Nokea
A 70 year old man has severe urinary hesitancy associated with bPH. He has * tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
- A. Leuprolide
- B. Finasteride
- C. Flutamide
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride inhibits 5-alpha reductase, reducing conversion of testosterone to dihydrotestosterone (DHT) in the prostate. This helps shrink the prostate gland, relieving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used for prostate cancer. Flutamide (C) is an antiandrogen for prostate cancer. Ketoconazole (D) is an antifungal, not for BPH. Finasteride is the most appropriate choice for this patient based on mechanism of action and indication.
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The following drug may cure typhoid fever, but does not prevent development of carrier state:
- A. Ceftriaxone
- B. Ciprofloxacin
- C. Cotrimoxazole
- D. Chloramphenicol
Correct Answer: D
Rationale: Step-by-step rationale:
1. Chloramphenicol is effective in curing typhoid fever by targeting the bacteria causing the infection.
2. However, chloramphenicol does not effectively eradicate the bacteria from the carrier state.
3. Ceftriaxone, ciprofloxacin, and cotrimoxazole are also effective in treating typhoid fever but do not specifically target the carrier state.
4. Therefore, the correct answer is D, Chloramphenicol, as it cures typhoid fever but does not prevent the carrier state.
A married couple has come to the clinic seeking advice on pregnancy. They have been trying to conceive for 4 months and have not been successful. What should the nurse do first?
- A. Ascertain whether either of them has been using broad-spectrum antibiotics.
- B. Explain that couples are considered infertile after 1 year of unprotected intercourse.
- C. Immediately refer the woman to an expert in pelvic inflammatory disease – the most common cause of infertility.
- D. Explain that couples are considered infertile after 3 months of engaging in unprotected intercourse and that they will need a referral to a fertility expert.
Correct Answer: B
Rationale: The correct answer is B because it aligns with standard medical guidelines. Couples are typically considered infertile after 1 year of trying to conceive without success. This timeframe allows for natural variations in fertility and is when medical intervention is usually recommended.
A: Ascertain antibiotic use is not the first step as it may not be directly related to infertility.
C: Referring to pelvic inflammatory disease assumes a diagnosis without proper evaluation.
D: Incorrect timeline of 3 months and immediate referral to a fertility expert is premature without giving time for natural conception.
A 40-year-old woman is experiencing heavy menstrual bleeding and frequent urination. The nurse suspects fibroids. Which of the following would the nurse expect to find during the pelvic examination?
- A. A smooth, enlarged uterus.
- B. A large, irregular, and tender uterus.
- C. A firm, mobile, and non-tender uterus.
- D. A hard, irregular, fixed uterus.
Correct Answer: B
Rationale: The correct answer is B: A large, irregular, and tender uterus. Fibroids are non-cancerous growths that can cause heavy menstrual bleeding and frequent urination. During the pelvic examination, the nurse would expect to find a large uterus due to the presence of fibroids. The irregular shape is indicative of the growths, and tenderness may be present due to inflammation or pressure on surrounding tissues. Choices A, C, and D do not align with the typical characteristics of fibroids, making them incorrect. A smooth, enlarged uterus (A) is not characteristic of fibroids. A firm, mobile, and non-tender uterus (C) is more indicative of a normal uterus. A hard, irregular, fixed uterus (D) may suggest a different pathology, such as endometriosis.
A patient has very high plasma uric acid and has high risk of developing acute * uric acid nephropathy. Which of the following agent should be avoided?
- A. Ethacrynic acid
- B. Acetazolamide
- C. Hydrochlorothiazide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that can worsen hyperuricemia by increasing renal uric acid reabsorption. This can further exacerbate the risk of acute uric acid nephropathy. Ethacrynic acid (A), Hydrochlorothiazide (C), and Furosemide (D) are loop diuretics that can actually help in reducing uric acid levels by increasing its excretion through the urine. Therefore, they would not be contraindicated in this scenario.
Which statement concerning the testes is true?
- A. The lymphatic vessels of the testes drain into the abdominal lymph nodes.
- B. The vas deferens is located along the inferior portion of each testis.
- C. The right testis is lower than the left because the right spermatic cord is longer.
- D. The cremaster muscle contracts in response to cold and draws the testicles closer to the body.
Correct Answer: D
Rationale: The correct answer is D: The cremaster muscle contracts in response to cold and draws the testicles closer to the body. This is true because the cremaster muscle is responsible for regulating the position of the testicles in response to temperature changes to maintain optimal conditions for sperm production. The other choices are incorrect because: A: The lymphatic vessels of the testes drain into the para-aortic lymph nodes, not the abdominal lymph nodes. B: The vas deferens is a duct that carries sperm from the testes to the urethra, not located along the inferior portion of each testis. C: The difference in height between the testes is due to differences in the descent of the testes during fetal development, not the length of the spermatic cord.