Nokea
Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.
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The drug of choice for monilial diarrhea is:
- A. Amphothericin B
- B. Nystatin
- C. Ketoconazole
- D. Itraconazole
Correct Answer: B
Rationale: Step-by-step rationale for why Nystatin is the correct choice for monilial diarrhea:
1. Nystatin is an antifungal medication specifically effective against Candida species causing monilial infections.
2. It works by binding to ergosterol in fungal cell membranes, disrupting membrane integrity and causing cell death.
3. Nystatin is not absorbed systemically, making it suitable for gastrointestinal infections.
4. Amphothericin B is reserved for severe systemic fungal infections due to its significant toxicity. Ketoconazole and Itraconazole are not typically used for gastrointestinal Candida infections, as they are more commonly used for systemic fungal infections.
A patient has undergone the creation of an Indiana been asked about actions to reduce the risk of bladder pouch for the treatment of bladder cancer. The nurse
- A. addresses a major risk factor for bladder cancer? How can the nurse best address the effects of this
- B. Smoking cessation urinary diversion on the patients body image?
- C. Reduction of alcohol intake
- D. Emphasize that the diversion is an integral part of
Correct Answer: A
Rationale: The correct answer is A because addressing a major risk factor for bladder cancer, such as smoking, is crucial in preventing recurrence. Smoking is a well-established risk factor for bladder cancer, so educating the patient on smoking cessation is essential. This step can significantly reduce the risk of developing bladder cancer again.
Choice B is incorrect as it focuses on body image concerns, which are important but not directly related to reducing the risk of bladder cancer. Choice C is incorrect because while reducing alcohol intake is beneficial for overall health, it is not a major risk factor for bladder cancer. Choice D is incorrect as it does not directly address a specific risk factor for bladder cancer like smoking does.
A patient is being treated with furosemide and Digoxin because of CHF. She * developed UTI. Which of the following antibiotics should NOT be prescribed?
- A. Cotrimoxazole
- B. Ciprooxacin
- C. Gentamycin
- D. Ampicillin
Correct Answer: C
Rationale: The correct answer is C: Gentamycin. Gentamycin is not recommended in this case due to its potential for nephrotoxicity, especially in patients already receiving furosemide. Furosemide is a loop diuretic that can also cause kidney damage, so combining it with Gentamycin increases the risk of further renal impairment. Cotrimoxazole (A) and Ampicillin (D) are commonly used antibiotics that do not have significant interactions with furosemide and Digoxin. Ciprofloxacin (B) is a fluoroquinolone antibiotic that is generally safe to use in patients with CHF and UTI.
The highest incidence of antibiotic associated pseudomembranous * enterocolitis has been noted with the use of:
- A. Ampicillin
- B. Chloramphenicol
- C. Vancomycin
- D. Clindamycin
Correct Answer: D
Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with a high incidence of antibiotic-associated pseudomembranous enterocolitis due to its strong impact on disrupting the normal gut flora, leading to overgrowth of Clostridium difficile. This bacterium can produce toxins causing inflammation and pseudomembrane formation in the colon. Ampicillin (A) can also cause C. difficile infection, but clindamycin is more strongly associated. Chloramphenicol (B) and vancomycin (C) are less commonly associated with pseudomembranous enterocolitis compared to clindamycin.
In the presence of antidiuretic hormone (ADH), or vasopressin, water is mostly reabsorbed in the ___________ of the nephron.
- A. Proximal convoluted tubule
- B. Loop of henle
- C. Collecting duct
- D. Distal convoluted tubule
Correct Answer: A
Rationale: The correct answer is A: Proximal convoluted tubule. ADH acts on the collecting duct and distal convoluted tubule to increase water reabsorption. However, the majority of water reabsorption occurs in the proximal convoluted tubule due to its high permeability to water. This segment reabsorbs about 65% of filtered water, mainly through osmosis. The loop of Henle plays a crucial role in concentrating urine, but it is not the main site of water reabsorption. The collecting duct responds to ADH but reabsorbs a smaller fraction of filtered water compared to the proximal tubule. The distal convoluted tubule is primarily involved in electrolyte reabsorption rather than water reabsorption.