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?

Correct Answer: C

Rationale: 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.

Correct Answer: B

Rationale: 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.

Correct Answer: D

Rationale: Step-by-step rationale for choosing option D: 1. Instruct the client to maintain limited physical activity to prevent contamination of the urine sample. 2. Physical activity can introduce bacteria from sweat or skin into the specimen, leading to inaccurate results. 3. By limiting physical activity, the client can ensure a clean-catch midstream urine sample for accurate testing. 4. Increasing fluid intake (option A), refraining from nephrotoxic drugs (option B), and taking sedative medications (option C) are not directly related to obtaining a clean-catch midstream urine specimen.

Correct Answer: B

Rationale: Step-by-step rationale: 1. Renal failure is a condition where the kidneys are unable to adequately filter waste from the blood. 2. Dialysis is a treatment used to perform the functions of the kidneys in patients with renal failure. 3. Dialysis helps remove excess waste, fluids, and toxins from the blood, maintaining proper electrolyte balance. 4. Patients with acute glomerulonephritis, nephrolithiasis, and pyelonephritis may not require dialysis as their conditions do not directly affect kidney function to the extent that renal failure does. Summary: - A: Acute glomerulonephritis does not always lead to renal failure requiring dialysis. - C: Nephrolithiasis is the formation of kidney stones and may not always require dialysis. - D: Pyelonephritis is a kidney infection and may not necessarily lead to renal failure requiring dialysis.

Correct Answer: B

Rationale: The correct answer is B because the patient with kidney stones requiring lithotripsy would benefit from the LPN/LVN's care. This task involves monitoring the patient's vital signs, providing pre and post-procedure care, and ensuring patient comfort. The LPN/LVN is trained to perform these duties safely. Choice A is incorrect as the patient with cystitis on oral antibiotics can be managed by a nursing assistant under supervision. Choice C is incorrect because bladder training for urinary incontinence typically requires the skills of an RN due to the complexity of the intervention. Choice D is incorrect as the patient with pyelonephritis and severe flank pain requires immediate assessment and intervention by an RN due to the severity of the condition.