During a physical examination, the nurse finds that a male patients 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 strictur
Correct Answer: A
Rationale: The correct answer is A: Phimosis. Phimosis is the condition where the foreskin is tight and cannot retract over the glans. This is a common condition in males and can lead to issues such as difficulty urinating and increased risk of infections. Epispadias (B) is a congenital condition where the urethra opens on the upper side of the penis. Urethral stricture (C) is a narrowing of the urethra that can cause difficulty with urination, but it is not related to tight foreskin.
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You are providing care for a patient with reflex urinary incontinence. Which action is appropriately delegated to the new LPN/LVN?
- A. Teach the patient bladder emptying by the Credé method.
- B. Demonstrate how to perform intermittent self-catheterization.
- C. Discuss the side effects of bethanechol chloride (Urecholine).
- D. Reinforce the importance of proper handwashing to prevent infection.
Correct Answer: B
Rationale: The correct answer is B because demonstrating how to perform intermittent self-catheterization is within the scope of practice for an LPN/LVN. This task involves a specific skill set that can be taught and supervised by the LPN/LVN. It is essential for managing reflex urinary incontinence and maintaining bladder function. Choices A, C, and D are incorrect because teaching the patient bladder emptying by the Credé method (A) and discussing the side effects of bethanechol chloride (C) are tasks that require a higher level of nursing education and knowledge. Reinforcing the importance of proper handwashing (D) is a basic nursing task that can be performed by a nursing assistant or other unlicensed assistive personnel.
A patient is being treated with furosemide and Digoxin because of CHF. She * developed UTI. Which of the following antibiotics should NOT be prescribed?
- A. Cotrimoxazole
- B. Ciprooxacin
- C. Gentamycin
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is not recommended in this case due to its potential for nephrotoxicity, especially in patients already receiving furosemide. Furosemide is a loop diuretic that can also cause kidney damage, so combining it with Gentamycin increases the risk of further renal impairment. Cotrimoxazole (A) and Ampicillin (D) are commonly used antibiotics that do not have significant interactions with furosemide and Digoxin. Ciprofloxacin (B) is a fluoroquinolone antibiotic that is generally safe to use in patients with CHF and UTI.
The Na+Cl- transporter in the distal convoluted tubule of the kidney is blocked by:
- A. Spironolactone
- B. Thiazides
- C. Furosemide
- D. Ethacrynic acid
Correct Answer: B
Rationale: The correct answer is B: Thiazides. Thiazides work by inhibiting the Na+/Cl- transporter in the distal convoluted tubule, leading to decreased sodium reabsorption and increased urine output. This results in decreased blood volume and lower blood pressure. Spironolactone (A) works by blocking aldosterone receptors, affecting potassium and sodium balance. Furosemide (C) and Ethacrynic acid (D) act on the loop of Henle, inhibiting the Na+/K+/2Cl- transporter. Therefore, the correct answer is B because thiazides specifically target the Na+/Cl- transporter in the distal convoluted tubule.
The highest incidence of antibiotic associated pseudomembranous * enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with a high incidence of antibiotic-associated pseudomembranous enterocolitis due to its strong impact on disrupting the normal gut flora, leading to overgrowth of Clostridium difficile. This bacterium can produce toxins causing inflammation and pseudomembrane formation in the colon. Ampicillin (A) can also cause C. difficile infection, but clindamycin is more strongly associated. Chloramphenicol (B) and vancomycin (C) are less commonly associated with pseudomembranous enterocolitis compared to clindamycin.
Combivir is a combination therapy used to treat HIV and AIDS include which of the following drugs?
- A. Lamivudine and stavudine
- B. Lamivudine and zidovudine
- C. Abacavir and zidovudine
- D. Abacavir and stavudine
Correct Answer: B
Rationale: The correct answer is B: Lamivudine and zidovudine. Combivir is a combination therapy that contains these two drugs, which are commonly used together to treat HIV and AIDS. Lamivudine and zidovudine work synergistically to inhibit viral replication by targeting different stages of the HIV life cycle. Lamivudine is a nucleoside reverse transcriptase inhibitor (NRTI) that blocks the action of the enzyme reverse transcriptase, while zidovudine is also an NRTI that interferes with viral DNA synthesis. This combination helps reduce the viral load and improve the immune response in patients.
Incorrect Choices:
A: Lamivudine and stavudine - Stavudine is not part of the Combivir combination therapy.
C: Abacavir and zidovudine - Abacavir is not part of the Combivir combination therapy.
D: Abacavir and stavudine