiosis, and rickettsia helvetica is associated (very rarely) with meningitis.
Example Question #3 : Identifying Bacteria
What is the most common cause of infectious diarrhea in HIV-positive patients?
Salmonella
Cryptosporidium
Clostridium
Campylobacter
Cryptosporidium
While all of the listed organisms can cause diarrhea, Cryptosporidium, a protozoa, is the most commonly isolated organism in HIV positive patients presenting with diarrhea.
Example Question #1 : Bacteria
What is the most common infection preceding the development of Guillain-Barré syndrome?
E. coli
Salmonella
Staphylococcus aureus
Campylobacter jejuni
Campylobacter jejuni
30% of cases of Guillain-Barré are preceded by infection by Campylobacter jejuni. There is no known association between Staphylococcus aureus, Salmonella, or E.coli and Guillain-Barré syndrome.
Example Question #2 : Bacteria
All of the following are frequently implicated in epiglottitis except __________.
Campylobacter jejuni
Staphylococcus aureus
H. influenzae type B
Streptococcus spp
Campylobacter jejuni
The most commonly implicated bacteria in epiglottiits are H. influenzae type B, Streptococcus spp, and Staphylococcus aureus. Campylobacter jejuni is a common cause of food poisoning.
Example Question #191 : Nclex
Which agar would be the best choice option to identify Escherichia coli?
EMB (eosin methylene blue), because it is selective and differential
Phenethyl alcohol
Nutrient agar
Selenium enriched media
EMB (eosin methylene blue), because it is selective and differential
The question requires the knowledge that Escherichia coli is a facultative, Gram negative, lactose fermenting bacteria. EMB (eosin methylene blue), or Mac (MacConkey) media is superior for isolating Escherichia coli because it is both selective and differential. Nutrient agar is neither selective nor differential. Selenium enriched media would not help identify this bacteria because Escherichia coli does not require this supplemented media to grow. Phenethyl alcohol can be used to select for anaerobic bacteria, which is of no utility in this situation.
Example Question #6 : Microbiology
Which of the following sexually transmitted infections is mismatched with its causative agent?
Syphillis - Treponema pallidum
Toxic shock syndrome - Staphylococcus aureus
Genital warts - herpes simplex virus 2
Gonorrhea - Neisseria gonorrhea
Genital warts - herpes simplex virus 2
Genital warts is caused by human papillomavirus. All other sexually transmitted infection is correctly matched with its causative agent.
Example Question #3 : Bacteria
Which of the following organisms causes fever, headache, fatigue, myalgia, and buboes?
Staphylococcus aureus
Borrelia burgdorferi
Bacillus anthracis
Yersinia pestis
Yersinia pestis
The question stem describes bubonic plague which is caused by Yersinia pestis. Staphylococcus aureus causes skin infections, toxic shock, and food poisoning. Bacillus anthracis causes anthrax, which is similar to plague, but does not cause buboes. Borrelia burgdorferi causes lyme disease., which presents as rash and arthralgia.
Example Question #1 : Bacteria
E. coli (Esherichia coli) are primarily found in the colon of humans, but can also cause cystitis. Which of the following best explains why this occurs?
E. coli are obligate aerobes
E. coli are microaerophiles
E coli are facultative anaerobes
E. coli are obligate anaerobes
E coli are facultative anaerobes
The colon is anaerobic and the bladder is aerobic. This fact explains why E. coli normally lives in an anaerobic environment, but can also survive aerobically. Facultative anaerobes normally live in anaerobic conditions but can adapt to aerobic conditions. Microaerophiles describes bacteria that are obligate aerobes, but are poisoned by high levels of oxygen and thus require specific oxygen levels to grow.