Nokea
When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?
- A. Autoimmune
- B. Anaphylaxis
- C. Alloimmune
- D. Allergic
Correct Answer: C
Rationale: When the maternal immune system becomes sensitized against antigens expressed by the fetus, an alloimmune reaction occurs. In this situation, the mother's immune system recognizes the fetus as foreign due to differences in antigens, leading to an immune response against the fetus. Choice A, 'Autoimmune,' is incorrect because it refers to the immune system mistakenly attacking the body's own cells and tissues. Choice B, 'Anaphylaxis,' is not the correct answer as it is a severe allergic reaction that can be life-threatening. Choice D, 'Allergic,' is also incorrect as it refers to an immune response triggered by allergens, not antigens expressed by the fetus.
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In a patient with renal failure secondary to an overdose of a nephrotoxic drug, which assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis?
- A. Frequent infections and low neutrophil levels
- B. Fatigue and increased heart rate
- C. Agitation and changes in cognition
- D. Increased blood pressure and peripheral edema
Correct Answer: A
Rationale: Impaired erythropoiesis refers to a decreased production of red blood cells. This can lead to anemia, resulting in symptoms like fatigue and increased heart rate (Choice B). However, the question specifically asks about assessment findings suggestive of impaired erythropoiesis. In this context, frequent infections and low neutrophil levels (Choice A) are more directly related to impaired erythropoiesis due to the impact of anemia on the immune system. Frequent infections are common in anemia due to a compromised immune response, and low neutrophil levels can be seen in conditions of impaired erythropoiesis. Agitation and changes in cognition (Choice C) are more indicative of neurological issues, while increased blood pressure and peripheral edema (Choice D) are commonly associated with renal failure but not specifically related to impaired erythropoiesis.
A 60-year-old male patient presents with severe and persistent pain in his left leg and hip that worsens with activity. After further evaluation, the patient is diagnosed with osteosarcoma. Which of the following is true about osteosarcoma?
- A. It is more common in children and young adults.
- B. Early diagnosis improves the prognosis.
- C. It is frequently located in the leg bones.
- D. All of the above are true.
Correct Answer: D
Rationale: Osteosarcoma is a type of bone cancer that can be found in any bone but is most commonly located in the long bones of the legs. While it is more prevalent in children and young adults, it can also occur in older individuals like the 60-year-old male patient in this case. Early diagnosis is crucial for a better prognosis in osteosarcoma cases. Therefore, all the statements provided are true regarding osteosarcoma, making option D the correct answer. Option A is accurate as osteosarcoma is more common in children and young adults. Option B is correct as early diagnosis improves the prognosis. Option C is accurate as osteosarcoma is frequently located in the leg bones.
A client presents to the emergency department with complaints of chest pain and shortness of breath. The client's ECG shows ST-segment elevation. What is the priority nursing intervention?
- A. Administer aspirin as prescribed.
- B. Prepare the client for emergent coronary angiography.
- C. Administer oxygen therapy.
- D. Initiate CPR.
Correct Answer: B
Rationale: In a client presenting with chest pain, shortness of breath, and ST-segment elevation on ECG, the priority nursing intervention is to prepare the client for emergent coronary angiography. This procedure is crucial in diagnosing and treating acute myocardial infarction promptly. Administering aspirin (Choice A) is important but not the priority over emergent coronary angiography. Administering oxygen therapy (Choice C) is supportive but does not address the underlying cause of the ST-segment elevation. Initiating CPR (Choice D) is not the priority in this scenario as the client is stable and conscious.
A male patient is concerned about the risk of prostate cancer while receiving finasteride (Proscar) for benign prostatic hyperplasia (BPH). What should the nurse explain about this risk?
- A. Finasteride has been shown to lower the risk of developing prostate cancer.
- B. Finasteride has no effect on the risk of developing prostate cancer.
- C. Finasteride may increase the risk of developing prostate cancer, so regular screening is important.
- D. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.
Correct Answer: A
Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. Studies have demonstrated that finasteride can reduce the incidence of prostate cancer. However, it is still recommended to have regular screening to monitor for any potential issues. Choice B is incorrect as finasteride has shown to have a positive effect on reducing prostate cancer risk. Choice C is inaccurate because finasteride decreases, not increases, the risk of prostate cancer. Choice D is incorrect as regular screening is still necessary despite the risk reduction associated with finasteride.
When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?
- A. Use a visual analog scale (VAS) to assess the pain.
- B. Ask the child to rate their pain on a scale of 0 to 10.
- C. Use the Wong-Baker FACES scale to assess the pain.
- D. Ask the parents to describe the child's pain behavior.
Correct Answer: C
Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.