Correct Answer: A

Rationale: Toll-like receptors (TLRs) are a group of cellular receptors responsible for recognizing pathogen-associated molecular patterns (PAMPs), which are molecular components commonly found on pathogens like bacteria and viruses. When TLRs recognize these PAMPs, they initiate signaling pathways that trigger the innate immune response, leading to inflammation, antimicrobial defense, and the activation of adaptive immunity. B cell receptors (BCRs) and T cell receptors (TCRs) are involved in adaptive immune responses and recognize specific antigens rather than PAMPs. Fc receptors primarily bind to the Fc portion of antibodies and are involved in antibody-mediated immune responses. Thus, TLRs specifically play a critical role in sensing and responding to pathogens through the recognition of PAMPs.

Correct Answer: B

Rationale: The patient's presenting symptoms of chest pain worsened by inspiration and relieved by sitting forward, with associated DVT in the lower extremity, suggest a high likelihood of pulmonary embolism. Chest pain that worsens with inspiration due to pleuritic involvement is a classic symptom of pulmonary embolism. Additionally, the presence of DVT in the lower extremity represents a risk factor for the development of pulmonary embolism, as clots originating in the deep veins can travel to the pulmonary circulation to cause an obstruction. Patients with pulmonary embolism may also exhibit signs of right heart strain, such as tachycardia, tachypnea, and sometimes hemoptysis.

Correct Answer: A

Rationale: Acute Respiratory Distress Syndrome (ARDS) is a severe form of acute lung injury that is characterized by hypoxemia, bilateral pulmonary infiltrates, and noncardiogenic pulmonary edema. When managing a patient with ARDS in the ICU, the priority intervention is to provide adequate oxygenation and ventilation. Mechanical ventilation is often necessary to support gas exchange in these patients.

Correct Answer: A

Rationale: Von Willebrand disease is a hereditary bleeding disorder that results from a deficiency or dysfunction of von Willebrand factor (vWF), a protein that plays a key role in platelet adhesion and the initiation of primary hemostasis. The clinical manifestations of von Willebrand disease include recurrent mucocutaneous bleeding, such as nosebleeds, easy bruising, and gum bleeding. Laboratory findings typically show a prolonged bleeding time due to impaired platelet function, while platelet count, PT (prothrombin time), and aPTT (activated partial thromboplastin time) are usually normal. This distinguishes von Willebrand disease from other bleeding disorders such as hemophilia A (Factor VIII deficiency), which would show abnormal PT and aPTT due to deficiencies in specific clotting factors. Thrombocytopenia, on the other hand, would be characterized by a low platelet count

Correct Answer: B

Rationale: Sundowning is a phenomenon commonly seen in elderly individuals, particularly those with cognitive impairments like dementia, where they become more restless, anxious, confused, or agitated during late afternoon and evening hours, typically around sunset. This change in behavior can manifest as increased confusion, wandering, aggression, or vocalization. The exact cause of sundowning is not completely understood but may involve a combination of factors such as disruptions in the sleep-wake cycle, fatigue, decreased lighting, and hormonal imbalances. Managing sundowning behaviors may involve environmental modifications, maintaining a regular routine, ensuring proper lighting, and addressing any underlying medical conditions contributing to the behavior changes.