Nokea
A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:
- A. If you are menstruating, please use pads to avoid placing anything into the vagina.
- B. Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.
- C. If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.
- D. We would like you to use a mild saline douche before your examination. You may pick this up in our office.
Correct Answer: B
Rationale: The correct answer is B because avoiding intercourse, inserting anything into the vagina, or douching within 24 hours of the appointment helps ensure an accurate Pap smear result. Intercourse, vaginal products, and douching can introduce foreign substances or disrupt the natural vaginal flora, potentially affecting the test results. Option A is incorrect because using pads during menstruation is a general recommendation and not specific to a Pap smear appointment. Option C is incorrect because bringing a sample of discharge is not necessary for a Pap smear. Option D is incorrect because douching is not recommended before a Pap smear as it can alter the vaginal environment.
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Which of the following anthelmintic acts as a cholinergic agonist in the * nematodes and causes spastic paralysis of the worms?:
- A. Piperazine
- B. Pyrantel pamoate
- C. Mebendazole
- D. Albendazole
Correct Answer: A
Rationale: Rationale:
1. Piperazine is the correct answer as it acts as a cholinergic agonist in nematodes, causing spastic paralysis by mimicking acetylcholine.
2. Pyrantel pamoate works by depolarizing neuromuscular junctions, not through cholinergic agonism.
3. Mebendazole and Albendazole inhibit microtubule synthesis in worms, leading to impaired glucose uptake, not cholinergic effects.
Corticosteroids are absolutely contraindicated in which of the following types * of tuberculosis?
- A. Miliary
- B. Meningeal
- C. Intestinal
- D. Renal
Correct Answer: B
Rationale: The correct answer is B: Meningeal tuberculosis. Corticosteroids are contraindicated in meningeal tuberculosis because they can suppress the immune response, leading to increased bacterial growth and dissemination in the central nervous system. For miliary, intestinal, and renal tuberculosis, corticosteroids can be beneficial in reducing inflammation and improving outcomes.
This drug is a pyrophosphate analog which inhibit DNA polymerase and * reverse transcriptase, is used only to treat associated cytomegalovirus infection in AIDS patient.
- A. Acyclovir
- B. Valacyclovir
- C. Amantadine
- D. Foscarnet
Correct Answer: D
Rationale: The correct answer is D: Foscarnet. Foscarnet is a pyrophosphate analog that inhibits both DNA polymerase and reverse transcriptase, making it effective against cytomegalovirus (CMV) infections in AIDS patients. Acyclovir (A) and Valacyclovir (B) are antiviral drugs used for herpes infections, not CMV. Amantadine (C) is an antiviral used for influenza, not CMV. Therefore, Foscarnet is the correct choice for treating CMV in AIDS patients.
The nurse is performing a genitourinary assessment on a 50-year-old obese male laborer. On examination, the nurse notices a painless round swelling close to the pubis in the area of the internal inguinal ring that is easily reduced when the individual is supine. These findings are most consistent with a(n) ______ hernia.
- A. Scrotal.
- B. Femoral.
- C. Direct inguinal.
- D. Indirect inguinal.
Correct Answer: C
Rationale: The correct answer is C: Direct inguinal hernia. In this scenario, the key clues are the painless round swelling close to the pubis, easily reduced when supine, and in the area of the internal inguinal ring. Direct inguinal hernias occur due to weakness in the abdominal wall muscles, often seen in older males with increased intra-abdominal pressure. The hernia protrudes directly through the abdominal wall, typically in the area of the internal inguinal ring. Scrotal hernias (Choice A) present in the scrotum, not close to the pubis. Femoral hernias (Choice B) occur below the inguinal ligament and are more common in females. Indirect inguinal hernias (Choice D) pass through the internal inguinal ring and are more common in young males.
Regarding renal colic secondary to calculi:
- A. Females are more commonly affected than males
- B. 50% of calculi are radio-opaque
- C. It may present without haematuria
- D. There is a 20% chance of recurrence by 5 years
Correct Answer: C
Rationale: The correct answer is C because renal colic can present without hematuria. Renal colic is typically associated with severe flank pain caused by ureteral stones. Hematuria is a common symptom but not always present. This is due to the stone's location and size affecting the degree of irritation and damage to the urinary tract. Therefore, the absence of hematuria does not exclude the possibility of renal colic. Choices A, B, and D are incorrect. Females are not more commonly affected than males, calculi can be either radio-opaque or radio-lucent, and the recurrence rate by 5 years is closer to 50% rather than 20%.