Nokea
Your patient does not seem to be responding to conservative treatment for acute renal failure, and dialysis is being considered. You understand that the main indication for dialysis is
- A. generalized edema
- B. elevated blood pressure
- C. elevated blood calcium
- D. a high and rising level of potassium
Correct Answer: D
Rationale: The correct answer is D: a high and rising level of potassium. Dialysis is indicated in acute renal failure when the patient has severe electrolyte imbalances, especially hyperkalemia, which can lead to life-threatening arrhythmias. Potassium levels must be closely monitored, and if they are high and continue to rise despite conservative treatment, dialysis is necessary to quickly lower the potassium levels. Generalized edema (A) is a symptom of renal failure but is not the main indication for dialysis. Elevated blood pressure (B) and elevated blood calcium (C) are not direct indications for dialysis in the context of acute renal failure.
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The mother of a 10-year-old boy asks the nurse to discuss the recognition of puberty. The nurse should reply by saying:
- A. Puberty usually begins around 15 years of ag
- C. The first sign of puberty is an enlargement of the testes.
- D. The penis size does not increase until about 16 years of ag
Correct Answer: C
Rationale: The correct answer is C because the first sign of puberty in boys is typically an enlargement of the testes due to increased testosterone production. This occurs around age 10-14. Choice A is incorrect as puberty usually begins around 10-14 years of age. Choice D is incorrect as penis growth usually starts during puberty, not at 16.
The commonest type of ureteric calculus is
- A. calcium oxalate
- B. triple phosphate
- C. urate
- D. cysteine
Correct Answer: A
Rationale: The correct answer is A: calcium oxalate. This is because calcium oxalate stones are the most common type of ureteric calculus, accounting for around 75% of cases. They form due to an excess of calcium and oxalate in the urine. Triple phosphate stones (choice B) are more commonly found in the bladder and are associated with urinary tract infections. Urate stones (choice C) are less common and typically seen in patients with gout or acidic urine. Cysteine stones (choice D) are rare and usually seen in patients with a genetic disorder affecting cysteine metabolism.
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.
Each kidney contains about a million and stored in the pituitary gland
- A. ADH plays a key role in the homeostatic filtration apparatus called: process called osmoregulation
- B. the distal tubule
- C. the proximal tubule
Correct Answer: A
Rationale: The correct answer is A: ADH plays a key role in the homeostatic filtration apparatus called the process called osmoregulation. ADH, or antidiuretic hormone, regulates water balance by controlling the permeability of the collecting duct in the kidney nephrons. This controls the concentration of urine produced. The other choices, B and C, refer to specific parts of the kidney tubules and are not related to the role of ADH in osmoregulation. Choice D is incomplete and does not provide any relevant information. Therefore, A is the correct choice as it directly relates to the function of ADH in maintaining water balance within the body.
A 25-year-old woman presents to the clinic with pain in her lower abdomen and an abnormal pap smear result. The nurse suspects that she might have an ectopic pregnancy. Which of the following is the most common symptom of ectopic pregnancy?
- A. Severe pain on one side of the lower abdomen.
- B. Severe nausea and vomiting.
- C. Pain with urination or bowel movements.
- D. Frequent urination.
Correct Answer: B
Rationale: The correct answer is B: Severe nausea and vomiting. In an ectopic pregnancy, the fertilized egg implants outside the uterus, commonly in the fallopian tube. As the pregnancy progresses, the tube can rupture, leading to severe internal bleeding. This bleeding can irritate the abdominal lining, causing nausea and vomiting. Severe pain on one side of the lower abdomen (choice A) is also common but not the most common symptom. Pain with urination or bowel movements (choice C) and frequent urination (choice D) are not typical symptoms of ectopic pregnancy.