Nokea
Pulmonary Rehabilitation for COPD has a duration of at least 4 to 12 weeks. Which of the following should be avoided while patient is having this program?
- A. Pursed lip breathing
- B. Smoking cessation
- C. Aerobic, upper and lower body conditioning
- D. Peripheral muscle wasting
Correct Answer: B
Rationale: During pulmonary rehabilitation for COPD, smoking cessation should not be avoided but instead strongly encouraged. Smoking cessation is a crucial component in managing COPD and improving lung function. Continued smoking can exacerbate COPD symptoms and hinder the progress made through rehabilitation efforts. Therefore, it is essential for patients to quit smoking while undergoing pulmonary rehabilitation to maximize the benefits of the program and improve their overall lung health.
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Which of the following mechanisms is responsible for the phenomenon of immunological memory, wherein the immune system mounts a faster and more robust response upon re-exposure to a previously encountered pathogen?
- A. Clonal expansion of memory B cells
- B. Differentiation of na(cid:239)ve T cells into effector T cells
- C. Production of antibodies by plasma cells
- D. Activation of the complement system
Correct Answer: A
Rationale: Immunological memory is primarily maintained by the clonal expansion of memory B cells. Memory B cells are a type of long-lived immune cell that originates from previously activated B cells during an immune response to a pathogen. When the immune system encounters the same pathogen again, memory B cells can quickly recognize and respond to it by undergoing rapid clonal expansion and differentiation into plasma cells that produce specific antibodies. This quick and robust response leads to the more efficient elimination of the pathogen during secondary exposure, resulting in the faster and stronger immune response characteristic of immunological memory.
In response to chronic hypoxia, which physiological adaptation occurs in the body to increase oxygen delivery to tissues?
- A. Decreased erythropoietin production
- B. Decreased red blood cell production
- C. Increased cardiac output
- D. Decreased ventilation rate
Correct Answer: C
Rationale: In response to chronic hypoxia, the body adapts to increase oxygen delivery to tissues by increasing cardiac output. This is achieved by increasing the heart rate and stroke volume, allowing more oxygenated blood to be pumped to the tissues. The increased cardiac output helps compensate for the lower oxygen levels in the blood, ensuring that tissues receive an adequate supply of oxygen despite the hypoxic conditions. This physiological adaptation is essential for maintaining tissue oxygenation and supporting overall cellular function in the presence of chronic hypoxia.
A woman in active labor demonstrates signs of cephalopelvic disproportion (CPD), with the fetal head failing to descend despite strong contractions. What nursing action should be prioritized to address this abnormal labor presentation?
- A. Perform a pelvic exam to assess for CPD.
- B. Assist the mother into a hands-and-knees position.
- C. Administer intravenous oxytocin to augment contractions.
- D. Prepare for immediate instrumental delivery.
Correct Answer: D
Rationale: When a woman in active labor demonstrates signs of cephalopelvic disproportion (CPD) with the fetal head failing to descend despite strong contractions, the nursing action that should be prioritized is to prepare for immediate instrumental delivery. CPD can lead to a prolonged and difficult labor, increasing the risks for both the mother and the fetus. In cases where the fetal head is not descending adequately and the mother's contractions are strong, instrumental delivery, like forceps or vacuum extraction, may be necessary to facilitate the safe delivery of the baby. It is important to act promptly to avoid potential complications associated with prolonged labor. Other actions, such as performing a pelvic exam, changing maternal positions, or administering oxytocin, may be considered but addressing the issue of CPD efficiently through instrumental delivery should take precedence in this scenario.
Baby Sharon was placed on phototherapy. What precaution should Nurses Juvy observe?
- A. Put sunglasses on the newborn to protect his/her eyes.
- B. Be certain that the newborn's intake is adequate.
- C. Assess the newborn for symptoms of headache.
- D. Keep the newborn wrapped to prevent sunburn.
Correct Answer: A
Rationale: When a baby is placed on phototherapy, especially for treating jaundice, it is crucial for the nurses to put sunglasses on the newborn to protect their eyes. Phototherapy involves exposing the baby's skin to certain types of light to help break down the bilirubin causing the jaundice. However, this light can be harmful to the baby's sensitive eyes, potentially leading to eye damage or other eye-related issues if not protected adequately. Therefore, placing sunglasses on the newborn is a necessary precaution to ensure the safety and well-being of the baby's eyes during the treatment.
A patient presents with recurrent episodes of epistaxis, gum bleeding, and easy bruising. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?
- A. Von Willebrand disease
- B. Glanzmann thrombasthenia
- C. Hemophilia A
- D. Bernard-Soulier syndrome
Correct Answer: A
Rationale: The clinical presentation of recurrent episodes of epistaxis, gum bleeding, and easy bruising, along with laboratory findings of prolonged bleeding time, normal platelet count, and normal coagulation studies (PT and aPTT) are highly suggestive of Von Willebrand disease. Von Willebrand disease is the most common inherited bleeding disorder and is characterized by a deficiency or dysfunction of von Willebrand factor (vWF), which plays a key role in platelet adhesion and aggregation. The prolonged bleeding time is due to impaired platelet adhesion to the damaged vessel wall in the absence of functional vWF. Normal platelet count and normal PT/aPTT help differentiate Von Willebrand disease from other bleeding disorders such as hemophilia and platelet function disorders like Glanzmann thrombasthenia and Bernard-Soulier syndrome.