Nokea
What would the nurse first anticipate in the treatment of a patient in the Injury stage of the RIFLE staging of AKI?
- A. Assess daily weight
- B. IV administration of fluid and furosemide (Lasix)
- C. IV administration of insulin and sodium bicarbonate
- D. Urinalysis to check for sediment, osmolality, sodium, and specific gravity
Correct Answer: B
Rationale: The correct answer is B because in the Injury stage of AKI, the priority is to maintain fluid balance and prevent further kidney damage. IV fluid administration helps improve renal perfusion, while furosemide helps manage fluid overload.
A: Assessing daily weight is important but not the first priority in the Injury stage.
C: IV insulin and sodium bicarbonate are not typically indicated in the initial treatment of AKI.
D: Urinalysis is important for diagnostics but not the first intervention in the Injury stage.
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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. Ethambutol
Correct Answer: D
Rationale: Mycolic acid synthesis is inhibited by Ethambutol by targeting the enzyme arabinosyltransferase, essential for cell wall synthesis in mycobacteria. Resistance develops slowly with Ethambutol, unlike other choices which target different pathways (A: Isoniazid - inhibits mycolic acid synthesis by targeting InhA enzyme, B: Rifampicin - inhibits RNA polymerase, C: Pyrazinamide - disrupts membrane potential). Ethambutol is essential in combination therapy to prevent resistance.
When performing a genital examination on a 25-year-old man, the nurse notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information, the nurse would:
- A. Squeeze the glans to check for the presence of discharg
- C. Consider this finding as normal, and proceed with the examination.
- D. Assess the testicles for the presence of masses or painless lumps.
Correct Answer: C
Rationale: Rationale: Choice C is correct because the description of deeply pigmented, wrinkled scrotal skin with large sebaceous follicles in a 25-year-old man is indicative of normal changes associated with development and aging. The nurse should recognize this as a normal finding and proceed with the examination without any further intervention.
Summary of Incorrect Choices:
A: Squeezing the glans to check for discharge is not indicated based on the information provided. This action is unnecessary and could potentially cause discomfort or harm to the patient.
D: Assessing the testicles for masses or painless lumps is not relevant to the described findings of pigmented, wrinkled scrotal skin with sebaceous follicles. This choice does not align with the presented information and would not be appropriate in this scenario.
The mother of an 8-year-old girl has brought her child to the clinic because she is wetting the bed at night. What terminology should the nurse use when documenting this situation?
- A. Ascites
- B. Dysuria
- C. Enuresis
- D. Urgency
Correct Answer: C
Rationale: The correct terminology for bedwetting in an 8-year-old is enuresis. Enuresis specifically refers to the involuntary discharge of urine during sleep at an age where bladder control is expected. This term is appropriate for the child's situation as it accurately describes the bedwetting issue. Ascites (A) refers to abnormal accumulation of fluid in the abdomen, not related to bedwetting. Dysuria (B) is painful urination, which is not the issue described. Urgency (D) refers to a sudden compelling need to urinate, which is also not relevant to this scenario. Using the correct term, enuresis, will ensure accurate documentation and communication regarding the child's bedwetting issue.
Mrs. Miller has a diagnosis of acute pyelonephritis. To prevent renal damage her plan of care should include
- A. restricting fluid intake until symptoms are under control
- B. reducing protein intake
- C. understanding the necessity of continuing drug therapy indefinitely
- D. preventing viral infections
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Acute pyelonephritis requires antibiotic therapy to eliminate the infection and prevent renal damage.
2. Continuing drug therapy indefinitely ensures complete eradication of the infection.
3. Stopping drug therapy prematurely can lead to recurrence and potential renal complications.
4. Understanding the necessity of drug therapy is crucial for Mrs. Miller's long-term renal health.
Summary:
A: Incorrect. Restricting fluid intake can worsen the infection and hinder recovery.
B: Incorrect. Protein intake is not directly related to the treatment of acute pyelonephritis.
D: Incorrect. Preventing viral infections is not directly relevant to the treatment of acute pyelonephritis.
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