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A nurse is working in a walk-in clinic. She has been alerted that there is an outbreak of tuberculosis (TB). Which of the following clients entering the clinic today is most likely to have TB?
- A. A 16-year-old female high school student
- B. A 33-year-old day-care worker.
- C. A 43-year-old homeless man with a history of alcoholism.
- D. A 54-year-old businessman.
Correct Answer: C
Rationale: The correct answer is C, a 43-year-old homeless man with a history of alcoholism. This choice is most likely to have TB because individuals who are homeless and have a history of alcoholism are at higher risk for TB due to weakened immune systems and living conditions. Homelessness and alcoholism increase the likelihood of exposure to TB.
Explanation for other choices:
A: A 16-year-old female high school student - Less likely to have TB compared to homeless individuals with risk factors.
B: A 33-year-old day-care worker - Possible but less likely compared to the homeless man with a history of alcoholism.
D: A 54-year-old businessman - Least likely to have TB compared to the homeless individual with risk factors.
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A patient has been diagnosed with pulmonary hypertension, in which the capillaries in the alveoli are squeezed excessively. The nurse should recognize a disturbance in what aspect of normal respiratory function?
- A. Acid-base balance
- B. Perfusion
- C. Diffusion
- D. Ventilation
Correct Answer: B
Rationale: The correct answer is B: Perfusion. Pulmonary hypertension affects blood flow through the lungs, leading to decreased perfusion. This results in inadequate oxygenation of the blood. Acid-base balance (A) is maintained by the kidneys and lungs, not directly impacted by pulmonary hypertension. Diffusion (C) refers to gas exchange in the alveoli, which is affected by perfusion but not the primary disturbance in pulmonary hypertension. Ventilation (D) is the process of moving air in and out of the lungs, which is not primarily affected by pulmonary hypertension; it is more related to conditions like COPD.
Which of the following statements is false?
- A. Hemoglobin functions as a buffer
- B. Bicarbonate ions tend to diffuse out of red blood cells into the blood plasma.
- C. The movement of molecules is in different directions in the metabolically active tissues and the alveoli.
- D. Carbonic anhydrase is an enzyme that promotes the formation of oxyhemoglobin.
Correct Answer: D
Rationale: The correct answer is D because carbonic anhydrase catalyzes the conversion of carbon dioxide and water into bicarbonate ions and protons, not the formation of oxyhemoglobin. Step-by-step rationale: 1. Hemoglobin functions as a buffer by binding to hydrogen ions to help regulate pH levels in the blood. 2. Bicarbonate ions do tend to diffuse out of red blood cells into the plasma to maintain the balance of CO2 and pH. 3. The movement of molecules is indeed different in metabolically active tissues (where oxygen is released and CO2 is taken up) compared to the alveoli (where the opposite occurs). Therefore, choices A, B, and C are all correct statements, making D the false statement.
Which of the following is a risk factor for developing heart failure?
- A. Regular exercise
- B. Low blood cholesterol levels
- C. Smoking
- D. Adequate sleep
Correct Answer: C
Rationale: The correct answer is C: Smoking. Smoking is a risk factor for developing heart failure because it damages the blood vessels, increases blood pressure, and reduces oxygen delivery to the heart. Regular exercise (A) is actually beneficial for heart health. Low blood cholesterol levels (B) are generally considered a positive factor for heart health. Adequate sleep (D) is important for overall well-being but is not a direct risk factor for heart failure. In conclusion, smoking (C) stands out as the correct answer due to its harmful effects on the cardiovascular system.
The nurse is performing an occupational history as part of the respiratory assessment. Which occupation(s) place the patient isn't at increased risk for an occupational lung disorder?
- A. A firefighter
- B. A cotton gin worker
- C. A construction contractor
- D. A bartender
Correct Answer: D
Rationale: The correct answer is D: A bartender. Bartenders are not typically exposed to occupational lung hazards like smoke, dust, or chemicals. Firefighters (A), cotton gin workers (B), and construction contractors (C) are all at increased risk due to exposure to smoke, cotton dust, and construction materials, respectively. As a result, the bartender is the least likely to develop an occupational lung disorder compared to the other professions listed.
TB skin test is called 'Scatch test or Mantoux test' in which Tuberculin Purified Protein Derivative (PPD) is injected subcutaneously. This test is based on
- A. Delayed Hypersensitivity
- B. Production of antibodies
- C. Production of Tubercle toxin
- D. All these
Correct Answer: A
Rationale: The correct answer is A: Delayed Hypersensitivity. The TB skin test, also known as the Mantoux test, is based on the principle of delayed hypersensitivity reaction. When Tuberculin Purified Protein Derivative (PPD) is injected subcutaneously, in individuals previously exposed to TB, the immune system mounts a delayed hypersensitivity reaction resulting in localized inflammation at the injection site. This reaction is mediated by T cells and is indicative of previous exposure to the TB bacterium.
Incorrect choices:
B: Production of antibodies - The TB skin test does not detect the production of antibodies specific to TB, but rather the cellular immune response.
C: Production of Tubercle toxin - The test is not based on the production of the tubercle toxin, but on the immune response to the tuberculin PPD.
D: All these - While the immune response may involve various components, such as antibodies and cellular responses, the primary basis of the TB skin test is the