A client with a gastrointestinal bleed secondary to alcohol abuse and a hemoglobin level of 5.8 g/dL has been ordered a transfusion of packed red blood cells. The client possesses type B antibodies but lacks type D antigens on his red cells. Transfusion of which of the following blood types would be least likely to produce a transfusion reaction?
Answers:
A. A+
B. B–
C. A–
D. B+
A nurse is providing care for a 17-year-old boy who has experienced recurrent sinus and chest infections throughout his life and presently has enlarged tonsils and lymph nodes. Blood work indicated normal levels of B cells and free immunoglobulins but a lack of differentiation into normal plasma cells. The boy is currently receiving intravenous immunoglobulin (IVIG) therapy. What is the boy’s most likely diagnosis?
Answers:
A. X-linked hypogammaglobulinemia
B. Transient hypoglobulinemia
C. Common variable immunodeficiency
D. IgG subclass deficiency
A patient diagnosed with H pylori asks the nurse, “How an infection can occur in the stomach since it is an acid environment?” The nurse responds,
Answers:
A. “This parasite secretes an enzyme called coagulase, which protects the pathogen from the antibodies.”
B. “H. pylori produces an enzyme called urease that converts gastric juices into ammonia, which neutralizes the acidic stomach environment.”
C. “H. pylori is a virus and is still being researched as to how it is able to survive in the stomach acids.”
D. “We have many infectious agents that can live in an acidic environment with a pH more than 8.0.”
The family members of an elderly patient are wondering why his “blood counts” are not rising after his last GI bleed. They state, “He has always bounced back after one of these episodes, but this time it isn’t happening. Do you know why?”The nurse will respond based on which of the following pathophysiological principles?
Answers:
A. “Everything slows down when you get older. You just have to wait and see what happens.”
B. “Due to stress, the red blood cells of older adults are not replaced as promptly as younger people.”
C. “Don’t worry about it. We can always give him more blood.”
D. “The doctor may start looking for another cause of his anemia, maybe cancer of the bone.”
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