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A nurse is examining a 40-year-old woman for signs of ovarian cancer. She has a family history of ovarian cancer. Which statement does the nurse know to be true regarding ovarian cancer?
- A. Ovarian cancer often does not show symptoms until late stages.
- B. The Pap smear test detects the presence of ovarian cancer.
- C. Women at high risk for ovarian cancer should have an annual pelvic ultrasound.
- D. Women over the age of 50 should be screened for ovarian cancer annually.
Correct Answer: A
Rationale: The correct answer is A: Ovarian cancer often does not show symptoms until late stages. This is true because ovarian cancer is often asymptomatic in the early stages, making it difficult to detect. By the time symptoms appear, the cancer is usually at an advanced stage.
Choice B is incorrect because the Pap smear test is used to detect cervical cancer, not ovarian cancer. Choice C is incorrect because while some high-risk women may benefit from periodic ultrasound screenings, it is not recommended for all women at high risk. Choice D is incorrect because there is no specific annual screening recommendation for ovarian cancer in women over the age of 50.
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When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) ______ hernia.
- A. Femoral.
- B. Incisional.
- C. Direct inguinal.
- D. Indirect inguinal.
Correct Answer: D
Rationale: The correct answer is D: Indirect inguinal hernia. In an indirect inguinal hernia, the swelling in the scrotum increases with increased intra-abdominal pressure due to the herniation of abdominal contents through the internal inguinal ring. The swelling decreases when lying down because the contents reduce back into the abdominal cavity. Pain with straining is also characteristic of an indirect inguinal hernia.
A: Femoral hernia presents as a bulge in the upper thigh and is more common in females.
B: Incisional hernia occurs at the site of a previous surgical incision and is not typically affected by intra-abdominal pressure.
C: Direct inguinal hernia protrudes directly through the abdominal wall and is typically not palpable in the scrotum.
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 a high incidence of antibiotic-associated pseudomembranous enterocolitis due to its strong impact on disrupting the normal gut flora, leading to overgrowth of Clostridium difficile. This bacterium can produce toxins causing inflammation and pseudomembrane formation in the colon. Ampicillin (A) can also cause C. difficile infection, but clindamycin is more strongly associated. Chloramphenicol (B) and vancomycin (C) are less commonly associated with pseudomembranous enterocolitis compared to clindamycin.
A woman who is 8 weeks pregnant is in the clinic for a checkup. The nurse reads on her chart that her cervix is softened and looks cyanotic. The nurse knows that the woman is exhibiting ________ sign and ________ sign.
- A. Tanner; Hegar
- B. Hegar; Goodell
- C. Chadwick; Hegar
- D. Goodell; Chadwick
Correct Answer: D
Rationale: The correct answer is D: Goodell; Chadwick. Goodell's sign refers to cervical softening, which is a common sign of pregnancy at 8 weeks. Chadwick's sign refers to the bluish discoloration of the cervix due to increased blood flow, also commonly seen at this stage. Tanner and Hegar signs are not relevant to the described scenario. Tanner's sign is related to breast development and Hegar's sign is related to softening of the isthmus of the uterus, not the cervix. Therefore, choices A, B, and C are incorrect.
Which of the following cephalosporins has in vitro activity against anaerobic gram negative bacteria such as Bacteroides fragilis?
- A. Cefdinir
- B. Cefuroxime
- C. Cefazolin
- D. Cefepime
Correct Answer: B
Rationale: The correct answer is B: Cefuroxime. Cefuroxime is a second-generation cephalosporin that has demonstrated in vitro activity against anaerobic gram-negative bacteria like Bacteroides fragilis. This is due to its broader spectrum of activity compared to other choices.
A: Cefdinir is a third-generation cephalosporin with limited activity against anaerobic gram-negative bacteria.
C: Cefazolin is a first-generation cephalosporin primarily effective against aerobic gram-positive bacteria.
D: Cefepime is a fourth-generation cephalosporin with limited activity against anaerobic gram-negative bacteria.
Which of the following drugs valuable in the treatment of edema and metabolic alkalosis?
- A. Digoxin
- B. Spironolactone
- C. Dobutamine
- D. Acetazolamide
Correct Answer: D
Rationale: The correct answer is D: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that helps in the treatment of edema and metabolic alkalosis by promoting diuresis and increasing renal excretion of bicarbonate. It is effective in treating conditions associated with fluid retention and alkalosis.
A: Digoxin is a cardiac glycoside used to treat heart conditions like heart failure and atrial fibrillation, not edema or metabolic alkalosis.
B: Spironolactone is a potassium-sparing diuretic commonly used for conditions like hypertension and heart failure, but not specifically for metabolic alkalosis.
C: Dobutamine is a beta-adrenergic agonist used in acute heart failure or shock situations, not for edema or alkalosis.
In summary, Acetazolamide is the correct choice as it directly targets edema and metabolic alkalosis by affecting renal excretion of bicarbonate. Other options are