Nokea
When the nurse is interviewing a preadolescent girl, which opening question would be least threatening?
- A. Do you have any questions about growing up?
- B. What has your mother told you about growing up?
- C. When did you notice that your body was changing?
- D. I remember being very scared when I got my period. How do you think you'll feel?
Correct Answer: C
Rationale: Correct Answer: C - "When did you notice that your body was changing?"
Rationale:
1. This question is open-ended and focuses on the preadolescent girl's personal experience, allowing her to share information at her comfort level.
2. It avoids assumptions and allows the girl to express herself without feeling pressured.
3. By asking about her own observations, it encourages self-reflection and empowers her to communicate about her body changes.
Summary:
A - Option A might indirectly suggest that the girl should have questions about growing up, potentially creating pressure.
B - Option B assumes the mother's role as the primary source of information, potentially overlooking the girl's own experiences.
D - Option D introduces the tutor's personal experience, which may lead the girl to compare her feelings to the tutor's, potentially causing unnecessary anxiety.
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A 35 year old man presents to the ER with severe headache. After lab workup, patient is diagnosed to have increased intracranial pressure. Which diuretic would work best to reduce this pressure?
- A. Hydrochlorothiazide
- B. Mannitol
- C. Acetazolamide
- D. Furosemide
Correct Answer: B
Rationale: The correct answer is B: Mannitol. Mannitol is an osmotic diuretic that works by drawing fluid out of brain tissue and reducing intracranial pressure. It is commonly used in cases of increased intracranial pressure due to its ability to easily cross the blood-brain barrier and reduce cerebral edema. Hydrochlorothiazide (A) is a thiazide diuretic mainly used for hypertension and not effective for this condition. Acetazolamide (C) is a carbonic anhydrase inhibitor that can reduce CSF production but is not as effective as mannitol for rapid reduction of intracranial pressure. Furosemide (D) is a loop diuretic that primarily acts on the kidneys and is not as effective as mannitol for reducing intracranial pressure.
The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to:
- A. Tell the patient that her examination is normal.
- B. Give her an immediate referral to a gynecologist.
- C. Suggest that she return in a month for a recheck to verify the findings.
- D. Tell the patient that she may have an ovarian cyst that should be evaluated further.
Correct Answer: B
Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.
A physician is caring for a patient with a urinary tract infection. The physician would expect the plan of care to include:
- A. Antibiotics and phenazopyridine.
- B. Erythropoietin and stent placement.
- C. Hormonal therapy and intravenous fluids.
- D. Hourly urine output measurements and antibiotics.
Correct Answer: A
Rationale: The correct answer is A: Antibiotics and phenazopyridine. Antibiotics are essential to treat the bacterial infection causing the UTI. Phenazopyridine can help relieve urinary discomfort. Erythropoietin and stent placement (B) are not indicated for UTI. Hormonal therapy and IV fluids (C) are not standard treatments for UTI. Hourly urine output measurements and antibiotics (D) are not typically necessary, as antibiotics alone are sufficient for treating UTIs.
The antiviral action of amantadine is exerted through: *
- A. Inhibition of viral protease enzyme
- B. Inhibition of viral RNA mediated DNA synthesis
- C. Interaction with the viral M2 protein
- D. Interaction with a virus directed thymidine kinase
Correct Answer: C
Rationale: The correct answer is C: Interaction with the viral M2 protein. Amantadine blocks the M2 ion channel of the influenza A virus, preventing the release of viral RNA into the host cell. This inhibits the viral replication process. Option A is incorrect as amantadine does not target viral protease enzymes. Option B is incorrect as amantadine does not inhibit viral RNA-mediated DNA synthesis, which is a process specific to retroviruses. Option D is incorrect as amantadine does not interact with virus-directed thymidine kinase, which is involved in the activation of certain antiviral medications.
A 28 year old male patient present with a painless sore in his penis and blood * test confirms Treponema pallidum. Which of the following agent is the treatment of choice that can be given as a single dose?
- A. Benzathine penicillin
- B. Ceftriaxone
- C. Vancomycin
- D. Aztreonam
Correct Answer: A
Rationale: The correct answer is A: Benzathine penicillin. The treatment of choice for syphilis caused by Treponema pallidum is penicillin. Benzathine penicillin is preferred due to its long-acting nature, providing sustained therapeutic levels. It is given as a single dose for early-stage syphilis. Ceftriaxone, vancomycin, and aztreonam are not effective against Treponema pallidum and are not recommended for the treatment of syphilis. Benzathine penicillin remains the first-line treatment due to its efficacy and established effectiveness against syphilis.