A 20-year-old patient has a family history of colon cancer. Genetic testing shows he has the gene for familial adenomatous polyposis. What should the nurse teach the patient to do?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Have annual colonoscopies. The rationale behind this is rooted in the understanding of familial adenomatous polyposis (FAP), which is an inherited condition that predisposes individuals to developing numerous polyps in the colon, leading to a significantly increased risk of developing colon cancer. By having annual colonoscopies, the patient can undergo regular monitoring to detect and remove any polyps early, thus reducing the risk of developing colon cancer. Option A) Change his diet is incorrect because while a healthy diet is important for overall well-being, it is not the primary intervention for managing FAP. Option C) Consider a referral for gene therapy is not typically the first-line approach for FAP management. Regular surveillance through colonoscopies is the standard of care. Option D) Not to have children so they will not be affected is not a necessary or appropriate recommendation. Genetic counseling may be beneficial for family planning discussions, but it is not the immediate priority in managing FAP. In an educational context, it is crucial for healthcare providers to understand the specific management strategies for genetic conditions like FAP. Teaching patients about the importance of regular screenings and interventions can significantly impact their long-term health outcomes and quality of life. Empowering patients with knowledge about their condition and appropriate management strategies is a key aspect of patient-centered care in pharmacology and healthcare in general.

Correct Answer: C

Rationale: The correct answer is C) It stimulates increased IgG to bind with allergen-reactive sites, preventing mast cell-bound IgE reactions. Explanation: Immunotherapy for atopic allergies involves introducing increasing doses of allergen to the patient to desensitize their immune system. This process aims to stimulate the production of allergen-specific IgG antibodies that compete with IgE antibodies for allergen binding sites. By binding to these sites, IgG prevents the allergen from triggering mast cell degranulation and the release of inflammatory mediators, thus reducing allergic reactions. Why others are wrong: A) Decreasing levels of allergen-specific T helper cells (Option A) does not directly address the mechanism of action of immunotherapy for atopic allergies. B) Decreasing the level of IgE (Option B) is not the primary goal of immunotherapy; the focus is on increasing IgG levels to outcompete IgE for allergen binding. D) Gradually increasing the amount of allergen in the body (Option D) is correct in principle, but the key factor in immunotherapy success is the production of allergen-specific IgG, not the allergen's recognition by the body. Educational context: Understanding the rationale behind immunotherapy for atopic allergies is crucial for pharmacology students and healthcare professionals. It demonstrates the practical application of immunological principles in treating allergic conditions and highlights the importance of inducing a shift from an IgE-mediated response to an IgG-mediated response to allergens. This knowledge helps in providing effective patient care and managing allergic diseases more efficiently.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) Transplanted bone marrow is rejecting her tissue; prevent with immunosuppressive agents. Explanation: When a patient undergoes a bone marrow transplant, there is a risk of graft-versus-host disease (GVHD), where the transplanted immune cells attack the recipient's tissues. Symptoms of GVHD include rash, itching, and abdominal pain. The treatment for GVHD involves using immunosuppressive agents to prevent the transplanted cells from attacking the recipient's tissues. Why other options are wrong: A) Graft rejection occurring; treat with different immunosuppressive agents - This is incorrect as the symptoms described are indicative of GVHD, not graft rejection. B) Dry skin and nausea are side effects of immunosuppressants; decrease the dose - This is incorrect as the symptoms are more likely due to GVHD rather than side effects of immunosuppressants. D) Dry skin from the dry air and nausea from the food in the hospital; treat with humidifier and home food - This is incorrect as the symptoms are not likely related to environmental factors but rather to the immune response post-transplant. Educational context: Understanding the complications and management of bone marrow transplants, including GVHD, is crucial for healthcare professionals involved in caring for transplant patients. Recognizing the signs and symptoms of GVHD and knowing the appropriate treatment options is essential for ensuring the best outcomes for patients undergoing bone marrow transplants.

Correct Answer: B

Rationale: In the context of HIV infection, the characteristic that corresponds with the acute stage is the temporary fall of CD4+ T cells, making option B the correct answer. During the acute stage of HIV infection, there is a rapid and significant decrease in the number of CD4+ T cells in the body as the virus infects and replicates within these immune cells. This temporary fall in CD4+ T cells is a hallmark of the early phase of HIV infection. Option A, Burkitt's lymphoma, is a type of cancer associated with Epstein-Barr virus infection, not directly related to the acute stage of HIV. Option C, persistent fevers and night sweats, are more indicative of the chronic stage of HIV when the immune system is significantly compromised. Option D, Pneumocystis jiroveci pneumonia, is an opportunistic infection that typically occurs in the later stages of HIV when the immune system is severely weakened. Educationally, understanding the progression of HIV infection is crucial for healthcare professionals to provide appropriate care and treatment to patients. Recognizing the characteristics of each stage of HIV infection helps in early detection, monitoring disease progression, and implementing timely interventions to manage the condition effectively. By knowing the specific features of the acute stage, healthcare providers can initiate interventions to slow down the progression of the disease and improve patient outcomes.

Correct Answer: C

Rationale: The correct answer is C) vaccines for pneumococcal pneumonia, influenza, and hepatitis A and B. Explanation: In HIV infection, the immune system is compromised, making individuals more susceptible to infections. Administering vaccines against these specific pathogens helps prevent serious secondary problems by bolstering the immune response against these infectious agents. Pneumococcal pneumonia, influenza, and hepatitis A and B are common infections that can have severe consequences in immunocompromised individuals. By vaccinating early in HIV infection, the chances of developing these infections are significantly reduced, leading to better health outcomes. Why the other options are wrong: A) Isoniazid (INH) is used to prevent tuberculosis, which is not a routine prophylactic measure in early HIV infection. B) Trimethoprim/sulfamethoxazole (TMP/SMX) is used for preventing certain opportunistic infections but not as a routine prophylactic measure in early HIV infection. D) Varicella-zoster immune globulin (VZIG) is used to prevent chickenpox or shingles but is not routinely administered in early HIV infection for prophylaxis against opportunistic infections. Educational context: Understanding the importance of prophylactic measures in HIV infection is crucial for healthcare providers managing patients with HIV. Vaccination plays a key role in preventing opportunistic infections and improving the overall health outcomes of individuals living with HIV. It is essential to prioritize early intervention strategies like vaccination to protect against common pathogens and reduce the burden of secondary complications in this vulnerable population.