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A 35 year old man presents to the ER with severe headache. After lab workup, patient is diagnosed to have increased intracranial pressure. Which diuretic would work best to reduce this pressure?
- A. Hydrochlorothiazide
- B. Mannitol
- C. Acetazolamide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Mannitol. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and reducing intracranial pressure. It is commonly used in cases of increased intracranial pressure due to its ability to easily cross the blood-brain barrier and reduce cerebral edema. Hydrochlorothiazide (A) is a thiazide diuretic mainly used for hypertension and not effective for this condition. Acetazolamide (C) is a carbonic anhydrase inhibitor that can reduce CSF production but is not as effective as mannitol for rapid reduction of intracranial pressure. Furosemide (D) is a loop diuretic that primarily acts on the kidneys and is not as effective as mannitol for reducing intracranial pressure.
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The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?
- A. “A good time to examine your testicles is just before you take a shower.â€
- B. “If you notice an enlarged testicle or a painless lump, call your health care provider.â€
- C. “The testicle is egg shaped and movable. It feels firm and has a lumpy consistency.â€
- D. “Perform a testicular examination at least once a week to detect the early stages of testicular cancer.â€
Correct Answer: B
Rationale: The correct answer is B because it emphasizes the importance of seeking medical advice if any abnormalities are detected during the self-examination. This statement encourages prompt action and follow-up with a healthcare provider, which is crucial for early detection and treatment of testicular cancer.
Incorrect options:
A: Timing of the examination is not as critical as the action to take if abnormalities are found.
C: Describing the testicle's shape and texture is not the primary focus of a testicular self-examination.
D: Performing the examination once a week is excessive and not recommended by medical guidelines.
A patient has low cardiac output due to poor cardiac function. He is eclematous. Which one of the following should be avoided because it can aggravate cardiac dysfunctions?
- A. Furosemide
- B. Spironolactone
- C. Mannitol
- D. Hydrochlorothiazide
Correct Answer: C
Rationale: The correct answer is C: Mannitol. Mannitol is an osmotic diuretic that can worsen heart failure by increasing plasma volume and exacerbating the workload on the heart. Furosemide (A) and Hydrochlorothiazide (D) are loop and thiazide diuretics, respectively, commonly used to manage fluid overload in heart failure patients. Spironolactone (B) is a potassium-sparing diuretic that can be beneficial in heart failure by counteracting potassium loss caused by other diuretics.
Clavulanic acid is combined with amoxicillin because: *
- A. It inhibits beta lactamases that destroy amoxicillin
- B. It prevents renal excretion of amoxicillin
- C. It destroy bacteria that are not destroyed by amoxicillin
- D. It counteracts the adverse effects of amoxicillin
Correct Answer: A
Rationale: The correct answer is A because clavulanic acid acts as a beta-lactamase inhibitor, protecting amoxicillin from being destroyed by beta-lactamase enzymes produced by bacteria. This allows amoxicillin to effectively kill the bacteria. Choices B, C, and D are incorrect because clavulanic acid does not prevent renal excretion of amoxicillin, destroy bacteria directly, or counteract adverse effects of amoxicillin. The primary purpose of combining clavulanic acid with amoxicillin is to enhance amoxicillin's effectiveness by preventing its degradation by bacterial enzymes.
Number the following physiologic occurrences in the order they occur in the formation of urine.
- A. Blood is filtered in the glomerulus.
- B. Reabsorption of water in the loop of Henle.
- C. Reabsorption of electrolytes, glucose, amino acids, and small proteins in the tubules.
- D. Acid-base regulation with conservation of bicarbonate (HCO–) and secretion of excess H+ in the distal tubule.
Correct Answer: A
Rationale: Rationale: The correct order of physiologic occurrences in urine formation is as follows: A) Blood is filtered in the glomerulus. This is the initial step where blood enters the nephron for filtration. The other choices are incorrect because B) Reabsorption of water in the loop of Henle occurs after filtration, C) Reabsorption of electrolytes, glucose, amino acids, and small proteins in the tubules happens after the initial filtration, and D) Acid-base regulation in the distal tubule occurs after other processes such as reabsorption and secretion have taken place.
How is an intravenous pyelogram performed?
- A. By palpating the suprapubic area.
- B. By percussing the area over the bladder.
- C. By injecting a contrast dye into the vein.
- D. By using a stethoscope to listen for abnormal sounds.
Correct Answer: C
Rationale: The correct answer is C because an intravenous pyelogram (IVP) is performed by injecting a contrast dye into the vein. This dye travels through the bloodstream, highlighting the kidneys, ureters, and bladder on X-ray images. Palpating the suprapubic area (A) involves feeling for the bladder, but it is not part of an IVP procedure. Percussing the area over the bladder (B) involves tapping to assess for fluid or air, which is not relevant to an IVP. Using a stethoscope to listen for abnormal sounds (D) is not related to the process of an IVP.