A 22-year-old woman presents to the clinic with a complaint of severe menstrual cramps. The nurse suspects dysmenorrhea. Which of the following is the most likely cause of dysmenorrhea?

Correct Answer: C

Rationale: The correct answer is C: Ovarian cysts. Ovarian cysts can cause dysmenorrhea by disrupting the normal menstrual cycle and causing pain. Endometriosis (B) is another common cause of dysmenorrhea, but it involves the abnormal growth of endometrial tissue outside the uterus. Uterine contractions (A) are a normal part of menstruation and may cause cramping but are not the primary cause of dysmenorrhea. PCOS (D) is a hormonal disorder that can cause irregular periods and pain, but it is not the most likely cause of dysmenorrhea in this case.

Correct Answer: A

Rationale: Rationale: Renin is produced and released by the kidney in response to low blood pressure or low sodium levels. Renin initiates the RAAS cascade by converting angiotensinogen to angiotensin I. Angiotensin I is then converted to angiotensin II, leading to vasoconstriction and aldosterone release. Aldosterone, produced by the adrenal glands, promotes sodium and water retention. Therefore, choice A is correct as renin is the hormone produced by the kidney to regulate blood pressure. Choices B, C, and D are incorrect as they are downstream products of the RAAS cascade and are not directly produced by the kidney.

Correct Answer: B

Rationale: The correct answer is B: Pituitary gland. The antidiuretic hormone (ADH), also known as vasopressin, is produced and secreted by the pituitary gland. This hormone helps regulate water balance in the body by increasing water reabsorption in the kidneys. The other choices, A: Lungs, C: Liver, and D: Pineal gland, do not secrete ADH. Lungs are responsible for gas exchange, the liver performs various metabolic functions, and the pineal gland regulates sleep-wake cycles through melatonin secretion. Therefore, the pituitary gland is the only gland among the options that secretes the antidiuretic hormone.

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.

Correct Answer: A

Rationale: The correct answer is A: Isoniazid. Isoniazid inhibits the synthesis of mycolic acid, a crucial component of mycobacterial cell walls. If used alone, resistance can develop rapidly due to its specific mechanism of action. Rifampicin (B) acts on RNA polymerase, not mycolic acid synthesis. Pyrazinamide (C) targets mycobacteria in acidic environments, not mycolic acid. Ethambutol (D) inhibits arabinosyltransferase, not mycolic acid synthesis.