Correct Answer: C

Rationale: The public health nurse's participation in the essential services that are relevant and accessible to the family and the community includes informing, educating, and empowering the people about health. This is a critical aspect of the role of a public health nurse as it involves engaging with individuals and communities to provide them with accurate information about health promotion, disease prevention, and access to healthcare services. By informing, educating, and empowering the people about health, public health nurses can help individuals and communities make informed decisions about their health and well-being, leading to improved health outcomes and overall community health.

Correct Answer: C

Rationale: The esophagus is responsible for propelling food from the oral cavity to the stomach through a series of coordinated muscular contractions. These contractions are known as peristalsis. The esophagus is a muscular tube connecting the throat (pharynx) to the stomach and plays a crucial role in moving food bolus from the mouth to the stomach for digestion. The tongue helps in the chewing and swallowing of food, the pharynx is involved in the passage of food and air, and the epiglottis helps prevent food from entering the airways during swallowing. However, it is the esophagus that actively moves the food to the stomach.

Correct Answer: C

Rationale: Incident reports are a crucial tool for capturing data on adverse events, near misses, and other incidents within a healthcare institution. These reports help in analyzing patterns, identifying areas for improvement, and implementing quality and safety measures. Therefore, incident reports themselves are not something that needs to be prevented; instead, they are a critical part of the risk management process to enhance patient safety and quality of care.

Correct Answer: D

Rationale: The initial step in the process of change for the senior nurse should be to identify the inefficiency that needs improvement or correction. Before setting goals, planning strategies, or identifying solutions, it is essential to first pinpoint the specific area or aspect that requires change. By identifying the inefficiency, the senior nurse can gain a clear understanding of the root cause of the issue and focus efforts on addressing it effectively. This step lays the foundation for the rest of the change process by providing a specific target for improvement.

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.