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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Tubular reabsorption
- A. eliminates wastes from the body
- B. occurs mostly in the distal convoluted tubule
- C. usually helps control blood pH by removing H+ from the filtrate
- D. returns 99% of the water filtered from the glomerulus to the blood
Correct Answer: D
Rationale: The correct answer is D because tubular reabsorption refers to the process of reabsorbing substances, including water, from the renal tubules back into the bloodstream. This process occurs mainly in the proximal convoluted tubule and loop of Henle, not the distal convoluted tubule as stated in choice B. Choice A is incorrect because tubular reabsorption does not specifically eliminate wastes; that is the role of tubular secretion. Choice C is incorrect because tubular reabsorption does not directly control blood pH by removing H+ ions from the filtrate; that is primarily done through the kidneys' buffering systems. Overall, choice D is the most accurate as it reflects the primary function of tubular reabsorption in returning water back to the blood.
Thiazide diuretics may produce an increase in blood levels of uric acid and: *
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: A
Rationale: Thiazide diuretics decrease urinary excretion of uric acid, leading to increased blood levels. Thiazides also increase potassium reabsorption, potentially causing hyperkalemia. However, the main effect on uric acid levels makes choice A correct. Choices B, C, and D are incorrect as thiazides do not directly impact BUN, urea, or glucose levels.
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.
The primary role of the phosphate buffer system is to?
- A. buffer stomach acid
- B. buffer carbonic acid formed by carbon dioxide
- C. limit pH changes caused by metabolic and fixed acids
- D. buffer the urine
Correct Answer: C
Rationale: The correct answer is C: limit pH changes caused by metabolic and fixed acids.
1. Phosphate buffer system consists of dihydrogen phosphate (H2PO4-) and hydrogen phosphate (HPO4^2-) ions, which can donate or accept H+ ions to maintain a stable pH.
2. Metabolic and fixed acids produced in the body can lead to pH changes. The phosphate buffer system helps to prevent drastic changes in pH by neutralizing excess H+ ions.
3. Options A, B, and D are incorrect because the phosphate buffer system is not specifically designed to buffer stomach acid, carbonic acid formed by carbon dioxide, or buffer the urine.
When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurse’s most appropriate action or response is to:
- A. Ask the patient if he would like someone else to examine him.
- B. Continue with the examination as though nothing has happened.
- C. Stop the examination, leave the room while stating that the examination will resume at a later time.
- D. Reassure the patient that this is a normal response and continue with the examination.
Correct Answer: D
Rationale: The correct answer is D. This is the most appropriate action because it acknowledges the patient's normal physiological response and reassures him. It helps maintain professionalism and respect for the patient's dignity. Choice A could potentially embarrass the patient further. Choice B may ignore the patient's discomfort. Choice C abruptly halts the examination without addressing the situation. Overall, choice D is the most respectful and professional response in this scenario.