Nokea
An 80-year-old man falls and suffers a compound fracture of the femur. Which immediate action is most appropriate?
- A. Position him flat on his back.
- B. Apply a tourniquet on the leg.
- C. Carefully splint the leg as it is.
- D. Carefully straighten the leg.
Correct Answer: C
Rationale: The correct answer is C: Carefully splint the leg as it is. This is the most appropriate immediate action because splinting the leg as it is will help stabilize the fracture and prevent further injury or damage to surrounding tissues. Moving or straightening the leg (option D) could worsen the fracture and cause more pain. Positioning him flat on his back (option A) may not provide enough support and could lead to additional complications. Applying a tourniquet (option B) is not necessary and could potentially cut off blood flow to the leg, causing more harm. Splinting the leg as it is will help maintain alignment and reduce the risk of further damage until proper medical care can be provided.
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Which of the following is NOT a random event
- A. Genetic recombination of VDJ segments for TCR assembly
- B. Genetic recombination of VDJ segments for BCR assembly
- C. CD4 vs CD8 T cell fate
- D. TH1 differentiation vs TH2 differentiation
Correct Answer: D
Rationale: The correct answer is D, TH1 differentiation vs TH2 differentiation, as it is not a random event. TH1 and TH2 differentiation is determined by cytokine signals, not random chance. A, Genetic recombination of VDJ segments for TCR assembly, and B, Genetic recombination of VDJ segments for BCR assembly, involve random processes during immune cell development. C, CD4 vs CD8 T cell fate, is determined by random rearrangement of gene segments during T cell development. Thus, D is the only choice that does not involve a random event in immune cell development.
All of the following are true about antibodies, EXCEPT which one?
- A. They fix complement.
- B. They occur on the surface of B-lymphocyte
- C. They predominate the primary immune response to antigen.
- D. have a single, defined amino acid sequence due to variability.
Correct Answer: D
Rationale: The correct answer is D because antibodies do not have a single, defined amino acid sequence due to variability in their structure. This variability is a result of somatic recombination and hypermutation.
A: Antibodies can fix complement, leading to the destruction of pathogens.
B: Antibodies are produced by B-lymphocytes and can occur on their surface as B-cell receptors.
C: Antibodies predominate the secondary immune response, not the primary response, as memory B-cells are generated during the primary response for a quicker and more robust secondary response.
The physician is having difficulty finding the appropriate dose for the patient taking warfarin (Coumadin). What can the nurse suggest that may solve this problem?
- A. Pharmacogenetic testing
- B. Start bivalirudin (Angiomax) IV
- C. Change from warfarin (Coumadin) to clopidogrel (Plavix) and aspirin
- D. Change from warfarin (Coumadin) to enoxoparin (Lovenox) injections
Correct Answer: A
Rationale: Pharmacogenetic testing evaluates genetic variations affecting drug metabolism, helping optimize dosing for medications like warfarin.
What is the mechanism of tissue damage in Type II hypersensitivity?
- A. Immune complex deposition
- B. Antibody binding to cell surface antigens, triggering complement activation or phagocytosis
- C. Mast cell degranulation
- D. T cell-mediated cytotoxicity
Correct Answer: B
Rationale: The correct answer is B: Antibody binding to cell surface antigens, triggering complement activation or phagocytosis. In Type II hypersensitivity, antibodies bind to antigens on host cells, leading to complement activation or phagocytosis by immune cells. This results in cell damage or destruction. Immune complex deposition (A) is more characteristic of Type III hypersensitivity. Mast cell degranulation (C) is seen in Type I hypersensitivity. T cell-mediated cytotoxicity (D) is associated with Type IV hypersensitivity, not Type II. Therefore, choice B is the most accurate mechanism of tissue damage in Type II hypersensitivity.
Which represents a correct grouping with respect to the target of an immune response, immune response strength, and resulting health status?
- A. Self-antigen, weak response, autoimmune disease
- B. Pathogen, strong response, recurrent infection
- C. Tumour antigen, weak response, cancer
- D. Transplanted organ, strong response, graft acceptance
Correct Answer: C
Rationale: Rationale:
1. Tumor antigens are non-self antigens that trigger a weak immune response due to immune tolerance.
2. Weak immune response against tumor antigens may lead to uncontrolled cell growth, resulting in cancer.
3. Strong immune responses are typically mounted against pathogens to clear infections.
4. Self-antigens should not trigger immune responses to prevent autoimmune diseases.
5. Transplanted organs can elicit strong immune responses leading to rejection, not acceptance.
Summary:
A - Incorrect: Self-antigens should not elicit immune responses to prevent autoimmune diseases.
B - Incorrect: Pathogens typically trigger strong immune responses to clear infections, not recurrent ones.
D - Incorrect: Transplanted organs often lead to strong immune responses and rejection, not acceptance.