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A 35-year-old woman is at the clinic for a gynecologic examination. During the examination, she asks the nurse, 'How often do I need to have this Pap test done?' Which reply by the nurse is correct?
- A. It depends. Do you smoke?
- B. A Pap test needs to be performed annually until you are 65 years of age.
- C. If you have two consecutive normal Pap tests, then you can wait 5 years between tests.
- D. After age 30 years, if you have three consecutive normal Pap tests, then you may be screened every 2 to 3 years.
Correct Answer: D
Rationale: The correct answer is D because it follows the current guidelines for cervical cancer screening. Starting at age 30, if a woman has had three consecutive normal Pap tests, she can be screened every 2 to 3 years. This is based on the evidence that the risk of cervical cancer is low in women with a history of normal Pap tests. Option A is incorrect as smoking status does not determine Pap test frequency. Option B is incorrect as annual Pap tests are no longer recommended for all women. Option C is incorrect as waiting 5 years between tests is not the standard recommendation based on guidelines.
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An outbreak of influenza A has just been reported in his community and a 45 year old man is exhibiting initial symptoms of influenza A. Which agent would be the most useful to treat him?
- A. Cidofovir
- B. Famciclovir
- C. Amantadine
- D. Ribavirin
Correct Answer: C
Rationale: The correct answer is C: Amantadine. Amantadine is an antiviral medication that is specifically effective against influenza A virus. It works by blocking the viral ion channel, preventing the virus from entering the host cell. This inhibits viral replication and helps reduce the severity and duration of symptoms.
Choice A, Cidofovir, is used to treat certain DNA viruses but is not effective against influenza A. Choice B, Famciclovir, is used to treat herpes viruses, not influenza A. Choice D, Ribavirin, is an antiviral medication used for respiratory syncytial virus and hepatitis C, but not as effective against influenza A. Therefore, the most appropriate choice in this scenario is Amantadine due to its specific activity against influenza A virus.
A 28-year-old woman presents to the clinic with complaints of pelvic pain, urinary urgency, and dysuria. The nurse suspects interstitial cystitis. Which of the following is a common symptom of interstitial cystitis?
- A. Severe abdominal cramping.
- B. Painful urination and frequent bladder infections.
- C. Frequent urination and pelvic pressure.
- D. Dysuria and urinary retention.
Correct Answer: B
Rationale: The correct answer is B: Painful urination and frequent bladder infections. Interstitial cystitis is characterized by chronic bladder inflammation causing pain and discomfort during urination. This leads to painful urination and an increased risk of developing frequent bladder infections due to the compromised bladder lining. Severe abdominal cramping (A) is not a common symptom of interstitial cystitis. Frequent urination and pelvic pressure (C) are also common symptoms but not specific to interstitial cystitis. Dysuria and urinary retention (D) are not typically associated with interstitial cystitis.
One of your patients is awaiting laboratory results for kidney function. The patient has recently recovered from a streptococcal throat infection. The patient has most likely developed symptoms of:
- A. Pyelonephritis.
- B. Nephrolithiasis.
- C. Chronic renal failure.
- D. Glomerulonephritis.
Correct Answer: D
Rationale: The correct answer is D: Glomerulonephritis. Streptococcal infection can lead to poststreptococcal glomerulonephritis (PSGN), an immune-mediated inflammation of the glomeruli in the kidneys. This results in hematuria, proteinuria, hypertension, and edema. Pyelonephritis (choice A) is a bacterial infection of the kidneys, not related to streptococcal infection. Nephrolithiasis (choice B) is the formation of kidney stones, which is not directly linked to streptococcal infection. Chronic renal failure (choice C) is a long-term decline in kidney function, not typically caused by streptococcal infection.
The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.
The mother of an 8-year-old girl has brought her child to the clinic because she is wetting the bed at night. What terminology should the nurse use when documenting this situation?
- A. Ascites
- B. Dysuria
- C. Enuresis
- D. Urgency
Correct Answer: C
Rationale: The correct terminology for bedwetting in an 8-year-old is enuresis. Enuresis specifically refers to the involuntary discharge of urine during sleep at an age where bladder control is expected. This term is appropriate for the child's situation as it accurately describes the bedwetting issue. Ascites (A) refers to abnormal accumulation of fluid in the abdomen, not related to bedwetting. Dysuria (B) is painful urination, which is not the issue described. Urgency (D) refers to a sudden compelling need to urinate, which is also not relevant to this scenario. Using the correct term, enuresis, will ensure accurate documentation and communication regarding the child's bedwetting issue.