Med Surg Exam 4
A patient with common variable immunodeficiency disease (CVID) has an order for an IVIG infusion. What actions should the nurse perform prior to beginning the infusion? Select all that apply. -Obtain the patient's height and weight -Assess baseline vital signs -Assess for history of migraine headaches -Premedicate with acetaminophen and diphenhydramine -Schedule peaks and trough blood draws with the laboratory
-Obtain the patient's height and weight -Assess baseline vital signs -Assess for history of migraine headaches -Premedicate with acetaminophen and diphenhydramine
Which statement made by a client with cancer who has moderate to severe pain and was prescribed oxymorphone indicates further instruction is required? A. "I will take this medication with breakfast for the best results." B. "I can also have this medication in an extended-release tablet." C. "I will stop drinking beer while I'm taking this medication." D. "The IR indicates I will get fast relief when I take the medication."
A. "I will take this medication with breakfast for the best results."
The nurse is working with a mother whose child has just been diagnosed with selective immunoglobulin A deficiency. The mother asks the nurse, "Does this mean that my child is going to die?" How will the nurse respond? A. "Your child has a mild genetic immune deficiency caused by a lack of immunoglobulin A (IgA), a type of antibody that protects against infections of the lining the mouth and digestive tract." B. "Selective immunoglobulin A deficiency is the term used to describe the early stages of the AIDS infection." C. "Your child may die without proper medication and treatment." D. "Selective immunoglobulin A deficiency can cause uncontrolled muscle movements with progressive neurologic deterioration if left untreated."
A. "Your child has a mild genetic immune deficiency caused by a lack of immunoglobulin A (IgA), a type of antibody that protects against infections of the lining the mouth and digestive tract."
What interventions is a priority when treating a patient with HIV/AIDS? A. Assessing fluid and electrolyte balance B. Assessing neurologic status C. Monitoring psychological status D. Monitoring skin integrity
A. Assessing fluid and electrolyte balance
The nurse is evaluating bloodwork results of a client with cancer who is receiving chemotherapy. The client's platelet count is 60,000/mm3. Which is an appropriate nursing action? A. Avoiding the use of products containing aspirin B. Taking the client's temperature rectally C. Providing commercial mouthwash to the client D. Providing a razor so the client can shave
A. Avoiding the use of products containing aspirin
Which of the following is usually the most important consideration in decisions to initiate antiretroviral therapy? A. CD4 counts B. Western blot assay C. ELISA D. HIV RNA
A. CD4 counts
Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? A. CDC category A: HIV asymptomatic B. CDC category B: HIV symptomatic C. Primary infection (acute HIV infection or acute HIV syndrome) D. CDC category C: AIDS
A. CDC category A: HIV asymptomatic
A client taking abacavir (ABC) has developed fever and rash. What is the priority nursing action? A. Call the health care provider to report. B. Administer acetaminophen (Tylenol) C. Administer Lidocaine cream for the rash D. Document the information
A. Call the health care provider to report.
Which occurs when fluid accumulates in the pericardial space and compresses the heart? A. Cardiac tamponade B. SIADH C. DIC D. Superior vena cava syndrome (SVCS)
A. Cardiac tamponade
Other than abstinence, what is the only proven method of decreasing the risk for sexual transmission of HIV infection? A. Consistent and correct use of condoms B. Vaginal lubricants C. Birth control pills D. Spermicides
A. Consistent and correct use of condoms
A patient is administered foscarnet to treat a case of cytomegalovirus (CMV) retinitis. Which of the following adverse effects should the nurse closely monitor in the patient? A. Electrolyte imbalances B. Hypotension C. Anemia D. Peripheral neuropathy
A. Electrolyte imbalances
The nurse is working with a client who has had an allohematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of A. Graft-versus-host disease B. Acute leukopenia C. Metastasis D. Nadir
A. Graft-versus-host disease
Which of the following is an early manifestation of HIV encephalopathy? A. Headache B. Hallucinations C. Hyperreflexia D. Vacant stare
A. Headache
Infants with DiGeorge syndrome have which type of endocrine disorder? A. Hypoparathyroidism B. Hyperthyroidism C. Hypothyroidism D. Hyperparathyroidism
A. Hypoparathyroidism
Chemotherapeutic agents have which effect associated with the renal system? A. Increased uric acid excretion B. Hypophosphatemia C. Hypokalemia D. Hypercalcemia
A. Increased uric acid excretion
The advance practice nurse is treating a client experiencing a neuropathic pain syndrome. Which statements by the client demonstrates an understanding of concepts related to neuropathic pain? A. "Neuropathic pain is the body's normal response to tissue damage that causes pain." B. "My phantom limb pain serves no purpose, and I may need to take antidepressants to help." C. "When the inflammation in my foot resolves, I will no longer have pain from neuropathy." D. "Neuropathic pain will only last a few days and is easily treated with COX-2 analgesic agents."
B. "My phantom limb pain serves no purpose, and I may need to take antidepressants to help."
Which of the following microorganisms is known to cause retinitis in people with HIV/AIDS? A. Cryptococcus neoformans B. Cytomegalovirus C. Pneumocystis carinii D. Mycobacterium avium
B. Cytomegalovirus
Which nursing intervention should a nurse perform when caring for a client who is prescribed opiate therapy for pain? A. Avoid caffeine or other stimulants, such as decongestants B. Do not administer if respirations are <12 breaths per minute C. Monitor blood counts and liver function tests D. Monitor weight, vital signs, and serum glucose concentration
B. Do not administer if respirations are <12 breaths per minute
Which of the following substances may be used to lubricate a condom? A. Skin lotion B. K-Y jelly C. Baby oil D. Petroleum jelly
B. K-Y jelly
A decrease in circulating white blood cells is A. Thrombocytopenia B. Leukopenia C. Granulocytopenia D. Neutropenia
B. Leukopenia
Which is a growth-based classification of tumors? A. Carcinoma B. Malignancy C. Sarcoma D. Leukemia
B. Malignancy
According to the TNM classification system, T0 means there is A. No regional lymph node metastasis. B. No evidence of primary tumor. C. No distant metastasis. D. Distant metastasis.
B. No evidence of primary tumor.
Which risk factor is related to venous stasis for deep vein thrombosis (DVT) and pulmonary embolism (PE)? A. Surgery B. Obesity C. Trauma D. Pacing wires
B. Obesity
Which of the following is a physiologic response to pain? A. Hypotension B. Pallor C. Dry skin D. Bradycardia
B. Pallor
T-cell deficiency occurs when which of the following glands fails to develop normally during embryogenesis? A. Thyroid B. Thymus C. Adrenal D. Pituitary
B. Thymus
A patient receiving antiretroviral therapy is complaining of "not urinating enough." What is the nurse's best action? A. Assess liver function tests. B. Administer fluids 100mL/hour via IV therapy C. Assess BUN and creatinine D. Encourage the patient to drink more fluids
C. Assess BUN and creatinine
Diagnosis of Kaposi's sarcoma (KS) is made by which of the following? A. CT scan B. Skin scraping C. Biopsy D. Visual assessment
C. Biopsy
Which factor is a leading health indicator used to measure the health of the nation? A. Cultural awareness B. Religion C. Overweight and obesity D. Intelligence
C. Overweight and Obesity
Which is a true statement regarding placebos? A. A positive response to a placebo indicates that the client's pain is not real. B. A placebo effect is an indication that the client does not have pain. C. Placebos should never be used to test a client's truthfulness about pain. D. A placebo should be used as the first line of treatment for a client.
C. Placebos should never be used to test a client's truthfulness about pain.
An obese client is scheduled for open abdominal surgery. What priority education should the nurse provide to this client? A. Prevention of wound dehiscence B. Wound care and infection prevention C. Prevention of respiratory complications D. Prevention of venous thromboembolism
C. Prevention of respiratory complications
The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as A. Systemic radiation B. External beam radiation therapy C. Contact mold D. Brachytherapy
D. Brachytherapy
When taking a client history, the nurse notes that the client has been taking herbal remedies in addition to acetaminophen for several years. Based on the admission history, the nurse understands that the client is experiencing which type of pain after an amputation? A. Phantom pain B. Acute pain C. Breakthrough pain D. Chronic pain
D. Chronic pain
During which step of cellular carcinogenesis do cellular changes exhibit increased malignant behavior? A. Initiation B. Promotion C. Prolongation D. Progression
D. Progression
A serum sodium concentration lower than 115 mEq/L (115 mmol/L) is associated with A. Weight gain B. Annorexia C. Myalgia D. Seizure
D. Seizure
The nurse is caring for a client with benign breast tumor. The tumor may have which characteristic? A. Undifferentiated cells B. Causes generalized symptoms C. Ability to invade other tissues D. Slow rate of growth
D. Slow rate of growth
A client with a brain tumor is undergoing radiation and chemotherapy for treatment of cancer. The client has recently reported swelling in the gums, tongue, and lips. Which is the most likely cause of these symptoms? A. Neutropenia B. Extravasation C. Nadir D. Stomatitis
D. Stomatitis
The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? A. To destroy marginal tissues B. To analyze the lymph nodes involved C. To remove the tumor from the brain D. To prevent the formation of new cancer cells
D. To prevent the formation of new cancer cells
The term used to define the balance between the amount of HIV in the body and the immune response is A. Primary infection stage B. Window period C. Viral clearance rate D. Viral set point
D. Viral set point
Which type of phagocytic disorder occurs when white blood cells cannot initiate an inflammatory response to infectious organisms? A. Agammaglobulinemia B. Hyperimmunoglobulinemia C. Telangiectasia D. Panhypoglobulkinemia
B. Hyperimmunoglobulinemia
When the nurse administers intravenous gamma-globulin infusion, she recognizes that which of the following complaints, if reported by the patient, may indicate an adverse effect of the infusion? A. Nasal stuffiness B. Tightness in the chest C. Burning urination D. Increased thirst
B. Tightness in the chest
A client is undergoing chemotherapy treatment for prostate cancer and has lost considerable weight due to nausea and vomiting. Which nursing intervention is appropriate for the client? A. adjusting the client's meal plan and after chemotherapy B. Decreasing dietary fluids 2 days before chemotherapy C. Increasing fresh fruits in the client's diet D. Administering beta-blockers as ordered by the physician
A. adjusting the client's meal plan and after chemotherapy
A 75-year-old client had surgery for a hip fracture yesterday. The client is under stress because of the pain, the medications, sleep deprivation, and hospital surroundings. Which nursing intervention to treat the client's pain should the nurse question when ordered by the doctor? A. Use of transelectrical nerve stimulator (TENS) B. Morphine rather than Advil for pain management C. Acetaminophen for pain management D. Advil for pain management
D. Advil for pain management
Which should a nurse thoroughly evaluate before a bone marrow transplant (BMT) procedure? A. Allergy history B. Family history C. Drug history D. Blood studies
D. Blood studies
Which type of disorder produces recurrent and persistent infection of the soft tissue, lungs, and other organs? A. Complement deficiency B. B-cell deficiency C. T-cell deficiency D. Primary phagocytic disorder
D. Primary phagocytic disorder
Which blood test confirms the presence of antibodies to HIV? A. P24 antigen B. Enzyme-linked immunoabsorbent assay (ELISA) C. Reverse transcriptase D. Erythrocyte sedimentation rate (ESR)
B. Enzyme-linked immunoabsorbent assay (ELISA)
Which is a nonmodifiable risk factor for coronary artery disease (CAD)? A. Obesity B. Gender C. Hypertension D. Diabetes mellitus
B. Gender
Which does a nurse thoroughly evaluate before a hematopoietic stem cell transplant (HSCT) procedure? A. Allergy history B. Family history C. Blood studies D. Drug history
C. Blood studies
The nurse is conducting an admission assessment and determines that the client's BMI is 37. The nurse documents the BMI as being which class of obesity? A. Class I B. Overweight C. Class II D. Class III
C. Class II
The nurse is conducting a community education program using the American Cancer Society's colorectal screening and prevention guidelines. The nurse determines that the participants understand the teaching when they identify that people over the age of 50 should have which screening test every 10 years? A. Fecal occult blood test B. Prostate-specific antigen (PSA) C. Colonoscopy D. Papanicolaou (Pap)
C. Colonoscopy
The nurse needs to carefully monitor a client with traumatic injuries. How often should the nurse check and document the client's pain? A. After every meal consumed by the client B. Upon admission and discharge C. Every time the client's vital signs are assessed D. An hour after analgesics are administered
C. Every time the client's vital signs are assessed
Which is a sign or symptom of septic shock? A. Hypertension B. Increased urine output C. Warm, moist skin D. Altered mental status
D. Altered mental status
Which class of antineoplastic agents is cell cycle-specific? A. Alkylating agents (cisplatin) B. Antitumor antibiotics (bleomycin) C. Nitrosoureas (carmustine) D. Antimetabolites (5-FU)
D. Antimetabolites (5-FU)
Regarding tolerance and addiction, the nurse understands that A. The nurse must be primarily concerned about the development of addiction by a client in pain B. Tolerance to opioids is uncommon C. Although clients may need increasing levels of opioids, they are not addicted D. Addiction to opioids often develops
C. Although clients may need increasing levels of opioids, they are not addicted
The advance nurse practitioner, who is treating a client diagnosed with neuropathic pain, decides to start adjuvant analgesic agent therapy. Which medication is appropriate for the nurse practitioner to prescribe? A. Ketamine B. Tramadol C. Gabapentin D. Hydromorphone
C. Gabapentin
A majority of patients with CVID develop which type of anemia? A. Hemolytic B. Macrocytic C. Sickle cell D. Pernicious
D. Pernicious
The nurse is conducting a screening for familial predisposition to cancer. Which element should the nurse note as possible indication of hereditary cancer syndrome? A. A second cousin diagnosed with cancer B. An aunt and uncle diagnosed with cancer C. Onset of cancer after age 50 in family member D. A first cousin diagnosed with cancer
B. An aunt and uncle diagnosed with cancer
When applying a fentanyl patch, the last dose of sustained-release morphine should be administered at what point? A. There are no administration requirements B. 1 hour after application C. At the same time the first patch is applied D. 1 hour before application
C. At the same time the first patch is applied
When taking a client history, the nurse notes that the client is taking herbal remedies in addition to acetaminophen. Which herb, when taken in conjunction with acetaminophen, enhances the risk of bleeding? A. Kava B. Willow C. Gingko D. Echinacea
C. Gingko
A patient comes in to get an EIA test done because her physician suspects AIDS. Which of the following nursing actions is essential before an EIA test is performed? A. Performing a polymerase chain reaction test B. Obtaining a written consent from the patient C. Obtaining a general consent for medical care from the patient D. Performing a Western blot test
C. Obtaining a general consent for medical care from the patient
Which type of surgery is used in an attempt to relieve complications of cancer? A. Palliative B. Salvage C. Prophylactic D. Reconstructive
A. Palliative
A patient is administered foscarnet to treat a case of CMV retinitis. Which of the following adverse effects should the nurse closely monitor in the patient? A. Anemia B. Electrolyte imbalances C. Hypotension D. Peripheral neuropathy
B. Electrolyte imbalances
Which condition, approved by the U.S. Food and Drug Administration, is the only use for the lidocaine 5% patch? A. General anesthesia B. Postherpetic neuralgia C. Diabetic neuropathy D. Epidural anesthesia
B. Postherpetic neuralgia
The nurse is caring for a client undergoing an incisional biopsy. Which statement does the nurse understand to be true about an incisional biopsy? A. It removes a wedge of tissue for diagnosis. B. It is used to remove cancerous cells using a needle. C. It treats cancer with lymph node involvement. D. It removes an entire lesion and the surrounding tissue.
A. It removes a wedge of tissue for diagnosis.
A high school football player hurts his foot while playing a game. The client complains of intense pain with muscle spasms and swelling of the toe. Which pain assessment tool will the nurse most likely use to assess the client's pain level? A. Numeric Rating Scale (NRS) B. Wong-Baker FACES Pain Rating Scale C. Verbal Descriptor Scales (VDS) D. Visual Analog Scale (VAS)
A. Numeric Rating Scale (NRS)
The nurse is caring for a client newly diagnosed with coronary artery disease (CAD). While developing a teaching plan for the client to address modifiable risk factors for CAD, the nurse will include which factor(s)? Select all that apply. -Drug use -Alcohol use -Elevated blood pressure -Obesity -Decreased LDL level
-Elevated blood pressure -Obesity
About which issue should the nurse inform clients who use pain medications on a regular basis? A. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician. B. Consume the medications just before or along with meals C. Avoid harsh sunlight for 2 hours after administering analgesic agents or salicylates D. Minimize fiber intake during the therapy
A. Inform the primary health care provider about the use of salicylates before any procedure, and avoid over-the-counter analgesics consistently without consulting a physician.
Which is a risk factor for venous disorders of the lower extremities? A. Obesity B. Pacing wires C. Trauma D. Surgery
A. Obesity
Which is a gastrointestinal route for administration of analgesics? A. Subcutaneous B. Rectal C. Oral mucosa D. Epidural space
B. Rectal
Which condition is a heightened response that occurs after exposure to a noxious stimulus? A. Dependence B. Sensitization C. Pain tolerance D. Pain threshold
B. Sensitization
Which of the following would be inaccurate information pertaining a SCID? A. It is one of the most common causes of primary immunodeficiencies. B. The inheritance of SCID can be autosomal dominant C. This disease affects B cells and T cells D. The incidence is unknown
B. The inheritance of SCID can be autosomal dominant
Which statement is true about malignant tumors? A. They demonstrate cells that are well differentiated. B. They usually grow slowly. C. They gain access to the blood and lymphatic channels. D. They grow by expansion.
C. They gain access to the blood and lymphatic channels.
A client with metastatic pancreatic cancer underwent surgery to remove a malignant tumor in the pancreas. Despite the tumor being removed, the physician informs the client that chemotherapy must be started. Why might the physician opt for chemotherapy? A. Stomatitis B. Angiogenesis C. To prevent metastasis D. Fatigue
C. To prevent metastasis
When a client who has been taking opioids becomes less sensitive to the drug's analgesic properties, that client is said to have developed a(n) A. Balanced analgesia B. Addiction C. Tolerance D. Dependence
C. Tolerance
A benign tumor of the blood vessels is a(n) A. Osteoma B. Chrondroma C. Neuroma D. Hemanigioma
D. Hemanigioma
Which term means a lack of one or more of the five immunoglobulins? A. Telangiectasia B. Panhypoglobulinemia C. Agammaglobulinemia D. Hypogammaglobulinemia
D. Hypogammaglobulinemia
An obese client is undergoing abdominal surgery. During the procedure a surgical resident states, "The amount of fat we have to cut through is disgusting." What is the best response by the nurse?" A. Discuss concerns regarding the comments with the charge nurse B. Report the resident to the attending surgeon C. Ignore the comment D. Inform the resident that all communication needs to remain professional
D. Inform the resident that all communication needs to remain professional
The nurse is caring for a client with cancer who is treating her cancer with deep-tissue massage in addition to radiation therapy. The nurse documents the use of which therapy on the client's chart? A. Global medicine B. Alternative therapy C. Compliant medicine D. Integrative medicine
D. Integrative medicine
Which route of administration of medication is preferred in the most acute care situations? A. Subcutaneous B. Epidural C. Intramuscular D. Intravenous
D. Intravenous
What pain assessment scale would be best to use with a 5-year-old child? A. A visual analog scale B. The Numeric Rating Scale C. A pain assessment scale is inappropriate for a 5-year-old child. D. The FACES scale
D. The FACES scale
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client? A. Allogeneic B. Therapeutic C. Prophylactic D. Autologous
Autologous
A client has been prescribed a fentanyl patch for pain control. The nurse understands that this patch should be replaced every A 48-72 hours B 36-60 hours C 24-36 hours D 12-24 hours
A 48-72 hours
A man with chronic mucocutaneous candidiasis, an autosomal recessive disorder, asks the nurse, "Will my children have this disease?" Which response by the nurse is appropriate? A. "All of your children will be carriers of the recessive gene but may not develop the disease." B. "Only your male children are at risk for developing this disease." C. "Your female children will be carriers for the disease, but only male children will develop the disease." D. "All of your children will develop the disease."
A. "All of your children will be carriers of the recessive gene but may not develop the disease."
The nurse is teaching the patient who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed? A. "I will be sure to eat lots of fresh fruits and vegetables every day." B. "I will make sure to have my own toothbrush and tube of toothpaste at home." C. "I will avoid contact with people who are sick or who have recently been vaccinated." D. "I will wash my hands whenever I get home from work."
A. "I will be sure to eat lots of fresh fruits and vegetables every day."
A nurse is teaching the parents of an infant about primary immunodeficiencies. Which of the following statements verifies that the parents understand the teaching? A. "The majority of primary immunodeficiencies are diagnosed infancy." B. "The primary immunodeficiency will disappear with age." C. "Girls are diagnosed with primary immunodeficiencies more often than boys." D. "My baby cannot survive into childhood with a diagnosis of primary immunodeficiency."
A. "The majority of primary immunodeficiencies are diagnosed infancy."
The nurse teaches the patient that lowering his or her viral load will have what effect? A. A longer survival time B. A shorter survival time C. A shorter time to AIDS diagnosis D. A longer immunity
A. A longer survival time
During a third-trimester transabdominal ultrasound, cardiac anomaly and facial abnormalities are noted on the fetus. Further testing reveals that the thymus gland has failed to develop normally and the fetus is diagnosed with thymic hypoplasia. Based on this diagnosis, the nurse anticipates careful monitoring for which common manifestation during the first 24 hours of life? A. Hypocalcemia B. Thrombocytopenia C. Hypoglycemia D. Hyperkalemia
A. Hypocalcemia
A patient with severe combined immunodeficiency disease is receiving immunosuppression therapy to ensure engraftment of depleted bone marrow during transplantation procedures. What is the priority nursing care for this patient? A. Meticulous infection control precautions B. Daily weights and strict monitoring of intake and output C. Continuous monitoring of cardiac status D. Daily oral assessment and oral care every 4 hours
A. Meticulous infection control precautions
Which of the following nursing actions is essential before an EIA test is performed? A. Obtaining a general consent for medical care from the patient B. Performing a polymerase chain reaction test C. Obtaining a written consent from the patient D. Performing a Western blot test
A. Obtaining a general consent for medical care from the patient
Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes? A. Primary infection (acute HIV infection or acute HIV syndrome) B. Stage 3 C. Stage 1 D. Stage 2
A. Primary infection (acute HIV infection or acute HIV syndrome)
A patient taking amprenavir (APV, Agenerase) complains of "getting fat." What is the nurse's best action? A. Teach the patient about medication side effects. B. Arrange for a psychological counseling. C. Assess the patient's diet. D. Have the patient increase exercise.
A. Teach the patient about medication side effects.
The nurse is teaching the patient with HIV about therapy. What is essential for the nurse to include in the teaching plan? Select all that apply. A. The CD4 count is the major indicator of immune function and guides therapy. B. Patients rarely respond to medication therapy. C. Medication therapy is rarely effective. D. The goal of antiretroviral therapy is to prevent opportunistic infections. E. Antiretroviral therapy targets different stages of the HIV life cycle.
A. The CD4 count is the major indicator of immune function and guides therapy. E. Antiretroviral therapy targets different stages of the HIV life cycle.
The balance between the amount of HIV in the body and the immune response is the A. Viral set point B. Window period C. Viral load test D. Anergy
A. Viral set point
When a client who has been taking opioids becomes less sensitive to the drug's analgesic properties, that clients is said to have developed a(n) A Balanced analgesia B Tolerance C Addiction D Dependence
B Tolerance
After a bone marrow transplant (BMT), the client should be monitored for at least A. 5 months B. 3 months C. 3 days D. 4 weeks
B. 3 months
Antiretroviral medications should be offered to individuals with T-cell counts of less than A. 250 cell/mm B. 350 cell/mm C. 50 cell/mm D. 150 cell/mm
B. 350 cell/mm
A patient being treated for HIV/AIDS has a decreased appetite, almost to the point of anorexia. What is the nurse's best action? A. Ask the dietician to prepare his favorite meals. B. Administer megestrol acetate (Megace). C. Talk to the patient about his unwillingness to eat. D. Ask his family to bring in food that he enjoys.
B. Administer megestrol acetate (Megace).
When do most perinatal HIV infections occur? A. Through breast feeding B. After exposure during delivery C. Through casual contact D. In utero
B. After exposure during delivery
Agammaglobulinemia is also known as A. Common variable immunodeficiency (CVID) B. Bruton's disease C. Nezelof syndrome D. Wiskott-Aldrich syndrome
B. Bruton's disease
Which of the following options should the nurse encourage to replace fluid and electrolyte losses in a patient with AIDS? A. Iron and Zinc B. Liquids C. Gluten D. Sucrose
B. Liquids
A patient with common variable immunodeficiency (CVID) comes to the ED with complaints of tingling and numbness in the hands and feet, muscle weakness, fatigue, and chronic diarrhea. An assessment reveals abdominal tenderness, weight loss, and loss of reflexes. A gastric biopsy shows lymphoid hyperplasia of the small intestine and spleen as well as gastric atrophy. Based on these findings, what common secondary problem has this patient developed? A. Hyperthyroidism B. Pernicious anemia C. Gastric ulcer D. Sickle cell anemia
B. Pernicious anemia
The lower the patient's viral load, A. The longer the time immunity B. The longer the survival time C. The shorter the survival time D. The shorter the time to AIDS diagnosis
B. The longer the survival time
A patient is scheduled to receive an intravenous immunoglobulin (IVIG) infusion. He asks the nurse about the infusion's administration and its adverse effects. Which of the following choices should the nurse instruct this patient to report immediately? A. Constipation B. Tickle in the throat C. Mouth sores D. Sneezing
B. Tickle in the throat
Which of the following statements reflects the treatment of HIV infection? A. Treatment should be offered to all patients once they reach CDC category B: HIV symptomatic. B. Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load). C. Treatment should be offered to individuals with plasma HIV RNA levels less than 55,000 copies/mL (RT-PCR assay). D. Treatment should be offered to only select patients once they reach CDC category B: HIV symptomatic.
B. Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).
What test will the nurse assess to determine the patient's response to antiretroviral therapy? A. CBC B. Viral load C. Western blot D. EIA enzyme immunoassay
B. Viral load
The nurse is caring for a young patient who has agammaglobulinemia. The nurse is teaching the family how to avoid infection at home. Which statement by the family indicates that additional teaching is needed? A. "I will let my neighbor have my pet iguana." B. "I will avoid letting my child drink any juice that has been sitting out for more than one hour." C. "I can take my child to the beach, as long as we play in the sand rather than swim in the water." D. "I will apply lotion following every bath to prevent dry skin."
C. "I can take my child to the beach, as long as we play in the sand rather than swim in the water."
The nurse is obtaining an assessment and health history from the parents of a 6-month-old infant with an elevated temperature. Which statement by the parents will alert the nurse to a possible immunodeficiency disorder? A. "I usually feed the baby a bottle every 4 to 6 hours during the day." B. "My husband's family has a history of hemophilia; can this be the problem?" C. "This is the third infection with a high fever the baby has had in the past month." D. "I had a good prenatal care and vaginal delivery, although they had to use forceps."
C. "This is the third infection with a high fever the baby has had in the past month."
A nurse is reviewing treatment options with parents of an infant born with severe combined immunodeficiency disease (SCID). The nurse recognizes that the parents understand the teaching based on which of the following statements? A. "The only treatment option is thymus gland transplantation." B. "We can ask our family members to donate blood for stem cell harvesting." C. "We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling." D. "Hematopoietic stem cell transplantation (HSCT) cannot be performed until the age of 5 years."
C. "We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling."
A nurse is caring for a client diagnosed with depression in the mental health unit. The nurse understands that therapeutic effects of tricyclic antidepressants occur at which time point? A. 1 week B. 4 weeks C. 3 weeks D. 2 weeks
C. 3 weeks
An infant is diagnosed with agammaglobulinemia. The nurse reviews the family history for a male relative with this disorder, which the nurse knows is also known by which of the following names? A. Nezelof syndrome B. Common variable immunodeficiency (CVID) C. Bruton's disease D. Wiskott-Aldrich syndrome
C. Bruton's disease
A client receiving atazanavir (ATV, Reyataz) requires what priority intervention? A. Renal function tests B. Increased fluids C. Cardiac assessment D. Diet modification
C. Cardiac assessment
A patient with paroxysmal hemoglobinuria, a deficiency of complement proteins, is complainging of headache and weakness of the right arm and leg. Based on these symptoms, for which health complication should the nurse assess with this patient? A. Bacterial meningitis B. Edema formation in the subcutaneous tissues of the extremities C. Cerebral venous thrombosis D. Rheumatoid arthritis
C. Cerebral venous thrombosis
A patient seen in the outpatient clinic has common variable immunodeficiency. It is important for the nurse to teach the patient about the need for more frequent screening for which of the following complications? A. Autoimmune disorders B. Human immunosuppressive virus (HIV) C. Malignancy D. Allergies
C. Malignancy
Which of the following has not been implicated as a factor for noncompliance with antiretroviral treatment? A. Lack of social support B. Depression C. Past substance abuse D. Active substance abuse
C. Past substance abuse
Which of the following adverse effects should the nurse closely monitor in a patient who has secondary immunodeficiencies due to immunosuppressive therapy? A. Depression, memory impairment, and coma B. Cardiac dysrhythmias and heart failure C. Respiratory or urinary system infections D. Rheumatoid arthritis
C. Respiratory or urinary system infections
Which group of patients is at high risk of developing breast cancer? A. Women that have sex with multiple partners B. Women who consume low-fat, low-calorie diet C. Women who are obese D. Women who do not consume alcohol
C. Women who are obese
An individual is considered obese when their BMI is what value? A. 18.6-24 B. <18.5 C. 25-29.9 D. 30-39
D. 30-39
A treatment option for SCID includes A. IV immunoglobulin B. Chemotherapy C. Vitamin D supplements D. A stem cell transplant
D. A stem cell transplant
Thirty minutes after the nurse begins an intravenous immunoglobulin (IVIG) infusion, the patient complains of itching at the site and a lump in the throat. Which is the first action the nurse should take? A. Apply a tourniquet above the infusion site. B. Notify the physician. C. Administer subcutaneous epinephrine. D. Stop the infusion.
D. Stop the infusion.
What intervention is appropriate before the patient starts on efavirenz (EFV, Sustiva) therapy? A. Assessing renal function B. Administering Benadryl C. Teaching the patient about restricted foods D. Testing for Stevens-Johnson syndrome potential
D. Testing for Stevens-Johnson syndrome potential
A nurse is reviewing the causes of genetic diseases with parents of an infant born with severe combined immunodeficiency disease (SCID). Which of the following would be inaccurate pertaining to SCID? A. The incidence is unknown. B. This is a rare disease in most population groups, but is one of the most common causes of primary immunodeficiencies. C. This illness occurs in all racial groups and both genders. D. The inheritance of SCID can be autosomal dominant.
D. The inheritance of SCID can be autosomal dominant.
A nurse is assessing a patient with a primry immunodeficiency. Afterward she documents that the patient displayed ataxia. Which of the following statements explains the documentation? A. The patient has vascular lesions caused by dilated blood vessels. B. The patient has difficulty swallowing. C. The patient has an inability to understand the spoken word. D. The patient has uncoordinated muscle movements.
D. The patient has uncoordinated muscle movements.
Which diagnostic test measure HIV RNA in the plasma? A. Western blot assay B. ELISA C. Enzyme immunoassay D. Viral load
D. Viral load
A client is being treated in a substance abuse unit of a local hospital. The nurse understands that when this client has compulsive behavior to use a drug for its psychic effect, the client needs to be monitored for which effect? A. Placebo B. Addiction C. Dependence D. Tolerance
B. Addiction
In which case it is most likely that pain management may not be readily forthcoming to an adult client who is in pain? A. When the pain is chronic B. When the client's expression of pain are incongruent with the nurse's expectations C. When a numeric scale is used to assess pain intensity D. When analgesics are contraindicated for the client's condition
B. When the client's expression of pain are incongruent with the nurse's expectations
The nurse needs to carefully monitor a client with traumatic injuries. Which action by the nurse demonstrates understanding of the most essential component of the client's pain assessment? A The nurse administers pain medication based on the client's reported pain level B The nurse administers ketorolac upon admission to the unit C The nurse validates the client's report of pain by assessing the client's blood pressure D The nurse assesses the response to medication after every meal consumed by the client
A The nurse administers pain medication based on the client's reported pain level
For which reasons are nonpharmacologic pain management techniques used? Select all that apply. -They help decrease the sensation of pain -They can successfully replace pain medications -They allow clients to match the technique to their own individual and cultural preferences -They help decrease the distress a client experiences as a result of pain -They lower the risk of clients becoming addicted to pain medications
-They help decrease the sensation of pain -They allow clients to match the technique to their own individual and cultural preferences -They help decrease the distress a client experiences as a result of pain
Ataxia is the term that refers to A. Uncoordinated muscle movement B. Difficulty swallowing C. Vascular lesions caused by dilated blood vessels D. Inability to understand the spoken word
A. Uncoordinated muscle movement
Prostaglandins are chemical substances with what property? A. Increase the sensitivity of pain receptors B. Inhibit the transmission of noxious stimuli C. Inhibit the transmission of pain D. Reduce the perception of pain
A. Increase the sensitivity of pain receptors
Which action by the nurse indicates understanding of one basic principle of providing effective pain management? A. Continuing to provide around-the-clock pain medications 72 hours after a surgical procedure. B. Awakening a new postoperative client to take pain medication C. Administering pain medications on a PRN (as needed) basis D. Administering a dose of an analgesic agent via client-controlled analgesia (PCA) during rounds
B. Awakening a new postoperative client to take pain medication
The nurse is providing education to a client with cancer radiation treatment options. The nurse determines that the client understands the teaching when the client states that which type of radiation aims to protect healthy tissue during the treatment? A. Teletherapy B. Brachytherapy C. Proton therapy D. External
B. Brachytherapy
The nurse observes that a client's medical report indicates that the client has Cushing syndrome. During inspection, the nurse notes that the client's BMI is 31, waist circumference is 40 inches, and localized fat pads exist around the neck and upper part of the back. Which of the following must the nurse keep in mind while planning the client's care? A. The nurse knows that a waist circumference of 40 places the client at risk. The nurse instructs the client to remember all food consumed over the next 24-hour period. B. The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment. C. A BMI of 31 indicates obesity, and the nurse instructs the patient to keep a record of food actually consumed over the next 3 to 7 days. D. Knowing that the client is obese, the nurse plans to provide dietary education to reduce the daily caloric intake using the U.S. Department of Agriculture's MyPlate pyramid.
B. The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
The nurse understands the definition of pain as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." Which of the following comments by a client confirm the client's understanding of the fundamental concepts of pain? Select all that apply. -"I will depend on you and your experience to treat my pain, as you feel appropriate." -"I would love to go to church, but my back pain is too uncomfortable to make it through the service." -"I feel good in knowing that my doctor will determine when and how I get my pain medication." -"I used to walk every day for exercise; pain in my knee made me stop walking." -"I am tired of living with this nagging pain; I'm not sure how much longer I can go on."
-"I would love to go to church, but my back pain is too uncomfortable to make it through the service." -"I used to walk every day for exercise; pain in my knee made me stop walking." -"I am tired of living with this nagging pain; I'm not sure how much longer I can go on."
The nurse is preparing to assess a client whose chart documents that the client experienced extravasation when receiving the vesicant vincristine during the previous shift. The documentation also notes that an antidote was administered immediately. The nurse prepares to assess for which conditions? Select all that apply. -Sloughing tissue -Tissue necrosis -Effectiveness of the antidote -Active bleeding
-Sloughing tissue -Tissue necrosis -Effectiveness of the antidote
The nurse is conducting a service project for a local elderly community group on the topic of hypertension. The nurse will relay that which risk factors and cardiovascular problems are related to hypertension? Select all that apply. -Decreased low-density lipoprotein (LDL) levels -Smoking -Overweight/obesity -65 or older in women -Elevated high-density lipoprotein (HDL) cholesterol
-Smoking -Overweight/obesity -65 or older in women
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean that A. His body has not produced antibodies to the AIDS virus B. He has not been infected with HIV C. He is immune to the AIDS virus D. Antibodies to the AIDS virus are in his blood
A. His body has not produced antibodies to the AIDS virus
Which route of medication administration should the nurse consider first after IV removal in a postoperative client with an NPO order? A. Rectal B. Topical C. Subcutaneous D. Intrathecal
A. Rectal
A major manifestation of Wiskott-Aldrich syndrome includes which of the following? A. Thrombocytopenia B. Episodes of edema C. Ataxia D. Bacterial infection
A. Thrombocytopenia
Nociception includes four specific processes: transduction, transmission, perception, and modulation. Which action illustrates the nociception process of pain transmission? A. A surgeon making an incision to perform surgery B. A patient taking tramadol to enhance pain management C. A child quickly removing a hand when touching a hot object D. A mother in labor utilizing imagery to reduce pain
C. A child quickly removing a hand when touching a hot object
A home health nurse is visiting a client who has been taking the same dose of acetaminophen/hydrocodone for 2 months. To monitor for the presence of expected side effects of this medication, what should the nurse include in the assessment of the client? A. Assess level of consciousness. B. Observe respiratory rate and depth. C. Ask about the client's bowel pattern. D. Take the client's blood pressure.
C. Ask about the client's bowel pattern.
A client is admitted to the health care center with abdominal pain, nausea, and vomiting. The client has a body mass index (BMI) of 30 and reports irregular menstrual cycles and feeling tired all the time. The nurse suspects the client's symptoms to indicate which condition? A. Bacterial vaginosis B. Endometriosis C. Polycystic Ovary syndrome (PCOS) D. Cancer of the cervix
C. Polycystic Ovary syndrome (PCOS)
Palliation refers to A. The spread of cancer cells from the primary tumor to distant sites. B. Hair loss related to the treatment of cancer. C. Relief of symptoms associated with disease and promotion of comfort and quality of life. D. The lowest point of white blood cell depression after therapy that has toxic effects on bone marrow.
C. Relief of symptoms associated with disease and promotion of comfort and quality of life.
Which procedure uses liquid nitrogen to freeze tissue, thereby destroying cells? A. Electrosurgery B. Chemosurgery C. Laser surgery D. Cryoablation
D. Cryoablation
The nurse's base knowledge of primary immunodeficiencies includes which of the following statements? Primary immunodeficiencies A. Occur most commonly in the aged population B. Disappear with age C. Develop as a result of treatment with antineoplastic agents D. Develop early in life after protection from maternal antibodies decreases
D. Develop early in life after protection from maternal antibodies decreases
What substance reduces the transmission of pain? A. Acetylcholine B. Substance P C. Serotonin D. Endorphins
D. Endorphins
