Nokea
What are the recommended measures to prevent the transmission of health care–associated infections (HAIs) (select all that apply)?
- A. Empty bedpans as soon as possible
- B. Use personal protective equipment
- C. Hand washing or alcohol-based sanitizing
- D. Have patients wear sandals in the shower
Correct Answer: B
Rationale: The correct answer includes options B and C. Using personal protective equipment and practicing proper hand hygiene are critical measures to prevent HAIs. Emptying bedpans promptly and having patients wear sandals in the shower are not directly related to preventing HAIs.
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Which of the following represents the correct sequence of host immune defenses as encountered by a pathogen?
- A. Innate responses; physical barriers; adaptive responses
- B. Physical barriers; innate responses; adaptive responses
- C. Adaptive responses; physical barriers; innate responses
- D. Physical barriers; adaptive responses; innate responses
Correct Answer: B
Rationale: The correct sequence is B: Physical barriers; innate responses; adaptive responses. Physical barriers like skin and mucous membranes are the first line of defense, followed by innate responses (e.g., inflammation, phagocytosis) that provide immediate, non-specific protection. Adaptive responses (e.g., antibody production, T cell activation) are the final defense mechanism, specifically targeting the pathogen. Choices A, C, and D are incorrect because they do not follow the correct chronological order of how host immune defenses are encountered by a pathogen. Option A and D have the innate and adaptive responses in the wrong order, while option C places adaptive responses before physical barriers, which is not accurate in terms of the sequence of host immune defenses.
The nurse is assessing a client for signs and symptoms of systemic lupus erythematosus (SLE). Which of the following would be consistent with this disorder? (Select one that does not apply.)
- A. Discoid rash on skin exposed to sunlight
- B. Urinalysis negative for casts and protein
- C. Painful, deformed small joints
- D. Pain on inspiration
Correct Answer: A
Rationale: The correct answer is A: Discoid rash on skin exposed to sunlight. Systemic lupus erythematosus (SLE) commonly presents with a characteristic butterfly-shaped rash on the face, especially over the cheeks and nose, that worsens with sunlight exposure. The rash is not limited to skin exposed to sunlight. Choices B, C, and D are inconsistent with SLE. B: Urinalysis negative for casts and protein is not indicative of SLE, as renal involvement in SLE often presents with the presence of casts and protein in the urine. C: Painful, deformed small joints is more typical of rheumatoid arthritis, not SLE. D: Pain on inspiration is a symptom of pleurisy, which can occur in SLE but is not a defining feature.
Examples of disease-modifying drugs used to treat autoimmune disease include
- A. Corticosteroids
- B. Aspirin
- C. Anti-TNF-α
- D. C-cell depleting agents
Correct Answer: C
Rationale: Step-by-step rationale for why choice C (Anti-TNF-α) is correct:
1. Anti-TNF-α drugs target specific molecules involved in autoimmune responses.
2. By inhibiting TNF-α, these drugs reduce inflammation and slow disease progression.
3. This makes them disease-modifying, as they alter the course of the autoimmune disease.
Summary of why other choices are incorrect:
A: Corticosteroids are anti-inflammatory but not disease-modifying in autoimmune diseases.
B: Aspirin is primarily used for pain relief and reducing inflammation, not modifying the disease.
D: C-cell depleting agents are not commonly used for autoimmune diseases and do not target TNF-α.
A patient’s breast tumor originates from embryonal ectoderm. It has moderate dysplasia and moderately differentiated cells. It is a small tumor with minimal lymph node involvement and no metastases. What is the best description of this tumor?
- A. Sarcoma,grade II,T3 N4 M0
- B. Leukemia,grade I,T1 N2 M1
- C. Carcinoma,grade II,T1 N1 M0
- D. Lymphoma,grade III,T1 N0 M
Correct Answer: C
Rationale: This tumor is classified as a carcinoma, grade II, with a small size, limited lymph node involvement, and no metastases.
Which of the following is not a systemic cytokine?
- A. TNF
- B. IL-1
- C. IL-6
- D. IL-8
Correct Answer: D
Rationale: The correct answer is D: IL-8. IL-8 is not a systemic cytokine because it mainly acts locally at the site of inflammation to recruit neutrophils. Systemic cytokines like TNF, IL-1, and IL-6 have widespread effects throughout the body, influencing various immune responses and inflammatory processes. IL-8's localized action distinguishes it from systemic cytokines, making it the correct choice. TNF, IL-1, and IL-6 are all systemic cytokines that play key roles in regulating the immune response and inflammation at a systemic level, unlike IL-8.