Which of the following patients is most likely to benefit from transportation of thymic tissue or major histocompatibility complex ( MHC) – compatible bone marrow?
A 12-year-old girl with a history of epilepsy and low IgG levels secondary to phenytoin use
A 7-year-old boy whose blood work indicates decreased IgA and IgG with increased IgM
A 6-year-old boy whose pre-B cells are incapable of translation to normal B cells
A 9-year-old girl who has a diagnosis of IgA deficiency
As part of his diagnostic workup, a 77 yo man nurse practitioner has ordered blood work that includes ferritin levels. The man is very interested in the details of his health care is unfamiliar with ferritin and it’s role. Which of the following explanations by the nurse practitioner is most accurate?
“Ferritin is the activated and usable form of iron that your red blood cells can use to transport oxygen.”
“Ferritin is a stored form of iron that indirectly shows me whether you would benefit from iron pills.”
“Ferritin is a protein-iron complex that allows your red blood cells to make use of the iron that you consume in your diet.”
“Ferritin is the form of iron that is transported in your blood plasma to the red blood cells that need it.”
The blood work of a 44 yo male with a diagnosis of liver disease secondary to alcohol abuse indicates low levels of albumin. Which of the following phenomena would a clinician be most justified in anticipating?
Impaired immune function
A 14 yo boy has been diagnosed with infectious Mono.Which of the following pathophysiological phenomena is most responsible for his symptoms?
The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.
Viruses are killing some of his B cells and becoming incorporated into the genome of others.
The EBV inhibits the maturation of white cells within his peripheral lymph nodes.
The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.
Which of the following phenome would be least likely to result in activation of the complement system?
Recognition of an antibody bound to the surface of a microbe
Increase in tissue blood flow and capillary permeability, so fluids/proteins can leak into the area
Activation of toll-like receptors (TLRs) on complement proteins
Direct recognition of microbial proteins
Following a course of the measles a 5yo girl developed scattered bruising over numerous body surfaces and was diagnosed with immune thrombocytopenia purpura (ITP). Diagnostic workup, blood work was performed.Which results is most likely to be considered unexpected by the health care team
Increased thrombopoietin levels
Decreased platelet count
Normal vitamin K levels
Normal leukocyte levels
A patient presented to the ED with a swollen, reddened, painful leg wound , diagnosed with MRSA cellulitis. The nurse practitioner ordered a CBC and white cell diff. Which of the following blood components would the nurse anticipate to be elevated?
A nurse practitioner is explaining to a 40 yo male pt the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the NP explanation?
Tissue destruction results from neutrophil deactivation.
Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.
Macrophages are unable to digest the bacteria, resulting in immune granulomas.
Neutrophils are ineffective against the Mycobacterium tuberculosis antigens
A 29 yo construction worker got silver under his fingernail 4 days ago. The affected finger is reddened, painful, swollen, and warm. Which of the following hematological processes is most likely occurring in response to the infection?
Proliferation of immature neutrophils
High circulatory levels of myeloblasts
Increased segmented neutrophil production
Phagocytosis by myelocytes
Which of the following patients would the student recognize as being least likely to have a diagnosis of antiphospholipid syndrome in his or her medical historory?
A 66-year-old obese male with left-sided hemiplegia secondary to a cerebrovascular accident
A 90-year-old female resident of a long-term care facility who has been experiencing transient ischemic attacks
A 30-year-old female with a diagnosis of left leg deep vein thrombosis and a pulmonary embolism
A 21-year-old male with a diagnosis of cellulitis and suspected endocarditis secondary to intravenous drug use
A couple who are expecting their first child have been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their NP with this request and are seeking clarification of exactly why stem cells are valuable.How can the nurse practitioner best respond to the couple’s inquiry?
Stem cells can help correct autoimmune diseases and come congenital defects
Stem cells can be used to regenerate damaged organs should the need ever arise
Stem cells can be used as a source of reserve cells for the entire blood production system
Stem cells can help treat some cancers and anemias, but they must come from your child himself or herself"
A 16 yo female has been brought to her primary NP by her mother due to perisistent sore throat and malaise. Which of the following facts revealed in the girl history and exam would lead the NP to r/o infectious mononucleosis?
The girl has a temperature of 38.1 °C (100.6 °F) and has enlarged lymph nodes.
Her liver and spleen are both enlarged.
Blood work reveals an increased white blood cell count.
Chest auscultation reveals crackles in her lower lung fields bilaterally.
A 60 yo woman is suspected of having non-Hodgkin lymphoma (NHL). Which of the following aspects of her condition would help to r/o Hodgkin lymphoma?
Her neoplasm originates in secondary lymphoid structures.
The lymph nodes involved are located in a large number of locations in the lymphatic system.
The presence of Reed-Sternberg cells has been confirmed.
The woman complains of recent debilitating fatigue.
A NP is providing prenatal care and eduction for a first-time expectant mother, 22 wks gest, who has a diagnosis of a STD. Which of the following statements by the expectant mother demonstrates an adequate understanding of vertical disease transmission and congenital infections?
“Gonorrhea and chlamydia pose the greatest risks of transmission from mother tochild.”
“I know that my baby will need observation for HIV signs and symptoms in the weeks following my delivery.”
“My baby could become infected either across the placenta or during the birth itself.”
“Prophylactic immunization will reduce my baby's chance of being born with an illness.”
A 71 yo male pt w/ a hx of MI and peripheral vascular disease has been advised by his NP to begin taking 81 mg of ASP once daily.Which of the underlying rationale for the NP suggestion?
Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.
Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation
Which of the following statements most accurately conveys an aspect of lymphatic system activity?
B and T lymphocyte development begins in the bone marrow and ends in the peripheral lymphoid structures.
B cells and macrophages are released from the bone marrow in their completed state.
Stem cells in the lymph nodes initiate and regulate the process of white cell synthesis.
Leukocytes bypass vascular circulation and are distributed instead by the lymphatic system.
A 23 yo man has received a recent dx of appendicitis following 24 hrs of acute abd pain. The NP providing care for the man is explaining that while it is unpleasant, the inflammation of his appendix is playing a role in his body’s fight against the underlying infectious process.Which of the following teaching points should the NP eliminate from his teaching for the patient?
“Inflammation can help to remove the body tissue cells that have been damaged by infection.”
“Inflammation will start your body on the path to growing new, healthy tissue at thesite of infection.”
“Inflammation helps your body to produce the right antibodies to fight the infection.”
“Inflammation ultimately aids in eliminating the initial cause of the cell injury in your appendix.”
A 66yo female pt has presented to the ED w/ several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed w/ a GI bleed secondary to overuse of NSAIDs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely?
The woman has depleted blood volume due to her ongoing blood loss.
She will have iron deficiency anemia due to depletion of iron stores.
The patient will be at risk for cardiovascular collapse or shock.
She will have delayed reticulocyte release.
A 40 yo woman experiences severe seasonal allergies has been referred by her family physician to an allergist for weekly allergy injections. The woman is confused as to why repeated exposure to substances that set off her allergies would ultimately benefit her. Which of the following phenomena best captures the rationale for allergy desensitization therapy?
Repeated exposure to offending allergens binds the basophils and mast cells that mediate the allergic response.
Allergens in large, regular quantities overwhelm the IgE antibodies that mediate the allergic response.
Repeated exposure stimulates adrenal production of epinephrine, mitigating the allergic response.
Injections of allergens simulate production of IgG, combining with the antigens to prevent activation of IgE antibodies.
A 44 yo female patient presents to the ED with abnormal bleeding and abd pain that is later attributed to gallbladder disease.Which of the following diagnoses would the medical team be most justified in suspecting as a caus of the patient’s bleeding?
Vitamin K deficiency
Idiopathic immune thrombocytopenic purpura (ITP).
A NP is teaching her colleagues about the role of cytokines in a variety of pathologies. Which of the following teaching points best captures an aspect of the functions and nature of cytokines?
“A particular cytokine can have varied effects on different systems, a fact that limits their therapeutic use.”
“Cytokine production is constant over time, but effects are noted when serum levels cross a particular threshold.”
“Most cytokines are produced by granular leukocytes, and different cells are capable of producing the same cytokine.”
“Cytokine actions are self-limiting in that activation of one precludes activation of other cytokines with similar actions.”
A 24 yo woman presents with fever and painful, swollen cervical lymph nodes. Her blood work indicates neutrophilia with a shift to the left. She most likely has:
a mild parasitic infection.
a severe bacterial infection.
a mild viral infection.
a severe fungal infection.
A tourist presented to a primary care health clinic complaining of malaise, fever, and headache. She has been diagnosed with Rocky Mountain Spotted fever, a pathology caused by Rickettsiaceae. Which of the following statements best captures a characteristic trait of Rickettsiaceae?
They are eukaryotic.
They have both RNA and DNA.
They have a distinct spiral-shaped morphology.
They are neither gram-negative nor gram-positive
A 22 yo female who adheres to a vegen diet has been diagnosed with iron-deficiency anemia. Which of the following componets of her diagnostic blood work would be most likely to necessitate further investigation?
Decreased mean corpuscular volume (MCV)
Decreased hemoglobin and hematocrit
Microcytic, hypochromic red cells
Decreased erythropoietin levels
Sputum samples from a pt with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This pneumonia is most likely:
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- Submitted On 02 Aug, 2018 03:27:55