Nokea
The commonest type of ureteric calculus is
- A. calcium oxalate
- B. triple phosphate
- C. urate
- D. cysteine
Correct Answer: A
Rationale: The correct answer is A: calcium oxalate. This is because calcium oxalate stones are the most common type of ureteric calculus, accounting for around 75% of cases. They form due to an excess of calcium and oxalate in the urine. Triple phosphate stones (choice B) are more commonly found in the bladder and are associated with urinary tract infections. Urate stones (choice C) are less common and typically seen in patients with gout or acidic urine. Cysteine stones (choice D) are rare and usually seen in patients with a genetic disorder affecting cysteine metabolism.
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Which of the following diuretics is the most potent and cause hypotension * due to hypovolemia from excessive diuresis?
- A. Acetazolamide
- B. Furosemide
- C. Spironolactone
- D. Hydrocholorpthiazide
Correct Answer: B
Rationale: Step 1: Furosemide is a loop diuretic, known for its high potency in inhibiting the reabsorption of sodium and chloride in the loop of Henle.
Step 2: This leads to significant diuresis, causing hypovolemia and subsequent hypotension.
Step 3: Acetazolamide is a carbonic anhydrase inhibitor diuretic, not as potent as loop diuretics.
Step 4: Spironolactone is a potassium-sparing diuretic, less likely to cause hypotension due to its mechanism of action.
Step 5: Hydrochlorothiazide is a thiazide diuretic, less potent than loop diuretics like furosemide in causing hypovolemia and hypotension.
Where are the glomeruli and Bowman’s capsules found?
- A. Renal pelvis
- B. Ureter
- C. Renal cortex
- D. Renal column
Correct Answer: C
Rationale: The glomeruli and Bowman's capsules are found in the renal cortex. The renal cortex is the outer layer of the kidney where the initial stages of urine formation occur. Glomeruli are clusters of capillaries responsible for filtering blood, while Bowman's capsules surround the glomeruli and collect the filtrate. The renal pelvis (A) is the innermost part of the kidney where urine collects before entering the ureter (B). Renal columns (D) are extensions of the renal cortex that project into the renal medulla. Therefore, the correct answer is C as it accurately locates the structures involved in urine filtration.
Your patient does not seem to be responding to conservative treatment for acute renal failure, and dialysis is being considered. You understand that the main indication for dialysis is
- A. generalized edema
- B. elevated blood pressure
- C. elevated blood calcium
- D. a high and rising level of potassium
Correct Answer: D
Rationale: The correct answer is D: a high and rising level of potassium. Dialysis is indicated in acute renal failure when the patient has severe electrolyte imbalances, especially hyperkalemia, which can lead to life-threatening arrhythmias. Potassium levels must be closely monitored, and if they are high and continue to rise despite conservative treatment, dialysis is necessary to quickly lower the potassium levels. Generalized edema (A) is a symptom of renal failure but is not the main indication for dialysis. Elevated blood pressure (B) and elevated blood calcium (C) are not direct indications for dialysis in the context of acute renal failure.
You should take this medication with meals to avoid stomach ulcers.
- A. TRUE
- B. FALSE
- C. Maybe
- D. Not mentioned
Correct Answer: A
Rationale: The correct answer is A: TRUE. Taking medication with meals can help to prevent stomach ulcers by reducing the direct contact of the medication with the stomach lining. Food acts as a buffer, decreasing the likelihood of irritation or ulcer formation. The other choices are incorrect because B: FALSE implies the opposite, C: Maybe lacks a clear stance, and D: Not mentioned does not provide any useful information to answer the question definitively.
A gerontologic nurse is assessing a patient who has
- A. The patients suprapubic region is dull on percussion. numerous comorbid health problems. What assessment
- B. The patient is uncharacteristically drowsy. findings should prompt the nurse to suspect a UTI?
- C. The patient claims to void large amounts of urine 2 to Select all that apply.
- D. Food cravings
Correct Answer: B
Rationale: The correct answer is B because uncharacteristic drowsiness can be a sign of a urinary tract infection (UTI) in older adults. UTIs can present atypically in older adults with symptoms like confusion, lethargy, and drowsiness. The other choices are incorrect because:
A: A dull suprapubic region on percussion is not specific to UTI.
C: Voiding large amounts of urine is not a typical symptom of UTI.
D: Food cravings are not associated with UTI symptoms.