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 is a 5α-reductase inhibitor that reduces the conversion of testosterone to dihydrotestosterone in the prostate, thereby shrinking the prostate gland and improving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used in prostate cancer, not BPH. Flutamide (C) is an antiandrogen used in prostate cancer. Ketoconazole (D) is an antifungal drug and not indicated for BPH.
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The examiner is going to inspect and palpate for a hernia. During this exam, the man is instructed to:
- A. Hold his breath during palpation.
- B. Cough after the examiner has gently inserted the exam finger into the rectum.
- C. Bear down when the examiner’s finger is at the inguinal canal.
- D. Relax in a supine position while the exam finger is inserted into the canal.
Correct Answer: C
Rationale: The correct answer is C: Bear down when the examiner's finger is at the inguinal canal. This action increases intra-abdominal pressure, which helps to push out any potential hernia through the inguinal canal for easier detection. Holding his breath (A) would not facilitate hernia detection. Coughing after insertion (B) is used for rectal exams, not hernia assessment. Relaxing in a supine position (D) is not helpful for hernia examination as it does not aid in hernia protrusion.
Intravenous Plain NSS infusion is the treatment of choice for the following * complications of furosemide therapy:
- A. Hypokalemia
- B. Severe dehydration
- C. Dilutional hyponatremia
- D. None of the above
Correct Answer: C
Rationale: Rationale: Intravenous Plain NSS infusion is the treatment of choice for dilutional hyponatremia, which can occur as a complication of furosemide therapy due to excessive diuresis leading to low sodium levels. This solution helps restore normal sodium levels without affecting the fluid balance.
Summary:
A: Hypokalemia - Furosemide therapy can cause hypokalemia, which is usually treated with potassium supplements, not NSS infusion.
B: Severe dehydration - NSS infusion may be used for severe dehydration but is not specific to furosemide therapy complications.
D: None of the above - Incorrect, as C is the correct answer for dilutional hyponatremia.
A 15-year-old boy is seen in the clinic for complaints of “dull pain and pulling†in the scrotal area. On examination, the nurse palpates a soft, irregular mass posterior to and above the testis on the left. This mass collapses when the patient is supine and refills when he is upright. This description is consistent with:
- A. Epididymitis.
- B. Spermatocele.
- C. Testicular torsion.
- D. Varicocele.
Correct Answer: D
Rationale: The correct answer is D: Varicocele. Varicocele is a dilatation of the pampiniform plexus of veins within the scrotum. In this case, the soft, irregular mass that collapses when the patient is supine and refills when he is upright is characteristic of a varicocele due to the pooling of blood causing the mass to vary in size with position changes.
A: Epididymitis typically presents with redness, warmth, and tenderness in the epididymis, not a soft, irregular mass.
B: Spermatocele is a cystic mass that is typically painless and does not change in size with position changes.
C: Testicular torsion presents with severe, sudden onset of testicular pain, swelling, and discoloration, not a soft, irregular mass that changes with position.
In summary, the description of a soft, irregular mass that changes with position is consistent with a varicocele,
What would the nurse first anticipate in the treatment of a patient in the Injury stage of the RIFLE staging of AKI?
- A. Assess daily weight
- B. IV administration of fluid and furosemide (Lasix)
- C. IV administration of insulin and sodium bicarbonate
- D. Urinalysis to check for sediment, osmolality, sodium, and specific gravity
Correct Answer: B
Rationale: The correct answer is B because in the Injury stage of AKI, the priority is to maintain fluid balance and prevent further kidney damage. IV fluid administration helps improve renal perfusion, while furosemide helps manage fluid overload.
A: Assessing daily weight is important but not the first priority in the Injury stage.
C: IV insulin and sodium bicarbonate are not typically indicated in the initial treatment of AKI.
D: Urinalysis is important for diagnostics but not the first intervention in the Injury stage.
Which of the following drug should be used only as clinical curative but not as prophylactic in malaria?:
- A. Pyrimethamine + sulfadoxine
- B. Proguanil
- C. Primaquine
- D. Mefloquine
Correct Answer: C
Rationale: The correct answer is C: Primaquine. Primaquine is used for clinical curative treatment of malaria, particularly for the eradication of hypnozoites in Plasmodium vivax and Plasmodium ovale infections. It is not used as a prophylactic drug due to its potential side effects, such as hemolysis in individuals with G6PD deficiency.
Choice A (Pyrimethamine + sulfadoxine) is a combination used for both treatment and prophylaxis.
Choice B (Proguanil) is used for prophylaxis and treatment.
Choice D (Mefloquine) is used for both prophylaxis and treatment of malaria.