Nokea
A 25-year-old woman presents to the clinic with pain in her lower abdomen and an abnormal pap smear result. The nurse suspects that she might have an ectopic pregnancy. Which of the following is the most common symptom of ectopic pregnancy?
- A. Severe pain on one side of the lower abdomen.
- B. Severe nausea and vomiting.
- C. Pain with urination or bowel movements.
- D. Frequent urination.
Correct Answer: B
Rationale: The correct answer is B: Severe nausea and vomiting. In an ectopic pregnancy, the fertilized egg implants outside the uterus, commonly in the fallopian tube. As the pregnancy progresses, the tube can rupture, leading to severe internal bleeding. This bleeding can irritate the abdominal lining, causing nausea and vomiting. Severe pain on one side of the lower abdomen (choice A) is also common but not the most common symptom. Pain with urination or bowel movements (choice C) and frequent urination (choice D) are not typical symptoms of ectopic pregnancy.
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Which of the following is true of nephrons?
- A. they are the functional units of the kidneys
- B. the proximal convoluted tubules allow the kidney to concentrate or dilute urine
- C. there are about a million nephrons in each kidney
- D. both a and c are correct
Correct Answer: D
Rationale: Step 1: Identify key characteristics of nephrons - functional units of kidneys, responsible for urine formation.
Step 2: Confirm accuracy of statements - A: Nephrons are functional units. C: About a million nephrons in each kidney.
Step 3: Combine statements - A + C = D, confirming both are correct.
Step 4: Justify choice D - correct because nephrons are indeed functional units and there are approximately a million in each kidney.
Summary: B is incorrect as the proximal convoluted tubules are not solely responsible for urine concentration/dilution. Choice D is correct as it combines the accurate statements from A and C.
How would you instruct the client to obtain a clean-catch midstream urine specimen?
- A. Increase fluid intake.
- B. Refrain from taking nephrotoxic drugs.
- C. Take sedative medications.
- D. Maintain limited physical activity.
Correct Answer: D
Rationale: Step-by-step rationale for choosing option D:
1. Instruct the client to maintain limited physical activity to prevent contamination of the urine sample.
2. Physical activity can introduce bacteria from sweat or skin into the specimen, leading to inaccurate results.
3. By limiting physical activity, the client can ensure a clean-catch midstream urine sample for accurate testing.
4. Increasing fluid intake (option A), refraining from nephrotoxic drugs (option B), and taking sedative medications (option C) are not directly related to obtaining a clean-catch midstream urine specimen.
Which of the following antimicrobial which acts by interfering with DNA function in the bacteria and can cure most cases of uncomplicated gonorrhea?:
- A. Chloramphenicol
- B. Ciprofloxacin
- C. Streptomycin
- D. Erythromycin
Correct Answer: B
Rationale: The correct answer is B: Ciprofloxacin. Ciprofloxacin is a fluoroquinolone antibiotic that interferes with DNA function in bacteria by inhibiting DNA gyrase and topoisomerase IV enzymes. This mechanism of action prevents bacterial DNA replication and repair, leading to bacterial cell death. Ciprofloxacin is effective in treating gonorrhea due to its ability to target and kill Neisseria gonorrhoeae, the bacteria causing gonorrhea.
A: Chloramphenicol inhibits bacterial protein synthesis, not DNA function.
C: Streptomycin disrupts bacterial protein synthesis by binding to the ribosome, not DNA function.
D: Erythromycin inhibits bacterial protein synthesis by binding to the ribosome, not DNA function.
A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?
- A. Residual urine greater than 200 mL
- B. A large, atonic bladder on urodynamic testing
- C. A voiding pattern that indicates psychogenic urinary retention
- D. Pain with bladder filling that is transiently relieved by urination
Correct Answer: D
Rationale: The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.
Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.
Which of the following viruses is most susceptible to acyclovir?: *
- A. Herpes simplex Type 1 virus
- B. Herpes simplex Type 2 virus
- C. Varicell
- D. zoster virus
Correct Answer: A
Rationale: Acyclovir is a nucleoside analog that inhibits viral DNA replication by targeting viral DNA polymerase. Herpes simplex Type 1 virus is most susceptible to acyclovir because it is a DNA virus that requires viral DNA polymerase for replication. The drug is selectively activated by viral thymidine kinase in infected cells, leading to its antiviral activity. Herpes simplex Type 2, Varicella zoster, and other viruses do not possess the same susceptibility to acyclovir due to differences in their replication mechanisms.