A nurse is caring for a client who is in hypovolemic shock. While waiting for a unit of blood, the nurse should administer which of the following IV solutions?

Correct Answer: A

Rationale: The correct answer is A: 0.9% sodium chloride. In hypovolemic shock, there is a loss of blood volume, so isotonic solutions like 0.9% sodium chloride are ideal to expand intravascular volume and help improve perfusion. This solution closely resembles the electrolyte composition of plasma, making it effective for fluid resuscitation. Explanation for other choices: B: 5% dextrose in water - This solution is hypotonic and not ideal for fluid resuscitation in hypovolemic shock as it may worsen the condition by diluting the remaining blood volume. C: Lactated Ringer’s - While this solution is isotonic and contains electrolytes, it may not be the best choice for hypovolemic shock as it contains potassium and lactate which may not be ideal in this situation. D: 0.45% sodium chloride - This solution is hypotonic and may not provide adequate volume expansion needed

Correct Answer: A

Rationale: The correct answer is A: Retinal damage. Antimalarial DMARDs like hydroxychloroquine can cause retinal damage, leading to vision loss. This is a serious side effect because it can be irreversible and impact quality of life. Bone marrow suppression (B), pulmonary fibrosis (C), and hepatotoxicity (D) are potential side effects of other medications but are not commonly associated with antimalarial DMARDs. It is important to monitor patients on antimalarials for early signs of retinal damage to prevent permanent vision loss.

Correct Answer: A

Rationale: The correct answer is A: Colchicine. Colchicine is used for acute gout attacks as it reduces inflammation and pain by inhibiting the inflammatory response to urate crystals. Allopurinol, Febuxostat, and Probenecid are used for long-term management by lowering uric acid levels, not for acute attacks. Colchicine is the preferred choice for acute gout due to its anti-inflammatory effects.

Correct Answer: A

Rationale: The correct answer is A: Belimumab. Belimumab is a monoclonal antibody that specifically targets B-cell activating factor (BAFF) and is approved for the treatment of SLE. BAFF plays a role in B-cell survival and maturation, which are key factors in the pathogenesis of SLE. Methotrexate (B), Hydroxychloroquine (C), and Leflunomide (D) are also used in the treatment of SLE, but they do not specifically target the underlying mechanisms of the disease like Belimumab does. Methotrexate is more commonly used for arthritis in SLE, Hydroxychloroquine is used for mild SLE cases, and Leflunomide is used for rheumatoid arthritis.

Correct Answer: B

Rationale: The correct answer is B because Type II hypersensitivity reactions are mediated by immunoglobulins G or M, not just IgM alone. Step-by-step rationale: 1. Type I hypersensitivity: Correctly matched with examples like hay fever and anaphylaxis. 2. Type II hypersensitivity: Incorrectly matched with IgM, as it is mediated by IgG or IgM. 3. Type III hypersensitivity: Correctly matched with immune complex deposits in blood vessel walls. 4. Type IV hypersensitivity: Correctly matched with examples like poison ivy and transplant rejection. In summary, choice B is incorrect because it inaccurately describes the immunoglobulin involved in Type II hypersensitivity reactions.