Nokea
What does the dialysate for PD routinely contain?
- A. Calcium in a lower concentration than in the blood
- B. Sodium in a higher concentration than in the blood
- C. Dextrose in a higher concentration than in the blood
- D. Electrolytes in an equal concentration to that of the blood
Correct Answer: C
Rationale: Correct Answer: C - Dextrose in a higher concentration than in the blood
Rationale:
1. Dextrose in PD dialysate helps to create an osmotic gradient for fluid removal.
2. Higher dextrose concentration ensures effective ultrafiltration.
3. Dextrose is the main osmotic agent used in PD.
4. A higher concentration of dextrose in the dialysate aids in waste removal.
Summary:
A: Incorrect - Calcium concentration in dialysate is similar to blood to avoid imbalance.
B: Incorrect - Sodium concentration is lower in dialysate to prevent sodium loading.
D: Incorrect - Electrolyte concentration in dialysate is tailored to patient needs, not equal to blood.
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A 60-year-old woman is undergoing a pelvic examination. During the examination, the nurse finds a mass in the pelvic region that is hard, irregular, and fixed. The nurse's most appropriate course of action would be to:
- A. Monitor the mass and perform routine follow-up.
- B. Refer the patient to a gynecologist for further evaluation.
- C. Obtain a biopsy of the mass to assess for malignancy.
- D. Perform a pelvic ultrasound to assess the mass.
Correct Answer: B
Rationale: The correct answer is B: Refer the patient to a gynecologist for further evaluation. Given the characteristics of the mass (hard, irregular, fixed), it raises concerns for possible malignancy. Referring the patient to a gynecologist allows for a specialist to conduct a thorough evaluation, which may include additional imaging studies and biopsies to determine the nature of the mass. Monitoring the mass (choice A) without further evaluation may delay potential diagnosis and treatment. Obtaining a biopsy (choice C) without proper evaluation by a specialist may not be appropriate at this stage. Performing a pelvic ultrasound (choice D) can provide additional information but may not be sufficient for a definitive diagnosis of malignancy.
Generally, the changes normally associated with menopause occur because the cells in the reproductive tract are:
- A. Aging.
- B. Becoming fibrous.
- C. Estrogen dependent.
- D. Able to respond to estrogen.
Correct Answer: C
Rationale: The correct answer is C: Estrogen dependent. During menopause, the changes in the reproductive tract are primarily due to the decline in estrogen levels. Estrogen plays a crucial role in regulating the menstrual cycle and maintaining the health of the reproductive tissues. As estrogen levels decrease, it leads to various symptoms and changes associated with menopause. Choices A and B are incorrect as they do not directly relate to the hormonal changes that occur during menopause. Choice D is incorrect because during menopause, the cells in the reproductive tract become less responsive to estrogen due to the decline in estrogen levels.
A 45-year-old mother of two children is seen at the clinic for complaints of “losing my urine when I sneeze.†The nurse documents that she is experiencing:
- A. Urinary frequency.
- B. Enuresis.
- C. Stress incontinence.
- D. Urge incontinence.
Correct Answer: C
Rationale: The correct answer is C: Stress incontinence. This type of incontinence is characterized by leakage of urine during activities that increase intra-abdominal pressure, such as sneezing, coughing, or laughing. In this case, the woman is experiencing urine loss specifically when she sneezes, which aligns with the definition of stress incontinence. Other choices are incorrect because urinary frequency (choice A) refers to a frequent need to urinate, enuresis (choice B) is involuntary urination during sleep, and urge incontinence (choice D) is the sudden, strong need to urinate followed by involuntary leakage.
Which of the following would be examples of foods selected to lower the pH of urine?
- A. Milk
- B. Tea
- C. Apples
- D. Meat
Correct Answer: C
Rationale: The correct answer is C: Apples. Apples are acidic in nature, which can help lower the pH of urine. Consuming acidic foods can make the urine more acidic. Milk is alkaline, so it would raise the pH of urine. Tea can vary in acidity, but generally it is not chosen to lower urine pH. Meat is also not acidic and would not contribute to lowering urine pH. So, apples are the most suitable choice for lowering urine pH among the options provided.
Which hormone does not play a role in regulating fluid and electrolyte balance?
- A. ADH
- B. aldosterone
- C. leptin
- D. atrial natriuretic peptide
Correct Answer: C
Rationale: Leptin does not play a role in regulating fluid and electrolyte balance because it is primarily involved in regulating energy balance and appetite. ADH (antidiuretic hormone) helps in water reabsorption, aldosterone regulates sodium and potassium levels, and atrial natriuretic peptide promotes sodium excretion. Leptin's main function is to regulate hunger and energy expenditure, making it unrelated to fluid and electrolyte balance regulation.