Nokea
What is most likely the underlying physiology of primary enuresis?
- A. Psychogenic stress
- B. Delayed bladder maturation
- C. Urinary tract infection
- D. Vesicoureteral reflux
Correct Answer: B
Rationale: Primary enuresis refers to involuntary wetting during sleep in children who have never been consistently dry at night. The most likely underlying physiology of primary enuresis is delayed bladder maturation. This means that the child's bladder is not yet able to hold urine for the entire night, leading to bedwetting episodes. As children age, their bladder capacity increases and their ability to remain dry at night improves. In most cases, primary enuresis resolves on its own as the child's bladder matures. It is important for parents and caregivers to provide support and reassurance to the child during this time.
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Nurse Nancy also gives a lecture at the community health center about the diet for patients with ulcerative colitis. Which one is appropriate?
- A. high calorie, low protein
- B. low fat, high fiber
- C. high protein, low residue
- D. low sodium, high carbohydrate
Correct Answer: C
Rationale: Patients with ulcerative colitis usually benefit from a high protein, low residue diet. A high protein diet helps promote tissue healing and repair. Low residue foods are preferred to reduce mechanical irritation to the inflamed colon. This combination can help manage symptoms and promote overall gut health for individuals with ulcerative colitis. High calorie, low protein (Option A) may not provide adequate nutrient density and healing support. Low fat, high fiber (Option B) may exacerbate symptoms and increase gastrointestinal discomfort. Low sodium, high carbohydrate (Option D) may not address the specific needs of patients with ulcerative colitis.
Laboratory studies indicate a client's blood pressure level is 185mg/dl. Two hours have passed since the client ate breakfast. Which test would yield the most occlusive diagnostic information about the client's glucose utilization?
- A. A fasting blood glucose test
- B. A test of serum glycosylated hemoglobin (HbA1c)
- C. A 6-hour glucose tolerance test
- D. A test for urine ketones
Correct Answer: C
Rationale: A 6-hour glucose tolerance test would yield the most occlusive diagnostic information about the client's glucose utilization in this case. The elevated blood pressure level of 185 mg/dL two hours after breakfast indicates poor glucose regulation. A glucose tolerance test involves monitoring the client's blood glucose levels over a period of time after ingesting a glucose solution. This test provides a comprehensive assessment of how the body processes glucose, revealing any abnormalities in glucose metabolism beyond fasting levels, such as postprandial (after-meal) glucose spikes and prolonged hyperglycemia. This can help identify conditions like insulin resistance, impaired glucose tolerance, or diabetes, which may not be evident from a fasting blood glucose test alone. Glycosylated hemoglobin (HbA1c) reflects average blood sugar levels over the past 2-3 months and would not provide immediate information about the client's current glucose metabolism. Urine ketones
The presence of anemia is characterized by a/an:
- A. Increase of red blood cells
- B. Increased hemoglobin
- C. Decrease in the concentration of red blood
- D. Decreased blood count cells
Correct Answer: C
Rationale: Anemia is a condition characterized by a decrease in the concentration of red blood cells in the blood. This can result from various factors such as decreased production of red blood cells, increased destruction of red blood cells, or blood loss. Hemoglobin levels are often used to diagnose anemia, but the key feature of anemia is the decrease in the number of red blood cells, leading to reduced oxygen-carrying capacity in the blood. This in turn can lead to symptoms such as fatigue, weakness, and shortness of breath.
The nurse understands that for the parathyroid hormone to exert its effect, what must be present?
- A. Decreased phosphate level
- B. Functioning thyroid gland
- C. Adequate vitamin D level
- D. Increased calcium level
Correct Answer: D
Rationale: Parathyroid hormone (PTH) is released by the parathyroid glands in response to low calcium levels in the blood. Its primary function is to regulate calcium and phosphorus levels in the body. When calcium levels in the blood are low, PTH is released, leading to increased calcium levels by stimulating the release of calcium from the bones, increasing calcium absorption in the intestines, and promoting calcium reabsorption in the kidneys. Therefore, for PTH to exert its effect, increased calcium levels must be present.
A 5 months child is brought for routine care. During auscultation of heart you find a short systolic murmur at left upper sternal border with soft 2nd heart sound. The most likely diagnosis is?
- A. Ventricular septal defect
- B. Atrial septal defect
- C. Patent ductus arteriosus
- D. Pulmonary stenosis
Correct Answer: B
Rationale: Atrial septal defect (ASD) often presents with a systolic ejection murmur at the left upper sternal border and a fixed split second heart sound.