Nokea
A patient has been using Viagra on an intermittent basis for several years. However, he has cited delays in the onset and peak of action as the occasional source of frustration. What PDE5 inhibitor may be of particular benefit to this patient's needs?
- A. Avanafil (Stendra)
- B. Tadalafil (Cialis)
- C. Vardenafil (Levitra)
- D. Alprostadil (Caverject)
Correct Answer: A
Rationale: The correct answer is Avanafil (Stendra). Avanafil has a rapid onset of action compared to other PDE5 inhibitors, making it suitable for patients experiencing delays in onset and peak of action with other medications like Viagra. Tadalafil (Cialis), Vardenafil (Levitra), and Alprostadil (Caverject) do not offer the same rapid onset of action as Avanafil, making them less suitable for addressing the specific needs of this patient.
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Which clients are at highest risk for pneumonia?
- A. Those in their 20s and 30s and generally healthy
- B. Those who exercise regularly and are not exposed to pathogens
- C. Those who are hospitalized and immunocompromised
- D. Those who have adequate respiratory function
Correct Answer: C
Rationale: Clients who are hospitalized and immunocompromised are at the highest risk for pneumonia due to their weakened immune systems. Choice A is incorrect as young and healthy individuals typically have stronger immune systems. Choice B is incorrect because regular exercise can actually boost the immune system and reduce the risk of infections. Choice D is incorrect as having adequate respiratory function does not necessarily correlate with the risk of developing pneumonia.
A child with a serious fungal infection is receiving amphotericin B parenterally. Which of the following minerals will the patient most likely be required to receive?
- A. Chloride
- B. Magnesium
- C. Glucose
- D. Sodium
Correct Answer: B
Rationale: When a patient is receiving amphotericin B, which is known to cause renal toxicity, they are most likely to require magnesium supplementation. Amphotericin B can lead to renal loss of magnesium, potassium, and calcium. Magnesium is an essential mineral that plays a vital role in various physiological functions, and its levels need to be monitored and supplemented when necessary. Chloride, glucose, and sodium are not typically supplemented in the context of amphotericin B therapy for a serious fungal infection.
What is the primary function of the kidneys in acid-base balance?
- A. The kidneys remove hydrogen ions and retain bicarbonate ions.
- B. The kidneys convert ammonia into urea, which is excreted in the urine.
- C. The kidneys produce aldosterone to regulate sodium levels.
- D. The kidneys secrete renin to regulate blood pressure.
Correct Answer: A
Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.
What causes hepatic encephalopathy?
- A. A brain infection
- B. Increased ammonia levels in the bloodstream
- C. Decreased albumin blood levels
- D. Untreated chronic bronchitis
Correct Answer: B
Rationale: Hepatic encephalopathy is caused by increased ammonia levels in the bloodstream. Ammonia, a byproduct of protein metabolism normally processed by the liver, accumulates in the bloodstream when the liver is unable to function properly. This excess ammonia affects brain function, leading to symptoms of hepatic encephalopathy. Choices A, C, and D are incorrect because they do not directly relate to the pathophysiology of hepatic encephalopathy.
What causes the appearance of a barrel chest in clients with emphysema?
- A. Peripheral edema
- B. Bacterial infections in the lungs
- C. Air trapping in the alveoli
- D. Muscle atrophy of the diaphragm
Correct Answer: C
Rationale: The correct answer is C: Air trapping in the alveoli. A barrel chest in emphysema results from the hyperinflation of the lungs due to air trapping in the alveoli. This leads to increased anteroposterior diameter of the chest. Choices A, B, and D are incorrect. Peripheral edema is swelling caused by fluid retention in tissues, not associated with a barrel chest in emphysema. Bacterial infections in the lungs can lead to conditions like pneumonia but do not directly cause a barrel chest. Muscle atrophy of the diaphragm could affect breathing mechanics but is not specifically linked to the development of a barrel chest in emphysema.