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Which of the following conditions may lead to death in a bulimic patient like sherry?
- A. Hypokalemia and cardiac arrhythmias and arrest
- B. Metabolic acidosis and renal failure
- C. Hyponatremia and circulatory collapse
- D. Hypernatremia and congestive heart failure
Correct Answer: A
Rationale: Bulimia nervosa is an eating disorder characterized by binge eating followed by compensatory behaviors such as self-induced vomiting, fasting, or excessive exercise. The repeated purging in bulimia can lead to electrolyte imbalances, such as hypokalemia (low potassium levels). Hypokalemia is a serious condition that can affect the function of the heart's electrical system, potentially leading to the development of cardiac arrhythmias (irregular heartbeats) and even cardiac arrest, which can result in death. Therefore, in a bulimic patient like Sherry, the risk of death is most likely due to the combination of hypokalemia and its complications, such as cardiac arrhythmias and arrest.
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Which of the following statements accurately describes the role of natural killer (NK) cells in the immune response?
- A. NK cells directly kill virus-infected cells and tumor cells.
- B. NK cells produce antibodies against pathogens.
- C. NK cells present antigens to T cells to initiate adaptive immunity.
- D. NK cells release cytokines to recruit other immune cells to the site of infection.
Correct Answer: A
Rationale: Natural killer (NK) cells play a vital role in the innate immune response by identifying and eliminating virus-infected cells, as well as tumor cells, without the need for prior exposure or activation. NK cells are able to detect abnormal cells by recognizing changes in the cell surface molecules, such as downregulation of MHC class I molecules. Once activated, NK cells release cytotoxic granules containing perforin and granzyme, leading to the destruction of the target cell. This direct killing mechanism is crucial for controlling viral infections and preventing the development of tumors. NK cells do not produce antibodies (option B), present antigens to T cells (option C), or release cytokines to recruit other immune cells (option D) as their primary function in the immune response.
While you are doing your physical assessment to patent Aster, she has been exhibiting a UNIQUE clinical manifestation different from patients Claire and Sonia which is characterized by________.
- A. Cyanosis, increasing growth of hands and feet
- B. anemia, weight 1oss and presence of
- C. moon facies, purple striae on trunk and buffalo hump
- D. moon facies, easy fatigability and peripheral edema
Correct Answer: A
Rationale: The clinical manifestations of Aster suggest acromegaly, a condition characterized by the excessive growth of hands and feet due to a tumor in the pituitary gland leading to overproduction of growth hormone. Cyanosis is a bluish discoloration of the skin caused by poor oxygenation, which is not typically associated with acromegaly. The other options do not match the unique clinical manifestation described for Aster. Anemia, weight loss, moon facies, and edema are more commonly associated with other conditions like Cushing's syndrome, anemia, or heart failure.
A patient with a history of chronic obstructive pulmonary disease (COPD) is prescribed ipratropium bromide inhaler. Which instruction should the nurse provide to the patient regarding ipratropium inhaler use?
- A. Shake the inhaler before each use.
- B. Inhale deeply and rapidly through the mouthpiece.
- C. Hold breath for 10 seconds after inhalation.
- D. Rinse mouth after each use.
Correct Answer: C
Rationale: The nurse should instruct the patient to hold their breath for at least 10 seconds after inhaling the medication from the ipratropium bromide inhaler. This allows the medication to reach deep into the lungs and be more effective. Holding the breath also helps reduce the risk of side effects such as throat irritation. It is essential for optimal drug delivery and therapeutic effect.
Bleeding is the most serious complication of Dengue infection. When is the patient be watched for symptoms of bleeding?
- A. 4 th to 7 days
- B. 2nd to 3rd day
- C. At the onset of symptoms
- D. 1St day
Correct Answer: A
Rationale: Bleeding is the most serious complication of Dengue infection, typically occurring between the 4th to 7th day after the onset of symptoms. This is known as the critical phase of Dengue fever, where the patient is at a higher risk of developing severe symptoms such as bleeding manifestations. Monitoring for symptoms of bleeding during this period is crucial for timely intervention and proper management to prevent further complications or fatalities. While bleeding can occur outside this timeframe in some cases, the 4th to 7th day window is when the risk is highest and vigilance is most needed.
A patient presents with urinary urgency, frequency, and nocturia. On physical examination, there is enlargement of the prostate gland with a smooth, firm consistency on digital rectal examination (DRE). Which of the following conditions is most likely?
- A. Benign prostatic hyperplasia (BPH)
- B. Prostate cancer
- C. Prostatitis
- D. Urinary tract infection (UTI)
Correct Answer: A
Rationale: The clinical presentation of urinary urgency, frequency, and nocturia along with prostate enlargement with a smooth, firm consistency on digital rectal examination (DRE) is classic for benign prostatic hyperplasia (BPH). BPH is a common condition in aging men characterized by non-malignant growth of the prostate gland, which can cause varying degrees of lower urinary tract symptoms due to obstruction of the urethra. In contrast, prostate cancer typically presents with findings like an asymmetric, hard, or nodular prostate on DRE, while prostatitis presents with symptoms like fever, perineal pain, and systemic symptoms. Urinary tract infection (UTI) may present with dysuria, frequency, urgency, and suprapubic pain, but it does not usually cause prostate enlargement.