Nokea
A patient who has received a kidney transplant has been admitted to the medical unit with acute rejection and is receiving IV cyclosporine (Sandimmune) and methylprednisolone (Solu-Medrol). Which staff member is best to assign to care for this patient?
- A. An RN who floated to the medical unit from the coronary care unit for the day.
- B. An RN with 3 years of experience in the operating room who is orienting to the medical unit.
- C. An RN who has worked on the medical unit for 5 years and is working a double shift today.
- D. A new graduate RN who needs experience with IV medication administration.
Correct Answer: C
Rationale: An experienced RN who is familiar with the medical unit and its protocols is the best choice for caring for a patient with acute rejection. This patient requires close monitoring and skilled care which an experienced RN can provide. The other options involve RNs who may not be as familiar with the unit or are less experienced.
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The patient is experiencing fibrosis and glomerulopathy a year after a kidney transplant. Which type of rejection is occurring?
- A. Acute
- B. Chronic
- C. Delayed
- D. Hyperacute
Correct Answer: B
Rationale: Chronic rejection occurs over time and involves fibrosis and structural changes in the transplanted organ.
A co-receptor on target cells for HIV is
- A. gp120
- B. CR4
- C. CR5
- D. CXCR4
Correct Answer: D
Rationale: The correct answer is D: CXCR4. CXCR4 is a chemokine receptor that serves as a co-receptor for HIV entry into target cells. Step 1: HIV binds to CD4 receptor on the target cell. Step 2: The viral envelope protein gp120 then interacts with either CXCR4 or CCR5 co-receptor to facilitate viral entry. Step 3: In the case of CXCR4-tropic HIV strains, CXCR4 is the co-receptor used for entry into the target cell. Therefore, choice D is correct. Choices A (gp120) and C (CR5) are incorrect as they are not co-receptors, while choice B (CR4) is not a known co-receptor for HIV entry.
What is the medical term for an abnormal decrease in red blood cells?
- A. Leukopenia
- B. Thrombocytopenia
- C. Anemia
- D. Hemolysis
Correct Answer: C
Rationale: The correct answer is C: Anemia. Anemia is the medical term for an abnormal decrease in red blood cells. Red blood cells are responsible for carrying oxygen throughout the body, and a decrease in their numbers can lead to symptoms like fatigue, weakness, and paleness.
Rationale:
1. Leukopenia (A) refers to a decrease in white blood cells, not red blood cells.
2. Thrombocytopenia (B) is a decrease in platelets, which are involved in blood clotting, not red blood cells.
3. Hemolysis (D) is the breakdown of red blood cells, not a decrease in their numbers.
In summary, anemia is the correct answer as it specifically describes the condition of low red blood cell count, while the other choices are related to decreases in different components of blood.
Which of the following is correct with respect to measles:
- A. Outbreaks of the disease have recently occurred in developed countries as a consequence of decreased vaccination rates
- B. The disease has been eradicated globally
- C. There is no effective vaccine for this disease
- D. The disease is now easily treated and has no known long-term effects
Correct Answer: A
Rationale: Rationale for Choice A: Outbreaks of measles in developed countries are due to decreased vaccination rates, leading to lower herd immunity. This is supported by data showing increasing cases in countries with vaccine hesitancy. Other choices are incorrect because B is false - measles has not been eradicated globally, C is false - there is an effective vaccine for measles, and D is false - measles can lead to severe complications and long-term effects, especially in unvaccinated individuals.
What is a hallmark of Type IV hypersensitivity?
- A. It is immediate and IgE-mediated
- B. It is delayed and T cell-mediated
- C. It involves immune complexes
- D. It stimulates mast cells to release histamine
Correct Answer: B
Rationale: The correct answer is B because Type IV hypersensitivity reactions are delayed and T cell-mediated. Upon exposure to an antigen, sensitized T cells, specifically CD4+ T cells, release cytokines that recruit and activate macrophages and other effector cells, leading to tissue damage. Choice A is incorrect because Type I hypersensitivity reactions are immediate and IgE-mediated. Choice C is incorrect because immune complex-mediated hypersensitivity reactions are typically associated with Type III hypersensitivity. Choice D is incorrect because histamine release by mast cells is characteristic of Type I hypersensitivity reactions, not Type IV.