Nokea
In a patient with HIV infected with Mycobacterium avium complex from an indoor pool, which of the following medications is the recommended treatment for MAC?
- A. Clarithromycin
- B. Isoniazid (INH)
- C. Rifabutin
- D. Azithromycin
Correct Answer: A
Rationale: The correct answer is Clarithromycin. Clarithromycin is one of the recommended medications for treating Mycobacterium avium complex (MAC) infections in patients with HIV. It is a macrolide antibiotic that is effective against MAC. Isoniazid (INH) is used to treat tuberculosis, not MAC. Rifabutin is another medication used in the treatment of MAC infections, but clarithromycin is preferred as a first-line agent. Azithromycin is also used in the treatment of MAC infections; however, clarithromycin is more commonly recommended due to its efficacy and safety profile.
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In emphysema, what features result in impaired oxygenation?
- A. The bronchioles are inflamed and filled with mucus
- B. The alveoli have lost surfactant and collapse
- C. Enlarged, permanently inflated alveoli
- D. The accumulation of purulent fluid in the bronchioles
Correct Answer: C
Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.
Which of the following disturbances would cause a client to experience gout?
- A. Serotonin receptors
- B. Uric acid metabolism
- C. Liver function
- D. Cardiac function
Correct Answer: B
Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.
What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?
- A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
- B. Asthma, deep vein thrombosis, hepatic encephalopathy
- C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
- D. Left-sided heart failure, pulmonary embolism, urinary tract infection
Correct Answer: C
Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.
Which of the following are normal arterial blood gas values?
- A. PH 7.25, PaCO2 52 mm Hg, PaO2 75 mm Hg, HCO3 18 mEq/L
- B. PH 7.50, PaCO2 30 mm Hg, PaO2 80 mm Hg, HCO3 28 mEq/L
- C. PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L
- D. PH 7.15, PaCO2 30 mm Hg, PaO2 50 mm Hg, HCO3 24 mEq/L
Correct Answer: C
Rationale: The correct answer is C: PH 7.40, PaCO2 40 mm Hg, PaO2 90 mm Hg, HCO3 24 mEq/L. These values represent a balanced state for arterial blood gas. Choice A has lower than normal PH and HCO3 levels and higher PaCO2 and lower PaO2 levels. Choice B has higher than normal PH and HCO3 levels, lower PaCO2, and a normal PaO2 level. Choice D has a significantly lower PH and PaO2 level, normal HCO3 level, and low PaCO2 level, indicating an acidic state with impaired oxygenation.
Which of the following is an example of a Type 1 hypersensitivity reaction?
- A. Anaphylaxis
- B. Indigestion
- C. Beta cell destruction
- D. ABO transfusion reaction
Correct Answer: A
Rationale: Anaphylaxis is a classic example of a Type 1 hypersensitivity reaction. In Type 1 hypersensitivity, allergens trigger an immediate immune response mediated by IgE antibodies, leading to the release of histamine and other mediators. This reaction can result in symptoms ranging from mild itching and hives to severe conditions like anaphylaxis, which is a life-threatening emergency. The other options, such as indigestion (choice B), beta cell destruction (choice C), and ABO transfusion reaction (choice D), are not classified as Type 1 hypersensitivity reactions. Indigestion is typically related to gastrointestinal disturbances, beta cell destruction is associated with autoimmune conditions like type 1 diabetes, and ABO transfusion reaction involves antibodies targeting incompatible blood groups, which is a different immune mechanism compared to Type 1 hypersensitivity.