NU372 EAQ Evolve Elsevier: HESI Prep Immunologic System and Infectious Disease

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Which statement would the nurse include in the teaching plan of a client anticipating discharge with acquired immunodeficiency syndrome (AIDS)? o "Wash used dishes in hot, soapy water." o "Let dishes soak in hot water for 24 hours before washing." o "You should boil the client's dishes for 30 minutes after use." o "Have the client eat from paper plates so they can be discarded."

o "Wash used dishes in hot, soapy water." · A person cannot contract human immunodeficiency virus (HIV) by eating from dishes previously used by an individual with AIDS; routine care is adequate. Washing used dishes in hot, soapy water is sufficient care for dishes used by the AIDS client. Dishes do not need to soak for 24 hours before being washed. The client's dishes do not need to be boiled for 30 minutes after use. Paper plates are fine to use but are not indicated to prevent the spread of AIDS.

Which length of time would the nurse teach a client regarding the incubation period of syphilis? o 1 week o 4 months o 2 to 6 weeks o 48 to 72 hours

o 2 to 6 weeks · Although the usual incubation period of syphilis is about 3 weeks, clinical symptoms may appear as early as 9 days or as long as 3 months after exposure. The usual incubation period is 21 days.

When assessing a client with a new diagnosis of syphilis, which actions would the nurse implement? Select all that apply. o Ask the client about medication allergies. o Use the fingers of one hand to palpate lesions. o Examine the client's lymph nodes for enlargement. o Gather information about any ulcers or rashes. o Perform a Papanicolaou (Pap) test (smear) of the cervix. o Ask about the client's sexual activity and protection methods.

o Ask the client about medication allergies. o Examine the client's lymph nodes for enlargement. o Gather information about any ulcers or rashes. o Ask about the client's sexual activity and protection methods. · Syphilis is a highly contagious disease and transmitted by close contact. The nurse should ask the client about medication allergies (primarily allergies to penicillin) to provide safe and effective treatment. The nurse would examine the client for enlarged and firm lymph nodes. Ulcers and rashes are the initial manifestations of syphilis; thus the nurse would gather information regarding these. The nurse would inquire and assess a client's sexual activity because the information regarding partners must be communicated with the individual and the health department. The nurse assessing the client with syphilis should wear gloves before palpating any lesions. Performing a Pap test (smear) is not within the scope of practice for a registered nurse. The nurse would inquire as to the client's sexual activity. Health care staff members are to share incidence of communicable infections with the department of health and sexual partners.

Which condition presents with elevated immunoglobulin E (IgE) levels, positive allergic skin test reactivity, and widespread skin vesicles? o Allergic rhinitis o Atopic dermatitis o Contact dermatitis o Goodpasture syndrome

o Atopic dermatitis · Elevated IgE levels, positive skin tests, and presence of widespread skin lesions occur in individuals with atopic dermatitis. Contact dermatitis is a localized red, itchy rash that involves mediators such as cytokines, resulting in a delayed hypersensitivity reaction. Allergic rhinitis may occur yearly or seasonally and involves mediators such as histamine and mast cells resulting in an IgE-mediated hypersensitivity reaction. Goodpasture syndrome is an autoimmune disorder involving the lungs and kidneys and does not cause edematous papules or lesions. Goodpasture syndrome involves mediators such as complement lysis and tissue macrophages that cause type II cytotoxic hypersensitivity reaction.

Which would the nurse identify as increasing the risk of human immunodeficiency virus (HIV) transmission? Select all that apply. o Childbirth o Monogamy o Breast-feeding o Needle sharing o Shared plates and cups

o Childbirth o Breast-feeding o Needle sharing · HIV can be spread through breast-feeding and childbirth, sharing needles, and unprotected sexual contact. Having multiple sexual partners, not monogamy, increases the risk of HIV transmission. HIV cannot be transmitted through sharing plates and cups.

Which virus is responsible for causing infectious mononucleosis in clients? o Parvovirus o Coronavirus o Rotavirus o Epstein-Barr virus

o Epstein-Barr virus · Epstein-Barr virus is responsible for mononucleosis and possibly Burkitt lymphoma. Parvovirus and rotavirus cause gastroenteritis. Coronavirus causes upper respiratory tract infections.

Which condition may be present in the client with a neutrophil count of 12,000/mm3? o Influenza o Pneumonia o Immunosuppression o Autoimmune disorder

o Pneumonia · The normal adult leukocyte count is 5000 to 10,000/mm3. A count of 12,000/mm3 indicates an increased neutrophil level, which indicates the presence of an acute bacterial infection that could result in pneumonia or inflammation. Viral influenza may occur when the neutrophil count is low. Immunosuppression and autoimmune disorders may result from a decreased leukocyte count.

Which statement reflects a client's active immunity response to an infection acquired from traveling abroad? o Protein antigens are formed in the blood to fight invading antibodies. o Protein substances are formed within the body to neutralize antigens. o Blood antigens are aided by phagocytes in defending the body against pathogens. o Sensitized lymphocytes from an immune donor act as antibodies against invading pathogens.

o Protein substances are formed within the body to neutralize antigens. · Active immunity occurs when an individual's cells produce antibodies in response to an agent or its products; these antibodies will destroy the agent (antigen) should it enter the body again. Antigens do not fight antibodies; they trigger antibody formation that in turn attacks the antigen. Antigens are foreign substances that enter the body and trigger antibody formation. Sensitized lymphocytes do not act as antibodies.

Which dietary modifications help improve the nutritional status of a client with acquired immunodeficiency syndrome (AIDS)? o Refraining from consuming fatty foods o Refraining from consuming frequent meals o Refraining from consuming high-calorie foods o Refraining from consuming high-protein foods

o Refraining from consuming fatty foods · Many clients with AIDS become intolerant to fat due to the disease and the antiretroviral medications. The client should be instructed to refrain from consuming fatty foods. The client should be encouraged to eat small and frequent meals to improve nutritional status. High-calorie and high-protein foods are beneficial to clients with AIDS because they provide energy and build immunity.

A client with erythematous papules in the interdigital spaces reports severe itching at night. Which insect is responsible for this condition? o Phthirus pubis o Sarcoptes scabiei o Pediculus humanus o Borrelia burgdorferi

o Sarcoptes scabiei · Erythematous papules and itching at night in the interdigital spaces indicates scabies. This condition is caused by Sarcoptes scabiei. Phthirus pubis and Pediculus humanus may cause pediculosis, manifested as minute, red, and noninflammatory skin lesions. Borrelia burgdorferi causes Lyme disease, manifested as a warm, itchy, and painful rash in the groin, axillae, trunk, legs, and upper arms.

Which hypersensitivity reaction may occur in a newborn with hemolytic disease? o Type I o Type II o Type III o Type IV

o Type II · Hemolytic disease in a pregnant woman may result in erythroblastosis fetalis, a type II hypersensitivity reaction. Type I reactions involve immunoglobulin E (IgE)-mediated reactions such as anaphylaxis and wheal-and-flare reactions. Type III reactions are immune complex reactions such as rheumatoid arthritis or systemic lupus erythematosus. Type IV reactions are delayed hypersensitivity reactions such as contact dermatitis.

A client presents with a circumscribed, hypertrophic, flesh-colored papule on the skin and reports pain upon lateral compression of the papule. Which organism would the nurse suspect? o Plantar warts o Herpes zoster o Tinea corporis o Verruca vulgaris

o Verruca vulgaris · A client with a painful, circumscribed, hypertrophic, and flesh-colored papule on the skin may have verruca vulgaris. Plantar warts are usually located on the foot and occur because of pressure by walking or prolonged standing. The varicella-zoster virus causes herpes zoster and may cause grouped vesicles and pustules on the trunk, face, and lumbosacral areas. Tinea corporis is a ringworm infection with a scaly and erythematous appearance on the skin.


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