Nokea
During a pelvic examination, the nurse notes that the patient's cervix is irregular and hard to the touch. The nurse's next best action would be to:
- A. Perform a Pap smear test to confirm the diagnosis.
- B. Referral to a gynecologist for further examination.
- C. Complete a cervical cancer screening.
- D. Complete an endometrial biopsy to assess for malignancy.
Correct Answer: B
Rationale: The correct answer is B: Referral to a gynecologist for further examination. This is the best course of action because an irregular and hard cervix can indicate various underlying issues such as cervical dysplasia, fibroids, or cervical stenosis. A gynecologist can conduct a more thorough evaluation including additional tests like colposcopy or ultrasound to determine the cause and appropriate treatment.
A: Performing a Pap smear test may not provide sufficient information about the specific condition causing the irregularity.
C: Completing a cervical cancer screening may not address the immediate concern of the irregular and hard cervix.
D: Completing an endometrial biopsy is not indicated for assessing cervical abnormalities, as it focuses on the endometrium rather than the cervix.
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Which is the most common from of acute glomerulonephritis?
- A. Post streptococcal.
- B. IgA nephropathy
- C. Rapidly progressive glomerulonephritis
- D. Goodpasture's syndrome
Correct Answer: A
Rationale: The correct answer is A: Post streptococcal glomerulonephritis. It is the most common form of acute glomerulonephritis caused by a previous streptococcal infection. This type of glomerulonephritis typically occurs in children and young adults. The immune response to the streptococcal infection leads to the deposition of immune complexes in the glomeruli, causing inflammation and kidney damage.
Choice B (IgA nephropathy) is a chronic form of glomerulonephritis characterized by the deposition of IgA immune complexes in the glomeruli. Choice C (Rapidly progressive glomerulonephritis) is a severe form of glomerulonephritis characterized by rapid loss of kidney function. Choice D (Goodpasture's syndrome) is a rare autoimmune disease affecting the lungs and kidneys, characterized by the production of antibodies against the basement membrane of the glomeruli.
Which of the following organism is notorious for developing antimicrobial resistance rapidly?:
- A. Streptococcus pyogenes
- B. Meningococcus
- C. Treponema pallidum
- D. Escherichia coli
Correct Answer: D
Rationale: The correct answer is D: Escherichia coli. E. coli is notorious for developing antimicrobial resistance rapidly due to its ability to acquire resistance genes through plasmid exchange and mutation. This bacterium is commonly found in the gut of humans and animals, leading to frequent exposure to antibiotics. On the other hand, choices A, B, and C are less likely to develop resistance as rapidly as E. coli due to their lower frequency of exposure to antibiotics and differences in genetic makeup. Streptococcus pyogenes is susceptible to penicillin, Meningococcus has shown susceptibility to several antibiotics, and Treponema pallidum has limited exposure to antibiotics due to its unique nature as the causative agent of syphilis.
Thirty percent of patients with kidney cancer have metastasis at the time of diagnosis. Why does this occur?
- A. The only treatment modalities for the disease are palliative.
- B. Diagnostic tests are not available to detect tumors before they metastasize.
- C. Classic symptoms of hematuria and palpable mass do not occur until the disease is advanced.
- D. Early metastasis to the brain impairs the patient’s ability to recognize the seriousness of symptoms.
Correct Answer: D
Rationale: The correct answer is D because early metastasis to the brain can impair the patient's ability to recognize the seriousness of symptoms. This can delay diagnosis and treatment, leading to a higher percentage of patients having metastasis at the time of diagnosis.
A is incorrect because there are treatment modalities for kidney cancer beyond palliative care. B is incorrect as diagnostic tests like imaging studies can detect tumors before they metastasize. C is incorrect because while classic symptoms may not always be present, other symptoms and diagnostic tests can still lead to an earlier diagnosis.
Which of the following diuretics needs close monitoring with use of * potassium sparing diuretics such as spironolactone?
- A. Furosemide
- B. Captopril
- C. Verapamil
- D. Hydrochlorothiazid
Correct Answer: A
Rationale: The correct answer is A: Furosemide. Furosemide is a loop diuretic that can cause potassium depletion, which can be exacerbated when used with potassium-sparing diuretics like spironolactone. This combination can lead to hyperkalemia, necessitating close monitoring of potassium levels.
B: Captopril is an ACE inhibitor, not a diuretic.
C: Verapamil is a calcium channel blocker, not a diuretic.
D: Hydrochlorothiazide is a thiazide diuretic that can also cause potassium depletion, but it does not specifically need close monitoring when used with potassium-sparing diuretics.
In which segment of the nephron is glucose reabsorbed?
- A. Loop of henle
- B. Collecting duct
- C. Distal convoluted tubule
- D. Proximal convoluted tubule
Correct Answer: D
Rationale: The correct answer is D: Proximal convoluted tubule. Glucose reabsorption primarily occurs in the proximal convoluted tubule due to the presence of specialized glucose transporters. Step-by-step rationale: 1. Glucose is filtered in the glomerulus and enters the renal tubules. 2. In the proximal convoluted tubule, glucose is reabsorbed through sodium-glucose cotransporters (SGLT) and facilitated diffusion via glucose transporters (GLUT). 3. The loop of Henle is primarily responsible for water and electrolyte reabsorption, not glucose. 4. The collecting duct mainly concentrates urine by reabsorbing water and electrolytes, not glucose. 5. The distal convoluted tubule is involved in fine-tuning electrolyte balance and regulating acid-base balance, not glucose reabsorption.