Nokea
A 59-year-old patient has been diagnosed with prostatitis and is being seen at the clinic for complaints of burning and pain during urination. He is experiencing:
- A. Dysuri
- C. Nocturi
Correct Answer: A
Rationale: The correct answer is A: Dysuria. Dysuria refers to painful or difficult urination, which is a common symptom of prostatitis due to inflammation of the prostate gland. The patient's complaint of burning and pain during urination aligns with the definition of dysuria.
B: This choice is incomplete and does not provide any relevant information related to the patient's symptoms.
C: Nocturia is the increased need to urinate at night and is not directly related to the patient's complaint of burning and pain during urination.
D: This choice is also incomplete and does not address the patient's specific symptoms of prostatitis.
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The main reason for the use of combination therapy in the drug treatment of Tuberculosis is:
- A. Reduce the incidence of side effects
- B. Delay or prevent the emergence of resistance
- C. Synergistically increase antimycobacterial activity
- D. Provide prophylaxis against other bacterial infections
Correct Answer: B
Rationale: The main reason for using combination therapy in TB treatment is to delay or prevent the emergence of resistance. Step 1: TB is caused by Mycobacterium tuberculosis, which has a high mutation rate leading to drug resistance. Step 2: With combination therapy, multiple drugs target different aspects of the bacteria's lifecycle, making it harder for resistance to develop. Step 3: This approach ensures that if one drug becomes ineffective due to resistance, others can still be effective. Summary: Choice B is correct as it directly addresses the issue of resistance, which is a critical concern in TB treatment. Choices A, C, and D are incorrect because reducing side effects, increasing antimycobacterial activity, and providing prophylaxis against other bacterial infections are not the primary reasons for using combination therapy in TB.
When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurse’s most appropriate action or response is to:
- A. Ask the patient if he would like someone else to examine him.
- B. Continue with the examination as though nothing has happened.
- C. Stop the examination, leave the room while stating that the examination will resume at a later time.
- D. Reassure the patient that this is a normal response and continue with the examination.
Correct Answer: D
Rationale: The correct answer is D. This is the most appropriate action because it acknowledges the patient's normal physiological response and reassures him. It helps maintain professionalism and respect for the patient's dignity. Choice A could potentially embarrass the patient further. Choice B may ignore the patient's discomfort. Choice C abruptly halts the examination without addressing the situation. Overall, choice D is the most respectful and professional response in this scenario.
A patient calls the clinic for instructions before having a Papanicolaou (Pap) smear. The most appropriate instructions from the nurse are:
- A. If you are menstruating, please use pads to avoid placing anything into the vagina.
- B. Avoid intercourse, inserting anything into the vagina, or douching within 24 hours of your appointment.
- C. If you suspect that you have a vaginal infection, please gather a sample of the discharge to bring with you.
- D. We would like you to use a mild saline douche before your examination. You may pick this up in our office.
Correct Answer: B
Rationale: The correct answer is B because avoiding intercourse, inserting anything into the vagina, or douching within 24 hours of the appointment helps ensure an accurate Pap smear result. Intercourse, vaginal products, and douching can introduce foreign substances or disrupt the natural vaginal flora, potentially affecting the test results. Option A is incorrect because using pads during menstruation is a general recommendation and not specific to a Pap smear appointment. Option C is incorrect because bringing a sample of discharge is not necessary for a Pap smear. Option D is incorrect because douching is not recommended before a Pap smear as it can alter the vaginal environment.
Which of the following fungicidal drug that acts by inhibiting fungal squalene epoxidase enzyme and is the drug of choice for onychomycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinafine
- C. Itraconazole
- D. Amphotericin B
Correct Answer: B
Rationale: Step 1: Terbinafine is a fungicidal drug that inhibits fungal squalene epoxidase enzyme, disrupting fungal cell membrane synthesis.
Step 2: Onychomycosis of toenails is a common fungal infection that terbinafine is specifically effective against.
Step 3: The patient being a 56-year-old woman with diabetes may require a drug with good efficacy and safety profile, making terbinafine an appropriate choice.
Step 4: Griseofulvin (A) works by disrupting microtubule function, not inhibiting squalene epoxidase. Itraconazole (C) is an azole antifungal that inhibits ergosterol synthesis, not squalene epoxidase. Amphotericin B (D) is a polyene antifungal used for systemic mycoses, not onychomycosis.
The staff educator is giving a class for a group of biopsy 12 hours ago. The presence of what assessment nurses new to the renal unit. The educator is discussing finding should prompt the nurse to notify the physician?
- A. Scant hematuria
- B. Renal colic
- C. A 64-year-old patient with chronic glomerulonephritis
- D. Temperature 100.2F orally
Correct Answer: B
Rationale: Step 1: Renal colic is a symptom of possible kidney stones or obstruction, which can lead to severe pain and require immediate medical attention.
Step 2: Scant hematuria may be common after a biopsy and does not necessarily indicate an urgent issue.
Step 3: Chronic glomerulonephritis in a 64-year-old patient is a chronic condition that may not require immediate physician notification.
Step 4: A temperature of 100.2F orally is slightly elevated but not a critical finding that would warrant immediate physician notification.
Summary:
Renal colic is the correct answer as it indicates a potential urgent issue requiring immediate physician notification. Scant hematuria, chronic glomerulonephritis, and a slightly elevated temperature are not as concerning in this context.