Nokea
The right atrium myocytes secrete atrial natriuretic peptide (ANP) when there is increased plasma volume. What actions does ANP take to produce a large volume of dilute urine?
- A. Inhibits renin
- B. Increases ADH
- C. Inhibits angiotensin II action
- D. Decreases sodium excretion
Correct Answer: A
Rationale: The correct answer is A: Inhibits renin. ANP inhibits renin release, which leads to decreased aldosterone secretion. This results in decreased reabsorption of sodium and water in the kidneys, promoting excretion of sodium and water, ultimately producing a large volume of dilute urine.
Summary:
B: Increases ADH - ANP actually opposes the action of ADH, which promotes water reabsorption in the kidneys.
C: Inhibits angiotensin II action - ANP does inhibit the action of angiotensin II, but this does not directly lead to the production of dilute urine.
D: Decreases sodium excretion - ANP actually increases sodium excretion by inhibiting renin and aldosterone, leading to decreased reabsorption of sodium.
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Which of the following interferes with mycolic acid synthesis an essential component of mycobacterial cell walls for which resistance will develop rapidly if the drug is used alone?
- A. Isoniazid
- B. Rifampicin
- C. Pyrazinamide
- D. Ethanbutol
Correct Answer: A
Rationale: The correct answer is A: Isoniazid. Isoniazid inhibits the synthesis of mycolic acid, a crucial component of mycobacterial cell walls. If used alone, resistance can develop rapidly due to its specific mechanism of action. Rifampicin (B) acts on RNA polymerase, not mycolic acid synthesis. Pyrazinamide (C) targets mycobacteria in acidic environments, not mycolic acid. Ethambutol (D) inhibits arabinosyltransferase, not mycolic acid synthesis.
The examiner is going to inspect and palpate for a hernia. During this exam, the man is instructed to:
- A. Hold his breath during palpation.
- B. Cough after the examiner has gently inserted the exam finger into the rectum.
- C. Bear down when the examiner’s finger is at the inguinal canal.
- D. Relax in a supine position while the exam finger is inserted into the canal.
Correct Answer: C
Rationale: The correct answer is C: Bear down when the examiner's finger is at the inguinal canal. This action increases intra-abdominal pressure, which helps to push out any potential hernia through the inguinal canal for easier detection. Holding his breath (A) would not facilitate hernia detection. Coughing after insertion (B) is used for rectal exams, not hernia assessment. Relaxing in a supine position (D) is not helpful for hernia examination as it does not aid in hernia protrusion.
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.
The following tetracycline has the potential to cause vestibular toxicity:
- A. Doxycycline
- B. Oxytetracycline
- C. Minocycline
- D. Demeclocycline
Correct Answer: C
Rationale: Step-by-step rationale:
1. Minocycline is known to cause vestibular toxicity due to its lipophilicity and ability to accumulate in inner ear structures.
2. Vestibular toxicity can manifest as dizziness, vertigo, and imbalance.
3. Doxycycline, oxytetracycline, and demeclocycline are less likely to cause vestibular toxicity.
4. Doxycycline is commonly used and well-tolerated, oxytetracycline has a different side effect profile, and demeclocycline is primarily associated with nephrotoxicity.
Summary:
Choice C (Minocycline) is correct due to its propensity for causing vestibular toxicity. Choices A, B, and D are incorrect as they are less likely to cause this specific adverse effect.
A nurse is caring for a 73-year-old patient with a renal dysfunction. When reviewing laboratory results for urethral obstruction related to prostatic enlargement. this patient, the nurse interprets the presence of which When planning this patients care, the nurse should be substances in the urine as most suggestive of aware of the consequent risk of what complication?
- A. Urinary tract infection
- B. Potassium and sodium
- C. Enuresis
- D. Bicarbonate and urea
Correct Answer: A
Rationale: The correct answer is A: Urinary tract infection. In patients with urethral obstruction, the presence of substances in the urine such as bacteria, leukocytes, and nitrites indicates a high likelihood of urinary tract infection. The obstruction can lead to stasis of urine, providing an ideal environment for bacterial growth. This increases the risk of infection spreading to the kidneys, causing pyelonephritis or sepsis. Therefore, the nurse should be vigilant in monitoring for signs of infection and promptly initiate appropriate treatment to prevent complications.
Summary:
B: Potassium and sodium - While electrolyte imbalance can occur in renal dysfunction, it is not directly related to urethral obstruction or suggestive of a urinary tract infection.
C: Enuresis - Enuresis refers to involuntary urination, which is not directly related to the presence of substances in the urine or indicative of urinary tract infection.
D: Bicarbonate and urea - While these substances are relevant in assessing renal function, their