Nokea
Intravenous furosemide is an alternative potent diuretic to Mannitol in the treatment of the following condition:
- A. Cardiac edema
- B. Cerebral edema
- C. Cirrhotic edema
- D. Pulmonary edema
Correct Answer: D
Rationale: The correct answer is D: Pulmonary edema. Furosemide is a loop diuretic that is commonly used to treat pulmonary edema by reducing fluid overload in the lungs. It works by inhibiting the reabsorption of sodium and water in the loop of Henle in the kidneys, leading to increased urine output. This helps to alleviate the congestion and fluid accumulation in the lungs seen in pulmonary edema. Mannitol, on the other hand, is typically used for cerebral edema due to its osmotic diuretic properties. Choices A, B, and C are incorrect as furosemide is not the preferred diuretic for cardiac, cerebral, or cirrhotic edema.
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The nurse is preparing to examine the external genitalia of a school-age girl. Which position would be most appropriate in this situation?
- A. In the parents lap
- B. In a frog-leg position on the examining table
- C. In the lithotomy position with the feet in stirrups
- D. Lying flat on the examining table with legs extended
Correct Answer: B
Rationale: The correct answer is B, placing the girl in a frog-leg position on the examining table. This position provides optimal access and visualization of the external genitalia while ensuring the child's comfort and privacy. Placing the child in the parent's lap (A) may hinder the nurse's ability to perform the examination effectively. The lithotomy position (C) with feet in stirrups is typically used for pelvic exams in older females and may not be necessary for a school-age girl. Lying flat with legs extended (D) would also not provide the necessary access and visibility required for the examination.
Which of the following secretes the antidiuretic hormone?
- A. Lungs
- B. Pituitary gland
- C. Liver
- D. Pineal gland
Correct Answer: B
Rationale: The correct answer is B: Pituitary gland. The antidiuretic hormone (ADH), also known as vasopressin, is produced and secreted by the pituitary gland. This hormone helps regulate water balance in the body by increasing water reabsorption in the kidneys. The other choices, A: Lungs, C: Liver, and D: Pineal gland, do not secrete ADH. Lungs are responsible for gas exchange, the liver performs various metabolic functions, and the pineal gland regulates sleep-wake cycles through melatonin secretion. Therefore, the pituitary gland is the only gland among the options that secretes the antidiuretic hormone.
Desmopressin reduces urine volume in which of the following condition?
- A. Central (neurogenic) diabetes insipidus
- B. Renal (nephrogenic) diabetes insipidus
- C. Both (a) and (b)
- D. Neither (a) nor (b)
Correct Answer: A
Rationale: Desmopressin reduces urine volume by mimicking the effects of antidiuretic hormone (ADH). In central diabetes insipidus, there is a deficiency of ADH production, so desmopressin can help by supplementing ADH. In renal diabetes insipidus, the kidneys do not respond to ADH, so desmopressin would not be effective. Therefore, the correct answer is A. Choice B is incorrect because desmopressin does not address the underlying issue of kidney insensitivity to ADH. Choice C is incorrect because desmopressin is effective only in central diabetes insipidus. Choice D is incorrect because desmopressin is effective in central diabetes insipidus.
Superinfections are more common with:
- A. Use of narrow spectrum antibiotics
- B. Short courses of antibiotics
- C. Use of antibiotics that are completely absorbed from the small intestines
- D. Use of antibiotic combinations covering both gram positive and gram negative bacteria
Correct Answer: D
Rationale: The correct answer is D because using antibiotic combinations covering both gram positive and gram negative bacteria can disrupt the balance of normal flora in the body, leading to superinfections. Gram positive and gram negative bacteria have different susceptibility patterns, so using a combination of antibiotics increases the likelihood of killing off a wider range of bacteria, including the beneficial ones. This disruption paves the way for opportunistic pathogens to overgrow and cause superinfections. Choices A, B, and C are incorrect because narrow spectrum antibiotics target specific bacteria, short courses of antibiotics reduce the risk of resistance and overgrowth, and antibiotics completely absorbed from the small intestines have minimal impact on gut flora compared to systemic antibiotics.
The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.