Nokea
In a patient with a CD4 count less than 200, the most important nursing assessment would include:
- A. Bowel movements.
- B. Urinary output.
- C. Fever.
- D. Blood pressure.
Correct Answer: C
Rationale: A CD4 count below 200 indicates advanced HIV infection (AIDS), making the patient highly susceptible to opportunistic infections. Fever is a key sign of infection and requires immediate attention. Bowel movements and urinary output are less urgent priorities in this context.
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One of the most significant factors in determining when to start antiretroviral therapy in a patient with HIV infection is:
- A. Whether the patient has high levels of HIV antibodies
- B. Confirmation that the patient has contracted HIV infection
- C. The patient’s readiness to commit to a complex, lifelong, uncomfortable drug regimen
- D. Whether the patient has a support system to help manage the costs and side effects of the drugs
Correct Answer: C
Rationale: Patient adherence is critical for successful antiretroviral therapy. Ensuring the patient is prepared to follow the regimen long-term improves outcomes.
Which of the following is NOT true about live attenuated vaccines
- A. Usually effective at a single dose
- B. Expensive handling and storage
- C. Potential hazard due to reversion to a virulent form
- D. Able to induce only a humoral response
Correct Answer: D
Rationale: The correct answer is D: Able to induce only a humoral response. Live attenuated vaccines can induce both humoral and cellular immune responses, not just humoral. This is because they mimic natural infection, leading to a broader immune response.
A: Usually effective at a single dose - This is true for live attenuated vaccines, as they often provide long-lasting immunity with just one dose.
B: Expensive handling and storage - Live attenuated vaccines can be more cost-effective due to fewer doses needed, not expensive.
C: Potential hazard due to reversion to a virulent form - This is a concern with live attenuated vaccines, as there is a risk of the weakened virus reverting to a virulent form.
What do pattern recognition receptors (PRRs) identify?
- A. Specific antigens
- B. Pathogen-associated molecular patterns (PAMPs)
- C. Host self-proteins
- D. Specific viruses only
Correct Answer: B
Rationale: Pattern recognition receptors (PRRs) identify Pathogen-associated molecular patterns (PAMPs) because PAMPs are unique molecules found on pathogens that trigger an immune response. PRRs recognize these patterns to distinguish between self and non-self. This recognition is crucial for initiating an immune response against potential threats. Specific antigens (A) and specific viruses only (D) are too narrow in scope as PRRs are designed to detect a wide range of patterns. Host self-proteins (C) are recognized by other mechanisms in the immune system to prevent autoimmunity.
The physician plans to prescribe trastuzumab (Herceptin) for the patient with breast cancer. What testing will the physician order before prescribing this medication?
- A. HER2 protein levels
- B. BRCA2 gene mutation
- C. BRCA1 gene mutation
- D. Stage II cancer identification
Correct Answer: A
Rationale: Trastuzumab targets HER2-positive breast cancers, so HER2 protein level testing is essential to determine eligibility.
Attenuated vaccines can be obtained by
- A. Passage through cultured cells
- B. Formaldehyde treatment
- C. The use of viral vectors carrying pathogen subunits
- D. All of the above treatments would lead to attenuated vaccines
Correct Answer: A
Rationale: The correct answer is A: Passage through cultured cells. Attenuated vaccines are produced by weakening the pathogen through serial passages in cultured cells, reducing virulence while maintaining immunogenicity. Formaldehyde treatment (B) disrupts the pathogen's structure and is used for inactivated vaccines. The use of viral vectors carrying pathogen subunits (C) is a method for creating subunit vaccines, not attenuated vaccines. Therefore, D is incorrect as not all treatments lead to attenuated vaccines.