Nokea
Which of the following mechanisms is responsible for the generation of diversity in the antigen-binding sites of immunoglobulins?
- A. Somatic hypermutation
- B. Gene rearrangement
- C. Isotype switching
- D. Clonal expansion
Correct Answer: A
Rationale: Somatic hypermutation is the mechanism responsible for generating diversity in the antigen-binding sites of immunoglobulins. During somatic hypermutation, point mutations are introduced into the variable regions of immunoglobulin genes in B cells. These mutations occur randomly and lead to a wide range of amino acid changes in the antigen-binding sites of antibodies. As a result, a diverse repertoire of antibodies with varying specificities for different antigens is created. Gene rearrangement and isotype switching are other mechanisms that contribute to antibody diversity but do not specifically target the antigen-binding sites. Clonal expansion, on the other hand, refers to the proliferation of specific B cell clones after activation by antigens, which amplifies the immune response but does not directly impact the diversity of antigen-binding sites.
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A nurse is caring for a patient who is expressing concerns about their upcoming surgical procedure. What action demonstrates therapeutic communication by the nurse?
- A. Providing minimal responses to the patient's questions
- B. Offering reassurance and encouragement to the patient
- C. Ignoring the patient's concerns and focusing on tasks
- D. Interrupting the patient to redirect the conversation
Correct Answer: B
Rationale: Offering reassurance and encouragement to the patient demonstrates therapeutic communication by the nurse. In this situation, the nurse shows empathy and understanding towards the patient's concerns about the upcoming surgical procedure, which can help alleviate anxiety and build trust. Providing reassurance and encouragement can help the patient feel supported and understood, creating a positive and therapeutic interaction between the nurse and the patient. This approach fosters open communication and helps establish a therapeutic nurse-patient relationship, which is essential for effective patient care.
An infant's current weight indicates that the maximum safe dose of Tylenol is 30 mg by mouth. The physician orders 65 mg to be given, the pharmacist is responsible for filling the medication order, and the nurse administers Tylenol 65 mg. Who is legally responsible in the event that the infant has a toxic reaction to the medication?
- A. nurse
- B. physician
- C. pharmacist
- D. pharmacist and physician
Correct Answer: C
Rationale: The pharmacist is legally responsible in this situation because they are the healthcare professional authorized to dispense medications according to the physician's order. In this case, the physician ordered a dose higher than the maximum safe dose recommended based on the infant's current weight. While the nurse administers the medication, the pharmacist has the responsibility to ensure that the correct dose is dispensed and to alert the physician if there is a discrepancy in the order. If the pharmacist dispensed the incorrect dose without verifying with the physician, they would bear legal responsibility for any adverse effects resulting from the medication error.
Applying multidisciplinary approach of patient care, which among the members of the multidisciplinary team that the nurse would MOST likely collaborate with when the patient is at risk of fall due to an impaired gait?
- A. Podiatrist
- B. Speech therapist
- C. Physica l therapist
- D. Nutritionist
Correct Answer: C
Rationale: When a patient is at risk of falls due to an impaired gait, a physical therapist would be the most appropriate member of the multidisciplinary team for the nurse to collaborate with. Physical therapists specialize in improving mobility, balance, and coordination through exercises, gait training, and other interventions. They can assess the patient's gait pattern, strength, and balance, and develop a personalized plan to address the impairments contributing to the fall risk. By working closely with a physical therapist, the nurse can help the patient improve their gait and reduce the risk of falls, ultimately promoting safety and independence.
Ms. Cruz is the supervisor of a hospital on night shift. Several nurses did not report due to Jeepney strike. When the supervisor is executing proper allocation of nurses to the PRIORITY wards to address this concern, she is observing what type of principle?
- A. Beneficence
- B. Non-maleficence
- C. Justice
- D. Fidelity
Correct Answer: C
Rationale: In this situation, the principle of justice is being observed by the supervisor, Ms. Cruz. Justice in healthcare ethics involves fairness and equality in the distribution of resources, including the allocation of staff to provide care. By prioritizing the allocation of nurses to the PRIORITY wards to ensure that essential care is delivered despite the shortage caused by the Jeepney strike, Ms. Cruz is upholding the principle of justice by ensuring that each patient receives equal and fair access to healthcare services. This decision aligns with the ethical responsibility to provide care in a just and fair manner.
When communicating with a patient from a different cultural background, what should the nurse prioritize?
- A. Ignoring cultural differences to avoid making the patient uncomfortable.
- B. Using medical jargon to ensure clarity and precision.
- C. Recognizing and respecting the patient's cultural beliefs and practices.
- D. Minimizing the time spent communicating with the patient.
Correct Answer: C
Rationale: When communicating with a patient from a different cultural background, the nurse should prioritize recognizing and respecting the patient's cultural beliefs and practices. This is essential in providing culturally competent care, fostering trust and rapport with the patient, and ultimately improving health outcomes. By acknowledging and understanding the cultural context of the patient, the nurse can adapt communication strategies, address the patient's needs effectively, and avoid misunderstandings or misinterpretations. Building a culturally sensitive approach can enhance the quality of care and strengthen the therapeutic relationship between the nurse and patient.