Nokea
Spironolactone can be usefully combined with the following diuretics except: *
- A. Amiloride
- B. Chlorthalidone
- C. Furosemide
- D. Hydrochlorothiazide
Correct Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic, so combining it with another potassium-sparing diuretic like amiloride can lead to hyperkalemia. Chlorthalidone, a thiazide-like diuretic, can be synergistic with spironolactone. Furosemide, a loop diuretic, can counteract the potassium-sparing effects of spironolactone. Hydrochlorothiazide, a thiazide diuretic, can also lead to hypokalemia when combined with spironolactone. Therefore, the correct answer is D, as combining spironolactone with hydrochlorothiazide may increase the risk of potassium imbalance.
You may also like to solve these questions
Which of the following drugs for treatment of leprosy can cause hemolysis especially in patients with G6PD deficiency?
- A. Dapsone
- B. Rifampicin
- C. Clofazimine
- D. None of these
Correct Answer: A
Rationale: The correct answer is A: Dapsone. Dapsone is known to cause hemolysis in patients with G6PD deficiency due to oxidative stress. G6PD deficiency leads to reduced ability to protect red blood cells from oxidative damage, which can be exacerbated by drugs like dapsone. Rifampicin and clofazimine are not associated with hemolysis in G6PD deficient patients. Option D is incorrect as dapsone is known to cause hemolysis in this population.
The nurse is caring for a patient who underwent with renal calculi. The nurse should instruct the patient to percutaneous lithotripsy earlier in the day. What increase fluid intake to a level where the patient instruction should the nurse give the patient? produces at least how much urine each day?
- A. Limit oral fluid intake for 1 to 2 days.
- B. 1,250 mL
- C. Report the presence of fine, sand like particles
- D. 2,000 mL
Correct Answer: D
Rationale: The correct answer is D (2,000 mL). Adequate fluid intake helps prevent renal calculi formation and aids in flushing out the stone fragments post-lithotripsy. A daily urine output of at least 2,000 mL is recommended to prevent urinary stasis and stone recurrence. Choice A is incorrect as limiting fluid intake can lead to dehydration and hinder stone passage. Choice B is insufficient to ensure proper hydration. Choice C is incorrect as sand-like particles may be expected post-lithotripsy and do not indicate adequate fluid intake.
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.
During a vaginal examination of a 38-year-old woman, the nurse notices that the vulva and vagina are erythematous and edematous with thick, white, curdlike discharge adhering to the vaginal walls. The woman reports intense pruritus and thick white discharge from her vagina. The nurse knows that these history and physical examination findings are most consistent with which condition?
- A. Candidiasis
- B. Trichomoniasis
- C. Atrophic vaginitis
- D. Bacterial vaginosis
Correct Answer: A
Rationale: Step 1: The key clues in the question are thick, white, curdlike discharge, intense pruritus, erythematous, and edematous vulva and vagina.
Step 2: These symptoms are classic for candidiasis, a fungal infection caused by Candida species.
Step 3: Candidiasis commonly presents with thick, white discharge, itching, and inflamed vaginal tissues.
Step 4: Trichomoniasis (choice B) typically presents with frothy, greenish-yellow discharge and vaginal itching.
Step 5: Atrophic vaginitis (choice C) is more common in postmenopausal women and presents with thin, watery discharge and vaginal dryness.
Step 6: Bacterial vaginosis (choice D) presents with thin, grayish-white discharge and a fishy odor.
Step 7: Therefore, based on the symptoms described in the question, the correct answer is A: Candidiasis.
Which of the following fungicidal drug that acts by inhibiting fungal squalene * epoxidase enzyme and is the drug of choice for onymycosis of the toe nails in 56 year old woman with diabetes?
- A. Griseofulvin
- B. Terbinane
- C. Itraconazole
- D. Amphotiricin B
Correct Answer: B
Rationale: Rationale: Terbinafine is the correct answer as it inhibits fungal squalene epoxidase, disrupting ergosterol synthesis in the fungal cell membrane. This drug is specifically effective against onychomycosis in diabetic patients due to its fungicidal action and good nail penetration. Griseofulvin (A) targets microtubules, not squalene epoxidase. Itraconazole (C) inhibits ergosterol synthesis via a different mechanism. Amphotericin B (D) disrupts fungal cell membrane by binding to ergosterol, not squalene epoxidase.