Nokea
The first step in urine production
- A. is called reabsorption.
- B. moves water and solutes from the renal tubules into the peritubular capillaries.
- C. is called secretion.
- D. occurs as water and solutes move from the glomerulus to the glomerular capsul
Correct Answer: D
Rationale: The correct answer is D because the first step in urine production occurs as water and solutes move from the glomerulus to the glomerular capsule during the process of filtration. This initial step involves the passive movement of water and small solutes through the filtration membrane in the glomerulus. Reabsorption (choice A) occurs later in the process when useful substances are reclaimed from the filtrate. Choice B is incorrect as it describes the process of reabsorption, not the initial step. Choice C is also incorrect as secretion is the process of actively transporting substances from the blood into the renal tubules, not the first step in urine production.
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Which antibiotic course is inappropriate for clinical scenario?
- A. Acute simple cystitis - trimethoprim for 3 days in otherwise well young women.
- B. Acute uncomplicated pyelonephritis - gentamycin + amoxicillin IV initially followed by 7 days of Augmentin orally.
- C. Pregnancy associated cystitis - nitrofurantoin 5 mg QID for 14 days.
- D. Acute simple cystitis in male patients - Augmentin or trimethoprim for 14 days.
Correct Answer: B
Rationale: The correct answer is B because the antibiotic regimen for acute uncomplicated pyelonephritis should not include gentamycin due to its potential toxicity and nephrotoxicity. The initial use of IV gentamycin is not recommended for uncomplicated pyelonephritis. The combination of gentamycin and amoxicillin is not the standard treatment for this condition. Gentamycin should be reserved for more serious infections. The choice of Augmentin for 7 days orally is also not the standard of care for pyelonephritis. The other choices (A, C, D) are appropriate antibiotic regimens for the corresponding clinical scenarios.
Which statement best describes Zidovudine:
- A. Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection
- B. Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia
- C. Peripheral neuropathy is a specific adverse reaction to Zidovudine
- D. Zidovudine is converted by cellular enzymes to an active form
Correct Answer: zidovudine diphosphate
Rationale: The correct answer is D: Zidovudine is converted by cellular enzymes to an active form (zidovudine diphosphate). Zidovudine itself is a prodrug that needs to be metabolized by cellular enzymes to its active form, zidovudine diphosphate, which inhibits HIV replication by acting as a nucleoside reverse transcriptase inhibitor. This active form is essential for its antiretroviral activity.
Incorrect Choices:
A: Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection - This is incorrect because zidovudine is commonly used in combination with other antiretrovirals as a first-line treatment for HIV infection, not as an alternative treatment.
B: Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia - This is incorrect because zidovudine is primarily used in
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.
A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?
- A. Residual urine greater than 200 mL
- B. A large, atonic bladder on urodynamic testing
- C. A voiding pattern that indicates psychogenic urinary retention
- D. Pain with bladder filling that is transiently relieved by urination
Correct Answer: D
Rationale: The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.
Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.
During the interview, a patient reveals that she has some vaginal discharge. She is worried that it may be a sexually transmitted infection. The nurse's most appropriate response to this would be:
- A. Oh, don't worry. Some cyclic vaginal discharge is normal.
- B. Have you been engaging in unprotected sexual intercourse?
- C. I'd like some information about the discharge. What color is it?
- D. Have you had any urinary incontinence associated with the discharge?
Correct Answer: C
Rationale: The correct answer is C because it focuses on gathering more information about the vaginal discharge, which is essential in assessing the patient's condition. By asking about the color of the discharge, the nurse can gather valuable information to help determine if it might be related to a sexually transmitted infection or another issue. This approach shows a patient-centered and thorough assessment.
Choice A is incorrect as it dismisses the patient's concerns without obtaining further information. Choice B jumps to conclusions about unprotected sexual intercourse without first assessing the situation. Choice D is unrelated to the patient's primary concern about vaginal discharge and urinary incontinence.