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After receiving a vaccination for a communicable disease, the patient was asked to return in 2 to 3 weeks to get an antibody titer and asks why blood testing can’t be done immediately. How should the RN (registered nurse) respond?

 

A.

It takes about 14 days to develop antibodies and immunity to the disease after vaccine administration.

B.

The laboratory ran out of blood specimen tubes and is unable to perform the test today.

C.

It takes about 14 days to develop antigens and immunity to the disease after vaccine administration.

D.

After receiving the vaccine, you might transmit the communicable disease to the laboratory.

Answer and Explanation

The Correct Answer is A

Choice A rationale

 

It takes about 14 days to develop antibodies and immunity to the disease after vaccine administration. This is why the patient is asked to return in 2 to 3 weeks for an antibody titer. The immune system needs time to respond to the vaccine and produce detectable levels of antibodies.

 

Choice B rationale

 

The laboratory running out of blood specimen tubes is not a valid reason for delaying the antibody titer. This choice does not provide an accurate explanation for the patient.

 

Choice C rationale

 

It takes about 14 days to develop antibodies, not antigens, and immunity to the disease after vaccine administration. This choice contains incorrect information about the immune response.

 

Choice D rationale

 

After receiving the vaccine, the patient is not likely to transmit the communicable disease to the laboratory. This choice does not provide a valid reason for delaying the antibody titer.


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Correct Answer is A

Explanation

Choice A rationale

Bacterial infection often leads to an elevated white blood cell count (15,000/mm³) and fever (38.5°C). The body’s immune response to bacterial pathogens results in these clinical manifestations.

Choice B rationale

Viral infections can cause fever, but they typically do not lead to a significant increase in white blood cell count.

Choice C rationale

Fungal infections can cause fever and elevated white blood cell count, but they are less common and usually occur in immunocompromised individuals.

Choice D rationale

Parasitic infections can cause fever and elevated white blood cell count, but they are less common and usually present with other specific symptoms.

Correct Answer is A

Explanation

Choice A rationale

Elevated blood ammonia levels are a common consequence of liver dysfunction, particularly in conditions like cirrhosis and alcoholic liver disease. The liver is responsible for converting ammonia, a byproduct of protein metabolism, into urea, which is then excreted by the kidneys. When the liver is damaged, it cannot effectively perform this function, leading to elevated blood ammonia levels. High ammonia levels can cross the blood-brain barrier and cause hepatic encephalopathy, which manifests as confusion, memory loss, and asterixis (a flapping tremor of the hands). These neurological symptoms are consistent with the patient’s presentation.

Choice B rationale

An increased white blood cell count typically indicates an infection or inflammation. While infections can occur in patients with liver disease due to a compromised immune system, the symptoms described (increased blood glucose, blurred vision, memory loss, and asterixis) are more indicative of hepatic encephalopathy rather than an infection.

Choice C rationale

Elevated blood urea nitrogen (BUN) levels can occur in liver disease, but they are more commonly associated with kidney dysfunction. BUN is a measure of the amount of nitrogen in the blood that comes from the waste product urea. While liver dysfunction can affect BUN levels, the symptoms described are more specifically related to elevated ammonia levels and hepatic encephalopathy.

Choice D rationale

A decreased platelet count, or thrombocytopenia, is a common finding in liver disease due to splenic sequestration and decreased production of thrombopoietin. However, thrombocytopenia does not directly cause the neurological symptoms described in the patient. The symptoms of increased blood glucose, blurred vision, memory loss, and asterixis are more specifically related to elevated ammonia levels and hepatic encephalopathy.

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