Nokea
A 35 year old man heroin addict on methadone maintenance therapy for the last one year, is positive for TB on Chest x-ray. He was started on standard quadri anti-TB drug. He is rushed to ER complaining of withdrawal symptoms. Which of the following anti-TB drugs is likely to cause this patient’s withdrawal reaction?
- A. Streptomycin
- B. Rifampicin
- C. INH
- D. Pyrazinamide
Correct Answer: B
Rationale: The correct answer is B: Rifampicin. Rifampicin is known to induce cytochrome P450 enzymes, leading to increased metabolism of methadone and subsequently causing withdrawal symptoms in methadone-maintained patients. Streptomycin (A) is an aminoglycoside antibiotic used in TB treatment but does not interact with methadone. INH (C) and Pyrazinamide (D) do not have significant interactions with methadone metabolism. Therefore, Rifampicin is the likely cause of this patient's withdrawal symptoms.
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What is the upper expanded region of the ureter called?
- A. Renal pelvis
- B. Renal papilla
- C. Renal pyramids
- D. Renal cortex
Correct Answer: A
Rationale: The correct answer is A: Renal pelvis. The upper expanded region of the ureter is called the renal pelvis, which is where the major calyces converge to collect urine before it travels down the ureter. The other choices are incorrect: B) Renal papilla is the tip of the renal pyramid where urine is collected before entering the minor calyx, C) Renal pyramids are the conical structures in the renal medulla that contain the nephrons, and D) Renal cortex is the outer region of the kidney where the nephrons are located.
Dipstick testing of an older adult patients urine indicates the presence of protein. Which of the following statements is true of this assessment finding?
- A. This finding needs to be considered in light of other forms of testing.
- B. This finding is a risk factor for urinary incontinenc
- D. This finding is likely the result of an ag
Correct Answer: A
Rationale: Rationale:
1. Protein in urine can indicate renal issues, so further testing like urine protein/creatinine ratio is needed.
2. Proteinuria doesn't directly relate to urinary incontinence.
3. The finding is not related to age or gender, ruling out options B and D.
4. Option A is correct as it emphasizes the need for additional testing to confirm the presence and significance of protein in urine.
Glomerular filtrate is produced as a result of
- A. tubule secretion
- B. facilitated diffusion
- C. blood colloid osmotic pressure
- D. blood hydrostatic pressure
Correct Answer: D
Rationale: The correct answer is D: blood hydrostatic pressure. Glomerular filtrate is produced as a result of the pressure exerted by the blood in the glomerular capillaries forcing water and small solutes into the Bowman's capsule. This pressure, known as blood hydrostatic pressure, is the driving force for the initial filtration of blood in the kidneys.
Rationale:
1. A: Tubule secretion is the process by which substances are actively transported from the blood into the renal tubules, not the initial production of glomerular filtrate.
2. B: Facilitated diffusion is a passive transport process that requires specific carrier proteins, not a mechanism for producing glomerular filtrate.
3. C: Blood colloid osmotic pressure is the pressure exerted by proteins in the blood that tends to pull water back into the capillaries, opposing filtration, not causing the production of glomerular filtrate.
A patient has had three pregnancies and two live births. The nurse would record this information as gravida _____, para _____, AB _____
- A. 2; 2; 1
- B. 3; 2; 0
- C. 3; 2; 1
- D. 3; 3; 1
Correct Answer: C
Rationale: The correct answer is C: 3; 2; 1. Gravida refers to the total number of pregnancies, including the current one. As the patient has had three pregnancies, the gravida is 3. Para indicates the number of live births, so since the patient has had two live births, the para is 2. AB represents the number of abortions or miscarriages, which is 1 in this case. Therefore, the correct way to record this patient's obstetric history is gravida 3, para 2, AB 1.
Choice A (2; 2; 1) is incorrect because the patient has had three pregnancies, not two. Choice B (3; 2; 0) is incorrect as it does not account for the abortion/miscarriage that occurred. Choice D (3; 3; 1) is also incorrect because the patient has had two live births, not three.
Cloxacillin is indicated in infections caused by the following organism(s):
- A. Staphylococci
- B. Streptococci
- C. Gonococci
- D. All of the above
Correct Answer: A
Rationale: Cloxacillin is a beta-lactam antibiotic effective against Staphylococci. Staphylococci commonly cause skin and soft tissue infections. Streptococci are not typically treated with cloxacillin. Gonococci are not susceptible to cloxacillin. Therefore, the correct answer is A, as it is the only organism listed that is indicated for treatment with cloxacillin.