Nokea
Acetazolamide is not frequently used as diuretic but the current indication is * in the treatment of:
- A. Liver cirrhosis
- B. CHF
- C. Glaucoma
- D. Kidney failure
Correct Answer: C
Rationale: Acetazolamide is a carbonic anhydrase inhibitor commonly used in treating glaucoma due to its ability to decrease intraocular pressure. The drug works by reducing the production of aqueous humor in the eye. This mechanism makes it an effective treatment for glaucoma. In contrast, liver cirrhosis (choice A) is typically managed with diuretics that act on the kidneys to reduce fluid accumulation. CHF (choice B) is commonly treated with loop diuretics to reduce fluid overload and improve cardiac function. Acetazolamide is not indicated for treating heart failure. Kidney failure (choice D) may require diuretics to manage fluid balance, but acetazolamide is not the first-line treatment in this condition. Therefore, the correct answer is C, as acetazolamide's current indication is in the treatment of glaucoma.
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A 22-year-old woman is being seen at the clinic for problems with vulvar pain, dysuria, and fever. On physical examination, the nurse notices clusters of small, shallow vesicles with surrounding erythema on the labia. Inguinal lymphadenopathy is present. The most likely cause of these lesions is:
- A. Pediculosis pubis.
- B. Contact dermatitis.
- C. HPV.
- D. Herpes simplex virus type 2.
Correct Answer: D
Rationale: The correct answer is D: Herpes simplex virus type 2. The presence of small, shallow vesicles with surrounding erythema on the labia, along with symptoms of vulvar pain, dysuria, and fever, are classic signs of genital herpes caused by HSV-2. The inguinal lymphadenopathy further supports the diagnosis. Herpes simplex virus is known for causing painful vesicular lesions in the genital area.
Choice A, Pediculosis pubis, is incorrect as it presents with itching and nits (eggs) attached to the hair shafts, not vesicles. Choice B, Contact dermatitis, typically presents with red, itchy, and inflamed skin due to an allergic reaction. Choice C, HPV, does not typically present with vesicles but rather with warts or abnormal cell changes on the skin or mucous membranes.
A 23 year old pregnant woman has UTI and presents to the ER with fever, frequency and urgency. Which of the following antibiotics can cause potential harm to her fetus?
- A. Nitrofurantoin
- B. Amoxicillin
- C. Gentamycin
- D. Cephalexin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is known to have potential harmful effects on the fetus, such as causing hearing loss and kidney damage. This is due to its ability to cross the placental barrier. Amoxicillin (B) and Cephalexin (D) are both considered safe for use in pregnancy and are commonly prescribed for UTIs. Nitrofurantoin (A) is typically avoided in the third trimester due to the risk of hemolytic anemia in the newborn, but it is considered safe earlier in pregnancy. Therefore, Gentamycin is the correct choice as it poses a higher risk to the fetus compared to the other antibiotics.
Which of the following drug used in the treatment of filariasis?
- A. Diethylcarbamazine
- B. Albendazole
- C. Levamisole
- D. Piperazine
Correct Answer: A
Rationale: Diethylcarbamazine is the correct answer for treating filariasis because it targets the microfilariae, adult worms, and larvae of filarial parasites. It is specifically designed to kill these parasites and is considered the drug of choice for filariasis treatment. Albendazole, Levamisole, and Piperazine are not effective against filarial parasites and are used for different types of infections or conditions. Albendazole is mainly used for treating intestinal worms, Levamisole is used for parasitic infections in animals, and Piperazine is used for treating pinworm infections. Thus, only Diethylcarbamazine directly targets and eliminates filarial parasites, making it the correct choice for filariasis treatment.
Which of the following fungicidal drug that acts by inhibiting fungal squalene epoxidase enzyme and is the drug of choice for onychomycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinafine
- C. Itraconazole
- D. Amphotericin B
Correct Answer: B
Rationale: Step 1: Terbinafine is a fungicidal drug that inhibits fungal squalene epoxidase enzyme, disrupting fungal cell membrane synthesis.
Step 2: Onychomycosis of toenails is a common fungal infection that terbinafine is specifically effective against.
Step 3: The patient being a 56-year-old woman with diabetes may require a drug with good efficacy and safety profile, making terbinafine an appropriate choice.
Step 4: Griseofulvin (A) works by disrupting microtubule function, not inhibiting squalene epoxidase. Itraconazole (C) is an azole antifungal that inhibits ergosterol synthesis, not squalene epoxidase. Amphotericin B (D) is a polyene antifungal used for systemic mycoses, not onychomycosis.
A patient has been experiencing vaginal bleeding and cramping, which the nurse suspects could be an early sign of a miscarriage. Which of the following should the nurse assess for during this examination?
- A. Hyperthyroidism.
- B. High blood pressure.
- C. Weight loss and fatigue.
- D. Changes in breast size or tenderness.
Correct Answer: C
Rationale: The correct answer is C: Weight loss and fatigue. In the context of vaginal bleeding and cramping, weight loss and fatigue are concerning signs that may indicate a potential miscarriage. Weight loss could be due to decreased appetite or nutritional deficiencies associated with the stress of a miscarriage. Fatigue may result from hormonal changes and emotional distress. Assessing for weight loss and fatigue helps the nurse monitor the patient's overall well-being and provide appropriate support.
Choice A (Hyperthyroidism) is incorrect as it is not directly related to the symptoms of vaginal bleeding and cramping suggestive of a possible miscarriage.
Choice B (High blood pressure) is also incorrect as it is not typically associated with early signs of a miscarriage.
Choice D (Changes in breast size or tenderness) is incorrect as these symptoms are more commonly related to pregnancy rather than miscarriage.