Nokea
A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?
- A. IgE-mediated
- B. Tissue-specific
- C. Immune complex
- D. Cell-mediated
Correct Answer: D
Rationale: The father's immune reaction to poison ivy is an example of cell-mediated immunity, specifically a type IV hypersensitivity reaction. In this type of reaction, sensitized T cells react to antigens, leading to inflammation and tissue damage. IgE-mediated reactions involve antibodies of the IgE class, commonly seen in allergic responses like anaphylaxis. Tissue-specific reactions target specific organs or tissues. Immune complex reactions involve immune complexes formed by antigens and antibodies that can deposit in tissues, leading to inflammation.
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A female patient is taking combined hormonal contraceptives to prevent pregnancy. She visits the gynecology clinic and is noted to have a blood pressure of 176/102 mm Hg. The patient is started on enalapril mesylate 10 mg. In collaboration with the primary care provider, what other patient teaching should be provided based on her current medication regimen?
- A. Instruct on a low-salt diet.
- B. Instruct to discontinue the contraceptives.
- C. Instruct on the use of relaxation techniques to decrease stress.
- D. Instruct on the rationale for increasing the contraceptive dose.
Correct Answer: A
Rationale: Women on hormonal contraceptives and antihypertensives like enalapril should be counseled to adopt a low-salt diet if severe hypertension occurs. This dietary modification can help in managing blood pressure levels. Instructing to discontinue the contraceptives is crucial in cases of severe hypertension as it poses an increased risk of cardiovascular events. Instructing on relaxation techniques may have some benefits in reducing stress levels but addressing the root cause, such as discontinuing contraceptives in this scenario, is more critical. There is no rationale for increasing the contraceptive dose when hypertension is present; in fact, it should be stopped to prevent complications.
A client with chronic bronchitis is receiving education from a healthcare provider about the condition. Which statement made by the client indicates a need for further teaching?
- A. I should avoid being around people who smoke.
- B. I should try to avoid any exposure to pollutants and irritants.
- C. I should limit my fluid intake to avoid worsening my cough.
- D. I should use my inhaler regularly, even when I don't have symptoms.
Correct Answer: C
Rationale: The correct answer is C because limiting fluid intake is not recommended for chronic bronchitis. Hydration is essential as it helps thin mucus, making it easier to clear from the airways. Choices A, B, and D are all correct statements for managing chronic bronchitis. Avoiding exposure to smoke, pollutants, and irritants can help reduce respiratory symptoms and exacerbations. Using the inhaler regularly, even in the absence of symptoms, is crucial for controlling inflammation and maintaining airway function.
Why is testosterone therapy prescribed for a 70-year-old man being treated for osteoporosis?
- A. To increase bone density
- B. To reduce the risk of fractures
- C. To enhance sexual performance
- D. To restore testosterone levels
Correct Answer: D
Rationale: The primary reason for prescribing testosterone therapy for osteoporosis in men is to restore testosterone levels, not specifically to increase bone density. Testosterone plays a crucial role in maintaining bone density, so by restoring testosterone levels, it indirectly helps in maintaining bone density. Choices A and B are partially correct but do not address the primary reason for testosterone therapy in this context. Choice C is incorrect as the main focus of testosterone therapy in osteoporosis treatment is not related to enhancing sexual performance.
A young man has received a diagnosis of androgen deficiency and has been prescribed testosterone. At clinic follow-up appointments, the nurse should prioritize which of the following assessments?
- A. Bladder ultrasound and urine testing for glucose and ketones
- B. Weight and measurement of blood pressure
- C. Hearing assessment and abdominal girth measurement
- D. Deep tendon reflexes and random blood glucose testing
Correct Answer: B
Rationale: In a patient receiving testosterone therapy for androgen deficiency, monitoring weight and blood pressure is crucial. Testosterone therapy can lead to weight gain and hypertension, making regular assessments of these parameters important to detect and manage any adverse effects. Choices A, C, and D are not the priority assessments for a patient on testosterone therapy. Bladder ultrasound and urine testing for glucose and ketones, hearing assessment and abdominal girth measurement, and deep tendon reflexes and random blood glucose testing are not directly related to the common side effects or monitoring requirements of testosterone therapy.
In osteoporosis, what is the expected therapeutic action of raloxifene (Evista)?
- A. It decreases bone resorption and increases bone density.
- B. It stimulates the formation of new bone.
- C. It increases calcium absorption in the intestines.
- D. It decreases the excretion of calcium through the kidneys.
Correct Answer: A
Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in strengthening bones, reducing the risk of fractures, and improving bone health in patients with osteoporosis. Choice B is incorrect because raloxifene does not directly stimulate the formation of new bone but rather prevents bone loss. Choice C is incorrect as raloxifene does not primarily affect calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not primarily decrease the excretion of calcium through the kidneys.