a nurse is teaching a class about immune deficiencies and a person from the audience asks which cells are affected by severe combined immune deficienc

ATI RN

Pathophysiology Final Exam

1. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

A. B cell deficits
B. T cell deficits
C. Complement deficits
D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

2. In a patient with chronic kidney disease and a hemoglobin level of 9 g/dL, which of the following treatments is most appropriate?

A. Iron supplementation
B. Erythropoiesis-stimulating agents
C. Blood transfusion
D. Vitamin B12 supplementation

Correct answer: B

Rationale: In chronic kidney disease, anemia commonly occurs due to decreased erythropoietin production. Erythropoiesis-stimulating agents, such as erythropoietin or darbepoetin, are the mainstay of treatment to stimulate red blood cell production. Iron supplementation is more appropriate for iron-deficiency anemia, not the anemia of chronic kidney disease. Blood transfusion is reserved for severe cases or acute blood loss. Vitamin B12 supplementation is indicated for megaloblastic anemia caused by vitamin B12 deficiency, not specifically in chronic kidney disease-related anemia.

3. The parents of a 3-year-old boy have brought him to a pediatrician for assessment of the boy's late ambulation and frequent falls. Subsequent muscle biopsy has confirmed a diagnosis of Duchenne muscular dystrophy. Which teaching point should the physician include when explaining the child's diagnosis to his parents?

A. Your child may develop breathing difficulties as the disease progresses.
B. Your child is likely to benefit from physical therapy and exercise.
C. This condition can be cured with early intervention and treatment.
D. The disease is caused by inflammation in the muscles, which leads to weakness.

Correct answer: A

Rationale: The correct teaching point that the physician should include when explaining Duchenne muscular dystrophy to the parents is that 'Your child may develop breathing difficulties as the disease progresses.' Duchenne muscular dystrophy is a progressive condition that affects muscle strength, including respiratory muscles, leading to breathing difficulties as the disease advances. Choice B is incorrect because while physical therapy and exercise can help maintain muscle function and mobility, they do not cure the condition. Choice C is incorrect because Duchenne muscular dystrophy is a genetic disorder with no known cure. Choice D is incorrect as Duchenne muscular dystrophy is primarily characterized by a lack of dystrophin protein due to genetic mutations, not inflammation in the muscles.

4. A patient with a history of breast cancer is being prescribed tamoxifen (Nolvadex). What is a critical point the nurse should include in the patient education?

A. Tamoxifen may increase the risk of venous thromboembolism.
B. Tamoxifen may decrease the risk of osteoporosis.
C. Tamoxifen may cause hot flashes and other menopausal symptoms.
D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots. Choice B is incorrect because tamoxifen does not decrease the risk of osteoporosis. Choice C is incorrect as tamoxifen may cause hot flashes and other menopausal symptoms but this is not the critical point for patient education. Choice D is incorrect as tamoxifen may cause weight gain and fluid retention, but it is not the critical point that the nurse should focus on in patient education.

5. What function does aldosterone serve in the body?

A. Aldosterone causes a release of sodium from the body, decreases fluid volume, and decreases blood pressure
B. Aldosterone causes a retention of sodium in the body, increases fluid volume, and increases blood pressure
C. Aldosterone causes a release of sodium from the body, increases fluid volume, and decreases blood pressure
D. Aldosterone enhances intracellular sodium production and lowers blood pressure

Correct answer: B

Rationale: Aldosterone functions by causing the retention of sodium in the body, which results in an increase in fluid volume and blood pressure. Choice A is incorrect because aldosterone actually promotes sodium retention rather than release. Choice C is incorrect as it states that aldosterone decreases fluid volume, which is not accurate. Choice D is incorrect because aldosterone does not enhance intracellular sodium production; instead, it primarily acts on sodium reabsorption in the kidneys.