Nokea
The patient in a long arm cast (from below the shoulder to the wrist, with a 90-degree elbow flexion) complains of a burning sensation over the elbow. The nurse's initial intervention should be:
- A. Elevate the casted arm on pillows.
- B. Check to see if the cast is properly supported.
- C. Notify the charge nurse of developing pressure ulcer.
- D. Cut a "window" in the cast.
Correct Answer: B
Rationale: The correct answer is B: Check to see if the cast is properly supported. The burning sensation over the elbow could indicate nerve compression due to improper cast positioning. By checking if the cast is properly supported, the nurse can ensure that there is no pressure on the nerves causing the burning sensation. Elevating the casted arm (choice A) may not address the root cause of the burning sensation. Notifying the charge nurse of developing pressure ulcer (choice C) is premature without confirming the cause of the burning sensation. Cutting a "window" in the cast (choice D) should be a last resort after ruling out other issues.
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Which immunoglobulins will initially protect a newborn baby of a breastfeeding mother (select all that apply)?
- A. IgA
- B. IgD
- C. IgE
- D. IgG
Correct Answer: A
Rationale: IgA is transferred through breast milk and provides mucosal immunity, while IgG crosses the placenta during pregnancy to provide systemic protection.
Which of the following concerned with Leishmania is NOT true
- A. Meditated by IgE
- B. Is a unicellular parasite
- C. Activation of macrophages is essential for killing the parasite
- D. Escapes host immune attack by hiding inside neutrophils
Correct Answer: a
Rationale: The correct answer is A: Mediated by IgE. Leishmania infection is not primarily mediated by IgE antibodies. The immune response against Leishmania involves T cells, macrophages, and cytokines. IgE is not a major player in the defense against Leishmania. Choices B, C, and D are incorrect because Leishmania is indeed a unicellular parasite, activation of macrophages is essential for killing the parasite, and Leishmania can hide inside neutrophils to escape the host immune attack.
Which factor is primarily responsible for the division of bacterial populations into specific zones within sediments?
- A. predation by protozoans
- B. free oxygen availability
- C. competition for suitable electron acceptors
- D. cometabolism of organic compounds
Correct Answer: B
Rationale: The correct answer is B: free oxygen availability. In sediment environments, free oxygen availability plays a crucial role in determining bacterial population distribution due to oxygen gradients. Bacteria that require oxygen will be found in aerobic zones where oxygen is present, while anaerobic bacteria will thrive in zones with limited or no oxygen. This division is primarily responsible for the spatial organization of bacterial populations within sediments.
Choice A: Predation by protozoans is not primarily responsible for division of bacterial populations within sediments as it focuses on interactions between different organisms rather than the environmental factor of oxygen availability.
Choice C: While competition for suitable electron acceptors is important for microbial communities, it is not the primary factor responsible for the division of bacterial populations within sediments.
Choice D: Cometabolism of organic compounds refers to the metabolism of compounds alongside the primary substrate, and it is not directly related to the spatial distribution of bacterial populations within sediments based on oxygen availability.
The rearrangement of B cell antigen receptor genes occurs in
- A. Germinal centres
- B. Cortical areas of lymph nodes
- C. Bone marrow
- D. All secondary lymphoid organs
Correct Answer: C
Rationale: The rearrangement of B cell antigen receptor genes occurs in the bone marrow. This process involves the assembly of variable (V), diversity (D), and joining (J) gene segments to generate a diverse repertoire of B cell receptors. The bone marrow provides the necessary environment for this gene rearrangement to take place, ensuring the development of functional B cells. Germinal centers and cortical areas of lymph nodes are involved in B cell activation and differentiation, not gene rearrangement. While secondary lymphoid organs support B cell activation and immune responses, they are not specifically where the gene rearrangement occurs.
As the nurse manager in a public health department,you are responsible for developing a plan to reduce the incidence of infection with the human immunodeficiency virus (HIV) in the community. Which nursing action is best delegated to health assistants working for the agency?
- A. Supply injection drug users with bleach solution for cleaning needles and syringes.
- B. Provide pretest and post-test counseling to those patients who are seeking HIV testing.
- C. Educate high-risk community members about the use of condoms in HIV prevention.
- D. Determine which population groups to target for education based on community assessment.
Correct Answer: A
Rationale: Health assistants can effectively distribute bleach solutions to injection drug users as part of harm reduction strategies. Pretest and post-test counseling education on condom use and community assessment require more advanced training and are typically responsibilities of registered nurses or other healthcare professionals.