DUNPHY PRIMARY CARE EXA M WITH

DUNPHY PRIMARY CARE EXA M WITH

QUESTIONS AND VERIFIED ANSWERS ||

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Which diagnostic procedure can visualize the renal outline and identify lower rib fractures?

• Intravenous pyelography.
• Renal angiography.
• Computed tomography.
• A kidney, ureter, and bladder (KUB) film. - ANSWER- A kidney, ureter, and

bladder (KUB) film.

Dietary management for a client in acute renal failure includes:

• Decreasing carbohydrate intake.
• Increasing dietary sodium intake.
• Limiting protein intake.
• Increasing potassium intake. - ANSWER-Limiting protein intake.

The increased presence in a urinalysis of which of the following indicates the presence of bacteria or protein, which is seen in severe renal disease and could also indicate urinary calculi?

• Crystals.
• Casts. 1 / 4

• Nitrites.
• Ketones. - ANSWER-Casts.

What is the percussion tone heard over a distended bladder?

• Dullness.
• Resonance.
• Hyperresonance.
• Tympany. - ANSWER-Dullness.

Jim, age 35, has had several episodes of kidney stones. The last stone he passed was examined and found to be an oxalate stone. You tell him to avoid foods high

in oxalate, such as:

• Beans and lentils, chocolate and cocoa, dried fruits, canned or smoked fish

(except tuna), flour, milk, and milk products.

• Cheese, cranberries, eggs, grapes, meat and poultry, plums and prunes,

tomatoes, and whole grains.

• Asparagus, beer, beets, cabbage, celery, chocolate and cocoa, fruits, green

beans, nuts, tea, cola, and tomatoes.

• Goose, organ meats, sardines, herring, and venison, with only a moderate intake

of beef, chicken, crab, pork, salmon, and veal. - ANSWER-Asparagus, beer, beets, cabbage, celery, chocolate and cocoa, fruits, green beans, nuts, tea, cola, and tomatoes.

Postmenopausal women tend to have more recurrent urinary tract infections

because of:

• Frequent urination.
• Estrogen depletion-related changes.
• An increase in lactobacilli. 2 / 4

• A decrease in Escherichia coli. - ANSWER-Estrogen depletion-related changes.

Which of the following diagnostic studies for the evaluation of renal function assesses for the lack of erythropoietin?

• Urine creatinine clearance.
• Serum urea nitrogen.
• Serum albumin.
• Serum hemoglobin and hematocrit. - ANSWER-Serum hemoglobin and

hematocrit.

What is the first step in the treatment of uric acid kidney stones?

• Encouraging hydration.
• Alkalinizing the urine.
• Prescribing allopurinol (Zyloprim).
• Reducing protein intake. - ANSWER-Encouraging hydration.

Joyce, age 48, is being treated conservatively for her low back pain with a nonsteroidal anti-inflammatory drug (NSAID), a muscle relaxant, and physical therapy. She has recently been diagnosed with chronic kidney disease. Which of the following statements is true?

• She should switch to a different NSAID.
• She should not be taking anything for pain other than narcotics.
• You should just increase her physical therapy and hope for the best.
• She could try acetaminophen 650 mg 3 times daily. - ANSWER-She could try

acetaminophen 650 mg 3 times daily.

Which finding in urinary sediment is indicative of pyelonephritis and interstitial nephritis? 3 / 4

• Hyaline casts.
• Granular casts.
• Red blood cell casts.
• White blood cell casts. - ANSWER-White blood cell casts.

Which of the following is considered a nephrotoxic agent and should be avoided in clients with chronic renal failure (CRF)?

• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Kayexalate.
• Calcium carbonate.
• Erythropoietin. - ANSWER-Nonsteroidal anti-inflammatory drugs (NSAIDs).

When you teach clients about using steroid inhalers for asthma or chronic obstructive pulmonary disease (COPD), what information is essential?

• Keep the inhaler in the refrigerator.
• Do not use another inhaler for 10 minutes after the steroid inhaler.
• Rinse your mouth after using the inhaler.
• Be careful not to shake the container before using it. - ANSWER- Rinse your

mouth after using the inhaler.

Martin, age 76, has just been given a diagnosis of pneumonia. Which of the following is an indication that he should be hospitalized?

• Inability to take oral medications and multilobar involvement on chest x-ray.
• Alert and oriented status, slightly high but stable vital signs, and no one to take

care of him at home.

• Sputum with gram-positive organisms.
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