Immune Prepu
A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?
Administering ordered analgesics and monitoring their effects
The nurse is caring for a patient diagnose with severe acute respiratory syndrome (SARS). A family member asks what causes SARS. Which of the following responses by the nurse is accurate?
"Coronavirus"
A nurse is assessing a woman with vaginal discharge. The nurse suspects bacterial vaginosis when the client states which of the following?
"I noticed a strange fishy odor during my period."
Atopic allergic disorders are characterized by which of the following?
A hereditary predisposition
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex
The nurse intervenes to assist the patient with fibromyalgia to cope with what symptoms?
Chronic fatigue, generalized muscle aching, and stiffness
Which of the following would be consistent with the diagnosis of rheumatoid arthritis?
Cloudy synovial fluid
You are a school nurse teaching a health class about the chain of infection in the transmission of sexually transmitted diseases (STDs). A student asks you which part of the chain of infection can be missing when transmission occurs. What would be your best answer?
All parts of the chain of infection have to be present for the disease to be passed to another human."
A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply.
• Respiratory rate of 24 breaths/minute • Temperature of 102°F • Heart rate of 120 beats/minute
The nurse is instructing the family on home care of a patient with shingles. The family member asks if their teenage children should stay in a different room. What is the best response by the nurse?
"Have they had chickenpox or the varicella vaccine?"
A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?
"My finger joints are oddly shaped."
A 36-year-old patient is in the clinic for an annual physical. The patient asks the nurse "should I get a flu shot." Which of the following is the best response by the nurse?
"The flu shot is recommended for people over 6 months of age."
A patient diagnosed with influenza is admitted to the hospital. Which of the following transmission-based precautions should the nurse initiate?
*Influenza is transmitted via droplets. *Tuberculosis and varicella would qualify for airborne precautions. *Contact are used for organisms that are transmitted by skin-to-skin contact. *Neutropenic (or reverse) precautions are used for immunosuppressed patients.
Which of the following is the most effective treatment for trichomoniasis?
Metronidazole (Flagyl)
Your client was admitted to your unit for observation regarding possible sepsis. As her nurse, you monitor her carefully and are to report any suspicious findings, which could indicate the development of systemic infection. What would be your primary nursing tasks in this effort?
Monitor your client's vital signs. *Clients who are septic will exhibit two or more of the following: * Temp greater than 100.4°F or less than 96.8°F , * HR greater than 90 bpm, *RR greater than 20 or *PaCO2 less than 32 mm Hg, *WBC count greater than 12,000 cells/mm3 or 10% immature (band) forms
Which diagnostic study is decreased in patient diagnosed with rheumatoid arthritis?
RBC count
When assessing a client with infectious diarrhea, which of the following would lead the nurse to suspect that the client is experiencing severe dehydration?
Rapid, thready pulse
Which diagnostic study finding is decreased in patients diagnosed with rheumatoid arthritis?
Red blood cell count
A patient complains of nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes to be pale and dry. The patient has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which of the following is the priority nursing intervention?
Request an order from the physician for IV rehydration therapy.
Which organism is responsible for impetigo?
Staphylococcus aureus
Painless chancre lesions are associated with which systemic disease?
Syphilis
Which of the following disorders is characterized by an increased autoantibody production?
Systemic lupus erythematosus (SLE)
The nurse has been teaching a client with genital herpes how to care for the lesions. Which of the following statements by the client indicates that she needs additional instruction?
The client should wear loose, cotton underwear to promote cleanliness and dryness in the genital area. Sitz baths can promote cleanliness and decrease inflammation in the area. A hair dryer, set on a cool setting, can be used to carefully dry the lesions in the perineal area. Drinking plenty of fluids is advised to decrease dysuria, which accompanies genital herpes.
Which of the following is the most common joint affected in gout?
The metatarsophalangeal joint of the big toe is the most commonly affected joint (90% of patients), and this is referred to as podagra.
Which of the following is an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?
Tophi
Which of the following newer pharmacological therapies, used for the treatment of osteoarthritis, is thought to improve cartilage function and retard degradation as well as have some anti-inflammatory effects?
Viscosupplementation
A nurse would perform handwashing instead of using an alcohol-based product for which situation?
When hands are visibly soiled from client care
Symptoms of pelvic infection usually begin with which of the following?
dyspareunia (painful sexual intercourse)
A college student comes to the campus health care center complaining of headache, malaise, and a sore throat that has worsened over the past 10 days. The nurse measures a temperature of 102.6° F (39.2° C) and finds an enlarged spleen and liver and exudative tonsillitis. Laboratory tests reveal a leukocyte count of 20,000/mm3, antibodies to Epstein-Barr virus, and abnormal liver function tests. These findings suggest:
infectious mononucleosis.
During chemotherapy for lymphocytic leukemia, a client develops abdominal pain, fever, and "horse barn"-smelling diarrhea. It would be most important for the nurse to advise the physician to order:
stools for a Clostridium difficile test.
The nurse is caring for a patient who has been diagnosed with "rheumatic disease." What nursing diagnoses will most likely apply to this patient's care? Select all that apply
• Fatigue • Pain • Alteration in self-concept • Fluid and electrolyte imbalance
A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority?
Acute pain related to the development of the genital lesions
A client is diagnosed with a methicillin-resistant staphylococcus aureus (MRSA) infection. When developing the client's plan of care, the nurse would include which of the following?
Administration of prescribed vancomycin
The nurse is evaluating the plan of care for a client with an allergic disorder who has a nursing diagnosis of deficient knowledge related to measures for allergy control. Which of the following would indicate to the nurse that the outcome has been met?
Client identifies methods for reducing exposure risk to allergens.
Which of the following is a term used to describe microorganisms present without host interference or interaction?
Colonization
Which of the following terms refers to a state of microorganisms being present within a host without causing host interference or interaction?
Colonization
Which of the following is a plasma protein associated with the immunologic reaction?
Complement
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point would the nurse place in bold letters?
Many people are asymptomatic and show no symptoms contributing to the spread of the disease.
A client is in the acute care facility for the administration of intravenous (IV) antibiotics to treat bacterial pneumonia. The client begins to have severe diarrhea 3 days after the IV antibiotics with abdominal cramping and pain. What does the nurse suspect the client has developed due to the antibiotic use?
Pseudomembranous colitis. When a client is taking an antibiotic, a superinfection can result from overgrowth of microorganisms not affected by the drug. This can lead to a serious inflammation of the colon called pseudomembranous colitis accompanied by potentially life-threatening diarrhea. Report fever, abdominal cramps, and severe diarrhea immediately.
The nurse working in an allergy clinic is preparing to administer skin testing to a patient. Which of the following routes is the safest for the nurse to use to administer the solution?
Intradermal
Which of the following aid in diagnosing the risk of anaphylaxis?
Intradermal testing
Which of the following statements is accurate regarding osteoarthritis?
It is a noninflammatory disorder and the most common and frequently disabling of joint disorders.
Which of the following points should be included in the medication-teaching plan for a patient taking adalimumab (Humira)?
It is important to monitor for injection site reactions. The medication is injected subcutaneously and must be refrigerated. The medication should be withheld if fever occurs.
What should the nurse teach the patient about the diagnosis of osteoarthritis?
It is the most common and frequently disabling of joint disorders."
After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which of the following?
Jabs the autoinjector into the outer thigh at a 90-degree angle
Which findings best correlate with a diagnosis of osteoarthritis?
Joint stiffness that decreases with activity
Which of the following is the most frequent route of exposure to a latex allergy?
Cutaneous
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?
Desensitization is a form of immunotherapy in which a person receives weekly or twice-weekly injections of dilute but increasingly higher concentrations of an allergen without interruption.
Which of the following is an appropriate nursing intervention in the care of the patient with osteoarthritis?
Encourage weight loss and an increase in aerobic activity.
The best treatment for latex allergy includes which of the following?
Avoidance of latex-based products
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?
Instruct the patient not to drink alcohol with this treatment.
Scleroderma typically begins with which system involvement?
Integumentary
A client with influenza is admitted to an acute care facility. The nurse monitors the client closely for complications. What is the most common complication of influenza?
Pneumonia
A patient with rheumatoid arthritis is complaining of joint pain. What intervention is a priority to assist the patient?
NSAID's
What is the most common cause of anaphylaxis?
PCN
Which route of exposure to latex products occurs from use of hemodialysis equipment?
Parenteral
Nursing care for the patient with fibromyalgia should be guided by what assumption?
Patients with fibromyalgia may feel as if their symptoms are not taken seriously.
Which of the following allergies is responsible for most severe food allergy reactions?
Peanuts
Which of the following is the medication of choice for early syphilis?
Penicillin G benzathine
The nurse is caring for a patient who is being treated for fibromyalgia. What intervention will best assist the patient to restore normal sleep patterns?
Tricyclic antidepressants
The nurse is required to manage and minimize sepsis in a patient with severe infection. Which of the following would be an appropriate nursing intervention?
Monitor the patient's vital signs.
A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client?
An isolation room three doors from the nurses' station
A client is diagnosed with a viral illness and requests an antibiotic to "cure" his illness. When the request is refused by the physician, the client states to the nurse, "I will never get better."What is the best response by the nurse?
"Prescribing antibiotics for a viral infection may result in drug-resistant bacteria."
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."
A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. She asks which of the tests ordered will determine if she is positive for the disorder. Which statement by the nurse is most accurate?
"The diagnosis won't be based on the findings of a single test but by combining all data found."
The nurse is teaching a patient about her rheumatic disease. What statement best helps to explain "autoimmunity"?
"Your symptoms are a result of your body attacking itself."
Which of the following medications are used to suppress viral load of the HSV-2 infection?
Acyclovir (Zovirax)
The side effect of bone marrow depression may occur with which medication used to treat gout?
Allopurinol (Zyloprim). A patient taking Zyloprim needs to be monitored for the side effects of bone marrow depression, vomiting, and abdominal pain.
A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?
An induration of 12mm
You are caring for a client with an impaired immune system. You are concerned about the client acquiring a nosocomial infection. What intervention would help nurses control nosocomial infections?
Apply principles of medical and surgical asepsis.
The nurse observes a physician leave the room of a patient in isolation for Clostridium difficile (C. difficile). The physician uses the alcohol-based hand sanitizer hanging on the wall to wash her hands and leaves the door open. Which of the following actions should the nurse take?
Ask the physician to wash her hands with soap and water.
What is the priority intervention for a patient who has been admitted repeatedly with attacks of gout?
Assess dietary diet and activity at home
The nurse is providing discharge instructions to a female client following inpatient therapy for a gonorrhea infection. The client is being discharged on doxycycline (Vibramycin) for 7 days. Which nursing instruction is essential for a therapeutic outcome?
Complete all prescribed medication.
A nurse assesses a client in the physician's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?
Facial erythema, pericarditis, pleuritis, fever, and weight loss
The client with rheumatoid arthritis has a red blood cell count of 3.2 cells/cu mm. Which nursing diagnosis has the highest priority for the client?
Fatigue
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?
Genital herpes
A client is hospitalized with a Clostridium difficile infection. Which of the following would the nurse include when providing care to this client?
Gloves and gowns for all client contact
The nurse teaches the patient that the presence of crystals in his or her synovial fluid obtained from an arthrocentesis confirms which disease process?
Gout
Which of the following is the most common sexually transmitted infection (STI) among young, sexually active people?
HPV
Which of the following suggests to the nurse that the client with systemic lupus erythematous is having renal involvement?
HTN
Which of the following terms refers to an incomplete antigen?
Hapten
The six elements necessary for infection include a causative organism, a reservoir of available organisms, a portal or mode of exit from the reservoir, a mode of transmission from reservoir to host, a susceptible host, in addition to which of the following?
Mode of entry to host
Max Thornton, a 24-year-old chef, is being seen by a physician at the urology group where you practice nursing. He has developed a painless ulcer on his penis and is rather concerned about his health. The urologist will be communicating his diagnosis of syphilis and prescribing treatment. What would you expect the physician prescribe as treatment?
IV penicillin G—single dose
When describing the immunoglobulin most likely involved with allergic reactions, which of the following would the nurse address?
IgE
The nurse is completing the admission assessment on a patient with renal failure. The patient states, "I was diagnosed with impetigo yesterday." Which of the following is the appropriate nursing intervention?
Impetigo is a bacterial infection transmitted via contact. Therefore, the nurse should initiate contact isolation protocol.
Flu and cold season offers excellent examples of physiologic reflexes to ward off illness. One problem is that an effective mechanical defense for one person can complete a link in the chain of infection for someone else. To which link is the above referring?
Means of transmission
What intervention is a priority for a patient diagnosed with osteoarthritis?
Physical therapy and exercise
Which of the following disorder is characterized by a butterfly-shaped rash across the bridge of the nose and cheeks?
SLE
Which statement reflects what is known about the Ebola and Marburg viruses?
The diagnosis should be considered in a patient who has a febrile, hemorrhagic illness after traveling to Asia or Africa.
Nursing students are reviewing information about infectious diseases and events associated with infection. Students demonstrate understanding of the information when they identify the incubation period as which of the following?
The incubation period is time between contact or exposure and the development of the first signs and symptoms. The presence of microorganisms without the host interacting with them is called colonization. The state in which the host displays a decrease in wellness characterizes an infectious disease. The process of the host shedding the microorganisms to another reflects the mode of exit.
Which of the following statements holds true for a client with untreated genital warts?
Untreated genital warts may resolve on their own, remain unchanged, or increase in size or number.
After demonstrating to a group of nursing students the proper technique for handwashing using soap and water, the nursing instructor determines that the teaching has been successful when the students demonstrate which of the following?
Vigorously scrubbing between the fingers Correct
A patient is placed in isolation for suspected tuberculosis. Which of the following actions should the nurse take when entering the patient's room?
Wear an N-95 respirator.
How often should women diagnosed with human papillomavirus (HPV) have Pap smears?
Yearly
Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis?
You must inform all sexual partners.
The nurse is caring for a client with an abscess on his back. The nurse observes purulent drainage coming from the abscess. What type of specimen does the nurse anticipate the physician will order to determine the type of bacteria present in the exudate?
a culture
A nurse visits the employee health department because of mild itching and a rash on both hands. During the assessment interview, the employee health nurse should focus on:
chemical and latex glove use.
The nurse teaches the parent of the child with chickenpox that the child is no longer contagious to others when
the vesicles and pustules have crusted.
A patient is admitted with an acute attack of gout. What interventions are essential for this patient? Select all that apply
• Probenecid (Benemid) • Corticosteroid therapy • Pain medications • Serum uric acid level
