Chapter 33: Assessment and Management of Patients with Allergic Disorders

Which of the following is the most frequent route of exposure to a latex allergy? Cutaneous Inhalation Mucosal Parenteral

Cutaneous

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about? Sublingual-swallow immunotherapy (SLIT) Desensitization Sublingual-topical immunotherapy (STIT) Resensitization

Desensitization

A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors? Diphenhydramine Flunisolide Beclomethasone dipropionate Pseudoephedrine hydrochloride

Diphenhydramine

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? Diphenhydramine Omeprazole Cimetidine Nizatidine

Diphenhydramine

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve the nasal congestion the client is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications? Report white patches in the mouth because the medication can cause a fungal infection. Do not overuse the medication as rebound congestion can occur. Taper the dose when discontinuing the medication. Do not operate machinery or drive while using the medication.

Do not overuse the medication as rebound congestion can occur.

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likely expect to find irritation at which area? Dorsal aspect of the hand Lower arms Ankles Plantar aspects of the feet

Dorsal aspect of the hand

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? To decrease the body's risk of infection Because an autoimmune disease is a neoplastic disease So the client has strong drug therapy For their immunosuppressant effects

For their immunosuppressant effects

Which term refers to an incomplete antigen? Hapten Allergen Antigen Antibody

Hapten

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? Histamine Bradykinin Serotonin Prostaglandin

Histamine

Which is a primary chemical mediator of hypersensitivity? Serotonin Bradykinin Histamine Heparin

Histamine

A client develops a facial rash and urticaria after receiving penicillin. Which laboratory value does the nurse expect to be elevated? IgA IgB IgE IgG

IgE

The nurse is teaching a group of health care workers about latex allergies. What reaction will the nurse teach the workers to be most concerned about with laryngeal edema? irritant contact allergic contact IgE-mediated hypersensitivity IgG antibodies

IgE-mediated hypersensitivity

What is the most common cause of anaphylaxis? Opioids NSAIDs Penicillin Radiocontrast agent

Penicillin

A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines? Diarrhea Anorexia Palpitations Sedation

Sedation

A patient with a history of allergies comes to the clinic for an evaluation. The following laboratory test findings are recorded in a patient's medical record :Total serum IgE levels: 2.8 mg/mLWhite blood cell count: 5,100/cu mmEosinophil count: 4%Erythrocyte sedimentation rate: 20 mm/hThe nurse identifies which result as suggesting an allergic reaction? Serum IgE level White blood cell count Eosinophil count Erythrocyte sedimentation rate

Serum IgE level

The nurse working in the emergency department is asked to explain allergy testing to a client who experienced an allergic reaction to an unknown allergen. Which test indicates the quantity of allergen necessary to evoke an allergic reaction? Serum-specific IgE test Provocative testing Scratch test Intradermal test

Serum-specific IgE test

Which test indicates the quantity of allergen necessary to evoke an allergic reaction? Serum-specific IgE test Provocative testing Scratch test Intradermal test

Serum-specific IgE test

The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which statement describes the clinical manifestations of this reaction? Symptoms are localized to the area of exposure, usually the back of the hands. Symptoms can be eliminated by changing glove brands. Symptoms worsen when hand lotion is applied before donning latex gloves. Symptoms occur within minutes after exposure to latex.

Symptoms are localized to the area of exposure, usually the back of the hands.

What education should the nurse provide to the patient taking long-term corticosteroids? The patient should not stop taking the medication abruptly and should be weaned off of the medication. The patient should take the medication only as needed and not take it unnecessarily. Corticosteroids are relatively safe drugs with very few side effects. The patient should discontinue using the drug immediately if weight gain is observed.

The patient should not stop taking the medication abruptly and should be weaned off of the medication.

A client reports to a health care provider's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which client statement indicates a need for further education? "I may experience itching and irritation at the site of the testing." "If I notice tingling in my lips or mouth, gargling may help the symptoms." "I'll go directly to the pharmacy with my EpiPen prescription." "The test may be mildly uncomfortable."

"If I notice tingling in my lips or mouth, gargling may help the symptoms."

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? "You need to come back to the clinic to get a different medication since this one is not working for you." "You may be immune to the effects of this medication and will need something else in its place." "The full benefit of the medication may take up to 2 weeks to be achieved." "I am sorry that you are feeling poorly but this is the only medication that will work for your problem."

"The full benefit of the medication may take up to 2 weeks to be achieved."

The nurse tells the client that if exposure to an allergen occurs around 8:00 AM, then the client should expect a mild or moderate reaction by what time? 10:00 AM 11:00 AM 1:00 PM 3:00 PM

10:00 AM

A client has been having joint pain and swelling in the left foot and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered? An exacerbation of a previous disorder Autoimmune An alloimmunity disorder A cause-and-effect relationship

Autoimmune

The nurse is teaching a client after a medication allergic reaction has occurred. What is the most important action for the nurse to teach the client to take to prevent anaphylaxis? Avoid potential allergens. Undergo desensitization treatment. Carry an emergency kit. Wear a medical alert bracelet.

Avoid potential allergens.

The nurse is evaluating the plan of care for a client with an allergic disorder who has a nursing diagnosis of deficient knowledge related to measures for allergy control. What client statement will indicate to the nurse that the outcome has been met? Client states the need for coughing and deep breathing. Client demonstrates appropriate coping strategies for dealing with a chronic disorder. Client identifies methods for reducing exposure risk to allergens. Client reports an absence of symptoms associated with the allergy.

Client identifies methods for reducing exposure risk to allergens.

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, which part of the body is more sensitive to allergens? back forearm upper arm chest

back

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid? cromolyn sodium fluticasone zileuton fexofenadine

fluticasone

A client has had several recent clinical visits for allergic contact dermatitis. The nurse explains to the client that allergy testing is indicated. Which test will most likely be performed? patch test intradermal injection test scratch test All options are correct.

patch test

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response? plant pollen animal dander dust mites mold spores

plant pollen

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action? Avoids massaging the injection site after administration Jabs the autoinjector into the outer thigh at a 90-degree angle Pushes down on the grey release cap to administer the medication Maintains pressure on the auto-injector for about 30 seconds after insertion

Jabs the autoinjector into the outer thigh at a 90-degree angle

An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occurred? Bacterial endocarditis Rh-hemolytic disease Lupus erythematosus Rheumatoid arthritis

Rh-hemolytic disease

A nurse is working in a dermatology clinic with clients who have allergies. What is the most important chemical mediator involved in the allergic response? serotonin leukotrienes histamine prostaglandins

histamine

A college student reports the onset of skin burning and hives when walking outdoors in cold weather. Which suggestions will the nurse make to limit this reaction from occurring? Select all that apply. Use a wetsuit when planning to go swimming in cold water. Soak in a tub of tepid water when the itching and hives occur. Avoid ingesting foods and beverages that are cold in temperature. Apply an over-the-counter topical corticosteroid to the areas every day. Take an over-the-counter antihistamine before going outdoors in cold weather.

Use a wetsuit when planning to go swimming in cold water. Avoid ingesting foods and beverages that are cold in temperature. Take an over-the-counter antihistamine before going outdoors in cold weather.