Nokea
A patient who has a large amount of carbon dioxide in the blood also has what in the blood?
- A. Large amount of carbonic acid and low hydrogen ion concentration
- B. Small amount of carbonic acid and low hydrogen ion concentration
- C. Large amount of carbonic acid and high hydrogen ion concentration
- D. Small amount of carbonic acid and high hydrogen ion concentration
Correct Answer: C
Rationale: Excess CO2 forms carbonic acid, increasing hydrogen ion concentration and lowering pH.
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Priority Decision: Key interventions for treating soft tissue injury and resulting inflammation are remembered using the acronym RICE. What are the most important actions for the emergency department nurse to do for the patient with an ankle injury?
- A. Reduce swelling, shine light on wound, control mobility, and elicit the history of the injury
- B. Rub the wound clean, immobilize the area, cover the area protectively, and exercise that leg
- C. Rest with immobility, apply a cold compress, apply a compress bandage, and elevate the ankle
- D. Rinse the wounded ankle, image the ankle, carry the patient, and extend the ankle with imaging
Correct Answer: C
Rationale: RICE stands for Rest, Ice, Compression, and Elevation, which are critical steps in managing acute soft tissue injuries like sprains. These actions help reduce swelling, limit further damage, and promote healing.
What are the important functions of cell-mediated immunity (select all that apply)?
- A. Fungal infections
- B. Transfusion reactions
- C. Rejection of transplanted tissues
- D. Immunity against pathogens that survive outside cells
Correct Answer: A
Rationale: Cell-mediated immunity targets intracellular pathogens, such as viruses and fungi, and is critical in transplant rejection and certain hypersensitivity reactions.
Viral antigenic shift
- A. Is caused by multiple random mutations
- B. Is caused by a single mutation
- C. It affects only internal viral proteins not recognized by preexisting antibodies
- D. It refers to the appearance of new HA variants not recognized by preexisting antibodies
Correct Answer: D
Rationale: Step 1: Viral antigenic shift involves major changes in the surface proteins of the virus, particularly the hemagglutinin (HA) protein.
Step 2: These changes result in the emergence of new variants that are not recognized by preexisting antibodies.
Step 3: This process is distinct from antigenic drift, which involves minor changes due to random mutations.
Step 4: Choice D correctly states that viral antigenic shift refers to the appearance of new HA variants not recognized by preexisting antibodies.
Summary: Choice A is incorrect because viral antigenic shift is not caused by multiple random mutations. Choice B is incorrect as antigenic shift involves major changes, not a single mutation. Choice C is incorrect as it affects surface proteins like HA, not just internal proteins.
What disease is associated with autoantibodies binding to type IV collagen?
- A. Sarcoidosis
- B. Goodpasture's syndrome
- C. Systemic lupus erythematosus (SLE)
- D. Rheumatoid arthritis
Correct Answer: B
Rationale: The correct answer is B: Goodpasture's syndrome. This disease is specifically associated with autoantibodies targeting type IV collagen in the basement membranes of the kidneys and lungs, leading to glomerulonephritis and pulmonary hemorrhage. Sarcoidosis (A) involves non-caseating granulomas, not collagen autoantibodies. Systemic lupus erythematosus (SLE) (C) is associated with various autoantibodies but not specifically targeting type IV collagen. Rheumatoid arthritis (D) is characterized by autoantibodies against citrullinated peptides and synovial tissue, not type IV collagen.
The nurse determines that a patient has long-term immunity against a disease. Which part of the immune system should the nurse recognize is responsible for this patient's long-term immunity?
- A. IgE
- B. IgG
- C. Mast cells
- D. Plasma cells
Correct Answer: B
Rationale: The correct answer is B: IgG. IgG is an immunoglobulin that provides long-term immunity by recognizing and neutralizing pathogens. It is produced by plasma cells in response to an infection, allowing the body to remember the pathogen and mount a quicker and more effective immune response upon re-exposure. IgE is involved in allergic reactions, not long-term immunity. Mast cells are involved in allergic responses and inflammation, not long-term immunity. Plasma cells produce antibodies, including IgG, but the plasma cells themselves are not responsible for long-term immunity.