Glomerular filtrate is produced as a result of
- A. tubule secretion
- B. facilitated diffusion
- C. blood colloid osmotic pressure
- D. blood hydrostatic pressure
Correct Answer: D
Rationale: The correct answer is D: blood hydrostatic pressure. Glomerular filtrate is produced as a result of the pressure exerted by the blood in the glomerular capillaries forcing water and small solutes into the Bowman's capsule. This pressure, known as blood hydrostatic pressure, is the driving force for the initial filtration of blood in the kidneys.
Rationale:
1. A: Tubule secretion is the process by which substances are actively transported from the blood into the renal tubules, not the initial production of glomerular filtrate.
2. B: Facilitated diffusion is a passive transport process that requires specific carrier proteins, not a mechanism for producing glomerular filtrate.
3. C: Blood colloid osmotic pressure is the pressure exerted by proteins in the blood that tends to pull water back into the capillaries, opposing filtration, not causing the production of glomerular filtrate.
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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.
What causes the gastrointestinal (GI) manifestation of stomatitis in the patient with CKD?
- A. High serum sodium levels
- B. Irritation of the GI tract from creatinine
- C. Increased ammonia from bacterial breakdown of urea
- D. Iron salts, calcium-containing phosphate binders, and limited fluid intake
Correct Answer: D
Rationale: The correct answer is D. Stomatitis in CKD patients is often caused by iron salts, calcium-containing phosphate binders, and limited fluid intake. Iron salts and calcium binders can lead to mucosal irritation in the GI tract, exacerbating stomatitis. Limited fluid intake can cause dehydration, leading to oral mucosal dryness and vulnerability to stomatitis.
A: High serum sodium levels do not directly cause stomatitis in CKD patients.
B: Irritation of the GI tract from creatinine is not a common cause of stomatitis in CKD patients.
C: Increased ammonia from bacterial breakdown of urea is more related to hepatic encephalopathy rather than stomatitis in CKD patients.
The following drug is used for oral treatment of trichomonas vaginitis:
- A. Diiodohydroxyquin
- B. Tinidazole
- C. Clotrimazole
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B, Tinidazole, for oral treatment of trichomonas vaginitis. Tinidazole is a nitroimidazole antibiotic that is effective against trichomonas. It has good oral bioavailability and is commonly used for this infection. Diiodohydroxyquin (A) is not indicated for trichomonas vaginitis. Clotrimazole (C) and Ketoconazole (D) are antifungal agents used for yeast infections, not trichomonas. Tinidazole is the most appropriate choice due to its effectiveness against trichomonas and its oral administration route.
The nurse is describing how to perform a testicular self-examination to a patient. Which statement is most appropriate?
- A. “A good time to examine your testicles is just before you take a shower.â€
- B. “If you notice an enlarged testicle or a painless lump, call your health care provider.â€
- C. “The testicle is egg shaped and movable. It feels firm and has a lumpy consistency.â€
- D. “Perform a testicular examination at least once a week to detect the early stages of testicular cancer.â€
Correct Answer: B
Rationale: The correct answer is B because it emphasizes the importance of seeking medical advice if any abnormalities are detected during the self-examination. This statement encourages prompt action and follow-up with a healthcare provider, which is crucial for early detection and treatment of testicular cancer.
Incorrect options:
A: Timing of the examination is not as critical as the action to take if abnormalities are found.
C: Describing the testicle's shape and texture is not the primary focus of a testicular self-examination.
D: Performing the examination once a week is excessive and not recommended by medical guidelines.
A 22-year-old woman with a history of chronic pelvic pain is being examined. The nurse suspects endometriosis. Which of the following is the most common symptom of endometriosis?
- A. Pain during menstruation.
- B. Pelvic pain that worsens during menstruation.
- C. Pain during ovulation.
- D. Heavy bleeding during menstruation.
Correct Answer: B
Rationale: The correct answer is B: Pelvic pain that worsens during menstruation. This is because endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation and pain in the pelvic region. The pain typically worsens during menstruation due to the shedding of this tissue, causing irritation and further inflammation.
A: Pain during menstruation is a common symptom, but what distinguishes endometriosis is the worsening of pain during menstruation.
C: Pain during ovulation is not a typical symptom of endometriosis. While some individuals may experience pain during ovulation, it is not the most common symptom.
D: Heavy bleeding during menstruation can occur in endometriosis, but it is not the most common symptom. Pelvic pain that worsens during menstruation is the hallmark symptom of endometriosis.