A patient presents with petechiae, ecchymoses, and gingival bleeding. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?

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Question 1 of 9

A patient presents with petechiae, ecchymoses, and gingival bleeding. Laboratory tests reveal prolonged bleeding time, normal platelet count, and normal PT and aPTT. Which of the following conditions is most likely to cause these findings?

Correct Answer: C

Rationale: The correct answer is C: Acquired von Willebrand syndrome. This condition is characterized by a defect in von Willebrand factor function, leading to prolonged bleeding time and mucocutaneous bleeding. Normal platelet count rules out Glanzmann thrombasthenia and Bernard-Soulier syndrome which are platelet disorders. Normal PT and aPTT rule out Hemophilia A, a coagulation factor deficiency. Acquired von Willebrand syndrome is the most likely cause based on the clinical presentation and laboratory findings.

Question 2 of 9

A patient with a history of multiple myeloma demonstrates hypogammaglobulinemia. Which of the following immunoglobulin classes is most likely to be deficient in this patient?

Correct Answer: B

Rationale: The correct answer is B: IgA. In multiple myeloma, there is a proliferation of abnormal plasma cells, leading to a decrease in normal antibody production. IgA is the most abundant immunoglobulin in mucosal secretions and plays a crucial role in mucosal immunity. Therefore, a deficiency in IgA is common in patients with multiple myeloma. IgG is the most abundant immunoglobulin in the blood and is typically less affected in multiple myeloma. IgM is the first antibody produced in response to an infection and is less likely to be deficient in this case. IgE is primarily involved in allergic responses and is not typically affected in multiple myeloma.

Question 3 of 9

A patient with a history of diabetes mellitus is admitted with a foot ulcer. Which nursing intervention is essential for preventing infection in the foot ulcer?

Correct Answer: C

Rationale: Rationale: C is correct as keeping the ulcer covered with a sterile dressing provides a barrier against pathogens, promoting wound healing and preventing infection. A (topical antibiotics) can lead to resistance and disrupt normal flora. B (daily wound debridement) may introduce pathogens and delay healing. D (oral antibiotics prophylactically) is not recommended without evidence of infection.

Question 4 of 9

For the past 6 months, several nurses are resigning. Some have verbalized in the exit interview that there are not happy anymore. Which of the following descriptions manifest BEST, a nurse who has job satisfaction?

Correct Answer: B

Rationale: The correct answer is B because an empowered nurse feels in control and valued, leading to job satisfaction. Enthusiasm shows motivation and engagement with their work. Being ethical indicates a commitment to moral principles, contributing to a sense of fulfillment. Choice A is incorrect as competitiveness and self-centeredness do not necessarily equate to job satisfaction. Euphoria may not be a sustainable indicator of satisfaction. Choice C is incorrect because being a loner and egoistic are not traits associated with job satisfaction. Reactivity may suggest a lack of control or frustration. Choice D is incorrect as being outgoing and competitive might not directly translate to job satisfaction. Sensitivity alone does not guarantee satisfaction in the workplace.

Question 5 of 9

Informed consent in this study will be obtained by Myra from the

Correct Answer: D

Rationale: The correct answer is D because informed consent should be obtained from both the participants and their parents to ensure full understanding and agreement from all parties involved. This is crucial when working with minors to protect their rights and ensure ethical standards are met. Choice A is incorrect as it excludes parental consent, which is necessary for minors. Choice B is also incorrect as it neglects the participants' direct involvement in consenting to participate. Choice C is incorrect because it only includes available relatives, which may not be legally authorized to provide consent on behalf of the participants.

Question 6 of 9

A patient with a suspected autoimmune disorder exhibits antibodies directed against self-antigens, leading to tissue damage and inflammation. Which of the following mechanisms is primarily responsible for the development of autoimmune diseases?

Correct Answer: A

Rationale: The correct answer is A: Loss of self-tolerance. This is because autoimmune diseases result from a breakdown in the immune system's ability to distinguish between self and non-self antigens, leading to the production of antibodies against self-antigens. When self-tolerance is lost, immune cells mistakenly target the body's own tissues, causing tissue damage and inflammation. Choice B (Failure of innate immunity) is incorrect because autoimmune diseases are primarily driven by adaptive immunity rather than innate immunity. Choice C (Defective T cell activation) is incorrect as T cells play a critical role in the immune response to self-antigens in autoimmune diseases. Choice D (Impaired phagocytosis) is incorrect as phagocytosis is a mechanism primarily involved in the removal of pathogens, not in the development of autoimmune diseases.

Question 7 of 9

While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that the client was prescribed in the hospital. This nurse may be guilty of what?

Correct Answer: A

Rationale: The correct answer is A: Malpractice. The nurse's failure to document and remove the over-the-counter medication, which led to a serious adverse drug reaction, constitutes malpractice. Malpractice refers to negligence or failure to provide the standard of care expected in a professional setting. In this case, the nurse's actions directly resulted in harm to the client, which is a clear example of malpractice. Incorrect Choices: B: Failure of duty to warn - This choice implies that the nurse had a duty to warn the client about the potential drug interaction, which may not necessarily be the case. The primary issue here is the nurse's failure to document and remove the medication, not a failure to warn. C: Assault - Assault involves intentional harm or threat of harm, which is not applicable in this scenario where the harm was due to negligence. D: Incompetence - While the nurse's actions may demonstrate incompetence, the more specific legal term for this situation would be malpractice, as it directly

Question 8 of 9

A patient is prescribed a statin medication for lipid-lowering therapy. Which adverse effect should the nurse monitor closely in the patient?

Correct Answer: A

Rationale: The correct answer is A: Muscle pain or weakness. Statins can cause muscle-related side effects, including rhabdomyolysis, a severe condition that can lead to muscle pain and weakness. Monitoring for these symptoms is crucial to prevent serious complications. B: Dry cough is not a common side effect of statins. C: Hypertension is not directly associated with statin use. D: Hyperkalemia is not a typical adverse effect of statins.

Question 9 of 9

Which of the following cell types is primarily responsible for presenting antigens to T cells during the immune response?

Correct Answer: C

Rationale: The correct answer is C: Macrophages. Macrophages are antigen-presenting cells that engulf pathogens and present their antigens to T cells, initiating an immune response. They express major histocompatibility complex (MHC) molecules necessary for T cell recognition. B cells also present antigens but primarily to B cells for antibody production. NK cells are involved in killing infected cells, not antigen presentation. Eosinophils are mainly involved in allergic responses and defense against parasites, not antigen presentation.

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