Adult Health Nursing Test Bank

Correct Answer: B

Rationale: The correct answer is B: IgA. In multiple myeloma, there is a proliferation of abnormal plasma cells, leading to a decrease in normal antibody production. IgA is the most abundant immunoglobulin in mucosal secretions and plays a crucial role in mucosal immunity. Therefore, a deficiency in IgA is common in patients with multiple myeloma. IgG is the most abundant immunoglobulin in the blood and is typically less affected in multiple myeloma. IgM is the first antibody produced in response to an infection and is less likely to be deficient in this case. IgE is primarily involved in allergic responses and is not typically affected in multiple myeloma.

Correct Answer: B

Rationale: The correct answer is B: Initiate non-invasive positive pressure ventilation (NIPPV) for respiratory support. In acute exacerbations of COPD, NIPPV helps improve ventilation and oxygenation, reducing the work of breathing and preventing the need for intubation. This intervention is a priority as it can rapidly stabilize the patient's respiratory status. A: Administering bronchodilator medications is important in COPD management, but in severe exacerbations, NIPPV takes precedence. C: Arterial blood gas analysis is important for assessing oxygenation and ventilation status, but it does not directly address the acute respiratory distress. D: Chest physiotherapy can help with airway clearance in COPD, but in acute exacerbations, respiratory support with NIPPV is more urgent.

Correct Answer: D

Rationale: The correct answer is D: Tilt the head slightly forward and angle the bottle toward the side of the nostril. This method allows for proper administration of the spray into the nasal passage, ensuring effective delivery of the medication. Tilted head helps direct the spray towards the nasal cavity without causing discomfort or leakage. It also helps prevent the medication from dripping down the back of the throat. Choices A, B, and C are incorrect: A: Finishing instillation in one nostril before moving to the other can lead to uneven distribution of medication and reduced effectiveness. B: Inhaling quickly may cause irritation and discomfort to the mucous membranes due to the forceful intake of the spray. C: Blowing the nose after spraying can expel the medication before it has a chance to be absorbed, decreasing its efficacy.

Correct Answer: A

Rationale: The correct answer is A: Amoxicillin. Amoxicillin is the first-line treatment for GAS pharyngitis due to its effectiveness against Streptococcus bacteria. It is a penicillin-class antibiotic recommended by guidelines. Azithromycin is an alternative for patients allergic to penicillin. Cephalexin is not the first-line choice for GAS. Clindamycin is reserved for patients allergic to both penicillin and macrolides.

Correct Answer: B

Rationale: The correct answer is B: Psoriasis. Psoriasis is characterized by pruritic, erythematous patches with silvery scales, commonly found on the elbows, knees, and scalp. This presentation matches the patient's symptoms. Eczema (choice A) typically presents with red, inflamed, and itchy skin patches. Pityriasis rosea (choice C) manifests as a herald patch followed by smaller scaly patches in a "Christmas tree" distribution. Seborrheic dermatitis (choice D) involves oily, yellowish, scaly patches mainly on the scalp, face, and ears, and does not typically present with silvery scales.