Nokea
An older client asks the nurse why 'people my age' have weaker immune systems than younger people. What responses by the nurse are best? (Select all that apply.)
- A. Bone marrow produces more blood cells as you age.'
- B. You may have decreased levels of circulating platelets.'
- C. You have lower levels of plasma proteins in the blood.'
- D. Lymphocytes become more reactive to antigens.'
Correct Answer: C
Rationale: Rationale:
- As we age, there is a decrease in the production of plasma proteins, which are essential for immune function.
- Lower levels of plasma proteins can lead to a weaker immune response.
- This decline in plasma proteins can make older individuals more susceptible to infections.
- Choices A, B, and D are incorrect as they do not directly address the impact of aging on immune system function.
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A nurse is caring for a client who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. The nurse should monitor the client for which of the following adverse reactions?
- A. Weight loss
- B. Edema
- C. Polyuria
- D. Bradycardia
Correct Answer: B
Rationale: The correct answer is B: Edema. Desmopressin is a medication that can cause fluid retention, leading to edema. Hemophilia A clients are at risk for bleeding, so desmopressin is given to improve clotting. Weight loss (A), polyuria (C), and bradycardia (D) are not common adverse reactions of desmopressin. Weight loss and polyuria are more associated with diabetes insipidus, a condition that desmopressin is used to treat. Bradycardia is not a typical adverse reaction of desmopressin.
A patient is scheduled for upcoming surgery. He is on nonsteroidal anti-inflammatory drugs (NSAIDs) for rheumatoid arthritis. You are being asked what to do with his medications for the surgery. What is the mechanism of action of NSAIDS?
- A. Irreversible inhibition of cyclooxygenase 1
- B. Irreversible inhibition of cyclooxygenase 2
- C. Reversible inhibition of cyclooxygenase 1
- D. Reversible inhibition of cyclooxygenase 2
Correct Answer: C
Rationale: The correct answer is C: Reversible inhibition of cyclooxygenase 1. NSAIDs work by reversibly inhibiting cyclooxygenase enzymes, particularly COX-1 and COX-2, which are involved in the synthesis of prostaglandins. In this case, reversible inhibition is crucial because it allows for the temporary suppression of prostaglandin production, leading to pain relief and anti-inflammatory effects.
Explanation of other choices:
A: Irreversible inhibition of cyclooxygenase 1 - This is incorrect because NSAIDs typically do not irreversibly inhibit COX-1.
B: Irreversible inhibition of cyclooxygenase 2 - This is incorrect because NSAIDs do not irreversibly inhibit COX-2.
D: Reversible inhibition of cyclooxygenase 2 - This is incorrect because while NSAIDs can inhibit COX-2, the primary target is COX-1 for their therapeutic effects.
The nurse is caring for a patient who has a white blood cell (WBC) count of 8000/mm³. What concern should the nurse have about this finding?
- A. The patient has an infection.
- B. The patient is at risk for infection.
- C. The patient has a hematological disorder.
- D. There is no concern; this is a normal finding.
Correct Answer: D
Rationale: The correct answer is D because a WBC count of 8000/mm³ falls within the normal reference range of 4000-11000/mm³. Therefore, there is no immediate concern regarding infection or hematological disorder. Choice A is incorrect because a normal WBC count does not indicate infection. Choice B is incorrect as the count is within the normal range, not indicating increased infection risk. Choice C is incorrect as a normal WBC count does not suggest a hematological disorder.
You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
- A. Extremity
- B. Prostate
- C. Infratemporal fossa
- D. Neck
Correct Answer: A
Rationale: The correct answer is A: Extremity. Rhabdomyosarcoma has a better prognosis when located in the extremities compared to other sites due to easier surgical resection and less risk of metastasis. Prostate (B) is less common in children and has a poorer prognosis. Infratemporal fossa (C) and neck (D) sites have a higher risk of local invasion and metastasis, leading to a worse prognosis compared to extremity sites.
You are discussing prognosis with the mother of a patient with stage 3, group III rhabdomyosarcoma. Which of the following is the most unfavorable primary site?
- A. Extremity
- B. Prostate
- C. Infratemporal fossa
- D. Neck
Correct Answer: A
Rationale: The correct answer is A: Extremity. Rhabdomyosarcoma in extremities has a worse prognosis due to difficulties in achieving complete surgical resection and higher risk of metastasis. Extremity tumors are often larger and more challenging to remove completely, leading to a higher chance of recurrence and poor outcomes. Prostate (B) and neck (D) sites are more favorable as they are easier to access for surgery and have lower rates of metastasis. Infratemporal fossa (C) is also a difficult site, but extremity tumors generally have a worse prognosis due to their anatomical and surgical challenges.