Nokea
Which of the following is not an autoimmune disease?
- A. Multiple sclerosis
- B. Pernicious anemia
- C. Goodpasture syndrome
- D. Transfusion reaction
Correct Answer: D
Rationale: The correct answer is D, Transfusion reaction. Transfusion reaction is not an autoimmune disease because it occurs when the immune system responds to foreign blood cells, not to the body's own cells. Choices A, B, and C (Multiple sclerosis, Pernicious anemia, Goodpasture syndrome) are autoimmune diseases where the immune system mistakenly attacks the body's own tissues or organs.
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A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?
- A. Reduction in prostate size and improvement in urinary symptoms
- B. Increase in urine flow and relief of urinary obstruction
- C. Improvement in erectile function
- D. Relief of pain associated with BPH
Correct Answer: A
Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.
A 23-year-old pregnant female visits her primary care provider for her final prenatal checkup. The primary care provider determines that the fetus has developed an infection in utero. Which of the following would be increased in the fetus at birth?
- A. IgG
- B. IgA
- C. IgM
- D. IgD
Correct Answer: C
Rationale: The correct answer is IgM. IgM is the first antibody produced in response to an infection and is elevated in a fetus with an in utero infection. IgG is the primary antibody responsible for providing immunity to the fetus and is transferred across the placenta during the third trimester. IgA is mainly found in mucosal areas and colostrum but not significantly elevated in fetal infections. IgD is involved in the development and maturation of B cells but not typically increased in fetal infections.
A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:
- A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
- B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
- C. call the physician and request an order for a psychological consult.
- D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.
Correct Answer: B
Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.
Which of the following wounds is most likely to heal by secondary intention?
- A. A finger laceration received while cutting onions
- B. A stage IV pressure ulcer that developed in a nursing home
- C. A needlestick injury received while administering parenteral medication
- D. An incision from an open appendectomy
Correct Answer: B
Rationale: A stage IV pressure ulcer is a deep wound involving tissue loss that typically heals by secondary intention. This process involves the wound healing from the bottom up with granulation tissue and often results in significant scarring. Choice A, a finger laceration, would generally heal by primary intention due to its clean edges and minimal tissue loss. Choice C, a needlestick injury, is likely to be sutured and heal by primary intention since it is a small, clean wound. Choice D, an incision from an open appendectomy, is usually closed with sutures and heals by primary intention as well.
A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect to observe if the medication is effective?
- A. Increased urinary frequency and urgency
- B. Decreased prostate size
- C. Increased prostate size
- D. Decreased blood pressure
Correct Answer: B
Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.