Nokea
In a patient with a positive Chvostek’s sign, the nurse would anticipate the IV administration of which medication?
- A. Calcitonin
- B. Vitamin D
- C. Loop diuretics
- D. Calcium gluconate
Correct Answer: D
Rationale: Chvostek’s sign indicates hypocalcemia, so calcium gluconate is administered to restore normal calcium levels.
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What is a hallmark of Type IV hypersensitivity?
- A. It is immediate and IgE-mediated
- B. It is delayed and T cell-mediated
- C. It involves immune complexes
- D. It stimulates mast cells to release histamine
Correct Answer: B
Rationale: The correct answer is B because Type IV hypersensitivity reactions are delayed and T cell-mediated. Upon exposure to an antigen, sensitized T cells, specifically CD4+ T cells, release cytokines that recruit and activate macrophages and other effector cells, leading to tissue damage. Choice A is incorrect because Type I hypersensitivity reactions are immediate and IgE-mediated. Choice C is incorrect because immune complex-mediated hypersensitivity reactions are typically associated with Type III hypersensitivity. Choice D is incorrect because histamine release by mast cells is characteristic of Type I hypersensitivity reactions, not Type IV.
What is the significance of HER2 positivity in breast cancer?
- A. Indicates aggressive tumor behavior and potential resistance to certain treatments
- B. Signifies slower tumor growth
- C. Indicates sensitivity to hormone therapy
- D. Denotes a benign tumor
Correct Answer: A
Rationale: HER2 positivity signifies aggressive tumor behavior and potential resistance to certain treatments, requiring targeted therapies.
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.
Select the correct statement during an allergic reaction.
- A. An allergen binds with IgE antibodies.
- B. The mast cells are deactivated.
- C. The body is immunodeficient.
- D. Helper T cells release histamine.
Correct Answer: A
Rationale: Step-by-step rationale:
1. During an allergic reaction, allergens trigger the release of IgE antibodies.
2. The allergen binds with IgE antibodies, leading to the activation of mast cells.
3. Activated mast cells release histamine and other inflammatory mediators.
4. This cascade of events causes allergic symptoms.
Therefore, option A is correct as it accurately describes the initial binding of allergen with IgE antibodies. Option B is incorrect as mast cells are activated, not deactivated. Option C is incorrect as the body is hypersensitive, not immunodeficient. Option D is incorrect as it is mast cells, not Helper T cells, that release histamine.
The nurse is caring for a patient who just returned from surgical decompression of the carpal tunnel. Which finding requires the nurse's immediate action?
- A. The patient's fingers swollen and warm.
- B. The patient complains of generalized pain 5/10.
- C. The capillary refill time is 8 seconds.
- D. The patient's fingers are pink and cool bilaterally.
Correct Answer: C
Rationale: The correct answer is C because a capillary refill time of 8 seconds indicates poor perfusion, which could be a sign of compromised blood flow to the fingers post-surgical decompression. This finding requires immediate action to prevent complications such as ischemia or impaired wound healing.
A: Swollen and warm fingers are expected after surgery due to inflammation.
B: Generalized pain can be managed with appropriate pain relief measures and is not an immediate concern post-surgery.
D: Pink and cool fingers indicate adequate perfusion and are normal findings post-surgery.