Nokea
Which organ is most commonly affected in sarcoidosis?
- A. Kidney
- B. Lungs
- C. Liver
- D. Thyroid
Correct Answer: B
Rationale: The correct answer is B: Lungs. Sarcoidosis is a systemic inflammatory disease that primarily affects the lungs in about 90% of cases. This is due to the formation of granulomas, inflammatory nodules, in the lung tissue. Kidney (A), Liver (C), and Thyroid (D) are less commonly affected organs in sarcoidosis. Kidney involvement occurs in about 20-30% of cases, liver involvement in about 10-30% of cases, and thyroid involvement is relatively rare. Therefore, based on the prevalence of organ involvement in sarcoidosis, the lungs are the most commonly affected organ.
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The nurse is reinforcing teaching to a person who has tested positive for HIV. Which test should the nurse explain is done to confirm the diagnosis of HIV?
- A. Western blot
- B. Rheumatoid factor
- C. Antinuclear antibodies
- D. Immunoglobulin assay
Correct Answer: A
Rationale: The correct answer is A: Western blot. This test is used to confirm the diagnosis of HIV by detecting specific antibodies produced in response to the virus. It is considered the gold standard for confirming HIV infection due to its high specificity and sensitivity. The other choices (B, C, D) are not used to diagnose HIV. Rheumatoid factor and antinuclear antibodies are tests for autoimmune conditions, while immunoglobulin assay measures levels of antibodies in the blood, not specific to HIV.
The nurse is studying hypersensitivity reactions. Which reactions are correctly matched with their hypersensitivity types? (Select one that does not apply.)
- A. Type I—examples include hay fever and anaphylaxis.
- B. Type II—mediated by action of immunoglobulin M (IgM).
- C. Type III—immune complex deposits in blood vessel walls.
- D. Type IV—examples are poison ivy and transplant rejection.
Correct Answer: B
Rationale: The correct answer is B because Type II hypersensitivity reactions are mediated by the action of immunoglobulin G (IgG) or immunoglobulin M (IgM), not just IgM alone. IgG or IgM antibodies target specific antigens on the surface of cells or tissues, leading to cell destruction. In contrast, Type I hypersensitivity reactions (choice A) involve immediate IgE-mediated responses to allergens like hay fever and anaphylaxis. Type III reactions (choice C) are characterized by immune complex deposition in tissues, not blood vessel walls. Type IV reactions (choice D) are delayed hypersensitivity reactions involving T cell-mediated responses, such as poison ivy contact dermatitis and transplant rejection.
Which of the following is a characteristic of CTL?
- A. They kill target cells through recognition of peptide-MHC class I complexes
- B. They die in the process of killing a target cell
- C. They can kill target cells by activating complement
- D. They carry out their effector function in secondary lymphoid tissues
Correct Answer: A
Rationale: The correct answer is A because cytotoxic T lymphocytes (CTLs) kill target cells by recognizing specific peptide antigens presented on major histocompatibility complex (MHC) class I molecules. This recognition triggers the CTLs to release cytotoxic molecules that induce apoptosis in the target cells. Choice B is incorrect because CTLs do not die in the process of killing target cells; they survive to continue their immune response. Choice C is incorrect as CTLs do not kill target cells by activating complement, but rather through direct cell-cell contact. Choice D is incorrect because CTLs carry out their effector function in peripheral tissues where they encounter target cells, not specifically in secondary lymphoid tissues.
A patient with advanced AIDS has a nursing diagnosis of impaired memory related to neurologic changes. In planning care for the patient, what should the nurse set as the highest priority?
- A. Maintain a safe patient environment
- B. Provide a quiet, nonstressful environment to avoid overstimulation
- C. Use memory cues such as calendars and clocks to promote orientation
- D. Provide written instructions of directions to promote understanding and orientation
Correct Answer: A
Rationale: Safety is paramount for cognitively impaired patients. Preventing falls and ensuring access to necessities takes precedence over other interventions.
When teaching the patient with cancer about chemotherapy, which approach should the nurse take?
- A. Avoid telling the patient about possible side effects of the drugs to prevent anticipatory anxiety
- B. Explain that antiemetics,antidiarrheals and analgesics will be provided as needed to control side effects
- C. Assure the patient that the side effects from chemotherapy are uncomfortable but never life threatening
- D. Inform the patient that chemotherapy-related alopecia is usually permanent but can be managed with lifelong use of wigs
Correct Answer: B
Rationale: Providing information about available supportive therapies helps patients manage side effects effectively.