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Which of the following describes the etiology of a cerebrovascular accident (CVA)?
- A. A blow to the head from a hard object
- B. Lack of blood flow to part of the brain
- C. Excessive exercise, such as running
- D. A ruptured artery in the heart
Correct Answer: B
Rationale: The correct answer is B. A cerebrovascular accident (CVA), or stroke, is often caused by a lack of blood flow to part of the brain. This leads to damage in the brain tissue due to the deprived oxygen and nutrients. Choices A, C, and D are incorrect. A blow to the head from a hard object can cause a traumatic brain injury but is not the etiology of a CVA. Excessive exercise like running does not typically lead to a stroke. A ruptured artery in the heart may result in a heart attack, not a cerebrovascular accident.
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In which of the following patients may the administration of a live vaccine be contraindicated?
- A. Patient with renal insufficiency
- B. Patient with hepatic failure
- C. Patient taking steroid therapy
- D. Patient over the age of 65 years
Correct Answer: C
Rationale: The correct answer is C. The administration of live vaccines may be contraindicated in patients taking steroid therapy. Steroids can suppress the immune system, reducing the effectiveness of live vaccines. Patients with renal insufficiency or hepatic failure can typically receive live vaccines as these conditions are not direct contraindications. Age alone, such as being over 65 years old, is not a contraindication for live vaccines unless there are other specific health considerations. Therefore, the patient taking steroid therapy is the most likely candidate for whom the administration of a live vaccine would be contraindicated.
After a patient is exposed to a specific antigen, B cells will differentiate into:
- A. B cytotoxic cells
- B. Plasma cells
- C. Bursal cells
- D. Clonal equivalents
Correct Answer: B
Rationale: After exposure to a specific antigen, B cells undergo differentiation into plasma cells. Plasma cells are responsible for producing antibodies in response to the antigen. Choice A ('B cytotoxic cells') is incorrect because B cells do not differentiate into cytotoxic cells; cytotoxic cells are typically associated with T cells. Choice C ('Bursal cells') is incorrect as bursal cells are specific to birds and not relevant to human immune responses. Choice D ('Clonal equivalents') is incorrect as it does not describe the differentiation process of B cells exposed to antigens.
A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?
- A. Adherence to the medication schedule
- B. The possibility of pregnancy
- C. The need for an increased dosage
- D. The effectiveness of the current oral contraceptive
Correct Answer: A
Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.
Which of the following describes the type of incontinence due to an increase in intraabdominal pressure such as coughing, sneezing, and laughing?
- A. Overflow
- B. Stress
- C. Mixed
- D. Functional
Correct Answer: B
Rationale: The correct answer is B: Stress. Stress incontinence occurs when there is an increase in intraabdominal pressure, for example, during activities like coughing, sneezing, or laughing, leading to urine leakage. This type of incontinence is specifically triggered by physical movements or activities that put pressure on the bladder. Choices A, C, and D are incorrect because overflow incontinence is characterized by the bladder not emptying properly, mixed incontinence is a combination of stress and urge incontinence, and functional incontinence is typically due to physical or cognitive impairments.
A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?
- A. Epoetin alfa (Epogen, Procrit)
- B. Pentoxifylline (Pentoxil)
- C. Estazolam (ProSom)
- D. Dextromethorphan hydrobromide
Correct Answer: A
Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.