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.
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When discussing the risks associated with hormone replacement therapy (HRT) with a patient who has a history of coronary artery disease, what should the nurse emphasize?
- A. HRT may increase the risk of cardiovascular events such as heart attack and stroke.
- B. HRT may increase the risk of osteoporosis.
- C. HRT may decrease the risk of venous thromboembolism.
- D. HRT may increase the risk of breast cancer.
Correct Answer: A
Rationale: The correct answer is A. Hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, such as heart attack and stroke, especially in patients with a history of coronary artery disease. Choice B is incorrect because HRT is actually known to decrease the risk of osteoporosis. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism. Choice D is also incorrect as HRT may slightly increase the risk of breast cancer.
After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:
- A. Bone marrow
- B. Lymph nodes
- C. Gut-associated lymphoid tissue
- D. Thymus
Correct Answer: A
Rationale: The correct answer is A: Bone marrow. B cells are originally derived from cells of the bone marrow. Bone marrow is the primary site where B cells develop and mature. Lymph nodes (choice B), gut-associated lymphoid tissue (choice C), and the thymus (choice D) are involved in the immune response but are not the primary site of origin for B cells.
Seizures are diagnosed by which of the following?
- A. Electroencephalogram (EEG) and ECG
- B. Seizure symptoms and complete blood count (CBC)
- C. Seizure symptoms and electrocardiogram (ECG)
- D. Seizure symptoms and EEG
Correct Answer: D
Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.
Which of the following describes the pathophysiology of exercise-induced asthma?
- A. Bronchospasm after exercise
- B. IgE-mediated inflammatory response to antigen
- C. Bronchoconstriction after ingesting high-allergen foods
- D. Increased mucus production due to a genetic mutation
Correct Answer: A
Rationale: The correct answer is A: 'Bronchospasm after exercise.' Exercise-induced asthma involves the narrowing of the airways (bronchospasm) triggered by physical activity. This bronchospasm leads to symptoms such as coughing, wheezing, and shortness of breath. Choices B, C, and D are incorrect because exercise-induced asthma is not primarily caused by an IgE-mediated inflammatory response to an antigen, bronchoconstriction after ingesting high-allergen foods, or increased mucus production due to a genetic mutation.
A patient is starting on a new oral contraceptive. What should the nurse emphasize about the timing of the medication?
- A. Take the medication at the same time each day to maintain stable hormone levels.
- B. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
- C. Oral contraceptives can be taken at any time of day as long as the schedule is consistent.
- D. Oral contraceptives are effective immediately upon starting, regardless of timing.
Correct Answer: A
Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take the medication at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because there is no specific requirement to take oral contraceptives in the morning. Choice C is incorrect because consistency in timing is essential, but it should be at the same time each day. Choice D is incorrect because oral contraceptives may take some time to reach peak effectiveness, so it is important to emphasize the need for consistent timing.