Which of the following diuretics needs close monitoring with use of * potassium sparing diuretics such as spironolactone?
- A. Furosemide
- B. Captopril
- C. Verapamil
- D. Hydrochlorothiazid
Correct Answer: A
Rationale: The correct answer is A: Furosemide. Furosemide is a loop diuretic that can cause potassium depletion, which can be exacerbated when used with potassium-sparing diuretics like spironolactone. This combination can lead to hyperkalemia, necessitating close monitoring of potassium levels.
B: Captopril is an ACE inhibitor, not a diuretic.
C: Verapamil is a calcium channel blocker, not a diuretic.
D: Hydrochlorothiazide is a thiazide diuretic that can also cause potassium depletion, but it does not specifically need close monitoring when used with potassium-sparing diuretics.
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Which of the following is a respiratory response to acidosis?
- A. secretion of H+
- B. increase tubule buffer activity
- C. decreased respiratory rate
- D. decreased ventilation-perfusion ratio
Correct Answer: C
Rationale: The correct answer is C: decreased respiratory rate. Acidosis is a condition where the blood pH is below the normal range, leading to increased levels of carbon dioxide. To compensate, the body increases respiratory rate to eliminate excess CO2 through the lungs. Therefore, in response to acidosis, the respiratory rate decreases.
A: Secretion of H+ is a metabolic response, not a respiratory response to acidosis.
B: Increased tubule buffer activity is a renal response, not a respiratory response to acidosis.
D: Decreased ventilation-perfusion ratio is a consequence of respiratory diseases but not a direct response to acidosis.
Clients who have had a ureterolithotomy should be taught to expect
- A. a great deal of postoperative pain
- B. postoperative depression
- C. enforced bed rest for a week postoperatively
- D. large amounts of drainage from the tissue drain
Correct Answer: D
Rationale: The correct answer is D because after a ureterolithotomy, there may be drainage from the tissue drain, which is a normal occurrence. This drainage helps to prevent complications such as infection and promotes healing. The drainage should decrease over time as the body heals. Choices A, B, and C are incorrect as they do not align with the typical expectations following a ureterolithotomy procedure. Postoperative pain should be managed with medication, postoperative depression may occur but is not a universal expectation, and enforced bed rest for a week is not typically necessary.
A 40 year old man is HIV positive with CD4 count of 200/ cu.mm . After 2 months of therapy, he develops a peripheral WBC count of 1000 and hemoglobin of 9. Which of the following drugs most likely cause d this hematologic abnormality?
- A. Zidovudine
- B. Acyclovir
- C. Foscarnet
- D. Amantadine
Correct Answer: A
Rationale: The correct answer is A: Zidovudine. Zidovudine is known to cause bone marrow suppression, leading to decreased white blood cell and red blood cell counts. In this case, the patient's peripheral WBC count of 1000 and low hemoglobin after starting therapy are indicative of hematologic abnormalities consistent with zidovudine use. Acyclovir, Foscarnet, and Amantadine do not typically cause bone marrow suppression and are not associated with the hematologic abnormalities seen in this patient.
The nurse is providing patient teaching about an erectile dysfunction drug. One of the drugs potential side effects is prolonged, painful erection of the penis without sexual stimulation, which is known as:
- A. Orchitis.
- B. Strictur
- C. Priapism.
- D. Phimosis.
Correct Answer: C
Rationale: Step 1: Define priapism - Priapism is a prolonged, painful erection of the penis without sexual stimulation.
Step 2: Link to the drug side effect - The question mentions a potential side effect of an erectile dysfunction drug, which is priapism.
Step 3: Eliminate other choices - Orchitis is inflammation of the testicle, stricture is a narrowing of a tube or passage, and phimosis is the inability to retract the foreskin. These do not match the description of priapism.
Step 4: Conclusion - The correct answer is C because it directly aligns with the described side effect and the other choices do not.
Which of these statements is most appropriate when the nurse is obtaining a genitourinary history from an older man?
- A. Do you need to get up at night to urinate?
- B. Do you experience nocturnal emissions, or wet dreams?
- C. Do you know how to perform a testicular self-examination?
- D. Has anyone ever touched your genitals when you did not want them to?
Correct Answer: A
Rationale: The correct answer is A because it pertains to a common genitourinary issue in older men, nocturia. Nocturnal emissions (choice B) are not typically relevant in this context. Testicular self-examination (choice C) is more appropriate for younger men, and asking about unwanted touching (choice D) is not relevant to obtaining a genitourinary history. Asking about nocturia can provide valuable information about potential prostate issues, urinary tract infections, or other conditions commonly affecting older men.