Infection
The nurse is teaching a post-radiation therapy client regarding proper skin care to the radiation treatment area. Which statement made by the client indicates the nurse needs to follow up? "I will avoid wearing tight-fitting clothing." "I will avoid using adhesive bandages." "I will avoid exposing the area to cold temperatures." "I will avoid rinsing the area with the saline solution."
A client who underwent radiation therapy should rinse the radiation treatment area with saline solution to prevent infection. Therefore the nurse should follow up to correct the misconception of not using saline. Tight-fitting clothing such as brassieres and belts should be avoided in the area of the treatment field. The use of adhesive bandages should be avoided and should not be used unless permitted by the radiation therapist. The radiation treatment area should not be exposed to cold temperatures.
A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action? Applying cold compresses to the affected area Ensuring the client keeps the skin clean and dry Monitoring for neurological and cardiac symptoms Advising the client to launder all clothes with bleach
A client with a bee sting may have localized redness, swelling, pain, and itching due to an allergic reaction. The nurse should apply cold compresses to the affected area to reduce the pain in the client. A client with Candida albicans infection should keep his or her skin clean and dry to prevent further fungal infections. A client with a Borrelia burgdorferi infection may suffer from cardiac, arthritic, and neurologic manifestations. Therefore the nurse has to monitor for these symptoms. Direct contact may transmit a Sarcoptes scabiei infection; the nurse should make sure that the client's clothes are bleached to prevent the transmission of the infection.
A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan? "Wash used dishes in hot, soapy water." "Let dishes soak in hot water for 24 hours before washing." "You should boil the client's dishes for 30 minutes after use." "Have the client eat from paper plates so they can be discarded."
A person cannot contract human immunodeficiency virus (HIV) by eating from dishes previously used by an individual with AIDS; routine care is adequate. Washing used dishes in hot, soapy water is sufficient care for dishes used by the AIDS client. Dishes do not need to soak for 24 hours before being washed. The client's dishes do not need to be boiled for 30 minutes after use. Paper plates are fine to use but are not indicated to prevent the spread of AIDS.
A client's laboratory report reveals a CD4+ T-cell count of 520 cells/mm 3. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client? Stage 1 Stage 2 Stage 3 Stage 4
According to the CDC, HIV disease is divided into four stages. A client with a CD4+ T-cell count of greater than 500 cells/mm 3 is in the first stage of HIV disease. A client with a CD4+ T-cell count between 200 and 499 cells/mm 3 is in the second stage of HIV disease. A client with a CD4+ T-cell count of less than 200 cells/mm 3 is in the third stage of HIV disease. The fourth stage of HIV disease indicates a confirmed HIV infection with no information regarding the CD4+ T-cell counts.
Which antimicrobial medication acts on susceptible pathogens by inhibiting nucleic acid synthesis? Penicillin Actinomycin Erythromycin Cephalosporin
Actinomycin is an antimicrobial medication that acts on susceptible pathogens by inhibiting nucleic acid synthesis. Penicillin acts on susceptible pathogens by inhibiting cell wall synthesis. Erythromycin acts on susceptible pathogens by inhibiting biosynthesis and reproduction. Cephalosporin acts on susceptible pathogens by inhibiting cell wall synthesis.
What is an example of a type I hypersensitivity reaction? Anaphylaxis Serum sickness Contact dermatitis Blood transfusion reaction
An example of a type I hypersensitivity reaction is anaphylaxis. Serum sickness is a type III immune complex reaction. Contact dermatitis is a type IV delayed hypersensitivity reaction. A blood transfusion reaction is a type II cytotoxic reaction.Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
Which type of immunity will clients acquire through immunizations with live or killed vaccines? Natural active immunity Artificial active immunity Natural passive immunity Artificial passive immunity
Artificial active immunity is acquired through immunization with live or killed vaccines. Natural active immunity is acquired when there is natural contact with antigens through a clinical infection. Natural passive immunity is acquired through the transfer of colostrums from mother to child. Artificial passive immunity is acquired by injecting serum from an immune human.
Which malnutrition condition may predispose a client to secondary immunodeficiency? Cachexia Cirrhosis Diabetes mellitus Hodgkin's lymphoma
Cachexia is a nutrition disorder that may occur due to wasting of muscle mass and weight, resulting in secondary immunodeficiency disorder. Cirrhosis, diabetes mellitus, and Hodgkin's lymphoma also lead to secondary immunodeficiency disorder, but these are not malnutrition disorders.
Which sexually transmitted infection is caused by Chlamydia trachomatis? Cervicitis Gonorrhea Genital warts Genital herpes
Cervicitis is caused by Chlamydia trachomatis. Gonorrhea is a sexually transmitted infection caused by Neisseria gonorrhoeae. Genital warts are caused by the Human papillomavirus. Genital herpes is caused by the Herpes simplex virus.
What is important nursing care for pediatric clients with leukemia on chemotherapeutic protocols? Preventing physical activity Checking their vital signs every 2 hours Having them avoid contact with infected persons Reducing unnecessary stimuli in their environment
Chemotherapy and acute lymphoblastic leukemia (ALL) cause immunosuppression (low white blood cells), thus increasing the risk for infection. Avoiding contact with infected persons is a necessary precaution. The client should maintain physical activity that can be tolerated. Although vital signs must be checked to assess for changes in pulse or blood pressure, unless there is clinical evidence of bleeding, it is not necessary to obtain vital signs every 2 hours. Children need stimulation that is appropriate for their developmental level except when acutely ill.
What is the most commonly reported sexually transmitted infection (STI)? Syphilis Chlamydia Gonorrhea Herpes simplex
Chlamydial infections are the most commonly reported sexually transmitted infection. Syphilis and gonorrhea are not the most commonly reported STI. Herpes simplex is not a reportable infection.
Which type of continuing care should a client expect if discharged home with an infusion device to continue treatment for a leg wound? Home care Rehabilitation Skilled nursing care Outpatient therapy
Clients who are discharged with an infusion device to continue drug therapy at home should expect home care services to teach appropriate administration of drug therapy in the client's home. The client is being discharged to the home and not to rehabilitation or to a skilled nursing facility. Outpatient therapy is not identified as a method for continuing antibiotic therapy with an infusion device.
Which conditions may result from immunoglobulin IgE antibodies on mast cells reacting with antigens? Select all that apply. Some correct answers were not selected Asthma Hay fever Sarcoidosis Myasthenia gravis Rheumatoid arthritis
Clinical conditions such as asthma and hay fever are considered type I hypersensitive reactions that are mediated by a reaction between IgE antibodies with antigens. It results in the release of mediators such as histamines. Type IV hypersensitivity reactions such as sarcoidosis result from reactions between sensitized T cells with antigens. Myasthenia gravis results from a type II hypersensitivity reaction that occurs due to an interaction between immunoglobulin IgG and the host cell membrane. Rheumatoid arthritis is a type III hypersensitivity reaction that results from the formation of immune complexes between antigens and antibodies that results in inflammation.
The bacteria Clostridium botulinum causes which condition in a client? Upper respiratory tract infection Toxic shock syndrome Urinary tract infection Food poisoning with progressive muscle paralysis
Clostridium botulinum bacteria causes food poisoning with progressive muscle paralysis. Toxic shock syndrome is caused by the bacteria Staphylococcus aureus. Many viruses and bacteria can cause upper respiratory tract infection but Clostridium is not one of them. Klebsiella-Enterobacter organisms most likely cause urinary tract infections.
Which term describes the practice of placing clients with the same infection in a semi-private room? Isolating Cohorting Colonizing Cross-referencing
Cohorting is the practice of grouping clients who are colonized or infected with the same pathogen. Isolating is limiting the exposure to individuals with an infection. Colonizing refers to the development of an infection in the body. Cross-referencing has nothing to do with an infectious process.
Which sexually transmitted disease is caused by the human papilloma virus? Gonorrhea Genital herpes Chlamydia infection Condylomata acuminata
Condylomata acuminata is a sexually transmitted disease caused by the human papilloma virus. Gonorrhea is caused by Neisseria gonorrhoeae. Genital herpes is causes by the herpes simplex virus. Chlamydia infection is caused by Chlamydia trachomatis.
What causes condylomata acuminate? Chlamydia Gonorrhea Herpes simplex Human papillomavirus (HPV)
Condylomata acuminate are genital warts which are caused by the human papillomavirus (HPV). Genital warts are not caused by chlamydia, gonorrhea, or herpes simplex.
Which autoantigens are responsible for the development of Crohn's disease? Crypt epithelial cells Thyroid cell surface Basement membranes of the lungs Basement membranes of the glomeruli
Crypt epithelial cells are considered to be the autoantigens responsible for Crohn's disease. Thyroid cell surfaces are autoantigens responsible for Hashimoto's thyroiditis. The pulmonary and glomerular basement membranes act as autoantigens responsible for Goodpasture syndrome.
Which cells are affected in DiGeorge syndrome? T-cells B-cells Monocytes Polymorphonuclear cells
DiGeorge syndrome is a primary immune deficiency disorder in which T-cells are affected. The B-cells are affected in Bruton's X-linked agammaglobulinemia; common variable hypogammaglobulinemia; and selective IgA, IgM, and IgG deficiency. Monocytes and polymorphonuclear cells are affected in chronic granulomatous disease and Job syndrome.
Why would a client with acquired immunodeficiency syndrome (AIDS) be prescribed diphenoxylate hydrochloride? To manage pain To manage diarrhea To manage candidal esophagitis To manage behavioral problems
Diphenoxylate hydrochloride is an antidiarrheal drug prescribed to clients with AIDS to manage frequent diarrhea experienced by a client with AIDS. Opioid analgesics such as tramadol are used to manage pain. Ketoconazole can be used to treat candidal esophagitis associated with AIDS. Behavioral problems are managed with psychotropic drugs.
A client presents with a localized bacterial infection of mucous membranes. Which organism is most likely responsible for this condition in the client? Giardia Aspergillus fumigatus Corynebacterium diphtheria Mycobacterium tuberculosis
Diphtheria is a re-emerging infection that can be characterized by localized infection of mucous membranes or skin. It is caused by Corynebacterium diphtheria. Giardia, a parasite, causes giardiasis, a diarrheal illness known as traveler's diarrhea. Aspergillosis is a lung disease caused by Aspergillus fumigatus, a fungus. Mycobacterium tuberculosis causes tuberculosis.
A client with radiation therapy for neck cancer reports, "I feel a lump while swallowing and foods get stuck." What does the nurse document in the client's medical history? Dysgeusia Dysphagia Xerostomia Odynophagia
Dysphagia is having difficulty while swallowing. This characterizes pharyngeal and esophageal involvement, which further impedes eating. In this condition, the client may report a feeling of having a "lump" when swallowing and feeling that "foods get stuck." Dysgeusia is the loss of taste; clients will report that all food has lost its flavor. While xerostomia may contribute to difficulty swallowing, it is not the term used; xerostomia is used to indicate dry mouth. Odynophagia is painful swallowing; clients will report severe pain while swallowing.
Which leukocyte releases vasoactive amines during a client's allergic reactions? Neutrophil Monocyte Eosinophil Macrophage
Eosinophils release vasoactive amines during allergic reactions to limit the extent of the allergic reactions. Neutrophils are phagocytes and increase in inflammation and infection. Monocytes are involved in the destruction of bacteria and cellular debris. Macrophages are involved in nonspecific recognition of foreign protein and microorganisms.
A mother with the diagnosis of acquired immunodeficiency syndrome (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine? If she has kissed the baby If the baby is breast-feeding When the baby last received antibiotics How long she has been caring for the baby
Epidemiologic evidence has identified breast milk as a source of human immunodeficiency virus (HIV) transmission. Kissing is not believed to transmit HIV. When the baby last received antibiotics is unrelated to transmission of HIV. HIV transmission does not occur from contact associated with caring for a newborn.
Which drug can be administered via the intramuscular route to treat anaphylaxis? Epinephrine Methdilazine Phenylephrine Mycophenolate mofetil
Epinephrine is administered through the intramuscular route to treat anaphylaxis. Methdilazine is administered to treat allergic reactions and pruritus. Phenylephrine is administered orally, not intramuscularly, to treat anaphylaxis. Mycophenolate mofetil is administered intravenously as an immunosuppressant agent.
Which virus is responsible for causing infectious mononucleosis in clients? Parvovirus Coronavirus Rotavirus Epstein-Barr virus
Epstein-Barr virus is responsible for mononucleosis and possibly Burkitt's lymphoma. Parvovirus and rotavirus cause gastroenteritis. Corona virus causes upper respiratory tract infections.
Which type of cytokine is used to treat anemia related to chronic kidney disease? α-Interferon Interleukin-2 Interleukin-11 Erythropoietin
Erythropoietin is used to treat anemia related to chronic kidney disease. α-Interferon is used to treat hairy cell leukemia or malignant melanoma. Interleukin-2 is used to treat metastatic renal carcinoma. Interleukin-11 is used to prevent thrombocytopenia after chemotherapy.
Which bacteria colonies are commonly found in a client's large intestine? Escherichia coli Neisseria gonorrhoeae Staphylococcus aureus Haemophilus influenzae
Escherichia coli are bacteria that are part of the normal flora in the large intestine. Neisseria gonorrhoeae causes gonorrhea and pelvic inflammatory disease. Staphylococcus aureus secretes toxins that damage cells and causes skin infections, pneumonia, urinary tract infections, acute osteomyelitis, and toxic shock syndrome. Haemophilus influenzae causes nasopharyngitis, meningitis, and pneumonia.
Which disease is caused by Escherichia coli? Tetanus Peritonitis Diphtheria Food poisoning
Escherichia coli causes peritonitis. Clostridium tetani causes tetanus. Corynebacterium diphtheria causes diphtheria. Clostridium botulinum causes food poisoning.
Which skin infection is caused by bacteria? Folliculitis Candidiasis Herpes zoster Dermatophytosis
Folliculitis is caused by bacteria. Candidiasis is a skin infection caused by a fungus. Herpes zoster is caused by a virus. Dermatophytosis is caused by a fungus.
Which sexually transmitted disease is caused by a virus? Syphilis Gonorrhea Genital warts Chlamydial infection
Genital warts are caused by a sexually transmitted virus. Bacteria cause syphilis, gonorrhea, and chlamydial infections.
In clients with Goodpasture syndrome, what is the pathophysiology of this syndrome? Antigen-specific IgE binds to the surface of basophils and mast cells Auto-antibodies attack the glomerular basement membrane and neutrophils Rapid and systemic reactions of the organs within seconds after exposure to an allergen Autoimmune destruction of the lacrimal and salivary mucus-producing glands
Goodpasture syndrome is an autoimmune disorder in which auto-antibodies attack the glomerular basement membrane and neutrophils, especially in the lungs and kidneys. A client may have allergies when an antigen-specific IgE binds to the surface of basophils and mast cells, which stimulates the production of vasoactive amines. Rapid and systemic reactions of the organs within seconds after exposure to an allergen may lead to anaphylactic shock. A client with Sjögren's syndrome may have the autoimmune destruction of the lacrimal and salivary mucus/moisture-producing glands.
Which cytokine increases growth and maturation of myeloid stem cells? Interleukin-2 Thrombopoietin Granulocyte colony-stimulating factor Granulocyte-macrophage colony-stimulating factor
Granulocyte-macrophage colony-stimulating factor is a cytokine that increases growth and maturation of myeloid stem cells. Interleukin-2 is a cytokine that increases growth and differentiation of T-lymphocytes. Thrombopoietin is a cytokine that increases growth and differentiation of platelets. Granulocyte colony-stimulating factor is a cytokine that increases numbers and maturity of neutrophils.
Which disease conditions involve a cytotoxic hypersensitivity reaction? Select all that apply. Graves' disease Contact dermatitis Myasthenia gravis Rheumatoid arthritis Immune thrombocytopenic purpura
Graves' disease, myasthenia gravis, and immune thrombocytopenic purpura involve cytotoxic reactions. Rheumatoid arthritis and contact dermatitis are examples of immune complex and delayed hypersensitivity reactions, respectively.
What is a manifestation of tertiary syphilis? Chancre Alopecia Gummas Condylomata lata
Gummas which are chronic, destructive lesions affecting the skin, bone, liver, and mucous membranes occur during tertiary syphilis. A chancre appears during primary syphilis. Alopecia and condylomata lata occur during secondary syphilis.
A nurse is teaching a health class about human immunodeficiency virus (HIV). Which basic methods are used to reduce the incidence of HIV transmission? Select all that apply. Using condoms Using separate toilets Practicing sexual abstinence Preventing direct casual contacts Sterilizing the household utensils
HIV is found in body fluids such as blood, semen, vaginal secretions, breast milk, amniotic fluid, urine, feces, saliva, tears, and cerebrospinal fluid. Therefore a client should use condoms to prevent contact between the vaginal mucus membranes and semen. Practicing sexual abstinence is the best method to prevent transmission of the virus. The HIV virus is not transmitted by sharing the same toilet facilities, casual contacts such as shaking hands and kissing, or by sharing the same household utensils.
A registered nurse is teaching a student nurse regarding the interventions for a client with human immunodeficiency virus (HIV) infection. Which statement by the student nurse indicates the nurse needs to follow up? "I will ask the client to avoid exposure to new infectious agents." "I will ask the client about intake of vitamins and micronutrients." "I will ask the client to avoid involvement in community activities." "I will ask the client if he or she is up to date with recommended vaccines."
HIV-infected clients may feel isolated and lonely; therefore they should be involved in support groups and community activities. The nurse should follow up to correct this misconception. All the other statements are correct. The HIV infection decreases the client's immunity making the client prone to infection. Therefore HIV-infected clients should avoid exposure to new infectious agents. They should consume nutritional support to maintain lean body mass and ensure appropriate levels of vitamins and micronutrients. They need to be updated with recommended vaccines to prevent vaccine-preventable diseases.
What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection? Originated primarily from an exogenous source Is associated with a drug-resistant microorganism Occurred in conjunction with treatment for an illness Still has the infection despite completing the prescribed therapy
Health care-associated infections are classified as those that are contracted within a health care environment (e.g., hospital, long-term care facility) or result from a treatment (e.g., surgery, medications). Originating primarily from an exogenous source is not a criterion for identifying a health care-associated infection. The source of health care-associated infections may be endogenous (originate from within the client) or exogenous (originate from the health care environment or service personnel providing care); most health care-associated infections stem from endogenous sources and are caused by Escherichia coli and Staphylococcus aureus. Association with a drug-resistant microorganism is not a criterion for identifying a health care-associated infection. A health care-associated infection may or may not be caused by a drug-resistant microorganism. Still having the infection despite completing the prescribed therapy is not a criterion for identifying a health care-associated infection.
Which hypersensitivity reaction may occur in a newborn with hemolytic disease? Type I Type II Type III Type IV
Hemolytic disease in a pregnant woman may result in erythroblastosis fetalis, a type II hypersensitivity reaction. Type I reactions involve immunoglobulin E (IgE)-mediated reactions such as anaphylaxis and wheal-and-flare reactions. Type III reactions are immune complex reactions such as rheumatoid arthritis or systemic lupus erythematosus. Type IV reactions are delayed hypersensitivity reactions such as contact dermatitis.
Which type of hepatitis virus spreads through contaminated food and water? Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis D virus
Hepatitis A virus spreads through contaminated food and water. Hepatitis B, C, and D viruses spread through contaminated needles, syringes, and blood products.
Which type of immunoglobulin is present in tears, saliva, and breast milk? IgE IgA IgG IgM
IgA immunoglobulin is present in tears, saliva, and breast milk. IgE and IgG immunoglobulins are present in plasma and interstitial fluids. IgM immunoglobulin is present in plasma.
Which process does the IgD immunoglobulin support? Manifestation of allergic reactions Protection of the body's mucous surfaces Differentiation of the B-lymphocytes Provision of the primary immune response
IgD is present on the lymphocyte surface; this immunoglobulin differentiates B-lymphocytes. IgE causes symptoms of allergic reactions by adhering to mast cells and basophils. IgE also helps to defend the body against parasitic infections. IgA lines the mucous membranes and protects the body surfaces. IgM provides the primary immune response.
Which immunoglobulin crosses the placenta? IgE IgA IgG IgM
IgG is the only immunoglobulin that crosses the placenta. IgE is found in the plasma and interstitial fluids. IgA lines the mucous membranes and protects body surfaces. IgM is found in plasma; this immunoglobulin activates due to the invasion of ABO blood antigens.
A client has a tuberculin purified protein derivative test as part of a yearly physical examination. The area of induration is 10 mm within 48 hours after having the test. What does the nurse conclude about the client based on this response? The client has contracted clinical tuberculosis. The client has passive immunity to tuberculosis. The client has been exposed to the tubercle bacillus. The client has developed a resistance to the tubercle bacillus.
Induration measuring 10 mm or more in diameter is interpreted as significant; it does not indicate that active tuberculosis is present. About 90% of individuals who have significant induration do not develop the disease. Exposure to the tubercle bacillus indicates exposure; infection can be past or present. Passive immunity occurs when the body plays no part in the preparation of the antibodies; a positive tuberculin purified protein derivative indicates the presence of antibodies, not how they were formed. Developing a resistance to the tubercle bacillus reaction indicates exposure, not resistance.
Which test result should a nurse review to determine if the antibiotic prescribed for the client will be effective? Serologic test Sensitivity test Serum osmolality Sedimentation rate
Infected body fluids are tested to determine the antibiotics to which the organism is particularly sensitive or resistant (sensitivity). The serologic test checks for antibody content. The serum osmolality test provides data about fluid and electrolyte balance. The erythrocyte sedimentation rate (ESR) is a nonspecific test for the presence of inflammation.
What are the clinical manifestations of inhalation anthrax? Select all that apply. Fever Fatigue Rhinitis Dry cough Sore throat
Inhalation anthrax is a bacterial infection caused by Bacillus anthracis. Clinical manifestations include fever, fatigue, mild chest pain, and a dry cough. Rhinitis and sore throat are manifestations of many common upper respiratory infections, but are not associated with inhalation anthrax.
The nurse suspects that a client with inhalation anthrax is in the fulminant stage of the disease. Which symptom supports the nurse's conclusion? Fever Dry cough Hematemesis Mild chest pain
Inhalation anthrax is a bacterial infection caused by Bacillus anthracis. This disease has two stages of illness, the prodromal stage and the fulminant stage. The symptom of the fulminant stage is hematemesis. The symptoms of the prodromal stage are fever, dry cough, and mild chest pain.
Which cytokine stimulates the liver to produce fibrinogen and protein C? Interleukin-1 Interleukin-6 Thrombopoietin Tumor necrosis factor
Interleukin-6 stimulates the liver to produce fibrinogen and protein C. Interleukin-1 stimulates the production of prostaglandins. Thrombopoietin increases the growth and differentiation of platelets. Tumor necrosis factor stimulates delayed hypersensitivity reactions and allergies.
What should be used to clean needles and syringes between intravenous drug users (IDUs)? Bleach Hot water Ammonia Rubbing alcohol
Intravenous drug users (IDUs) should be instructed to fill syringes with household bleach and shake the syringe for 30 to 60 seconds. Hot water, ammonia, or rubbing alcohol are not used to disinfect used syringes.
Which medication should be immediately started when a client has an anaphylactic attack? Isoproterenol Diphenhydramine HCl Hydrocortisone sodium succinate Methylprednisolone sodium succinate
Isoproterenol is a beta-adrenergic, sympathomimetic drug that is considered to be a first-line of medication for the management of anaphylaxis. Diphenhydramine HCl is a second-line antihistamine to be used after the client is stabilized. Hydrocortisone sodium succinate and methylprednisolone sodium succinate are second-line corticosteroid medications that inhibit inflammatory mediators.
Which organism is responsible for causing Lyme disease in clients? Phthirus pubis Sarcoptes scabiei Borrelia burgdorferi Pediculushumanus var. corporis
Lyme disease is a bacterial infection caused by Borrelia burgdorferi, which is transmitted by ticks. Phthirus pubis causes pediculosis. Scabies is caused by Sarcoptes scabiei. Pediculushumanus var. corporis also causes pediculosis.
Which dietary modifications can help improve the nutritional status of a client with acquired immunodeficiency syndrome (AIDS)? Refraining from consuming fatty foods Refraining from consuming frequent meals Refraining from consuming high-calorie foods Refraining from consuming high-protein foods
Many clients with AIDS become intolerant to fat due to the disease and the antiretroviral medications. Therefore the client should be instructed to refrain from consuming fatty foods. The client should be encouraged to eat small and frequent meals to improve nutritional status. High-calorie and high-protein foods are beneficial to clients with AIDS because they provide energy and build immunity.
Why is a Neisseria gonorrhoeae infection particularly troublesome for a female client? The medication is expensive. It is difficult to treat with antibiotics. Symptoms are often overlooked. Treatment has many adverse effects.
Many female clients who contract gonorrhea are asymptomatic or have minor symptoms that are often overlooked, making it possible for them to remain a source of infection. There is no evidence to support that the medication to treat the infection is expensive. The infection can be treated with one intramuscular injection of ceftriaxone. There is no evidence to support that the medication to treat this infection has many adverse effects.
Which diseases can be transmitted by air? Select all that apply. Scabies Measles Pediculosis Chicken pox Tuberculosis
Measles, chicken pox, and tuberculosis are infectious diseases that are transmitted by air. Scabies and pediculosis are transmitted by direct contact.
Which leukocytes should the nurse include when teaching about antibody-mediated immunity? Select all that apply. Monocyte Memory cell Helper T cell B-lymphocyte Cytotoxic T cell
Memory cells and B-lymphocytes are involved in antibody-mediated immunity. Monocytes are involved in inflammation. Helper T cells and cytotoxic T cells are involved in cell-mediated immunity.
Which client organ is protected by microglial cells? Lung Liver Brain Kidney
Microglial cells are macrophages present in the brain. The lungs are protected by alveolar macrophages. The liver is protected by Kupffer cells. Mesangial cells are present in the kidneys.
What is the function of a client's natural killer cells? Secrete immunoglobulins in response to the presence of a specific antigen Heighten selectively and destroy non-self cells, including virally infected cells Enhance immune activity through secretion of various factors, cytokines, and lymphokines Attack non-selectively on non-self cells, especially mutated and malignant cells
Natural killer cells attack non-selectively on non-self cells, especially body cells that have undergone mutation and become malignant. Plasma cells secrete immunoglobulins in response to the presence of a specific antigen. Cytotoxic T-cells attack selectively and destroy non-self cells, including virally infected cells. Helper T-cells enhance immune activity through secretion of various factors, cytokines, and lymphokines.
Which type of immunity is acquired through the transfer of colostrum from the mother to the child? Natural active immunity Artificial active immunity Natural passive immunity Artificial passive immunity
Natural passive immunity is acquired through the transfer of colostrum from the mother to the child. Natural active immunity is acquired when there is a natural contact with an antigen through a clinical infection. Artificial active immunity is acquired through immunization with an antigen. Artificial passive immunity is acquired by injecting serum from an immune human.
Which mechanism of action does norepinephrine promote to manage anaphylaxis? Blocks the effects of histamine Inhibits mast cell degranulation Increases blood pressure and cardiac output Stimulates muscarinic and nicotinic receptors
Norepinephrine is a sympathomimetic vasopressor that elevates the blood pressure and cardiac output in clients with hypotension from anaphylaxis by stimulating alpha- and beta-adrenergic receptors. Diphenhydramine blocks the effects of histamine on various organs. Corticosteroids such as dexamethasone prevent mast cell degranulation. Acetylcholinesterase inhibitors such as neostigmine stimulate the muscarinic and nicotinic receptors for the reversal of neuromuscular blockade agents.
A female client is upset with her diagnosis of gonorrhea and asks the nurse, "What can I do to prevent getting another infection in the future?" Which is the most practical response the nurse can give to someone who plans to be sexually active? "Douche after every intercourse." "Avoid engaging in sexual behavior." "Insist that your partner use a condom." "Use a spermicidal cream with intercourse."
Once people become sexually active, they usually remain sexually active; a condom, although not 100% effective, is the best protection against gonorrhea in a sexually active person. The response "Douche after every intercourse" has no proven protective effect against sexually transmitted infections; excessive douching can alter the vaginal environment and may promote an ascending infection. The response "Avoid engaging in sexual behavior" is not a realistic response to a sexually active person. Spermicidal cream has no protective effect against sexually transmitted infections.
Which is the most common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? Oropharyngeal candidiasis Cryptosporidiosis Toxoplasmosis encephalitis Pneumocystis jiroveci pneumonia
Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is the more common in a client infected with AIDs. It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat.
Which organism is responsible for causing dermatitis related to a sexually transmitted infection? Phthirus pubis Candida albicans Campylobacter jejuni Ureaplasma urealyticum
Phthirus pubis is responsible for dermatitis related to sexually transmitted infections. Candida albicans may lead to vulvovaginitis. Campylobacter jejuni may cause proctitis. Ureaplasma urealyticum may cause salpingitis, infertility, reproductive loss, and ectopic pregnancies.
Which parameter should the nurse consider while assessing the psychologic status of a client with acquired immune deficiency syndrome (AIDS)? Sleep pattern Severity of pain Cognitive changes Presence of anxiety
Presence of anxiety should be considered while assessing the psychologic status of a client with AIDS. Sleep patterns and severity of pain are related to the assessment of activity and rest, a physical status. Cognitive changes are related to the assessment of neurologic status.
What finding in the client is a sign of allergic rhinitis? Presence of high-grade fever Reduced breathing through the mouth Presence of pinkish nasal discharge Reduced transillumination on the skin over the sinuses
Reduced transillumination on the skin overlying the sinuses indicates allergic rhinitis. This effect is caused by the sinuses becoming inflamed and blocked with thick mucoid secretions. Generally, fever does not accompany allergic rhinitis unless the client develops a secondary infection. In allergic rhinitis, the client is unable to breathe through the nose because it gets stuffy and blocked. Instead the client will resort to mouth breathing. Clients with allergic rhinitis will have clear or white nasal discharge.
What is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs)? Removing the catheter Keeping the drainage bag off of the floor Washing hands before and after assessing the catheter Cleansing the urinary meatus with soap and water daily
Research demonstrates that decreasing the use of indwelling urinary catheters is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs). Keeping the drainage bag off the floor, washing hands before and after assessing the catheter, and cleansing the urinary meatus daily with soap and water will help reduce infections; however, these are not the most important interventions to prevent CAUTIs.
Which diseased condition associated with the client's heart is an example of an autoimmune disease? Uveitis Rheumatic fever Myasthenia gravis Graves' disease
Rheumatic fever is a heart disorder that is an example of an autoimmune disease. Uveitis is an eye disorder that is an example of an autoimmune disease. Myasthenia gravis is a muscle disorder that is an example of an autoimmune disease. Graves' disease is an endocrine disorder that is an example of an autoimmune disease.
Which type of hypersensitivity reaction is associated with rheumatoid arthritis? Delayed Cytotoxic IgE-mediated Immune-complex
Rheumatoid arthritis is an autoimmune disorder associated with an immune-complex type of hypersensitivity reaction. Contact dermatitis caused by poison ivy is associated with a delayed type of hypersensitivity reaction. Goodpasture's syndrome is associated with a cytotoxic type of hypersensitivity reaction. Asthma is associated with an IgE-mediated type of hypersensitivity reaction.
Which are examples of a type IV hypersensitivity reaction? Select all that apply. Poison ivy allergic reaction Sarcoidosis Myasthenia gravis Rheumatoid arthritis Systemic lupus erythematosus
Sarcoidosis and poison ivy reactions are examples of type IV hypersensitivity reactions. In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized T cells with the antigen and the resultant activation of macrophages due to lymphokine release. Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity reaction. Rheumatoid arthritis and systemic lupus erythematosus are examples of type III immune complex-mediated reactions.
Which disease is caused by Coronaviruses? Pertussis Inhalation anthrax Coccidioidomycosis Severe acute respiratory syndrome
Severe acute respiratory syndrome is a respiratory infection caused by Coronaviruses. Pertussis is caused by the bacterium Bordetella pertussis. Inhalation anthrax is caused by Bacillus anthracis. Coccidioidomycosis is caused by Coccidioides.
What is a common characteristic of Sjögren's syndrome (SS)? Dry eyes Muscle cramping Urinary tract infection Elevated blood pressure
Sjögren's syndrome (SS) is a group of problems that often appear with other autoimmune disorders. Problems include dry eyes, which are caused by autoimmune destruction of the lacrimal glands. Muscle cramping, urinary tract infection, and elevated blood pressure are not common characteristics of Sjögren's syndrome (SS).
Which organism causes smallpox? Variola virus Yersinia pestis Bacillus anthracis Clostridium botulinum
Smallpox is an infectious disease caused by the Variola virus . Yersinia pestis causes plague. Bacillus anthracis causes anthrax. Clostridium botulinum causes botulism.
Which organism causes malaria? Vibrio Sporozoa Ringworm Spirochetes
Sporozoa such as Plasmodium malariae cause malaria. Vibrio are curved-rod-shaped bacteria; these microorganisms causes cholera. Ringworm such as tinea corporis may cause mycotic infections. Spirochetes are spiral-shaped bacteria; these microorganisms may cause leprosy and syphilis.
Which stage of HIV would a client with a CD4+ T-cell count of 325 cells/mm 3 be classified? Stage 1 Stage 2 Stage 3 Stage 4
Stage 2 describes a client with a CD4+ T-cell count between 200 and 499 cells/mm 3. Stage 1 describes a client with a CD4+ T-cell count of greater than 500 cells/mm 3. Stage 3 describes a client with a CD4+ T-cell count of less than 200 cells/mm 3. Stage 4 describes a client with a confirmed HIV infection but no information regarding CD4+ T-cell counts is available.
Which bacteria causes toxic shock syndrome in female clients? Treponema pallidum Streptococcus faecalis Staphylococcus aureus Neisseria gonorrhoeae
Staphylococcus aureus causes toxic shock syndrome. Treponema pallidum causes syphilis. Streptococcus faecalis causes genitourinary tract infections and infection of surgical wounds. Neisseria gonorrhoeae causes gonorrhea and pelvic inflammatory disease.
Which sexually transmitted infection (STI) is caused by Treponema pallidum? Syphilis Gonorrhea Genital warts Vulvovaginitis
Syphilis is an STI caused by Treponema pallidum. Neisseria gonorrhoeae causes gonorrhea. Haemophilus ducreyi and Klebsiella granulomatis cause genital warts. Herpes simplex virus, Trichomonas vaginalis, and Candida albicans may cause vulvovaginitis.
A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client? Use standard precautions. Employ airborne precautions. Plan interventions to limit direct contact. Discourage long visits from family members.
The Centers for Disease Control and Prevention (Canada: Public Health Agency of Canada) states that standard precautions should be used for all clients; these precautions include wearing of gloves, gown, mask, and goggles when there is risk for exposure to blood or body secretions. There is no indication that airborne precautions are necessary. Planning interventions to limit direct contact and discouraging long visits from family members will unnecessarily isolate the client.
Which virus can cause encephalitis in adults and children? Rubella virus Parvovirus Rotaviruses West Nile virus
The West Nile virus causes encephalitis. German measles is caused by rubella. Gastroenteritis is caused by parvovirus. Rotavirus also causes gastroenteritis.
A client diagnosed with osteomyelitis is being discharged. Which statement indicates a need for further teaching? "I will take the antibiotic at the same time every day." "I will take the antibiotic regularly until my symptoms subside." "I will take the antibiotic with food if I develop gastric distress when on the antibiotic." "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath."
The antibiotic should be taken as prescribed for the full length of treatment. The client should not discontinue the medication when symptoms subside. The statements "I will take the antibiotic at the same time every day," "I will take the antibiotic with food if I develop gastric distress when on the antibiotic," and "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath" demonstrate understanding of the discharge instructions.
A school nurse is asked to develop a program for teachers about infection control, especially focusing on hand washing technique. What is the most effective way for the nurse to evaluate what the teachers have learned? Observe the teachers lecture the children about hand hygiene. Give an objective written final examination to the teachers. Schedule a seminar for the teachers to share their knowledge. Watch the teachers demonstrate infection control techniques.
The best way to evaluate learning is by feedback demonstration of precautions related to infection control, such as hand washing techniques. This method is observable and must meet objective criteria. Although observing a lecture, giving a written exam, or sharing what has been learned in a seminar are all evaluation techniques that may be used, none of these methods are as objective and definitive as observing an actual psychomotor demonstration of techniques.
What is the causative organism for syphilis? Treponema pallidum Campylobacter jejuni Trichomonas vaginalis Chlamydia trachomatis
The causative organism for syphilis is Treponema pallidum. Campylobacter jejuni is the causative organism for proctitis. Trichomonas vaginalis is the causative organism for vulvovaginitis. Chlamydia trachomatis is the causative organism for salpingitis.
What is the function of IgG in the body? Activates the degranulation of mast cells Activates the classic complement pathway Prevents upper respiratory tract infections Prevents lower respiratory tract infections
The classic complement pathway is activated by the IgG and IgM antibodies. IgE antibodies cause a degranulation of mast cells. IgA antibodies are found largely in mucous membrane secretions and play an important role in preventing upper and lower respiratory tract infections.
The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up? "I should abstain from sexual activity." "I can safely have anal sex without any barriers." "I should get HIV counseling if planning for pregnancy." "I will use condoms while having sexual intercourse."
The client with HIV should use barrier protection when engaging in insertive sexual activity such as anal, oral, and vaginal. Therefore the nurse should follow up to provide the client with the correct information. All the other statements are correct and need no follow up. Abstaining from all sexual activity is a safe way to eliminate the risk of exposure to HIV in semen and vaginal secretions. The client should undergo HIV counseling and routinely offer access to voluntary HIV-antibody testing when planning for pregnancy. The most commonly used barrier is a condom, which allows for protected intercourse.
A chronically ill, older client tells the home care nurse that the daughter with whom the client lives seems run-down and disinterested in her own health, as well as the health of her children, who are 5, 7, and 12 years old. The client tells the nurse that the daughter coughs a good deal and sleeps a lot. Why is it important that the nurse pursue the daughter's condition for potential case findings? Tuberculosis has been rising dramatically in the general population. Older adults with chronic illness are more susceptible to tuberculosis. There is a high incidence of tuberculosis in children less than 12 years of age. Death from tuberculosis has been generally on the decrease in the United States (Canada).
The client's chronic illness and older age increase vulnerability; the daughter's condition should be explored in greater detail. Tuberculosis is only one of many potential causes of the daughter's clinical condition. Children who have not yet reached puberty and adolescence have the lowest incidence of tuberculosis. Morbidity and mortality resulting from tuberculosis are increasing, not decreasing.
What is the most effective strategy for preventing the transmission of infection? Wearing gloves and a gown Applying face mask and a gown Applying a face mask and gloves Wearing gloves and hand hygiene
The combination of hand hygiene and wearing gloves is the most effective strategy for preventing infection transmission. A gown and face mask are considered personal protective equipment; however, they are not considered the most effective strategy to prevent the transmission of infection.
Which age-related effects on the immune system are seen in the older client? Increased autoantibodies Increased expression of IL-2 receptors Increased delayed hypersensitivity reaction Increased primary and secondary antibody responses
The effects of aging on the immune system include increased autoantibodies. Expression of IL-2 receptors, delayed hypersensitivity reaction, and primary and secondary antibody responses decrease in older adults because of the effects of aging on the immune system.
The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). What does the nurse expect to find? A decrease in CD4 T cells An increase in thymic hormones An increase in immunoglobulin E A decrease in the serum level of glucose-6-phosphate dehydrogenase
The human immunodeficiency virus (HIV) infects helper T-cell lymphocytes; therefore 300 or fewer CD4 T cells per cubic millimeter of blood or CD4 cells accounting for less than 20% of lymphocytes is suggestive of AIDS. The thymic hormones necessary for T-cell growth are decreased. An increase in immunoglobulin E is associated with allergies and parasitic infections. A decrease in the serum level of glucose-6-phosphate dehydrogenase is associated with drug-induced hemolytic anemia and hemolytic disease of the newborn.
What causes medications used to treat AIDS to become ineffective? Taking the medications 90% of the time Missing doses of the prescribed medications Taking medications from different classifications Developing immune reconstitution inflammatory syndrome (IRIS)
The most important reason for the development of drug resistance in the treatment of AIDS is missing doses of drugs. When doses are missed, the blood drug concentrations become lower than what is needed to inhibit viral replication. The virus replicates and produces new particles that are resistant to the drugs. Taking the medications 90% of the time prevents medications from becoming ineffective. Taking medications from different classes prevents the drugs from becoming ineffective. Immune reconstitution inflammatory syndrome (IRIS) occurs when T-cells rebound with medication therapy and become aware of opportunistic infections.
A client expresses concern that because of supply and demand there is no vaccine available for the annual flu vaccine. What is the nurse's best reply? "It's unfortunate, but there was such a limited supply available." "There are many others who also were unable to get a flu vaccine." "It doesn't matter because the vaccine is for just one particular strain." "There are other things you can do to prevent the flu, such as hand washing."
The statement "There are other things you can do to prevent the flu, such as hand washing" is a teaching opportunity of which the nurse can take advantage and show the client the things that can be done to avoid infection. The response "It's unfortunate, but there was such a limited supply available" is empathic, but it does not address the client's concern of vulnerability. The response "There are many others who also were unable to get a flu vaccine" belittles the client for being concerned. The response "It doesn't matter because the vaccine is for just one particular strain" may be true, but it belittles the client's concern.
A client with tuberculosis asks the nurse about the communicability of the disease. Which is the best response by the nurse? "Tuberculosis is not communicable at this time." "Untreated active tuberculosis is communicable." "Tuberculosis is communicable during the primary stage." "With the newer long-term therapies, tuberculosis is not communicable."
The statement that untreated active tuberculosis is communicable is an accurate statement; treatment is necessary to stop communicability. The statement that tuberculosis is not communicable at this time is false reassurance; untreated active tuberculosis is communicable. Tuberculosis is not communicable when there is no active infection; the primary complex refers to the presence of a primary (Ghon) tubercle and enlarged lymph nodes and is the initial response to exposure; active disease may or may not occur. Tuberculosis is a communicable disease; close contacts should be screened via a skin test.
A spouse of a client with pulmonary tuberculosis (TB) receives a tuberculin skin test. The nurse reads the test and identifies an area of induration greater than 10 mm. What does this result indicate to the nurse? No further action is required. Additional tests are necessary. Repeating the skin test is indicated. Results are positive, indicating infection.
The test does not indicate whether TB is dormant or active. However, a client with an induration of 5 mm or greater is considered positive if there is repeated close contact with a person diagnosed with pulmonary tuberculosis or if the client has a disease causing decreased resistance; this requires further diagnostic study, such as chest x-rays and sputum culture. A newly infected client will receive preventive therapy with isoniazid (INH). Isoniazid will be continued for 6 months if chest x-rays are normal, or 12 months if chest x-rays are abnormal. Repeating the skin test is not necessary; the test is considered positive.
A nurse identifies 12 mm of induration at the site of a tuberculin purified protein derivative (PPD) test when a client returns to the health office to have it read. What does the nurse explain to the client about this test? Test result is negative and no follow-up is needed Result indicates a need for further tests and a chest x-ray Test was used for screening and a Tine test now will be given Skin test is inconclusive and will have to be repeated in 6 weeks
The tuberculin PPD is injected intradermally; it is the most accurate skin test for tuberculosis (TB) because of the testing material and the intradermal method used. No other skin test is appropriate as a follow-up; further tests are now warranted, including a chest x-ray film. The test result is positive, not negative; thus further testing is necessary. The Tine test is less accurate than the tuberculin PPD and is not used as a follow-up test. More than 10 mm of induration is a positive test result, not a doubtful test result.
Which is the first medication approved to reduce the risk of human immunodeficiency virus (HIV) infection in unaffected individuals? Truvada Abacavir Cromolyn Methdilazine
Truvada is the first medication approved to reduce the risk of HIV infection in unaffected individuals who are at a high risk of HIV infection. Abacavir is administered to treat HIV infection and is a reverse transcriptase inhibitor. Cromolyn is administered in the management of allergic rhinitis and asthma. Methdilazine, an antihistamine, is administered to treat the skin and provide relief from itching.
What are the symptoms of tuberculosis? Select all that apply. Fatigue Nausea Weight gain Low-grade fever Increased appetite
Tuberculosis is an infectious respiratory disease caused by Mycobacterium tuberculosis. The symptoms of tuberculosis are fatigue, nausea, low-grade fever, weight loss, and anorexia.
Which diseases may occur due to rickettsial infections? Select all that apply. Some correct answers were not selected Leprosy Lyme disease Epidemic typhus West Nile fever Rocky Mountain spotted fever
Typhoid fever and Rocky Mountain spotted fever are caused by rickettsial infections. Spirochetes and Mycobacterium leprae cause leprosy. Borrelia burgdorferi cause Lyme disease. The West Nile virus causes West Nile fever.
Which viral infection will cause the nurse to observe for warts? Pox virus Rhabdovirus Epstein-Barr virus Papillomavirus
Warts are caused by papillomavirus. Pox viruses cause smallpox. Rhabdovirus causes rabies. Epstein-Barr causes mononucleosis and Burkitt's lymphoma.
What determines if a client will develop AIDS from an HIV infection? Level of IgM in the blood The number of CD4+ T-cells available Presence of antigen-antibody complexes Speed with which the virus invades the RNA
Whether HIV becomes AIDS depends upon the number of CD4+ T-cells. IgM and the presence of antigen-antibody complexes have no effect on HIV. The speed with which HIV invades the RNA has no impact on the future development of AIDS.
A nurse is caring for a client with a negative-pressure wound treatment device. When should the nurse tell the client to call the wound center about this system? When the negative pressure seal is broken When the tubing coming from the wound has no kinks When the drainage chamber is one-third full of exudate When the dressing has a small amount of exudate under the seal
With negative pressure wound therapy, the client should understand that when the seal is broken, the wound center should be contacted immediately. There should be a tight seal covering the foam and an air-tight seal covering the wound and vacuum.
Which is a leukotriene modifier used to manage and prevent allergic rhinitis? Zileuton Ephedrine Scopolamine Cromolyn sodium
Zileuton is a leukotriene modifier used to manage and prevent allergic rhinitis. Ephedrine is an ingredient in decongestants used to treat allergic rhinitis. Scopolamine is an anticholinergic used to reduce secretions. Cromolyn sodium is a mast cell stabilizing drug used to prevent mast cell membranes from opening when an allergen binds to IgE.
Which drug treats hay fever by preventing leukotriene synthesis? Zileuton Cromolyn sodium Chlorpheniramine Diphenhydramine
Zileuton[1][2] is a leukotriene antagonist drug; this substance prevents the synthesis of leukotrienes and helps in managing and preventing hay fever. Cromolyn sodium stabilizes mast cells and prevents the opening of mast cell membranes in response to allergens binding to immunoglobulin E. Chlorpheniramine and diphenhydramine are antihistamines and prevent the binding of histamine to receptor cells and decrease allergic manifestations.
Which cytokine is used to treat multiple sclerosis? β-Interferon Interleukin-2 Erythropoietin Colony-stimulating factor
β-Interferon is a cytokine used to treat multiple sclerosis. Interleukin-2 is used to treat metastatic melanoma. Erythropoietin is a cytokine used to treat anemia related to chemotherapy. Colony-stimulating factor is a cytokine used to treat chemotherapy-induced neutropenia.