Correct Answer: B

Rationale: CPAP therapy is considered the gold standard treatment for obstructive sleep apnea (OSA) and is the most appropriate intervention for managing OSA and improving symptoms. CPAP therapy involves using a machine that delivers a continuous flow of air through a mask worn over the nose or mouth during sleep. This air pressure helps keep the airway open, preventing the collapse that causes apneas and snoring during sleep.

Correct Answer: D

Rationale: Nurse Noli should include in his teachings less saturated fat, maintaining weight within normal limits, and exercising regularly as these are all components of a healthy lifestyle. However, including "more fats in the diet" goes against the principles of healthy eating and weight management. Consuming excessive amounts of fats, especially unhealthy saturated fats, can contribute to various health issues such as obesity, cardiovascular diseases, and other medical conditions. Therefore, it is crucial for Nurse Noli to emphasize reducing saturated fat intake rather than promoting more fats in the diet for overall health and wellness.

Correct Answer: C

Rationale: Hyperthyroidism is a condition where the thyroid gland produces an excess amount of thyroid hormone. One of the clinical manifestations of hyperthyroidism is a fine motor tremor, which is characterized by hand tremors or shaky movements in the fingers. This tremor is often more noticeable when the individual is trying to perform delicate tasks requiring fine motor skills. It is important for Nurse Rachel to watch for this symptom in patient Claire as it can impact her ability to perform daily activities and may require intervention or management strategies to help alleviate the tremor and improve quality of life.

Correct Answer: A

Rationale: Somatic hypermutation is the mechanism responsible for generating diversity in the antigen-binding sites of immunoglobulins. During somatic hypermutation, point mutations are introduced into the variable regions of immunoglobulin genes in B cells. These mutations occur randomly and lead to a wide range of amino acid changes in the antigen-binding sites of antibodies. As a result, a diverse repertoire of antibodies with varying specificities for different antigens is created. Gene rearrangement and isotype switching are other mechanisms that contribute to antibody diversity but do not specifically target the antigen-binding sites. Clonal expansion, on the other hand, refers to the proliferation of specific B cell clones after activation by antigens, which amplifies the immune response but does not directly impact the diversity of antigen-binding sites.

Correct Answer: D

Rationale: Nurse Rey can be liable of committing malpractice by performing circumcisions without the proper training, qualifications, and legal authority to do so. Malpractice refers to negligence or failure to provide a standard level of care that results in harm to a patient. In this case, Nurse Rey participating in performing circumcisions may not have the necessary skills and expertise compared to the doctors who are trained to perform such procedures. This can lead to potential harm or complications for the patients, making it a case of malpractice.