PrepU Exam 2

A client with megaloblastic anemia reports mouth and tongue soreness. What instruction will the nurse give the client regarding eating while managing the client's symptoms ?

"Eat small amounts of bland, soft foods frequently"

The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?

"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."A fungal infection, Cryptococcus neoformans is another common opportunistic infection among clients with AIDS, and it causes neurologic disease. Cryptococcal meningitis is characterized by symptoms such as fever, headache, malaise, stiff neck, nausea, vomiting, mental status changes, and seizures.

A client with a recent diagnosed of ITP has asked the nurse why the care team has not chosen to administer platelets, stating, "I have low platelets, so why not give me a transfusion of exactly what I'm missing?" How should the nurse respond?

"Transfused platelets usually aren't beneficial because they're rapidly destroyed in the body" Despite extremely low platelet counts, platelet transfusions are usually avoided. Transfusions tend to be ineffective not because the platelets are nonfunctional but because the client's anti platelet antibodies bind with the transfused platelets, causing them to be destroyed

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population?

Anemia Anemia is the most common hematological condition in older adults, particularly those admitted to hospitals and long-term care facilities.

A nurse is educating a client about the role of B lymphocytes. The nurse's description will include which of the following physiologic processes?

Antibody production B lymphocytes are capable of differentiating into plasma cells. Plasma cells, in turn, produce antibodies. Cytokines are produced by natural killer (NK) cells. Stem cell differentiation greatly precedes B lymphocyte production.

A hospital client is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?

Arrange for a portable x-ray machine to be used. A client who is immunocompromised is at an increased risk of contracting nosocomial infections due to suppressed immunity. The safest way the test can be facilitated is to have a portable x-ray machine in the client's room. This confers more protection than disinfecting the radiology department or using masks.

A child has been transported to the emergency department (ED) after a severe allergic reaction. How will the nurse evaluate the client's respiratory system? Select all that apply.

Assess breath sounds Measure the client's oxygen saturation Monitor the client's respiratory pattern Assess the client's respiratory rate

A school nurse is caring for a child who appears to be having an allergic response. What should be the initial action of the school nurse?

Assess for signs and symptoms of anaphylaxis

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods?

Beans, dried fruits, and leafy green vegetables

Which is a symptom of hemochromatosis?

Bronzing of the skin The skin may appear hyperpigmented from melanin deposits or appear bronze in color

A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of?

Chronic diarrhea Chronic diarrhea is believed related to the direct effect of HIV on cells lining the intestine. Although all gastrointestinal manifestations of acquired immune deficiency syndrome (AIDS) can be debilitating, the most devastating is chronic diarrhea. It can cause profound weight loss and severe fluid and electrolyte imbalances.

A night nurse is reviewing the next day's medication administration record (MAR) of a hospital client who has hemophilia. The nurse notes that the MAR specifies both oral and subcutaneous options for the administration of a PRN antiemetic. What is the nurse's best action ?

Contact the prescriber to have the subcutaneous option discontinued Injections must be avoided in clients with hemophilia.

A patient with chronic kidney disease is being examined by the nurse practitioner for anemia. The nurse has reviewed the laboratory data for hemoglobin and RBC count. What other test results would the nurse anticipate observing?

Decreased level of erythropoietin

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months A diagnosis of AIDS cannot be made until the person with HIV meets case criteria established by the Centers for Disease Control and Prevention. The immune system becomes compromised. The CD4 T-cell count drops below 200 cells and develops one of the opportunistic diseases, such as Pneumocystis carinii pneumonia, candidiasis, cytomegalovirus, or herpes simplex.

Which immunoglobulin assumes a major role in bloodborne and tissue infections?

IgG

A nurse is planning the care of a client with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. Which nursing diagnosis should the nurse prioritize in the client's plan of care ?

Ineffective tissue perfusion related to thrombosis

A nurse practitioner is assessing a client who has a fever, malaise, and a white blood cell count that is elevated. What principle should guide the nurse's management of the client's care?

Infection is the most likely cause of the client's change in health status Leukocytes is most often the result of infection

The nurse is caring for a client who has a unit of whole blood removed every 6 weeks as treatment for polycythemia vera. Which laboratory test will the nurse monitor to determine if the procedure is adversely affecting the client?

Iron Therapeutic phlebotomy is the removal of a certain amount of blood under controlled conditions. A client with an elevated hematocrit from polycythemia vera can usually be managed by periodically removing 1 unit (about 500 mL) of whole blood. Over time, this process can produce iron deficiency, Therapeutic phlebotomy does not affect the calcium or potassium levels or the white blood cell count.

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include

adrenal suppression

The nurse is teaching a client about histamine release during an anaphylactic reaction. What does histamine release in anaphylaxis cause?

nasal congestion

An adult client has had mumps when the client was a child. The client had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect?

naturally acquired active immunity

Which cells have the lifespan of approximately 7.5 days, and one-third of their population remains in the spleen (unless needed to fight significant bleeding)?

platelets

Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply.

polymerase chain reaction p24 antigen test

The lower the client's viral load,

the longer the survival time The lower the client's viral load, the longer the time to AIDS diagnosis and the longer the survival time. The key goal of antiretroviral therapy is to achieve and maintain durable viral suppression.

A nurse is assessing the skin integrity of a client who has AIDS. When performing this inspection, the nurse should prioritize assessment of what skin surfaces?

Perianal region and oral mucosa The nurse should inspect all the client's skin surfaces and mucous membranes, but the oral mucosa and perianal region are particularly vulnerable to skin breakdown and fungal infection and thus should be prioritized

A nurse is assisting a client into position prior to bone marrow aspiration. Which position will the nurse place the client prior to the procedure?

Prone

After the completion of testing, a child's allergies have been attributed to the family's cat. When introducing the family to the principles of avoidance therapy, the nurse should promote what action?

Removing the cat from the family's home In avoidance therapy, every attempt is made to remove the allergens that act as precipitating factors.

A client has recently been diagnosed with Hodgkin's disease. Which treatment possibility is least likely for this client ?

Surgery Surgery to remove affected lymph nodes is not included in the medical management for Hodgkin's disease. Treatment of Hodgkin's disease includes localized radiation to affected lymph nodes and chemotherapy with chemotherapy with combinations of antineoplastic drugs

A young client is diagnosed with a mild form of hemophilia and is experiencing bleeding in the joints with pain. In preparing the client for discharge, what instructions should the nurse provide?

Wear a medical identification bracelet Clients with hemophilia should wear a medical identification bracelet about having this disease.

IVIG has been ordered for the treatment of a patient with an immunodeficiency. Which of the following actions should the nurse perform before administering this blood product?

Weigh the patient before administration to verify the correct dose.