Nokea
A patient identified as HIV antibody–positive 1 year ago manifests acute HIV infection but does not want to start antiretroviral therapy at this time. What is an appropriate nursing intervention for the patient at this stage of illness?
- A. Assist with end-of-life issues
- B. Provide care during acute exacerbations
- C. Provide physical care for chronic diseases
- D. Teach the patient about immune enhancement
Correct Answer: D
Rationale: Immune enhancement strategies, such as nutrition and stress reduction, can help maintain health until the patient decides to initiate ART.
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The lectin and the classical pathway are similar because:
- A. The same component initiates the complement cascade
- B. The same enzyme cleaves C4 and C2
- C. They lead to the formation of the same C3 convertase
- D. They both involve recognition of an antigen/antibody complex as a trigger for complement activation
Correct Answer: C
Rationale: The lectin and classical pathways both lead to the formation of the same C3 convertase (C4b2a). This is because in the lectin pathway, mannose-binding lectin (MBL) binds to specific sugar residues on pathogens, activating MBL-associated serine proteases (MASPs) that cleave C4 and C2 to form the C3 convertase. Similarly, in the classical pathway, C1 complex binds to antigen-antibody complexes, activating C1s to cleave C4 and C2 to form the C3 convertase. This convergent step in both pathways results in the cleavage of C3 into C3a and C3b, leading to downstream complement activation. The other choices are incorrect because they do not accurately reflect the key similarity between the lectin and classical pathways in terms of the formation of the C3 convertase.
Which of the following is the most severe complication among clients with allergies,regardless of type?
- A. Bronchitis
- B. Cardiac arrest
- C. Anaphylactic shock and angioneurotic edema
- D. Asthma and nasal polyps
Correct Answer: C
Rationale: Anaphylactic shock and angioneurotic edema are life-threatening allergic reactions that require immediate medical intervention.
What is the primary trigger for NK cell activation?
- A. Presence of PAMPs
- B. Lack of normal self-surface structures
- C. High levels of complement proteins
- D. Antigen presentation by dendritic cells
Correct Answer: B
Rationale: The primary trigger for NK cell activation is the lack of normal self-surface structures. NK cells are part of the innate immune system and recognize cells with altered or missing self-antigens. This triggers their activation to eliminate these abnormal cells. Presence of PAMPs (A) activates other immune cells like macrophages. High levels of complement proteins (C) activate the complement cascade but do not directly trigger NK cell activation. Antigen presentation by dendritic cells (D) activates adaptive immune responses through T cells, not NK cells. Therefore, the correct answer is B as it directly relates to NK cell function.
The patient in a long arm cast (from below the shoulder to the wrist, with a 90-degree elbow flexion) complains of a burning sensation over the elbow. The nurse's initial intervention should be:
- A. Elevate the casted arm on pillows.
- B. Check to see if the cast is properly supported.
- C. Notify the charge nurse of developing pressure ulcer.
- D. Cut a "window" in the cast.
Correct Answer: B
Rationale: The correct answer is B: Check to see if the cast is properly supported. The burning sensation over the elbow could indicate nerve compression due to improper cast positioning. By checking if the cast is properly supported, the nurse can ensure that there is no pressure on the nerves causing the burning sensation. Elevating the casted arm (choice A) may not address the root cause of the burning sensation. Notifying the charge nurse of developing pressure ulcer (choice C) is premature without confirming the cause of the burning sensation. Cutting a "window" in the cast (choice D) should be a last resort after ruling out other issues.
Which word identifies a mutation of protooncogenes?
- A. Oncogenes
- B. Retrogenes
- C. Oncofetal antigens
- D. Tumor angiogenesis factor
Correct Answer: A
Rationale: Protooncogenes, when mutated, become oncogenes, which promote uncontrolled cell growth.