Nokea
Which statement best describes Zidovudine:
- A. Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection
- B. Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia
- C. Peripheral neuropathy is a specific adverse reaction to Zidovudine
- D. Zidovudine is converted by cellular enzymes to an active form
Correct Answer: zidovudine diphosphate
Rationale: The correct answer is D: Zidovudine is converted by cellular enzymes to an active form (zidovudine diphosphate). Zidovudine itself is a prodrug that needs to be metabolized by cellular enzymes to its active form, zidovudine diphosphate, which inhibits HIV replication by acting as a nucleoside reverse transcriptase inhibitor. This active form is essential for its antiretroviral activity.
Incorrect Choices:
A: Zidovudine in combination with other antiretrovirals is an alternative initial treatment for HIV infection - This is incorrect because zidovudine is commonly used in combination with other antiretrovirals as a first-line treatment for HIV infection, not as an alternative treatment.
B: Zidovudine is also used to prevent transmission of HIV from the mother to her fetus and to treat AIDS-related dementia - This is incorrect because zidovudine is primarily used in
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Due to its potential for severe hepatotoxicity, Nevirapine should NOT be initiated in:
- A. Women with CD4 cell counts >150 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- B. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >400 cells/mm3
- C. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >500 cells/mm3
- D. Women with CD4 cell counts >250 cells/mm3 or in men with CD4 cell count >450 cells/mm3
Correct Answer: B
Rationale: The correct answer is B. Nevirapine has a higher risk of severe hepatotoxicity in patients with higher CD4 cell counts. Choice B specifies a lower threshold for CD4 cell counts in women compared to men, which aligns with the caution needed for initiating Nevirapine. Choices A, C, and D have higher CD4 cell count thresholds for both women and men, which would increase the risk of hepatotoxicity if Nevirapine is initiated in those patients. Therefore, Choice B is the most appropriate option to minimize the risk of hepatotoxicity when initiating Nevirapine.
What indicates to the nurse that a patient with oliguria has prerenal oliguria?
- A. Urine testing reveals a low specific gravity.
- B. Causative factor is malignant hypertension.
- C. Urine testing reveals a high sodium concentration.
- D. Reversal of oliguria occurs with fluid replacement.
Correct Answer: A
Rationale: The correct answer is A because prerenal oliguria is typically characterized by a low specific gravity in urine testing. This indicates that the kidneys are conserving water due to decreased blood flow or volume. Choices B and C are incorrect as they do not specifically relate to prerenal oliguria. Choice D is also incorrect as reversal of oliguria with fluid replacement is not specific to prerenal oliguria and can occur in other types of renal failure.
Which antibiotic course is inappropriate for clinical scenario?
- A. Acute simple cystitis - trimethoprim for 3 days in otherwise well young women.
- B. Acute uncomplicated pyelonephritis - gentamycin + amoxicillin IV initially followed by 7 days of Augmentin orally.
- C. Pregnancy associated cystitis - nitrofurantoin 5 mg QID for 14 days.
- D. Acute simple cystitis in male patients - Augmentin or trimethoprim for 14 days.
Correct Answer: B
Rationale: The correct answer is B because the antibiotic regimen for acute uncomplicated pyelonephritis should not include gentamycin due to its potential toxicity and nephrotoxicity. The initial use of IV gentamycin is not recommended for uncomplicated pyelonephritis. The combination of gentamycin and amoxicillin is not the standard treatment for this condition. Gentamycin should be reserved for more serious infections. The choice of Augmentin for 7 days orally is also not the standard of care for pyelonephritis. The other choices (A, C, D) are appropriate antibiotic regimens for the corresponding clinical scenarios.
What does the dialysate for PD routinely contain?
- A. Calcium in a lower concentration than in the blood
- B. Sodium in a higher concentration than in the blood
- C. Dextrose in a higher concentration than in the blood
- D. Electrolytes in an equal concentration to that of the blood
Correct Answer: C
Rationale: Correct Answer: C - Dextrose in a higher concentration than in the blood
Rationale:
1. Dextrose in PD dialysate helps to create an osmotic gradient for fluid removal.
2. Higher dextrose concentration ensures effective ultrafiltration.
3. Dextrose is the main osmotic agent used in PD.
4. A higher concentration of dextrose in the dialysate aids in waste removal.
Summary:
A: Incorrect - Calcium concentration in dialysate is similar to blood to avoid imbalance.
B: Incorrect - Sodium concentration is lower in dialysate to prevent sodium loading.
D: Incorrect - Electrolyte concentration in dialysate is tailored to patient needs, not equal to blood.
A 45-year-old mother of two children is seen at the clinic for complaints of “losing my urine when I sneeze.†The nurse documents that she is experiencing:
- A. Urinary frequency.
- B. Enuresis.
- C. Stress incontinence.
- D. Urge incontinence.
Correct Answer: C
Rationale: The correct answer is C: Stress incontinence. This type of incontinence is characterized by leakage of urine during activities that increase intra-abdominal pressure, such as sneezing, coughing, or laughing. In this case, the woman is experiencing urine loss specifically when she sneezes, which aligns with the definition of stress incontinence. Other choices are incorrect because urinary frequency (choice A) refers to a frequent need to urinate, enuresis (choice B) is involuntary urination during sleep, and urge incontinence (choice D) is the sudden, strong need to urinate followed by involuntary leakage.