Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
A 22-year-old architecture major comes to your office, complaining of severe burning with urination, a fever of 101 degrees, and aching all over. She denies any upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms. Her past medical history consists of severe acne. She is currently on an oral contraceptive. She has had no pregnancies or surgeries. She reports one new partner within the last month. She does not smoke but does drink occasionally. Her parents are both in good health. On examination you see a young woman appearing slightly ill. Her temperature is 100.3 and her pulse and blood pressure are unremarkable. Her head, ears, eyes, nose, throat, cardiac, pulmonary, and abdominal examinations are unremarkable. Palpation of the inguinal nodes shows lymphadenopathy bilaterally. On visualization of the perineum there are more than 10 shallow ulcers along each side of the vulva. Speculum and bimanual examination are unremarkable for findings, although she is very tender at the introitus. Urine analysis has some white blood cells but no red blood cells or bacteria. Her urine pregnancy test is negative. Which disorder of the vulva is most likely in this case?
- A. Genital herpes
- B. Condylomata acuminata
- C. Syphilitic chancre
- D. Epidermoid cyst
Show answer and rationale
Correct answer: A — Genital herpes
The correct answer is A: Genital herpes. The clinical presentation of severe burning with urination, fever, aching all over, lymphadenopathy, and multiple shallow ulcers along the vulva is highly suggestive of genital herpes. The history of a new sexual partner and the absence of upper respiratory, gastrointestinal, cardiac, or pulmonary symptoms further support this diagnosis. The presence of white blood cells in the urine is consistent with the systemic inflammatory response seen in genital herpes. The negative urine pregnancy test rules out pregnancy-related complications. Condylomata acuminata (choice B) presents as warty growths, not ulcers. Syphilitic chancre (choice C) typically presents as a painless ulcer with regional lymphadenopathy. Epidermoid cyst (choice D) does not typically cause symptoms like severe burning with urination and fever.
Question 2
A nurse is providing care for a patient with anorexia nervosa who has refused to eat. What is the nurse's priority intervention?
- A. Provide a structured meal plan and encourage the patient to eat.
- B. Allow the patient to skip meals to avoid overwhelming them.
- C. Focus on addressing body image concerns before eating.
- D. Monitor the patient's weight closely without intervention.
Show answer and rationale
Correct answer: A — Provide a structured meal plan and encourage the patient to eat.
The correct answer is A: Provide a structured meal plan and encourage the patient to eat. This is the priority intervention because patients with anorexia nervosa often have a distorted perception of their body and food intake. By providing a structured meal plan, the nurse can help the patient establish a healthy eating routine. Encouraging the patient to eat is crucial to prevent further malnutrition and complications.
Choice B is incorrect because allowing the patient to skip meals can worsen their condition and reinforce unhealthy behaviors. Choice C is incorrect because addressing body image concerns should be done in conjunction with addressing the patient's nutritional needs. Choice D is incorrect because monitoring weight without intervening to address the underlying issue of refusal to eat is not sufficient in managing anorexia nervosa.
Question 3
Nursing considerations that should be applied in the management of people with type 2 diabetes mellitus include:
- A. Blood glucose level monitoring before and after meals.
- B. Preventing the consumption of all high carbohydrate foods.
- C. Skin, foot, and pressure area care when hospitalised.
- D. Minimising exercise to prevent fatigue and foot ulcers.
Show answer and rationale
Correct answer: C — Skin, foot, and pressure area care when hospitalised.
Nursing care for type 2 diabetes balances monitoring, prevention, and education. Blood glucose monitoring pre/post-meals informs insulin adjustments but isn't universally required frequency varies. Banning all high-carb foods is unrealistic; moderation via glycemic index guides diet, not prohibition. Skin, foot, and pressure area care is critical in hospital peripheral neuropathy and poor healing (e.g., Bob's case) risk ulcers and infections, needing daily inspection and protection, per standards in chronic care texts. Minimizing exercise contradicts management; activity improves insulin sensitivity and glucose uptake ulcer risk is mitigated with proper footwear, not inactivity. Foot care addresses diabetes' microvascular damage (neuropathy, angiopathy), preventing amputation, a leading morbidity, making it a priority intervention in acute settings.
Question 4
The entire process of spermatogenesis takes approximately ________.
- A. 25-50 days
- B. 64-72 days
- C. 120 days
- D. 1 year
Show answer and rationale
Correct answer: C — 120 days
The correct answer is C: 120 days. Spermatogenesis is the process of sperm production, which involves several stages including mitosis, meiosis, and maturation. It takes around 64 days for the sperm to develop from spermatogonia to mature spermatozoa in the seminiferous tubules. After that, the sperm undergo additional maturation in the epididymis for approximately 12-14 days. Therefore, the entire process of spermatogenesis, from the initial division of spermatogonia to the release of mature sperm, takes approximately 120 days.
Choice A (25-50 days) is too short for the complete process of spermatogenesis. Choice B (64-72 days) only covers the time for sperm development in the seminiferous tubules but does not include the maturation period in the epididymis. Choice D (1 year) is too long for spermatogenesis and does not accurately represent the
Question 5
A 10 year old is at the clinic for "a sore throat that has lasted 6 days." Which of these findings would be consistent with an acute infection?
- A. Tonsils 1+/1-4+ and pink; the same color as the oral mucosa
- B. Tonsils 2+/1-4+ with small plugs of white debris
- C. Tonsils 3+/1-4+ with large white spots
- D. Tonsils 3+/1-4+ with pale coloring
Show answer and rationale
Correct answer: C — Tonsils 3+/1-4+ with large white spots
The correct answer is C because tonsils that are 3+/1-4+ with large white spots are indicative of exudative tonsillitis, which commonly occurs in acute bacterial infections like streptococcal pharyngitis. Here's the rationale:
1. Tonsils 3+ indicate significant enlargement, more than the normal size.
2. 1-4+ refers to the extent of the white spots or exudate present on the tonsils.
3. Large white spots suggest a substantial amount of exudate, commonly seen in bacterial infections like streptococcal pharyngitis.
Therefore, the presentation of enlarged tonsils with large white spots aligns with an acute bacterial infection.
Other choices are incorrect:
A: Tonsils are not significantly enlarged nor do they have white spots.
B: While there is white debris, it is not extensive as indicated by the 1-4+ scale.
D: Pale coloring does not indicate an
