Nokea
Each kidney contains about a million and stored in the pituitary gland
- A. ADH plays a key role in the homeostatic filtration apparatus called: process called osmoregulation
- B. the distal tubule
- C. the proximal tubule
Correct Answer: A
Rationale: The correct answer is A: ADH plays a key role in the homeostatic filtration apparatus called the process called osmoregulation. ADH, or antidiuretic hormone, regulates water balance by controlling the permeability of the collecting duct in the kidney nephrons. This controls the concentration of urine produced. The other choices, B and C, refer to specific parts of the kidney tubules and are not related to the role of ADH in osmoregulation. Choice D is incomplete and does not provide any relevant information. Therefore, A is the correct choice as it directly relates to the function of ADH in maintaining water balance within the body.
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Which antibiotic course is inappropriate for clinical scenario?
- A. Acute simple cystitis - trimethoprim for 3 days in otherwise well young women.
- B. Acute uncomplicated pyelonephritis - gentamycin + amoxicillin IV initially followed by 7 days of Augmentin orally.
- C. Pregnancy associated cystitis - nitrofurantoin 5 mg QID for 14 days.
- D. Acute simple cystitis in male patients - Augmentin or trimethoprim for 14 days.
Correct Answer: B
Rationale: The correct answer is B because the antibiotic regimen for acute uncomplicated pyelonephritis should not include gentamycin due to its potential toxicity and nephrotoxicity. The initial use of IV gentamycin is not recommended for uncomplicated pyelonephritis. The combination of gentamycin and amoxicillin is not the standard treatment for this condition. Gentamycin should be reserved for more serious infections. The choice of Augmentin for 7 days orally is also not the standard of care for pyelonephritis. The other choices (A, C, D) are appropriate antibiotic regimens for the corresponding clinical scenarios.
On assessment of the patient with a renal calculus passing down the ureter, what should the nurse expect the patient to report?
- A. A history of chronic UTIs
- B. Dull, costovertebral flank pain
- C. Severe, colicky back pain radiating to the groin
- D. A feeling of bladder fullness with urgency and frequency
Correct Answer: C
Rationale: The correct answer is C: Severe, colicky back pain radiating to the groin. This type of pain is characteristic of renal colic caused by a renal calculus passing down the ureter. The sharp, severe pain originates in the flank and radiates to the groin as the stone moves. Choices A and D are incorrect because they do not describe the typical pain associated with renal colic. Choice B describes dull, costovertebral flank pain, which is not characteristic of the sharp, severe colicky pain seen in renal colic. Therefore, option C is the most appropriate response based on the typical presentation of a patient with a renal calculus passing down the ureter.
What does the dialysate for PD routinely contain?
- A. Calcium in a lower concentration than in the blood
- B. Sodium in a higher concentration than in the blood
- C. Dextrose in a higher concentration than in the blood
- D. Electrolytes in an equal concentration to that of the blood
Correct Answer: C
Rationale: Correct Answer: C - Dextrose in a higher concentration than in the blood
Rationale:
1. Dextrose in PD dialysate helps to create an osmotic gradient for fluid removal.
2. Higher dextrose concentration ensures effective ultrafiltration.
3. Dextrose is the main osmotic agent used in PD.
4. A higher concentration of dextrose in the dialysate aids in waste removal.
Summary:
A: Incorrect - Calcium concentration in dialysate is similar to blood to avoid imbalance.
B: Incorrect - Sodium concentration is lower in dialysate to prevent sodium loading.
D: Incorrect - Electrolyte concentration in dialysate is tailored to patient needs, not equal to blood.
Carol Carson was taught self breast examination (SBE) during her last hospitalization and tells you that she has been doing the examination every month without difficulty. Which statement by Mrs. Carson would indicate to you that she does NOT have a complete understanding of the self breast examination technique?
- A. I do the examination every month a few days after my period.
- B. I use my fingertips to examine all of the breast tissues.
- C. I begin the examination by inspecting my breasts with hands at my side.
- D. I especially check the upper, outer quadrants and under my arms.
Correct Answer: C
Rationale: The correct answer is C. Mrs. Carson's statement indicates a lack of understanding because she mentions beginning the examination by inspecting her breasts with hands at her side. The correct technique for self breast examination (SBE) involves inspecting the breasts visually in front of a mirror with hands on hips or raised above the head. This position allows for better visualization and palpation of the breast tissue. Starting the examination with hands at the sides may result in missing important areas for inspection. Choices A, B, and D are incorrect because they all align with proper SBE techniques such as timing the examination, using fingertips to examine all breast tissues, and focusing on specific areas like the upper, outer quadrants, and underarms.
The first physical sign associated with puberty in boys is:
- A. Height spurt
- B. Penis lengthening
- C. Sperm production
- D. Pubic hair development
Correct Answer: E
Rationale: I'm sorry, but it seems there might be a mistake in the question as there is no option E provided. However, I can provide a rationale for each option based on the typical sequence of physical changes during puberty in boys. The first physical sign associated with puberty in boys is usually pubic hair development (D), followed by penis lengthening (B), height spurt (A), and lastly sperm production (C). Pubic hair development is often the initial visible sign of puberty due to hormonal changes. Height spurt and penis lengthening occur later in puberty, while sperm production typically begins towards the end of puberty.