diagnosis of myasthenia gravis
A 22-year-old female college student is shocked to receive a diagnosis of myasthenia gravis. What are the etiology and most likely treatment for her health problem?
A. Excess acetylcholinesterase production; treatment with thymectomy
B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins
C. Cerebellar lesions; surgical and immunosuppressive treatment
D. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids
A baseball player was hit in the head with a bat during practice. In the emergency department, the physician tells the family that he has a “coup”injury. How will the nurse explain this to the family so they can understand?
A. “It’s like squeezing an orange so tight that the juice runs out of the top.”
B. “When the bat hit his head, his neck jerked backward causing injury to the spine.”
C. “Your son has a contusion of the brain at the site where the bat hit his head.”
D. “Your son has a huge laceration inside his brain where the bat hit his skull.”
Which of the following glycoproteins is responsible for treating such diseases as bone marrow failure following chemotherapy and hematopoietic neoplasms such as leukemia?
A. Growth factors and cytokines
B. T lymphocytes and natural killer cells
C. Neutrophils and eosinophils
D. Natural killer cells and granulocytes
While being on subcutaneous heparin injections for deep vein thrombosis during her latter pregnancy, a patient begins to experience major side effects. Her OB-GYN physician has called in a specialist who thinks that the patient is experiencing heparin-induced thrombocytopenia. The nurse should anticipate which of the following orders?
A. Immediately discontinue the heparin therapy
B. Switch to Coumadin 2.5 mg once/day
C. Decrease the dose of heparin from 5000 units b.i.d to 3000 units b.i.d
D. Infuse FFP stat
Which of the following individuals would most likely experience global ischemia to his or her brain?
A. A woman who is being brought to hospital by ambulance following suspected carbon monoxide poisoning related to a faulty portable heater
B. A male client who has just had an ischemic stroke confirmed by CT of his head
C. A woman who has been admitted to the emergency department with a suspected intracranial bleed
D. A man who has entered cardiogenic shock following a severe myocardial infarction
A new mother and father are upset that their 2-day-old infant is requiring phototherapy for hyperbilirubinemia. The pediatrician who has followed the infant since birth is explaining the multiplicity of factors that can contribute to high serum bilirubin levels in neonates. Which of the following factors would the physician be most likely to rule out as a contributor?
A. Transitioning of hemoglobin F (HbF) to hemoglobin A (HbA)
B. Hepatic immaturity of the infant
D. The fact that the infant is being breast-fed
A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms?
A. Viruses are killing some of his B cells and becoming incorporated into the genome of others.
B. The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.
C. The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
D. The EBV inhibits the maturation of white cells within his peripheral lymph nodes.
A 16-year-old female has been brought to her primary care physician by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the physician to rule out infectious mononucleosis?
A. Chest auscultation reveals crackles in her lower lung fields bilaterally.
B. Her liver and spleen are both enlarged.
C. Blood work reveals an increased white blood cell count.
D. The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.
A 30-year-old woman who has given birth 12 hours prior is displaying signs and symptoms of disseminated intravascular coagulation (DIC). The client’s husband is confused as to why a disease of coagulation can result in bleeding. Which of the nurse’s following statements best characterizes DIC?
A. “The same hormones and bacteria that cause clotting also cause bleeding.”
B. “Massive clotting causes irritation, friction, and bleeding in the small blood vessels.”
C. “So much clotting takes place that there are no available clotting components left, and bleeding ensues.”
D. “Excessive activation of clotting causes an overload of vital organs, resulting in bleeding.”
A 20-year-old has been diagnosed with an astrocytic brain tumor located in the brain stem. Which of the following statements by the oncologist treating the client is most accurate?
A. “Our treatment plan will depend on whether your tumor is malignant or benign.”
B. “This is likely a result of a combination of heredity and lifestyle.”
C. “The major risk that you face is metastases to your lungs, liver, or bones.”
D. “Your prognosis will depend on whether we can surgically resect your tumor.”
A patient diagnosed with low-risk chronic lymphocytic leukemia (CLL) has recently developed thrombocytopenia. One of the medications utilized to treat this would be
A. cisplatin, a chemotherapeutic.
B. vincristine, a Vinca alkaloid.
C. dexamethasone, a corticosteroid.
D. doxorubicin, a cytotoxic antibiotic.
Two nursing students are attempting to differentiate between the presentations of immune thrombocytopenic purpura (ITP) and thrombotic thrombocytopenic purpura (TTP). Which of the students’ following statements best captures an aspect of the two health problems?
A. “ITP can be either inherited or acquired, and if it’s acquired, it involves an enzyme deficiency.”
B. “Both of them involve low platelet counts, but in TTP, there can be more, not less, hemostasis.
C. “TTP can be treated with plasmapheresis, but ITP is best addressed with transfusion of fresh frozen plasma.”
D. “Both diseases can result from inadequate production of thrombopoietin by megakaryocytes.”
A physician is explaining to a 40-year-old male patient the importance of completing his course of antibiotics for the treatment of tuberculosis. The physician explains the damage that could occur to lung tissue by Mycobacterium tuberculosis. Which of the following phenomena would underlie the physician’s explanation?
A. Tissue destruction results from neutrophil deactivation.
B. Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.
C. Macrophages form a capsule around the Mycobacterium tuberculosis bacteria, resulting in immune granulomas.
D. Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.
A teenager, exposed to West Nile virus a few weeks ago while camping with friends, is admitted with headache, fever, and nuchal rigidity. The teenager is also displaying some lethargy and disorientation. The nurse knows which of the following medical diagnoses listed below may be associated with these clinical manifestations?
B. Lyme disease
C. Rocky Mountain spotted fever
D. Spinal infection