A patient with a severe viral infection exhibits reduced levels of circulating lymphocytes. Which of the following mechanisms is most likely responsible for this observation?
- A. Apoptosis of infected lymphocytes
- B. Clonal expansion of memory T cells
- C. T cell anergy
- D. Upregulation of adhesion molecules on lymphocytes
Correct Answer: A
Rationale: A patient with a severe viral infection exhibiting reduced levels of circulating lymphocytes is likely due to the apoptosis of infected lymphocytes. When a virus enters the body, it can infect and replicate within lymphocytes, subsequently triggering the immune system to induce apoptosis in infected cells to prevent further spread of the virus. This process is part of the body's defense mechanism to control the viral infection. As a result, the circulating lymphocyte levels may decrease as infected lymphocytes are targeted for apoptosis. This phenomenon helps to limit viral replication and spread within the body, thereby aiding in the immune response to eliminate the virus.
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A postpartum client exhibits signs of postpartum psychosis, including hallucinations, delusions, and disorganized behavior. Which nursing intervention is most appropriate?
- A. Administering antipsychotic medication as ordered
- B. Encouraging the client to participate in group therapy sessions
- C. Providing education on coping skills and stress management
- D. Notifying the healthcare provider immediately
Correct Answer: D
Rationale: When a postpartum client exhibits signs of postpartum psychosis such as hallucinations, delusions, and disorganized behavior, it is crucial to involve the healthcare provider immediately. Postpartum psychosis is a psychiatric emergency that requires prompt assessment and intervention by mental health professionals. The healthcare provider can determine the appropriate course of action, which may include hospitalization, medication management, and specialized psychiatric care. Delaying notification can lead to serious consequences for both the client and her infant, so timely intervention is essential in managing postpartum psychosis.
A patient admitted to the ICU develops acute pancreatitis with severe abdominal pain and elevated pancreatic enzymes. What intervention should the healthcare team prioritize to manage the patient's pancreatitis?
- A. Administer intravenous fluids to maintain adequate hydration.
- B. Perform an abdominal ultrasound to assess pancreatic morphology.
- C. Implement total parenteral nutrition (TPN) to meet nutritional needs.
- D. Recommend proton pump inhibitors (PPIs) for gastric acid suppression.
Correct Answer: A
Rationale: The priority intervention in managing acute pancreatitis is to administer intravenous fluids to maintain adequate hydration. Acute pancreatitis can lead to significant fluid loss and dehydration due to factors such as vomiting and third-spacing of fluids into the retroperitoneal space. Adequate hydration helps to optimize perfusion to the pancreas, prevent hypovolemic shock, and support overall organ function. This intervention also aids in flushing out inflammatory mediators and preventing complications such as acute kidney injury. Monitoring fluid status and adjusting the rate of intravenous fluid administration based on the patient's response is crucial in the management of acute pancreatitis. While other interventions such as imaging studies, nutritional support, and gastric acid suppression may be important in managing acute pancreatitis, ensuring adequate hydration is the most critical initial step.
A nurse is preparing to perform a colposcopy procedure for a patient with abnormal cervical cytology results. What action should the nurse prioritize to enhance patient comfort during colposcopy?
- A. Administering intravenous sedation to the patient before the procedure
- B. Explaining the procedure steps and providing emotional support to the patient
- C. Applying a topical anesthetic cream to the cervix before colposcopy
- D. Allowing the patient to have a support person present during the procedure
Correct Answer: B
Rationale: The best action the nurse should prioritize to enhance patient comfort during a colposcopy procedure is to explain the procedure steps and provide emotional support to the patient. Colposcopy is a procedure that involves examining the cervix, vagina, and vulva closely. Patients may feel anxious or uncomfortable during the procedure due to the sensitive nature of the area being examined and the potential concerns related to abnormal cervical cytology results. By explaining the procedure steps in detail before starting and providing emotional support, the nurse can help alleviate the patient's fears and anxieties, thereby enhancing their comfort and promoting a more positive experience overall. Additionally, establishing good communication and trust with the patient can also improve their cooperation during the procedure. Administering sedation, applying a topical anesthetic cream, and allowing a support person to be present are all important factors in providing holistic care as well, but the initial priority should be on communication and emotional support.
Which of the following is the central theme of Sr. Calista Roys theory
- A. Self care deficit
- B. Nursing as caring
- C. Adaptation
- D. Transcultural
Correct Answer: C
Rationale: The central theme of Sr. Callista Roy's theory is adaptation. Roy's Adaptation Model focuses on the individual's ability to adapt to internal and external stimuli in order to maintain health and well-being. The theory emphasizes the interconnectedness of the individual and their environment, highlighting the dynamic process of adaptation in response to stimuli. By focusing on adaptation, Roy's theory guides nursing practice in promoting holistic care that supports individuals in adapting to changes and achieving optimal health outcomes.
A patient presents with gross hematuria, flank pain, and a palpable abdominal mass. Imaging reveals a large heterogeneous renal mass with areas of necrosis and calcifications. Which of the following conditions is most likely?
- A. Renal cell carcinoma
- B. Renal cyst
- C. Renal abscess
- D. Renal angiomyolipoma
Correct Answer: A
Rationale: The clinical presentation of gross hematuria, flank pain, palpable abdominal mass, along with imaging findings of a large heterogeneous renal mass with necrosis and calcifications are highly suggestive of renal cell carcinoma (RCC). RCC is the most common type of kidney cancer in adults. The presence of necrosis and calcifications are characteristic features of RCC. Imaging modalities such as CT scans or MRI can confirm the diagnosis by showing the typical features of RCC, including a solid mass with areas of necrosis and calcifications. It is important to further evaluate this patient, likely with a biopsy, to confirm the diagnosis and determine the extent of the disease for appropriate management.