Nokea
A 70-year-old man with back pain, fatigue, fever, Hb 7 g/dL, MCV 89 fL, high Ca, renal insufficiency. Definitive diagnosis best made by?
- A. 24-hour urine protein
- B. Bone scan
- C. Renal biopsy
- D. Greater than 30% plasma cells in bone marrow
Correct Answer: D
Rationale: The correct answer is D: Greater than 30% plasma cells in bone marrow. This scenario is indicative of multiple myeloma, a plasma cell disorder. High Ca and renal insufficiency suggest hypercalcemia and kidney damage due to monoclonal protein deposition. Anemia and MCV suggest bone marrow involvement. Choice A is not specific for multiple myeloma. Choice B is used to evaluate bone metastasis. Choice C is invasive and not typically done for initial diagnosis of multiple myeloma. Therefore, D is the best option for definitive diagnosis in this case.
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What are the treatment options for Wilson's disease?
- A. Penicillamine
- B. Riboflavin
- C. Trientine
- D. Potassium disulfide
Correct Answer: A
Rationale: The correct treatment option for Wilson's disease is A: Penicillamine. Penicillamine is a chelating agent that helps remove excess copper from the body. It binds to copper, forming a stable complex that can be excreted in the urine. Riboflavin (B) is a vitamin and not used in Wilson's disease treatment. Trientine (C) is another chelating agent used in Wilson's disease treatment but is not as commonly prescribed as penicillamine. Potassium disulfide (D) is not a recognized treatment for Wilson's disease.
Imagine this. You enter the unit as an RN on your first day on the job. You breathe in the smell of awesomeness and drink your Starbucks coffee. You see that you are taking care of a Mr. Smith who has been diagnosed Polycythemia Vera. Because you are so freakin' awesome, you know that Mr. Smith is at risk for which of the following complications?
- A. Excessive Bleeding
- B. Pruritus
- C. Hepatomegaly
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is A: Excessive Bleeding. Polycythemia Vera is a condition characterized by an overproduction of red blood cells, leading to increased blood viscosity and risk of thrombosis. Due to the increased number of red blood cells, there is a higher risk of clot formation, which can result in complications such as thrombosis, stroke, or heart attack. Excessive bleeding can also occur as a result of abnormal blood clotting mechanisms in Polycythemia Vera. Pruritus (choice B) is a common symptom but not a direct complication of Polycythemia Vera. Hepatomegaly (choice C) and Pancreatitis (choice D) are not commonly associated complications of Polycythemia Vera.
Which of the following is not a characteristic of inflammation?
- A. inactivation of macrophages
- B. increased vascular permeability and edema
- C. vasodilation
- D. pain
Correct Answer: A
Rationale: The correct answer is A: inactivation of macrophages. Inflammation involves activation of macrophages to help phagocytize pathogens. Inactivation of macrophages would hinder the immune response. Increased vascular permeability, vasodilation, and pain are all typical characteristics of inflammation. Macrophages play a crucial role in the inflammatory response by engulfing and destroying pathogens, therefore, inactivation of macrophages is not a characteristic of inflammation.
The immunity conferred by the tetanus toxoid vaccine is:
- A. Artificially acquired passive immunity
- B. Naturally acquired active immunity
- C. Artificially acquired active immunity
- D. Naturally acquired passive immunity
Correct Answer: C
Rationale: The correct answer is C: Artificially acquired active immunity. The tetanus toxoid vaccine contains inactivated tetanus toxin, which stimulates the immune system to produce antibodies against tetanus. This process results in the person developing immunity to tetanus in the future. It is considered active immunity because the individual's immune system is actively involved in producing antibodies.
A: Artificially acquired passive immunity involves receiving pre-formed antibodies, which provide immediate but temporary protection. This is not the case with the tetanus toxoid vaccine.
B: Naturally acquired active immunity occurs when a person is exposed to the pathogen and develops immunity through their own immune response. This is not the case with the tetanus toxoid vaccine.
D: Naturally acquired passive immunity involves receiving antibodies from another source, such as through breastfeeding. This is not how the tetanus toxoid vaccine works.
A nurse is assessing a client who has pericarditis. Which of the following manifestations should the nurse expect?
- A. Dyspnea with hiccups
- B. Chest pain relieved by sitting upright
- C. Fever with chills
- D. Tachycardia alone
Correct Answer: A
Rationale: The correct answer is A: Dyspnea with hiccups. Pericarditis is inflammation of the pericardium, leading to chest pain worsened by lying flat and relieved by sitting upright. Dyspnea (shortness of breath) may occur due to compression of the heart by fluid or inflammation. Hiccups can result from irritation of the diaphragm. Fever with chills (choice C) is more indicative of an infectious process. Tachycardia alone (choice D) is a nonspecific symptom and can occur in various conditions, but pericarditis typically presents with a combination of symptoms including chest pain and dyspnea.