Nokea
What is the distinguishing feature of Hodgkin disease noted on histologic exam?
- A. Reed-Sternberg cells
- B. Red-stained cells
- C. Human Papillomavirus
- D. B-cells and T-cells
Correct Answer: A
Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.
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A patient is receiving oral nystatin suspension for a fungal infection of the mouth. Which of the following adverse effects is most likely to be experienced with this form of nystatin?
- A. Local irritation
- B. Burning
- C. Nausea
- D. Urinary urgency
Correct Answer: A
Rationale: The correct answer is A: Local irritation. When using oral nystatin suspension for a fungal infection of the mouth, local irritation is the most likely adverse effect that a patient may experience. Nystatin is generally well-tolerated, but some patients may develop local irritation, such as mouth or throat irritation. Choices B, C, and D are less likely adverse effects of oral nystatin suspension. Burning, nausea, and urinary urgency are not commonly associated with nystatin use for a fungal infection of the mouth.
When teaching a young woman about the use of hormonal contraceptives, a nurse should emphasize that these drugs are most effective when taken:
- A. Immediately after sexual intercourse.
- B. At the same time each day.
- C. Before going to bed at night.
- D. On an empty stomach.
Correct Answer: B
Rationale: The correct answer is B: 'At the same time each day.' Hormonal contraceptives should be taken consistently at the same time each day to maintain stable hormone levels, which is crucial for their effectiveness. Taking them at random times can increase the risk of contraceptive failure. Choices A, C, and D are incorrect because taking hormonal contraceptives immediately after sexual intercourse, before going to bed at night, or on an empty stomach does not align with the recommended usage instructions for these drugs.
What is the most sensitive indicator of altered brain function?
- A. The ability to perform complex mathematics
- B. Altered level of consciousness
- C. The lack of cerebrospinal fluid production
- D. Intact cranial nerve functions
Correct Answer: B
Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.
A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?
- A. They improve treatment adherence.
- B. They reduce the duration of illness.
- C. They exhibit synergistic antiviral effects.
- D. They prevent opportunistic infections.
Correct Answer: C
Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.
A 5-year-old male presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnoses is most likely?
- A. B cell deficiency
- B. T cell deficiency
- C. Combined immunodeficiency
- D. Complement deficiency
Correct Answer: B
Rationale: The correct answer is B: T cell deficiency. The symptoms described in the case, including low-set ears, a fish-shaped mouth, involuntary rapid muscular contraction, and decreased calcium levels, are indicative of DiGeorge syndrome. This syndrome is characterized by T cell deficiency due to thymic hypoplasia. B cell deficiency (Choice A), combined immunodeficiency (Choice C), and complement deficiency (Choice D) do not align with the clinical presentation and laboratory findings provided in the case. Therefore, T cell deficiency is the most likely diagnosis in this scenario.