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Which of these diseases can be prevented with a vaccine for humans?
- A. eastern equine encephalitis
- B. western equine encephalitis
- C. West Nile encephalitis
- D. Japanese encephalitis
Correct Answer: D
Rationale: Step 1: Identify the disease - Japanese encephalitis is caused by a virus transmitted by mosquitoes.
Step 2: Understand the role of a vaccine - a vaccine stimulates the immune system to produce antibodies to fight the virus.
Step 3: Vaccines prevent future infections - by administering a vaccine for Japanese encephalitis, individuals can develop immunity and prevent the disease.
Step 4: Therefore, the correct answer is D because a vaccine is available to prevent Japanese encephalitis.
Summary: A, B, and C are incorrect because there are no vaccines available for eastern equine encephalitis, western equine encephalitis, and West Nile encephalitis, respectively.
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The action potential is measured in millivolts (mV) and is ranged from:
- A. -90mV to +20mV
- B. -70mV to +30mV
- C. -65mV to +40mV
- D. -30mV to +60mV
Correct Answer: C
Rationale: The action potential involves a rapid change in membrane potential, typically ranging from -65mV (resting potential) to +40mV (peak depolarization). This change is driven by the influx of sodium ions and the subsequent efflux of potassium ions. The action potential is a key mechanism for transmitting information within the nervous system, enabling neurons to communicate over long distances.
What should be included in the management of a patient with delirium?
- A. The use of restraints to protect the patient from injury
- B. The use of short-acting benzodiazepines to sedate the patient
- C. Identification and treatment of underlying causes when possible
- D. Administration of high doses of an antipsychotic drug such as haloperidol (Haldol)
Correct Answer: C
Rationale: Identifying and treating underlying causes is key in managing delirium.
A 25 year-old housewife presents to the urgent care clinic for evaluation of paralysis in her face on the right side. She has a history of an upper respiratory infection 2 weeks before the onset of symptoms. She states that her face on the right is drooping and she is not able to close the right eye. On physical examination, you note that her forehead is smooth on the right, the left palpebral fissure appears wider than the right, and her nasolabial fold on the right is flattened and she is drooling. Based on this information, what is the most likely diagnosis?
- A. Cortical stroke
- B. Bell's palsy
- C. Horner's syndrome
- D. Stress reaction
Correct Answer: B
Rationale: Bell's palsy is a condition characterized by sudden, unilateral facial paralysis due to inflammation or compression of the facial nerve (CN VII). It often follows a viral infection and presents with drooping of the face, inability to close the eye, and flattening of the nasolabial fold. A cortical stroke typically spares the forehead, and Horner's syndrome involves ptosis and miosis.
Laboratory findings that the nurse would expect to be present in the patient with RA include
- A. polycythemia.
- B. increased immunoglobulin G (IgG).
- C. decreased white blood cell (WBC) count.
- D. anti-citrullinated protein antibody (ACPA).
Correct Answer: D
Rationale: ACPA is specific to RA.
An elderly patient presents with a right-sided headache and acute loss of vision on the same side. Tenderness is noted to the right temporal region as well as to the scalp. To obtain a definitive diagnosis, the nurse practitioner will order:
- A. Erythrocyte sedimentation rate (ESR)
- B. C-reactive protein (CRP)
- C. Temporal artery biopsy
- D. CT scan of the head
Correct Answer: C
Rationale: The correct answer is C: Temporal artery biopsy. This is the gold standard for diagnosing giant cell arteritis, which presents with symptoms such as headache, vision loss, and tenderness to the temporal region and scalp. The biopsy will show characteristic inflammatory changes in the artery wall.
A: ESR and B: CRP are nonspecific markers of inflammation and can be elevated in various conditions, including giant cell arteritis, but they do not provide a definitive diagnosis.
D: CT scan of the head may show signs of inflammation in the temporal artery, but it is less sensitive than a biopsy for diagnosing giant cell arteritis.