Ch 38: Allergic Disorders - PrepU

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 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 muted response to something in the environment."

"It is a hyperimmune response to something in the environment that is usually harmless."

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." "The full benefit of the medication may take up to 2 weeks to be achieved." "You may be immune to the effects of this medication and will need something else in its place." "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."

A middle-aged woman suffers from debilitating seasonal allergies and has sought care because over-the-counter remedies do not adequately relieve her symptoms. The clinician's understanding of the patient's problem should include the fact that hypersensitivity is a result of what pathophysiological process? A lack of antibodies against common pathogens Lack of "self" and "non-self" differentiation by the immune system An exaggerated, inappropriate response to an antigen Deranged function of killer T cells and helper T cells

An exaggerated, inappropriate response to an antigen

At an office birthday party, one of the executives ate a piece of cake that he was unaware had been made with peanut oil. He begins wheezing, with an inspiratory stridor and air hunger. The occupational health nurse is called to the office. The nurse recognizes he is suffering from which type of hypersensitivity? Cytotoxic (type II) Immune Complex (type III) Anaphylactic (type 1) Delayed type (type IV)

Anaphylactic (type 1)

A patient has developed severe contact dermatitis with burning, itching, cracking, and peeling of the skin on her hands. What should the patient be instructed to do? Wear powdered latex gloves. Keep her hands well moisturized. Wash her hands with antibacterial soap. Maintain the room temperature at 80°F.

Keep her hands well moisturized.

A client is prescribed montelukast as part of a treatment plan for an allergic disorder. The nurse understands that this drug belongs to which class? Mast cell stabilizer Nonsedating antihistamine Corticosteroid Leukotriene-receptor antagonist

Leukotriene-receptor antagonist

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

Penicillin

A nurse who works on a busy medical unit has been experiencing dry, itchy, reddened hands that she believes are a result of the frequent hand-washing that her job requires. What should the nurse's colleague recommend for the relief of this problem? Handwashing with water alone Over-the-counter antihistamines Topical corticosteroids Use of a different type of soap

Use of a different type of soap

The nurse explains to a client that immunotherapy initially starts with injections at which interval? Weekly Daily Bi-monthly Monthly

Weekly

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

adrenal suppression.

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 fexofenadine fluticasone zileuton

fluticasone

The nurse is teaching a client with allergic rhinitis about medications. What medication is a mast cell stabilizer used in the treatment of allergic rhinitis? pseudoephedrine hydrochloride tetrahydrozoline hydrochloride intranasal cromolyn sodium oxymetazoline hydrochloride

intranasal cromolyn sodium

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

plant pollen

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 alloimmunity disorder An exacerbation of a previous disorder A cause-and-effect relationship Autoimmune

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? Carry an emergency kit. Avoid potential allergens. Wear a medical alert bracelet. Undergo desensitization treatment.

Avoid potential allergens.

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

Cutaneous

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 Plantar aspects of the feet Ankles Lower arms

Dorsal aspect of the hand

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

Hapten

An occupational health nurse is assessing a woman who experienced an anaphylactic reaction to a dip that contained crab during an office celebration. Because the woman promptly self-administered epinephrine, her status has normalized and she is now resting in a colleague's office. What action should the nurse perform? Liaise with the woman's family and arrange for her to return home. Have the woman transported to a nearby emergency department. Provide reassurance to limit the woman's anxiety. Encourage the woman to limit her physical activity for the next 24 to 48 hours.

Have the woman transported to a nearby emergency department.

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? High neutrophil count High IgE concentration Low white blood cell count Low eosinophil count

High IgE concentration

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

Histamine

The nurse working in an allergy clinic is preparing to administer skin testing to a client. Which route is the safest for the nurse to use to administer the solution? Intramuscular Intravenous Intradermal Subcutaneous

Intradermal

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? Maintains pressure on the auto-injector for about 30 seconds after insertion 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 medicatio

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

Which statement describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex? They are localized to the area of exposure, usually the back of the hands. They occur within minutes after exposure to latex. They may worsen when hand lotion is applied before donning latex gloves. They can be eliminated by changing glove brands or using powder-free gloves.

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

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. What medication prescribed may be responsible for the reaction? Angiotensin-converting enzyme (ACE) inhibitor Vasodilator Beta blocker Angiotensin receptor blocker

Angiotensin-converting enzyme (ACE) inhibitor

A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. What will the nurse include when teaching the client about this drug? Use ice chips to alleviate the symptoms of dry mouth. Place the prescribed number of drops into the conjunctiva. Be aware that some nasal burning and itching may occur. Take the drug orally before, with, or after meals.

Be aware that some nasal burning and itching may occur.

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 Blistering Rhinitis Angioedema

Blistering

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

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? allergic contact IgE-mediated hypersensitivity irritant contact IgG antibodies

IgE-mediated hypersensitivity

A 44-year-old man has come to the clinic with an asthma exacerbation. He tells the nurse that his father and brother also suffer from asthma, as does his 15-year-old son. The nurse explains that this is an allergic response based on a genetic predisposition. The specific allergen initiated by this immunological mechanism is usually mediated by: Immunoglobulin G Immunoglobulin M Immunoglobulin A Immunoglobulin E

Immunoglobulin E

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. What would the nurse identify as a common cause of anaphylaxis? Select all that apply. Chicken Shrimp Milk Beef Eggs

Milk Eggs Shrimp

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"? Drink plenty of fluids. Use the medication every 4 hours to prevent congestion from recurring. Be sure to use the nasal spray for at least 10 days to ensure the stuffiness is gone. Only use the nasal spray for 3 to 4 days once every 12 hours.

Only use the nasal spray for 3 to 4 days once every 12 hours.

The nurse is teaching a client about a recent order for loratadine to help with seasonal allergies. What client statements indicate no further teaching is required? Select all that apply. "Being careful driving is important after taking the medication." "Sucking on ice chips will help if my mouth is dry." "It is recommended that I buy a humidifier for my bedroom." "Taking my medication on an empty stomach is a must." "Drinking two or three alcoholic drinks a week is okay."

"Taking my medication on an empty stomach is a must." "Sucking on ice chips will help if my mouth is dry." "Being careful driving is important after taking the medication." "It is recommended that I buy a humidifier for my bedroom."

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? 3:00 PM 1:00 PM 10:00 AM 11:00 AM

10:00 AM

A patient received epinephrine in response to an anaphylactic reaction at 10:00 AM. The nurse knows to observe the patient for a "rebound" reaction that may occur as early as: 4:00 PM. 10:00 PM. 6:00 PM. 2:00 PM.

2:00 PM.

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

Diphenhydramine

The parents of a child with contact dermatitis are asking questions about the reaction within the immune system. What description regarding contact dermatitis as a type IV hypersensitivity reaction is accurate? a delayed-type hypersensitivity that is mediated by T cells the immediate release of chemical mediators the involvement of immune complexes formed when antigens bind to antibodies a cross-reacting antibody that mistakes a normal constituent of the body as foreign

a delayed-type hypersensitivity that is mediated by T cells

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 contact dermatitis. pitting edema. angioneurotic edema. urticaria.

angioneurotic edema.

A clinic nurse has been charged with the responsibility of teaching avoidance strategies to an adult patient who has allergic rhinitis. What measure should the nurse recommend to this patient? "Make sure that there are never air drafts in your home." "Avoid the use of air conditioning whenever possible." "If possible, make sure that no one smokes tobacco in your home." "Keep your windows open to ensure adequate air circulation."

"If possible, make sure that no one smokes tobacco in your home."

The nurse is caring for a client experiencing an anaphylactic reaction. The nurse prepares for the maximum intensity of histamine response to occur within which time frame? 5 to 10 minutes 15 to 20 minutes 30 to 35 minutes 40 to 45 minutes

5 to 10 minutes

A 10-year-old boy has been brought to the emergency department (ED) by ambulance in apparent anaphylaxis after accidentally eating a snack bar that contained peanuts. The ED nurse should be aware that this patient's signs and symptoms are attributable to: Rapid activation of the clotting cascade A massive release of histamine Dissolution of the basement membranes of epithelium Activation of the sympathetic nervous system (SNS)

A massive release of histamine

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? Do not operate machinery or drive while using the medication. Do not overuse the medication as rebound congestion can occur. Report white patches in the mouth because the medication can cause a fungal infection. Taper the dose when discontinuing the medication.

Do not overuse the medication as rebound congestion can occur.

A client with an allergic disorder is in treatment for their disorder. What might their treatment be? Autoimmune therapy Hypersensitive therapy Resensitization therapy Drug therapy

Drug therapy

A client develops contact dermatitis in response to adhesive tape used to secure a dressing. The nurse interprets this reaction as an example of which type of hypersensitivity? Type II Type IV Type III Type I

Type IV

The nurse is teaching a client about histamine release during an anaphylactic reaction. What does histamine release in anaphylaxis cause? urinary urgency stomach cramps feeling of impending doom nasal congestion

nasal congestion