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: D

Rationale: Alzheimer's disease is the most common form of dementia. Dementia is a general term for a decline in mental ability that becomes severe enough to interfere with daily life. It can affect memory, thinking skills, and the ability to perform everyday tasks. Alzheimer's disease specifically is a progressive brain disorder that slowly destroys memory and thinking skills and eventually impairs the ability to carry out simple tasks. Therefore, the provided condition of having difficulty in processing stimuli and new information aligns with the symptoms commonly seen in individuals with Alzheimer's disease.

Correct Answer: B

Rationale: The best example of how the nurse can create a climate in which clients do not feel threatened is by teaching on good nutrition while providing a meal. This approach not only addresses an important topic that is beneficial for the clients but also creates a comfortable and welcoming atmosphere. By offering a meal, the nurse is able to engage the clients in a familiar and non-threatening activity, making them more receptive to the information being shared. Additionally, sharing a meal can help to build rapport and create a sense of community among the clients and the nurse, leading to a more positive learning experience.

Correct Answer: D

Rationale: In research involving adults who are capable of providing informed consent, such as a 21-year-old subject, the absolute way to ensure autonomy and respect for the individual's rights is to obtain informed and written consent directly from the subject herself. The subject's autonomy and right to self-determination should be respected, and obtaining consent directly from the subject ensures that they are fully informed about the research, its risks, benefits, and their rights regarding anonymity and confidentiality. In this case, Nurse Carmi must explain the research process clearly to the 21-year-old subject, obtain her informed consent in writing, and ensure that her anonymity, confidentiality, and human rights are protected throughout the study.

Correct Answer: C

Rationale: Neuman's adaptation model, also known as the Neuman Systems Model, is a nursing theory that focuses on how individuals respond to stressors in their environment. The model views individuals as being in a constant state of dynamic equilibrium, where they are interacting with stressors that can disrupt their normal functioning. Nursing care, according to this model, is aimed at helping individuals maintain or restore their optimal level of wellness by assisting them in adapting to these stressors. Therefore, Nurse Sandy's selection of a framework that emphasizes the constant relationship between humans and stressors in the environment aligns best with Neuman's adaptation model.

Correct Answer: A

Rationale: The presentation of flank pain, hematuria, and a palpable mass in the abdomen is characteristic of renal cell carcinoma. Renal cell carcinoma is a common type of kidney cancer that often presents with these symptoms. The presence of a solid renal mass with calcifications on imaging further supports this diagnosis, as renal cell carcinoma is known to have this appearance on imaging studies. It is important to promptly evaluate and manage patients with suspected renal cell carcinoma to optimize outcomes.

Correct Answer: D

Rationale: Activating emergency medical services (EMS) for rapid transport to a stroke center is the most appropriate action for managing a conscious patient with a suspected stroke. Time is critical in stroke care, and receiving specialized treatment at a stroke center as soon as possible can significantly improve outcomes for stroke patients. EMS providers are trained to recognize the signs of stroke and can begin essential pre-hospital care measures while en route to the hospital. Administering aspirin immediately is not recommended without medical evaluation, as certain types of strokes (such as hemorrhagic strokes) can be worsened by aspirin. Placing the patient in a supine position may not be ideal, as maintaining an elevated position can help prevent aspiration in stroke patients. Encouraging the patient to eat and drink is not appropriate, as swallowing difficulties are common in stroke patients and can lead to aspiration pneumonia.

Correct Answer: D

Rationale: Nurse Parker functioned independently when she initiated the visit by arranging for the clergy to see patient Ximena. In this scenario, the nurse took the initiative on her own without needing approval or direction from others. She recognized the patient's request for spiritual guidance and took independent action to meet that need. Independently functioning in this context demonstrates the nurse's autonomy and ability to make decisions based on the patient's preferences and well-being.

Correct Answer: A

Rationale: Administering a stool softener as ordered is the most appropriate nursing intervention for a postpartum client experiencing severe perineal pain and difficulty passing stools following a vaginal delivery. Stool softeners help to soften the stool, making it easier for the client to pass without straining, which can exacerbate perineal pain. It is important to follow the healthcare provider's orders when administering medications to ensure proper dosing and effectiveness. Encouraging the client to refrain from defecation may lead to constipation and worsen the situation. Applying ice packs to the perineum can provide temporary pain relief, but addressing the underlying issue of constipation with a stool softener is more effective in the long term. Providing education on proper perineal hygiene is important for overall postpartum care, but addressing the immediate issue of constipation with a stool softener takes precedence in this scenario.