Nokea
Which type of cell is responsible for producing antibodies in the immune system?
- A. B lymphocytes
- B. T lymphocytes
- C. Macrophages
- D. Neutrophils
Correct Answer: A
Rationale: The correct answer is A: B lymphocytes. B lymphocytes (B cells) are a crucial part of the adaptive immune system. They produce antibodies, which are proteins that specifically target and neutralize pathogens such as bacteria and viruses. T lymphocytes (choice B) are involved in cell-mediated immunity rather than antibody production. Macrophages (choice C) are phagocytic cells that engulf and digest pathogens but do not produce antibodies. Neutrophils (choice D) are a type of white blood cell that primarily function in the innate immune response by phagocytosing pathogens.
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An older client is admitted to the psychiatric unit for assessment of a recent onset of dementia. The PN notes that in the evening this client often becomes restless, confused, and agitated. Which intervention is most important for the PN to implement?
- A. Ask family members to remain with the client in the evenings from 5 to 8 pm
- B. Administer a prescribed PRN benzodiazepine at the onset of a confused state
- C. Ensure that the client is assigned to a room close to the nurses' station
- D. Postpone administration of nighttime medications until after 11 pm
Correct Answer: C
Rationale: Sundowning, a phenomenon where dementia symptoms worsen in the evening, can be managed by ensuring the client is close to the nurses' station for frequent monitoring and quick intervention, if necessary. This reduces the risk of harm and helps manage agitation. Asking family members to remain with the client may not always be feasible and does not address the need for close monitoring. Administering benzodiazepines should not be the first-line intervention for sundowning as it can increase the risk of falls and other adverse effects. Postponing medication administration may disrupt the client's routine and potentially worsen symptoms.
When documenting information in a client's medical record, what should the nurse do?
- A. Cross out errors with a single line and initial them
- B. Use a black ink pen
- C. Leave one line blank before each new entry
- D. End each entry with the nurse's signature and title
Correct Answer: D
Rationale: When documenting information in a client's medical record, the nurse should end each entry with their signature and title. This practice is crucial for legal and professional standards compliance as it ensures that the documentation is attributable to the responsible individual. Choices A, B, and C are incorrect because while crossing out errors, using a black ink pen, and leaving a blank line before each entry are good practices, they are not as critical as ensuring each entry is signed and titled by the nurse for accountability and traceability.
The UAP reports to the PN that a client refused to bathe for the third consecutive day. Which action is best for the PN to take?
- A. Explain the importance of good hygiene to the client
- B. Ask family members to encourage the client to bathe
- C. Reschedule the bath for the following day
- D. Ask the client why the bath was refused
Correct Answer: D
Rationale: The best action for the PN to take when a client refuses to bathe is to ask the client why the bath was refused. Understanding the client's reasons for refusing a bath is crucial as it helps to address any underlying issues, such as fear, discomfort, or physical limitations. By communicating directly with the client, the PN can provide appropriate care tailored to the client's needs. Choices A, B, and C do not directly address the root cause of the refusal and may not effectively resolve the issue.
A client is admitted to the postoperative surgical unit with two test tubes after a left lobectomy. The nurse observed that the chambers are set at the prescribed suction of 20 cm water pressure, and tidying occurs with respirations and bubbling. What action should the nurse implement?
- A. Clamp the chest tube to see if the bubbling activity stops
- B. Notify the registered nurse of the observed bubbling
- C. Maintain system integrity to promote lung reexpansion
- D. Apply an occlusive dressing to the chest
Correct Answer: C
Rationale: Maintaining system integrity is essential to promote lung reexpansion in postoperative patients with chest tubes. Clamping the chest tube abruptly can lead to tension pneumothorax, a life-threatening condition. The bubbling observed is a normal sign indicating that the system is functioning correctly, as it allows the drainage of air or fluid from the pleural space. Notifying the registered nurse may be necessary if there are significant concerns or changes observed, but the immediate action should be to ensure system integrity and lung reexpansion.
A homeless male client with a history of alcohol abuse had a CVA 10 years ago that resulted in left hemiparesis. Today he is brought to the clinic reporting pain in his left leg. He is afebrile, has 4+ pitting edema in the lower left leg, and has minimal swelling of the right leg. Which action should the PN implement first?
- A. Obtain a blood alcohol test
- B. Inspect legs for infection or trauma
- C. Complete a mental status exam
- D. Inquire about dietary salt intake
Correct Answer: B
Rationale: Inspecting the legs for infection or trauma is the priority to assess the cause of the pain and edema, which could indicate deep vein thrombosis or cellulitis. Checking for signs of infection or trauma is crucial in this scenario to rule out potentially serious conditions. Obtaining a blood alcohol test, completing a mental status exam, or inquiring about dietary salt intake can be considered after addressing the immediate concern of identifying any infection or trauma in the leg.