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The MMR (Measles, MUMPs, Rubella) vaccine has been the object of controversy after a report (lately declared fraudulent) of an association with development of:
- A. Multiple sclerosis
- B. Autism
- C. Encephalitis
- D. Epilepsy
Correct Answer: B
Rationale: The correct answer is B: Autism. The controversy surrounding the MMR vaccine and autism emerged from a fraudulent report that falsely claimed a link between the two. Numerous scientific studies have since debunked this association, confirming the safety of the MMR vaccine. Autism is a neurodevelopmental disorder with a complex etiology, involving genetic and environmental factors, but not vaccines. Choices A, C, and D are incorrect as there is no proven causal link between the MMR vaccine and multiple sclerosis, encephalitis, or epilepsy.
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A 21-year-old patient says no one in his family has type 1 diabetes mellitus but he has had it since childhood. He asks how his diabetes was transmitted to him. The nurse should explain to him that this disease is
- A. a single gene disorder
- B. a chromosome disorder
- C. an acquired genetic disorder
- D. a multifactorial genetic disorder
Correct Answer: D
Rationale: Type 1 diabetes is considered a multifactorial genetic disorder influenced by multiple genes and environmental factors rather than being caused by a single gene or chromosome.
Which of the following is a feature of antigen recognition by B cells?
- A. Their antigen receptors are never secreted
- B. Their antigen receptors recognize a fragment of protein in combination with an MHC molecule
- C. Their receptors each have two identical antigen binding sites
- D. They recognize pattern associated molecular structures (PAMPs) that are unique to a particular pathogen
Correct Answer: C
Rationale: The correct answer is C because B cell receptors, known as antibodies, are Y-shaped proteins with two identical antigen-binding sites. This feature allows B cells to bind to specific antigens with high specificity. Each B cell receptor can bind to a unique antigen, leading to the initiation of an immune response.
Choice A is incorrect because B cell receptors can be secreted as antibodies to target antigens outside the cell.
Choice B is incorrect because B cell receptors recognize antigens directly, not in combination with MHC molecules.
Choice D is incorrect because B cells primarily recognize specific antigens rather than general PAMPs associated with pathogens.
Which of the following statements about the 2009 H1N1 pandemic is NOT true
- A. Caused by a virus originated from 4 different strains
- B. Individuals over 60 were especially affected
- C. A level 6 pandemic phase was declared by WHO in June 2009
- D. 2009 H1N1 is considered moderately virulent in terms of severity of disease
Correct Answer: B
Rationale: The correct answer is B. Individuals over 60 were not especially affected by the 2009 H1N1 pandemic. This is because older individuals had some level of immunity due to previous exposure to similar strains. The other choices are incorrect because: A: The 2009 H1N1 virus originated from a combination of 2 different strains, not 4. C: WHO declared a level 6 pandemic phase in June 2009. D: The 2009 H1N1 virus was considered less virulent compared to other strains.
Treatment with two nucleoside reverse transcriptase inhibitors (NRTIs) and a protease inhibitor (PI) is prescribed for a patient with HIV infection who has a CD4+ T-cell count of <400/µL. The patient asks why so many drugs are necessary for treatment. What should the nurse explain as the primary rationale for combination therapy?
- A. Cross-resistance between specific antiretroviral drugs is reduced when drugs are given in combination.
- B. Combinations of antiretroviral drugs decrease the potential for development of antiretroviral-resistant HIV variants.
- C. Side effects of the drugs are reduced when smaller doses of three different drugs are used rather than large doses of one drug.
- D. When CD4+ T-cell counts are <500/µL, a combination of drugs that have different actions is more effective in slowing HIV growth.
Correct Answer: B
Rationale: Combination therapy minimizes the chance of developing resistant HIV strains by targeting the virus at multiple points in its lifecycle.
A confirmatory lab test for HIV includes:
- A. Western blot.
- B. Low WBC.
- C. Comprehensive metabolic panel.
- D. Enzyme-linked immunosorbent assay (ELISA).
Correct Answer: A
Rationale: The Western blot test is considered the gold standard for confirming HIV infection after initial screening tests like ELISA. Low WBC and comprehensive metabolic panels are not specific to HIV diagnosis.