Mary Jane develops edema after the birth of her first child and will be treated by peritoneal dialysis. The nurse will have the patient void before the catheter is introduced into the peritoneal space to
- A. determine the effectiveness of the treatment
- B. prevent accidental puncture of the bladder
- C. get an accurate output record
- D. prevent incontinence
Correct Answer: B
Rationale: The correct answer is B: prevent accidental puncture of the bladder. Voiding before catheter insertion ensures the bladder is empty, reducing the risk of bladder puncture during peritoneal dialysis. Choice A is incorrect as voiding does not determine treatment effectiveness. Choice C is incorrect as output recording is not the primary reason for voiding. Choice D is incorrect as voiding does not directly prevent incontinence during peritoneal dialysis.
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One of your patients is awaiting laboratory results for kidney function. The patient has recently recovered from a streptococcal throat infection. The patient has most likely developed symptoms of:
- A. Pyelonephritis.
- B. Nephrolithiasis.
- C. Chronic renal failure.
- D. Glomerulonephritis.
Correct Answer: D
Rationale: The correct answer is D: Glomerulonephritis. Streptococcal infection can lead to poststreptococcal glomerulonephritis (PSGN), an immune-mediated inflammation of the glomeruli in the kidneys. This results in hematuria, proteinuria, hypertension, and edema. Pyelonephritis (choice A) is a bacterial infection of the kidneys, not related to streptococcal infection. Nephrolithiasis (choice B) is the formation of kidney stones, which is not directly linked to streptococcal infection. Chronic renal failure (choice C) is a long-term decline in kidney function, not typically caused by streptococcal infection.
Which of the following interferes with mycolic acid synthesis an essential component of mycobacterial cell walls for which resistance will develop rapidly if the drug is used alone?
- A. Isoniazid
- B. Rifampicin
- C. Pyrazinamide
- D. Ethanbutol
Correct Answer: A
Rationale: The correct answer is A: Isoniazid. Isoniazid inhibits the synthesis of mycolic acid, a crucial component of mycobacterial cell walls. If used alone, resistance can develop rapidly due to its specific mechanism of action. Rifampicin (B) acts on RNA polymerase, not mycolic acid synthesis. Pyrazinamide (C) targets mycobacteria in acidic environments, not mycolic acid. Ethambutol (D) inhibits arabinosyltransferase, not mycolic acid synthesis.
Mrs. Miller has a diagnosis of acute pyelonephritis. To prevent renal damage her plan of care should include
- A. restricting fluid intake until symptoms are under control
- B. reducing protein intake
- C. understanding the necessity of continuing drug therapy indefinitely
- D. preventing viral infections
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Acute pyelonephritis requires antibiotic therapy to eliminate the infection and prevent renal damage.
2. Continuing drug therapy indefinitely ensures complete eradication of the infection.
3. Stopping drug therapy prematurely can lead to recurrence and potential renal complications.
4. Understanding the necessity of drug therapy is crucial for Mrs. Miller's long-term renal health.
Summary:
A: Incorrect. Restricting fluid intake can worsen the infection and hinder recovery.
B: Incorrect. Protein intake is not directly related to the treatment of acute pyelonephritis.
D: Incorrect. Preventing viral infections is not directly relevant to the treatment of acute pyelonephritis.
Which laboratory result is of most concern for a patient with cystitis?
- A. Serum WBC 9000/mm?
- B. Urinalysis with 1-2 WBCs present
- C. Urine bacteria 100,000 colonies/mL
- D. Serum hematocrit 36%
Correct Answer: C
Rationale: The correct answer is C because a urine bacteria count of 100,000 colonies/mL indicates a significant bacterial infection, which is concerning for cystitis. This result suggests an active infection in the urinary tract, requiring prompt treatment.
A: Serum WBC of 9000/mm³ is within the normal range and may not necessarily indicate an active infection.
B: Urinalysis with 1-2 WBCs present is also within the normal range and may not be indicative of an acute infection.
D: Serum hematocrit of 36% is a measure of the proportion of red blood cells in the blood and is not directly related to cystitis.
A 70 year old man has severe urinary hesitancy associated with BPH. He has tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
- A. Leuprolide
- B. Finasteride
- C. Flutamide
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride is a 5α-reductase inhibitor that reduces the conversion of testosterone to dihydrotestosterone in the prostate, thereby shrinking the prostate gland and improving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used in prostate cancer, not BPH. Flutamide (C) is an antiandrogen used in prostate cancer. Ketoconazole (D) is an antifungal drug and not indicated for BPH.