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A patient presents with fatigue, weakness, and jaundice. Laboratory tests reveal hemolytic anemia, elevated LDH, decreased haptoglobin, and presence of schistocytes on peripheral blood smear. Which of the following conditions is most likely to cause these findings?
- A. Hereditary spherocytosis
- B. Glucose-6-phosphate dehydrogenase (G6PD) deficiency
- C. Autoimmune hemolytic anemia (AIHA)
- D. Thalassemia
Correct Answer: B
Rationale: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive disorder that leads to hemolytic anemia in response to oxidative stress. The patient's presentation of fatigue, weakness, and jaundice along with laboratory findings of hemolytic anemia (evidenced by schistocytes), elevated LDH, and decreased haptoglobin are all characteristic of G6PD deficiency. The oxidative stress causes red blood cell destruction, resulting in the release of LDH and bilirubin, leading to jaundice. Decreased haptoglobin is seen due to its consumption in binding free hemoglobin released from the lysed red blood cells. Additionally, the presence of schistocytes on a peripheral blood smear is indicative of red blood cell fragmentation, a common finding in hemolytic anemias including G6PD deficiency
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A postpartum client presents with sudden chest pain, dyspnea, and tachycardia. Which nursing action should be prioritized?
- A. Elevating the head of the bed
- B. Providing supplemental oxygen therapy
- C. Administering analgesics for pain relief
- D. Notifying the healthcare provider immediately
Correct Answer: D
Rationale: Sudden chest pain, dyspnea, and tachycardia in a postpartum client can be indicative of serious conditions such as pulmonary embolism or myocardial infarction. These conditions are emergencies that require immediate medical attention. Notifying the healthcare provider immediately is the priority to ensure prompt evaluation and intervention to address the potential life-threatening situation. While other nursing interventions such as elevating the head of the bed, providing supplemental oxygen therapy, and administering analgesics may be necessary, they should be done after notifying the healthcare provider to ensure appropriate management of the underlying cause.
Which procedure has to be done to the patient to establish a definitive diagnosis of lung cancer?
- A. Chest x-ray followed by a CT scan
- B. Cytological study of the sputum
- C. Bronchoscopy
- D. Magnetic resonance imaging
Correct Answer: C
Rationale: Bronchoscopy is a procedure that allows direct visualization of the inside of the airways in the lungs. It is considered the most definitive method to establish a diagnosis of lung cancer as it can directly visualize any abnormal growths or tumors in the bronchial tubes. During bronchoscopy, tissue samples can be collected for biopsy to confirm the presence of cancer cells. This procedure is more accurate compared to other diagnostic methods such as chest x-ray, CT scan, cytological study of sputum, or magnetic resonance imaging in confirming a diagnosis of lung cancer.
A patient is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for the management of osteoarthritis. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypoglycemia
- B. Hyperkalemia
- C. Gastrointestinal bleeding
- D. Hypertension
Correct Answer: C
Rationale: NSAIDs are known to increase the risk of gastrointestinal complications, particularly gastrointestinal bleeding, ulcers, and perforation. This risk is higher in patients who are elderly, have a history of peptic ulcer disease, are taking high doses of NSAIDs, or are using them for a prolonged period. It is important for the nurse to closely monitor the patient for signs and symptoms of gastrointestinal bleeding, such as abdominal pain, black or tarry stools, vomiting blood, and anemia. Prompt identification and management of these complications are essential to prevent serious consequences. Monitoring for gastrointestinal adverse effects is crucial when a patient is prescribed NSAIDs for managing conditions like osteoarthritis.
A patient receiving palliative care for end-stage renal disease expresses distress over changes in body image due to edema and weight gain. What intervention should the palliative nurse prioritize to address the patient's concerns?
- A. Encourage the patient to focus on accepting their body changes as part of the illness.
- B. Provide education on dietary modifications to manage fluid retention and edema.
- C. Offer emotional support and validate the patient's feelings about body image changes.
- D. Prescribe diuretic medications to reduce fluid retention and alleviate edema.
Correct Answer: C
Rationale: The most appropriate intervention for the palliative nurse to prioritize in this situation is to offer emotional support and validate the patient's feelings about body image changes. End-stage renal disease can lead to significant physical changes such as edema and weight gain, which can impact a patient's body image and self-esteem. By providing emotional support and validating the patient's feelings, the nurse can help address the patient's distress and concerns, improving their overall psychological well-being. While providing education on dietary modifications (choice B) and prescribing diuretic medications (choice D) may be important aspects of managing fluid retention and edema, addressing the patient's emotional distress and body image concerns should be the initial priority in a palliative care setting. Encouraging the patient to accept their body changes (choice A) may overlook the emotional impact these changes have on the patient, making choice C the most appropriate intervention.
Which of the following statements accurately describes the role of dendritic cells in the immune response?
- A. Dendritic cells directly kill infected cells and tumor cells.
- B. Dendritic cells produce antibodies against pathogens.
- C. Dendritic cells activate na(cid:239)ve T cells and initiate adaptive immune responses.
- D. Dendritic cells release histamine and other inflammatory mediators.
Correct Answer: C
Rationale: Dendritic cells play a critical role in initiating adaptive immune responses by capturing antigens from pathogens, migrating to lymphoid organs, and presenting these antigens to naïve T cells. This activation of naïve T cells by dendritic cells is essential for the adaptive immune system to generate specific immune responses against pathogens. Dendritic cells act as professional antigen-presenting cells, which are specialized to capture, process, and present antigens to T cells, thereby facilitating the activation of T cells and the coordination of adaptive immune responses, such as the production of specific antibodies and the generation of memory T cells.