A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

infuse lipoproteins to restore the myelin sheath.

remove excess fluid from the blood stream.

restore protein levels in the blood.

remove circulating antibodies from the blood stream.

Answer and Explanation

The Correct Answer is D

A) Infuse lipoproteins to restore the myelin sheath:
Multiple sclerosis (MS) is an autoimmune disease where the immune system attacks the myelin sheath around nerve fibers. Plasmapheresis does not work by infusing lipoproteins to restore the myelin sheath. The treatment's primary goal is to remove harmful substances from the blood that may be contributing to the autoimmune attack, particularly antibodies that target the nervous system, not by restoring the myelin itself.

B) Remove excess fluid from the bloodstream:
Plasmapheresis is a process used to remove certain substances from the plasma, including antibodies and immune complexes that might be exacerbating an autoimmune condition like MS. If the goal were to remove excess fluid, the treatment would be more akin to dialysis or a fluid management procedure, but this is not the case with plasmapheresis.

C) Restore protein levels in the blood:
While plasmapheresis can sometimes lead to a temporary decrease in protein levels due to the removal of plasma, this is not its primary purpose. The primary goal of plasmapheresis in the context of multiple sclerosis is to remove circulating antibodies and other immune-related substances.

D) Remove circulating antibodies from the bloodstream:
Plasmapheresis works by removing circulating antibodies from the bloodstream. In multiple sclerosis, the immune system mistakenly targets the myelin sheath, and plasmapheresis helps to remove the antibodies responsible for this autoimmune response. This can provide temporary relief of symptoms during acute flare-ups of MS by reducing the immune system's attack on the nervous system.

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Correct Answer is A

Explanation

A) Women should start yearly mammograms at age 40:
Mammography is a key screening tool for breast cancer detection. According to guidelines from the American Cancer Society (ACS) and other leading health organizations, women should begin annual mammograms at age 40. This recommendation applies to average-risk women who are not showing any symptoms of breast cancer. Mammograms are effective in detecting early-stage breast cancer, which is crucial for better treatment outcomes.

B) Women should have a yearly clinical breast examination starting at age 50:
The clinical breast examination (CBE) is a physical exam performed by a healthcare provider to check for breast cancer. However, the recommendation is to have a clinical breast examination every 1-3 years for women in their 20s and 30s and annually for women 40 and older, not just beginning at age 50. It is not necessary to wait until age 50 to start yearly CBEs.

C) Clients should have fecal occult blood test every other year:
The fecal occult blood test (FOBT) is used to detect hidden blood in the stool, which may be a sign of colon cancer. However, this test is not typically performed every other year for all clients. The recommended schedule for colorectal cancer screening depends on risk factors. The American Cancer Society recommends annual FOBT or fecal immunochemical test (FIT) for clients over the age of 45 who are at average risk for colon cancer. More invasive tests, such as colonoscopy, are generally recommended for people at higher risk or after positive results from non-invasive tests like FOBT.

D) Clients should have a colonoscopy at age 40 and every 10 years thereafter:
The recommended age for the first colonoscopy is age 45 for individuals at average risk of colorectal cancer, not 40. Colonoscopies are typically performed every 10 years after the initial screening unless there are risk factors (e.g., family history, genetic conditions) that require earlier or more frequent screenings.

A. Respiratory rate of 8 bpm B. A large barrel chest C. Fine crackles D. The patient assumes the orthopenic position

Correct Answer is A

Explanation

A) Respiratory rate of 8 bpm:
This a sign of respiratory depression, which can occur in patients with chronic obstructive pulmonary disease (COPD) who are receiving high-flow oxygen. In COPD patients, particularly those with chronic hypercapnia (elevated carbon dioxide), the body may become less sensitive to CO2 buildup and more reliant on low oxygen levels to trigger the respiratory drive. If oxygen is administered at high flow rate, it can reduce the stimulus for breathing, leading to hypoventilation or even respiratory arrest.

B) A large barrel chest:
A barrel chest is a common physical finding in patients with chronic COPD due to the hyperinflation of the lungs. This is a result of air trapping, which is a hallmark of COPD. While it indicates the long-term effects of COPD, it does not require immediate intervention. It is a chronic sign and not an acute or urgent concern unless accompanied by other signs of acute respiratory distress.

C) Fine crackles:
Fine crackles (or rales) on auscultation can be indicative of fluid in the lungs and may suggest conditions such as pulmonary edema, heart failure, or pneumonia. While crackles could be concerning, they are not as immediately life-threatening as a respiratory rate of 8 bpm. In a patient with COPD, crackles might indicate worsening of their condition, possibly due to an infection or fluid overload, but the priority would still be to assess the patient's breathing and ventilation status first.

D) The patient assumes the orthopneic position:
The orthopneic position (sitting upright or leaning forward) is a common way for patients with COPD to relieve shortness of breath. It is a compensatory action to help improve lung expansion and facilitate breathing. While it is a sign of respiratory distress, it is not an immediate emergency. Many COPD patients use this position to cope with chronic difficulty breathing.

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A client with a diagnosis of multiple sclerosis is scheduled to receive plasmapheresis treatments. A nurse explains to the client's spouse that the purpose of plasmapheresis is to:

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