Nokea
The kidney does all of the following when the pH of the extracellular fluid drops, EXCEPT:
- A. excrete more hydrogen ions.
- B. excrete fewer bicarbonate ions.
- C. secrete more hydrogen ions and more bicarbonate ions.
- D. secrete more hydrogen ions and fewer bicarbonate ions.
Correct Answer: C
Rationale: The correct answer is C because when the pH drops, the kidney aims to restore acid-base balance by excreting more hydrogen ions and reabsorbing more bicarbonate ions. Choice A is incorrect because the kidney excretes more hydrogen ions to help raise the pH. Choice B is incorrect because the kidney excretes more bicarbonate ions to help buffer the excess hydrogen ions. Choice D is incorrect because the kidney would not secrete fewer bicarbonate ions when trying to compensate for a drop in pH.
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A 28 year old male patient present with a painless sore in his penis and blood * test confirms Treponema pallidum. Which of the following agent is the treatment of choice that can be given as a single dose?
- A. Benzathine penicillin
- B. Ceftriaxone
- C. Vancomycin
- D. Aztreonam
Correct Answer: A
Rationale: The correct answer is A: Benzathine penicillin. The treatment of choice for syphilis caused by Treponema pallidum is penicillin. Benzathine penicillin is preferred due to its long-acting nature, providing sustained therapeutic levels. It is given as a single dose for early-stage syphilis. Ceftriaxone, vancomycin, and aztreonam are not effective against Treponema pallidum and are not recommended for the treatment of syphilis. Benzathine penicillin remains the first-line treatment due to its efficacy and established effectiveness against syphilis.
While managing a client after a medical or surgical procedure for bladder stones, when should the nurse notify the physician?
- A. Assessment of sexual habits
- B. Assessment and recognition of abnormal findings
- C. Assessment of allergies to seafood
- D. Assessment of insurance coverage
Correct Answer: B
Rationale: The correct answer is B because assessing and recognizing abnormal findings is crucial in post-procedure care for bladder stones. This includes monitoring for signs of infection, urinary retention, bleeding, or other complications that may require immediate medical intervention. Notifying the physician promptly allows for timely treatment and prevents potential complications. Choices A, C, and D are incorrect as they are not directly related to the immediate post-procedure care for bladder stones and do not require immediate physician notification.
A 35 year old man presents to the ER with severe headache. After lab workup, patient is diagnosed to have increased intracranial pressure. Which diuretic would work best to reduce this pressure?
- A. Hydrochlorothiazide
- B. Mannitol
- C. Acetazolamide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Mannitol. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and reducing intracranial pressure. It is commonly used in cases of increased intracranial pressure due to its ability to easily cross the blood-brain barrier and reduce cerebral edema. Hydrochlorothiazide (A) is a thiazide diuretic mainly used for hypertension and not effective for this condition. Acetazolamide (C) is a carbonic anhydrase inhibitor that can reduce CSF production but is not as effective as mannitol for rapid reduction of intracranial pressure. Furosemide (D) is a loop diuretic that primarily acts on the kidneys and is not as effective as mannitol for reducing intracranial pressure.
When the nurse is interviewing a preadolescent girl, which opening question would be least threatening?
- A. Do you have any questions about growing up?
- B. What has your mother told you about growing up?
- C. When did you notice that your body was changing?
- D. I remember being very scared when I got my period. How do you think you'll feel?
Correct Answer: C
Rationale: Correct Answer: C - "When did you notice that your body was changing?"
Rationale:
1. This question is open-ended and focuses on the preadolescent girl's personal experience, allowing her to share information at her comfort level.
2. It avoids assumptions and allows the girl to express herself without feeling pressured.
3. By asking about her own observations, it encourages self-reflection and empowers her to communicate about her body changes.
Summary:
A - Option A might indirectly suggest that the girl should have questions about growing up, potentially creating pressure.
B - Option B assumes the mother's role as the primary source of information, potentially overlooking the girl's own experiences.
D - Option D introduces the tutor's personal experience, which may lead the girl to compare her feelings to the tutor's, potentially causing unnecessary anxiety.
Which of the following drug which directly inhibits HIV-reverse transcriptase * without the need for intracellular activation by phosphorylation:
- A. Nelnavir
- B. Nevirapine
- C. Stavudine
- D. Didanosine
Correct Answer: B
Rationale: The correct answer is B: Nevirapine. Nevirapine is a non-nucleoside reverse transcriptase inhibitor (NNRTI) that directly inhibits HIV-reverse transcriptase without needing intracellular activation. It binds directly to the enzyme's active site, preventing the conversion of viral RNA to DNA.
Rationale:
1. Nelnavir (A) is a protease inhibitor that works by blocking the protease enzyme needed for viral replication, not reverse transcriptase inhibition.
2. Stavudine (C) and Didanosine (D) are nucleoside reverse transcriptase inhibitors (NRTIs) that require intracellular phosphorylation to become active, unlike Nevirapine.
In summary, Nevirapine is the correct answer as it directly inhibits HIV-reverse transcriptase without needing intracellular activation, distinguishing it from the other choices which belong to different drug classes or require intracellular phosphorylation.