345 Test 4 Practice Questions
Which of the following may be contained in an "emergency kit" for a hospice patient exhibiting restlessness? Oral sucrose Benzodiazepine Atropine sulfate drops Laxative
Benzodiazepine
A nurse comes to the employee health center for evaluation and is diagnosed with allergic contact dermatitis related to latex. What manifestation would the nurse most likely exhibit? Laryngeal edema Angioedema Rhinitis Blistering
Blistering
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure? Drug history Allergy history Blood studies Family history
Blood studies
A client has discussed therapy for his HIV-positive status. What does the nurse understand is the goal of antiretroviral therapy? Treat mycobacterium avium complex. Reverse the HIV+ status to a negative status. Bring the viral load to a virtually undetectable level Eliminate the risk of AIDS.
Bring the viral load to a virtually undetectable level
A client with systemic lupus erythematosus (SLE) has the classic rash of lesions on the cheeks and bridge of the nose. What term should the nurse use to describe this characteristic pattern? Bull's eye rash Papular rash Pustular rash Butterfly rash
Butterfly rash
The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? Corticosteroids Diuretics Nonsteroidal anti-inflammatory Angiotensin-converting enzyme inhibitors (ACE-I)
Corticosteroids
Which of the following is the most frequent route of exposure to a latex allergy? Inhalation Mucosal Parenteral Cutaneous
Cutaneous
Which microorganism is known to cause retinitis in people with HIV/AIDS? Cytomegalovirus Cryptococcus neoformans Pneumocystis carinii Mycobacterium avium
Cytomegalovirus
A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment? The presence and location of pruritus The severity of cutaneous warmth and flushing Hypotension and tachycardia Dyspnea, bronchospasm, and/or laryngeal edema.
Dyspnea, bronchospasm, and/or laryngeal edema.
A patient has a sensitivity to ragweed and tells the nurse that it comes at the same time every year. When does the patient typically notice the symptoms? Early spring Early fall
Early fall
The nurse is caring for a client with rheumatoid arthritis who suffers with chronic pain in the hands. When would be the best time for the nurse to perform range-of-motion exercises? First thing in the morning when the client wakes After the client has had a warm paraffin hand bath After the client has a diagnostic test After cool compresses have been applied to the hands
After the client has had a warm paraffin hand bath
A patient who has received a kidney transplant has been admitted to the medical unit with acute rejection and is receiving IV clyclosporine and methlyprednisolone. Which staff member is best to care for this patient? An RN who floated to the medical unit from the coronary care unit for the day An RN who has worked on the medical unit for 5 years and is working a double shift today An RN with 3 years of experience in the OR who is orienting to the medical unit A newly grad nurse who needs experience with IV med administration
An RN who has worked on the medical unit for 5 years and is working a double shift today
Which term refers to an incomplete antigen? Antigen Hapten Allergen Antibody
Hapten
The nurse is evaluating a client's complete blood cell count and differential along with the serum immunoglobulin E (IgE) concentration. Which result might indicate that the client has an allergic disorder? Low eosinophil count Low white blood cell count High neutrophil count High IgE concentration
High IgE concentration
Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? Bradykinin Serotonin Prostaglandin Histamine
Histamine
Which of the following protective responses begin with the B lymphocytes? Recognition Humoral Cellular Phagocytic
Humoral
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement? Decreased cognitive ability Behavioral changes Hypertension Chest pain
Hypertension
A nursing student has been assigned to care for a client with DiGeorge syndrome. The student has reviewed the clinical manifestations of this syndrome and knows that the most frequent presenting sign is Neutropenia Hypocalcemia Chronic diarrhea Pernicious anemia
Hypocalcemia
Disease teaching for lupus? I can expect a temporary improvement if I become pregnant I need to restrict my exposure to sunlight I should expect to have a low fever all the time I should try to ignore my symptoms as much as possible
I need to restrict my exposure to sunlight
A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen? Platelet administration Factor VIII administration IV gamma globulin administration Thymus grafting
IV gamma globulin administration
For individuals known to be dying by virtue of age and/or diagnosis, which sign indicates approaching death? Increased eating Increased restlessness Increased wakefulness Increased urinary output
Increased restlessness
For a client newly diagnosed with radiation-induced thrombocytopenia, the nurse should include which intervention in the care plan? Providing for frequent rest periods Administering aspirin if the temperature exceeds 102° F (38.8° C) Inspecting the skin for petechiae once every shift Placing the client in strict isolation
Inspecting the skin for petechiae once every shift
Scleroderma typically begins with the involvement of which system? Integumentary Cardiovascular Urinary Respiratory
Integumentary
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 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
Jabs the autoinjector into the outer thigh at a 90-degree angle
A nurse is preparing to administer an antiretroviral medication to a client who is positive for HIV. The nurse identifies the drug as a nucleoside reverse transcriptase inhibitor (NRTI). What drug will the nurse administer? Lamivudine Nevirapine Etravirine Delavirdine
Lamivudine
Which is a growth-based classification of tumors? Carcinoma Sarcoma Malignancy Leukemia
Malignancy
The nurse is aware that the most prevalent cause of immunodeficiency worldwide is Neutropenia Hypocalcemia Chronic diarrhea Malnutrition
Malnutrition
A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? Facial erythema, pericarditis, pleuritis, fever, and weight loss Hypothermia, weight gain, lethargy, and edema of the arms Weight gain, hypervigilance, hypothermia, and edema of the legs Photosensitivity, polyarthralgia, and painful mucous membrane ulcers
Facial erythema, pericarditis, pleuritis, fever, and weight loss
The nurse teaches the client that the presence of crystals in the synovial fluid obtained from arthrocentesis confirms which disease process? Infection Degeneration Gout Inflammation
Gout
Which term is used to describe the personal feelings that accompany an anticipated or actual loss? Bereavement Grief Mourning Spirituality
Grief
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic? HIV-1 is more prevalent than HIV-2 subtypes means of transmission cure rate the fact that it is a mutated virus originally thought to be bovine in nature
HIV-1 is more prevalent than HIV-2 subtypes
A client with acquired immune deficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse most likely suspect? Cytomegalovirus Legionella Pneumocystis jiroveci Mycobacterium avium complex
Pneumocystis jiroveci
Which intervention is the single most important aspect for the client at risk for anaphylaxis? Wearing a medical alert bracelet Prevention Desensitization Use of antihistamines
Prevention
The nurse is evaluating the client's risk for cancer. The nurse should recommend the client change which lifestyle choice? drinks one glass of wine at dinner each night uses the treadmill for 30 minutes on 5 days each week eats red meat such as steaks or hamburgers every day works as a secretary at a medical radiation treatment center
eats red meat such as steaks or hamburgers every day
For a patient with oral cancer, what can you delegate to the LPN/LVN? Assist the patient to brush and floss explain when brushing and flossing are contraindicated give antacids and sucralfate suspension as ordered recommend saliva substitutes
give antacids and sucralfate suspension as ordered
The nurse is working with a client who has had an allo-hematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of acute leukopenia. nadir. graft-versus-host disease. metastasis.
graft-versus-host disease.
if someone has breast cancer and it metastasizes to the lungs do they have lung cancer?
no
According to the TNM classification system, T0 means there is distant metastasis. no evidence of primary tumor. no regional lymph node metastasis. no distant metastasis.
no evidence of primary tumor.
Which of the following disorders is characterized by an increased autoantibody production? Scleroderma Rheumatoid arthritis (RA) Polymyalgia rheumatic Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE)
A nurse is developing a teaching plan for a terminally ill client and his family about the stages of dying and emotional reactions experienced. The nurse integrates knowledge of which of the following in the teaching plan? The stages are applicable to any loss. Each client experiences each of the stages. Most clients reach acceptance by the time of death. Typically, the stages occur in succession.
The stages are applicable to any loss.
A client is scheduled to receive an intravenous immunoglobulin (IVIG) infusion. The client asks the nurse about the infusion's administration and its adverse effects. Which condition should the nurse instruct this client to report immediately? Constipation Mouth sores Sneezing Tickle in the throat
Tickle in the throat
autoimmune disorders are type ___
type III: immune complex reaction
A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process? "It will never get any better than it is right now." "I'll definitely need surgery for this." "It will get better and worse again." "When it clears up, it will never come back."
"It will get better and worse again."
difference between benign and malignant
benign- non cancerous, encapsulated, doesn't travel malignant- cancerous, it spreads benign might not kill you normally when you remove a benign tumor it doesn't come back
Fastest route for malignant cells
blood and lymph
When could a "rebound" anaphylactic reaction occur after an initial attack even when epinephrine has been given? 2 hours 4 hours 6 hours
4 hours
A nurse educator is preparing to discuss immunodeficiency disorders with a group of fellow nurses. What would the nurse identify as the most common secondary immunodeficiency disorder? AIDS CVID SCID DAF
AIDS
The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care? Limit fluid intake to 1 1/2 to 2 liters per day. Assist with chest physiotherapy every 2 to 4 hours. Maintain the client in a supine or side-lying position. Encourage client to ambulate frequently in the halls.
Assist with chest physiotherapy every 2 to 4 hours.
A nurse is preparing an in-service presentation about human immunodeficiency virus (HIV) for a group of new graduate nurses, including the steps in the process of HIV entering the host cell. What would the nurse describe as the first step? Attachment Budding Uncoating Cleavage
Attachment
Which is usually the most important consideration in the decision to initiate antiretroviral therapy? CD4+ counts Western blotting assay HIV RNA ELISA
CD4+ counts
A family of a dying client reports that their loved one is experiencing more shortness of breath. Which nursing intervention is most appropriate at this time? Offer the client sips to drink. Offer the bedpan to urinate or defecate Call the health care provider to obtain an oxygen order Get the client out of bed to the chair.
Call the health care provider to obtain an oxygen order
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: Nausea and vomiting. Chronic diarrhea. Oral candida. Anorexia.
Chronic diarrhea.
A nurse is assessing a client with Kaposi's sarcoma. What initial sign does the nurse know to look for during assessment? Severe joint pain Lymphedema of the lower extremities Deep purple cutaneous lesions Venous stasis and phlebitis formation
Deep purple cutaneous lesions
A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder? Degenerative joint disease Scoliosis Muscular dystrophy Paget's disease
Degenerative joint disease
Which type of surgery is used in an attempt to relieve complications of cancer? Prophylactic Reconstructive Salvage Palliative
Palliative
Primary gout is often caused by an inherited disorder in which type of metabolism? Glucose Purine Fat Carbohydrate
Purine
A client has had skin testing and the results are inconclusive. The nurse would expect to prepare the client for which type of testing? Serum immunoglobulin E levels Eosinophil count Radioallergosorbent test Complete blood count with differential
Radioallergosorbent test
A client comes to the clinic with a rash. While inspecting the client's skin, the nurse determines that the rash is medication-related based on which finding? Rash is localized to a body area. Rash has several large raised areas. Rash has developed gradually. Rash is pale in color.
Rash has several large raised areas.
Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy? Rheumatoid arthritis Depression, memory impairment, and coma Respiratory or urinary system infections Cardiac dysrhythmias and heart failure
Respiratory or urinary system infections
A client with HIV will be started on a medication regimen of three medications. What class of drugs will the nurse instruct the client about? Anticholinergics Disinhibitors Hydroxyurea Reverse transcriptase inhibitors
Reverse transcriptase inhibitors
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as the form of the genetic viral material? Ribonucleic acid (RNA) Viral core Deoxyribonucleic acid (DNA) Glycoprotein envelope
Ribonucleic acid (RNA)
As the moment of death approaches, which of the following does the nurse encourage the family to do? Speak to the client in a calm and soothing voice. Lie next to the client and hold the client. Have the family sit in front of the client so they can be seen. Rub the client's hand and arm to comfort the client.
Speak to the client in a calm and soothing voice.
A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? Surgical history of a splenectomy Previous organ transplantation History of radiation therapy Surgical removal of the appendix
Surgical removal of the appendix
A nurse is preparing a discharge teaching plan for a client with atopic dermatitis. Which instruction should the nurse include in the teaching plan? Wear only synthetic fabrics. Keep the thermostat above 75° F (23.9° C). Use a topical skin moisturizer daily. Bathe only three times per week.
Use a topical skin moisturizer daily.
Telangiectasia is the term that refers to Uncoordinated muscle movement Inability to understand the spoken word Vascular lesions caused by dilated blood vessels Difficulty swallowing
Vascular lesions caused by dilated blood vessels
A client is recovering from an attack of gout. What will the nurse include in the client teaching? Weight loss will reduce inflammation. Weight loss will reduce uric acid levels and reduce stress on joints. Weight loss will increase uric acid levels and reduce stress on joints. Weight loss will reduce purine levels.
Weight loss will reduce uric acid levels and reduce stress on joints.
stages of cancer survivorship
acute: tumor is removed it looks like they're cured extended: is it going to come back? permanent stage: it's gone for 5 years
A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include hypoglycemia. hypotension. diuresis. adrenal suppression.
adrenal suppression.
An older woman with cancer. The nursing assistant informs you that she has a change in level of consciousness what should you do first? Take vitals check responsiveness and LOC Obtain a blood glucose reading check electrolyte levels administer oxygen if needed
check responsiveness and LOC
A client visits the employee health department because of mild itching and a rash on both hands. What will the employee health nurse focus on during the assessment interview? chemical and latex glove use medication allergies laundry detergent or bath soap changes life stressors the nurse may be experiencing
chemical and latex glove use
Fibromyalgia is a common condition that involves diminished vision, chronic fatigue, and reduced appetite. generalized muscle aching, mood swings, and loss of balance. pain, viral infection, and tremors. chronic fatigue, generalized muscle aching, and stiffness.
chronic fatigue, generalized muscle aching, and stiffness.
A 90-year-old home care client's son has been designated to make decisions regarding the client's medical care when the client is no longer able to do so. As the client nears the end of life, the son is consulted on an ever-increasing basis. What legal instrument activates the son's decision-making designation? living will power of attorney durable power of attorney for health care designated signer
durable power of attorney for health care
The nurse is administering intravenous vancomycin. What will the nurse initially assess the client for if an allergic reaction occurs? the severity of cutaneous warmth and flushing hypotension and tachycardia dyspnea, bronchospasm, and/or laryngeal edema the presence and location of pruritus
dyspnea, bronchospasm, and/or laryngeal edema
The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care? increased fatigue a weight gain of 2 pounds ability to perform activities of daily living (ADL) decreased joint pain
increased fatigue
The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? tumor necrosis factor interferons interleukins colony-stimulating factor
interferons
Osteoarthritis is known as a disease that requires early treatment because most of the damage seems to occur early in the course of the disease. affects young males. is the most common and frequently disabling of joint disorders. affects the cartilaginous joints of the spine and surrounding tissues.
is the most common and frequently disabling of joint disorders.
Nursing care for the client with fibromyalgia should be guided by the assumption that patients with fibromyalgia may feel as if their symptoms are not taken seriously. rarely respond to treatment. all have the same type of symptoms. will eventually lose their ability to walk.
may feel as if their symptoms are not taken seriously.
Which leukocytes arrive first at the inflammation site? basophils neutrophils monocytes
neutrophils
Which of the following would a nurse encourage a client with gout to limit? protein-rich foods purine-rich foods carbohydrates fluid intake
purine-rich foods
Which of the following would a nurse encourage a client with gout to limit? purine-rich foods fluid intake carbohydrates protein-rich foods
purine-rich foods
70% of people who die from lupus die from ______ problems
renal lupus nephritis
The nurse is teaching a client with osteoarthritis about the disease. What is the most important client focus for disease management? prevention of joint deformity detection of systemic complications strategies for remaining active disease-modifying antirheumatic drug therapy
strategies for remaining active
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wart-like lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding? instructing the client to wear cotton underwear testing the client for the presence of HIV having the client abstain from sexual activity for 6 weeks while the medication is working using a medicated douche in order to keep the vaginal pH normal
testing the client for the presence of HIV
single most preventable cause of cancer
tobacco use
A client who is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication will the client take for the treatment of this infection? amphotericin B nystatin fluconazole trimethoprim-sulfamethoxazole
trimethoprim-sulfamethoxazole
A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit? type III type I type II type IV
type I
A nurse is evaluating a client with a terminal illness. What should the nurse report so that the health care team can consider alternative nutritional approaches and fluid administration routes for the client at the end of life? weight loss and inadequate food intake drop in blood pressure and rapid heart rate altered gastrointestinal function irregular eating habits
weight loss and inadequate food intake
What does poorly differentiated cells mean? the cells in your tumor have mutated from the normal bowel cells the tumor cells have DNA that is different from your normal bowel cells your tumor cells look more like immature fetal cells than normal bowel cells
your tumor cells look more like immature fetal cells than normal bowel cells
The main things that cause death from anaphylaxis
Bronchoconstriction and hypotension
_______ antibodies are involved in allergic disorders
IgE
Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage? Joint effusion Pannus Tophi Subchondral bone
Tophi
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? Prophylactic Therapeutic Allogeneic Autologous
Autologous
The physician is attending to a 72-year-old client with a malignant brain tumor. Family members report that the client rarely sleeps and frequently reports seeing things that are not real. Which intervention is an appropriate request for the hospice nurse to suggest to the physician? Begin radiation therapy to prevent cellular growth. Add haloperidol to the client's treatment plan. Perform surgery to remove the tumor from the brain. Obtain a biopsy to analyze the lymph nodes.
Add haloperidol to the client's treatment plan.
The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? Diphenhydramine Omeprazole Nizatidine Cimetidine
Diphenhydramine
Which is also known as a proxy directive? Treatment directive Medical directive Durable power of attorney for health care Living will
Durable power of attorney for health care
A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive? Schick Enzyme-linked immunosorbent assay (ELISA) Complete blood count (CBC) Western Blot
Enzyme-linked immunosorbent assay (ELISA)
The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant? Monitor the client's toilet patterns. Monitor the client's physical condition. Monitor the client's heart rate. Monitor the client closely to prevent infection.
Monitor the client closely to prevent infection.
A nurse is caring for a client after a bone marrow transplant. What is the nurse's priority in caring for the client? Monitor the client to prevent sepsis. Monitor the client's toilet patterns. Monitor the client's physical condition. Monitor the client's heart rate.
Monitor the client to prevent sepsis.
A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand? Monocytes Neutrophils Eosinophils B cells
Neutrophils
Side effects of radiation therapy? an increased risk for infection constipation an increased appetite hemorrhagic cystitis
an increased risk for infection
Which allergic reaction is potentially life threatening? None of the listed allergic reactions is potentially life threatening. angioedema urticaria contact dermatitis
angioedema
The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as angioneurotic edema. contact dermatitis. urticaria. pitting edema.
angioneurotic edema.
A patient with HIV develops mycobacterium avian complex. What is an appropriate outcome? The patient will... Maintain adequate oxygenation Be free from injury maintain intact perineal skin contact agencies that provide services for the visually impaired
maintain intact perineal skin
A client with rheumatoid arthritis has experienced increasing pain and progressing inflammation of the hands and feet. What would be the expected goal of the likely prescribed treatment regimen? promoting sleep minimizing damage eliminating deformities eradicating pain
minimizing damage
Which statement by a client undergoing external radiation therapy indicates the need for further teaching? "I'll not use my heating pad during my treatment." "I'll wear protective clothing when outside." "I'll wash my skin with mild soap and water only." "I'm worried I'll expose my family members to radiation."
"I'm worried I'll expose my family members to radiation."
A client is recovering from a craniotomy with tumor debulking. Which comment by the client indicates to the nurse a correct understanding of what the surgery entailed? "I will be glad to finally be done with treatments for this thing." "I am so glad the doctor was able to remove the entire tumor." "Thank goodness the tumor is contained and curable." "I guess the doctor could not remove the entire tumor."
"I guess the doctor could not remove the entire tumor."
A terminally ill patient in pain asks the nurse to administer enough pain medication to end the suffering forever. What is the best response by the nurse? "I will notify the physician that the current dose of medication is not relieving your pain." "I can't do that, I will go to jail." "I will see if the physician will order enough for that to occur." "I am surprised that you would ask me to do something like that."
"I will notify the physician that the current dose of medication is not relieving your pain."
A client receiving chemotherapy has a nursing diagnosis of Deficient diversional activity related to decreased energy. Which client statement indicates an accurate understanding of appropriate ways to deal with this deficit? "I'll bowl with my team after discharge." "I'll eat lunch in a restaurant every day." "I'll take a long trip to visit my aunt." "I'll play card games with my friends."
"I'll play card games with my friends."
When evaluating a client's knowledge about use of antihistamines, what statement indicates further education is required? "This medication may be taken with food." "If I am pregnant, I should take half the dose." "Hard candy will relieve my dry mouth." "I should be careful when driving."
"If I am pregnant, I should take half the dose."
A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? "It is a muted response to something in the environment." "It is a hyperimmune response to something in the environment that is usually harmless." "It is a harmless reaction to something in the environment." "It means you are very sensitive to something inside of yourself."
"It is a hyperimmune response to something in the environment that is usually harmless."
A patient's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse? "It will hasten the death of the patient." "It will use artificial means of life support if the patient requests it." "It will enable the patient to remain home if that is what is desired." "It will prolong life in a dignified manner."
"It will enable the patient to remain home if that is what is desired."
A mother of three young children has been diagnosed with stage III breast cancer and is distraught. Which statement best communicates a spirit of hopefulness to this client? "I know another client with the same diagnosis who has been in remission for 10 years." "Let's take this one day at a time; remember you have your daughter's dance recital next week." "I believe that you will fight hard to beat this and see your babies grow up." "You should seek a second medical opinion about your diagnosis."
"Let's take this one day at a time; remember you have your daughter's dance recital next week."
A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan? "There are no activity limitations between flare-ups." "Exposure to sunlight will help control skin rashes." "Corticosteroids may be stopped when symptoms are relieved." "Monitor your body temperature."
"Monitor your body temperature."
A client is informed that his white blood cell count is low and that he is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? "White blood cells are produced in the lymphatic tissue." "White blood cells are produced in the thymus gland." "White blood cells are produced in the bone marrow." "White blood cells are produced in the plasma."
"White blood cells are produced in the bone marrow."
A young female client has received chemotherapeutic medications and asks about any effects the treatments will have related to her sexual health. The most appropriate statement by the nurse is "You will be unable to have children." "You will experience menopause now." "You will need to practice birth control measures." "You will continue having your menses every month."
"You will need to practice birth control measures."
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should assign highest priority to which intervention? Encouraging rhythmic breathing exercises Serving small portions of bland food Withholding fluids for the first 4 to 6 hours after chemotherapy administration Administering metoclopramide and dexamethasone as ordered
Administering metoclopramide and dexamethasone as ordered
A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do? Assess the client's vital signs. Administer epinephrine. Intubate the client. Perform an electrocardiogram (ECG).
Administer epinephrine.
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be? Supplying adaptive devices, such as a zipper-pull, easy-to-open beverage cartons, lightweight cups, and unpackaged silverware Administering ordered analgesics and monitoring their effects Providing comprehensive client teaching; including symptoms of the disorder, treatment options, and expected outcomes Performing meticulous skin care
Administering ordered analgesics and monitoring their effects
What do you give for someone who is wheezing and coughing from an allergic reaction? Albuterol Methylprednisone Aminophillene Cromolyn
Albuterol
Which is a sign or symptom of septic shock? Increased urine output Hypertension Warm, moist skin Altered mental status
Altered mental status
A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage according to Kübler-Ross? Acceptance Bargaining Denial Anger
Anger
Which term refers to fixation or immobility of a joint? Ankylosis Arthroplasty Diarthrodial Hemarthrosis
Ankylosis
Which of the following cell types are involved in humoral immunity? Suppressor T lymphocyte Helper T lymphocyte B lymphocytes Memory T lymphocyte
B lymphocytes
Activation of a natural immunity response is enhanced by physical and chemical barriers. Which of the following is a physical barrier, which the nurse knows can be altered by illness, nutrition, or lifestyle? Enzymes in saliva Mucus Acidic gastric secretions Cilia of the respiratory tract
Cilia of the respiratory tract
A nurse is providing care to a client experiencing symptoms associated with terminal illness. Which of the following would be most appropriate to use as a means for managing the client's symptoms? Physician's orders Client's goals Length of required treatment Invasiveness of the treatment
Client's goals
Which of the following remains the greatest barrier to improving end-of-life care? Focus on managing acute illness to achieve a cure Client and family denial about the seriousness of terminal illness Clinician's attitudes toward the terminally ill Advances in technology available to prolong life
Clinician's attitudes toward the terminally ill
Which primary cancer treatment goal is prolonged survival and containment of cancer cell growth? Cure Palliation Control Prevention
Control
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
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find? Elevated erythrocyte sedimentation rate Increased albumin levels Increased red blood cell count Increased C4 complement
Elevated erythrocyte sedimentation rate
Which is an appropriate nursing intervention in the care of the client with osteoarthritis? Avoid the use of topical analgesics Encourage weight loss and an increase in aerobic activity Provide an analgesic after exercise Assess for gastrointestinal complications associated with COX-2 inhibitors
Encourage weight loss and an increase in aerobic activity
The nurse practitioner has four patients with chronic illness that require consistent medical and nursing management. Select the condition that is the best example of a "chronically critical and progressively ill" condition. Carcinoma-in-situ End-stage renal disease Coronary artery disease Type 2 diabetes mellitus
End-stage renal disease
A client is suspected of having an immune system disorder. The health care provider wants to perform a diagnostic test to confirm the diagnosis. What test should the nurse prepare the client for? T-and C-cell assays Enzyme-linked immunosorbent assay Complete chemistry panel Plasmapheresis
Enzyme-linked immunosorbent assay
A nurse is taking health history from a new client, which includes asking about a history of blood transfusions. This is important for which reason? Exposure to foreign antigens may cause altered immune function. Blood products cause lower antibody titers. Blood products cause a high risk for hepatitis B. Blood products cause a high risk for exposure to HIV.
Exposure to foreign antigens may cause altered immune function.
A patient with lung cancer develops SIADH. They have weight gain, weakness, and nausea and vomiting. What should you do? Fluid restrictions a fluid bolus as ordered urinalysis as ordered sodium restricted diet as ordered
Fluid restrictions
Which of the following is an appropriate method of assessing the dying client? Sedate the client before completing range-of-motion exercises. Stimulate the client every 30 minutes. Repeat assessments as necessary. Focus on the client's basic needs.
Focus on the client's basic needs.
A nurse is teaching a client about the rationale for administering allopurinol with chemotherapy. Which example would be the best teaching by the nurse? It lowers serum and uric acid levels. It prevents alopecia. It treats drug-related anemia. It stimulates the immune system against the tumor cells.
It lowers serum and uric acid levels.
Which joint is most commonly affected in gout? Metatarsophalangeal Tarsal area Ankle Knee
Metatarsophalangeal
The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about? Etanercept (Enbrel) Methotrexate (Rheumatrex) Infliximab (Remicade) Methylprednisolone (Medrol)
Methotrexate (Rheumatrex)
A client with severe combined immunodeficiency disease is receiving immunosuppression therapy to ensure engraftment of depleted bone marrow during transplantation procedures. What is the priority nursing care for this client? Meticulous infection control precautions Continuous monitoring of cardiac status Daily weight measurements and strict monitoring of intake and output Daily oral assessment and oral care every 4 hours
Meticulous infection control precautions
In which phase of the cell cycle does cell division occur? G2 phase S phase Mitosis G1 phase
Mitosis
A client comes in to get an EIA test done because the health care provider suspects HIV. Which nursing action is essential before an EIA test is performed? Obtaining a general consent for medical care from the client Obtaining a written consent from the client Performing a polymerase chain reaction test Performing Western blotting
Obtaining a general consent for medical care from the client
What is the most common cause of anaphylaxis? Penicillin Opioids Radiocontrast agent NSAIDs
Penicillin
A majority of clients with CVID develop which type of anemia? Sickle cell Hemolytic Pernicious Macrocytic
Pernicious
A nurse is receiving a client with a radioactive implant for the treatment of cervical cancer. What is the nurse's best action? Place a chair next to the bed to allow the spouse to sit. Place the client in a private room. Allow visitors to telephone only. Have visitors wear dosimeters for safety.
Place the client in a private room.
The nurse knows that a patient who presents with the symptom of "blanching of fingers on exposure to cold" would be assessed for what rheumatic disease? Sjögren's syndrome Raynaud's phenomenon Ankylosing spondylitis Reiter's syndrome
Raynaud's phenomenon
Which condition is associated with impaired immunity relating to the aging client? Antibody production increases Renal function decreases Incidence of autoimmune disease decreases Skin becomes thicker
Renal function decreases
A terminally ill client is receiving morphine around-the-clock for pain control. As part of the client's plan of care focusing on pain management, which nursing diagnosis would the nurse most likely identify? Risk for ineffective cerebral tissue perfusion related to central nervous system effects of the drug Risk for constipation related to the effects of an opioid Impaired physical mobility related to sedative effects of the drug Caregiver role strain related to the need for around-the-clock pain control
Risk for constipation related to the effects of an opioid
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? Sedation Anorexia Diarrhea Palpitations
Sedation
The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response? The invading antigens link together (agglutination). T-cell lymphocytes survey proteins in the body and attack the invading antigens. Toxins of invading antigens are neutralized. The invading antigens precipitate.
Serum, which depletes the body's store of immunoglobulins
The nurse is beginning the physical examination of a client with a complaint of fatigue. What documentation will the nurse provide to describe this general appraisal of the client's health? The client is alert and oriented to all spheres. The client has a blood pressure of 120/72 mm Hg. The client appears mildly ill, listless, and disheveled. The client has palpable peripheral pulses in the upper extremities.
The client appears mildly ill, listless, and disheveled.
The nurse is gathering data from laboratory studies for a client who has HIV. The client's CD4+ cell count is 200/mm³, and the client has been diagnosed with pneumocystis pneumonia. What does this indicate to the nurse? The client has advanced HIV infection. The client has converted from HIV infection to AIDS. The client has another infection present that is causing a decrease in the CD4+ cell count. The client's CD4+ cell count has decreased due to the pneumocystis pneumonia.
The client has converted from HIV infection to AIDS.
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? The body overproduces immunoglobulins. The normal protective immune response attacks the body, damaging tissues. The body produces inappropriate or exaggerated responses to specific antigens. A deficiency results from improper development of immune cells or tissues.
The normal protective immune response attacks the body, damaging tissues.
Which do you expect to see if epinephrine injection has been effective? The patient's breathing becomes easier Their blood pressure goes down
The patient's breathing becomes easier
A nurse is assessing a client with possible osteoarthritis. What is the most significant risk factor for primary osteoarthritis? obesity trauma congenital deformity age
age
In spite of administering the prescribed pain medication, a dying client is still experiencing dyspnea due to fear and anxiety. Which nursing intervention should the nurse use to potentiate the effects of pain medication and help reduce the dyspnea? Offer small amounts of nourishment frequently Encourage the patient to sleep Use imagery, humor, and progressive relaxation Gently massage the arms and legs
Use imagery, humor, and progressive relaxation
A client is prescribed antihistamines, and asks the nurse about administration and adverse effects. The nurse should advise the client to avoid: exposure to sunlight. alcohol. seafood. applying skin moisturizers.
alcohol
The nurse explains to a client that immunotherapy initially starts with injections at which interval? Weekly Daily Bi-monthly Monthly
Weekly
Which specific factor is associated with etiology of cancer? Dietary hormonal and chemical agents physical factors all of the above
all of the above
A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer? furosemide calcium gluconate aspirin colchicine
colchicine
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? leukotrienes prostaglandins serotonin histamine
histamine
The nurse is caring for a client exposed to peanuts with a known allergy. What assessment is considered the most serious manifestation of angioneurotic edema? laryngeal swelling conjunctivitis abdominal pain urticaria
laryngeal swelling
A decrease in circulating white blood cells (WBCs) is referred to as Granulocytopenia Thrombocytopenia Neutropenia Leukopenia
leukopenia
A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include? nonmovable reddened tender to the touch located over bony prominence
located over bony prominence
A diet plan is developed for a client with gouty arthritis. What should the nurse advise the client to limit the intake of? organ meats citrus fruits green vegetables fresh fish
organ meats
A type of comprehensive care for clients whose disease is not responsive to cure is a terminal illness. palliative care.
palliative care.
The nurse is teaching a client about contact dermatitis. What type of contact dermatitis requires light exposure in addition to allergen contact? photoallergic phototoxic allergic irritant
photoallergic
The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response? mold spores animal dander plant pollen dust mites
plant pollen
A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? reticulocyte count of 1% neutrophil count of 40% platelet count of 60,000/mm3 lymphocyte count of 30%
platelet count of 60,000/mm3
Patient has neutropenia, What should the nurse plan? restrict all visitors teach the patient and family about the need for hand hygiene insert a Foley catheter to prevent skin breakdown restrict fluid intake
teach the patient and family about the need for hand hygiene