Question: 1. Alzheimer's patient incontinent of urine during the night times. The nursing care includes a) Offers bed pan every 2 hours b) Limit fluids during evening times c) Foley's catheter
2. After immediate post operative hysterectomy patient to observe (or) Nursing care includes a) Observe vaginal bleeding b) Urine output c) Vital signs
3. Dilantin prescribed to the patient, instructions to patient include a) Reticulocyte counts b) Platelet counts 4. On the ECG found a straight line, first Nurse a) Assess the patient b) Cardiopulmonary resuscitation c) IV fluids 5. 15% superficial burns, 20% partial thickness burns. If the fluids adequate a) Urine output 30-40ml/hr b) BP c) Vital signs d) Skin turgor 6. 20 week pregnant most concerned a) Butterfly rash on both cheeks and nose b) Uterus palpate at the level of symphysis pubis c) Sereous fluid drain in the breasts d) Breast enlargement 7. The sterile technique is broken when: a) The sterile field and supplies are wet b) Clean the area peripheral to center
8. The metal piece is embedded on the left eye a) Pressure dressing is applied on the left eye b) Dressing is applied on both eyes c) Irrigate the eye with saline 9. After cerebral angiogram, patient is a) Encourage fluids b) obseve contrast medium in the urine c) walking
10. Using clean, non sterile gloves, care is appropriate a) wash the genitelia........YES/NO Answers:The following possible best answers are based on the information found in nursing textbooks, and the underlying principle for safe and effective care that NCLEX is testing for. 1. Alzheimer's patient incontinent of urine during the night times. The nursing care includes a) Offers bed pan every 2 hours-NO, would be appropriate to bring the client to the toilet or commode every 2 hours during the day, but this action means you disturb the client's sleep. b) Limit fluids during evening times, BEST ANSWER-(Source: Black & Hawks, MedicalSurgical Nursing 7th edition) Specific interventions for the Alzheirmer's client with urinary incontinence: "Sometimes the client forgets where the bathroom is located. Having bright lights and frequently taking the client there may help control incontinence. Fluid intake after the dinner meal can be restricted to maintain continence during the night." c) Foley's catheter-NO, would increase risk of lower urinary tract infection, inappropriate and not necessary.
2. After immediate post operative hysterctomy patient to observe (or) Nursing care includes a) Observe vaginal bleeding b) Urine output c) Vital signs-BEST ANSWER, as this provides the best/most information about the client's response to surgery and anesthesia.
3. Dilantin prescribed to the patient, to instruct the patient that includes a) Reticulocyte counts-Yes, this will test for decreased reticulocyte count a sign that the patient is developing aplastic anemia, a potentially life threatening side effect of Dilantin therapy. b) Platelet counts-No, however Dilantin can decrease the platelet count and result in thrombocytopenia. Aplastic anemia is considered to be more serious (Davis Drug Guide) 4. On the ECG found a straight line, first Nurse a) Assess the patient-BEST ANSWER, always assess the patient to be sure there is no equipment malfunction, and/or to confirm the information on the monitor. b) Cardiopulmonary resuscitation c) IV fluids 5. 15% superficial burns, 20% partial thickness burns. If the fluids adequate a) Urine output 30-40ml/hr BEST ANSWER, the patient's fluid balance/hydration status is best evaluated by assessing urine output. Urine output should be between 0.5 and 1.0 mL/kg/hr, which for a 130 lb adult would be between 29.5 -59 mL/hr. Most nursing textbooks consider 30 mL/hr of urine output to indicate appropriate fluid balance/hydration. b) BP c) Vital signs d) Skin turgor For b, c, and d many other factors can affect these findings. Urine output directly correlates with the patient's hydration status/fluid balance. 6. 20 week pregnant most concerned A ) Butterfly rash on both cheeks and nose-NO this is Cholasma the "mask of pregancy", result of hormonal changes in pregnancy. b) Uterus palpate at the level of symphysis pubis-BEST ANSWER this correlates with 12 weeks gestation and the patient in the question is 20 weeks. This is a significant difference. c) Sereous fluid drain in the breasts-NO, leaking of clear fluid from the breasts during pregnancy is not unusual. d) Breast enlargement-NO, the breast enlarge during pregnancy. 7. The sterile technique is broke when
a) The sterile field and supplies are wet-BEST ANSWER, this would allow microorganisms to enter the sterile field through the wet surface. b) Clean the area peripheral to center-NO, this is inappropriate technique but response a, specifically describes how a sterile field can be contaminated and is an important principle in maintaining sterile fields. 8. The metal piece is embedded on the left eye a) Pressure dressing is applied on the left eye-NO, this would "push" the object further into the eye. b) Dressing is applied on both eyes-BEST ANSWER, you want to keep the left eye still, and because both eyes move together the uninjured eye must be covered to prevent movement in the injured eye. c) Irrigate the eye with saline-NO, the object is embedded, meaning deep within the eye. Irrigation will not remove the object but theoretically it could cause it to move resulting in further damage. 9. After cerebral angiogram, patient is a) Encourage fluids-BEST ANSWER, when ever contrast medium/X-ray dyes are administer the client is hydrated to facilitate excretion of the dye. b) obseve contrast medium in the urine-NO, should not be observable to patient or nurse. c) walking-NO, bedrest would be maintained for a prescribed period of time. 10. Using clean, non sterile gloves care is appropriate a) wash the genitelia........YES/NO- YES, this is not a sterile procedure.
Question:
A patient is receiving 1,000 ml of 5% glucose and 0.45% normal saline with 40 mEq of potassium chloride. most important for nurse to monitor the patient : A. pulse rate B. daily weight C. skin turgor
Answer1: I would say, always check for urine output before commencing anything with Potassium because it can only be excreted in the urine. Hence if you are dehydrated & have decrease urine output & commenced on K+ hyperkalemia will arise leading to cardiac arrythmia. Answer2: The answer is pulse rate
Question: 1)a young patient most likely to get lead poisining if? a. he is drinking from a ceramic pitcher. b. father refurnishes old furniture at their home 2) a TB pt understands that he can reduce the risk of spreading his disease if he states? a. i wont sleep in same room w/ my wife for 1-2 months b. i will stay away from pregnant women and children c. i will use plastic utensil when i eat 3) 4 years old with salmonella what u should do? a. private room b. isolation c. place in a room with 4 year old with cellulitis d. keep door closed at all times. 4) wat herb would help with vomiting? a. ginkgo b. ginseng. c. ginger root d. echinacea 5) allergic to sulfa wat not to take? a. ma huang b. echinacea. 6) mother called a nurse from home stating that her child having chicken pox, which of the following statements by the mother needs immediate follow up?
a. father of the child with liver failure b. sibling with anemia c. child just had tonsillectomy d. child has intermittent low grade fever 7) client with allergy to sudafed ..which of the statments is correct? a. i will take valerian b. i will take ma huang c. i will take echinacea for acute viral inf. d. i will take black cohosh 8) food processing a. frozen food can be defrost for up to six hours b. frozen food which has been defrost can be return back to fridge. c. cook perishable food should cover and cool d. frozen food should be defrost by hot water 9) child in a mist tent and the parents brought him a car toy...the child was clutching the toy and the nurse refused to let him play for wat reason? a. it will get contaminated with bacteria b. it will accumalate moisture c. it could cause a fire 11) a mother reported that her son is throwing up each time she feeds him what would be the best question u ask? a. did u warm up the formula b. wot kind of formula did u give him c. does ur son feel hungry each time he throws up d. does ur son have a jelly like stool 12) a patient had aids the nurse should advise? a. cook ur meat very well b. not to eat in the same table with family c. avoid crowds
Answer: 1)a young patient most likely to get lead poisining if?
a. he is drinking from a ceramic pitcher. b. father refurbishes old furniture at their home
> ANSWER is B. probably if he refurbishes an old furniture at home.. that is, if the furniture has old paint on it and during 60's paints have lead content on it (heavy metals) and if you need to remove that, chips from the old paint may be taken by a kid that leads to Pb poisoning 2) a TB pt understands that he can reduce the risk of spreading his disease if he states? a. i wont sleep in same room w/ my wife for 1-2 months b. i will stay away from pregnant women and children c. i will use plastic utensil when i eat ****>> if the patient is already taking anti-TB drugs, it will only be 2 weeks of chemotherapy and that (+) PTB will no longer be communicable.. and 1-2 months is long! CHildren are more susceptible to acquire Primary complex and pregnant women are susceptible and almost vulnerable to all type of illnesses.. There is no need for the patient to separate their utensils since PTB is airborne and not by contact in terms of transmission.. so i go for B answer. 3) 4 years old with salmonella what u should do? a. private room b. isolation c. place in a room with 4 year old with cellulitis d. keep door closed at all times. *** the (+) salmonella kid may be placed in a private room. Salmonella is transmitted by Enteric.. therefore Enteric precaution is needed and handwashing is very important and gown and gloves, diaper or bedpan in necessary. Option B, and D are all for pulmonary tuberculosis precautions. I suppose, the answer is A. place in a private room. 4) wat herb would help with vomiting? a. ginko b. ginsing. c. ginger root d. echinacea ****> ginger root is good for nausea.. most especially in morning sickness but in moderation for pregnant women... Option C is the answer 5) allergic to sulfa wat not to take?
a. ma huang b. echinacea.
...I think the answer is... geez, i forgot..i think its Echinacea..let me check again ok.. 6) mother called a nurse from home stating that her child having chicken pox..which of the following statements by the mother needs immediate follow up? a. father of the child with liver failure b. sibling with anemia c. child just had tonsillectomy d. child has intermittent low grade fever I think the answer is C. the child that just had tonsillectomy. i think the child is immunocompromised. and varicella (Chicken pox) is a viral one.. we all know that tonsils are one of the lymph defenses we have against any infection.. Im not really sure with this answer. 7) client with allergy to sudafed ..which of the statments is correct? a. i will take valerian b. i will take ma huang c. i will take echinacea for acute viral inf. d. i will take black cohosh **valerian root is for cystitis and fungal infections; ma huang is for (I forgot!!),echinacea is for immune booster but not to be taken with patients with progressive systemic disorders such as AIDS, PTB, HIV, etc. black cohosh is for menopause. *** don't you think that Echinacea is the correct option??
8)food processing a. frozen food can be defrost for up to six hours b. frozen food which has been defrost can be return back to fridge. c. cook perishible food should cover and cool d. frozen food should be defrost by hot water usually, frozen food must be thawed at cool tap water for freshness. not in the microwave because it can be cooked outside and raw inside, not in the hotwater with same principle. so i believe, thawing it FOR UP TO 6 HOURS would be ok. returning thawed food back at fridge is ok but it is unsafe since salmonella can start thriving in.. Answer is OPTION A.
9) child in a mist tent and the parents brought him a car toy...the child was clutching the toy and the nurse refused to let him play for wot reason? a. it will get contaminated with bacteria b. it will accumalate moisture c. it could cause a fire ** The answer is OPTION C. Usually car toy have friction on it for the wheels to run.. Oxygen supports combustion.. and if friction is present together with oxygen (in a mist tent) then, fire could commence. 11) a mother reported that her son is throwing up each time she feeds him wat would be the best question u ask? a. did u warm up the formula b. wot kind of formula did u give him c. does ur son feel hungry each time he throws up d. does r son have a jelly like stool ***>>> CORRECT OPTION is D.. Does your son have jelly like stool.. jelly like or currant like stool is a cardinal sign of Intussusception/ Telescoping or invagination of the large intestines in the Ileoceccal area.. 12) a patient had AIDS the nurse should advise? a. cook ur meat very well b. not to eat in the same table with family c. avoid crowds ***>> if you have AIDS, u are immunocompromised.. therefore you are prone to infection.. neutropenic precaution is advised and one that is a must is Avoiding Crowds.. Correct option is C. Posted by anaski from IP 203.131.185.106 on September 08, 2005 at 03:45:59: Thank you so much English RN2B
Future USRNs, this for you: PRIORITY QUESTIONS (WHO TO SEE FIRST) Sample Test Item: 1. Which of the following clients should the nurse deal with FIRST? o 1 A client who needs his daily vitamin o 2 A client who needs to be suctioned o 3 A client who needs diaper to be changed o 4 A client who is being prepared for discharge Correct Answer: 2. A client who needs to be suctioned
PRIORITY (Use ABC) Obstruction in the airway ± secretions Need to be suctioned
2. Delegation, RN, LVN, UAP, CAN Which of the following clients should the LPN be assigned to? o 1 A newly diagnosed patient with MYASTHENIC CRISIS o 2 An immediate post-op client in PACU o 3 A client awaiting medication for vitamins o 4 A new admission for KIDNEY Transplant Patient Correct Answer: 3-stable, A client awaiting medication for vitamins Myasthenic Crisis ± Unstable, Acute Respiratory Failure
Immediate Post ± op ± Unstable, Risk for Complications,
Kidney Transplant ± Unstable, needs assessment for rejection DELEGATION: Remember the 5R's, Right Task, Right Person, Right Circumstance, Right Communication & Right Feedback) RN Least stable, unstable, central catheters (hickman, broviac), admission, discharge, health teachings, patient for transfer, blood transfusion (2RNs) LPN Technical Doer, Stable, medications, wound dressing CNA Routine Care, Urine Dip Stix, Reporting to RN, Routine VS UAP turning q2H, conducting group activities, ambulation For future USRNs
This is for you... from the purkinje fibers of my heart.... Room Assignment(Who to Share Room with) Check: A ge B eside the nurse's station? At the end of the hallway? Single Room/Private Room? C hain of infection/circumstance D iagnosis E nviroment (dim light, darkened, red nightlapm)
Sample Test Item: The best roommate for patient with LEUKEMIA is O 1 A 9-year-old with ruptured appendix O 2 A 12-year-old with chicken pox O 3 A 2-year-old with fever of unknown origin O 4 A 5-year-old with nephrotic syndrome Correct Answer: 4. A 5-year-old with nephrotic syndrome.
1,2 & 3, manifest symptoms of infection. A client with leukemia is immunosuppressed and Patients with infection shouldn't be placed in this room. Since patient with nephrotic syndrome receives diuretics and steroids, this child will also need immunocompromised host precaution.
INFECTION CONTROL: Sample Test Item: 3. Which of the following methods should the RN utilize in patient with SALMONELLA? O 1 Airborne Precautions O 2 Droplet Precautions O 3 Neutropenic Precautions O 4 Enteric Precautions The correct answer: 4. Salmonella mode of transmission is fecal oral (enteric)
Handwashing Gloves must be used in handling bedpan and diapers Gown - if soiling is likely to happen. Source of infection: Contaminated food and water.
Remember - Transmission Based precautions: A ir B orne, small particles are dispersed in the air like MTB, varicella C ontact, drug-resistant microorganisms D roplet, large particles are dispersed into air, resp.infections except resp syncytial E nteric, fecal-oral like hepaA & salmonella AGE APPROPRIATE GROWTH AND DEVELOPMENT (HOPPING WITH ONE LEG) Sample test Item: 4. Which of the following is NOT a characteristic of a preschooler? O 1 predominantly "parallel play" period O 2 balances on 1 foot with eyes closed O 3 skips on alternate feet O 4 jumps rope The correct answer is: 1. Parallel play is more common in TODDLERS. Preschooler (3-6 years) Gross motor development HOPS ON ONE (1) FOOT BY 4 YEARS SKIPS & HOPS ON ALTERNATE FEET BY 5 YEARS PLAY : ASSOCIATIVE, IMAGINATIVE, MAGICAL THINKING, SUPERHEROES (Remember the movie: Jingle All The way!) FEAR: Intrusive procedures, venipunctures, IM injections, body mutilation
Toxoplasmosis, where else you can contract this (thinking of cat litter but it aint there) Sample test Item: 5. To which of the following pregnant clients will be risk for TOXOPLASMOSIS? Select all that apply: O 1 A pregnant client who eat raw meat. O 2 A pregnant client handling cat litter of infected cats. O 3 A pregnant client gardening and cultivating soil exposed to cat feces. O 4 A pregnant client with low rubella titer O 5 A pregnant client who have undergone external radiation. O 6 A pregnant client with draining, painful vesicles in the external genitalia. The correct answers: 1, 2 & 3. TOXOPLASMOSIS How do people get toxoplasmosis? A Toxoplasma infection occurs by: Accidentally swallowing cat feces from a Toxoplasma-infected cat that is shedding the organism in its feces. This might happen if you were to accidentally touch your hands to your mouth after gardening, cleaning a cat's litter box, or touching anything that has come into contact with cat feces. Eating contaminated raw or partly cooked meat, especially pork, lamb, or venison; by touching your hands to your mouth after handling undercooked meat. Contaminating food with knives, utensils, cutting boards and other foods that have had contact with raw meat. Drinking water contaminated with Toxoplasma. Receiving an infected organ transplant or blood transfusion, though this is rare. (From the internet-Division of Parasitic Disease) Which of these statements by the nurse is incorrect if the nurse has the goal to reinforce information about cancers to a group of young adults? 1. ³You can reduce your risk of this serious type of stomach cancer by eating lots of fruits and vegetables, limiting all meat, and avoiding nitrate-containing foods.´ 2. ³Prostate cancer is the most common cancer in American men with results to threaten sexuality and life.´ 3. ³Colorectal cancer is the second-leading cause of cancer-related deaths in the United States.´ 4. ³Lung cancer is the leading cause of cancer deaths in the United States. Yet it's the most preventable of all cancers. SOURCE: Emailed to me by
[email protected]
Ms. X is diagnosed with acquired immunodeficiency syndrome (AIDS). The nurse caring for this patient is aware that for a patient to be diagnosed with HIV she should have which condition? a. Infection of HIV, have a CD4+ T-cell count of 500 cells/microliter, history of acute HIV infection b. Infection with Tuberculosis, HIV and cyto megalovirus c. Infection of HIV, have a CD4+ T-cell count of >200 cells/microliter, history of acute HIV infection d. Infection with HIV, history of HIV infection and T-cell count below 200 cells/microliter 2. The nurse observes precaution in caring for Mr. X as HIV is most easily transmitted in: a. Vaginal secretions and urine b. Breast milk and tears c. Feces and saliva d. Blood and semen 3. Nurse Jaja is giving an injection to Ms. X. After giving an injection, the nurse accidentally stuck her finger with the needle when t he client became very agitated. To determine if the nurse became infected with HIV when is the best time to test her for HIV antibodies? a. Immediately and repeat the test after 12 weeks b. Immediately and repeat the test after 4 weeks c. After a week and repeat the test in 4 months d. After a weeks and repeat the test in 6 months 4. The blood test first used to identify a response to HIV infection is: a. Western blot b. ELISA test c. CD4+ T-cell count d. CBC 5. What is the main reason why it is difficult to develop a vaccine against HIV? a. HIV is still unknown to human b. HIV mutates easily c. HIV spreads rapidly throughout the body d. HIV matures easily 6. Human Immunodeficiency virus belongs to which classifications? a. Rhabdovirus b. Rhinovirus c. Retrovirus d. Rotavirus 7. Which organ is responsible for stimulating the pro duction of red blood cells? a. Yellow marrow b. Red marrow c. Spleen d. Kidney
8.
In anemia, which of the following blood components is decreased? a. Erythrocytes b. Granulocytes c. Leukocytes d. Platelets 9. The precursor of red blood cells is called: a. T cells b. B cells c. Stem cells d. Macrophage 10. In erythropoiesis, the sequence of erythrocyte formation is chronologically described in which option? a. Stem cells, erythroblast, reticulocyte, erythrocytes b. Stem cells, reticulocyte, erythroblast, erythrocytes c. Erythroblast, stem cells, reticulocyte, erythrocytes d. Erythroblast, reticulocyte, stem cells, erythrocytes 11. Which of the following is true of red blood cell? a. It is nucleated. b. It has a lifespan of 100 days c. It¶s production and formation depends o n the action of the kidney d. It is produced in the yellow marrow 12. Which type of immunoglobulin passes or crosses the placenta starting at the first trimester of pregnancy? a. IgG b. IgA c. IgM d. All of these 13. The first immunoglobulin produced by the body when the neonate is distressed, has acquired an infection or is challenged is: a. IgG b. IgA c. IgM d. All of these 14. Which of the following is essential for the hemoglobin synthesis during RBC production? a. Folic Acid b. Iron c. Vitamin B12 d. All of these
15. The age group most at risk for developing anemia is: a. 20-25 years old b. 26-32 years old c. 40-50 years old d. >65 years old 16. Decreased number of platelets is called: a. Thrombectomy b. Thrombocytopenia c. Thrombocytopathy d. Thrombocytosis 17. To improve the platelet count of a patient with an idiopathic thrombocytopenic purpura, this medication should be given: a. Vitamin K b. Methotrexate c. Corticosteroid d. Acetylsalicylic Acid 18. B-cells are involved in which o f the following types of immunity? a. Humoral immunity b. Cell-mediated immunity c. Antigen-mediated immunity d. All of these 19. What is the life span of normal platelets? a. 3-4 months b. 1-2 months c. 1-3 days d. 7-10 days 20. A patient is diagnosed with a systematic lupus erythematous (SLE). SLE primarily attacks which tissues? a. Heart b. Lung c. Nerve d. Connective 21. A sign of neurologic involvement in SLE is manifested by: a. CVA b. Infection c. Psychosis d. Facial tic
22. A classic sign of SLE is: a. Rashes over the cheeks and nose b. Weight loss c. Vomiting d. Difficulty urinating 23. A laboratory test result that supports the diagnosis of SLE is: a. Leukocytosis, elevated BUN and CREA b. Pancytopenia, elevated antinuclear antibody (ANA) titer c. Thrombocytosis, elevated ESR d. None of these 24. Which food should a client with leukemia avoid? a. Wheat bread b. Steak c. Orange d. All of these 25. The average length of time from HIV infection to the development o f AIDS is? a. Less than 3 years b. 5-7 years c. 10 years d. More than 10 years 1. Answer C. The three cr iteria for a client to be diagnosed with AIDS are the following: HIV positive CD4+ T-cell count below 200 cells/microliter Have one or more specific conditions that include acute infection of HIV 2. Answer D. Keyword: MOST EASILY. Rat ionale: HIV is MOST EASILY transmitted in blood, semen and vaginal secret ions. However, it has been noted to be found in fecal materials, urine, saliva, tears and breast milk. 3. Answer A. Keyword: BEST TIME. Rationale: To determine if a preexisting infection is present a test should be done immediately and is repeated again in 3 months time (12 weeks) to detect seroconversion as a result of the needle st ick. 4. Answer B. Keyword: FIRST. Rationale: The ELISA test is the first screening test for HIV. A Western blot test confirms a positive ELISA test. Other blood tests that support the diagno sis of HIV include CD4+ and CD8 + counts, CBC, immunoglobulin levels, p24 antigen assay, and quantitative ribonucleic acid assays. 5. Answer B. Keyword: MAIN REASON. Rationale: HIV was identified in 1983, thus, A is incorrect. By 1988 two strains of HIV existed, HIV-1 and HIV-2. Viruses spread rapidly and mature easily but these factors don¶t affect the potential for development against HIV. Mutating too easily makes it hard to create a vaccine against it.
6. Answer C. Rationale: HIV is a retrovirus that has a ribonucleic acid dependent reverse transcriptase. 7. Answer D. Keyword: STIMULATING THE PRODUCTION OF RBC. Rat ionale: Kidneys produce and release the hormone erythropoietin that is responsible for initiating the production of RBCs in the red marrow, thus, the correct answer is D. The Red Marrow is the site of RBC production. The spleen is responsible for removing the damage RBC. 8.
Answer A. Rationale: Anemia is character ized by a decreased in the number of RBCs.
9. Answer C. Keyword: PRECURSOR. Rationale: the precursor of RBC is the stem cells in the red marrow. 10. Answer A. Rationale: Stem cells ± erythroblast- reticulocyte ± erythrocytes. Erythropoietin is the hormone that stimulates red blood cell production in the red marrow. Mature red b lood cells are formed from stem cells in the bone marrow. With the presence of erythropoietin, red cell pathway starts to form proerythroblast from stem cells. At this point the ce ll still contains nucleus. However, as the development progresses the nucleus becomes smaller and the cytoplasm becomes basophilic due to the presence of ribosome, thus the cell is now called basophilic erythroblast. As the cell becomes older it a lso becomes smaller and eventually when it begins to produce hemoglobin it is now termed as polychromatic erythroblast. Later on the cytoplasm will become more eosinophilic and the cell is now called orthochro matic erythroblast, which will then extrude its nucleus as the cells slowly fill with hemoglobin before entering the circulation as reticulocytes. Reticulocytes will mature to form the anucleat ed red blood cells. 11. Answer C. Keyword: TRUE. Rationale: Kidneys produce and release the hormone erythropoietin that is responsible for initiating the production of RBCs in the red marrow. Red blood cells are anucleated cells (without nucleus) and have a life span of 120 days or 4 months. 12. Answer A. Keyword: PASSES/CROSSES THE PLACENTA. Rationale: There is only one immunoglobulin that passes or crosses that placenta, the IgG. IgG starts to cross the placenta at the first trimester of pregnancy. However, the largest amount of IgG transfer is noted during the third trimester of pregnancy. This type of immunog lobulin provides the fetus a passive immunity to possible bacterial and viral infections. However, the p assive immunity it provides is only temporary. The immunity gradually disappears at about 6 to 8 months of life. The gradual disappearance of passive immunity, leads to the gradual production of larger quantities of immunoglobulin to replace the IgG from the mother. 13. Answer C. Keyword: FIRST IMMUNOGLOBULIN PRODUCED BY THE BODY. Rationale: IgM is the first immunoglobulin produced by the body when the neonate is distressed, has acquired an infection or is challenged. When a newborn is exposed to environmental antigens, production of IgM rapidly increases. T his type of immunoglobulin provides protection from gram-negative bacteria. IgM cannot cross t he placental barrier. In cases where large amount of IgM is found in the placenta, possible exposure to infection in the ut ero is probable
14. Answer B. Keyword: HEMOGLOBIN SYNTHESIS. Rationale: Dietary elements are essential for RBC production. The following are needed by the red marrow to produce erythrocytes: Iron ± for hemoglobin synthesis Folic Acid ± for DNA synthesis Vitamin B12 ± for DNA synthesis 15. Answer D. Keyword: MOST AT RISK. Rationale: The elderly are most at risk for anemia often due to financial concerns affecting protein intake or poor dentition that interferes with chewing meat. 16. Answer B. Keyword: DECREASED NUMBER OF PLATELETS. Rationale: thrombocytopenia is a decreased number o f platelets. Thrombocytosis is an excess in the number of platelets. Thrombocytopathy is a platelet dysfunction. Thrombectomy is the surgical removal of a thrombus. 17. Answer C. Rationale: TO IMPROVE PLATELET COUNT. Rationale: Corticosteroid therapy can decrease antibody production and phagocytosis of the antibody-coated platelets, retaining more functioning platelets. Methotrexate can cause t hrombocytopenia. Vitamin K is used to treat an excessive anticoagulable state from warfarin overload, and ASA decreases platelet aggregation. 18. Answer A. Keyword: B-CELLS. Rationale: B-Cells are responsible for humoral or immunoglobulin mediated immunity. T-cells are responsible for cell-mediated immunity. There is such thing as antigen-mediated immunity. 19. Answer D. Rationale: The life span of a normal platelet is 7-10 days. However, in idiopathic thrombocytopenia the life span is reduced to 1-3 days. 20. Answer D. Keyword: PRIMARILY. Rationale: SLE is a chronic, inflammatory, autoimmune disorder affecting primarily the connective tissues. It also affects the skin and k idneys and may affect the pulmonary, cardiac, neural and renal systems. 21. Answer C. Keyword: NEUROLOGICAL INVOLVEMENT. Rationale: neurologic involvement may be shown by: Psychosis Seizures Headaches 22. Answer A. Keyword: CLASSIC SIGN. Rationale: Although all these symptoms can be signs of SLE, the classic sign is the butterfly rash over the cheeks and nose. 23. Answer B. Keyword: SUPPORTS THE DIAGNOSIS. Rationale: lab findings for clients with SLE usually show: Pancytopenia
Elevated ANA titer Decreased serum complement levels 24. Answer C. Keyword: AVOID. Rationale: a low-bacteria diet would be indicated. Raw fruits and vegetables are excluded in the client¶s diet. 25. Answer C. Keyword: AVERAGE LENGTH OF TIME. Rationale: epidemiologic studies show the average time from initial contact with HIV to the development of AIDS is 10 years.
