A 66-year-old female patient has presented to the emergency department because of several months of intermittently

A 66-year-old female patient has presented to the emergency department because of several months of intermittently bloody stools that has recently become worse. The woman has since been diagnosed with a gastrointestinal bleed secondary to overuse of nonsteroidal anti-inflammatory drugs that she takes for her arthritis. The health care team would realize that which of the following situations is most likely?

The woman has depleted blood volume due to her ongoing blood loss.

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She will have iron-deficiency anemia due to depletion of iron stores.

The patient will be at risk for cardiovascular collapse or shock.

She will have delayed reticulocyte release.

Question 12.                      

A 16-year-old female has been brought to her primary care nurse practitioner by her mother due to the girl’s persistent sore throat and malaise. Which of the following facts revealed in the girl’s history and examination would lead the nurse practitioner to rule out infectious mononucleosis?

The girl has a temperature of 38.1°C (100.6°F) and has enlarged lymph nodes.

Her liver and spleen are both enlarged.

Blood work reveals an increased white blood cell count.

Chest auscultation reveals crackles in her lower lung fields bilaterally.

Question 13.                      

A 30-year-old man has spent 5 hours on a cross-country flight seated next to a passenger who has been sneezing and coughing, and the man has been inhaling viral particles periodically. Which of the following situations would most likely result in the stimulation of the man’s T lymphocytes and adaptive immune system?

Presentation of a foreign antigen by a familiar immunoglobulin

Recognition of a foreign MHC molecule

Recognition of a foreign peptide bound to a self MHC molecule

Cytokine stimulation of a T lymphocyte with macrophage or dendritic cell mediation

Question 14.                      

A nurse practitioner is explaining to a 40-year-old male patient the damage that Mycobacterium tuberculosis could do to lung tissue. Which of the following phenomena would underlie the nurse practitioner’s explanation?

Tissue destruction results from neutrophil deactivation.

Nonspecific macrophage activity leads to pulmonary tissue destruction and resulting hemoptysis.

Macrophages are unable to digest the bacteria, resulting in immune granulomas.

Neutrophils are ineffective against the Mycobacterium tuberculosis antigens.

Question 15.                      

A 14-year-old boy has been diagnosed with infectious mononucleosis. Which of the following pathophysiological phenomena is most responsible for his symptoms?

The Epstein-Barr virus (EBV) is lysing many of the boy’s neutrophils.

Viruses are killing some of his B cells and becoming incorporated into the genomes of others.

The EBV inhibits the maturation of white cells within his peripheral lymph nodes.

The virus responsible for mononucleosis inhibits the maturation of myeloblasts into promyelocytes.

Question 16.                      

A couple who are expecting their first child have been advised by friends to consider harvesting umbilical cord blood in order to have a future source of stem cells. The couple have approached their nurse practitioner with this request and are seeking clarification of exactly why stem cells are valuable and what they might expect to gain from harvesting them. How can the nurse practitioner best respond to the couple’s inquiry?

“Stem cells can help correct autoimmune diseases and some congenital defects.”

“Stem cells can be used to regenerate damaged organs should the need ever arise.”

“Stem cells can be used as a source of reserve cells for the entire blood production system.”

“Stem cells can help treat some cancers and anemias, but they must come from your child himself or herself.”

Question 17.                      

A 71-year-old male patient with a history of myocardial infarction and peripheral vascular disease has been advised by his nurse practitioner to begin taking 81 mg aspirin once daily. Which of the following statements best captures an aspect of the underlying rationale for the nurse practitioner’s suggestion?

Platelet aggregation can be precluded through inhibition of prostaglandin production by aspirin.

Aspirin helps to inhibit adenosine disphosphate (ADP) action and minimizes platelet plug formation.

Aspirin can reduce unwanted platelet adhesion by inhibiting thromboxane A2 (TXA2) synthesis.

Aspirin inhibits the conversion of fibrinogen into fibrin and consequent platelet plug formation.

Question 18.                      

A 60-year-old male patient with an acute viral infection is receiving interferon therapy. The nurse practitioner is teaching the family of the patient about the diverse actions of the treatment and the ways that it differs from other anti-infective therapies. Which of the following teaching points should the nurse practitioner exclude?

“Interferon can help your father’s unaffected cells adjacent to his infected cells produce antiviral proteins that limit the spread of the infection.”

“Interferon can help limit the replication of the virus that’s affecting your father.”

“Interferon helps your father’s body recognize infected cells more effectively.”

“Interferon can bolster your father’s immune system by stimulating natural killer cells that attack viruses.

Question 11.