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A patient post-thyroidectomy develops signs of hypocalcemia, including tingling around the mouth and muscle cramps. Which action should the nurse take first?
- A. Administer oral calcium supplements
- B. Notify the healthcare provider
- C. Assess the patient's calcium level
- D. Encourage increased intake of dairy products
Correct Answer: C
Rationale: The first action the nurse should take when a patient post-thyroidectomy develops signs of hypocalcemia is to assess the patient's calcium level. By assessing the patient's calcium level through laboratory testing, the nurse can confirm the presence of hypocalcemia and determine the severity of the condition. This information will guide further interventions, such as administering calcium supplements or notifying the healthcare provider for additional management. It is important to confirm the diagnosis before proceeding with treatment to ensure appropriate and safe care for the patient.
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A patient undergoing mechanical ventilation in the ICU develops ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA). What intervention should the healthcare team prioritize to manage the patient's infection?
- A. Administer vancomycin or linezolid for MRSA coverage.
- B. Perform bronchoalveolar lavage for diagnostic purposes.
- C. Implement contact precautions to prevent transmission.
- D. Recommend prophylactic antifungal therapy to prevent candidiasis.
Correct Answer: A
Rationale: The most important intervention for managing ventilator-associated pneumonia (VAP) caused by methicillin-resistant Staphylococcus aureus (MRSA) in a patient undergoing mechanical ventilation in the ICU is to start appropriate antimicrobial therapy targeting MRSA. Vancomycin or linezolid are commonly used antibiotics for MRSA infections. These medications are effective against MRSA and can help in treating the infection and preventing further complications. It is crucial to initiate antimicrobial therapy promptly once the diagnosis of VAP caused by MRSA is suspected or confirmed to improve patient outcomes. Other interventions such as bronchoalveolar lavage for diagnostic purposes, contact precautions, or antifungal therapy may be relevant but the priority is to start effective antibiotic therapy to target the specific pathogen causing the infection.
Patients like Emmy who have experienced delayed hypersensivity to latex FREQUENTLY complains of ______.
- A. flushing, bronchospasm
- B. urticaria, laryngeal edema
- C. rhinitis, conjunctivitis, blisters
- D. papules, vesicles, pruritus
Correct Answer: C
Rationale: Patients like Emmy who have experienced delayed hypersensitivity to latex typically present with symptoms such as rhinitis (runny or stuffy nose) and conjunctivitis (inflammation of the eyes). In addition, delayed hypersensitivity reactions often involve skin manifestations, such as blisters. These symptoms are reflective of the inflammatory response triggered by exposure to latex in individuals with delayed hypersensitivity. Symptoms like flushing, bronchospasm, urticaria, laryngeal edema, papules, vesicles, and pruritus are more commonly associated with immediate-type hypersensitivity reactions rather than delayed hypersensitivity reactions in latex-sensitive individuals.
A patient presents with delayed puberty, short stature, and a childlike appearance. Laboratory tests reveal low levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Which endocrine disorder is most likely responsible for these symptoms?
- A. Hyperthyroidism
- B. Hypothyroidism
- C. Diabetes mellitus
- D. Growth hormone deficiency
Correct Answer: D
Rationale: The patient mentioned in the scenario presents with delayed puberty, short stature, and a childlike appearance. These symptoms are indicative of growth hormone deficiency (GHD). GHD is a condition where the pituitary gland does not produce enough growth hormone, which is crucial for normal growth and development.
A patient is prescribed a loop diuretic for the management of heart failure. Which electrolyte imbalance is most commonly associated with loop diuretic therapy?
- A. Hypercalcemia
- B. Hypokalemia
- C. Hypernatremia
- D. Hypomagnesemia
Correct Answer: B
Rationale: Loop diuretics such as furosemide are commonly prescribed for the management of heart failure to reduce fluid overload and lower blood pressure by increasing the excretion of sodium and water. These medications promote the loss of potassium through increased urinary output. Hypokalemia, or low potassium levels in the blood, is the most common electrolyte imbalance associated with loop diuretic therapy. Potassium is an essential electrolyte for proper functioning of the heart, muscles, and nerves. Low potassium levels can lead to symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias. Patients on loop diuretics are often monitored for potassium levels, and sometimes potassium supplements may be prescribed to prevent or correct hypokalemia.
A patient with a chronic viral infection demonstrates persistently elevated levels of CD8+ cytotoxic T cells in their blood. Which of the following mechanisms is most likely responsible for this observation?
- A. Activation-induced cell death (AICD)
- B. T cell exhaustion
- C. Thymic involution
- D. Antigenic variation
Correct Answer: B
Rationale: T cell exhaustion is a state of T cell dysfunction that arises during chronic viral infections or cancer. In the case of a chronic viral infection, the persistent exposure to viral antigens leads to continuous stimulation of CD8+ cytotoxic T cells. Over time, this sustained stimulation can lead to T cell exhaustion, characterized by the upregulation of inhibitory receptors, impaired effector functions, and reduced proliferative capacity. As a result, despite the elevated levels of CD8+ T cells in the blood, their function may be compromised, ultimately impacting the immune response against the viral infection. In contrast, activation-induced cell death (AICD) may contribute to T cell loss during chronic infections but would not explain the persistently elevated CD8+ T cell levels. Thymic involution refers to the age-related decline in thymus function, which is not directly related to the observed increase in CD8+ T cells. Antigenic