Nokea
During a physical examination, the nurse finds that a male patient’s foreskin is fixed and tight and will not retract over the glans. The nurse recognizes that this condition is:
- A. Phimosis.
- B. Epispadias.
- C. Urethral stricture.
- D. Peyronie disease.
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis is a condition where the foreskin is tight and cannot be retracted over the glans. This can lead to problems with hygiene and urination. Epispadias (B) is a congenital malformation where the urethra opens on the dorsal side of the penis. Urethral stricture (C) is a narrowing of the urethra, causing difficulty with urination. Peyronie disease (D) is the development of fibrous scar tissue inside the penis, leading to curvature during erection. In this case, the fixed and tight foreskin indicates phimosis.
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Which of the following drug adverse reactions precludes a patient from being given the same drug in the future?
- A. GI upset from Clarithromycin
- B. Skin Rash from Ampicillin
- C. Steven-Johnson syndrome from Trimethoprim/Sulfamethoxazole
- D. Clostridium difficile superinfection from Ofloxacin
Correct Answer: C
Rationale: The correct answer is C because Steven-Johnson syndrome is a severe and life-threatening skin reaction that can occur with certain medications like Trimethoprim/Sulfamethoxazole. Once a patient experiences this reaction, they should never be given the same drug again to avoid a potentially fatal outcome. The other choices, GI upset from Clarithromycin, skin rash from Ampicillin, and Clostridium difficile superinfection from Ofloxacin, are adverse reactions that can be managed or treated without completely excluding the drug from future use.
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.
When the nurse is interviewing a preadolescent girl, which opening question would be least threatening?
- A. Do you have any questions about growing up?
- B. What has your mother told you about growing up?
- C. When did you notice that your body was changing?
- D. I remember being very scared when I got my period. How do you think you'll feel?
Correct Answer: C
Rationale: Correct Answer: C - "When did you notice that your body was changing?"
Rationale:
1. This question is open-ended and focuses on the preadolescent girl's personal experience, allowing her to share information at her comfort level.
2. It avoids assumptions and allows the girl to express herself without feeling pressured.
3. By asking about her own observations, it encourages self-reflection and empowers her to communicate about her body changes.
Summary:
A - Option A might indirectly suggest that the girl should have questions about growing up, potentially creating pressure.
B - Option B assumes the mother's role as the primary source of information, potentially overlooking the girl's own experiences.
D - Option D introduces the tutor's personal experience, which may lead the girl to compare her feelings to the tutor's, potentially causing unnecessary anxiety.
The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to:
- A. Tell the patient that her examination is normal.
- B. Give her an immediate referral to a gynecologist.
- C. Suggest that she return in a month for a recheck to verify the findings.
- D. Tell the patient that she may have an ovarian cyst that should be evaluated further.
Correct Answer: B
Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.
The most frequent side effect of oral ampicillin is : *
- A. Nausea and vomiting
- B. Loose bowel movements
- C. Constipation
- D. Urticaria
Correct Answer: A
Rationale: The correct answer is A: Nausea and vomiting. Oral ampicillin commonly causes gastrointestinal side effects such as nausea and vomiting due to its impact on the gut flora. This side effect is a result of the antibiotic's mechanism of action and is well-documented in clinical practice. Choices B, C, and D are incorrect as loose bowel movements, constipation, and urticaria are not typically associated with oral ampicillin use.