Nokea
Which is a sign of benign prostatic hyperplasia?
- A. Weight loss
- B. Bone pain
- C. Fever
- D. Nocturia
Correct Answer: D
Rationale: The correct answer is D: Nocturia. Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, leading to urinary symptoms such as frequent urination at night (nocturia). This occurs due to the prostate pressing against the urethra, causing urinary flow issues. Weight loss (A) is not typically associated with BPH. Bone pain (B) is more indicative of conditions like prostate cancer or metastasis. Fever (C) is not a common symptom of BPH. Therefore, D is the most appropriate sign of BPH.
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Unilateral rhinitis could be caused by all of the following except:
- A. A foreign body in the nasal canal
- B. A nasal polyp
- C. Drug-induced rhinitis
- D. A deviated septum
Correct Answer: D
Rationale: The correct answer is D: A deviated septum. Unilateral rhinitis typically refers to inflammation in one nostril. A deviated septum is a physical obstruction in the nasal passage that affects both nostrils, not just one. Choices A, B, and C can all cause unilateral rhinitis as they specifically affect one side of the nasal passage. A foreign body in the nasal canal, a nasal polyp, and drug-induced rhinitis can all lead to inflammation and symptoms in one nostril.
The nurse is teaching an older client with hypertension about lifestyle changes. Which of the following is most effective in managing high blood pressure?
- A. Reducing sodium intake
- B. Increasing intake of fatty foods
- C. Limiting physical activity
- D. Reducing fiber in the diet
Correct Answer: A
Rationale: The correct answer is A: Reducing sodium intake. High sodium intake can lead to fluid retention and increased blood pressure. By reducing sodium intake, blood pressure can be effectively managed. Increasing intake of fatty foods (B) can contribute to heart disease and worsen hypertension. Limiting physical activity (C) can lead to weight gain and higher blood pressure. Reducing fiber in the diet (D) can negatively impact overall health and increase the risk of hypertension.
The addition of benzoyl peroxide to erythromycin for the topical treatment of acne:
- A. Improve the efficacy of erythromycin
- B. Decrease the risk of desquamation
- C. Decreases the risk of resistance to erythromycin
- D. Increases the time the patient can be exposed to sunlight
Correct Answer: C
Rationale: Step-by-step rationale for why choice C is correct:
1. Benzoyl peroxide has antibacterial properties.
2. Combining benzoyl peroxide with erythromycin reduces bacterial resistance.
3. This combination therapy prevents the development of resistance to erythromycin.
4. Therefore, the risk of resistance to erythromycin is decreased.
Summary:
- Choice A is incorrect as benzoyl peroxide does not directly improve the efficacy of erythromycin.
- Choice B is incorrect as desquamation is not directly affected by the addition of benzoyl peroxide.
- Choice D is incorrect as there is no evidence to suggest that benzoyl peroxide increases the time a patient can be exposed to sunlight.
Mr. W. is a 51-year-old auto mechanic who comes to the emergency room wanting to be checked out for the symptom of chest pain. As you listen to him describe his symptom in more detail, you say "Go on," and later, "Mm-hmmm." This is an example of which of the following skilled interviewing techniques?
- A. Echoing
- B. Nonverbal communication
- C. Facilitation
- D. Empathic response
Correct Answer: C
Rationale: Facilitation involves using verbal and nonverbal cues to encourage the patient to continue talking. In this scenario, saying "Go on" and "Mm-hmm" indicates active listening and prompts Mr. W. to elaborate on his symptoms. This technique helps gather more information and shows empathy without imposing personal assumptions or judgments. Echoing involves repeating the patient's last words, nonverbal communication refers to gestures and body language, and an empathic response involves acknowledging and validating the patient's feelings. In this case, the best fit is facilitation as it encourages further discussion without interrupting or steering the conversation.
A 42-year-old realtor comes to your clinic, complaining of "growths" in her vulvar area. She is currently undergoing a divorce and is convinced she has a sexually transmitted disease. She denies any vaginal discharge or pain with urination. She has had no fever, malaise, or night sweats. Her past medical history consists of depression and hypothyroidism. She has had two spontaneous vaginal deliveries and one cesarean section. She has had no other surgeries. She denies smoking or drug use. She has two to three drinks weekly. Her mother also has hypothyroidism and her father has high blood pressure and hypercholesterolemia. On examination you see a woman who is anxious but appears otherwise healthy. Her blood pressure, pulse, and temperature are unremarkable. On visualization of the perineum you see two 2- to 3- mm, round, yellow nodules on the left labia. On palpation they are nontender and quite firm. What diagnosis best fits this description of her examination?
- A. Genital herpes
- B. Condylomata acuminata
- C. Syphilitic chancre
- D. Epidermoid cyst
Correct Answer: D
Rationale: The correct answer is D: Epidermoid cyst. The key features in the clinical scenario that point towards an epidermoid cyst are the presence of painless, firm, non-tender, round, yellow nodules on the labia. These cysts are common in the vulvar area and often arise from blocked hair follicles. The absence of symptoms suggestive of a sexually transmitted infection (STI) such as vaginal discharge, pain with urination, fever, malaise, or night sweats, along with the patient's history of anxiety and the appearance of the nodules being consistent with an epidermoid cyst support this diagnosis.
Choice A: Genital herpes typically presents with painful vesicles or ulcers, which are not described in this case.
Choice B: Condylomata acuminata (genital warts) would present as soft, pink, or flesh-colored growths and are associated with HPV infection, which is not suggested in this scenario.
Choice C: Sy