Nokea
The minor histocompatibility antigens on cells
- A. are detected by reaction with antibodies and complement
- B. are controlled by several genes in the major histocompatibility complex
- C. are unimportant in human transplantation
- D. induce reactions that can cumulatively lead to a strong rejection response
Correct Answer: D
Rationale: The correct answer is D because minor histocompatibility antigens can induce immune reactions leading to rejection in transplantation. These antigens are derived from genetic variations, not detected by antibodies and complement (A), controlled by genes outside the major histocompatibility complex (B), and are important in transplantation as they contribute to rejection responses (C).
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Imagine this. You enter the unit as an RN on your first day on the job. You breathe in the smell of awesomeness and drink your Starbucks coffee. You see that you are taking care of a Mr. Smith who has been diagnosed Polycythemia Vera. Because you are so freakin' awesome, you know that Mr. Smith is at risk for which of the following complications?
- A. Excessive Bleeding
- B. Pruritus
- C. Hepatomegaly
- D. Pancreatitis
Correct Answer: A
Rationale: The correct answer is A: Excessive Bleeding. Polycythemia Vera is a condition characterized by an overproduction of red blood cells, leading to increased blood viscosity and risk of thrombosis. Due to the increased number of red blood cells, there is a higher risk of clot formation, which can result in complications such as thrombosis, stroke, or heart attack. Excessive bleeding can also occur as a result of abnormal blood clotting mechanisms in Polycythemia Vera. Pruritus (choice B) is a common symptom but not a direct complication of Polycythemia Vera. Hepatomegaly (choice C) and Pancreatitis (choice D) are not commonly associated complications of Polycythemia Vera.
What is the most common form of childhood cancer?
- A. Lymphoma
- B. Brain tumor
- C. Leukemia
- D. Osteosarcoma
Correct Answer: C
Rationale: The correct answer is C: Leukemia. Leukemia is the most common form of childhood cancer, accounting for around 30% of all childhood cancers. It affects the blood and bone marrow, leading to abnormal production of white blood cells. Lymphoma (A) and brain tumors (B) are also common childhood cancers but not as prevalent as leukemia. Osteosarcoma (D) is a type of bone cancer that is rare in children compared to leukemia. Thus, based on the prevalence and incidence rates, leukemia is the most common form of childhood cancer.
A 64-year-old woman on chemo for breast cancer, thoracic pain, leg weakness, incontinence. Most important study?
- A. Serum calcium
- B. Bone scan
- C. Plain radiographs
- D. MRI scan of spine
Correct Answer: D
Rationale: The correct answer is D: MRI scan of spine. For a patient with thoracic pain, leg weakness, and incontinence during chemo for breast cancer, an MRI of the spine is crucial to evaluate for spinal cord compression, a serious complication. This can present with the mentioned symptoms and requires urgent intervention. Serum calcium (A) is not the most important study as it is less likely to explain the patient's symptoms. A bone scan (B) and plain radiographs (C) may not provide detailed imaging of the spinal cord to assess for compression. An MRI scan of the spine (D) offers the best visualization to identify spinal cord compression and guide appropriate management.
A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, the nurse’s priority intervention is to:
- A. Reduce environmental stimulation to prevent seizures.
- B. Have the laboratory repeat the analysis with a new specimen.
- C. Minimize energy expenditure to decrease cardiac workload.
- D. Administer intravenous fluids to correct the dehydration.
Correct Answer: C
Rationale: The correct answer is C: Minimize energy expenditure to decrease cardiac workload. The child's low hemoglobin level of 6.4 g/dl indicates severe anemia, leading to reduced oxygen-carrying capacity. With pale skin, conjunctiva, and muscle weakness, the child likely has symptoms of anemia, causing fatigue and decreased exercise tolerance. By minimizing energy expenditure, the nurse can prevent further strain on the child's already compromised cardiovascular system, reducing the risk of cardiac complications. This intervention prioritizes the child's safety and well-being by addressing the immediate physiological concern of decreased oxygen supply to tissues.
Summary of why the other choices are incorrect:
A: Reducing environmental stimulation is not the priority as the child's main issue is related to severe anemia, not seizures.
B: Repeating the analysis with a new specimen may be necessary to confirm the hemoglobin level but is not the immediate priority when dealing with a critically low hemoglobin level.
D: Administering intr
Which is not a good prognostic factor in ALL?
- A. Mature B cell immunophenotype
- B. Female gender
- C. Hyperploidy
- D. Age 4-10 years
Correct Answer: A
Rationale: The correct answer is A: Mature B cell immunophenotype. In ALL, a mature B cell immunophenotype is associated with a poorer prognosis because it indicates that the leukemia cells have progressed to a more advanced stage of differentiation, making them more aggressive and resistant to treatment. On the other hand, choices B, C, and D are good prognostic factors in ALL. Female gender is associated with a better response to treatment, hyperploidy is a favorable genetic feature, and age 4-10 years is a common age group with a higher likelihood of responding well to treatment.