Nokea
You are working with a student nurse who is assigned to care for an HIV-positive patient with severe esophagitis caused by Candida albicans. Which action by the student indicates that you need to intervene most quickly?
- A. The student puts on a mask and gown before entering the patient room.
- B. The student gives the patient a glass of water after the oral nystatin (Mycostatin) suspension.
- C. The student offers the patient a choice of chicken soup or chile con carne for lunch.
- D. The student places a “No Visitors” sign on the door of the patient’s room.
Correct Answer: B
Rationale: The student should not give the patient water immediately after administering oral nystatin as it can wash away the medication before it has a chance to coat the esophagus and treat the infection. The other actions are appropriate: wearing protective gear offering food choices and limiting visitors to reduce infection risk.
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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.
What are the key steps of phagocytosis?
- A. Recognition, digestion, and excretion
- B. Recognition, ingestion, and digestion
- C. Adhesion, secretion, and ingestion
- D. Activation, release, and excretion
Correct Answer: B
Rationale: The correct answer is B: Recognition, ingestion, and digestion. Firstly, recognition is essential for phagocytes to identify and bind to the target. Next, ingestion involves engulfing the target into a phagosome. Finally, digestion occurs within the phagolysosome, where enzymes break down the target. Choices A, C, and D are incorrect because they do not accurately represent the sequential key steps of phagocytosis.
NOD2
- A. Is a cytosolic receptor for bacteria
- B. Is mutated in 30% of patients with Crohn's disease
- C. Activates NFκB
- D. All of the above is correct
Correct Answer: D
Rationale: Step-by-step rationale:
1. NOD2 is a cytosolic receptor for bacteria, detecting bacterial molecules.
2. Mutations in NOD2 are found in 30% of patients with Crohn's disease.
3. NOD2 activation triggers NFκB signaling pathway.
4. Therefore, all the statements (A, B, C) are correct, making option D the correct answer. Other choices are incorrect as they do not encompass all the correct statements about NOD2.
In mice, mutations of which of the following genes cause the 'scurfy' phenotype (scaly skin and multiple autoimmune disorders)?
- A. FOXP3
- B. AIRE
- C. NFkB
- D. IRF
Correct Answer: A
Rationale: Rationale:
1. FOXP3 gene encodes a transcription factor crucial for regulatory T cells function.
2. Mutations in FOXP3 lead to dysfunctional regulatory T cells, causing autoimmune disorders.
3. Scurfy phenotype matches the symptoms of autoimmune disorders seen with FOXP3 mutations.
Summary:
- B (AIRE): AIRE mutations cause autoimmune polyendocrine syndrome, not scurfy phenotype.
- C (NFkB): NFkB is a transcription factor involved in immune response but not linked to scurfy phenotype.
- D (IRF): IRF is a regulator of interferon signaling, not directly associated with scurfy phenotype.
The nurse is performing an assessment on the patient who is in bilateral Buck traction. Which finding indicates the need to reposition the patient?
- A. The patient's heels are not touching the surface of the mattress.
- B. The elastic bandages need to be revrapped.
- C. The patient's feet are against the footboard.
- D. The weights are hanging free.
Correct Answer: C
Rationale: The correct answer is C because if the patient's feet are against the footboard in Buck traction, it can cause pressure ulcers and compromise circulation. Repositioning the patient is necessary to ensure proper alignment and prevent complications.
Incorrect choices:
A: The patient's heels not touching the mattress can be due to the traction pulling the legs in a specific position.
B: Rewrapping the elastic bandages may be necessary for proper traction maintenance but doesn't indicate immediate need for repositioning.
D: The weights hanging free is a normal finding in Buck traction and indicates proper traction application.