Nokea
To provide free water and intracellular fluid hydration for a patient with acute gastroenteritis who is NPO, the nurse would expect administration of which infusion?
- A. Dextrose 5% in water
- B. Dextrose 10% in water
- C. Lactated Ringer’s solution
- D. Dextrose 5% in normal saline (0.9%)
Correct Answer: A
Rationale: D5W provides free water without adding significant electrolytes, aiding intracellular hydration.
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To produce better flu vaccines we want:
- A. To block spreading of the infection by inducing a cytotoxic T cell response that would directly prevent viral entry into uninfected cells
- B. To induce the formation of highly strain-specific neutralizing antibodies that would prevent viral entry into uninfected cells
- C. To induce antibodies able to recognize HA across different strains by targeting less variable regions of HA
- D. All of the above is reasonably expected to improve the success of flu vaccines
Correct Answer: C
Rationale: The correct answer is C because inducing antibodies that can recognize the less variable regions of the Hemagglutinin (HA) protein across different strains allows for cross-protection against various flu strains. This approach is effective as it targets conserved regions of the virus, increasing the likelihood of providing broad immunity. Option A focuses on cytotoxic T cell response, which primarily targets infected cells and may not prevent viral entry into uninfected cells. Option B, on the other hand, is limited to highly strain-specific neutralizing antibodies, which may not provide adequate protection against evolving flu strains. Therefore, option C is the most effective in producing better flu vaccines by targeting less variable regions of HA for broader immunity.
A patient with acquired immunodeficiency syndrome (AIDS) has a negative tuberculosis (TB) skin test. Which nursing action is indicated next?
- A. Obtain a chest x-ray and sputum smear.
- B. No further action is needed after the negative skin test.
- C. Teach about the anti-tuberculosis drug isoniazid (INH).
- D. Schedule TB testing again in 6 months.
Correct Answer: A
Rationale: A negative TB skin test in an immunocompromised patient such as one with AIDS does not rule out TB infection. Further diagnostic testing such as a chest x-ray and sputum smear is necessary to confirm the absence of TB. Teaching about INH or scheduling another test is premature without further diagnostic confirmation.
Dendritic cells migrating from tissues enter the lymph nodes through
- A. Thoracic duct
- B. HEV
- C. Afferent lymphatics
- D. Efferent lymphatics
Correct Answer: C
Rationale: The correct answer is C: Afferent lymphatics. Dendritic cells migrate from tissues to lymph nodes through afferent lymphatics, which are small vessels that carry lymph into the lymph nodes. Once inside the lymph nodes, dendritic cells interact with T cells to initiate immune responses. The thoracic duct (A) drains lymph from the entire body into the bloodstream, not directly into lymph nodes. High endothelial venules (HEV) (B) are specialized blood vessels in lymph nodes where lymphocytes enter from the bloodstream, not dendritic cells. Efferent lymphatics (D) carry lymph out of the lymph nodes, not into them.
What is the primary advantage of the memory function in adaptive immunity?
- A. Rapid and stronger responses to previously encountered antigens
- B. Direct killing of pathogens without prior activation
- C. Enhanced cytokine secretion
- D. Resistance to all infections without exposure
Correct Answer: A
Rationale: The correct answer is A because memory function in adaptive immunity allows for rapid and stronger responses to previously encountered antigens. This is achieved through the presence of memory cells, such as memory B and T cells, which can quickly recognize and respond to specific pathogens upon re-exposure. This leads to a faster and more efficient immune response, providing better protection against future infections.
Choice B is incorrect because direct killing of pathogens without prior activation is a function of innate immunity, not adaptive immunity. Choice C is incorrect as enhanced cytokine secretion is not the primary advantage of memory function. Choice D is incorrect because while memory function provides protection against previously encountered antigens, it does not confer resistance to all infections without exposure.
Which of the following concerning nosocomial infections is incorrect?
- A. Caused by both Gram-negative and Gram-positive
- B. A common example is represented by Helicobacter pylori
- C. Caused by species that are often antibiotic-resistant
- D. Include infections by Clostridium difficile, a bacterial species that is often part of the commensal flora
Correct Answer: B
Rationale: The correct answer is B because Helicobacter pylori is not typically associated with nosocomial infections. Nosocomial infections are usually caused by bacteria commonly found in healthcare settings, such as Clostridium difficile, which is mentioned in choice D. Choices A, C, and D are correct as nosocomial infections can be caused by both Gram-negative and Gram-positive bacteria, often antibiotic-resistant species, and commensal flora bacteria like Clostridium difficile.