Nokea
The nurse instructs the patient that the BEST time for an incontinent patient to take his diuretics is
- A. Any time of the day
- B. In the morning
- C. After 4:00 PM
- D. At bedtime
Correct Answer: D
Rationale: The best time for an incontinent patient to take diuretics is at bedtime. This timing allows for increased urine production during the night, consequently reducing the need for frequent toileting during the day. By taking the diuretic at bedtime, the patient can manage their incontinence more effectively and have better rest without disruptions from frequent urination during the day.
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Which of the following definition MOST accurately describes meningomyelocele? It is _______.
- A. Spinal cord tumor containing nerve roots.
- B. Complete exposure of the spinal cord and meninges.
- C. Herniation of spinal cord, cerebro-spinal fluid and meninges into a sac.
- D. Sac formation containing meninges and spinal fluid.
Correct Answer: C
Rationale: Meningomyelocele is a type of neural tube defect where there is a protrusion of the spinal cord, cerebrospinal fluid, and meninges through a defect in the vertebrae, forming a sac on the surface of the back. This condition occurs during fetal development when the neural tube fails to close completely, leading to the exposure of the spinal cord and its coverings. This herniation can result in a range of neurological deficits and complications, requiring surgical repair shortly after birth to prevent further damage and infections.
A retired nurse stops to help in an emergency at the scene of an accident, if the injured party files suit and the, the nurse would probably be covered by
- A. Her homeowner's insurance
- B. National Care Act
- C. Her automobile insurance
- D. The Good Samaritan Law
Correct Answer: D
Rationale: The Good Samaritan Law offers legal protection to individuals who voluntarily provide assistance at the scene of an emergency or accident. These laws vary by state, but generally, they grant immunity from civil liability for the individual providing aid as long as they act in good faith and without expectation of compensation. In this case, the retired nurse who stopped to help in the emergency at the scene of an accident would likely be covered by the Good Samaritan Law, protecting her from being sued by the injured party for any unintended consequences of her efforts to assist.
A few days later, the patient comes into the emergency department via ambulance stretcher and reveals a work-up of blood sugar level at 800mg/dl, ketones are absent in the urine, she is dehydrated, and has an altered mental status. Based on the data, t he patient is most likely suferring from what specifi medical condition?
- A. Hyperosmolar nonketotic coma (HNKC)
- B. Diabetic retinopathy
- C. Acute renal failure
- D. Diabetic ketoacidosis (DKA)
Correct Answer: A
Rationale: The patient's presentation with a blood sugar level of 800mg/dL, absence of ketones in the urine, dehydration, and altered mental status points towards Hyperosmolar nonketotic coma (HNKC). HNKC typically occurs in patients with Type 2 diabetes and is characterized by extremely high blood glucose levels (hyperglycemia) without significant ketosis. The absence of ketones in the urine distinguishes HNKC from Diabetic ketoacidosis (DKA). Patients with HNKC often present with severe dehydration, altered mental status, and hyperosmolarity. It is crucial to address the underlying cause of the hyperglycemia, correct dehydration, and normalize blood glucose levels promptly in the management of HNKC.
Which of the following is the most common type of ovarian tumor in women of reproductive age?
- A. Serous cystadenoma
- B. Mucinous cystadenoma
- C. Teratoma (dermoid cyst)
- D. Endometrioma
Correct Answer: C
Rationale: Among the given options, teratoma (dermoid cyst) is the most common type of ovarian tumor in women of reproductive age. Dermoid cysts are a type of ovarian teratoma that contains tissues derived from the ectoderm (skin), mesoderm (bone, muscle), and endoderm (mucous membranes). They are usually benign and can contain a variety of elements such as hair, teeth, bone, and sebaceous material. Serous cystadenomas and mucinous cystadenomas are more commonly seen in older women, whereas endometriomas are typically associated with endometriosis rather than being the most common ovarian tumor type in women of reproductive age.
Amitriptyline, an antidepressant is the drug of choice in treating Bulimia. What is a COMMON side effect of this drug?
- A. Anticholinergic effects
- B. Cholinergic effects
- C. Urinary frequency
- D. Diarrhea
Correct Answer: A
Rationale: Amitriptyline, being a tricyclic antidepressant, commonly causes anticholinergic side effects. These effects include dry mouth, constipation, blurred vision, urinary retention, and confusion. Anticholinergic effects are due to the drug's inhibition of the neurotransmitter acetylcholine, which can lead to the symptoms mentioned above. These side effects can be bothersome for patients taking amitriptyline, but they are generally manageable and often improve over time as the body adjusts to the medication. In the case of bulimia treatment, the benefits of using amitriptyline to address the underlying psychological issues often outweigh the side effects.