Nokea
When the nurse is performing a genital examination on a male patient, the patient has an erection. The nurse’s most appropriate action or response is to:
- A. Ask the patient if he would like someone else to examine him.
- B. Continue with the examination as though nothing has happened.
- C. Stop the examination, leave the room while stating that the examination will resume at a later time.
- D. Reassure the patient that this is a normal response and continue with the examination.
Correct Answer: D
Rationale: The correct answer is D. This is the most appropriate action because it acknowledges the patient's normal physiological response and reassures him. It helps maintain professionalism and respect for the patient's dignity. Choice A could potentially embarrass the patient further. Choice B may ignore the patient's discomfort. Choice C abruptly halts the examination without addressing the situation. Overall, choice D is the most respectful and professional response in this scenario.
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Imipenem has the broadest spectrum of activity currently available to beta-lactams. This include antimicrobial activity against the following organisms EXCEPT:
- A. Staphylococcus aureus
- B. Staphylococcus epidermidis
- C. Pseudomonas aeruginosa
- D. Mycoplasma pneumoniae
Correct Answer: D
Rationale: The correct answer is D: Mycoplasma pneumoniae. Imipenem, a carbapenem antibiotic, has broad-spectrum activity against Gram-positive, Gram-negative, anaerobic, and some atypical bacteria. Mycoplasma pneumoniae is an atypical bacteria lacking a cell wall, making it resistant to beta-lactam antibiotics like imipenem. Staphylococcus aureus, Staphylococcus epidermidis, and Pseudomonas aeruginosa are all susceptible to imipenem due to their cell wall composition.
Thiazide diuretics may produce an increase in blood levels of uric acid and:
- A. Potassium
- B. BUN
- C. Urea
- D. Glucose
Correct Answer: D
Rationale: Thiazide diuretics can lead to hyperglycemia by reducing insulin sensitivity. This can result in increased blood glucose levels. Thiazides also elevate uric acid levels by reducing its excretion. Therefore, the correct answer is D (Glucose).
Incorrect choices:
A (Potassium) - Thiazides typically cause hypokalemia, not hyperkalemia.
B (BUN) and C (Urea) - Thiazides may cause a slight increase in BUN and serum creatinine levels due to reduced kidney function, but not as significantly as glucose levels.
A 45-year-old woman is seeking advice on contraception. She is considering using an intrauterine device (IUD). The nurse should inform her that the IUD is effective for:
- A. 5 to 10 years.
- B. 1 to 2 years.
- C. 3 to 5 years.
- D. Indefinitely.
Correct Answer: A
Rationale: The correct answer is A: 5 to 10 years. IUDs are long-acting reversible contraceptives effective for 5 to 10 years depending on the type. Hormonal IUDs last around 5 years, while copper IUDs can last up to 10 years. This extended duration provides reliable contraception for an extended period with minimal user intervention.
Choice B: 1 to 2 years is incorrect because IUDs have a longer duration of effectiveness.
Choice C: 3 to 5 years is incorrect as it falls short of the typical duration of effectiveness for most IUD types.
Choice D: Indefinitely is incorrect as IUDs do have a maximum effective period, after which they need to be removed or replaced.
Which of the following new drug is indicated in managing SIADH , non - * peptide and competitive antagonist of ADH 's water sparing effects in the collecting ducts of nephron?
- A. Mannitol
- B. Bumetanide
- C. Spironolactone
- D. Conivaptan
Correct Answer: D
Rationale: The correct answer is D: Conivaptan. Conivaptan is a non-peptide competitive antagonist of ADH, specifically targeting the V2 receptors in the collecting ducts of the nephron. This mechanism of action inhibits ADH's water-sparing effects, making it an effective treatment for SIADH.
A: Mannitol is an osmotic diuretic used for conditions like cerebral edema and acute kidney injury, not specifically for SIADH.
B: Bumetanide is a loop diuretic used for conditions like heart failure and hypertension, not for managing SIADH.
C: Spironolactone is a potassium-sparing diuretic used for conditions like heart failure and hypertension, not for treating SIADH.
In summary, Conivaptan is the correct choice for managing SIADH due to its specific mechanism of action as a competitive antagonist of ADH in the collecting ducts, while the other options are
A 20 year old male patient is diagnosed with Chaga’s disease, American trypanosomiasis. Which drug would be the most appropriate for this patient?
- A. Nifurtimox
- B. Metronidazole
- C. Suramin
- D. Chloroquine
Correct Answer: A
Rationale: The correct answer is A: Nifurtimox. Nifurtimox is the first-line treatment for Chagas disease caused by Trypanosoma cruzi. It is effective in treating both acute and chronic phases of the disease by reducing parasitemia. Metronidazole (B) is used for anaerobic bacterial infections, not trypanosomiasis. Suramin (C) is used for African trypanosomiasis, not American trypanosomiasis. Chloroquine (D) is used for malaria, not trypanosomiasis. Therefore, A is the most appropriate choice for this patient.