Nokea
In the presence of antidiuretic hormone (ADH), or vasopressin, water is mostly reabsorbed in the ___________ of the nephron.
- A. Proximal convoluted tubule
- B. Loop of henle
- C. Collecting duct
- D. Distal convoluted tubule
Correct Answer: A
Rationale: The correct answer is A: Proximal convoluted tubule. ADH acts on the collecting duct and distal convoluted tubule to increase water reabsorption. However, the majority of water reabsorption occurs in the proximal convoluted tubule due to its high permeability to water. This segment reabsorbs about 65% of filtered water, mainly through osmosis. The loop of Henle plays a crucial role in concentrating urine, but it is not the main site of water reabsorption. The collecting duct responds to ADH but reabsorbs a smaller fraction of filtered water compared to the proximal tubule. The distal convoluted tubule is primarily involved in electrolyte reabsorption rather than water reabsorption.
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An older man is concerned about his sexual performance. The nurse knows that in the absence of disease, a withdrawal from sexual activity later in life may be attributable to:
- A. Side effects of medications.
- B. Decreased libido with aging.
- C. Decreased sperm production.
- D. Decreased pleasure from sexual intercourse.
Correct Answer: A
Rationale: The correct answer is A: Side effects of medications. As people age, they are more likely to be on multiple medications, some of which can have side effects like erectile dysfunction or decreased libido, leading to a withdrawal from sexual activity. This is a common issue for older adults.
Choice B (Decreased libido with aging) is incorrect because while libido may decrease with age, it is not usually the sole reason for a complete withdrawal from sexual activity.
Choice C (Decreased sperm production) is incorrect as it is not directly related to a withdrawal from sexual activity in older men.
Choice D (Decreased pleasure from sexual intercourse) is incorrect as pleasure can still be experienced regardless of age, and it is unlikely to be the primary reason for withdrawal.
What is a factor that contributes to an increased incidence of urinary tract infections in aging women?
- A. Length of the urethra
- B. Larger capacity of bladder
- C. Relaxation of pelvic floor and bladder muscles
- D. Tight muscular support at the urinary sphincter
Correct Answer: C
Rationale: Rationale for Choice C (Correct Answer):
1. Aging causes relaxation of pelvic floor and bladder muscles.
2. This relaxation can lead to incomplete emptying of the bladder.
3. Residual urine in the bladder can increase the risk of UTIs.
4. Therefore, relaxation of pelvic floor and bladder muscles contributes to increased UTI incidence.
Summary of Incorrect Choices:
A: Length of the urethra - Longer urethra typically reduces UTI risk by providing more distance for bacteria to travel.
B: Larger capacity of bladder - Larger bladder capacity does not directly increase UTI risk.
D: Tight muscular support at the urinary sphincter - Tight support does not directly impact UTI risk; relaxation is the key factor.
A 50-year-old woman reports that she has been experiencing hot flashes, night sweats, and vaginal dryness. The nurse suspects that she is in the peri-menopausal stage. What is the primary reason for these symptoms?
- A. Decreased estrogen levels.
- B. Increased estrogen levels.
- C. Hormonal fluctuations.
- D. Psychological stress.
Correct Answer: D
Rationale: I must clarify that the correct answer should be A: Decreased estrogen levels. In the peri-menopausal stage, a woman's ovaries produce less estrogen, leading to symptoms like hot flashes, night sweats, and vaginal dryness. Option B is incorrect because increased estrogen levels are not typical during peri-menopause. Option C is vague and does not specifically address the primary reason for the symptoms. Option D, psychological stress, may exacerbate symptoms but is not the primary cause in this scenario.
Most physical problems that occur during peritoneal or hemodialysis are related to which phenomenon that may result from
- A. nausea and vomiting due to too rapid removal of fluid
- B. movement of red blood cells across the dialyzing membrane
- C. movement of glucose from the dialyzing solution into the blood
- D. water intoxication from excessive fluid removal
Correct Answer: A
Rationale: The correct answer is A: nausea and vomiting due to too rapid removal of fluid during peritoneal or hemodialysis. This is because rapid removal of fluid can lead to electrolyte imbalances and changes in blood pressure, causing nausea and vomiting.
Choice B is incorrect because movement of red blood cells across the dialyzing membrane is not a common physical problem during dialysis.
Choice C is incorrect because movement of glucose from the dialyzing solution into the blood is not typically associated with physical problems during dialysis.
Choice D is incorrect because water intoxication from excessive fluid removal can occur, but it is not the most common physical problem during dialysis.
A 70 year old man has severe urinary hesitancy associated with bPH. He has * tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
- A. Leuprolide
- B. Finasteride
- C. Flutamide
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride inhibits 5-alpha reductase, reducing conversion of testosterone to dihydrotestosterone (DHT) in the prostate. This helps shrink the prostate gland, relieving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used for prostate cancer. Flutamide (C) is an antiandrogen for prostate cancer. Ketoconazole (D) is an antifungal, not for BPH. Finasteride is the most appropriate choice for this patient based on mechanism of action and indication.