Immune and infection NCLEX style questions

A nurse is caring for a client who has human immunodeficiency virus (HIV). The client asks the nurse, "should I tell my partner that I am HIV positive?" Which of the following statements should the nurse give?

"It sounds like you are unsure what to say to your partner." Rationale - This response uses the therapeutic communication tools of clarifying and restatement. It identifies that the client is unsure about if or how to approach the issue of being HIV positive with his partner, a common concern of clients due to fear of rejection. This response shows that the nurse is open to further communication with the client and encourages his expression of feelings.

A nurse is teaching a client who has AIDS about the transmission of Pneumocystis jiroveci pneumonia (PCP). Which of the following information should the nurse include in the teaching?

"PCP results from an impaired immune system." The organism that causes PCP exists as part of the normal flora of the lungs and develops into a fungus. It becomes an aggressive pathogen when the immune system is compromised, causing infection.

A nurse is providing discharge teaching to a client who has HIV. Which of the instructions about infection prevention should the nurse include? (Select all that apply.) A. Avoid large gatherings of people B. Clean toothbrush by running through the dishwasher C. Change pet litter boxes with disposable gloves D. Consume fresh fruit and raw vegetables E. Avoid digging in the garden

A. Avoid large gatherings of people B. Clean toothbrush by running through the dishwasher E. Avoid digging in the garden The nurse should instruct the client to avoid large crowds or gatherings of people, especially if individuals have been ill or exposed to illness; this can place clients who have HIV at risk of infection. The client should clean the toothbrush by running it through the dishwasher. If the client does not have a dishwasher, rinsing the toothbrush with bleach followed by hot water is also effective at destroying bacteria on the toothbrush. The client should avoid digging in the garden because exposure to the dirt, which contains bacteria and organisms, places the client at risk of infection.

A nurse is evaluating the injection site of a client who had a Mantoux skin test 48 hr ago. The nurse finds 10 mm of induration with slight redness. Which of the following conclusions should the nurse make? A. The client has active tuberculosis. B. The client had an exposure to tuberculosis. C. The nurse must re-evaluate the result in 24 hr. D. The test is negative for tuberculosis.

B. The client had an exposure to tuberculosis.

A nurse is teaching a client with systemic lupus erythematosus who has a new prescription for prednisone. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Hypoglycemia B. Tendinitis C. Infection D. Weight loss

C. Infection The nurse should instruct the client to avoid contact with people who are ill and monitor for manifestations of an infection such as a fever or a sore throat. Prednisone can suppress the client's immune response and mask the manifestations of an infection.

A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the following interventions should the nurse include in the plan of care? A. Rinse the mouth with chlorhexidine solution every 2 hr B. Limit fluid intake with meals C. Provide oral hygiene with a firm-bristled toothbrush after each meal D. Avoid salty foods

D. Avoid salty foods Stomatitis is an inflammation of the mucosa of the mouth, usually with ulcerations. Foods that are spicy, acidic, or salty should be avoided to prevent further irritation and damage to the oral mucos

A nurse is caring for a client who is concerned about the possibility of contracting Lyme disease after receiving a tick bite. For which of the following early manifestations of Lyme disease should the nurse assess the client? A. Diffuse maculopapular rash B. Dyspnea C. Double vision D. Progressive circular rash

D. Progressive circular rash

A home health nurse is planning care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client's plan of care? A. Soft boiled eggs B. Brie cheese made of unpasteurized milk C. Cold deli meat sandwiches D. Baked chicken

D.Well cooked meats, including baked chicken, do not pose a threat to clients who have neutropenia and may be included in the client's dietary plan.

A nurse is caring for a client who has pseudomembranous colitis due to a clostridium difficile infection. Which of the following interventions is the nurse's priority?

Performing hand hygiene before and after contact with the client

A nurse is reinforcing teaching with a client who is HIV positive about the early manifestations of acquired immune deficiency syndrome (AIDS). Which of the following statements should the nurse include in the teaching?

You can expect a persistent fever and swollen glands Clients who have AIDS can have persistent fever, swollen glands, diarrhea, weight loss, and fatigue.These manifestations indicate the onset of AIDS. Clients who have AIDS are more likely to have a decreased WBC count as a result of the HIV virus destroying CD4-T-cells. This decrease in the client's WBC and CD4-T-cell count is the primary reason that clients who have AIDS are at increased risk for infection.

A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching?

You can suck on popsicles to numb your mouth.

A nurse is assessing a client who has an exacerbation of herpes zoster. Which of the following manifestations of the client's skin should the nurse expect? a. Confluent, honey-colored, crusted lesions. b.Large, tender nodules located on a hair follicles. c.Unilateral, localized, nodular skin lesions. d.A fluid-filled vesicular rash in the genital region

c. Unilateral, localized, nodular skin lesions.Rationale - Herpes zoster, or shingles, results from the reactivation of a dormant varicella virus, It is the acute, unilateral inflammation of the dorsal root ganglion. The infection typically develops in adults and produces localized vesicular lesions confined to a dormant. It produces unilateral, localized, nodular skin lesions.

A nurse is teaching a client who has genital herpes about self-management. Which of the following instructions should the nurse include in the teaching? a. Use an alcohol-based to clean lesions. b. Wear a condom during sexual activity when lesions are present. c. Take a sitz bath once per day. d. Apply a warm compress to the lesions. d. Apply a warm compress to the lesions.Rationale - The nurse should instruct the client to apply a warm compares to the lesions to relieve discomfort.

d. Apply a warm compress to the lesions.Rationale - The nurse should instruct the client to apply a warm compares to the lesions to relieve discomfort.

A nurse is assessing a client who has Kaposi's sarcoma. Which of the following findings should the nurse expect?

reddish-purple skin lesions Rationale - Kaposi's sarcoma is commonly associated with AIDS and manifests as hyper-pigmentated multi centric lesions that can be firm, flat, raised, or nodular. Following biopsy, the lesions are treated with radiation and/or chemotherapy.