Many clients with chronic fatigue syndrome (CFS) report severe,ongoing fatigue without any explanation that has lasted for at least — months.

Correct Answer: B

Rationale: In the context of pharmacology and understanding chronic fatigue syndrome (CFS), it is crucial to grasp the duration of the symptoms for appropriate diagnosis and management. The correct answer is B) 6 months. This is because the diagnostic criteria for CFS, such as the CDC criteria, require the presence of severe, ongoing fatigue without any other medical or psychiatric explanation lasting for at least 6 months. Option A) 12 months is incorrect as CFS diagnosis does not require symptoms to persist for a full year. Option C) 3 months is too short a duration to meet the diagnostic criteria for CFS. Option D) 2 months also falls short of the required duration for a CFS diagnosis. Educationally, understanding the specific criteria for diagnosing CFS is essential for healthcare professionals, especially pharmacologists who may be involved in managing the symptoms of this condition. It highlights the importance of thorough assessment and consideration of the duration of symptoms in determining appropriate treatment strategies.

Correct Answer: A

Rationale: A negative TB skin test in an immunocompromised patient such as one with AIDS does not rule out TB infection. Further diagnostic testing such as a chest x-ray and sputum smear is necessary to confirm the absence of TB. Teaching about INH or scheduling another test is premature without further diagnostic confirmation.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Administer first dose of varicella vaccine. This answer should be questioned because the patient is currently on prednisone, a corticosteroid that can suppress the immune system's response. Administering a live attenuated vaccine like the varicella vaccine can pose a risk of causing an infection in an immunocompromised individual like the patient with SLE. Option A) Discontinuing prednisone abruptly can lead to adrenal insufficiency and exacerbation of the lupus symptoms. It is important to taper corticosteroid doses gradually. Option C) Checking the patient's C-reactive protein (CRP) is a valid monitoring parameter to assess inflammation levels in SLE and response to treatment. Option D) Giving ibuprofen is not contraindicated in this scenario as it can help with managing inflammation and pain in SLE, although long-term use should be monitored due to potential side effects on the gastrointestinal system and kidneys. Educationally, this question highlights the importance of understanding drug interactions and contraindications, especially in patients with autoimmune conditions like SLE who are on immunosuppressive therapy. It emphasizes the need for healthcare providers to be vigilant in assessing medication orders to prevent potential harm to patients.

Correct Answer: C

Rationale: In the treatment of exacerbations of systemic lupus erythematosus (SL), corticosteroids (Option C) are often used due to their potent anti-inflammatory properties. Corticosteroids help reduce inflammation and suppress the overactive immune response seen in SL, providing relief from symptoms such as joint pain, skin rashes, and organ involvement. They are a mainstay in managing acute flares of autoimmune diseases like SL. Option A, Antiemetics, are used to treat nausea and vomiting, which are not primary symptoms of SL exacerbations. Option B, Antineoplastics, are medications used to treat cancer and are not indicated for SL treatment. Option D, Antibiotics, are used to treat bacterial infections and do not target the underlying autoimmune response in SL. In an educational context, understanding the rationale behind using corticosteroids in SL exacerbations highlights the importance of anti-inflammatory therapy in managing autoimmune diseases. It also emphasizes the need for targeted and appropriate treatment to address the underlying pathophysiology of the condition, rather than just symptomatic relief. This knowledge is crucial for healthcare professionals involved in the care of patients with autoimmune disorders like SL.

Correct Answer: C

Rationale: The primary difference between healing by primary intention and healing by secondary intention lies in the amount of granulation tissue formed during the healing process. In primary intention healing, the wound edges are brought together and sutured, resulting in minimal granulation tissue formation and less scarring. On the other hand, in secondary intention healing, the wound is left open to heal, leading to the formation of more granulation tissue, which in turn causes more scarring. Option A is incorrect because surgical debridement is not a requirement for healing by secondary intention. Debridement may be necessary in certain cases to remove necrotic tissue, but it is not a defining factor of secondary intention healing. Option B is incorrect because primary intention healing involves the approximation of wound edges and the formation of a minimal amount of granulation tissue, rather than suturing two layers of granulation tissue together. Option D is incorrect because healing by secondary intention takes longer primarily due to the increased formation of granulation tissue, which is a necessary step in the natural healing process for wounds left open to heal. Understanding the differences between primary and secondary intention healing is crucial in clinical practice as it informs healthcare professionals about the expected outcomes, healing timelines, and potential complications associated with each type of wound healing. This knowledge allows for appropriate wound management decisions to be made based on the specific characteristics of the wound and the patient's overall health status.