Nokea
A 78-year-old patient has developed Haemophilus influenzae. In addition to standard precautions, what should the nurse use to protect herself and other patients when working within 3 feet of the patient?
- A. Mask
- B. Gown
- C. Gloves
- D. Shoe covers
Correct Answer: A
Rationale: Haemophilus influenzae is primarily transmitted via respiratory droplets. Wearing a mask is essential to prevent inhalation of these droplets within close proximity.
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How does an antigen stimulate an immune response?
- A. It is captured, processed, and presented to a lymphocyte by a macrophage.
- B. It circulates in the blood, where it comes in contact with circulating lymphocytes.
- C. It is a foreign protein that has antigenic determinants different from those of the body.
- D. It combines with larger molecules that are capable of stimulating production of antibodies.
Correct Answer: A
Rationale: Antigens are captured, processed, and presented to lymphocytes by antigen-presenting cells like macrophages, initiating an immune response.
You assess a 24-year-old patient with RA who is considering using methotrexate (Rheumatrex) for treatment. Which information is most important to communicate with the physician?
- A. The patient has many concerns about the safety of the drug.
- B. The patient has been trying to get pregnant.
- C. The patient takes a daily multivitamin tablet.
- D. The patient says that she has taken methotrexate in the past.
Correct Answer: B
Rationale: Methotrexate is teratogenic and should not be used during pregnancy. If the patient is trying to get pregnant this is a critical consideration that must be discussed with the physician before starting the medication. The other information while important does not have the same immediate implications for treatment.
Which disease is an example of Type V hypersensitivity?
- A. Multiple sclerosis
- B. Grave's disease
- C. Rheumatoid arthritis
- D. Type 1 diabetes mellitus
Correct Answer: B
Rationale: The correct answer is B, Grave's disease, for Type V hypersensitivity. In Type V hypersensitivity, antibodies target cell surface receptors, leading to abnormal stimulation or blockage. In Grave's disease, antibodies target the thyroid-stimulating hormone receptor, leading to excessive thyroid hormone production. Multiple sclerosis (A) is an example of Type IV hypersensitivity involving T cell-mediated response. Rheumatoid arthritis (C) is an example of Type III hypersensitivity involving immune complex deposition. Type 1 diabetes mellitus (D) is an example of Type II hypersensitivity involving antibody-mediated destruction of cells.
Epithelial cells at mucosal sites have barrier functions exerted through several mechanisms. These mechanisms do not include:
- A. Secretion of mucins
- B. Secretion of antimicrobial peptides
- C. Phagocytosis of microbes
- D. Tight junctions
Correct Answer: C
Rationale: The correct answer is C: Phagocytosis of microbes. Epithelial cells primarily act as a physical barrier to prevent the entry of microbes. Phagocytosis is a function of immune cells, not epithelial cells. A: Secretion of mucins helps trap pathogens. B: Secretion of antimicrobial peptides aids in defense. D: Tight junctions form a physical barrier between cells. Therefore, phagocytosis is not a direct mechanism exerted by epithelial cells at mucosal sites.
What is the main function of the Membrane Attack Complex (MAC)?
- A. Recruitment of neutrophils
- B. Phagocytosis activation
- C. Lysis of pathogens
- D. Enhancing cytokine production
Correct Answer: C
Rationale: The main function of the Membrane Attack Complex (MAC) is to lyse pathogens by creating pores in their cell membranes. First, MAC assembles on the pathogen's surface. Then, it forms a pore, disrupting the pathogen's membrane integrity, leading to cell lysis. This mechanism is crucial for the immune system to effectively eliminate pathogens.
Choice A (Recruitment of neutrophils) is incorrect because MAC is not involved in recruiting neutrophils. Neutrophil recruitment is typically mediated by other signaling molecules.
Choice B (Phagocytosis activation) is incorrect as MAC does not directly activate phagocytosis. Phagocytosis is a separate process involving the engulfment of pathogens by immune cells.
Choice D (Enhancing cytokine production) is incorrect because MAC does not directly enhance cytokine production. Cytokine production is mainly regulated by other immune cells and signaling pathways.