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A patient is being treated with furosemide and Digoxin because of CHF. She developed UTI. Which of the following antibiotics should NOT be prescribed?
- A. Cotrimoxazole
- B. Ciprofloxacin
- C. Gentamycin
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is known to have potential nephrotoxicity, which can exacerbate renal dysfunction caused by furosemide. It should be avoided in patients with CHF and UTI. Cotrimoxazole (A) can be used with caution, Ciprofloxacin (B) is generally safe, and Ampicillin (D) is a suitable choice for UTI treatment in this scenario.
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The nurse is reviewing the changes that occur with menopause. Which changes are associated with menopause?
- A. Uterine and ovarian atrophy, along with a thinning of the vaginal epithelium
- B. Ovarian atrophy, increased vaginal secretions, and increasing clitoral size
- C. Cervical hypertrophy, ovarian atrophy, and increased acidity of vaginal secretions
- D. Vaginal mucosa fragility, increased acidity of vaginal secretions, and uterine hypertrophy
Correct Answer: A
Rationale: Rationale: Answer A is correct because during menopause, there is uterine and ovarian atrophy due to decreased estrogen levels, leading to a thinning of the vaginal epithelium. This is a common physiological change associated with menopause.
Summary of other choices:
B: Incorrect - Increased vaginal secretions and clitoral size do not typically occur with menopause.
C: Incorrect - Cervical hypertrophy and increased acidity of vaginal secretions are not common changes seen with menopause.
D: Incorrect - Vaginal mucosa fragility and uterine hypertrophy are not typical changes associated with menopause.
A 45-year-old woman is seeking advice on contraception. She is considering using an intrauterine device (IUD). The nurse should inform her that the IUD is effective for:
- A. 5 to 10 years.
- B. 1 to 2 years.
- C. 3 to 5 years.
- D. Indefinitely.
Correct Answer: A
Rationale: The correct answer is A: 5 to 10 years. IUDs are long-acting reversible contraceptives effective for 5 to 10 years depending on the type. Hormonal IUDs last around 5 years, while copper IUDs can last up to 10 years. This extended duration provides reliable contraception for an extended period with minimal user intervention.
Choice B: 1 to 2 years is incorrect because IUDs have a longer duration of effectiveness.
Choice C: 3 to 5 years is incorrect as it falls short of the typical duration of effectiveness for most IUD types.
Choice D: Indefinitely is incorrect as IUDs do have a maximum effective period, after which they need to be removed or replaced.
The nurse is inspecting the scrotum and testes of a 43-year-old man. Which finding would require additional follow-up and evaluation?
- A. Skin on the scrotum is taut.
- B. Left testicle hangs lower than the right testicl
- D. Scrotal skin has yellowish 1-cm nodules that are firm and nontender.
Correct Answer: D
Rationale: The correct answer is D because the presence of yellowish 1-cm nodules that are firm and nontender on the scrotal skin could indicate a serious issue such as testicular cancer or a benign condition like sebaceous cysts. Further evaluation is necessary to rule out malignancy or infection.
A: Skin on the scrotum being taut is a normal finding.
B: Left testicle hanging lower than the right is a common anatomical variation, not a cause for concern.
C: The absence of information makes it impossible to determine if this finding requires follow-up.
A 25 year old patient is diagnosed with genital herpes simplex virus infection. * Which of the following drug would be most appropriate to prescribe in treating this patient's illness?
- A. Zanamivir
- B. Lamivudine
- C. Valacyclovir
- D. Cidofovir
Correct Answer: C
Rationale: The correct answer is C: Valacyclovir. Valacyclovir is an antiviral medication commonly used to treat herpes simplex virus infections. It is a prodrug of acyclovir, which inhibits viral DNA replication. Zanamivir (A) is used to treat influenza viruses, not herpes. Lamivudine (B) is used for HIV and hepatitis B, not herpes. Cidofovir (D) is used for cytomegalovirus and other viral infections, but not the first line for herpes. Valacyclovir is the most appropriate choice due to its effectiveness and safety profile in treating herpes simplex virus infections.
Regarding renal colic secondary to calculi:
- A. Females are more commonly affected than males
- B. 50% of calculi are radio-opaque
- C. It may present without haematuria
- D. There is a 20% chance of recurrence by 5 years
Correct Answer: C
Rationale: The correct answer is C because renal colic can present without hematuria. Renal colic is typically associated with severe flank pain caused by ureteral stones. Hematuria is a common symptom but not always present. This is due to the stone's location and size affecting the degree of irritation and damage to the urinary tract. Therefore, the absence of hematuria does not exclude the possibility of renal colic. Choices A, B, and D are incorrect. Females are not more commonly affected than males, calculi can be either radio-opaque or radio-lucent, and the recurrence rate by 5 years is closer to 50% rather than 20%.