A patient is diagnosed with selective IgA deficiency, a primary immunodeficiency disorder. Which of the following complications is most commonly associated with this condition?

Correct Answer: A

Rationale: Selective IgA deficiency is a primary immunodeficiency disorder characterized by low or absent levels of immunoglobulin A (IgA) in the blood. Since IgA plays a crucial role in mucosal immunity and defense against pathogens at mucosal surfaces, individuals with this deficiency are more susceptible to recurrent bacterial infections, particularly of the respiratory and gastrointestinal tracts. In contrast, severe combined immunodeficiency (SCID) is a more severe immunodeficiency disorder affecting T and B lymphocytes, chronic granulomatous disease (CGD) is a disorder of phagocytes, and autoimmune hemolytic anemia is an autoimmune disease involving red blood cells, none of which are directly associated with selective IgA deficiency.

Correct Answer: B

Rationale: The best response for the nurse in this situation would be to listen actively to the patient's concerns, acknowledge the lack of information, and offer to address the issue. It is important for healthcare providers to validate the patient's feelings and actively work towards resolving any issues that are causing frustration. By being empathetic and willing to address the problem, the nurse can help improve the patient's experience and build trust in the healthcare team. Dismissing or ignoring the patient's frustration can lead to further dissatisfaction and breakdown in communication. It is crucial for healthcare providers to prioritize open communication and address any concerns or lack of information promptly.

Correct Answer: B

Rationale: Malpractice is a type of tort that involves professional negligence or misconduct by a professional such as a nurse that results in harm to a patient. In this scenario, failing to obtain informed consent before performing a procedure is considered a breach of the standard of care expected from a healthcare professional, which falls under malpractice. This failure to obtain informed consent deprives the patient of the right to make an informed decision about their treatment and can lead to legal consequences for the nurse.

Correct Answer: A

Rationale: Tricyclic antidepressants (TCAs) are known to have anticholinergic effects, which can lead to various cardiovascular side effects, including orthostatic hypotension, tachycardia, and potential hypertension. While hypotension is a possible adverse effect, hypertension is more commonly associated with TCAs. Therefore, it is essential for the nurse to monitor the patient for signs of hypertension, such as elevated blood pressure readings, to prevent any adverse outcomes and ensure the patient's safety while on this medication.

Correct Answer: B

Rationale: The nurse's priority action after noticing a sudden drop in blood pressure after administering anesthesia is to assess the patient's airway, breathing, and circulation (ABCs). This is crucial to determine the immediate cause of the sudden drop in blood pressure and to ensure the patient's safety and stability. Assessment of the ABCs will help identify any potential airway obstruction, respiratory distress, or circulatory issues that may be contributing to the drop in blood pressure. Once the assessment is done, appropriate interventions can be initiated to stabilize the patient's condition. Administering vasopressors, documenting the blood pressure readings, and notifying the anesthesiologist are important actions but assessing the ABCs takes precedence in this situation to ensure the patient's immediate needs are addressed.

Correct Answer: C

Rationale: In a postpartum client exhibiting signs of anxiety, restlessness, and palpitations, it is essential to prioritize notifying the healthcare provider immediately. These symptoms could indicate a serious condition such as postpartum preeclampsia, postpartum hemorrhage, or postpartum cardiomyopathy, which require urgent medical attention. It is crucial to rule out any life-threatening conditions and ensure the client receives appropriate treatment promptly. While relaxation techniques and deep breathing exercises can be helpful for anxiety management in some cases, in this situation, the priority is to ensure the client's safety and well-being by seeking medical evaluation and intervention. Administering a benzodiazepine without consulting the healthcare provider first could potentially mask symptoms or interact with other medications the client may be taking, making it unsafe to proceed without professional guidance.

Correct Answer: D

Rationale: Respiratory depression resulting from drug overdose typically leads to a decrease in the respiratory rate, known as bradypnea. This is characterized by abnormally slow breathing, which can be dangerous as it may lead to decreased oxygen levels in the blood. Bradypnea indicates a slowing down of the respiratory drive, in contrast to hyperventilation, biot's respiration, or tachypnea. It is crucial for the nurse to monitor a patient experiencing respiratory depression for signs of bradypnea and intervene promptly to prevent further complications.

Correct Answer: B

Rationale: Thrombotic thrombocytopenic purpura (TTP) is a rare blood disorder characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, neurological abnormalities, and renal dysfunction. The peripheral blood smear in TTP typically shows fragmented red blood cells (schistocytes) due to mechanical destruction within small blood vessels. Laboratory findings in TTP commonly include elevated lactate dehydrogenase (LDH), decreased haptoglobin (as it is consumed in the clearance of free hemoglobin), and increased indirect bilirubin due to increased red blood cell breakdown. This combination of clinical presentation and laboratory abnormalities is classic for TTP. Hemolytic uremic syndrome (HUS) may present similarly but is more commonly associated with renal dysfunction and is often triggered by infection with Shiga toxin-producing E. coli.

Correct Answer: B

Rationale: The nurse's priority when a patient appears confused and disoriented during a consultation is to provide clear and simple explanations and assess for any underlying causes of confusion. It is essential to ensure that the patient understands the information being provided and to address any potential reasons for the confusion, such as medication side effects, medical conditions, or cognitive impairment. Ignoring the patient's confusion or assuming they cannot understand can lead to misunderstandings, errors in care, and ultimately jeopardize the patient's well-being. It is crucial to approach the situation with empathy, patience, and a focus on ensuring effective communication and understanding between the nurse and the patient.