Exam #8

The development of a positive HIV antibody test following initial infection generally occurs in which timeframe? A) 4 weeks B) 6 weeks C) 8 weeks D) 10 weeks

A) 4 weeks Development of a positive HIV antibody test generally occurs within 4 weeks and with few exceptions by 6 months.

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? A) Lymphocytes B) Cytoblasts C) Antibodies D) Capillaries

A) lymphocytes

A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which reason? A) Antineoplastic drug therapy B) Excess circulating lymphocytes C) Deficient circulating antibodies D) Excess circulating hemoglobin

A) Antineoplastic drug therapy Clients who receive chemotherapy are immunosuppressed. Antineoplastic drugs cause a compromised immune system. Breast cancer is not associated with an excess of lymphocytes, a deficiency of circulating antibodies, or an excess of hemoglobin.

Which of the following is a center for immune cell proliferation? A) Lymph node B) Spleen C) Pancreas D) Liver

A) Lymph node The lymph nodes remove foreign material from the lymph system before it enters the bloodstream. They are centers for immune cell proliferation.

A nurse is reviewing the history of a client diagnosed with erectile dysfunction. Which information would the nurse interpret as indicating that use of a PDE-5 inhibitor would be contraindicated. A) use of nitroglycerin for angina B) history of heart attack 2 years ago C) hypertension controlled with medications D) use of antiseizure medications

A) use of nitroglycerin for angina PDE-5 inhibitors should not be taken if the client is taking nitrate medications, such as nitroglycerine or isosorbide mononitrate, or if the client has high uncontrolled blood pressure, coronary artery disease, or a heart attack within the past 6 months. Use of antiseizure medications can cause erectile dysfunction.

A 66-year-old man has been admitted to the postsurgical unit after his immediate recovery from a prostatectomy. The patient has asked the nurse when he will be able to get up out of bed, since this subject was not addressed in his preoperative teaching. How should the nurse best respond to the patient's question about mobility and activity? A) "It's best to stay in bed for the first 36 to 48 hours after your surgery to prevent some of the common complications of your surgery." B) "I can help you get up as soon as you feel strong enough, but make sure you don't sit in a chair for too long." C)"You can probably get up as soon as your urinary catheter is removed." D)"See if you can sit on the edge of your bed for an hour or so before you try walking."

B) "I can help you get up as soon as you feel strong enough, but make sure you don't sit in a chair for too long." As with most surgeries, early ambulation is encouraged after prostatectomy. After the patient is ambulatory, he is encouraged to walk but not to sit for prolonged periods, because this increases intra-abdominal pressure and the possibility of discomfort and bleeding. The patient's catheter will likely be in place for several days following prostatectomy.

One of a hospital patient's scheduled 08:00 medications is finasteride (Proscar), a 5-alpha-reductase inhibitor that the nurse recognizes as a treatment for benign prostatic hyperplasia (BPH). The nurse should be aware that this drug achieves a therapeutic effect by: A) Increasing the osmolality of urine, facilitating easier passage through the urethra B) Relaxing the smooth muscle of the bladder neck and prostate C) Inhibiting the conversion of testosterone to dihydrotestosterone D) Increasing the tone of the bladder's detrusor muscle

C) Inhibiting the conversion of testosterone to dihydrotestosterone 5-alpha-reductase inhibitors interfere with the conversion of testosterone to dihydrotestosterone (DHT), which is associated with prostate growth. They do not affect bladder tone, urine chemistry, or the muscle tone of the bladder neck and prostate.

While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? A) 1% to 3% B) 3% to 4% C) 5% to 10% D) 15% to 40%

D) 15% to 40%

A health care provider orders tests to determine if a client has systemic lupus erythematosus (SLE). Which test result helps to confirm an SLE diagnosis? A) Increased total serum complement levels B) Negative antinuclear antibody test C) Negative lupus erythematosus cell test D) An above-normal anti-deoxyribonucleic acid (DNA) test

D) An above normal anti- deoxyribonucleic acid test Laboratory results specific for SLE include an above-normal anti-DNA test, a positive antinuclear antibody test, and a positive lupus erythematosus cell test. Because the anti-DNA test rarely is positive in other diseases, this test is important in diagnosing SLE. (The anti-DNA antibody level may be depressed in clients who are in remission from SLE.) Decreased total serum complement levels indicate active SLE.

A 22-year-old woman is scheduled to begin radiotherapy for the treatment of invasive cervical cancer. The nurse should be aware that there is a high likelihood that the woman has a history of what sexually transmitted infection? A) Trichomonas vaginalis B) Pelvic inflammatory disease (PID) C) Neisseriae gonorrhoeae D) Human papillomavirus (HPV)

D) HPV Certain types of HPV can cause the cells of the cervix to become abnormal, attributing to approximately 70% of cervical cancer cases. The other listed diseases are not directly implicated in the etiology of cervical cancer.

A client informs the nurse that he has been diagnosed with degenerative joint disease of the fingers but now has these bumps on his fingers that don't hurt. The nurse observes bony nodules on the distal interphalangeal joints. What type of "bumps" does the nurse understand these are? A) Rheumatoid nodules B) Tophi C) Bouchard's nodes D) Heberden's nodes

D) Heberden's nodes DJD affects the hands; the fingers frequently develop painless bony nodules on the dorsolateral surface of the interphalangeal joints. Heberden's nodes are bony enlargement of the distal interphalangeal joints. Bouchard's nodes are bony enlargement of the proximal interphalangeal joints. Rheumatoid nodules are associated with rheumatoid arthritis. Tophi occur with gout and elevated uric acid levels.

Which drug is not used in the treatment of rheumatoid arthritis? A) allopurinol B) etanercept C) adalimumab D) methotrexate

A) Allopruinol Allopurinol is used in the treatment of gout. Etanercept, adalimumab, and methotrexate are all used in the treatment of rheumatoid arthritis.

Which of the following procedures involves a surgical fusion of the joint? A) Arthrodesis B) Synovectomy C) Tenorrhaphy D) Osteotomy

A) Arthrodesis An arthrodesis is a surgical fusion of the joint. Synovectomy is the excision of the synovial membrane. Tenorrhaphy is the suturing of a tendon. An osteotomy alters the distribution of the weight within the joint.

The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? A) Natural killer cells B)Cytokines C) Interleukins D) Interferons

A) Natural killer cells Natural killer cells are lymphocyte-like cells that circulate throughout the body looking for virus-infected cells and cancer cells. Cytokines are chemical messengers released by lymphocytes, monocytes, and macrophages. Interleukins carry messages between leukocytes and tissues that form blood cells. Interferons are chemicals that primarily protect cells from viral infections.

Which finding is consistent with the diagnosis of rheumatoid arthritis? A) Decreased ESR B) Cloudy synovial fluid C)Increased red blood cell count D) Increased C4 complement component

B) Cloudy synovial fluid In a client with rheumatoid arthritis, arthrocentesis shows synovial fluid that is cloudy, milky, or dark yellow and contains numerous inflammatory components, such as leukocytes and complement

A 48-year-old man recently diagnosed with benign prostatic hyperplasia (BPH) reports consuming <i>Serenoa repens</i> (saw palmetto berry). The nurse needs to intervene if the physician orders which treatment? A) Terazosin B) Finasteride C) Sipuleucel-T D) Ketoconazole

B) Finasteride Serenoa repens (saw palmetto berry) should not be used with finasteride. Terazosin is an alpha-adrenergic blocker and can be taken with Serenoa repens. Sipuleucel-T is a therapeutic cancer vaccine. Ketoconazole is an adrenal-ablating drug used to inhibit cytochrome P450 enzymes.

There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? A) Sharing the diagnosis with a support group B) Caring for a client who can kill other people C) Disclosure of the client's condition D) Caring for a client with an infectious terminal disease

C) disclosure of clients condition Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client's diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue.

The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count? A) Less than 200/mm3 B) Between 200 to 350/mm3 C) Between 350 to 499/mm3 D) Greater than 500/mm3

D) Greater than 500/mm3

A client with degenerative joint disease asks the nurse for suggestions to avoid unusual stress on the joints. Which suggestion would be most appropriate? A) Keep shifting weight from one foot to the other. B)Perform aerobic exercises. C) Maintain complete bed rest. D) Maintain good posture.

D) Maintain good posture The nurse needs to remind the client with degenerative joint disease to maintain good posture. While the client need not maintain complete bed rest, performing aerobic exercises is not advisable as it may place undue stress on the joint worsening the condition. Shifting weight from one foot to the other does not help avoid unusual stress on a joint.

Which statement holds true? Untreated genital warts: A) may resolve on their own, remain unchanged, or increase in size or number. B)may lead to AIDS. C)do not resolve on their own and increase in size with abscess formations. D)do not lead to any other illness and resolve on their own without treatment.

A) May resolve on their own, remain unchanged, or increase in size or number. Untreated genital warts do not lead to AIDS. Untreated genital warts may resolve on their own, remain unchanged, or increase in size or number. They may lead to cervical or other pelvic reproductive types of cancer.

A client has had several diagnostic tests to determine if he has systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis? A) Positive Anti-dsDNA antibody test B) Positive Anti-Sm antibodies C) Positive ANA titre D) Elevated ESR

A) Positive Anti-dsDNA antibody test Anti-double-stranded DNA (anti-dsDNA) antibody test is a test that shows high titers of antibodies against native DNA. This is very specific for SLE because this test is not positive for other autoimmune disorders. Anti-Smith (anti-Sm) antibodies are specific for SLE, but are found in only 20% to 30% of clients with SLE. ANA titre shows the presence of an autoimmune disease but is not specific to SLE. The other lab studies may also indicate multisystem involvement.

The nurse is preparing to infuse gamma-globulin intravenously (IV). When administering this drug, the nurse knows the speed of the infusion should not exceed what rate? A) 1.5 mL/min B) 3 mL/min C) 6 mL/min D) 10 mL/min

B) 3 mL/min The nurse should administer the IV infusion at a slow rate, not to exceed 3 mL/min, usually at 100-200 mL/h.

The nurse is preparing to administer the recommended dose of intravenous gamma-globulin for a 60-kg male patient. How many grams will the nurse administer? A) 15 g B) 30 g C) 60 g D) 90 g

B) 30 g

Which condition is associated with impaired immunity relating to the aging client? A) Increase in humoral immunity B) Breakdown and thinning of the skin C) Decrease in inflammatory cytokines D) Increase in peripheral circulation

B) Breakdown and thinning of the skin The aging process stimulates changes in the immune system. Age-related changes in many body systems also contribute to impaired immunity. Changes such as poor circulation, as well as the breakdown of natural mechanical barriers such as the skin, place the aging immune system at even greater disadvantage against infection. As the immune system undergoes age-associated alterations, its response to infections progressively deteriorates. Humoral immunity declines and the number of inflammatory cytokines increase with age.

Infants with DiGeorge syndrome have which type of endocrine disorder? A) Hypothyroidism B) Hyperthyroidism C) Hypoparathyroidism D) Hyperparathyroidism

C) Hypooparthyroidism Infants born with DiGeorge syndrome have hypoparathyroidism with resultant hypocalcemia resistant to standard therapy. The other endocrine disorders do not occur in DiGeorge syndrome.

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported? A) Genital herpes B)Hepatitis B C) Syphilis D) Condylomata acuminata

C) Syphilis The law mandates reporting of syphilis, chlamydia, gonorrhea, chancroid, and HIV/AIDs. Genital herpes, hepatitis B, veneral warts (condylomata acuminata), granuloma inguinale, and lymphoma venereum are not reportable by law.

A gardener sustained a deep laceration while working and requires sutures. The patient is asked about the date of his last tetanus shot, which he tells the nurse was more than 10 years ago. Based on this information, the patient will receive a tetanus immunization. The tetanus injection will allow for the release of what? A) An antibody B) An antigen C) A bacteria D) A virus

A) An antibody The structural part of the invading or attacking organism that is responsible for stimulating antibody production is called an antigen. For example, an antigen can be a small patch of proteins on the outer surface of the microorganism. Not all antigens are naturally immunogenic, and these must be coupled to other molecules to stimulate the immune response. A single bacterium or large molecule, such as diphtheria or tetanus toxin, may have several antigens, or markers, on its surface, thus inducing the body to produce a number of different antibodies. Bacteria are microorganisms. A virus is an organism that can cause disease.

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? A) Latency B) Secondary C) Primary D) Tertiary

A) Latency Secondary syphilis occurs when the hematogenous spread of organisms from the original chancre leads to generalized infection. A period of latency occurs when the infected person has no signs or symptoms of syphilis. Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. Tertiary syphilis presents as a slowly progressive inflammatory disease with the potential to affect multiple organs.

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity? A)The normal protective immune response attacks the body, damaging tissues. B)The body produces inappropriate or exaggerated responses to specific antigens. C)The body overproduces immunoglobulins. D)A deficiency results from improper development of immune cells or tissues.

A) The normal protective immune response attacks the body, damaging tissue

What chemical is released by cytotoxic T cells? A) Lymphokine B) Antigen C) Antibody D) Microphages

A) Lymphokine Cytotoxic T cells bind to invading cells, destroy the targeted invader by altering their cellular membrane and intracellular environment, and release chemicals called lymphokines. Lymphokines, a type of cytokine, attract neutrophils and monocytes to remove the debris. Options B, C, and D are incorrect.

A 36-year-old woman has been experiencing debilitating pain and fatigue for several months and has sought care on numerous occasions from several different care providers. She is now being assessed for fibromyalgia. The patient tells the clinic nurse that it is an incredible relief to have a possible diagnosis, stating, "I felt for so long that absolutely no one was taking me seriously." The nurse should recognize that this statement represents an improvement in which of the following nursing diagnoses? A) Powerlessness B) Ineffective coping C) Ineffective therapeutic regimen management D) Anxiety

A) Powerlessness The patient's repeated complaints that failed to result in adequate follow-up are suggestive of a feeling of powerlessness. The patient's statement does not indicate that she was coping ineffectively or neglecting her health. Anxiety likely accompanied the woman's experience in the health care system, but her statement most clearly suggests powerlessness.

Which nursing assessment finding is most significant in determining the plan of care in a client with erectile dysfunction? A) Age B) Medication use C) Sexual history D) Undescended testicle

B) medication use Certain medications such as antihypertensive drugs, antidepressants, narcotics, etc. can cause sexual dysfunction in men. Impotence is not a normal part of aging. Undescended testicle is not indicative of ED. Sexual history is not indicative of ED.

When assessing a client with benign prostatic hyperplasia, which of the following would the nurse expect the client to report as the initial complaint? A) Dark brown urine B) Increased effort to void C)Narrowing of urinary stream D) Nocturia

B) increased effort to void The symptoms of BPH appear gradually. At first, the client notices that it takes more effort to void. Eventually, the urinary stream narrows and has decreased force. The bladder empties incompletely. As residual urine accumulates, the client has an urge to void more often and nocturia occurs.

A client developed an infection while on vacation in Central America and is now taking the antibiotic chloramphenicol. What should the client be monitored for when taking this drug? A) Eosinophilia B)Neutropenia C)Aplastic anemia D) Hypoprothrombinemia

C) Aplastic anemia The effects of chloramphenicol (Chloromycetin) on the immune system include leukopenia and aplastic anemia.

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. A) Helper T cell B) Suppressor T cell C) Cytotoxic T cell D) Memory T cell

C) Cytotoxic T cell

A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: A) Antibodies reside in the plasma B)Antibodies are released into the bloodstream C) B-lymphocytes respond to a specific antigen D)Lymphocytes migrate to areas of the lymph node

D) lymphocyte migrate to areas of the lymph node Lymphocytes migrate to areas other than those programmed to become plasma cells.

Which of the following is a lack of one or more of the five immunoglobulins? A) Hypogammaglobulinemia B) Agammaglobulinemia C) Panhypoglobulinemia D) Telangiectasia

A) Hypogammaglobulinemia Hypogammaglobulinemia is a lack of one or more of the five immunoglobulins. Agammaglobulinemia is a disorder marked by an almost complete lack of immunoglobulins or antibodies. Panhypoglobulinemia is a general lack of immunoglobulins in the blood. Telangiectasia are vascular lesions caused by dilated blood vessels.

A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which reason? A) Use of anti-rejection drugs B) Excess circulating lymphocytes C) Deficient circulating antibodies D) Excess circulating hemoglobin

A) Use of anti-rejection drugs Clients who receive a kidney transplant must take immunosuppressant drugs to prevent rejection of the transplant. These drugs cause a compromised immune system. Renal transplant is not associated with excess lymphocytes, deficient circulating antibodies, or excess hemoglobin.

A child is brought to the clinic with a rash. The child is diagnosed with measles. The mother tells the nurse that she had the measles when she was a little girl. What immunity to measles develops after the initial infection? A) Naturally acquired active immunity B)Artificially acquired active immunity C)Naturally acquired passive immunity D) Artificially acquired passive immunity

A) naturally acquired active immunity Immunity to measles that develops after the initial infection is an example of naturally acquired active immunity. Artificially acquired active immunity results from the administration of a killed or weakened microorganism or toxoid (attenuated toxin), whereas passive immunity develops when ready-made antibodies are given to a susceptible client.

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? A) Mucus B) Acidic gastric secretions C) Cilia of the respiratory tract D) Enzymes in saliva

C) Cilia of the respiratory tract Cilia are considered a physical barrier, along with intact skin and mucous membranes.

A triple-lumen indwelling urinary catheter is inserted for continuous bladder irrigation following a transurethral resection of the prostate. In addition to balloon inflation, the functions of the three lumens include: A) continuous inflow and outflow of irrigation solution. B)intermittent inflow and continuous outflow of irrigation solution. C) continuous inflow and intermittent outflow of irrigation solution. D) intermittent flow of irrigation solution and prevention of hemorrhage.

A) Continuous inflow and outflow of irrigation solution When preparing for continuous bladder irrigation, a triple-lumen indwelling urinary catheter is inserted. The three lumens provide for balloon inflation and continuous inflow and outflow of irrigation solution.

Which of the following maybe the first and only physical sign of symptomatic osteoarthritis (OA)? A) Limited passive movement B) Joint enlargement C) Joint instability D) Limb shortening

A) Limited passive movement Limited passive movement can be the first and only physical sign of symptomatic OA. Physical assessment of the musculoskeletal system reveals joint enlargement, joint instability, and limb shortening.

A 29-year-old patient has just been told that he has testicular cancer and needs to have surgery. The surgery is scheduled for the following week. That afternoon, the patient calls the nurse and tells her he wants to cancel the surgery because he thinks he might be better off dead. The nurse asks him why he feels that way. The patient states "My wife won't want to have sex with me anymore. He says he feels like he's spoiled a happy, satisfying sex life with his wife and he starts to cry. Based on these statements, which nursing diagnosis would be most appropriate for creating a plan of care for this patient? A) Situational low self-esteem B) Inability to function C) Social isolation D) Risk for loneliness

A) Situational low self-esteem Because the patient may have difficulty coping with his condition, issues related to body image and sexuality should be addressed. The scenario stated in this case is typical of a patient with situational low self-esteem. The diagnosis of inability to function is a distracter for this question. This patient is at risk for social isolation and loneliness, but there's no indication in the scenario that these diagnoses are present.

The nurse is gathering objective data for a client at the clinic complaining of arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as? A) Swan neck deformity B) Boutonnière deformity C) Ulnar deviation D) Rheumatoid nodules

A) Swan neck deformity A swan neck deformity is a hyperextension of the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. A Boutonnière deformity is a persistent flexion of the proximal interphalangeal joint with hyperextension of the distal interphalangeal joint. Ulnar deviation is when the fingers are deviating laterally toward the ulna. A rheumatoid nodule is a subcutaneous nodule.

T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? A) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. B) T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. C) T-cell and B-cell lymphocytes react to the body's lack of B12 . D) T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.

A) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. T-cell and B-cell lymphocytes are the primary participants in the immune response. They distinguish harmful substances and ignore those natural and unique to a person. Options B, C, and D are incorrect.

The nurse is assessing a client who has had rheumatoid arthritis for several years. What clinical manifestation will the nurse expect to find in a client? A) small joint involvement B) obesity C) Bouchard's nodes D) asymmetric joint involvement

A) small joint involvement Clinical manifestations of rheumatoid arthritis are usually bilateral and symmetrical and include small joint involvement and joint stiffness in the morning. Other systemic manifestations occur over time. Obesity, Bouchards nodes, and asymmetric joint involvement can be seen with the early stage of the disease.

Which condition is associated with buildup of fibrous plaques in the sheath of the corpus cavernosum, causing curvature of the penis when it is erect? A) Bowen's disease B)Phimosis C) Peyronie's disease D) Priapism

C) Peyronie's disease Peyronie's disease may require surgical removal of the plaques when the disease makes sexual intercourse painful, difficult, or impossible. Bowen's disease refers to a form of squamous cell carcinoma in situ of the penile shaft. Phimosis refers to the condition in which the foreskin is constricted so that it cannot be retracted over the glans. Priapism refers to an uncontrolled, persistent erection of the penis occurring from either neural or vascular causes.

A young male patient of a free clinic has been diagnosed with gonorrhea and has begun treatment. The nurse at the clinic is providing the man with relevant health education and has emphasized the importance of using condoms. The man replies, "I can't stand using condoms because I can't feel anything if I use one. I'll have to think about that." The nurse should consequently identify which of the following nursing diagnoses? A) Anxiety related to diagnosis with an sexually transmitted infection (STI) B) Ineffective coping related to necessary health promotion measures C) Risk for infection transmission related to lack of STI prevention measures D) Deficient knowledge about the disease and risk for spread of infection

C) Risk for infection transmission related to lack of STI prevention measures This patient's ambivalence about important protective measures is suggestive of a risk for infection transmission. There is no indication that he lacks knowledge or is experiencing anxiety or ineffective coping.

Which type of hypersensitivity reaction involves immune complexes forming when antigens bind to antibodies? A) Type I B) Type II C) Type III D) Type IV

C) Type III Type III hypersensitivity is associated with systemic lupus erythematosus, rheumatoid arthritis, serum sickness, certain types of nephritis, and some types of bacterial endocarditis. Type I, or anaphylactic hypersensitivity, is an immediate reaction, beginning within minutes of exposure to an antigen. Type II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the body as foreign. Type IV, or delayed-type, hypersensitivity occurs 24 to 72 hours after exposure to an allergen.

A nurse is preparing a presentation about STIs for a local community group. When describing chlamydia, which age group would the nurse identify as being at greatest risk for this infection? A) Women younger than 24 years of age B)Men between the ages of 18-28 years C)Women in their 30s D)Men between the ages of 25-30

A) Women younger than 24 years of age. Any sexually active person can be infected with Chlamydia or N. gonorrhoeae, and the risk increases with the number of sexual partners. The group with the greatest risk for Chlamydia infection is young women age 24 and under; the high risk may be associated with a cervix that has not matured fully.

The nurse reviews laboratory results requested to track HIV. What laboratory test measures HIV RNA levels and is the best predictor of HIV disease progression? A) Enzyme immunoassay (EIA) B) Western blot C) Viral load D) CD4/CD8

C) Viral load The viral load test quantifies the plasma HIV RNA levels and response to treatment of the HIV infection. It also confirms a positive EIA result and detects HIV in high-risk seronegative individuals before antibodies are measurable.

A nurse is teaching a group of college-aged men about the risks of Chlamydia trachomatis and Neisseriae gonorrhoeae. A participant has implied that men do not need to be particularly concerned about these diseases since the health consequences for men are comparatively minor. The nurse counters that men may in fact become infertile because these diseases can cause: A) Priapism B) Epididymitis C) Incarcerated hernias D) Hydrocele

B) epididymitis In men younger than 35 years of age, the major cause of epididymitis or orchitis is C. trachomatis. Both conditions can result in infertility. Priapism, hernias, and hydrocele are not sequelae of C. trachomatis and N. gonorrhoeae.

After a routine physical exam, a female client is devastated to receive a diagnosis of the sexually transmitted infection, gonorrhea. What would contribute to the client's ignorance of this condition? A) being asymptomatic B) knowing the signs and symptoms of STIs C) being sexually inactive D) All options are correct.

A) being asymptomatic Many women who have gonorrhea are asymptomatic, a factor that contributes to the spread of the disease. Knowing the signs and symptoms of STIs will not help with an asymptomatic disease. Being sexually inactive currently will not prevent having been infected with a disease in the past.

After teaching a group of student about structural abnormalities of the male reproductive system, the instructor determines that the teaching was successful when the students identify which of the following as an example? A) Erectile dysfunction B) Prostatitis C) Cryptorchidism D) Priaprism

C) Cryptorchidism Structural abnormalities include cryptorchidism, torsion of the spermatic cord, phimosis, paraphimosis, hydrocele, spermatocele, and varicocele. Erectile dysfunction and priaprism are erection disorders. Prostatitis is an infectious disorder.

While taking the health history of a newly admitted client, the nurse asks for a list of the client's current medications. Which of the following medication classifications would place the client at risk for impaired immune function? A) Antimetabolites B) Antihypertensives C) Inotropics D) Pancreatic enzymes

A) antimetabolites Antimetabolites can cause leukopenia, eosinoplilia, aplastic bone marrow, and pancytopenia. The other choices do not directly affect the immune system.

A patient has been prescribed sildenafil citrate. What should the nurse teach the patient about this medication? A) Sexual stimulation is not needed to obtain an erection. B) The drug should be taken 1 hour prior to intercourse. C) Facial flushing or headache should be reported to the health care provider immediately. D) A high dose may result in a permanent change of vision.

B) this drug should be taken 1 hour prior to intercourse The patient must have sexual stimulation to create the erection, and the drug should be taken 1 hour before intercourse. Facial flushing, mild headache, indigestion, and runny nose are common side effects of Viagra. The "blue haze" that occurs with the 100-mg dosage is transient and will last for about 1 hour.

The nurse is preparing a discharge teaching plan for a client who has had a prostatectomy. Which of the following would be appropriate to include? A) Using a bearing down motion to promote complete bladder emptying when voiding B)Performing perineal exercises frequently throughout the day C)Engaging in strenuous exercise to strengthen abdominal muscles D) Waiting to urinate for 5 to 10 minutes after feeling the initial urge

B) performing perineal exercises frequently throughout the day. After a prostatectomy, the client should be instructed in how to perform perineal exercises and to perform them hourly throughout the day, each day. In addition, the client should avoid bearing down (straining) to urinate because of the increased risk for hematuria. He should also avoid strenuous exercise, which increases the tendency to rebleed. The client should be instructed to urinate as soon as he feels the first urge to do so.

What intervention will best help a client with ankylosing spondylitis (AS)? A) Have the client do range-of-motion exercises. B) Immobilize the client in traction. C) Teach the client about surgery. D) Teach the client to use a walker or cane.

D) Teach the client to use a walker or cane Ankylosing spondylitis (AS) affects the cartilaginous joints of the spine and can lead to decreased mobility and stability. Assisting the client to use a walker or cane will help prevent injury from falls. Range-of-motion exercises and traction will not help the client. The hallmark of the condition is back pain and sometimes fractures.

The nurse educator is teaching a group of young adult women about sexually transmitted infections. The nurse explains that which infection is most likley to be "silent" with no overt symptoms in women? A) Syphilis B) Chlamydia C) Herpes genitalis (HSV-2) D) Pelvic inflammatory disease

B) Chlamydia Both Chlamydia and gonorrhea infections frequently do not cause symptoms in women and thus are often referred to as "silent" related to clinical presentation. When infected with syphilis, both men and women will find a painless lesion at the site of infection is called a chancre. This finding often leads people to being assessed and the diagnosis of primary syphilis. With an HSV-2 infection, individuals may have a range of symptoms leading to awareness of the infection including but not limited to Itching and pain accompany the process as the infected area becomes red and edematous. Primary infection may begin with macules (small flat spots on skin) and papules (small circumscribed elevations) and progress to vesicles (small, serous-filled elevated spots) and ulcers. Pelvic inflammatory disease manifests with clinical symptoms that usually begin with vaginal discharge, dyspareunia (painful sexual intercourse), lower abdominal pelvic pain, and tenderness that occurs after menses. Pain may increase with voiding or with defecation.

The nurse is caring for an elderly client with a respiratory infection. While reviewing age-related changes in the immune system, the nurse identifies which factor as having contributed to this client's infection? A) Impaired ciliary action as a result of exposure to environmental toxins B) Failure of the immune system to differentiate "self" from "non-self" C) Decreased phagocytosis by Kupffer cells D) Decreased sensation and slowing of reflexes

A) Impaired ciliary action as a result of exposure to environmental toxins Impaired ciliary action from exposure to smoke and environmental toxins contributes to impaired clearance of pulmonary secretions and an increased incidence of respiratory infections in the elderly. Failure of immune system to differentiate "self" from "non-self" leads to an increased incidence of autoimmune diseases. Decreased phagocytosis by the liver's Kupffer cells leads to increased incidence and severity of hepatitis B. Decreased sensation and slowing of reflexes leads to increased risk of skin injury, skin ulcers, abrasions, burns, and other trauma.

A client was seen in the clinic for musculoskeletal pain, fatigue, mood disorders, and sleep disturbances. The physician has diagnosed fibromyalgia. What would not be a part of teaching plan for this condition? A) applications of ice B) encouraging the client to eat a healthy diet C) avoiding caffeine and alcohol D) regular exercise and stress reduction

A) application of ice Application of ice is not part of the treatment regimen. Encouraging the client to eat a healthy diet, avoiding caffeine and alcohol, regular exercise, and stress reduction are part of the teaching plan.

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning? A) Instruct the patient not to drink alcohol with this treatment. B) Counsel the patient to refrain from sex for 1 week. C) Advise the patient to take medication with a glass of milk. D) Reassure the patient further sexually transmitted infection (STI) testing is not indicated.

A) instruct the patient to not drink alcohol with this treatment. While counseling to abstain from sex for 1 week is appropriate, the most important intervention is counseling to avoid alcohol during Flagyl treatment. Alcohol consumption while taking Flagyl creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Flagyl does not have to be taken with milk, and further STI testing is indeed recommended with the diagnosis of an STI.

The nurse us assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual parnters in the 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented? A)The client will require treatment for the secondary stage of syphilis. B)planning for a chlamydial infection is needed. C)Pelvic inflammatory disease is the likely cause of the hair loss. D) The client will require a colposcopy to confirm any diagnosis.

A) the client will require treatment for the secondary stage of syphilis. In the secondary stage of syphilis, generalized signs of infection may include lymphadenopathy (abnormal enlargement of lymph nodes), arthritis, meningitis (inflammation of the pia mater, arachnoid, and the subarachnoid space), hair loss, fever, malaise, and weight loss. Hair loss and arthritis are not common symptoms associated with a chlamydial infection or pelvic inflammatory disease. The information collected in the health history confirms that the client has moved past the primary stage of the infection. A colposcopy is a diagnostic procedure carried out to determine if there have been any changes in cervical cells (dysplasia). Given the client's reported health history, secondary syphilis should be further investigated first.

A urologist suspects that a client might have prostate cancer. Which test would be used to make a diagnosis of cancer? A) tissue biopsy B) prostate-specific antigen C) cystoscopy D) digital rectal examination

A) tissue biopsy A needle biopsy of prostatic tissue is obtained to diagnose a definitive cancer of the prostate. The PSA assay is a blood test that, when elevated, may correspond with prostate cancer. However, an elevated PSA does not always indicate a malignancy; it may indicate benign disease or other factors such as an enlarged prostate gland, older age, prostatitis, recent ejaculation, and other innocuous causes. Cytoscopy involves a cystoscope inserted into the urinary meatus to inspect the bladder, prostate, and urethra. This aids in evaluating the degree of encroachment by the prostate on the urethra. A digital rectal examination is performed to assess the prostate for size as well as evidence of tumor.

Which term defines the balance between the amount of HIV in the body and the immune response? A) Viral set point B)Window period C) Primary infection stage D) Viral clearance rate

A) viral set point The viral set point is the amount of virus in the body after the initial immune response subsides is referred to as the viral set point, which results in an equilibrium between HIV levels and the immune response that may be elicited. During the primary infection period, the window period occurs because a person is infected with HIV but negative on the HIV antibody blood test. The period from infection with HIV to the development of antibodies to HIV is known as the primary infection stage. The amount of virus in circulation and the number of infected cells equals the rate of viral clearance

A nurse is assigned to a client with polymyositis. Which expected outcome in the care plan relates to a potential problem associated with polymyositis? A) "Client will lose 2 lb (0.91 kg) per week on a calorie-restricted diet." B) "Client will exhibit no signs or symptoms of aspiration." C) "Client will exhibit bowel and bladder continence." D) "Client will exhibit alertness and orientation to person, place, and time."

B) Client will exhibit no signs or symptoms of aspiration An expected outcome of no signs or symptoms of aspiration relates to symmetrical muscle weakness — a potential problem associated with polymyositis that may lead to speaking and swallowing problems. A client with a potential swallowing problem is at risk for inadequate nutrition and shouldn't be placed on a calorie-restricted diet; an expected outcome focusing on maintaining weight would be more appropriate than an outcome based on losing weight. Polymyositis doesn't affect bowel or bladder function or mental status; it isn't necessary to develop outcomes based on these parameters.

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a storm door. The fall resulted in a 6 cm laceration of the right antecubital. The nurse caring for this patient knows that the site of the injury will have an invasion of what? A) Interferon B) Phagocytic cells C) Apoptosis D) Cytokines

B) phagocytic cells Monocytes also function as phagocytic cells, engulfing, ingesting, and destroying greater numbers and quantities of foreign bodies or toxins than granulocytes. This occurs in response to the foreign bodies that have invaded the laceration from the dirt on the broken glass. Interferon, one type of biologic response modifier, is a nonspecific viricidal protein that is naturally produced by the body and is capable of activating other components of the immune system. Apoptosis, or programmed cell death, is the body's way of destroying worn out cells such as blood or skin cells or cells that need to be renewed. Helper T cells are activated upon recognition of antigens and stimulate the rest of the immune system. When activated, helper T cells secrete cytokines that attract and activate B cells, cytotoxic T cells, natural killer cells, macrophages, and other cells of the immune system.

Which is inconsistent with a digital rectal examination (DRE)? A) Recommended for men older than 40 years of age B) Assists in screening for cancer of prostate gland C) Enables examiner to assess size, shape, and consistency of prostate gland D) Can reveal a hydrocele

D) Can reveal a hydrocele DRE is recommended as part of the regular health checkup for every man older than 50 years of age. It is a screening for cancer of the prostate gland. It enables the examiner to assess the size, shape, and consistency of the prostate gland.

A 40-year-old woman has been receiving increasing amounts of care at home from her mother since she was diagnosed with HIV and became symptomatic. During a home visit from a community health nurse, the patient's mother tells the nurse that caregiving is an onerous responsibility, stating, "I'm completely at the end of my rope." What action should the nurse prioritize in response to the mother's statement? A) Have the patient admitted to hospital for a respite period. B) Validate the important contributions the mother is making to her daughter's well-being. C) Arrange for the transfer of the patient to a hospice setting. D) Identify community supports that can mobilized to provide for the patient's needs.

D) Identify community supports that can mobilized to provide fro the patient's needs. Increased involvement by community support groups and individuals is normally preferable to hospital or hospice admission. It is important to validate the mother's efforts, but this does not resolve the underlying problem.