Nokea
You are completing an assessment and health history for an HIV-positive patient who is considering starting antiretroviral therapy with several medications. Which patient information concerns you the most?
- A. Patient has been HIV positive for 8 years and has never been on any drug therapy for the HIV infection.
- B. Patient tells you that he never has been very consistent about taking medications in the past.
- C. Patient continues to be sexually active with multiple partners and says that he is careful to use condoms.
- D. Patient has many questions and concerns regarding how effective and safe the medications are.
Correct Answer: B
Rationale: Adherence to antiretroviral therapy is critical for its success. If the patient has a history of inconsistent medication use this raises concerns about the effectiveness of the therapy and the risk of developing drug resistance. The other information while important does not directly impact the success of the treatment as much as adherence does.
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What type of immunity is provided by T lymphocytes?
- A. Humoral immunity
- B. Cell-mediated immunity
- C. Passive immunity
- D. Innate immunity
Correct Answer: B
Rationale: The correct answer is B: Cell-mediated immunity. T lymphocytes are a type of white blood cell that plays a critical role in cell-mediated immunity by directly attacking infected cells and coordinating the immune response. This type of immunity is essential for fighting intracellular pathogens such as viruses and certain bacteria.
A: Humoral immunity is mediated by B cells and involves the production of antibodies to neutralize pathogens. T lymphocytes do not directly participate in humoral immunity.
C: Passive immunity is acquired through the transfer of antibodies from one individual to another, providing immediate protection. T lymphocytes are not involved in passive immunity.
D: Innate immunity is the body's first line of defense against pathogens and does not involve T lymphocytes, which are part of the adaptive immune response.
What is the primary cause of anaphylaxis?
- A. Immune complex deposition
- B. Systemic release of vasoactive mediators
- C. Localized mast cell degranulation
- D. T cell activation
Correct Answer: B
Rationale: The correct answer is B: Systemic release of vasoactive mediators. Anaphylaxis is a severe allergic reaction that is primarily caused by the systemic release of vasoactive mediators such as histamine, prostaglandins, and leukotrienes from mast cells and basophils. These mediators lead to widespread vasodilation, increased vascular permeability, bronchoconstriction, and systemic hypotension, resulting in the characteristic symptoms of anaphylaxis.
Choice A (Immune complex deposition) is incorrect because anaphylaxis is not caused by the deposition of immune complexes but rather by the immediate hypersensitivity reaction.
Choice C (Localized mast cell degranulation) is incorrect because anaphylaxis involves systemic mast cell degranulation leading to widespread effects throughout the body, not just localized reactions.
Choice D (T cell activation) is incorrect because anaphylaxis is primarily mediated by IgE antibodies and mast cells, not T cells.
Which of the following statements is NOT true?
- A. A B cell epitope will often be destroyed by denaturation
- B. A pathogen will often have more than one B cell epitope
- C. A B cell epitope is the part of the antibody molecule that contacts an antigen
- D. B cell epitopes are most commonly found on the surface of pathogens
Correct Answer: C
Rationale: The correct answer is C because a B cell epitope is not a part of the antibody molecule that contacts an antigen. B cell epitopes are specific regions on an antigen that bind to B cell receptors. Choice A is incorrect because denaturation can expose B cell epitopes. Choice B is incorrect because pathogens typically have multiple B cell epitopes. Choice D is incorrect because B cell epitopes can be found on various parts of pathogens, not just on the surface.
What is a compensatory mechanism for metabolic alkalosis?
- A. Shifting of bicarbonate into cells in exchange for chloride
- B. Kidney conservation of bicarbonate and excretion of hydrogen ions
- C. Deep,rapid respirations (Kussmaul respirations) to increase CO2 excretion
- D. Decreased respiratory rate and depth to retain CO2 and kidney excretion of bicarbonate
Correct Answer: D
Rationale: To compensate for metabolic alkalosis, the body decreases respiratory rate to retain CO2 and excretes bicarbonate via kidneys.
Priority Decision: During care of patients, what is the most important precaution for preventing transmission of infections?
- A. Wearing face and eye protection during routine daily care of the patient
- B. Wearing nonsterile gloves when in contact with body fluids, excretions, and contaminated items
- C. Wearing a gown to protect the skin and clothing during patient care activities likely to soil clothing
- D. Hand washing after touching fluids and secretions and removing gloves, as well as between patient contacts
Correct Answer: D
Rationale: Hand hygiene remains the single most effective measure in preventing the spread of infections, even when personal protective equipment (PPE) is used.