Nursing Elites

1. Which immunoglobulin presents the first challenge to the antigen?

• A. IgA
• B. IgG
• C. IgM
• D. IgE

Correct answer: C

Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.

2. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?

• A. Intramuscularly
• B. Subcutaneously
• C. Intravenously
• D. Orally

Correct answer: A

Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.

3. What causes the appearance of a barrel chest in clients with emphysema?

• A. Peripheral edema
• B. Bacterial infections in the lungs
• C. Air trapping in the alveoli
• D. Muscle atrophy of the diaphragm

Correct answer: C

Rationale: The correct answer is C: Air trapping in the alveoli. A barrel chest in emphysema results from the hyperinflation of the lungs due to air trapping in the alveoli. This leads to increased anteroposterior diameter of the chest. Choices A, B, and D are incorrect. Peripheral edema is swelling caused by fluid retention in tissues, not associated with a barrel chest in emphysema. Bacterial infections in the lungs can lead to conditions like pneumonia but do not directly cause a barrel chest. Muscle atrophy of the diaphragm could affect breathing mechanics but is not specifically linked to the development of a barrel chest in emphysema.

4. Manifestations of Cushing syndrome include:

• A. truncal obesity with thin extremities.
• B. enlargement of face, hands, and feet.
• C. cachexia.
• D. thick scalp hair.

Correct answer: A

Rationale: The correct manifestation of Cushing syndrome is truncal obesity with thin extremities. This occurs due to the redistribution of fat to the face, neck, and abdomen, while the arms and legs remain thin. Choice B, enlargement of face, hands, and feet, is more indicative of acromegaly. Choice C, cachexia, refers to extreme weight loss and muscle wasting, which is typically not seen in Cushing syndrome. Choice D, thick scalp hair, is not a typical manifestation of Cushing syndrome.

5. When teaching a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with certain antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the effectiveness of the contraceptive. It is important for patients to be aware of this interaction to consider additional contraceptive methods during antibiotic therapy. Choices A and B are incorrect as no contraceptive method is 100% effective, and oral contraceptives typically require a period of time to reach full effectiveness. Choice D is incorrect as taking oral contraceptives with food does not significantly impact their effectiveness.

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