Nokea
A function of the kidney is to
- A. produce angiotensin
- B. remove microorganisms from the blood
- C. remove aged blood from the blood
- D. regulate blood ionic composition
Correct Answer: D
Rationale: The correct answer is D: regulate blood ionic composition. The kidneys help maintain the body's electrolyte balance by regulating the levels of ions such as sodium, potassium, and calcium in the blood. This is crucial for proper nerve and muscle function, pH balance, and overall homeostasis.
Explanation for why the other choices are incorrect:
A: The production of angiotensin is primarily done by the liver and lungs, not the kidneys.
B: While the kidneys help filter out waste and toxins, they do not specifically target microorganisms in the blood.
C: Removing aged blood from the blood is not a function of the kidneys; this task is mainly carried out by the spleen and liver.
In summary, the kidney's main function is to regulate blood ionic composition to maintain overall bodily functions, making choice D the correct answer.
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In the presence of antidiuretic hormone (ADH), or vasopressin, water is mostly reabsorbed in the ___________ of the nephron.
- A. Proximal convoluted tubule
- B. Loop of henle
- C. Collecting duct
- D. Distal convoluted tubule
Correct Answer: A
Rationale: The correct answer is A: Proximal convoluted tubule. ADH acts on the collecting duct and distal convoluted tubule to increase water reabsorption. However, the majority of water reabsorption occurs in the proximal convoluted tubule due to its high permeability to water. This segment reabsorbs about 65% of filtered water, mainly through osmosis. The loop of Henle plays a crucial role in concentrating urine, but it is not the main site of water reabsorption. The collecting duct responds to ADH but reabsorbs a smaller fraction of filtered water compared to the proximal tubule. The distal convoluted tubule is primarily involved in electrolyte reabsorption rather than water reabsorption.
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.
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 with psychologic disorder is being treated with a drug. Few months he is worried that he is constantly thirsty and urinates copiously frequently throughout the day and night. Which of the following drugs most likely cause inappropriate secretion of ADH?
- A. Diazepam
- B. Lithium
- C. Haloperidol
- D. Phenytoin
Correct Answer: B
Rationale: The correct answer is B: Lithium. Lithium is known to cause nephrogenic diabetes insipidus, leading to inappropriate secretion of ADH. This results in excessive thirst and copious urination. Diazepam (A) does not affect ADH secretion. Haloperidol (C) and Phenytoin (D) are not associated with ADH dysregulation.
The drug of choice for monilial diarrhea is:
- A. Amphothericin B
- B. Nystatin
- C. Ketoconazole
- D. Itraconazole
Correct Answer: B
Rationale: Step-by-step rationale for why Nystatin is the correct choice for monilial diarrhea:
1. Nystatin is an antifungal medication specifically effective against Candida species causing monilial infections.
2. It works by binding to ergosterol in fungal cell membranes, disrupting membrane integrity and causing cell death.
3. Nystatin is not absorbed systemically, making it suitable for gastrointestinal infections.
4. Amphothericin B is reserved for severe systemic fungal infections due to its significant toxicity. Ketoconazole and Itraconazole are not typically used for gastrointestinal Candida infections, as they are more commonly used for systemic fungal infections.