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A patient with a suspected autoimmune disorder exhibits antibodies directed against self-antigens, leading to tissue damage and inflammation. Which of the following mechanisms is primarily responsible for the development of autoimmune diseases?
- A. Loss of self-tolerance
- B. Failure of innate immunity
- C. Defective T cell activation
- D. Impaired phagocytosis
Correct Answer: A
Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation.
Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.
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During surgery, the nurse observes a sudden change in the patient's level of consciousness. What is the nurse's immediate action?
- A. Administer a reversal agent for anesthesia
- B. Document the change in the patient's chart
- C. Check the patient's vital signs
- D. Notify the anesthesia provider immediately
Correct Answer: D
Rationale: The correct immediate action for the nurse is to notify the anesthesia provider immediately (Option D). This is crucial because a sudden change in the patient's level of consciousness during surgery could indicate a serious issue related to anesthesia administration. Notifying the anesthesia provider promptly allows for quick assessment and intervention to address the underlying cause, potentially preventing complications or even saving the patient's life. Administering a reversal agent (Option A) without proper evaluation by the anesthesia provider could be dangerous. Documenting the change in the patient's chart (Option B) is important but not the most immediate action. Checking the patient's vital signs (Option C) is also important but may not provide immediate insight into the cause of the change in consciousness.
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.
Which of the following conditions is characterized by inflammation of the plantar fascia, resulting in heel pain that is typically worse with the first steps in the morning?
- A. Achilles tendinitis
- B. Plantar fasciitis
- C. Morton's neuroma
- D. Stress fracture of the calcaneus
Correct Answer: B
Rationale: Plantar fasciitis is the correct answer. It is characterized by inflammation of the plantar fascia, leading to heel pain, especially in the morning. The plantar fascia is a band of tissue that connects the heel bone to the toes. The pain is usually worse with the first steps after resting.
Achilles tendinitis involves inflammation of the Achilles tendon, which connects the calf muscles to the heel bone, causing pain at the back of the heel and ankle. Morton's neuroma is a condition involving a thickening of tissue around a nerve in the ball of the foot, leading to sharp, burning pain in the toes.
Stress fracture of the calcaneus refers to a small crack in the heel bone due to repetitive stress or overuse, resulting in heel pain that may worsen with activity, but not specifically with the first steps in the morning.
A patient presents with chronic nasal congestion, hyposmia, and anosmia. Nasal endoscopy reveals polypoid masses obstructing the nasal cavity and sinuses. Which of the following conditions is most likely responsible for this presentation?
- A. Allergic rhinitis
- B. Chronic sinusitis
- C. Nasal polyps
- D. Deviated nasal septum
Correct Answer: C
Rationale: The correct answer is C: Nasal polyps. Nasal polyps are benign growths that form in the nasal cavity and sinuses, leading to symptoms such as chronic nasal congestion, hyposmia, and anosmia. The presence of polypoid masses seen on nasal endoscopy is characteristic of nasal polyps.
Rationale:
1. Chronic nasal congestion, hyposmia, and anosmia are common symptoms of nasal polyps.
2. Nasal endoscopy revealing polypoid masses confirms the presence of nasal polyps.
3. Allergic rhinitis may cause nasal congestion but does not typically present with polypoid masses.
4. Chronic sinusitis can cause nasal congestion but is usually associated with inflammation of the sinuses, not just polypoid masses.
5. A deviated nasal septum can lead to nasal congestion but does not typically cause polypoid masses obstructing the nasal cavity and sinuses.
A woman in active labor demonstrates signs of prolonged second stage, characterized by ineffective pushing efforts and slow fetal descent. What maternal condition should the nurse assess for that may contribute to this abnormal labor pattern?
- A. Maternal fatigue
- B. Pelvic floor dysfunction
- C. Fetal macrosomia
- D. Maternal hypotension
Correct Answer: B
Rationale: When a woman in active labor exhibits signs of prolonged second stage, such as ineffective pushing efforts and slow fetal descent, one of the maternal conditions that should be considered is pelvic floor dysfunction. The pelvic floor muscles play a crucial role in supporting the uterus, bladder, and rectum. If these muscles are weak or dysfunctional, it can lead to difficulty in pushing effectively and impede the descent of the fetus through the birth canal. This can result in prolonged labor and increase the risk of complications for both the mother and the baby. Therefore, assessing for pelvic floor dysfunction is important in addressing the abnormal labor pattern and providing appropriate interventions to support the progress of labor.