Nokea
A patient with a recent history of nephrolithiasis has
- A. After determining that the patients
- B. Irrigate the ileal conduit with a dilute citric acid
- D. IV fluid administration
Correct Answer: D
Rationale: The correct answer is D: IV fluid administration. This is the most appropriate choice for a patient with nephrolithiasis as it helps to increase urine volume and dilute the concentration of minerals in the urine, reducing the risk of stone formation. Adequate hydration is crucial in preventing the recurrence of kidney stones. Choice A is incomplete and does not offer a specific intervention for nephrolithiasis. Choice B is unnecessary and could potentially cause harm by altering the pH of the urine. Choice C is blank and does not provide any relevant information for managing nephrolithiasis.
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A 35 year old man presents to the ER with severe headache. After lab workup, patient is diagnosed to have increased intracranial pressure. Which diuretic would work best to reduce this pressure?
- A. Hydrochlorothiazide
- B. Mannitol
- C. Acetazolamide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Mannitol. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and reducing intracranial pressure. It is commonly used in cases of increased intracranial pressure due to its ability to easily cross the blood-brain barrier and reduce cerebral edema. Hydrochlorothiazide (A) is a thiazide diuretic mainly used for hypertension and not effective for this condition. Acetazolamide (C) is a carbonic anhydrase inhibitor that can reduce CSF production but is not as effective as mannitol for rapid reduction of intracranial pressure. Furosemide (D) is a loop diuretic that primarily acts on the kidneys and is not as effective as mannitol for reducing intracranial pressure.
Which of the following activities is not related to kidney function?
- A. control of hydrogen ion and pH in the blood
- B. control of wastes in the blood
- C. lipid digestion
- D. regulation of blood pressure
Correct Answer: C
Rationale: The correct answer is C: lipid digestion. Kidneys are not involved in the process of lipid digestion. Kidneys primarily function in filtering blood, controlling water and electrolyte balance, regulating blood pressure, and removing waste products. Lipid digestion occurs in the gastrointestinal system, specifically in the small intestine, where bile from the liver aids in breaking down fats. Choices A, B, and D are all functions directly related to kidney function, as the kidneys play a crucial role in maintaining proper pH balance, filtering waste products from the blood, and regulating blood pressure.
While managing a client after a medical or surgical procedure for bladder stones, when should the nurse notify the physician?
- A. Assessment of sexual habits
- B. Assessment and recognition of abnormal findings
- C. Assessment of allergies to seafood
- D. Assessment of insurance coverage
Correct Answer: B
Rationale: The correct answer is B because assessing and recognizing abnormal findings is crucial in post-procedure care for bladder stones. This includes monitoring for signs of infection, urinary retention, bleeding, or other complications that may require immediate medical intervention. Notifying the physician promptly allows for timely treatment and prevents potential complications. Choices A, C, and D are incorrect as they are not directly related to the immediate post-procedure care for bladder stones and do not require immediate physician notification.
The patient has a thoracic spinal cord lesion and incontinence that occurs equally during the day and night. What type of incontinence is this patient experiencing?
- A. Reflex incontinence
- B. Overflow incontinence
- C. Functional incontinence
- D. Incontinence after trauma
Correct Answer: A
Rationale: The correct answer is A: Reflex incontinence. This type of incontinence occurs due to a lack of voluntary control over the bladder, usually resulting from a spinal cord lesion. In this case, the thoracic spinal cord lesion is causing the incontinence. The fact that incontinence occurs equally during the day and night suggests a lack of awareness or sensation of bladder fullness, characteristic of reflex incontinence.
Summary of other choices:
B: Overflow incontinence is due to bladder overdistension and is commonly associated with conditions like BPH or spinal cord injuries at the sacral level.
C: Functional incontinence is when a person is unable to reach the toilet in time due to physical or cognitive impairments.
D: Incontinence after trauma is a broad term and does not specifically address the pattern of incontinence described in the question.
A patient with HIV-AIDS being treated with combined antiviral drugs and immunosuppressive agents, develops an opportunistic infection caused by Pneumocystis carinii. Which of the following drugs most likely be used in the treatment of pulmonary infection caused by P. carinii?
- A. Metronidazole
- B. Carbenicillin
- C. Trimethoprim/Sulfamethoxazole
- D. Penicillin G
Correct Answer: C
Rationale: The correct answer is C: Trimethoprim/Sulfamethoxazole. This combination is the first-line treatment for Pneumocystis carinii pneumonia in patients with HIV-AIDS due to its efficacy against the organism. Trimethoprim inhibits dihydrofolate reductase, while sulfamethoxazole inhibits dihydropteroate synthase, both essential enzymes for folate synthesis in bacteria and protozoa like P. carinii. Metronidazole (A) is used for anaerobic infections, Carbenicillin (B) is a penicillinase-resistant penicillin used for Gram-negative infections, and Penicillin G (D) is a narrow-spectrum antibiotic mainly used for Gram-positive infections.