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Which of the following actions is appropriate when managing a patient with a suspected heat stroke?
- A. Administering warm intravenous fluids.
- B. Applying ice packs to the patient's skin.
- C. Encouraging the patient to drink cold water rapidly.
- D. Removing the patient from the hot environment and cooling the body.
Correct Answer: D
Rationale: When managing a patient with a suspected heat stroke, the appropriate action is to remove the patient from the hot environment and start cooling the body. Heat stroke is a medical emergency that can be life-threatening if not promptly treated. Cooling the body is essential to lower the core body temperature as quickly as possible. Ice packs should not be directly applied to the skin as they can cause vasoconstriction and may actually hinder heat dissipation. Administering warm intravenous fluids and encouraging the patient to drink cold water rapidly are also not recommended in the initial management of a heat stroke. The priority is to cool the patient down and seek medical attention immediately.
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A patient with a chronic viral infection demonstrates persistently elevated levels of CD8+ cytotoxic T cells in their blood. Which of the following mechanisms is most likely responsible for this observation?
- A. Activation-induced cell death (AICD)
- B. T cell exhaustion
- C. Thymic involution
- D. Antigenic variation
Correct Answer: B
Rationale: T cell exhaustion is a state of T cell dysfunction that arises during chronic viral infections or cancer. In the case of a chronic viral infection, the persistent exposure to viral antigens leads to continuous stimulation of CD8+ cytotoxic T cells. Over time, this sustained stimulation can lead to T cell exhaustion, characterized by the upregulation of inhibitory receptors, impaired effector functions, and reduced proliferative capacity. As a result, despite the elevated levels of CD8+ T cells in the blood, their function may be compromised, ultimately impacting the immune response against the viral infection. In contrast, activation-induced cell death (AICD) may contribute to T cell loss during chronic infections but would not explain the persistently elevated CD8+ T cell levels. Thymic involution refers to the age-related decline in thymus function, which is not directly related to the observed increase in CD8+ T cells. Antigenic
The patient refuses to take the medication because it causes diarrhea. Nurse Parker explains the action of the drug but the patient vehemently refuses the medication. What should be the INITIAL action of the nurse?
- A. Discuss with a family member the need for the patient to take the medication.
- B. Document the patient 's refusa l to take the medication.
- C. Notify the physician of the patient 's refusal to take the medication.
- D. Explain again to the patient the consequences of refusing to take the medication.
Correct Answer: C
Rationale: The initial action the nurse should take when faced with a situation where a patient refuses to take medication after education and explanation is to notify the physician. The physician may need to be informed so they can reassess the medication and potentially explore alternative options or make adjustments based on the patient's concerns and preferences. It is important for medical decisions to be made in collaboration with the healthcare team to ensure the best care for the patient. Consulting the physician also helps in avoiding any potential negative outcomes resulting from the patient's refusal to take the prescribed medication. Once the physician is aware, further actions can be discussed and implemented to address the patient's concerns.
A patient presents with fever, chills, headache, and myalgia after returning from a trip to sub-Saharan Africa. Laboratory tests reveal intraerythrocytic ring forms and trophozoites on blood smear examination. Which of the following is the most likely causative agent?
- A. Plasmodium falciparum
- B. Trypanosoma cruzi
- C. Borrelia burgdorferi
- D. Leishmania donovani
Correct Answer: A
Rationale: The most likely causative agent in this scenario is Plasmodium falciparum, a protozoan parasite that causes malaria. The patient's symptoms of fever, chills, headache, and myalgia align with the typical presentation of malaria. Additionally, the presence of intraerythrocytic ring forms and trophozoites on blood smear examination is characteristic of Plasmodium species, particularly P. falciparum, which causes the most severe form of malaria.
In her capacity to teach, the nurse describes the changes of the uterus after childbirth to return to a nonpregnant state as _____
- A. catabolism
- B. subinvolution
- C. contraction of muscle fibers
- D. Involution
Correct Answer: D
Rationale: Involution refers to the process of the uterus returning to its nonpregnant state after childbirth. During pregnancy, the uterus undergoes significant changes and enlarges to accommodate the growing fetus. After childbirth, the uterus begins to contract, leading to a decrease in its size and a return to its pre-pregnant state. This process involves the shedding of the excess endometrial tissue and the reduction of the size of the uterine muscle fibers. It is a normal and essential process for postpartum recovery. Failure of the uterus to undergo proper involution is known as subinvolution, which can lead to complications such as postpartum hemorrhage.
Patient's health teaching for Lamotrigine (Lamictal} should include which of the following?
- A. Take each dose with food to avoid nausea.
- B. Eat a balanced diet to avoid weight gain.
- C. Report any rashes to your doctor immediately.
- D. This drug may cause psychological dependence.
Correct Answer: C
Rationale: Lamotrigine (Lamictal) is known to cause a serious rash, such as Stevens-Johnson syndrome or toxic epidermal necrolysis, which can be life-threatening. Therefore, it is crucial for patients taking Lamotrigine to be aware of this potential side effect and report any skin rashes to their healthcare provider promptly. Early detection and appropriate management are essential in preventing serious complications related to these rashes.