Nokea
A geriatric nurse is performing an assessment of body patient whose renal function is progressively declining. systems on an 85-year-old patient. The nurse should be
- A. related change affecting the renal or following situations? urinary system?
- B. When the patients creatinine level drops below 1.2
- C. Increased ability to concentrate urine
- D. Increased bladder capacity
Correct Answer: A
Rationale: The correct answer is A because as renal function declines in an elderly patient, there will be related changes affecting the urinary system. This is important for the nurse to assess to monitor the patient's renal health and intervene as necessary. Choice B is incorrect because a decrease in creatinine level is not a typical indicator of declining renal function. Choice C is incorrect because with declining renal function, the ability to concentrate urine actually decreases. Choice D is incorrect because increased bladder capacity is not a direct result of declining renal function.
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The following topical antifungal drugs include all EXCEPT:
- A. Tolnaftate
- B. Crotamiton
- C. Terbinafine
- D. Ciclopirox
Correct Answer: B
Rationale: The correct answer is B: Crotamiton. Crotamiton is not a topical antifungal drug; it is a scabicidal and antipruritic agent used to treat scabies and itching. Tolnaftate (A), Terbinafine (C), and Ciclopirox (D) are all topical antifungal drugs used to treat various fungal skin infections. Tolnaftate is commonly used for athlete's foot, ringworm, and jock itch. Terbinafine is effective against fungal infections like athlete's foot and ringworm. Ciclopirox is used to treat fungal infections like athlete's foot and ringworm as well.
Your patient does not seem to be responding to conservative treatment for acute renal failure, and dialysis is being considered. You understand that the main indication for dialysis is
- A. generalized edema
- B. elevated blood pressure
- C. elevated blood calcium
- D. a high and rising level of potassium
Correct Answer: D
Rationale: The correct answer is D: a high and rising level of potassium. Dialysis is indicated in acute renal failure when the patient has severe electrolyte imbalances, especially hyperkalemia, which can lead to life-threatening arrhythmias. Potassium levels must be closely monitored, and if they are high and continue to rise despite conservative treatment, dialysis is necessary to quickly lower the potassium levels. Generalized edema (A) is a symptom of renal failure but is not the main indication for dialysis. Elevated blood pressure (B) and elevated blood calcium (C) are not direct indications for dialysis in the context of acute renal failure.
On assessment of the patient with a renal calculus passing down the ureter, what should the nurse expect the patient to report?
- A. A history of chronic UTIs
- B. Dull, costovertebral flank pain
- C. Severe, colicky back pain radiating to the groin
- D. A feeling of bladder fullness with urgency and frequency
Correct Answer: C
Rationale: The correct answer is C: Severe, colicky back pain radiating to the groin. This type of pain is characteristic of renal colic caused by a renal calculus passing down the ureter. The sharp, severe pain originates in the flank and radiates to the groin as the stone moves. Choices A and D are incorrect because they do not describe the typical pain associated with renal colic. Choice B describes dull, costovertebral flank pain, which is not characteristic of the sharp, severe colicky pain seen in renal colic. Therefore, option C is the most appropriate response based on the typical presentation of a patient with a renal calculus passing down the ureter.
The drug of choice for treatment and secondary prophylaxis against cryptococcal meningitis among AIDS patients is:
- A. Amphotericin B
- B. Flucytosine
- C. Fluconazole
- D. Ketoconazole
Correct Answer: C
Rationale: Step-by-step rationale:
1. Fluconazole is preferred due to its efficacy, safety, and tolerability in Cryptococcal meningitis.
2. It has better CNS penetration compared to other azoles.
3. It is less toxic than Amphotericin B and Flucytosine.
4. Ketoconazole is less effective and not recommended for this indication.
Summary:
- A: Amphotericin B is reserved for severe cases due to its toxicity.
- B: Flucytosine is used in combination therapy but not as the primary drug of choice.
- D: Ketoconazole is less effective and not preferred for Cryptococcal meningitis in AIDS patients.
Which statement best describes Zidovudine:
- A. Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection
- B. Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia
- C. Peripheral neuropathy is a specific adverse reaction to Zidovudine
- D. Zidovudine is converted by cellular enzymes to an active form
Correct Answer: zidovudine diphosphate
Rationale: The correct answer is D: Zidovudine is converted by cellular enzymes to an active form (zidovudine diphosphate). Zidovudine itself is a prodrug that needs to be metabolized by cellular enzymes to its active form, zidovudine diphosphate, which inhibits HIV replication by acting as a nucleoside reverse transcriptase inhibitor. This active form is essential for its antiretroviral activity.
Incorrect Choices:
A: Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection - This is incorrect because zidovudine is commonly used in combination with other antiretrovirals as a first-line treatment for HIV infection, not as an alternative treatment.
B: Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia - This is incorrect because zidovudine is primarily used in