Nokea
The nurse is performing a genital examination on a male patient and notices urethral drainage. When collecting urethral discharge for microscopic examination and culture, the nurse should:
- A. Ask the patient to urinate into a sterile cup.
- B. Ask the patient to obtain a specimen of semen.
- C. Insert a cotton-tipped applicator into the urethra.
- D. Compress the glans between the examiner’s thumb and forefinger, and collect any discharge.
Correct Answer: D
Rationale: The correct answer is D because gently compressing the glans between the thumb and forefinger can help express the urethral discharge for collection. This method minimizes contamination and ensures a proper sample for microscopic examination and culture.
A: Asking the patient to urinate into a cup would not capture the discharge.
B: Semen is not relevant for urethral discharge testing.
C: Inserting a cotton-tipped applicator into the urethra may cause trauma and is not recommended for collecting urethral discharge.
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Thirty percent of patients with kidney cancer have metastasis at the time of diagnosis. Why does this occur?
- A. The only treatment modalities for the disease are palliative.
- B. Diagnostic tests are not available to detect tumors before they metastasize.
- C. Classic symptoms of hematuria and palpable mass do not occur until the disease is advanced.
- D. Early metastasis to the brain impairs the patient’s ability to recognize the seriousness of symptoms.
Correct Answer: D
Rationale: The correct answer is D because early metastasis to the brain can impair the patient's ability to recognize the seriousness of symptoms. This can delay diagnosis and treatment, leading to a higher percentage of patients having metastasis at the time of diagnosis.
A is incorrect because there are treatment modalities for kidney cancer beyond palliative care. B is incorrect as diagnostic tests like imaging studies can detect tumors before they metastasize. C is incorrect because while classic symptoms may not always be present, other symptoms and diagnostic tests can still lead to an earlier diagnosis.
During an examination, the nurse would expect the cervical os of a woman who has never had children to appear:
- A. Stellate.
- B. Small and round.
- C. As a horizontal irregular slit.
- D. Everted.
Correct Answer: B
Rationale: The correct answer is B: Small and round. In a woman who has never had children, the cervical os is typically small and round due to the lack of previous childbirth stretching. This is considered normal and expected in nulliparous women.
A: Stellate - This is incorrect as a stellate appearance of the cervical os is more commonly associated with trauma or previous childbirth.
C: As a horizontal irregular slit - This is incorrect as an irregular slit appearance is more commonly seen in women who have had children.
D: Everted - This is incorrect as an everted cervical os is typically seen in conditions such as cervical ectropion or inflammation, not necessarily related to parity status.
Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?
- A. Do you need to get up at night to urinate?
- B. Do you experience nocturnal emissions, or wet dreams?
- C. Do you know how to perform a testicular self-examination?
- D. Has anyone ever touched your genitals when you did not want them to?
Correct Answer: A
Rationale: The correct answer is A because it pertains to a common genitourinary issue in older men, nocturia. Nocturnal emissions (choice B) are not typically relevant in this context. Testicular self-examination (choice C) is more appropriate for younger men, and asking about unwanted touching (choice D) is not relevant to obtaining a genitourinary history. Asking about nocturia can provide valuable information about potential prostate issues, urinary tract infections, or other conditions commonly affecting older men.
A 30-year-old woman presents to the clinic with a complaint of a delayed period and abdominal discomfort. The nurse suspects pregnancy. Which of the following is the earliest and most reliable sign of pregnancy?
- A. A missed period.
- B. Positive urine pregnancy test.
- C. Changes in breast size.
- D. Abdominal tenderness and bloating.
Correct Answer: C
Rationale: The correct answer is C: Changes in breast size. This is because hormonal changes in early pregnancy can cause breast tenderness, swelling, and darkening of the areola. This typically occurs before a missed period or a positive urine pregnancy test. A missed period (choice A) is a common sign of pregnancy, but not the earliest. A positive urine pregnancy test (choice B) confirms pregnancy but may not be the earliest sign. Abdominal tenderness and bloating (choice D) can occur due to various reasons and are not specific to pregnancy. Therefore, changes in breast size are the earliest and most reliable sign of pregnancy in this scenario.
Which of the following drug is a radical curative in plasmodium vivax malaria * and is used as prophylaxis for malaria at Chloroquine sensitive regions
- A. Quinine
- B. Primaquine
- C. Meoquine
- D. Chloroquine
Correct Answer: B
Rationale: The correct answer is B: Primaquine. Primaquine is a radical curative drug for Plasmodium vivax malaria, as it targets the hypnozoite stage in the liver, preventing relapses. It is also used as prophylaxis in Chloroquine-sensitive regions due to its efficacy against P. vivax and P. ovale.
Rationale:
1. Quinine (A) is not a radical curative drug for P. vivax malaria. It is mainly used for treatment of acute malaria.
2. Meoquine (C) is not a radical curative drug for P. vivax malaria and is used more for prophylaxis in certain regions.
3. Chloroquine (D) is not a radical curative drug for P. vivax malaria and is primarily used for treatment and prevention of malaria caused by susceptible strains of Plasmodium species.