Nokea
Due to its potential for severe hepatotoxicity, Nevirapine should NOT be initiated in:
- A. Women with CD4 cell counts >150 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- B. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- C. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >500 cells/mm3
- D. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >450 cells/mm3
Correct Answer: B
Rationale: The correct answer is B. Nevirapine has a higher risk of severe hepatotoxicity in patients with higher CD4 cell counts. Choice B specifies a lower threshold for CD4 cell counts in women compared to men, which aligns with the caution needed for initiating Nevirapine. Choices A, C, and D have higher CD4 cell count thresholds for both women and men, which would increase the risk of hepatotoxicity if Nevirapine is initiated in those patients. Therefore, Choice B is the most appropriate option to minimize the risk of hepatotoxicity when initiating Nevirapine.
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Which of the following drugs for treatment of leprosy can cause hemolysis especially in patients with G6PD deficiency?
- A. Dapsone
- B. Rifampicin
- C. Clofazimine
- D. None of these
Correct Answer: A
Rationale: The correct answer is A: Dapsone. Dapsone is known to cause hemolysis in patients with G6PD deficiency due to oxidative stress. G6PD deficiency leads to reduced ability to protect red blood cells from oxidative damage, which can be exacerbated by drugs like dapsone. Rifampicin and clofazimine are not associated with hemolysis in G6PD deficient patients. Option D is incorrect as dapsone is known to cause hemolysis in this population.
The commonest type of ureteric calculus is
- A. calcium oxalate
- B. triple phosphate
- C. urate
- D. cysteine
Correct Answer: A
Rationale: The correct answer is A: calcium oxalate. This is because calcium oxalate stones are the most common type of ureteric calculus, accounting for around 75% of cases. They form due to an excess of calcium and oxalate in the urine. Triple phosphate stones (choice B) are more commonly found in the bladder and are associated with urinary tract infections. Urate stones (choice C) are less common and typically seen in patients with gout or acidic urine. Cysteine stones (choice D) are rare and usually seen in patients with a genetic disorder affecting cysteine metabolism.
Which classification of urinary tract infection (UTI) is described as infection of the renal parenchyma, renal pelvis, and ureters?
- A. Upper UTI
- B. Lower UTI
- C. Complicated UTI
- D. Uncomplicated UTI
Correct Answer: A
Rationale: The correct answer is A: Upper UTI. This classification describes infection of the renal parenchyma, renal pelvis, and ureters, which are part of the upper urinary tract. In upper UTIs, the infection involves the kidneys (renal parenchyma), renal pelvis, and ureters, whereas lower UTIs typically involve the bladder (cystitis) and urethra. Complicated UTIs involve structural or functional abnormalities of the urinary tract, making treatment more challenging. Uncomplicated UTIs refer to infections in otherwise healthy individuals with normal urinary tracts. Therefore, the description provided aligns with the characteristics of an upper UTI, making it the correct choice.
A gerontologic nurse is assessing a patient who has
- A. The patients suprapubic region is dull on percussion. numerous comorbid health problems. What assessment
- B. The patient is uncharacteristically drowsy. findings should prompt the nurse to suspect a UTI?
- C. The patient claims to void large amounts of urine 2 to Select all that apply.
- D. Food cravings
Correct Answer: B
Rationale: The correct answer is B because uncharacteristic drowsiness can be a sign of a urinary tract infection (UTI) in older adults. UTIs can present atypically in older adults with symptoms like confusion, lethargy, and drowsiness. The other choices are incorrect because:
A: A dull suprapubic region on percussion is not specific to UTI.
C: Voiding large amounts of urine is not a typical symptom of UTI.
D: Food cravings are not associated with UTI symptoms.
When the nurse is performing a genital examination on a male patient, which action is correct?
- A. Auscultating for the presence of a bruit over the scrotum
- B. Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament
- C. Palpating the inguinal canal only if a bulge is present in the inguinal region during inspection
- D. Having the patient shift his weight onto the left (unexamine
Correct Answer: B
Rationale: The correct answer is B: Palpating for the vertical chain of lymph nodes along the groin, inferior to the inguinal ligament. This is the correct action during a male genital examination as it helps assess for any abnormalities or signs of infection in the lymphatic system. Palpating the lymph nodes allows the nurse to identify any swelling, tenderness, or enlargement which could indicate underlying health issues. The other choices are incorrect because:
A: Auscultating for a bruit over the scrotum is not a standard practice during a genital examination and is not relevant to assessing male genital health.
C: Palpating the inguinal canal only if a bulge is present is incorrect as palpating the inguinal canal should be done regardless of the presence of a bulge to check for hernias.
D: Having the patient shift his weight is not a standard procedure during a genital examination and is not relevant to assessing male genital health.