Nokea
After a patient is exposed to a specific antigen, B cells will differentiate into:
- A. B cytotoxic cells
- B. Plasma cells
- C. Bursal cells
- D. Clonal equivalents
Correct Answer: B
Rationale: After exposure to a specific antigen, B cells undergo differentiation into plasma cells. Plasma cells are responsible for producing antibodies in response to the antigen. Choice A ('B cytotoxic cells') is incorrect because B cells do not differentiate into cytotoxic cells; cytotoxic cells are typically associated with T cells. Choice C ('Bursal cells') is incorrect as bursal cells are specific to birds and not relevant to human immune responses. Choice D ('Clonal equivalents') is incorrect as it does not describe the differentiation process of B cells exposed to antigens.
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A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?
- A. Somatic pain resulting from pressure on the parietal peritoneum
- B. Referred pain from her small bowel
- C. Visceral pain resulting from distension and ischemia
- D. Neuropathic pain resulting from autonomic dysfunction
Correct Answer: C
Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.
A nurse working in a busy orthopedic clinic is asked to perform the Tinel sign on a client having problems in her hand/wrist. In order to test Tinel sign, the nurse should give the client which direction?
- A. Stand tall, arms at your side, shut your eyes; place the tip of your index finger to your nose.
- B. Hold your wrist in complete flexion, keep it in this position for 60 seconds. How does your hand feel after placing it in a neutral position?
- C. I'm going to tap (percuss) over the median nerve in your wrist; tell me what sensation you feel while I am doing this. Does the sensation stay in the wrist or go anywhere else?
- D. I'm going to tap this tuning fork; place it on the side of your thumb, then tell me what you are feeling in your hand and wrist.
Correct Answer: C
Rationale: The correct answer is C. The Tinel sign involves percussing over the median nerve in the wrist to test for carpal tunnel syndrome. Choice A is incorrect as it describes a different action unrelated to the Tinel sign. Choice B is also incorrect as it involves holding the wrist in flexion, which is not part of the Tinel sign assessment. Choice D is incorrect as it mentions using a tuning fork on the thumb, which is not the correct technique for assessing the Tinel sign.
Which of the following steps occurs first during hemostasis?
- A. Vascular spasm
- B. Platelet plug
- C. Coagulation
- D. Dissolution of the clot
Correct Answer: A
Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.
A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):
- A. May develop after viral infections
- B. Develop before birth
- C. May develop following immunosuppressive therapies
- D. Are caused by superimposed conditions
Correct Answer: B
Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.
In which of the following patients may the administration of a live vaccine be contraindicated?
- A. Patient with renal insufficiency
- B. Patient with hepatic failure
- C. Patient taking steroid therapy
- D. Patient over the age of 65 years
Correct Answer: C
Rationale: The correct answer is C. The administration of live vaccines may be contraindicated in patients taking steroid therapy. Steroids can suppress the immune system, reducing the effectiveness of live vaccines. Patients with renal insufficiency or hepatic failure can typically receive live vaccines as these conditions are not direct contraindications. Age alone, such as being over 65 years old, is not a contraindication for live vaccines unless there are other specific health considerations. Therefore, the patient taking steroid therapy is the most likely candidate for whom the administration of a live vaccine would be contraindicated.