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Which test is required for a diagnosis of pyelonephritis?
- A. Renal biopsy
- B. Blood culture
- C. Intravenous pyelogram (IVP)
- D. Urine for culture and sensitivity
Correct Answer: D
Rationale: The correct answer is D, Urine for culture and sensitivity. This test is required for a diagnosis of pyelonephritis as it helps identify the specific bacteria causing the infection and determines the most effective antibiotic treatment. Renal biopsy (A) is not typically required for diagnosing pyelonephritis. Blood culture (B) may be helpful in severe cases but is not specific for pyelonephritis. Intravenous pyelogram (IVP) (C) is a radiological test used to visualize the urinary tract but does not confirm the diagnosis of pyelonephritis.
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The examiner is going to inspect and palpate for a hernia. During this exam, the man is instructed to:
- A. Hold his breath during palpation.
- B. Cough after the examiner has gently inserted the exam finger into the rectum.
- C. Bear down when the examiner’s finger is at the inguinal canal.
- D. Relax in a supine position while the exam finger is inserted into the canal.
Correct Answer: C
Rationale: The correct answer is C: Bear down when the examiner's finger is at the inguinal canal. This action increases intra-abdominal pressure, which helps to push out any potential hernia through the inguinal canal for easier detection. Holding his breath (A) would not facilitate hernia detection. Coughing after insertion (B) is used for rectal exams, not hernia assessment. Relaxing in a supine position (D) is not helpful for hernia examination as it does not aid in hernia protrusion.
The nurse is assessing a patient admitted with renal
- A. Provide privacy for the patient. stones. During the admission assessment, what parameters would be priorities for the nurse to address?
Correct Answer: B
Rationale: The correct answer is B because assessing the patient's renal function parameters such as serum creatinine, blood urea nitrogen, and urine output are essential in determining the status of the kidneys. These parameters help the nurse evaluate renal function, assess for renal impairment, and monitor for any complications related to renal stones. Option A is incorrect as providing privacy is important but not a priority in this situation. Option C and D are incorrect as they do not address the specific parameters related to renal function assessment.
A 75 year old man is suffering from benign prostatic hypertrophy and is being treated with terazosin. Which of the following adverse reaction would be expected taking this drug?
- A. Erectile dysfunction
- B. Orthostatic hypotension
- C. GI distress
- D. Gynecomastia
Correct Answer: B
Rationale: The correct answer is B: Orthostatic hypotension. Terazosin is an alpha-1 blocker commonly used to treat benign prostatic hypertrophy. It works by relaxing smooth muscle in the prostate and bladder neck. This relaxation can lead to vasodilation and subsequently cause a drop in blood pressure. Orthostatic hypotension is a common adverse reaction of alpha-1 blockers due to this mechanism. The other choices, A: Erectile dysfunction, C: GI distress, and D: Gynecomastia are not typically associated with terazosin use. Erectile dysfunction can actually be improved with alpha-1 blockers as they relax smooth muscle in the prostate, allowing for easier urination and potentially improved sexual function. GI distress and gynecomastia are not common side effects of terazosin.
Which macrolide antibiotic that can be given once a day for 3 days for * empirical treatment of ENT, respiratory and genital infections?
- A. Erythromycin
- B. Azithromycin
- C. Clarithromycin
- D. Roxithromycin
Correct Answer: B
Rationale: The correct answer is B: Azithromycin. It has a long half-life allowing for once-daily dosing for 3 days. Azithromycin is effective against common ENT, respiratory, and genital infections.
Rationale:
A: Erythromycin requires more frequent dosing due to shorter half-life.
C: Clarithromycin is not typically given once a day for 3 days.
D: Roxithromycin is less commonly used for these infections and has a shorter half-life.
An outbreak of influenza A has just been reported in his community and a 45 year old man is exhibiting initial symptoms of influenza A. Which agent would be the most useful to treat him?
- A. Cidofovir
- B. Famciclovir
- C. Amantadine
- D. Ribavirin
Correct Answer: C
Rationale: The correct answer is C: Amantadine. Amantadine is an antiviral medication that is specifically effective against influenza A virus. It works by blocking the viral ion channel, preventing the virus from entering the host cell. This inhibits viral replication and helps reduce the severity and duration of symptoms.
Choice A, Cidofovir, is used to treat certain DNA viruses but is not effective against influenza A. Choice B, Famciclovir, is used to treat herpes viruses, not influenza A. Choice D, Ribavirin, is an antiviral medication used for respiratory syncytial virus and hepatitis C, but not as effective against influenza A. Therefore, the most appropriate choice in this scenario is Amantadine due to its specific activity against influenza A virus.