Nokea
A nurse recalls an example of an immune-complex-mediated disease is:
- A. Bronchial asthma
- B. Contact dermatitis
- C. Serum sickness
- D. Rheumatoid arthritis
Correct Answer: C
Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.
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What aspect of hormonal contraceptives places a woman at the greatest risk for the development of blood clots?
- A. Hormonal contraceptives increase serum triglyceride and cholesterol levels.
- B. Hormonal contraceptives increase platelet levels.
- C. Hormonal contraceptives increase blood levels of clotting factors.
- D. Hormonal contraceptives cause injury to blood vessel linings.
Correct Answer: C
Rationale: The correct answer is C. Hormonal contraceptives increase blood levels of clotting factors, particularly factors II, VII, IX, and X. This elevation in clotting factors can predispose individuals to thromboembolic events, including blood clots. Choices A, B, and D are incorrect because hormonal contraceptives do not have a significant effect on serum triglycerides and cholesterol, platelet levels, or causing direct injury to blood vessel linings as the primary mechanism for clot formation.
When administering an immunization, which of the following medications should be available?
- A. Diphenhydramine (Benadryl)
- B. Hydroxyzine (Vistaril)
- C. Physostigmine
- D. Epinephrine
Correct Answer: D
Rationale: When administering an immunization, it is essential to have epinephrine available in case of an allergic reaction such as anaphylaxis. Epinephrine is the medication of choice for treating severe allergic reactions due to its ability to reverse the symptoms rapidly. Diphenhydramine and hydroxyzine are antihistamines that can help manage mild allergic reactions but are not the primary medications for severe reactions like anaphylaxis. Physostigmine is not indicated for managing allergic reactions and is used for specific conditions such as anticholinergic toxicity.
When assessing for potential signs and symptoms of cryptococcosis in a patient with HIV being treated with Amphotericin B, the nurse should prioritize what assessment?
- A. Neurological assessment
- B. Functional assessment
- C. Nutritional assessment
- D. Cardiac assessment
Correct Answer: A
Rationale: In a patient with cryptococcosis and HIV, neurological assessment should be prioritized because cryptococcosis commonly affects the central nervous system, leading to symptoms such as headache, confusion, and altered mental status. This assessment is crucial in monitoring for any neurological complications and guiding appropriate interventions. Functional assessment focuses on the patient's ability to perform activities of daily living and is not directly associated with cryptococcosis. Nutritional assessment is important for overall health but is not the priority when assessing for cryptococcosis. Cardiac assessment is not a priority in cryptococcosis as the primary manifestations are related to the central nervous system.
A patient is receiving chloroquine (Aralen) for extraintestinal amebiasis. Which of the following medications should be administered with chloroquine?
- A. Iodoquinol (Yodoxin)
- B. Metronidazole (Flagyl)
- C. Metyrosine (Demser)
- D. Carbamazepine (Tegretol)
Correct Answer: B
Rationale: The correct answer is B: Metronidazole (Flagyl). When treating extraintestinal amebiasis, chloroquine is often used in combination with metronidazole to ensure the eradication of the parasite. Metronidazole helps to target the infection more effectively. Choices A, C, and D are incorrect. Iodoquinol (Yodoxin) is another antiprotozoal agent but is not typically used in combination with chloroquine for amebiasis. Metyrosine (Demser) is used in the management of pheochromocytoma, and carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing drug, neither of which are indicated for extraintestinal amebiasis.
Which patient is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)?
- A. A patient who has experienced a spinal cord injury and reports severe, burning pain in his legs.
- B. A patient who reports severe pain in her hand following a surgery for carpal tunnel syndrome.
- C. A patient who develops pain in his foot following a fracture and immobilization with a cast.
- D. A patient who experiences chronic pain and swelling in his arm following a brachial plexus injury.
Correct Answer: D
Rationale: Complex regional pain syndrome II (CRPS II) typically occurs after an injury to a peripheral nerve. In this case, a brachial plexus injury involves damage to the nerves that control muscles in the arm and hand, leading to chronic pain and swelling. Choices A, B, and C describe pain related to other conditions such as spinal cord injury, carpal tunnel surgery, and fracture immobilization, which are not typically associated with CRPS II.