Nokea
You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis carinii pneumonia. Which information is most important to communicate to the physician?
- A. The blood pressure decreased to 104/76 during administration.
- B. The patient is complaining of pain at the site of the infusion.
- C. The patient is not taking in an adequate amount of oral fluids.
- D. Blood glucose is 55 mg/dL after the medication administration.
Correct Answer: D
Rationale: Pentamidine can cause hypoglycemia which is a serious and potentially life-threatening side effect. A blood glucose level of 55 mg/dL is critically low and requires immediate intervention. The other findings while important are less urgent and can be managed with standard nursing interventions.
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What disease is associated with autoantibodies binding to type IV collagen?
- A. Sarcoidosis
- B. Goodpasture's syndrome
- C. Systemic lupus erythematosus (SLE)
- D. Rheumatoid arthritis
Correct Answer: B
Rationale: The correct answer is B: Goodpasture's syndrome. This disease is specifically associated with autoantibodies targeting type IV collagen in the basement membranes of the kidneys and lungs, leading to glomerulonephritis and pulmonary hemorrhage. Sarcoidosis (A) involves non-caseating granulomas, not collagen autoantibodies. Systemic lupus erythematosus (SLE) (C) is associated with various autoantibodies but not specifically targeting type IV collagen. Rheumatoid arthritis (D) is characterized by autoantibodies against citrullinated peptides and synovial tissue, not type IV collagen.
Examples of disease-modifying drugs used to treat autoimmune disease include
- A. Corticosteroids
- B. Aspirin
- C. Anti-TNF-α
- D. C-cell depleting agents
Correct Answer: C
Rationale: Step-by-step rationale for why choice C (Anti-TNF-α) is correct:
1. Anti-TNF-α drugs target specific molecules involved in autoimmune responses.
2. By inhibiting TNF-α, these drugs reduce inflammation and slow disease progression.
3. This makes them disease-modifying, as they alter the course of the autoimmune disease.
Summary of why other choices are incorrect:
A: Corticosteroids are anti-inflammatory but not disease-modifying in autoimmune diseases.
B: Aspirin is primarily used for pain relief and reducing inflammation, not modifying the disease.
D: C-cell depleting agents are not commonly used for autoimmune diseases and do not target TNF-α.
Cardiac output
- A. coronary insufficient circulation
- B. A defect in one or more heart valves
- C. Disorder in a heartbeat
- D. Amount of blood/minute pumped into systemic circuit
Correct Answer: D
Rationale: The correct answer is D because cardiac output refers to the amount of blood pumped by the heart into the systemic circulation per minute. It is a crucial measure of heart function. Option A, coronary insufficient circulation, specifically refers to inadequate blood flow to the heart muscle itself, not overall cardiac output. Option B, a defect in heart valves, would affect the efficiency of blood flow but not necessarily the total amount of blood pumped. Option C, a disorder in heart rhythm, relates to irregular heartbeat patterns rather than the volume of blood pumped. Therefore, D is the correct choice as it directly relates to the definition of cardiac output.
Identify the fluid that is least possible to transmit AIDS.
- A. Blood
- B. Breast milk
- C. Semen
- D. Saliva
Correct Answer: D
Rationale: The correct answer is D: Saliva. Saliva has very low levels of HIV, making it least likely to transmit AIDS. HIV transmission requires direct contact with infected bodily fluids containing high viral loads, such as blood, breast milk, and semen. Saliva does not typically contain enough HIV to transmit the virus, as it has enzymes that can inhibit HIV. Therefore, the risk of HIV transmission through saliva is extremely low compared to the other fluids listed.
What is the key immune cell involved in granuloma formation?
- A. Mast cells
- B. Macrophages
- C. Neutrophils
- D. Dendritic cells
Correct Answer: B
Rationale: The correct answer is B: Macrophages. Macrophages are key immune cells involved in granuloma formation. They play a crucial role in engulfing and processing pathogens or foreign particles, leading to the formation of granulomas as part of the body's immune response. Mast cells (A) are primarily involved in allergic reactions. Neutrophils (C) are important in the initial immune response to infections but are not typically associated with granuloma formation. Dendritic cells (D) are important in antigen presentation and activation of T cells, but they are not the primary immune cells involved in granuloma formation.