A patient is exposed to the hepatitis B virus (HBV) and develops immunity against future infections. Which type of immunity is primarily responsible for this protection?

Correct Answer: C

Rationale: Humoral immunity is primarily responsible for protecting against infections by pathogens like viruses. In the case of the hepatitis B virus (HBV), the individual is exposed to the virus and develops immunity, which is typically mediated by antibodies produced by B cells. These antibodies circulate in the blood and can neutralize the virus, preventing future infections. This type of immunity is known as humoral immunity, as it involves the production of antibodies that target specific antigens, such as those present on the surface of the hepatitis B virus. In contrast, passive immunity is when antibodies are transferred from an external source, innate immunity provides immediate, non-specific defenses against pathogens, and cell-mediated immunity involves the activation of T cells to combat intracellular pathogens.

Correct Answer: B

Rationale: The statement "Multigravida patient has shorter labor" is the best response to Patient Josephine's question about her shorter labor compared to previous deliveries. In obstetrics, it is commonly observed that labor tends to be shorter in patients who have had previous pregnancies (multigravida patients) due to factors such as prior cervical changes and previous stretching of the birth canal. This phenomenon is known as "multigravida cervical efficiency," and it can lead to faster and more efficient labors in subsequent pregnancies for women who have had previous deliveries.

Correct Answer: B

Rationale: When managing a conscious patient with a severe nosebleed (epistaxis), the appropriate intervention is to have the patient sit upright and lean slightly forward to prevent blood from flowing into the throat and causing choking or swallowing. Pinching the soft part of the nose just below the bony part can help apply pressure to the bleeding vessel and stop the bleeding. This maneuver also helps compress the blood vessels in the nose, promoting clot formation and stopping the bleeding. It is important not to tilt the head back as this can cause blood to flow into the throat and potentially lead to swallowing, choking, or aspiration. Packing the nose with cotton gauze should be done by medical professionals if the bleeding does not stop with direct pressure. Applying direct pressure to the forehead is not effective for managing nosebleeds; pressure should be applied to the nostrils instead.

Correct Answer: D

Rationale: It is important for the nurse to acknowledge the patient's preference and respect their choice. By responding with "So then you would prefer to speak with your doctor?" the nurse is showing understanding and willingness to accommodate the patient's request. This response helps to maintain a positive and respectful interaction with the patient.

Correct Answer: B

Rationale: Urinary incontinence is a common complication associated with prostatectomy for the treatment of benign prostatic hyperplasia (BPH). Prostate surgery, such as a prostatectomy, can disrupt the sphincter muscle that controls the flow of urine from the bladder, leading to temporary or even long-term urinary incontinence in some patients. This usually improves over time with pelvic floor exercises and other treatment options, but it is an important consideration when discussing the potential risks and benefits of prostate surgery with patients. While erectile dysfunction and retrograde ejaculation can also be potential side effects of prostate surgery, urinary incontinence is specifically associated with issues related to bladder control following the procedure. Urethral stricture, although it can occur post prostate surgery, is less common compared to urinary incontinence.

Correct Answer: D

Rationale: Before any procedure, it is crucial to ensure that you have the proper authorization and guidelines in place. By checking the physician's order and the patient care plan, you confirm that suctioning is indeed needed and that you follow the specific instructions for that patient. This step helps ensure patient safety and effective care delivery. Once you have verified this information, you can proceed with gathering equipment, performing hand hygiene, and assessing the patient's condition as necessary.

Correct Answer: D

Rationale: Papillary thyroid carcinoma is the most common type of thyroid cancer and is known for presenting as a painless unilateral enlargement of the thyroid gland. Fine-needle aspiration cytology typically reveals classic features such as numerous microfollicles and psammoma bodies. Thyroglossal duct cyst, Hashimoto's thyroiditis, and thyroid adenoma would not typically present with these cytological features or with painless thyroid enlargement as seen in papillary thyroid carcinoma.

Correct Answer: C

Rationale: Ventricular tachycardia (VT) is a potentially life-threatening arrhythmia characterized by wide QRS complexes and absence of P waves on electrocardiogram (ECG). Patients with VT may present with symptoms such as chest pain, dyspnea, and syncope due to reduced cardiac output and ineffective pumping of the heart. VT is a serious condition that requires prompt treatment to prevent hemodynamic compromise and potential cardiac arrest. Stable angina typically presents with chest pain that is provoked by exertion and relieved by rest or nitroglycerin. Atrial fibrillation is characterized by an irregularly irregular rhythm with absent P waves on ECG. Supraventricular tachycardia typically presents with a narrow QRS complex on ECG.

Correct Answer: A

Rationale: In this case, the patient is experiencing respiratory acidosis as indicated by the low pH (7.28), elevated PaCO2 (65 mmHg), and elevated HCO3- (30 mEq/L). The primary acid-base disturbance is respiratory acidosis due to the retention of carbon dioxide (PaCO2 >45 mmHg) leading to an increase in HCO3- as a compensatory mechanism to maintain pH within normal limits. The elevated HCO3- levels (metabolic compensation) are trying to counterbalance the increased PaCO2 levels (respiratory acidosis) by increasing bicarbonate to attempt to normalize the pH. Overall, the ABG analysis shows respiratory acidosis with metabolic compensation in this COPD patient with an acute exacerbation and severe dyspnea.