RN exams renal and urinary practice questions, set 4
RN exams · renal and urinary
RN exams renal and urinary practice questionsset 4
You use fluids, electrolytes, and kidney cues to decide what to hold, give, or report. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the RN exams exam guide or more RN exams practice questions.
Five renal and urinary questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
This class of drug exert its antimicrobial action by binding to 30S ribosomes * and inhibit bacterial protein synthesis, is the drug of choice for treating non- gonoccocal urethritis caused by Chlamydia and Ureaplasma, but should be avoided in patients with liver disease:
A. Daptomycin
B. Carbapenems
C. Cephalosphorins
D. Tetracyclines
Show answer and rationale
Correct answer: D — Tetracyclines
The correct answer is D: Tetracyclines. Tetracyclines bind to the 30S ribosomal subunit and inhibit bacterial protein synthesis, making them effective against Chlamydia and Ureaplasma causing non-gonococcal urethritis. They should be avoided in patients with liver disease due to the potential for hepatotoxicity.
A: Daptomycin is not the correct choice as it works by disrupting bacterial cell membrane function, not by binding to ribosomes.
B: Carbapenems are broad-spectrum antibiotics that inhibit cell wall synthesis by binding to penicillin-binding proteins, not ribosomes.
C: Cephalosporins are beta-lactam antibiotics that inhibit cell wall synthesis, not protein synthesis by binding to ribosomes.
In summary, tetracyclines are the drug of choice for the given condition due to their mechanism of action on ribosomes, while the other choices are incorrect as they target different
Question 2
A 70 year old man requires treatment with an alpha-blocker for overflow incontinence due to enlarged prostate. Which of the following alpha blocking drugs is most appropriate drug to prescribe that will not affect his blood pressure significantly?
A. Prazosin
B. Phentolamine
C. Tamsulosin
D. Terazosin
Show answer and rationale
Correct answer: C — Tamsulosin
The correct answer is C: Tamsulosin. It is the most appropriate alpha-blocker for the elderly man with enlarged prostate and overflow incontinence because of its selective action on alpha-1A receptors in the prostate, leading to relaxation of smooth muscle without significantly affecting blood pressure.
Rationale:
1. Prazosin (Choice A) and Terazosin (Choice D) are non-selective alpha-blockers that can cause significant blood pressure lowering due to their action on alpha-1 receptors in blood vessels, which may not be suitable for this patient.
2. Phentolamine (Choice B) is also a non-selective alpha-blocker that can lead to significant blood pressure reduction, making it unsuitable for this patient.
3. Tamsulosin (Choice C) is a selective alpha-1A blocker, primarily acting on the prostate, with minimal impact on blood pressure, making it the most appropriate choice for this patient.
Question 3
Which of the following anti-HIV regimen that is generally reserved for advanced cases of AIDS or for repeated treatment failures?:
A. Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI)
B. Three NRTIs
C. Two NRTIs + one non-NRTI
D. One NRTI + one non-NRTI + one PI
Show answer and rationale
Correct answer: A — Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI)
The correct answer is A: Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI). This regimen is typically reserved for advanced cases of AIDS or repeated treatment failures due to its high potency and effectiveness in suppressing HIV replication. NRTIs work by blocking the reverse transcriptase enzyme, while PIs inhibit the protease enzyme, both essential for HIV replication. Combining two NRTIs with a PI targets the virus at multiple stages, reducing the likelihood of resistance development. In contrast, the other choices (B, C, D) do not offer the same level of efficacy or resistance prevention as the combination in choice A. B: Three NRTIs may lead to increased toxicity without added benefit. C: Two NRTIs + one non-NRTI lacks the potency of a PI in advanced cases. D: One NRTI + one non-NRTI + one PI is not as effective as two NRTIs + one PI in suppressing
Question 4
Intravenous Plain NSS infusion is the treatment of choice for the following complications of furosemide therapy:
A. Hypokalemia
B. Severe dehydration
C. Dilutional hyponatremia
D. None of the above
Show answer and rationale
Correct answer: B — Severe dehydration
The correct answer is B: Severe dehydration. Intravenous Plain NSS (Normal Saline Solution) infusion is the treatment of choice for severe dehydration due to its ability to rapidly restore fluid and electrolyte balance. Furosemide, a loop diuretic, can lead to excessive fluid loss and dehydration. Plain NSS helps replenish lost fluids and electrolytes quickly.
Rationale for other choices:
A: Hypokalemia - Furosemide can cause hypokalemia by increasing potassium excretion, but treatment involves potassium supplementation or potassium-sparing diuretics, not NSS infusion.
C: Dilutional hyponatremia - Furosemide can lead to dilutional hyponatremia by causing excessive water retention, but treatment focuses on fluid restriction and correcting underlying causes, not NSS infusion.
D: None of the above - This is incorrect as NSS infusion is indicated for severe dehydration in furosemide therapy.
Question 5
Which of the following anti-HIV regimen that is generally reserved for advanced cases of AIDS or for repeated treatment failures?:
A. Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI)
B. Three NRTIs
C. Two NRTIs + one non-NRTI
D. One NRTI + one non-NRTI + one PI
Show answer and rationale
Correct answer: A — Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI)
The correct answer is A: Two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor (PI). This regimen is typically reserved for advanced cases of AIDS or repeated treatment failures due to its high potency and effectiveness in suppressing HIV replication. NRTIs work by blocking the reverse transcriptase enzyme, while PIs inhibit the protease enzyme, both essential for HIV replication. Combining two NRTIs with a PI targets the virus at multiple stages, reducing the likelihood of resistance development. In contrast, the other choices (B, C, D) do not offer the same level of efficacy or resistance prevention as the combination in choice A. B: Three NRTIs may lead to increased toxicity without added benefit. C: Two NRTIs + one non-NRTI lacks the potency of a PI in advanced cases. D: One NRTI + one non-NRTI + one PI is not as effective as two NRTIs + one PI in suppressing
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Question 6
The penicillin G preparation with the longest duration of action is:
A. Benzathine penicillin
B. Sodium penicillin
C. Potassium penicillin
D. Procaine penicillin
Correct answer:
The correct answer is A: Benzathine penicillin. Benzathine penicillin has the longest duration of action among the choices because it is formulated as a salt that releases the active drug slowly over an extended period. The benzathine salt forms a depot at the injection site, leading to a sustained release of penicillin into the bloodstream. This results in a prolonged therapeutic effect and less frequent dosing compared to other penicillin preparations.
Summary:
- Choice B: Sodium penicillin has a shorter duration of action as it gets rapidly absorbed and eliminated from the body.
- Choice C: Potassium penicillin is not a standard form of penicillin and does not exist as a distinct preparation.
- Choice D: Procaine penicillin has an intermediate duration of action compared to benzathine penicillin due to the addition of procaine for local anesthesia, but it is not as long-acting.
A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?
A. Residual urine greater than 200 mL
B. A large, atonic bladder on urodynamic testing
C. A voiding pattern that indicates psychogenic urinary retention
D. Pain with bladder filling that is transiently relieved by urination
Correct answer:
The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.
Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.
While on-scene with a 70-year-old complaining of chest pain, what is one of the first indicators that should alert the paramedic to the probability that an acute myocardial infarction is occurring?
A. The relief to some degree of chest pain after the administration of nitroglycerin
B. The presence of chest pain not changed or relieved by oxygen therapy alone
C. The presence of persistent chest pain not relieved by nitroglycerin therapy
D. Cyanosis around the patient's mouth, nose, and nail beds
Correct answer:
Step 1: Chest pain that is not relieved by oxygen therapy alone suggests that the cause of the pain is not related to a lack of oxygen to the heart muscle.
Step 2: Acute myocardial infarction (heart attack) is caused by a blockage in the coronary arteries, leading to reduced blood flow and oxygen to the heart muscle.
Step 3: If the chest pain is not affected by oxygen therapy, it indicates that the pain is likely due to a problem other than lack of oxygen, such as a heart attack.
Step 4: Therefore, choice B is the correct answer as it points to a symptom consistent with an acute myocardial infarction.
Summary: Choices A and C mention relief or lack of relief of chest pain with nitroglycerin, which is typically used for angina and may not necessarily indicate a heart attack. Choice D, cyanosis, is a late sign of inadequate oxygenation and not specific to an acute myocardial infarction
A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?
A. Residual urine greater than 200 mL
B. A large, atonic bladder on urodynamic testing
C. A voiding pattern that indicates psychogenic urinary retention
D. Pain with bladder filling that is transiently relieved by urination
Correct answer:
The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.
Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.
The correct answer is D: blood hydrostatic pressure. Glomerular filtrate is produced as a result of the pressure exerted by the blood in the glomerular capillaries forcing water and small solutes into the Bowman's capsule. This pressure, known as blood hydrostatic pressure, is the driving force for the initial filtration of blood in the kidneys.
Rationale:
1. A: Tubule secretion is the process by which substances are actively transported from the blood into the renal tubules, not the initial production of glomerular filtrate.
2. B: Facilitated diffusion is a passive transport process that requires specific carrier proteins, not a mechanism for producing glomerular filtrate.
3. C: Blood colloid osmotic pressure is the pressure exerted by proteins in the blood that tends to pull water back into the capillaries, opposing filtration, not causing the production of glomerular filtrate.
The process by which water is reabsorbed by following solutes when they are reabsorbed is called
A. obligatory water reabsorption
B. facultative water reabsorption
C. osmotic water reabsorption
D. renin-angiotensin water reabsorption
Correct answer:
The correct answer is B: facultative water reabsorption. This process occurs in the collecting ducts of the nephron in the kidney, where water reabsorption is regulated based on the body's hydration levels. When solutes like sodium are reabsorbed, water follows passively through aquaporin channels, adjusting the amount of water reabsorbed according to the body's needs.
A: Obligatory water reabsorption refers to the constant reabsorption of water in the proximal tubule and descending loop of Henle, not regulated based on hydration levels.
C: Osmotic water reabsorption is a general term referring to the movement of water based on osmotic gradients, not specifically regulated by solute reabsorption.
D: Renin-angiotensin water reabsorption involves the renin-angiotensin-aldosterone system in response to low blood pressure, focusing on sodium reabsorption rather than direct regulation of
Which of the following drugs valuable in the treatment of edema and metabolic alkalosis?
A. Digoxin
B. Spironolactone
C. Dobutamine
D. Acetazolamide
Correct answer:
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
A 70 year old man requires treatment with an alpha-blocker for overflow incontinence due to enlarged prostate. Which of the following alpha blocking drugs is most appropriate drug to prescribe that will not affect his blood pressure significantly?
A. Prazosin
B. Phentolamine
C. Tamsulosin
D. Terazosin
Correct answer:
The correct answer is C: Tamsulosin. It is the most appropriate alpha-blocker for the elderly man with enlarged prostate and overflow incontinence because of its selective action on alpha-1A receptors in the prostate, leading to relaxation of smooth muscle without significantly affecting blood pressure.
Rationale:
1. Prazosin (Choice A) and Terazosin (Choice D) are non-selective alpha-blockers that can cause significant blood pressure lowering due to their action on alpha-1 receptors in blood vessels, which may not be suitable for this patient.
2. Phentolamine (Choice B) is also a non-selective alpha-blocker that can lead to significant blood pressure reduction, making it unsuitable for this patient.
3. Tamsulosin (Choice C) is a selective alpha-1A blocker, primarily acting on the prostate, with minimal impact on blood pressure, making it the most appropriate choice for this patient.
While on-scene with a 70-year-old complaining of chest pain, what is one of the first indicators that should alert the paramedic to the probability that an acute myocardial infarction is occurring?
A. The relief to some degree of chest pain after the administration of nitroglycerin
B. The presence of chest pain not changed or relieved by oxygen therapy alone
C. The presence of persistent chest pain not relieved by nitroglycerin therapy
D. Cyanosis around the patient's mouth, nose, and nail beds
Correct answer:
Step 1: Chest pain that is not relieved by oxygen therapy alone suggests that the cause of the pain is not related to a lack of oxygen to the heart muscle.
Step 2: Acute myocardial infarction (heart attack) is caused by a blockage in the coronary arteries, leading to reduced blood flow and oxygen to the heart muscle.
Step 3: If the chest pain is not affected by oxygen therapy, it indicates that the pain is likely due to a problem other than lack of oxygen, such as a heart attack.
Step 4: Therefore, choice B is the correct answer as it points to a symptom consistent with an acute myocardial infarction.
Summary: Choices A and C mention relief or lack of relief of chest pain with nitroglycerin, which is typically used for angina and may not necessarily indicate a heart attack. Choice D, cyanosis, is a late sign of inadequate oxygenation and not specific to an acute myocardial infarction
This class of drug exert its antimicrobial action by binding to 30S ribosomes * and inhibit bacterial protein synthesis, is the drug of choice for treating non- gonoccocal urethritis caused by Chlamydia and Ureaplasma, but should be avoided in patients with liver disease:
A. Daptomycin
B. Carbapenems
C. Cephalosphorins
D. Tetracyclines
Correct answer:
The correct answer is D: Tetracyclines. Tetracyclines bind to the 30S ribosomal subunit and inhibit bacterial protein synthesis, making them effective against Chlamydia and Ureaplasma causing non-gonococcal urethritis. They should be avoided in patients with liver disease due to the potential for hepatotoxicity.
A: Daptomycin is not the correct choice as it works by disrupting bacterial cell membrane function, not by binding to ribosomes.
B: Carbapenems are broad-spectrum antibiotics that inhibit cell wall synthesis by binding to penicillin-binding proteins, not ribosomes.
C: Cephalosporins are beta-lactam antibiotics that inhibit cell wall synthesis, not protein synthesis by binding to ribosomes.
In summary, tetracyclines are the drug of choice for the given condition due to their mechanism of action on ribosomes, while the other choices are incorrect as they target different
RN exams renal and urinary practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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Keep going past these 15 questions
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