Nokea
The nurse has implemented a bladder retraining
- A. Risk for deficient fluid volume related to urinary program for an older adult patient. The nurse places the diversion patient on a timed voiding schedule and performs an
- B. Risk for autonomic dysreflexia related to disruption of ultrasonic bladder scan after each voi
- C. The nurse notes the sacral plexus that the patient typically has approximately 50 mL of urine remaining in her bladder after voiding. What would
Correct Answer: A
Rationale: The correct answer is A because bladder retraining aims to improve urinary control and prevent incontinence in older adults. Implementing a timed voiding schedule helps the patient regain control over their bladder function and reduces the risk of urinary issues. Option B is incorrect as autonomic dysreflexia is not typically associated with bladder retraining. Option C is incorrect as it describes a normal bladder residual volume, which does not directly relate to bladder retraining. Option D is incomplete.
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The patient with chronic kidney disease is considering whether to use peritoneal dialysis (PD) or hemodialysis (HD). What are advantages of PD when compared to HD (select all that apply)?
- A. Less protein loss
- B. Rapid fluid removal
- C. Less cardiovascular stress
- D. Decreased hyperlipidemia
Correct Answer: A
Rationale: The correct answer is A: Less protein loss. Peritoneal dialysis (PD) occurs continuously, allowing for a slower and gentler removal of waste products, leading to less protein loss compared to the intermittent nature of hemodialysis (HD). This is because PD uses the peritoneal membrane as a filter, which is more gentle on proteins.
Rapid fluid removal (B) is actually an advantage of HD, as it can quickly remove excess fluids. Less cardiovascular stress (C) is not a specific advantage of PD over HD, as both types of dialysis can impact cardiovascular health. Decreased hyperlipidemia (D) is not a direct advantage of PD over HD.
A 20 year old patient presented to the ER with headache, stiff neck and fever for 3 days and is diagnosed with bacterial meningitis. Which one of the following antibiotics is the best choice to treat meningitis?
- A. Cefuroxime
- B. Cephalexin
- C. Cefotaxime
- D. Cefdinir
Correct Answer: C
Rationale: The correct answer is Cefotaxime (C) because it is a third-generation cephalosporin with excellent penetration into the cerebrospinal fluid, making it effective against bacterial meningitis pathogens. Cefotaxime covers a broad spectrum of bacteria commonly causing meningitis, including Streptococcus pneumoniae and Neisseria meningitidis.
A: Cefuroxime (A) is not the best choice as it has limited activity against some of the common pathogens causing meningitis.
B: Cephalexin (B) is a first-generation cephalosporin with poor central nervous system penetration and limited activity against meningitis pathogens.
D: Cefdinir (D) is a third-generation cephalosporin but is not the preferred choice for treating bacterial meningitis due to its inferior CNS penetration compared to cefotaxime.
Antiviral agents that is/ are active against cytomegalovirus (CMV) include * which of the following?
- A. Ganciclovir
- B. Foscarnet
- C. Acyclovir
- D. (
Correct Answer: A
Rationale: Step-by-step rationale for choice A (Ganciclovir) being the correct answer:
1. Ganciclovir is a nucleoside analog that inhibits CMV DNA synthesis.
2. It is specifically approved for the treatment of CMV retinitis in immunocompromised patients.
3. Ganciclovir has a high specificity for CMV, making it an effective antiviral agent against CMV.
Summary of why the other choices are incorrect:
- Choice B (Foscarnet) is also active against CMV but is not as commonly used as Ganciclovir.
- Choice C (Acyclovir) is not effective against CMV as it primarily targets herpes simplex virus and varicella-zoster virus.
- Choice D ( ) is an incomplete choice and does not correspond to any known antiviral agent.
A 62-year-old man states that his physician told him that he has an “inguinal hernia.†He asks the nurse to explain what a hernia is. The nurse should:
- A. Tell him not to worry and that most men his age develop hernias.
- B. Explain that a hernia is often the result of prenatal growth abnormalities.
- C. Refer him to his physician for additional consultation because the physician made the initial diagnosis.
- D. Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
Correct Answer: D
Rationale: Step 1: Define hernia as a condition where an organ or fatty tissue protrudes through a weak spot in the surrounding muscle or connective tissue.
Step 2: Emphasize the relevance to the patient's situation.
Step 3: Clarify that an inguinal hernia specifically involves the intestines protruding through the inguinal canal in the groin area.
Step 4: Explain that surgery may be needed to repair the hernia.
Step 5: Stress the importance of seeking medical attention for proper evaluation and treatment.
Summary:
A: Incorrect - Dismissing the patient's concerns is not appropriate.
B: Incorrect - Hernias are not typically related to prenatal growth abnormalities.
C: Incorrect - The nurse can provide basic information about hernias without needing the physician to explain further.
One of your patients is awaiting laboratory results for kidney function. The patient has recently recovered from a streptococcal throat infection. The patient has most likely developed symptoms of:
- A. Pyelonephritis.
- B. Nephrolithiasis.
- C. Chronic renal failure.
- D. Glomerulonephritis.
Correct Answer: D
Rationale: The correct answer is D: Glomerulonephritis. Streptococcal infection can lead to poststreptococcal glomerulonephritis (PSGN), an immune-mediated inflammation of the glomeruli in the kidneys. This results in hematuria, proteinuria, hypertension, and edema. Pyelonephritis (choice A) is a bacterial infection of the kidneys, not related to streptococcal infection. Nephrolithiasis (choice B) is the formation of kidney stones, which is not directly linked to streptococcal infection. Chronic renal failure (choice C) is a long-term decline in kidney function, not typically caused by streptococcal infection.