Nokea
What dietary advice should the nurse give to clients with HIV/AIDS?
- A. Encourage intake of fat-soluble vitamins in amounts two to five times the RDA
- B. Encourage intake of water-soluble vitamins in amounts two to five times the RDA
- C. Increase the intake of iron and zinc
- D. Decrease the intake of trace element and antioxidant supplements
Correct Answer: B
Rationale: Water-soluble vitamins are crucial for immune function and are often depleted in HIV/AIDS patients so increasing their intake is beneficial.
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The patient with osteoporosis calls the nurse in the doctor's office to report that she should have taken but has forgotten to take her weekly bisphosphonate (alendronate [Fosamax]) that was due 2 days ago. How should the nurse advise the patient?
- A. "Take the dose now with 8 ounces of water."
- B. "Take two doses 3 days apart."
- C. "Skip this week and pick up the schedule next week."
- D. "Take two tablets now with a snack."
Correct Answer: C
Rationale: The correct answer is C: "Skip this week and pick up the schedule next week." Bisphosphonates like alendronate should be taken as directed, typically once weekly. It is important to maintain consistency in dosing to maximize effectiveness and minimize potential side effects. Taking a double dose or taking it late can increase the risk of side effects like gastrointestinal irritation or esophageal damage. Skipping a dose and resuming the schedule next week helps maintain the proper dosing interval. Options A and D suggest taking extra doses, which can be harmful. Option B of taking two doses 3 days apart is also incorrect as it deviates from the prescribed weekly schedule.
The site of ATP synthesis in microorganisms includes:
- A. cytoplasmic membranes
- B. cell walls
- C. chloroplasts
- D. mitochondria
Correct Answer: B
Rationale: The correct answer is B: cell walls. Microorganisms, such as bacteria and archaea, do not have mitochondria or chloroplasts. ATP synthesis in microorganisms primarily occurs in the cell walls through processes like glycolysis and fermentation. Cytoplasmic membranes are involved in electron transport and ATP synthesis in prokaryotic cells, not cell walls. Chloroplasts are only present in photosynthetic organisms, not in microorganisms.
What is the immunologic term to indicate the process that eliminates developing T cells whose T-cell receptors bind too strongly to self-peptide/MHC complexes?
- A. Negative selection
- B. Positive selection
- C. Peripheral tolerance
- D. Lineage commitment
Correct Answer: A
Rationale: Negative selection is the correct answer because it refers to the process that eliminates developing T cells with high affinity for self-peptide/MHC complexes to prevent autoimmune reactions. During negative selection, T cells that bind too strongly to self-antigens are deleted or rendered functionally inactive. This ensures that only T cells with moderate affinity for self-antigens are allowed to mature and participate in immune responses.
Summary of other choices:
B: Positive selection involves the selection of T cells that can recognize self-peptide/MHC complexes, promoting their maturation and survival.
C: Peripheral tolerance refers to mechanisms that maintain self-tolerance in the mature immune system, not specifically related to eliminating self-reactive T cells during development.
D: Lineage commitment is the process by which precursor cells differentiate into specific immune cell types and is not directly related to eliminating self-reactive T cells.
An 82-year-old male patient with pneumonia who is in the intensive care unit (ICU) is beginning to have decreased cognitive function. What should the nurse first suspect as a potential cause of this change?
- A. Fatigue
- B. Infection
- C. ICU psychosis
- D. Medication allergy
Correct Answer: C
Rationale: ICU psychosis is common in elderly patients due to sensory overload, sleep deprivation, and unfamiliar environments. While infection could also cause confusion, ICU psychosis is more likely given the context.
A patient is experiencing an immune response that involves the T lymphocytes. For which types of immunity should the nurse plan care for this patient?
- A. Passive immunity
- B. Humoral immunity
- C. Acquired immunity
- D. Cell-mediated immunity
Correct Answer: D
Rationale: The correct answer is D: Cell-mediated immunity. T lymphocytes are primarily involved in cell-mediated immunity, where they directly attack infected cells or pathogens. This type of immunity is crucial in fighting intracellular pathogens like viruses. Other choices are incorrect because:
A: Passive immunity involves receiving pre-formed antibodies, not T lymphocytes.
B: Humoral immunity involves B cells producing antibodies, not T lymphocytes.
C: Acquired immunity is a general term encompassing both humoral and cell-mediated immunity, but T lymphocytes specifically play a key role in cell-mediated immunity.