Nokea
The Na+Cl- transporter in the distal convoluted tubule of the kidney is blocked by:
- A. Spironolactone
- B. Thiazides
- C. Furosemide
- D. Ethacrynic acid
Correct Answer: B
Rationale: The correct answer is B: Thiazides. Thiazides work by inhibiting the Na+/Cl- transporter in the distal convoluted tubule, leading to decreased sodium reabsorption and increased urine output. This results in decreased blood volume and lower blood pressure. Spironolactone (A) works by blocking aldosterone receptors, affecting potassium and sodium balance. Furosemide (C) and Ethacrynic acid (D) act on the loop of Henle, inhibiting the Na+/K+/2Cl- transporter. Therefore, the correct answer is B because thiazides specifically target the Na+/Cl- transporter in the distal convoluted tubule.
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The nurse caring for a patient with suspected renal has been referred by her primary physician for further dysfunction calculates that the patients weight has evaluation. The nurse should anticipate the use of what increased by 5 pounds in the past 24 hours. The nurse initial diagnostic test?
- A. Ultrasound
- B. X-ray
- C. 1,300 mL of fluid in 24 hours
- D. Computed tomography (CT)
Correct Answer: A
Rationale: The correct answer is A: Ultrasound. This is the appropriate initial diagnostic test for suspected renal dysfunction due to its non-invasive nature and ability to visualize the kidneys and urinary system. Ultrasound can detect abnormalities such as kidney stones or obstruction. X-ray (B) does not provide detailed imaging of the kidneys. Option C refers to fluid intake, which is not a diagnostic test. Computed tomography (CT) scan (D) involves radiation exposure and is usually reserved for more advanced imaging after initial ultrasound. Ultrasound is the most suitable choice for initial evaluation of renal dysfunction.
Which antibiotic is primarily bacteriostatic but becomes bactericidal at higher * concentrations?:
- A. Erythromycin
- B. Tetracycline
- C. Chloramphenicol
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Chloramphenicol. At lower concentrations, Chloramphenicol is primarily bacteriostatic, inhibiting bacterial protein synthesis. However, at higher concentrations, it can disrupt the bacterial ribosome, leading to bacterial cell death, making it bactericidal. Erythromycin (A) and Tetracycline (B) are primarily bacteriostatic by inhibiting protein synthesis. Ampicillin (D) interferes with bacterial cell wall synthesis but does not exhibit a concentration-dependent shift to bactericidal activity like Chloramphenicol.
In which type of dialysis does the patient dialyze during sleep and leave the fluid in the abdomen during the day?
- A. Long nocturnal hemodialysis
- B. Automated peritoneal dialysis (APD)
- C. Continuous venovenous hemofiltration (CVVH)
- D. Continuous ambulatory peritoneal dialysis (CAPD)
Correct Answer: B
Rationale: The correct answer is B: Automated peritoneal dialysis (APD). In APD, the patient connects to a machine at night for dialysis while sleeping, and during the day, the dialysis fluid remains in the abdomen. This allows for continuous treatment without the need for daytime exchanges.
A: Long nocturnal hemodialysis involves nighttime hemodialysis sessions but does not involve leaving fluid in the abdomen during the day.
C: Continuous venovenous hemofiltration is a continuous renal replacement therapy used in critically ill patients, not for ambulatory dialysis.
D: Continuous ambulatory peritoneal dialysis (CAPD) requires manual exchanges throughout the day, unlike APD where the fluid remains in the abdomen during the day.
Which disease causes connective tissue changes that cause glomerulonephritis?
- A. Gout
- B. Amyloidosis
- C. Diabetes mellitus
- D. Systemic lupus erythematosus
Correct Answer: D
Rationale: The correct answer is D: Systemic lupus erythematosus (SLE). SLE is an autoimmune disease that can affect multiple organs, including the kidneys. In SLE, the immune system attacks healthy tissues, leading to inflammation and damage to the connective tissues in the kidneys, resulting in glomerulonephritis. Gout (A) is a form of arthritis caused by the buildup of uric acid crystals, not directly related to glomerulonephritis. Amyloidosis (B) is a condition where abnormal protein deposits can accumulate in organs, but it does not primarily cause glomerulonephritis. Diabetes mellitus (C) can lead to diabetic nephropathy, a common cause of kidney damage, but it does not directly cause glomerulonephritis associated with connective tissue changes.
While caring for a 77-year-old woman who has a urinary catheter, the nurse monitors the patient for the development of a UTI. What clinical manifestations is the patient most likely to experience?
- A. Cloudy urine and fever
- B. Urethral burning and bloody urine
- C. Vague abdominal discomfort and disorientation
- D. Suprapubic pain and slight decline in body temperature
Correct Answer: A
Rationale: The correct answer is A: Cloudy urine and fever. UTI in a patient with a urinary catheter may present with cloudy urine due to pus or bacteria, and fever due to infection. Urethral burning and bloody urine (B) are more indicative of urethritis or bladder trauma. Vague abdominal discomfort and disorientation (C) are not specific to UTI. Suprapubic pain and slight decline in body temperature (D) are less likely with UTI.