Nokea
A gerontologic nurse is assessing a patient who has
- A. The patients suprapubic region is dull on percussion. numerous comorbid health problems. What assessment
- B. The patient is uncharacteristically drowsy. findings should prompt the nurse to suspect a UTI?
- C. The patient claims to void large amounts of urine 2 to Select all that apply.
- D. Food cravings
Correct Answer: B
Rationale: The correct answer is B because uncharacteristic drowsiness can be a sign of a urinary tract infection (UTI) in older adults. UTIs can present atypically in older adults with symptoms like confusion, lethargy, and drowsiness. The other choices are incorrect because:
A: A dull suprapubic region on percussion is not specific to UTI.
C: Voiding large amounts of urine is not a typical symptom of UTI.
D: Food cravings are not associated with UTI symptoms.
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The highest incidence of antibiotic associated pseudomembranous enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with the highest incidence of antibiotic-associated pseudomembranous enterocolitis due to its broad-spectrum activity that disrupts the normal gut flora, leading to overgrowth of Clostridium difficile. Ampicillin, Chloramphenicol, and Vancomycin are also associated with pseudomembranous enterocolitis, but the highest incidence is seen with Clindamycin due to its stronger impact on gut flora imbalance.
Which of the following drugs for treatment of leprosy can cause hemolysis especially in patients with G6PD deficiency?
- A. Dapsone
- B. Rifampicin
- C. Clofazimine
- D. None of these
Correct Answer: A
Rationale: The correct answer is A: Dapsone. Dapsone is known to cause hemolysis in patients with G6PD deficiency due to oxidative stress. G6PD deficiency leads to reduced ability to protect red blood cells from oxidative damage, which can be exacerbated by drugs like dapsone. Rifampicin and clofazimine are not associated with hemolysis in G6PD deficient patients. Option D is incorrect as dapsone is known to cause hemolysis in this population.
Which of the following is true of nephrons?
- A. they are the functional units of the kidneys
- B. the proximal convoluted tubules allow the kidney to concentrate or dilute urine
- C. there are about a million nephrons in each kidney
- D. both a and c are correct
Correct Answer: D
Rationale: Step 1: Identify key characteristics of nephrons - functional units of kidneys, responsible for urine formation.
Step 2: Confirm accuracy of statements - A: Nephrons are functional units. C: About a million nephrons in each kidney.
Step 3: Combine statements - A + C = D, confirming both are correct.
Step 4: Justify choice D - correct because nephrons are indeed functional units and there are approximately a million in each kidney.
Summary: B is incorrect as the proximal convoluted tubules are not solely responsible for urine concentration/dilution. Choice D is correct as it combines the accurate statements from A and C.
Red man syndrome has been associated with rapid intravenous injection of which of the following antibiotic?
- A. Vancomycin
- B. Clindamycin
- C. Cefoperazone
- D. Piperacillin
Correct Answer: A
Rationale: The correct answer is A: Vancomycin. Red man syndrome is a type of hypersensitivity reaction associated with rapid intravenous infusion of vancomycin. This is due to the release of histamine from mast cells and basophils. Vancomycin is known to cause this syndrome, while the other antibiotics listed do not have a similar association. Clindamycin is more commonly associated with pseudomembranous colitis, Cefoperazone with liver toxicity, and Piperacillin with hypersensitivity reactions like rash or anaphylaxis. Therefore, based on the mechanism of action and clinical evidence, vancomycin is the correct choice for causing red man syndrome.
A 60-year-old woman is undergoing a pelvic examination. During the examination, the nurse finds a mass in the pelvic region that is hard, irregular, and fixed. The nurse's most appropriate course of action would be to:
- A. Monitor the mass and perform routine follow-up.
- B. Refer the patient to a gynecologist for further evaluation.
- C. Obtain a biopsy of the mass to assess for malignancy.
- D. Perform a pelvic ultrasound to assess the mass.
Correct Answer: B
Rationale: The correct answer is B: Refer the patient to a gynecologist for further evaluation. Given the characteristics of the mass (hard, irregular, fixed), it raises concerns for possible malignancy. Referring the patient to a gynecologist allows for a specialist to conduct a thorough evaluation, which may include additional imaging studies and biopsies to determine the nature of the mass. Monitoring the mass (choice A) without further evaluation may delay potential diagnosis and treatment. Obtaining a biopsy (choice C) without proper evaluation by a specialist may not be appropriate at this stage. Performing a pelvic ultrasound (choice D) can provide additional information but may not be sufficient for a definitive diagnosis of malignancy.