Which immunoglobulin presents the first challenge to the antigen?
- A. IgA
- B. IgG
- C. IgM
- D. IgE
Correct Answer: C
Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.
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A client with Guillain-Barr© syndrome is experiencing ascending paralysis. Which of the following interventions should the nurse prioritize?
- A. Monitor for signs of respiratory distress.
- B. Prepare the client for plasmapheresis.
- C. Administer analgesics for pain management.
- D. Initiate passive range-of-motion exercises.
Correct Answer: A
Rationale: The correct answer is A: Monitor for signs of respiratory distress. In Guillain-Barr© syndrome, ascending paralysis can lead to respiratory muscle involvement, putting the client at risk for respiratory distress and failure. Prioritizing respiratory monitoring is crucial to ensure timely intervention if respiratory compromise occurs. Plasmapheresis (Choice B) may be indicated in some cases to remove harmful antibodies, but the priority in this situation is respiratory support. Administering analgesics (Choice C) for pain management and initiating passive range-of-motion exercises (Choice D) are important aspects of care but are not the priority when the client's respiratory status is at risk.
Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?
- A. CSF provides immune protection to the brain and spinal cord by serving as a physical barrier.
- B. CSF cushions the brain and spinal cord, protecting them from injury.
- C. CSF plays a limited role in the exchange of nutrients and waste products between the blood and brain.
- D. CSF functions primarily as a medium for the transmission of nerve impulses.
Correct Answer: B
Rationale: The correct answer is B. Cerebrospinal fluid primarily cushions the brain and spinal cord, protecting them from injury. Choice A is incorrect because while CSF contributes to the brain's immune environment, its main role is not providing immune protection as a physical barrier. Choice C is incorrect because CSF has a significant role in the exchange of nutrients and waste products, rather than a limited one. Choice D is incorrect as CSF is not primarily a medium for nerve impulse transmission, but rather serves as a protective and supportive fluid.
A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
- B. Tamoxifen may cause weight gain, so patients should monitor their diet.
- C. Tamoxifen may cause hot flashes and other menopausal symptoms.
- D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
Correct Answer: A
Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.
How often should a patient be administered a tetanus toxoid?
- A. Every year
- B. Every 10 years
- C. Every 2 years
- D. Every 5 years
Correct Answer: B
Rationale: Tetanus toxoid should be administered every 10 years to ensure continued protection against tetanus infection. The correct answer is 'Every 10 years.' Choice A ('Every year') is incorrect as the frequency is too frequent. Choice C ('Every 2 years') is incorrect as it is too frequent for tetanus toxoid administration. Choice D ('Every 5 years') is incorrect as it does not align with the recommended interval for tetanus toxoid booster doses.
During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.
- A. Physiologic
- B. Pathologic
- C. Disuse
- D. Neurogenic
Correct Answer: A
Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.