Nursing Elites

1. After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:

• A. Bone marrow
• B. Lymph nodes
• C. Gut-associated lymphoid tissue
• D. Thymus

Correct answer: A

Rationale: The correct answer is A: Bone marrow. B cells are originally derived from cells of the bone marrow. Bone marrow is the primary site where B cells develop and mature. Lymph nodes (choice B), gut-associated lymphoid tissue (choice C), and the thymus (choice D) are involved in the immune response but are not the primary site of origin for B cells.

2. In a patient with a subconjunctival hemorrhage due to allergic rhinitis, which statement is accurate?

• A. The hemorrhage will resolve without treatment within 2 weeks.
• B. The patient should be referred for immediate ophthalmologic examination.
• C. Oral antihistamines should be started to prevent further complications.
• D. Topical corticosteroids may be considered to reduce inflammation.

Correct answer: A

Rationale: In a patient with a subconjunctival hemorrhage secondary to allergic rhinitis, the hemorrhage is typically self-limiting and will resolve on its own within 2 weeks without the need for specific treatment. Referring the patient for immediate ophthalmologic examination is not necessary unless there are other concerning symptoms. Starting oral antihistamines may help manage the underlying allergic rhinitis but is not specifically indicated for the hemorrhage. Topical corticosteroids are not routinely prescribed for subconjunctival hemorrhage as they may have limited benefit and could potentially cause complications.

3. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

• A. Are easily treated with penicillin
• B. Are extremely rare
• C. Never occur with other infections
• D. Are commonly opportunistic

Correct answer: D

Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.

4. What causes the appearance of a barrel chest in clients with emphysema?

• A. Peripheral edema
• B. Bacterial infections in the lungs
• C. Air trapping in the alveoli
• D. Muscle atrophy of the diaphragm

Correct answer: C

Rationale: The correct answer is C: Air trapping in the alveoli. A barrel chest in emphysema results from the hyperinflation of the lungs due to air trapping in the alveoli. This leads to increased anteroposterior diameter of the chest. Choices A, B, and D are incorrect. Peripheral edema is swelling caused by fluid retention in tissues, not associated with a barrel chest in emphysema. Bacterial infections in the lungs can lead to conditions like pneumonia but do not directly cause a barrel chest. Muscle atrophy of the diaphragm could affect breathing mechanics but is not specifically linked to the development of a barrel chest in emphysema.

5. What is responsible for initiating clonal selection?

• A. B cells
• B. T cells
• C. Antigens
• D. Lymphocytes

Correct answer: C

Rationale: Antigens are the correct answer as they are the molecules that trigger the immune response by binding to specific B or T cells. This binding activates these cells, leading to their proliferation and differentiation to fight off the antigen. B cells and T cells are the responders to antigens, not the initiators of clonal selection. Lymphocytes is a broad term encompassing both B and T cells, so it is not the specific factor responsible for initiating clonal selection.

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