NURSING

Question 64

When discussing the sequence of clot dissolution, the science instructor will talk about which item that begins the process?

Answers:

A. Plasminogen

B. α-plasmin inhibitor

C. Dabigatran

D. Platelets

Question 65

A 30-year-old male’s blood work and biopsies indicate that he has proliferating osteoclasts that are producing large amounts of IgG. What is the man’s most likely diagnosis?

Answers:

A. Multiple myeloma

B. Acute lymphocytic leukemia

C. Hodgkin lymphoma

D. Acute myelogenous leukemia

Question 66

A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?

Answers:

A. A+

B. B–

C. A–

D. B+

Question 67

A nurse is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobulins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIG) therapy. What is the boy’s most likely diagnosis?

Answers:

A. X-linked hypogammaglobulinemia

B. Transient hypoglobulinemia

C. Common variable immunodeficiency

D. IgG subclass deficiency

Question 68

A patient diagnosed with H pylori asks the nurse, “How an infection can occur in the stomach since it is an acid environment?” The nurse responds,

Answers:

A. “This parasite secretes an enzyme called coagulase, which protects the pathogen from the antibodies.”

B. “H. pylori produces an enzyme called urease that converts gastric juices into ammonia, which neutralizes the acidic stomach environment.”

C. “H. pylori is a virus and is still being researched as to how it is able to survive in the stomach acids.”

D. “We have many infectious agents that can live in an acidic environment with a pH more than 8.0.”

Question 69

The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?”The nurse will respond based on which of the following pathophysiological principles?

Answers:

A. “Everything slows down when you get older. You just have to wait and see what happens.”

B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”

C. “Don’t worry about it. We can always give him more blood.”

D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”

Question 70

A 14-year-old boy is participating in his school’s track meet; the outdoor temperature is 99°F, and a teacher has found the boy sitting restless in the shade and disoriented to time. The teacher notes that the student has dry skin in spite of the high temperature and the fact that he has recently completed a running event. The teacher calls for the school nurse, who will recognize which of the following potential diagnoses and anticipated hospital treatments?

Answers:

A. Heat exhaustion, likely treated with oral rehydration with cool water

B. Heat stroke, likely treated with rehydration by intravenous hypotonic solution

C. Heat stroke, likely treated with submersion in cold water

D. Heat exhaustion, likely treated with rest, shelter from the sun, and salt tablets

Question 71

A 40-year-old male who has been HIV positive for 6 years is experiencing a new increase in his viral load along with a corresponding decrease in his CD4+ count. Which of the following aspects of his immune system is likely to remain most intact?

Answers:

A. Activation of B lymphocytes

B. Phagocytic function of monocytes and macrophages

C. Orchestration of natural killer cells as part of cell-mediated immunity

D. Presentation of major histocompatibility molecules on body cells

Question 72

The nurse practitioner working in an overnight sleep lab is assessing and diagnosing patients with sleep apnea. During this diagnostic procedure, the nurse notes that a patient’s blood pressure is 162/97. The nurse explains this connection to the patient based on which of the following pathophysiological principles?

Answers:

A. When airways are obstructed, the body will retain extracellular fluid so that this fluid can be shifted to intravascular space to increase volume.

B. During apneic periods, the patient experiences hypoxemia that stimulates chemoreceptors to induce vasoconstriction.

C. When the patient starts to snore, his epiglottis is closed over the trachea.

D. When the airway is obstructed, specialized cells located in the back of the throat send signals to the kidney to increase pulse rate.

Question 73

A female dental assistant has developed signs and symptoms of a latex sensitivity and is undergoing allergy testing as well as blood work. Which of the following components of the assistant’s blood work would most likely be the focus of her health care provider’s analysis?

Answers:

A. Analysis of class II MHC antigens

B. Serum IgE immunoassays

C. Serum CD8+ levels

D. Serum B-lymphocyte levels

Q

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