Which statement by a nursing student about the mechanism of action of sulfonamides indicates the need for further instruction?
1. "Sulfonamides resemble the precursor molecule, PABA, so the enzymes needed for the synthesis of folic acid bind with sulfonamide instead of with PABA, stopping bacterial growth."
2. "Sulfonamides slow the growth of bacteria because they only inhibit folic acid that is synthesized by bacteria."
3. "Sulfonamides are effective against uropathogens by inhibiting the synthesis of bacterial folic acid."
4. "Sulfonamides are most effective in clients who eat large amounts of foods rich in folic acid."
Correct Answer: 4
Rationale 1: Sulfonamides resemble PABA, which allows the enzyme necessary for bacterial growth to mistakenly bind with the sulfonamide instead of with PABA.
Rationale 2: Sulfonamides only inhibit folic acid synthesized by bacteria. It is ineffective against "premade" folic acid needed by humans.
Rationale 3: Sulfonamides are effective by inhibiting the synthesis of bacterial folic acid.
Rationale 4: This is an incorrect statement. Sulfonamides are ineffective against "premade" folic acid needed by humans.
Global Rationale: Sulfonamides resemble PABA, which allows the enzyme necessary for bacterial growth to mistakenly bind with the sulfonamide instead of with PABA. Sulfonamides only inhibit folic acid synthesized by bacteria. It is ineffective against "premade" folic acid needed by humans, thus level of ingestion of folic acid is not relevant.
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