Nokea
Red man syndrome has been associated with rapid intravenous injection of which of the following antibiotic?
- A. Vancomycin
- B. Clindamycin
- C. Cefoperazone
- D. Piperacillin
Correct Answer: A
Rationale: The correct answer is A: Vancomycin. Red man syndrome is a type of hypersensitivity reaction associated with rapid intravenous infusion of vancomycin. This is due to the release of histamine from mast cells and basophils. Vancomycin is known to cause this syndrome, while the other antibiotics listed do not have a similar association. Clindamycin is more commonly associated with pseudomembranous colitis, Cefoperazone with liver toxicity, and Piperacillin with hypersensitivity reactions like rash or anaphylaxis. Therefore, based on the mechanism of action and clinical evidence, vancomycin is the correct choice for causing red man syndrome.
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A 70 year old man requires treatment with an alpha-blocker for overflow incontinence due to enlarged prostate. Which of the following alpha blocking drugs is most appropriate drug to prescribe that will not affect his blood pressure significantly?
- A. Prazosin
- B. Phentolamine
- C. Tamsulosin
- D. Terazosin
Correct Answer: C
Rationale: The correct answer is C: Tamsulosin. It is the most appropriate alpha-blocker for the elderly man with enlarged prostate and overflow incontinence because of its selective action on alpha-1A receptors in the prostate, leading to relaxation of smooth muscle without significantly affecting blood pressure.
Rationale:
1. Prazosin (Choice A) and Terazosin (Choice D) are non-selective alpha-blockers that can cause significant blood pressure lowering due to their action on alpha-1 receptors in blood vessels, which may not be suitable for this patient.
2. Phentolamine (Choice B) is also a non-selective alpha-blocker that can lead to significant blood pressure reduction, making it unsuitable for this patient.
3. Tamsulosin (Choice C) is a selective alpha-1A blocker, primarily acting on the prostate, with minimal impact on blood pressure, making it the most appropriate choice for this patient.
A 25-year-old woman presents to the clinic with pain in her lower abdomen and an abnormal pap smear result. The nurse suspects that she might have an ectopic pregnancy. Which of the following is the most common symptom of ectopic pregnancy?
- A. Severe pain on one side of the lower abdomen.
- B. Severe nausea and vomiting.
- C. Pain with urination or bowel movements.
- D. Frequent urination.
Correct Answer: B
Rationale: The correct answer is B: Severe nausea and vomiting. In an ectopic pregnancy, the fertilized egg implants outside the uterus, commonly in the fallopian tube. As the pregnancy progresses, the tube can rupture, leading to severe internal bleeding. This bleeding can irritate the abdominal lining, causing nausea and vomiting. Severe pain on one side of the lower abdomen (choice A) is also common but not the most common symptom. Pain with urination or bowel movements (choice C) and frequent urination (choice D) are not typical symptoms of ectopic pregnancy.
How would you instruct the client to obtain a clean-catch midstream urine specimen?
- A. Increase fluid intake.
- B. Refrain from taking nephrotoxic drugs.
- C. Take sedative medications.
- D. Maintain limited physical activity.
Correct Answer: D
Rationale: Step-by-step rationale for choosing option D:
1. Instruct the client to maintain limited physical activity to prevent contamination of the urine sample.
2. Physical activity can introduce bacteria from sweat or skin into the specimen, leading to inaccurate results.
3. By limiting physical activity, the client can ensure a clean-catch midstream urine sample for accurate testing.
4. Increasing fluid intake (option A), refraining from nephrotoxic drugs (option B), and taking sedative medications (option C) are not directly related to obtaining a clean-catch midstream urine specimen.
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.
Which hormone does not play a role in regulating fluid and electrolyte balance?
- A. ADH
- B. aldosterone
- C. leptin
- D. atrial natriuretic peptide
Correct Answer: C
Rationale: Leptin does not play a role in regulating fluid and electrolyte balance because it is primarily involved in regulating energy balance and appetite. ADH (antidiuretic hormone) helps in water reabsorption, aldosterone regulates sodium and potassium levels, and atrial natriuretic peptide promotes sodium excretion. Leptin's main function is to regulate hunger and energy expenditure, making it unrelated to fluid and electrolyte balance regulation.