Nokea
The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?
- A. Has your child received all recommended vaccinations?
- B. Has your child been feeding poorly or showing signs of constipation?
- C. Has your child been exposed to any sick individuals?
- D. Has your child been displaying signs of respiratory distress?
Correct Answer: B
Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.
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When a healthcare professional notices that a patient has type O blood, they realize that anti-_____ antibodies are present in the patient's body.
- A. A only
- B. B only
- C. A and B
- D. O
Correct Answer: C
Rationale: Individuals with type O blood have both anti-A and anti-B antibodies in their body. This is because type O blood lacks A or B antigens on the surface of red blood cells, causing the body to produce antibodies against both A and B antigens. Therefore, the correct answer is C. Choice A and B only antibodies are incorrect because type O individuals have both anti-A and anti-B antibodies. Choice D is incorrect as O represents the blood type itself, not the antibodies present in the blood.
A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?
- A. Decreased testosterone production
- B. Decreased libido
- C. Decreased viral shedding
- D. Decreased bacterial replication
Correct Answer: C
Rationale: The expected outcome of acyclovir (Zovirax) for the treatment of genital herpes is decreased viral shedding. Acyclovir is an antiviral medication that works by inhibiting the replication of the herpes virus, thereby reducing viral shedding and helping to control outbreaks. Choice A, decreased testosterone production, and Choice B, decreased libido, are unrelated outcomes of acyclovir treatment for genital herpes. Choice D, decreased bacterial replication, is also incorrect as acyclovir specifically targets viruses and does not affect bacterial replication.
A patient is prescribed medroxyprogesterone acetate (Provera) for the treatment of endometriosis. What should the nurse teach the patient about the use of this medication?
- A. Medroxyprogesterone should be taken with food to prevent nausea.
- B. Medroxyprogesterone can be taken intermittently when symptoms worsen.
- C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels.
- D. Medroxyprogesterone should be discontinued if side effects occur.
Correct Answer: C
Rationale: The correct answer is C. Medroxyprogesterone should be taken at the same time each day to maintain consistent hormone levels and effectiveness. Taking it at different times can lead to hormonal fluctuations and reduced medication efficacy. Choice A is incorrect because medroxyprogesterone does not need to be taken with food to prevent nausea. Choice B is incorrect as medroxyprogesterone is typically taken continuously rather than intermittently. Choice D is incorrect because side effects should be reported to the healthcare provider for further evaluation and management, not automatically leading to discontinuation of the medication.
The neurotransmitter GABA mainly functions to trigger inhibitory postsynaptic potentials (IPSPs). Therefore, when explaining this to a group of nursing students, the nurse will state:
- A. It takes at least three chemical substances (amino acids, neuropeptides, and monoamines) to stimulate any activity between the cells.
- B. There is a symbiotic relationship; therefore, the end result will be depolarization of the postsynaptic membrane.
- C. The combination of GABA with a receptor site is inhibitory since it causes the local nerve membrane to become hyperpolarized and less excitable.
- D. The neurotransmitters will interact with cholinergic receptors to bind to acetylcholine in order to produce hypopolarization within the cell.
Correct Answer: C
Rationale: When GABA binds with a receptor site, it causes hyperpolarization of the local nerve membrane, making it less excitable. This hyperpolarization leads to inhibition of nerve cell activity. Choice A is incorrect because GABA is a neurotransmitter itself and does not require three chemical substances to stimulate activity between cells. Choice B is incorrect as GABA triggers inhibitory postsynaptic potentials (IPSPs), leading to hyperpolarization, not depolarization, of the postsynaptic membrane. Choice D is also incorrect as it describes a process involving cholinergic receptors and acetylcholine, which is unrelated to GABA's mechanism of action.
A patient receiving isoniazid (INH) and rifampin (Rifadin) has a decreased urinary output and decreased sensation in his great toes. Which laboratory values should be assessed?
- A. Hematocrit and hemoglobin
- B. ALT and AST
- C. Urine culture and sensitivity
- D. Erythrocyte count and differential
Correct Answer: C
Rationale: In a patient receiving isoniazid (INH) and rifampin (Rifadin) with symptoms of decreased urinary output and decreased sensation in great toes, assessing urine culture and sensitivity is crucial. These symptoms could indicate peripheral neuropathy, a known side effect of isoniazid, and rifampin can cause renal toxicity. Checking for any urinary tract infection or drug-induced nephrotoxicity is important. Choices A, B, and D are incorrect as they do not directly address the symptoms presented by the patient or the potential side effects of the medications mentioned.