Nokea
Following a hemorrhoidectomy, what should the nurse advise the patient to do?
- A. Use daily laxatives to facilitate bowel emptying.
- B. Use ice packs to the perineum to prevent swelling.
- C. Avoid having a bowel movement for several days until healing occurs.
- D. Take warm sitz baths several times a day to promote comfort and cleaning.
Correct Answer: D
Rationale: Sitz baths help reduce pain and swelling, promote comfort, and support wound healing after a hemorrhoidectomy.
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Priority Decision: A patient with esophageal cancer is scheduled for a partial esophagectomy. Which nursing intervention is likely to be of highest priority preoperatively?
- A. Practice turning and deep breathing.
- B. Brush the teeth and mouth well each day.
- C. Encourage a high-calorie, high-protein diet.
- D. Teach about postoperative tubes and cares.
Correct Answer: C
Rationale: A high-calorie, high-protein diet is important preoperatively to optimize nutritional status before surgery.
The home health nurse is caring for a patient with tuberculosis who is taking rifampin and isoniazid (INH). The nurse should carefully monitor the patient for which potential side effect?
- A. Gallstones
- B. Liver disorders
- C. Bleeding ulcers
- D. Esophagitis
Correct Answer: B
Rationale: The correct answer is B: Liver disorders. Rifampin and isoniazid are known to cause hepatotoxicity as a potential side effect. The combination of these two medications can lead to liver damage, making it crucial for the nurse to monitor liver function tests regularly. Gallstones (A), bleeding ulcers (C), and esophagitis (D) are not typically associated with rifampin and isoniazid therapy. Monitoring for liver disorders is essential due to the risk of hepatotoxicity with these medications.
Regarding pancreatic secretion:
- A. Trypsin is secreted in the active form.
- B. CCK stimulates the secretion of bicarbonate.
- C. Secretin stimulates the secretion of enzymes.
- D. Chemotrypsinogen is activated by trypsin.
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Chemotrypsinogen is the inactive precursor of chymotrypsin.
2. Trypsin activates chemotrypsinogen to form active chymotrypsin.
3. This activation occurs in the small intestine, enabling protein digestion.
Summary:
A: Trypsin is secreted as an inactive zymogen, not in the active form.
B: CCK stimulates enzyme secretion, not bicarbonate.
C: Secretin mainly stimulates bicarbonate secretion, not enzymes.
Which of the following statements regarding the adaptive immune response is false?
- A. major histocompatibility complexes (MHC) display both self and non-self antigens
- B. the MHC is not required for the activation of T helper cells by a foreign antigen
- C. activated effector T helper cells can activate both T and B lymphocytes/cells
- D. T cells use 'chemical warfare' while B cells send out antibodies against the foreign antigen
Correct Answer: B
Rationale: Answer B is correct because the major histocompatibility complex (MHC) is indeed required for the activation of T helper cells by a foreign antigen. This is because T helper cells recognize antigens presented by MHC molecules on antigen-presenting cells. Without MHC presentation, T helper cells cannot be activated.
Choice A is incorrect because MHC molecules do display both self and non-self antigens, which is crucial for the immune system to distinguish between harmful invaders and healthy cells.
Choice C is incorrect because activated effector T helper cells can indeed activate both T and B lymphocytes/cells, playing a key role in coordinating the adaptive immune response.
Choice D is incorrect because T cells do not use 'chemical warfare'; instead, they directly attack infected cells, while B cells produce antibodies that target specific antigens.
In summary, choice B is false because the MHC is necessary for T helper cell activation, while choices A, C, and D are true statements regarding the adaptive immune response.
Donald is a 61 y.o. man with diverticulitis. Diverticulitis is characterized by:
- A. Periodic rectal hemorrhage.
- B. Hypertension and tachycardia.
- C. Vomiting and elevated temperature.
- D. Crampy and lower left quadrant pain and low-grade fever.
Correct Answer: D
Rationale: The correct answer is D because diverticulitis typically presents with crampy pain in the lower left quadrant of the abdomen and a low-grade fever. This is due to inflammation or infection of the diverticula.
A: Periodic rectal hemorrhage is more characteristic of diverticular bleeding, not diverticulitis.
B: Hypertension and tachycardia are not typically associated with diverticulitis but may occur in severe cases or with complications.
C: Vomiting and elevated temperature can occur but are not as specific to diverticulitis as the combination of symptoms described in option D.