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Author Question: Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the ... (Read 80 times)

mpobi80

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Four weeks after returning from a tropical vacation, a 40-year-old man has presented to the emergency department with malaise, nausea, and yellow eyes.
 
  Serology has confirmed a diagnosis of hepatitis A (HAV), to the shock of the client. What teaching is most appropriate for this client?
  A)
  You can expect these symptoms to disappear after about 2 months, but you'll be a carrier of the disease indefinitely.
  B)
  A vaccine before your trip would have prevented this, but be assured your body will rid itself of the virus in time.
  C)
  You likely came in contact with blood or body fluids at some point, and you'll have to ensure no one is subsequently exposed to your own blood or body fluids.
  D)
  You likely got this by way of what we call the 'fecal-oral' route; you will have chronic hepatitis now, but the symptoms can be controlled with medication.

Question 2

A woman with a diagnosis of type 2 diabetes has been ordered a hemoglobin A1C test for the first time by her primary care provider. The woman states, I don't see why you want to test my blood cells when its sugar that's the problem.
 
  What aspect of physiology will underlie the care provider's response to the client?
  A)
  The amount of glucose attached to A1C cells reflects the average blood glucose levels over the life of the cell.
  B)
  Hemoglobin synthesis by the bone marrow is inversely proportionate to blood glucose levels, with low A1C indicating hyperglycemia.
  C)
  The high metabolic needs of red cells and their affinity for free glucose indicate the amount of glucose that has been available over 6 to 12 weeks.
  D)
  Insulin is a glucose receptor agonist on the hemoglobin molecule, and high glucose suggests low insulin levels.



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Bsand8

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Answer to Question 1

Ans:
B

Feedback:

HAV is normally self-limiting and does not result in chronic hepatitis or carrier status. A vaccine is available, and the fecal-oral route of transmission, rather than contact with blood and body fluids, is typical.

Answer to Question 2

Ans:
A

Feedback:

Glucose entry into red blood cells is not insulin dependent, and the rate at which glucose becomes attached to the hemoglobin molecule depends on blood glucose levels. A1C levels thus indirectly indicate glucose levels. Hemoglobin synthesis, the metabolic needs of hemoglobin, and an agonist role of insulin do not underlie the A1C test.




Bsand8

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