Nokea
The nurse is developing a teaching plan for a 64-year-old client with coronary artery disease (CAD). Which factor should the nurse focus on during the teaching session?
- A. Family history of coronary artery disease
- B. Elevated low-density lipoprotein (LDL) level
- C. Greater risk associated with the patient's gender
- D. Increased risk of cardiovascular disease with aging
Correct Answer: B
Rationale: The correct answer is B: Elevated low-density lipoprotein (LDL) level. This is the most relevant factor to focus on during the teaching session for a client with CAD. Elevated LDL levels are a major risk factor for the development and progression of CAD. By addressing this factor, the nurse can educate the client on the importance of managing cholesterol levels through diet, exercise, and medication.
Incorrect choices:
A: Family history of CAD - While family history is a risk factor, it cannot be modified through education alone.
C: Greater risk associated with the patient's gender - Gender is a non-modifiable risk factor and not the primary focus for teaching.
D: Increased risk of cardiovascular disease with aging - While age is a risk factor, the focus should be on modifiable risk factors like LDL levels.
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A male client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects Legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What is the drug of choice for treating Legionnaires' disease?
- A. erythromycin (Erythrocin)
- B. rifampin (Rifadin)
- C. amantadine (Symmetrel)
- D. amphotericin B (Fungizone)
Correct Answer: A
Rationale: The correct answer is A: erythromycin (Erythrocin). Legionnaires' disease is caused by the bacterium Legionella pneumophila, and erythromycin is the drug of choice for treating this infection. Erythromycin is a macrolide antibiotic that effectively targets Legionella bacteria by inhibiting their protein synthesis. It is bacteriostatic at low concentrations and bactericidal at higher concentrations. Rifampin (B) is not the preferred choice for Legionnaires' disease. Amantadine (C) is used for treating influenza A virus, not Legionella bacteria. Amphotericin B (D) is an antifungal agent and is not effective against Legionella pneumophila. Utilizing erythromycin as the treatment of choice ensures successful eradication of the Legionella bacteria and helps the client recover from the infection.
A sensitized B cell is activated once:
- A. it binds a helper T cell that releases cytokines.
- B. it binds a cytotoxic T cell.
- C. memory B cells have been cloned.
- D. it has cloned plasma cells.
Correct Answer: A
Rationale: The correct answer is A because a sensitized B cell requires activation by a helper T cell releasing cytokines to undergo differentiation and proliferation into plasma cells. This interaction is crucial for initiating the humoral immune response. Choices B, C, and D are incorrect because binding to a cytotoxic T cell, cloning of memory B cells, or cloning of plasma cells do not directly activate a sensitized B cell for its function in producing antibodies.
The last mammalian structure that air moves through before the alveoli is the
- A. larynx.
- B. glottis.
- C. bronchioles.
- D. trachea.
Correct Answer: C
Rationale: The correct answer is C: bronchioles. After air passes through the trachea, it enters the bronchi, which further divide into bronchioles. The bronchioles are the last structures where air passes before reaching the alveoli for gas exchange. The larynx is involved in sound production and the glottis is the opening between the vocal cords in the larynx. While the trachea is the initial passage for air into the respiratory system, the bronchioles are the final branching structures where air reaches the alveoli, making them the correct answer.
Which of the following statements is false?
- A. Hemoglobin functions as a buffer
- B. Bicarbonate ions tend to diffuse out of red blood cells into the blood plasma.
- C. The movement of molecules is in different directions in the metabolically active tissues and the alveoli.
- D. Carbonic anhydrase is an enzyme that promotes the formation of oxyhemoglobin.
Correct Answer: D
Rationale: The correct answer is D because carbonic anhydrase catalyzes the conversion of carbon dioxide and water into bicarbonate ions and protons, not the formation of oxyhemoglobin. Step-by-step rationale: 1. Hemoglobin functions as a buffer by binding to hydrogen ions to help regulate pH levels in the blood. 2. Bicarbonate ions do tend to diffuse out of red blood cells into the plasma to maintain the balance of CO2 and pH. 3. The movement of molecules is indeed different in metabolically active tissues (where oxygen is released and CO2 is taken up) compared to the alveoli (where the opposite occurs). Therefore, choices A, B, and C are all correct statements, making D the false statement.
The obstructive lung disease in which connective tissues are lost, alveolar surfaces are damaged, and the respiratory surface is reduced is called
- A. asthma
- B. bronchitis
- C. emphysema
- D. tuberculosis
Correct Answer: C
Rationale: Emphysema is the correct answer because it is characterized by the destruction of alveolar walls and connective tissues in the lungs, leading to reduced respiratory surface area. Asthma is characterized by airway inflammation and bronchoconstriction. Bronchitis is inflammation of the bronchial tubes. Tuberculosis is a bacterial infection affecting the lungs. Emphysema best fits the description provided in the question.