The immunity conferred by the tetanus toxoid vaccine is:

Correct Answer: C

Rationale: The correct answer is C: Artificially acquired active immunity. The tetanus toxoid vaccine contains inactivated tetanus toxin, which stimulates the immune system to produce antibodies against tetanus. This process results in the person developing immunity to tetanus in the future. It is considered active immunity because the individual's immune system is actively involved in producing antibodies. A: Artificially acquired passive immunity involves receiving pre-formed antibodies, which provide immediate but temporary protection. This is not the case with the tetanus toxoid vaccine. B: Naturally acquired active immunity occurs when a person is exposed to the pathogen and develops immunity through their own immune response. This is not the case with the tetanus toxoid vaccine. D: Naturally acquired passive immunity involves receiving antibodies from another source, such as through breastfeeding. This is not how the tetanus toxoid vaccine works.

Correct Answer: B

Rationale: The correct answer is B: Ototoxicity. Aminoglycosides are known to cause damage to the inner ear, resulting in hearing loss and balance issues. The nurse should monitor for symptoms such as tinnitus, dizziness, and hearing loss. Seizures (A) are not a common adverse effect of aminoglycosides. Renal toxicity (C) is a potential side effect, but ototoxicity is more specific to aminoglycosides. Hepatotoxicity (D) is not a typical adverse effect associated with aminoglycosides. Therefore, monitoring for ototoxicity is essential in clients taking aminoglycosides.

Correct Answer: D

Rationale: The correct answer is D: Greater than 30% plasma cells in bone marrow. This scenario is indicative of multiple myeloma, a plasma cell disorder. High Ca and renal insufficiency suggest hypercalcemia and kidney damage due to monoclonal protein deposition. Anemia and MCV suggest bone marrow involvement. Choice A is not specific for multiple myeloma. Choice B is used to evaluate bone metastasis. Choice C is invasive and not typically done for initial diagnosis of multiple myeloma. Therefore, D is the best option for definitive diagnosis in this case.

Correct Answer: D

Rationale: The correct answer is D: MRI scan of spine. For a patient with thoracic pain, leg weakness, and incontinence during chemo for breast cancer, an MRI of the spine is crucial to evaluate for spinal cord compression, a serious complication. This can present with the mentioned symptoms and requires urgent intervention. Serum calcium (A) is not the most important study as it is less likely to explain the patient's symptoms. A bone scan (B) and plain radiographs (C) may not provide detailed imaging of the spinal cord to assess for compression. An MRI scan of the spine (D) offers the best visualization to identify spinal cord compression and guide appropriate management.

Correct Answer: D

Rationale: The correct answer is D: Adjuvant hormonal therapy. For ER/PR+ breast cancer, hormonal therapy is the standard treatment to reduce the risk of recurrence. This patient has a high-risk tumor with positive lymph nodes, making hormonal therapy crucial to target any remaining cancer cells. No further treatment (A) is not appropriate given the high-risk features. Radiation to mammary nodes (B) is not the standard of care for ER/PR+ breast cancer. Platinum chemotherapy (C) is not indicated for ER/PR+ breast cancer and is reserved for other subtypes.