Nokea
What would be the best nursing action for the female client admitted following a nephrolithotomy with a urinary tract infection?
- A. Administer IV fluids and blood transfusions.
- B. Administer narcotic analgesics as prescribed.
- C. Encourage fluid intake of 3000 mL/day.
- D. Suggest taking herbs or spices to increase food palatability.
Correct Answer: C
Rationale: The correct answer is C: Encourage fluid intake of 3000 mL/day. This is important post-nephrolithotomy to prevent urinary stasis and aid in flushing out potential stone fragments. Adequate hydration also helps in preventing urinary tract infections. Administering IV fluids and blood transfusions (A) may be necessary in certain cases, but not specifically indicated for this scenario. Administering narcotic analgesics (B) may be required for pain management, but it does not address the underlying issue of preventing complications. Suggesting herbs or spices (D) is unrelated and may not be recommended due to potential interactions with medications.
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A 55 year old man with kidney stones has been placed on a diuretic to decrease calcium excretion. However after a few weeks, he develops an attack of gout. Which diuretic is he taking?
- A. Furosemide
- B. Spironolactone
- C. Hydrochlorothiazide
- D. Triamterene
Correct Answer: C
Rationale: The correct answer is C: Hydrochlorothiazide. Hydrochlorothiazide is a thiazide diuretic that works by reducing calcium excretion and increasing uric acid levels, which can lead to gout attacks in susceptible individuals. Furosemide (choice A) is a loop diuretic that does not increase uric acid levels. Spironolactone (choice B) is a potassium-sparing diuretic and does not affect calcium or uric acid levels significantly. Triamterene (choice D) is also a potassium-sparing diuretic and does not impact calcium or uric acid levels in the same way as hydrochlorothiazide.
Prostatic hypertrophy occurs frequently in older men. The symptoms that may indicate this problem are:
- A. Polyuria and urgency
- B. Dysuria and oliguria
- C. Straining, loss of force, and sense of residual urine.
- D. Foul-smelling urine and dysuria
Correct Answer: C
Rationale: Rationale:
1. Prostatic hypertrophy causes an enlarged prostate gland.
2. Enlarged prostate can lead to symptoms like straining, loss of force, and sense of residual urine.
3. These symptoms are due to obstruction of the urethra by the enlarged prostate.
4. Polyuria, urgency, dysuria, oliguria, and foul-smelling urine are not typical symptoms of prostatic hypertrophy.
Summary:
Choice C is correct because it directly relates to the obstructive symptoms caused by prostatic hypertrophy. Choices A, B, and D do not align with the typical symptoms of this condition and are therefore incorrect.
When performing the bimanual examination, the nurse notices that the cervix feels smooth and firm, is round, and is fixed in place (does not move). When cervical palpation is performed, the patient complains of some pain. The nurse's interpretation of these results should be which of these?
- A. These findings are all within normal limits.
- B. Cervical consistency should be soft and velvety, not firm.
- C. The cervix should move when palpated; an immobile cervix may indicate malignancy.
- D. Pain may occur during palpation of the cervix.
Correct Answer: C
Rationale: Step-by-step rationale for the correct answer (C):
1. The cervix is normally mobile and should move when palpated. A fixed cervix may indicate malignancy.
2. Pain during cervical palpation can be a sign of inflammation, infection, or other abnormalities.
3. Smooth and firm cervix, along with pain, raise suspicion of an underlying issue.
4. Therefore, the nurse should interpret these findings as potentially concerning and further assessment is needed.
Summary:
Choice A is incorrect because the findings are not within normal limits. Choice B is incorrect as the cervix should not be firm. Choice D is incorrect as pain during palpation is significant and should not be dismissed.
The nurse is providing patient teaching about an erectile dysfunction drug. One of the drugs potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as:
- A. Orchitis.
- B. Strictur
- C. Priapism.
- D. Phimosis.
Correct Answer: C
Rationale: Step 1: Define priapism - Priapism is a prolonged, painful erection of the penis without sexual stimulation.
Step 2: Link to the drug side effect - The question mentions a potential side effect of an erectile dysfunction drug, which is priapism.
Step 3: Eliminate other choices - Orchitis is inflammation of the testicle, stricture is a narrowing of a tube or passage, and phimosis is the inability to retract the foreskin. These do not match the description of priapism.
Step 4: Conclusion - The correct answer is C because it directly aligns with the described side effect and the other choices do not.
Which of the following antiviral drug most commonly used drug for prevention and treatment of CMV infections in the immunocompromised patients?
- A. Ganciclovir
- B. Indinavir
- C. Amantadine
- D. Foscarnet
Correct Answer: A
Rationale: Rationale:
1. Ganciclovir is the preferred antiviral for CMV infections due to its effectiveness against CMV.
2. It works by inhibiting viral DNA polymerase, stopping viral replication.
3. Indinavir is a protease inhibitor used for HIV, not CMV.
4. Amantadine is used for influenza A virus, not CMV.
5. Foscarnet is an alternative for CMV if ganciclovir is not tolerated.