LPN exams medical-surgical practice questions set 9

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The correct answer is B: Systemic release of vasoactive mediators. Anaphylaxis is a severe allergic reaction that is primarily caused by the systemic release of vasoactive mediators such as histamine, prostaglandins, and leukotrienes from mast cells and basophils. These mediators lead to widespread vasodilation, increased vascular permeability, bronchoconstriction, and systemic hypotension, resulting in the characteristic symptoms of anaphylaxis. Choice A (Immune complex deposition) is incorrect because anaphylaxis is not caused by the deposition of immune complexes but rather by the immediate hypersensitivity reaction. Choice C (Localized mast cell degranulation) is incorrect because anaphylaxis involves systemic mast cell degranulation leading to widespread effects throughout the body, not just localized reactions. Choice D (T cell activation) is incorrect because anaphylaxis is primarily mediated by IgE antibodies and mast cells, not T cells.

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The integument performs diverse physiological roles. It eliminates salts, urea, and uric acid through sweat, a minor excretory function alongside the kidneys. It absorbs fat-soluble vitamins (e.g., A, D, E, K), steroids, and toxins through its lipid-rich layers, as seen in transdermal drug delivery. The hypodermis stores lipids as adipose tissue, providing energy and insulation. However, the skin does not synthesize proteins and carbohydrates. It produces keratin (a protein) and vitamin D (a sterol), but this involves assembly from dietary precursors, not de novo carbohydrate or protein synthesis, which occurs in the liver or muscles. Keratin forms via epidermal differentiation, not true synthesis, and carbohydrates are not made in skin cells. This limitation reflects the integument's specialized roles protection, sensation, and minor excretion versus metabolic organs' broader synthetic capacities, making this the impossible function among the options.

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The correct answer is C: Identifying and eliminating abnormal cells. This function is most relevant to cancer because the immune system's ability to recognize and destroy abnormal cells is crucial in preventing the development and spread of cancer. The immune system constantly surveys the body for cells that have mutated or become cancerous, and when identified, it initiates an immune response to eliminate them. This process is essential for maintaining the body's health and preventing cancerous cells from proliferating. Choice A (Suppressing cytokine release) is incorrect because cytokines play a role in regulating the immune response, which can be important in cancer immunity. Choice B (Promoting adaptive immunity only) is incorrect as both innate and adaptive immune responses are involved in combating cancer. Choice D (Limiting the effectiveness of phagocytes) is incorrect as phagocytes are important in recognizing and destroying cancer cells.

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The correct answer is D: Treating the fever before beginning the therapy. Fever can be a sign of infection or other serious underlying issues. Before starting the infusion, it is crucial to address the fever to prevent potential complications. The step-by-step rationale is: 1. Assess the patient's vital signs - In this case, the patient has a temperature of 101.5°F. 2. Recognize the significance of fever - Fever can indicate infection or other health concerns. 3. Prioritize patient safety - Treating the fever before starting the infusion ensures the patient's well-being. 4. Prevent potential adverse reactions - Infusing tositumomab with a fever could exacerbate the patient's condition. 5. Collaborate with the healthcare team - Once the fever is treated, the therapy can be safely initiated. Incorrect Choices: A: Holding the infusion until the patient is afebrile - This delays necessary treatment and does not address the underlying issue causing

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The correct answer is A: Assess the client's lung sounds and oxygenation. This is the most appropriate action because Lisinopril, an ACE inhibitor, can cause a side effect of cough due to bradykinin accumulation in the lungs. This cough can indicate potential pulmonary edema or bronchospasm. Assessing lung sounds and oxygenation can help determine the severity of the cough and any respiratory distress. It is crucial to evaluate the client's respiratory status promptly to prevent further complications. Summary of other choices: B: Instructing the client on another antihypertensive is not appropriate without assessing the current situation. C: Obtaining vital signs is important but assessing the respiratory status takes precedence due to potential respiratory distress. D: Reminding the client about the side effect of Prinivil is not sufficient; the focus should be on evaluating the current cough and its impact on the client's respiratory status.

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Tattoo ink is injected into the dermis, the thick layer beneath the epidermis. The epidermis, the outermost layer, constantly renews itself, shedding dead cells from the stratum corneum every few weeks. If ink were placed here, it would fade quickly as cells slough off. The dermis, however, is stable, containing collagen, blood vessels, and nerves, and does not regenerate rapidly. Tattoo needles penetrate about 1-2 mm deep, depositing ink into this layer, where it remains trapped by fibroblasts and immune cells, ensuring permanence. The hypodermis (or subcutaneous layer, also listed as 'SubQ') lies deeper, storing fat, and is too far below the surface for tattoo visibility or precision. Injecting ink there would blur the design and miss the dermis's ideal depth. The dermis's vascularity can cause initial bleeding, but its stationary nature preserves the tattoo long-term, a fact exploited by tattoo artists globally, confirming it as the target layer.

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The correct answer is D: Performing hand hygiene. Hand hygiene is the most effective way to prevent the spread of infection in a healthcare setting. By washing hands thoroughly and regularly, healthcare workers can reduce the transmission of pathogens between patients and themselves. This is crucial in preventing healthcare-associated infections. Raising the temperature in each client's room (Choice A) is not an effective method for preventing infection transmission. Assessing vital signs once daily (Choice B) is important for monitoring patient health but is not directly related to preventing infection. Wearing a mask for client care (Choice C) is important in certain situations, but hand hygiene is a more universal and crucial practice for infection prevention. In summary, performing hand hygiene is the priority teaching point as it is the most effective and fundamental measure in preventing infection transmission in a healthcare setting.

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Rationale for Choice A (Pelvic ultrasound): - Pelvic ultrasound is the most appropriate initial step for evaluating a 50-year-old woman with abdominal and adnexal fullness to assess for gynecologic issues like ovarian cysts, fibroids, or tumors. - It is non-invasive, cost-effective, and can provide valuable information about the structures in the pelvis. - It helps to visualize the ovaries and uterus, guiding further management decisions based on the findings. Summary of other choices: - Choice B (CA-125 antigen levels): While CA-125 is a tumor marker often elevated in ovarian cancer, it is not specific and can be elevated in other conditions. It is not the initial step in this case. - Choice C (Surgery): Surgery should not be the first step without proper diagnostic evaluation with imaging studies. - Choice D (CT scan of abdomen): CT scan may provide detailed information but is not the initial diagnostic modality for evaluating adnexal full

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The correct answer is B: Provide the child with play situations that allow for disclosure. This intervention is crucial as it provides a safe and non-threatening environment for the child to express their feelings and disclose any abuse they may have experienced. By engaging the child in play situations, the child may feel more comfortable opening up about the abuse. A: Avoid touching the child - This is incorrect as it does not address the child's emotional needs or provide an opportunity for the child to communicate about the abuse. C: Discourage the child from remembering the incident - This is incorrect as it can hinder the child's healing process and prevent them from receiving appropriate support and intervention. D: Deny the suspected perpetrator visiting rights to the child - While this may be necessary for the child's safety, it does not directly address the child's emotional needs or provide a supportive environment for disclosure.

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The correct answer is B: It is a dynamic field, continually evolving through research. Immunology is constantly evolving due to new discoveries and advancements in technology. Research in immunology leads to a deeper understanding of the immune system and its interactions with pathogens, cancer, and other diseases. This ongoing evolution is essential for the development of new treatments and vaccines. Explanation of why other choices are incorrect: A: It is largely static, with few modern discoveries - This is incorrect as immunology is a rapidly advancing field with numerous breakthroughs and discoveries. C: It exclusively studies pathogen biology - This is incorrect as immunology also encompasses the study of the immune system's responses to various stimuli, not just pathogens. D: It focuses solely on innate immunity - This is incorrect as immunology covers both innate and adaptive immunity, as well as the interactions between them.