The nurse explains to a student nurse the mechanism by which resistance to fluoroquinolones occurs. The nurse knows the student requires further education when the student states:
1. "Bacterial cell walls become less permeable to the fluoroquinolones."
2. "Mutations to DNA helicase alter its ability to bind with fluoroquinolones."
3. "Mutations to DNA gyrase alter its ability to bind with fluoroquinolones."
4. "Certain bacteria have developed resistance pumps that remove fluoroquinolones from the cell."
Correct Answer: 2
Rationale 1: A change in bacterial cell wall permeability, the development of resistance pumps, and mutations to DNA gyrase contribute to resistance to fluoroquinolones.
Rationale 2: Fluoroquinolones do not bind with the enzyme DNA helicase. They bind with DNA gyrase, so resistance will occur from mutations to DNA gyrase.
Rationale 3: A change in bacterial cell wall permeability, the development of resistance pumps, and mutations to DNA gyrase contribute to resistance to fluoroquinolones.
Rationale 4: A change in bacterial cell wall permeability, the development of resistance pumps, and mutations to DNA gyrase contribute to resistance to fluoroquinolones.
Global Rationale: Fluoroquinolones do not bind with the enzyme DNA helicase. They bind with DNA gyrase, so resistance will occur from mutations to DNA gyrase. A change in bacterial cell wall permeability, the development of resistance pumps, and mutations to DNA gyrase contribute to resistance to fluoroquinolones.
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