Immune pretest

A patient on immunosuppresive therapy is given tacrolimus as part of their drug regimen. Which side effect is most likely to occur with this drug? hypoglycemia renal toxicity diarrhea profound myelosuppression

renal toxicity

Which discharge instruction would be included in the care plan for a client diagnosed with atopic dermatitis? "Take weekly baths to avoid hydrating the skin." "Keep the room temperature between 78° and 80° F." "Apply hot or cold therapy to affected joints." "Add humidity to the dry air caused by dry heat during the winter."

"Add humidity to the dry air caused by dry heat during the winter."

Which discharge instruction would be included in the care plan for a client diagnosed with atopic dermatitis? "Take weekly baths to avoid hydrating the skin." "Apply hot or cold therapy to affected joints." "Add humidity to the dry air caused by dry heat during the winter." "Keep the room temperature between 78° and 80° F."

"Add humidity to the dry air caused by dry heat during the winter."

When preparing a patient with acquired immunodeficiency syndrome (AIDS) for discharge to the home, the nurse should be sure to include which instruction? (Select all that apply) "Sterilize all plates and utensils in boiling water." "Avoid sharing such articles as toothbrushes and razors." "Put on disposable gloves before bathing." "Avoid eating foods from serving dishes shared by other family members." "Have your partner use condoms to prevent the spread of disease."

"Avoid sharing such articles as toothbrushes and razors" "Have your partner use condoms to prevent the spread of disease."

A client calls the office of his primary care health care provider and tells the nurse that he was just stung by a bumblebee while gardening. The client is afraid of a severe reaction, because the client's neighbor experienced such a reaction just 1 week ago. What is the appropriate action by the nurse? Ask the client if he ever sustained a bee sting in the past. Advise the client to soak the site in hydrogen peroxide. Instruct the client to call an ambulance for transport to the emergency room. Tell the client not to worry about the sting unless difficulty with breathing occurs.

Ask the client if he ever sustained a bee sting in the past.

The nurse is monitoring a post-renal transplantation client taking Cyclosporine (Neoral). The nurse observes an elevation in one of the client's vital sign and the client is complaining of sweating and headache. Which of the following vital sign is most likely increased? Temperature Respiratory rate Pulse Blood pressure

Blood pressure

A client with acquired immunodeficiency syndrome is prescribed with zidovudine (Azidothymidine). Which laboratory results should the nurse monitor while on this medication? Blood uric acid Serum blood sugar Throat swab gram stain Complete blood count

Complete blood count

The nurse is caring for a client being discharged following kidney transplantation. The client is ordered mofetil to prevent organ rejection. Which nursing instruction is essential regarding medication use? Sprinkle the contents of the capsule on food. Administer the medication with an antacid to prevent stomach upset. Contact the health care provider at first signs of an infection. Administer medication following breakfast daily.

Contact the health care provider at first signs of an infection.

A patient who is human immunodeficiency positive (HIV) positive is receiving a nucleoside reverse transcriptase inhibitor (NRTI). Which of these clinical findings would indicate the patient is experiencing an adverse effect of this medication? Decreased hemoglobin Increased blood glucose Weight gain Metabolic alkalosis

Decreased hemoglobin

The client who is human immunodeficiency virus seropositive has been taking delavirdine (Rescriptor) . Which medication instruction would the nurse provide? Monitor skin for rashes Weight gain is expected Take the medication in the morning before meals Include a low-fat diet

Monitor skin for rashes

A patient is receiving cyclosporine (Neoral, Sandimmune) after a heart transplant. The patient exhibits a white blood cell count of 12,000 cells/mm3, a sore throat, fatigue, and a low-grade fever. Which complication would the nurse suspect? Graft versus host disease Strep throat Allergic rhinitis Dehydration

Strep throat

For a male client who has acquired immunodeficiency syndrome with chronic diarrhea, anorexia, a history of oral candidiasis, and weight loss, which dietary instruction would a nurse include in the teaching plan? "Ensure diet has low potassium and sodium." "Follow a high-protein, high-calorie diet." "Eat three large meals per day." "Include unpasteurized dairy products in the diet."

"Follow a high-protein, high-calorie diet."

The nurse is caring for a client newly diagnosed with human immunodeficiency virus (HIV) obtained from unprotected sex. The nurse is in the room when the client is explaining the disease to another person. Which statement by the client would the nurse clarify? Select all that apply. "I am afraid that I will give this disease to my nephew." "The disease can also be spread by body fluids." "I will have this for the rest of my life." "My sexual practices will have to change." "Medications can cure the disease." "I could pass this on to a baby before I give birth."

"I am afraid that I will give this disease to my nephew." "Medications can cure the disease."

Which of the following statements by a patient taking cyclosporine (Neoral, Sanimmune) would indicate the need for more teaching by the nurse? "I will take my cyclosporine at breakfast with a glass of grapefruit juice" "I will take my blood pressure at home every day" "I will report any reduction in urine output to my physician" "I will my wash my hands frequently"

"I will take my cyclosporine at breakfast with a glass of grapefruit juice"

A nurse is teaching a female patient who is HIV-positive about pregnancy, the nurse determines more teaching is necessary when the patient makes which statement? "I'll need to have a C-section if I become pregnant and have a baby." The baby can get the virus from my placenta." "Not everyone who has the virus gives birth to a baby who has the virus." "I will be placed on antiretroviral therapy to prevent HIV transmission to the baby."

"I'll need to have a C-section if I become pregnant and have a baby."

A patient who has been diagnosed with acquired immunodeficiency syndrome (AIDS) develops an oral Candida infection. When teaching the patient, the nurse will include which of the following instructions? "Rinse your mouth with a commercial mouthwash frequently." "Include hot soups and beverages with each meal." "Include plenty of citrus juices in your diet." "Select foods that are soft or pureed."

"Select foods that are soft or pureed."

The nursing instructor asks the student nurse to explain a type IV hypersensitivity reaction. Which statement by the student best describes type IV hypersensitivity? "It is a reaction of immune globulin (Ig)G with the host cell membrane or antigen." "The reaction of sensitized T-cells with antigen and release of cytokines activate macrophages and cause tissue destruction." "An immune complex of antigen and antibodies is formed and deposited in the walls of blood vessels." "It results in release of mediators, especially histamine, because of the reaction of IgE antibody on mast cells."

"The reaction of sensitized T-cells with antigen and release of cytokines activate macrophages and cause tissue destruction."

A patient is diagnosed with systemic lupus erythematosus. Which instruction would be included in the teaching plan for the client? "Carry injectable epinephrine at all times in case of exacerbation." "Exercising 60-90 minutes a day will result in an improve symptoms." "Remove all rugs, curtains, and dust-collecting items in home." "Wear large-brimmed hats when exposed to the sun."

"Wear large-brimmed hats when exposed to the sun."

A patient who has been receiving antiretroviral therapy (ART) to manage infection with human immunodeficiency virus (HIV) has an undetectable viral load. How would the nurse interpret this information? ART can be discontinued for three months More tests are needed to determine the effectiveness of ART. HIV has been eliminated from the patient's blood. ART has been effective in decreasing viral load.

ART has been effective in decreasing viral load.

A nurse is assisting in administering immunizations at a health care clinic. The nurse determines that an immunization will provide which type of immunity? Acquired Total Inate Natural

Acquired

A nurse is assisting in administering immunizations at a health care clinic. The nurse determines that an immunization will provide which type of immunity? Natural Acquired Innate Total

Acquired

Which interventions should a nurse discuss with a patient who has an allergic disorder and is requesting information for allergy symptom control? (Select all that apply.) Instructing the patient to refrain from using air conditioning or humidifiers in the house Advising the patient to cover the mattress with a hypoallergenic cover Teaching the patient to use curtains instead of pull shades over windows Informing the patient to avoid using sprays, powders, and perfumes Discussing with the patient why the need to change detergents frequently Telling the patient to wear a mask when cleaning

Advising the patient to cover the mattress with a hypoallergenic cover Informing the patient to avoid using sprays, powders, and perfumes Telling the patient to wear a mask when cleaning

A client is admitted to the emergency room complaints of a difficulty of breathing and upon auscultation, the nurse noted that the patient has wheezes. An allergic reaction to penicillin was diagnosed. Which of the following medications should the nurse expect to administer first? Albuterol (Ventolin HFA) Methylprednisolone (Solu-Medrol) Aminophylline (Theophylline) Budesonide (Pulmicort)

Albuterol (Ventolin HFA)

During the past 6 months, a client diagnosed with acquired immunodeficiency syndrome has had chronic diarrhea and has lost 18 pounds. Additional assessment findings include tented skin turgor, dry mucous membranes, and listlessness. Which nursing diagnosis focuses attention on the client's most immediate problem? Deficient fluid volume related to diarrhea and abnormal fluid loss Disturbed thought processes related to central nervous system effects of disease Diarrhea related to the disease process and acute infection Imbalanced nutrition: less than body requirements related to nausea and vomiting

Deficient fluid volume related to diarrhea and abnormal fluid loss

A client is recently diagnosed with HIV and a highly antiretroviral therapy is started. After the first week of therapy, the patient complains of headaches, dizziness, and nightmares. Which one of the following anti-retroviral drugs is most likely associated with these symptoms? Saquinavir Lamivudine Tenofovir Efavirenz

Efavirenz

A nurse is caring for a patient who is diagnosed of having allergic rhinitis, which nursing intervention is the most appropriate? Encouraging the patient to use nasal saline spray Advising use of bronchodilator regularly, even if having no symptoms Instructing the client to carry epinephrine with him at all times Discouraging nose blowing before administering nasal medication

Encouraging the patient to use nasal saline spray

Which intervention should a nurse discuss with patient who has an allergic disorder and is requesting information for allergy symptom control? (Select all that apply.) Teaching the patient to use curtains instead of pull shades over windows Instructing the client to refrain from using air conditioning or humidifiers in the house Explaining to the patient to avoid using sprays, powders, and perfumes Discussing with the patient to cover the mattress with a hypoallergenic cover Informing the patient to cover the mattress with a hypoallergenic cover

Explaining to the patient to avoid using sprays, powders, and perfumes Discussing with the patient to cover the mattress with a hypoallergenic cover Informing the patient to cover the mattress with a hypoallergenic cover

A nurse is providing education to a patient, who has a severe peanut allergy, on how to recognize the signs and symptoms of anaphylactic shock. Which signs and symptoms would the nurse include in the education? (Select all that apply) Hypertension Feeling dizzy Hyperglycemia Itchy Vomiting and Nausea Slow heart rate Dyspnea Difficulty speaking Fever

Feeling dizzy Itchy Vomiting and Nausea Dyspnea Difficulty speaking

A nurse determines the reason newborns are protected for the first 6 months of life from bacterial infections is because of the maternal transmission of which substance? IgM IgE IgA IgG

IgG

The nurse advises a friend who asks to administer the allergy shots that which of the following? The nurse is qualified to do it if the friend has epinephrine in an injectable syringe provided with the extract Avoiding the allergens is a more effective way of controlling allergies, and allergy shots are not usually effective Immunotherapy should only be administered in a setting where emergency equipment and drugs are available It is illegal for nurses to administer injections outside of a medical setting

Immunotherapy should only be administered in a setting where emergency equipment and drugs are available

The highest priority nursing diagnosis for the patient experiencing anaphylaxis is which one of the following? Impaired tissue perfusion Fluid volume deficit Anxiety Ineffective breathing pattern

Ineffective breathing pattern

Which clinical manifestation would cause the nurse to suspect that the client is diagnosed with systemic lupus erythematosus? Red, burning, tearing eyes Fever and night sweats Chest tightness and wheezing Joint edema and tenderness

Joint edema and tenderness

A nurse determines which health condition or problem demonstrates inflammation without invasion? Osteoarthritis Allergic rhinitis Cellulitis Viral hepatitis

Osteoarthritis

A patient was given a combination of immunosuppressant drugs following a liver transplant. Six months after his transplant his lab results indicate a 20 mm Hg increase in the systolic blood pressure, elevated fasting blood glucose, hypokalemia, and striae to the abdomen. Which drug may contribute to these side effects? Azathioprine tacrolimus Prednisone mycophenolate mofetil

Prednisone

A nurse is assessing the skin of a patient who is at risk for becoming infected with the human immunodeficiency virus (HIV). Which findings requires immediate follow-up by nurse? Purplish-red raised lesions Ecchymoses on the legs Patches of dry, flaky skin Numerous moles on the chest and back

Purplish-red raised lesions

A nurse determines a type 1 hypersensitivity reaction the primary immunologic disorder appears to be which of the following? Binding of IgG to an antigen on a cell surface Deposit of antigen-antibody complexes in small vessels Release of chemical mediators from IgE-bound mast cells and basophils Release of cytokines used to interact with specific antigens

Release of chemical mediators from IgE-bound mast cells and basophils

The nurse would question an order for immunostimulant therapy if the patient had which of following conditions? (Select all that apply) Pneumonia Rheumatoid arthritis Renal disease Pregnancy Cirrhosis

Renal disease Pregnancy Cirrhosis

The nurse should monitor a transplant patient for the major adverse effect of cyclosporine (Neoral, Sandimmune) therapy by assessing which lab test? White blood cell count Calcium and Phosphorus BUN and creatinine Serum AST & ALT

Serum AST & ALT

A patient is experiencing an anaphylactic reaction. A nurse determines that during anaphylactic shock the mast cells and basophils release large amounts of histamine. What effects does histamine have on the body during anaphylactic shock? (Select all that apply) Decreases capillary permeability Stimulates contraction of GI smooth muscles Itching Shifts intravascular fluid to interstitial space Vasodilation of vessels Constricts the airways Decreases heart rate

Stimulates contraction of GI smooth muscles Itching Shifts intravascular fluid to interstitial space Vasodilation of vessels Constricts the airways

A patient is experiencing an anaphylactic reaction. A nurse determines that during anaphylactic shock the mast cells and basophils release large amounts of histamine. What effects does histamine have on the body during anaphylactic shock? (Select all that apply) Decreases heart rate Stimulates contraction of GI smooth muscles Vasodilation of vessels Itching Shifts intravascular fluid to interstitial space Decreases capillary permeability Constricts the airways

Stimulates contraction of GI smooth muscles Vasodilation of vessels Itching Shifts intravascular fluid to interstitial space Constricts the airways

A patient is receiving 2 units of packed red blood cells at 125 mL/hr. Fifteen minutes after the start of the blood transfusion, the nurse notes the following vital signs: Pulse 110 beats, Respirations 28, blood pressure 95/58, and a temperature of 101. The patient is shivering. What is the nurse's initial action? Stop the infusion Replace blood with normal saline Notify the health care provider Draw blood cultures

Stop the infusion

A patient is undergoing plasmapheresis for treatment of systemic lupus erythematosus. A nurse determines the purpose of the plasmapheresis is what? The exchange of plasma that contains antinuclear antibodies with a substitute fluid The replacement of viral-damaged cellular components of blood with replacement whole blood The elimination of normal particles in the blood that are being damaged by autoantibodies The removal of T lymphocytes in her blood that are producing antinuclear antibodies

The exchange of plasma that contains antinuclear antibodies with a substitute fluid

A patient who has tested positive for the human immunodeficiency virus (HIV) arrives at the clinic with a report of fever, nonproductive cough, and fatigue. The patient's CD4 count is 184 cells/mcL. How should the nurse interpret these findings? These findings provide evidence that the patient has seroconverted The patient is now in the latent stages of HIV infection This is an expected finding because the patient has tested positive for HIV The patient is diagnosed with acquired immunodeficiency syndrome (AIDS)

The patient is diagnosed with acquired immunodeficiency syndrome (AIDS)

A patient with HIV infection has been receiving antiretroviral therapy for 2 months. At the initiation of treatment, the patient had a viral load (VL) of 60 copies/mL and a CD4 count of 450 cells/mm3. Today's lab results reveal a VL of 20 copies/mL and a CD4 cell count of 800 cells/mm3. How will the nurse interpret the patient's results? A drug resistant strain is likely Treatment failure has occurred The patient is cured The patient is progressing as expected

The patient is progressing as expected

A patient's low hemoglobin and hematocrit have necessitated a transfusion of packed red blood cells. Shortly after the first unit of red blood cells starts to infuse, the patient develops signs and symptoms of a transfusion reaction. Which type of hypersensitivity reaction has the patient experienced? Type III Type IV Type II Type I

Type II

An HIV-positive client who has been started on highly active antiretroviral therapy (HAART) came back for a follow-up checkup. Which test will be the most helpful to a nurse in determining the response to the therapy? Viral Load Test Rapid HIV antigen test Western Blot Analysis White Blood Cell Count

Viral Load Test

A patient is using a steroidal cream for allergic dermatoses. Which intervention should a nurse implement for the patient? Using alcohol to clean the inflamed area before applying the cream Avoiding washing the inflamed area before applying the cream Applying an occlusive dressing over the inflamed area afterward Washing hands before and after applying the cream

Washing hands before and after applying the cream

The nurse gave an intramuscular injection of penicillin to a patient. Which assessment finding would be most indicative of a systemic anaphylactic response? Wheezing Itching Oliguria Macular rash

Wheezing