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A patient with a history of multiple myeloma demonstrates hypogammaglobulinemia. Which of the following immunoglobulin classes is most likely to be deficient in this patient?
- A. IgG
- B. IgA
- C. IgM
- D. IgE
Correct Answer: B
Rationale: The correct answer is B: IgA. In multiple myeloma, there is a proliferation of abnormal plasma cells, leading to a decrease in normal antibody production. IgA is the most abundant immunoglobulin in mucosal secretions and plays a crucial role in mucosal immunity. Therefore, a deficiency in IgA is common in patients with multiple myeloma. IgG is the most abundant immunoglobulin in the blood and is typically less affected in multiple myeloma. IgM is the first antibody produced in response to an infection and is less likely to be deficient in this case. IgE is primarily involved in allergic responses and is not typically affected in multiple myeloma.
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Which of the following clinical manifestations is most indicative of acute respiratory distress syndrome (ARDS)?
- A. Hypocapnia with respiratory alkalosis
- B. Bradypnea with metabolic acidosis
- C. Tachypnea with hypoxemia refractory to supplemental oxygen
- D. Hypercapnia with hyperkalemia
Correct Answer: C
Rationale: Rationale:
- ARDS is characterized by severe hypoxemia and respiratory distress.
- Tachypnea is a hallmark sign of ARDS due to the body's compensatory mechanism to increase oxygenation.
- Hypoxemia refractory to supplemental oxygen signifies the inability to improve oxygen levels despite intervention.
- Choices A, B, and D do not align with typical manifestations of ARDS, as they do not directly reflect severe hypoxemia or respiratory distress.
A patient expresses distrust in the healthcare system due to previous negative experiences. What is the nurse's best approach to rebuild trust?
- A. Dismiss the patient's concerns and assure them that the healthcare team is trustworthy.
- B. Listen actively to the patient's concerns, acknowledge their past experiences, and work to rebuild trust through transparency and reliability.
- C. Ignore the patient's distrust and proceed with providing care.
- D. Tell the patient that their distrust is unfounded and they should trust the healthcare system.
Correct Answer: B
Rationale: The correct answer is B because actively listening, acknowledging the patient's concerns, and working towards rebuilding trust through transparency and reliability are essential steps in addressing distrust. By validating the patient's experiences and actively involving them in the process, the nurse can foster a supportive and trusting relationship.
Choice A is incorrect because dismissing the patient's concerns can further damage trust and undermine the patient's feelings. Choice C is incorrect as ignoring the distrust can lead to a breakdown in communication and trust. Choice D is incorrect because telling the patient to trust the healthcare system without addressing their concerns is dismissive and unhelpful.
Which of the following is a characteristic of qualitative research?
- A. Deductive process
- B. Fixed research design
- C. Control over the context
- D. Inductive process
Correct Answer: D
Rationale: The correct answer is D: Inductive process. Qualitative research typically involves an inductive approach, where researchers gather data, analyze patterns, and develop theories or hypotheses based on the observed data. This allows for exploration and discovery of new insights.
A) Deductive process is not a characteristic of qualitative research, as deductive reasoning involves starting with a hypothesis and testing it with data.
B) Fixed research design is not common in qualitative research, which often uses flexible and adaptive designs to accommodate emergent findings.
C) Control over the context is not a key characteristic of qualitative research, as it often involves studying real-world settings with natural contexts rather than controlled environments.
In summary, the inductive process is a key characteristic of qualitative research as it allows for exploration and theory development based on observed data, distinguishing it from deductive approaches, fixed designs, and controlled contexts.
Which of the following actions should be taken first when encountering a person experiencing an allergic reaction with signs of respiratory distress?
- A. Administer an epinephrine auto-injector.
- B. Position the person comfortably.
- C. Monitor vital signs.
- D. Assess the severity of the reaction.
Correct Answer: D
Rationale: The correct answer is D: Assess the severity of the reaction. This should be the first action taken because it helps determine the urgency of the situation and guides subsequent steps. Assessing the severity allows for appropriate intervention - from calling emergency services if the reaction is severe, to administering medication if necessary.
A: Administering an epinephrine auto-injector should only be done if the severity of the reaction warrants it, as it is a potent medication that can have serious side effects if used inappropriately.
B: Positioning the person comfortably is important, but assessing the severity of the reaction takes precedence to ensure prompt and appropriate care.
C: Monitoring vital signs is important, but assessing the severity of the reaction is crucial in determining the immediate course of action.
A patient with a history of diabetes mellitus is admitted with a foot ulcer. Which nursing intervention is essential for preventing infection in the foot ulcer?
- A. Applying topical antibiotics
- B. Performing daily wound debridement
- C. Keeping the ulcer covered with a sterile dressing
- D. Administering oral antibiotics prophylactically
Correct Answer: C
Rationale: Rationale:
C is correct as keeping the ulcer covered with a sterile dressing provides a barrier against pathogens, promoting wound healing and preventing infection. A (topical antibiotics) can lead to resistance and disrupt normal flora. B (daily wound debridement) may introduce pathogens and delay healing. D (oral antibiotics prophylactically) is not recommended without evidence of infection.