When performing a genitourinary assessment on a 16-year-old male adolescent, the nurse notices a swelling in the scrotum that increases with increased intra-abdominal pressure and decreases when he is lying down. The patient complains of pain when straining. The nurse knows that this description is most consistent with a(n) ______ hernia.

Correct Answer: D

Rationale: The correct answer is D: Indirect inguinal hernia. In an indirect inguinal hernia, the swelling in the scrotum increases with increased intra-abdominal pressure due to the herniation of abdominal contents through the internal inguinal ring. The swelling decreases when lying down because the contents reduce back into the abdominal cavity. Pain with straining is also characteristic of an indirect inguinal hernia. A: Femoral hernia presents as a bulge in the upper thigh and is more common in females. B: Incisional hernia occurs at the site of a previous surgical incision and is not typically affected by intra-abdominal pressure. C: Direct inguinal hernia protrudes directly through the abdominal wall and is typically not palpable in the scrotum.

Correct Answer: D

Rationale: The correct answer is D: Chloramphenicol. It is effective in curing typhoid fever but does not prevent carrier state due to its inability to eradicate the bacteria from the gallbladder. Ceftriaxone, Ciprofloxacin, and Cotrimoxazole can also cure typhoid fever but have been shown to reduce the carrier state development. Chloramphenicol lacks this preventive property, making it the correct answer.

Correct Answer: A

Rationale: Rationale: 1. Dapsone is a known cause of hemolysis in patients with G6PD deficiency due to oxidative stress. 2. Dapsone triggers the release of reactive oxygen species, leading to hemolysis in G6PD-deficient individuals. 3. Rifampicin and clofazimine do not have a direct association with hemolysis in G6PD deficiency. 4. Option D is incorrect as dapsone is a well-established drug associated with hemolysis in G6PD-deficient individuals.

Correct Answer: D

Rationale: The correct answer is D: Clindamycin. Clindamycin is associated with a high incidence of antibiotic-associated pseudomembranous enterocolitis due to its strong impact on disrupting the normal gut flora, leading to overgrowth of Clostridium difficile. This bacterium can produce toxins causing inflammation and pseudomembrane formation in the colon. Ampicillin (A) can also cause C. difficile infection, but clindamycin is more strongly associated. Chloramphenicol (B) and vancomycin (C) are less commonly associated with pseudomembranous enterocolitis compared to clindamycin.

Correct Answer: D

Rationale: The correct answer is D because Nevirapine is associated with an increased risk of severe hepatoxicity, especially within the first few weeks of treatment initiation. The recommended CD4 cell count thresholds for starting Nevirapine are lower in women compared to men to minimize this risk. In this case, women with CD4 cell counts >250 cells/mm3 and men with CD4 cell counts >450 cells/mm3 should not initiate Nevirapine due to the higher likelihood of developing hepatoxicity. A is incorrect because the CD4 cell count thresholds are too high for both women and men. B is incorrect as it sets the threshold for women too high. C is incorrect because the threshold for men is too high. Thus, D is the most appropriate choice based on the recommended guidelines to minimize the risk of severe hepatoxicity.