Genitourinary Review of Systems

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Which of the following drugs valuable in the treatment of edema and metabolic alkalosis?

  • A. Digoxin
  • B. Spironolactone
  • C. Dobutamine
  • D. Acetazolamide
Correct Answer: D

Rationale: The correct answer is D: Acetazolamide. Acetazolamide is a carbonic anhydrase inhibitor that helps in the treatment of edema and metabolic alkalosis by promoting diuresis and increasing renal excretion of bicarbonate. It is effective in treating conditions associated with fluid retention and alkalosis.

A: Digoxin is a cardiac glycoside used to treat heart conditions like heart failure and atrial fibrillation, not edema or metabolic alkalosis.
B: Spironolactone is a potassium-sparing diuretic commonly used for conditions like hypertension and heart failure, but not specifically for metabolic alkalosis.
C: Dobutamine is a beta-adrenergic agonist used in acute heart failure or shock situations, not for edema or alkalosis.

In summary, Acetazolamide is the correct choice as it directly targets edema and metabolic alkalosis by affecting renal excretion of bicarbonate. Other options are

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A patient with psychologic disorder is being treated with a drug. Few months he is worried that he is constantly thirsty and urinates copiously frequently throughout the day and night. Which of the following drugs most likely cause inappropriate secretion of ADH?

  • A. Diazepam
  • B. Lithium
  • C. Haloperidol
  • D. Phenytoin
Correct Answer: B

Rationale: The correct answer is B: Lithium. Lithium is known to cause nephrogenic diabetes insipidus, leading to inappropriate secretion of ADH. This results in excessive thirst and copious urination. Diazepam (A) does not affect ADH secretion. Haloperidol (C) and Phenytoin (D) are not associated with ADH dysregulation.

Which of the following drug is a radical curative in plasmodium vivax malaria and is used as prophylaxis for malaria at Chloroquine sensitive regions

  • A. Quinine
  • B. Primaquine
  • C. Mefloquine
  • D. Chloroquine
Correct Answer: B

Rationale: The correct answer is B: Primaquine. Primaquine is a radical curative drug for Plasmodium vivax malaria, targeting the liver stage of the parasite to prevent relapse. It is also used as prophylaxis in Chloroquine sensitive regions due to its effectiveness against both the liver and blood stages of the parasite. Quinine (A) is mainly used for treating severe malaria. Mefloquine (C) is used for prophylaxis but not as a radical curative for Plasmodium vivax. Chloroquine (D) is effective against Plasmodium vivax but not as a radical curative.

Which antibiotic is primarily bacteriostatic but becomes bactericidal at higher * concentrations?:

  • A. Erythromycin
  • B. Tetracycline
  • C. Chloramphenicol
  • D. Ampicillin
Correct Answer: C

Rationale: The correct answer is C: Chloramphenicol. At lower concentrations, Chloramphenicol is primarily bacteriostatic, inhibiting bacterial protein synthesis. However, at higher concentrations, it can disrupt the bacterial ribosome, leading to bacterial cell death, making it bactericidal. Erythromycin (A) and Tetracycline (B) are primarily bacteriostatic by inhibiting protein synthesis. Ampicillin (D) interferes with bacterial cell wall synthesis but does not exhibit a concentration-dependent shift to bactericidal activity like Chloramphenicol.

When assessing a newborn infant's genitalia, the nurse notices that the genitalia are somewhat engorged. The labia majora are swollen, the clitoris looks large, and the hymen is thick. The vaginal opening is difficult to visualize. The infant's mother states that she is worried about the labia being swollen. The nurse should reply:

  • A. This is a normal finding in newborns and should resolve within a few weeks.
  • B. This finding could indicate an abnormality and may need to be evaluated by a physician.
  • C. We will need to have estrogen levels evaluated to ensure that they are within normal limits.
  • D. We will need to keep close watch over the next few days to see if the genitalia decrease in size.
Correct Answer: A

Rationale: Step 1: Neonatal genital engorgement is a common finding due to maternal hormones.
Step 2: Maternal hormones can cause swelling of the labia majora, clitoris, and thickening of the hymen.
Step 3: This physiological phenomenon typically resolves within a few weeks post-birth.
Step 4: The nurse should reassure the mother that this is a normal finding in newborns.
Summary: Choice A is correct because it aligns with the normal physiological process, while the other options suggest unnecessary interventions or monitoring that are not indicated in this situation.

The nurse caring for a patient with suspected renal has been referred by her primary physician for further dysfunction calculates that the patients weight has evaluation. The nurse should anticipate the use of what increased by 5 pounds in the past 24 hours. The nurse initial diagnostic test?

  • A. Ultrasound
  • B. X-ray
  • C. 1,300 mL of fluid in 24 hours
  • D. Computed tomography (CT)
Correct Answer: A

Rationale: The correct answer is A: Ultrasound. This is the appropriate initial diagnostic test for suspected renal dysfunction due to its non-invasive nature and ability to visualize the kidneys and urinary system. Ultrasound can detect abnormalities such as kidney stones or obstruction. X-ray (B) does not provide detailed imaging of the kidneys. Option C refers to fluid intake, which is not a diagnostic test. Computed tomography (CT) scan (D) involves radiation exposure and is usually reserved for more advanced imaging after initial ultrasound. Ultrasound is the most suitable choice for initial evaluation of renal dysfunction.

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