1 :

Hint : 🧬 HIV weakens CD4 defense

Correct Answers:

  • "It is very easy to get infections as HIV suppresses the immune system."


Rationale :

💠 HIV attacks CD4+ T-helper lymphocytes, which coordinate immune defense.

💠 Destruction of these cells weakens the adaptive immune system, increasing infection risk.

💠 Opportunistic infections such as Pneumocystis jirovecii or tuberculosis become common.

💠 Antiretroviral therapy (ART) helps slow viral replication but does not cure the disease.

💠 Continuous immune monitoring and infection prevention education are vital for management.


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2 :

0700

Assisted client with getting dressed, provided morning cup of herbal tea. Client stated they did not sleep well and feel tired this morning Standby assist when walking to the dining hall

0730

Client ate 75% of breakfast: scrambled eggs, wheat toast, 2 slices bacon, glass of whole milk.

0815

Client requested a short nap, accompanied back to bed.

0930

Feeling well-rested, client participated in armchair exercise class, stayed to chat with residents then assisted to back patio for cigarette use

1130

Client ate 100% of lunch, roasted chicken, green beans, watermelon, glass of water.

1300

Attended group outing to local high school's music concert, ate snack of apple juice and crackers.

1700

Client ate 75% of dinner pork chops, cauliflower, couscous, glass of water

1900

Client reports pressure in chest along with "burning sensation with frequent belching

1915

Administered PRN calcium carbonate.


Which information documented in the client's activity log does the nurse identify that may have led to a flare-up of GER symptoms? Select all that apply.


Answer Options

Hint : 🍳 Fatty meals worsen GERD

Correct Answers:

  • Nicotine use
  • Breakfast intake


Rationale :

🔹 Nicotine use: Smoking relaxes the lower esophageal sphincter (LES), allowing acid reflux into the esophagus

🔹 Nicotine also increases gastric acid secretion and decreases salivation that neutralizes acid

🔹 Continuous smoking irritates the esophageal mucosa, worsening gastroesophageal reflux symptoms

🔹 Avoiding smoking is vital as it reduces symptom recurrence and aids mucosal healing

🔹 Nurses should promote smoking cessation and healthy habits in GERD clients

🔹 Breakfast intake: High-fat foods such as bacon and whole milk delay gastric emptying, worsening reflux

🔹 Fatty meals increase intra-abdominal pressure, allowing acid backflow

🔹 GERD patients should consume low-fat, small, frequent meals to minimize reflux risk

🔹 Avoiding lying down within 2 hours after meals prevents symptom flare-ups

🔹 Nurses should guide clients on dietary changes and trigger avoidance


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3 :

Hint : 🧠 Dopamine deficiency causes tremors

Correct Answers:

  • Risk for falls because of dopamine imbalance.


Rationale :

🔷 Parkinson’s disease results from loss of dopamine-producing neurons in the substantia nigra

🔷 Dopamine deficiency causes muscle rigidity, tremor, and bradykinesia affecting coordination

🔷 Clients are at high risk for falls due to postural instability and slow reflexes

🔷 Levodopa therapy helps replace dopamine, improving movement control

🔷 Nursing care includes assistive devices, safety education, and fall precautions


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4 :

Hint : 🌿 Wash resin off early

Correct Answers:

  • Wash the affected area.


Rationale :

✳️ Immediate washing removes urushiol resin from poison ivy, preventing deeper skin absorption

✳️ Soap and water reduce spread and intensity of allergic dermatitis

✳️ Applying creams before cleansing traps irritants, worsening inflammation

✳️ Nurses should advise washing contaminated clothing and equipment to prevent re-exposure

✳️ Early cleansing minimizes itching, redness, and blister formation


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5 :

Hint : ☀️ Body overheats dangerously

Correct Answers:

  • Heatstroke


Rationale :

💎 Heatstroke occurs when thermoregulatory mechanisms fail and body temperature rises above 40°C

💎 The absence of sweating indicates failure of heat dissipation

💎 Neurological changes like confusion or loss of consciousness signal brain dysfunction

💎 This is a medical emergency requiring rapid cooling and IV fluid resuscitation

💎 Older adults and dehydrated individuals are at greatest risk during hot weather


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6 :

Hint : ⚗️ Vomiting causes alkalosis

Correct Answers:

  • Metabolic alkalosis


Rationale :

🔶 Prolonged vomiting causes loss of gastric acid (HCl) leading to an alkaline state

🔶 The pH increases while bicarbonate levels rise, producing metabolic alkalosis

🔶 The body compensates by slowing respirations to retain CO₂

🔶 Hypokalemia commonly accompanies this due to hydrogen–potassium ion exchange

🔶 Treatment includes fluid and electrolyte replacement and antiemetic administration


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7 :

Hint : 🏋️‍♀️ Use it or lose it

Correct Answers:

  • Disuse atrophy


Rationale :

🟢 Muscles not used for prolonged periods lose mass and strength due to protein degradation

🟢 Immobility or casting causes muscle fiber shrinkage and reduced contractility

🟢 It is a reversible process with regular exercise and physiotherapy

🟢 Nursing interventions include range-of-motion (ROM) and early mobilization

🟢 Long-term disuse can result in joint stiffness and functional decline


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8 :

Hint : 🫁 Seal chest wound quickly

Correct Answers:

  • Cover the open area with an airtight bandage.


Rationale :

🔴 The open wound allows air entry into pleural space, leading to a sucking chest wound

🔴 Applying an occlusive dressing taped on three sides prevents further air from entering

🔴 This converts it into a closed pneumothorax and stabilizes breathing

🔴 Immediate oxygen therapy follows wound sealing to improve oxygenation

🔴 The nurse must then prepare for chest tube insertion to re-expand the lung


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9 :

Hint : ❤️ RBCs deform under stress

Correct Answers:

  • Sickle cell anemia


Rationale :

🟣 A genetic mutation produces hemoglobin S, which sickles under low oxygen conditions

🟣 Sickled cells clump and block vessels, causing pain and tissue ischemia

🟣 Repeated crises lead to organ damage and chronic anemia

🟣 Hydration, oxygen therapy, and pain management are key nursing priorities

🟣 Genetic counseling is recommended for family planning and education


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10 :

Hint : 🔁 Hormone levels self-regulate

Correct Answers:

  • Negative feedback


Rationale :

🟡 The hypothalamus–pituitary–thyroid axis regulates hormone balance via negative feedback

🟡 When thyroid hormones rise, they suppress TSH and TRH secretion

🟡 This prevents overproduction and maintains endocrine homeostasis

🟡 Disruption in this loop leads to hyperthyroidism or hypothyroidism

🟡 Nurses should teach clients that feedback systems maintain internal stability


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Total Questions: 10

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