Nokea
A 55 year old man with kidney stones has been placed on a diuretic to * decrease calcium excretion. However after a few weeks , he develops an attack of gout. Which diuretic is he taking?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Triamterene
Correct Answer: C
Rationale: The correct answer is C: Hydrochlorothiazide. Hydrochlorothiazide is a thiazide diuretic that can lead to hyperuricemia, a risk factor for gout. Thiazide diuretics decrease the excretion of uric acid, leading to its accumulation and potential for gout attacks. Furosemide (A) is a loop diuretic that does not have a significant impact on uric acid levels. Spironolactone (B) and Triamterene (D) are potassium-sparing diuretics and do not directly affect uric acid levels. So, Hydrochlorothiazide is the most likely diuretic causing the gout attack in this case.
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Furosemide acts by inhibiting the following in the renal tubular cell: *
- A. Na +K + ATPase
- B. Na +/Cl - transporter
- C. Na +K +/ 2Cl - transporter
- D. Na +H + antiporter
Correct Answer: C
Rationale: Furosemide inhibits the Na+K+/2Cl- transporter in the renal tubular cell. This transporter is responsible for reabsorbing sodium, potassium, and chloride ions from the urine back into the bloodstream. By inhibiting this transporter, furosemide prevents the reabsorption of these ions, leading to increased excretion of water and electrolytes, thereby promoting diuresis. Na+K+ ATPase (A) is not the target of furosemide. Na+/Cl- transporter (B) is not the primary mechanism of action for furosemide. Na+H+ antiporter (D) is not the target of furosemide in the renal tubular cell.
A 40 year old man is HIV positive with CD4 count of 200/ cu.mm . After 2 months of therapy, he develops a peripheral WBC count of 1000 and hemoglobin of 9. Which of the following drugs most likely cause d this hematologic abnormality?
- A. Zidovudine
- B. Acyclovir
- C. Foscarnet
- D. Amantadine
Correct Answer: A
Rationale: The correct answer is A: Zidovudine. Zidovudine is known to cause bone marrow suppression, leading to decreased white blood cell and red blood cell counts. In this case, the patient's peripheral WBC count of 1000 and low hemoglobin after starting therapy are indicative of hematologic abnormalities consistent with zidovudine use. Acyclovir, Foscarnet, and Amantadine do not typically cause bone marrow suppression and are not associated with the hematologic abnormalities seen in this patient.
In which segment of the nephron is glucose reabsorbed?
- A. Loop of henle
- B. Collecting duct
- C. Distal convoluted tubule
- D. Proximal convoluted tubule
Correct Answer: D
Rationale: The correct answer is D: Proximal convoluted tubule. Glucose reabsorption primarily occurs in the proximal convoluted tubule due to the presence of specialized glucose transporters. Step-by-step rationale: 1. Glucose is filtered in the glomerulus and enters the renal tubules. 2. In the proximal convoluted tubule, glucose is reabsorbed through sodium-glucose cotransporters (SGLT) and facilitated diffusion via glucose transporters (GLUT). 3. The loop of Henle is primarily responsible for water and electrolyte reabsorption, not glucose. 4. The collecting duct mainly concentrates urine by reabsorbing water and electrolytes, not glucose. 5. The distal convoluted tubule is involved in fine-tuning electrolyte balance and regulating acid-base balance, not glucose reabsorption.
During an examination, the nurse observes a female patient's vestibule and expects to see the:
- A. Urethral meatus and vaginal orifice.
- B. Vaginal orifice and vestibular (Bartholin) glands.
- C. Urethral meatus and paraurethral (Skene) glands.
- D. Paraurethral (Skene) and vestibular (Bartholin) glands.
Correct Answer: A
Rationale: The correct answer is A: Urethral meatus and vaginal orifice. The vestibule is the area between the labia minora where the urethral meatus and vaginal orifice are located. This is important for the nurse to observe during an examination to assess the patient's genital health.
Choice B is incorrect because the vestibular (Bartholin) glands are not typically visible in the vestibule during an examination. Choice C is incorrect because the paraurethral (Skene) glands are not typically visible in the vestibule either. Choice D is incorrect because it combines the paraurethral (Skene) and vestibular (Bartholin) glands, which are not typically visible in the vestibule during examination.
The nurse is caring for a patient who is going to have to an older adult?
- A. If possible, try to drink at least 4 liters of fluid daily.
- B. Ensure that you avoid replacing water with other procedure? beverages.
- C. Discuss the patients diagnosis with the family.
- D. Remember to drink frequently, even if you dont feel
Correct Answer: D
Rationale: The correct answer is D because older adults are at higher risk for dehydration due to decreased thirst sensation. Reminding the patient to drink frequently, even if they don't feel thirsty, helps prevent dehydration. A: Drinking 4 liters of fluid daily may not be suitable for all older adults and can lead to water intoxication. B: Avoiding replacing water with other beverages is important, but it is not the most critical aspect of hydration in older adults. C: Discussing the patient's diagnosis with the family is unrelated to the immediate need for hydration in this scenario.