Pathophysiology Exam 2 PrepU Q
When a client who has been newly diagnosed with HIV asks, "What are the chances that I can be cured?," what is the nurse's most therapeutic response? "Routine follow-up care of a stable, asymptomatic person infected with HIV , like yourself, will include a history and physical examination along with CD4+ cell count and viral load testing every 3 to 4 months." "The key to success is the management of your immune system so that life- threatening opportunistic diseases do not develop." "Your doctor will want to see you on a regular basis in order to evaluate your viral load and prescribe the appropriate medications." "Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."
"Although there is no current treatment that provides a possible cure, there are ones that have successfully managed the infection."
The nurse's review of a client's laboratory results indicates that inflammation is absent and platelet levels are low. Which test was performed to provide the platelet count? Bone marrow aspiration Complete blood count Hematocrit Sedimentation rate
Complete blood count
Which agent is the cause of malaria? Hansen bacillus Spirochete Filarial roundworm Protozoan parasite
Protozoan parasite
An infant has been born to a client who is HIV positive. What is the infant's most likely prognosis for developing AIDS? The infant will most likely have AIDS by his or her first birthday. The infant's immune system possesses high immunoglobulin levels due to passive immunity and will not likely develop HIV. The infant's immune system may or may not be able to eradicate HIV during the first few months of life. The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV.
The infant can be HIV antibody positive by ELISA for up to 18 months of age without being actively infected with HIV.
Select the first stage of hemostasis. Clot dissolution Vessel spasm Formation of the platelet plug Clot retraction
Vessel spasm Hemostasis is divided into five stages: (1) vessel spasm, (2) formation of the platelet plug, (3) blood coagulation or development of an insoluble fibrin clot, (4) clot retraction, and (5) clot dissolution.
A client describes himself as being "devastated" after hearing that his HIV test has come back positive. Which response by the nurse is most appropriate? "I've provided care for many clients living with HIV and AIDS, so I understand how you feel." "This is certainly scary news, but the care team is going to make sure that you get all the information you need." "It's entirely normal to feel that way. We are going to try our best to help you get all the support you need." "I understand how difficult this must be for you, but it's nothing that you should be ashamed of."
"It's entirely normal to feel that way. We are going to try our best to help you get all the support you need."
A client who was exposed to hepatitis A at a local restaurant has recovered from the disease. At the annual physical, the client asks whether to get the hepatitis A "shot." How will the nurse respond, based on the concepts of adaptive immunity? "I would not recommend getting it; the vaccine can damage your liver." "Of course. The virus changes every year." "No, because having an active case, you have already developed antibodies against hepatitis A." "Yes, because you could get a worse case the next time you are exposed."
"No, because having an active case, you have already developed antibodies against hepatitis A." A memory of the substance is also developed so that a repeat exposure to the same microbe or agent produces a quicker and more vigorous response. The hepatitis A virus does not change from year to year. The vaccine does not damage the liver; however, the active hepatitis A disease can.
A client with thrombotic thrombocytopenic purpura (TTP) is signing consent for plasmapheresis. The client asks, "What is this procedure and why do I need it?" Which response by the health care provider is most accurate? "The health care provider will perform a bone marrow aspiration to withdraw plasma to analyze." "Instead of giving you packed red blood cells, the health care provider will infuse white blood cells into your veins." "The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma." "It is very similar to donating a unit of blood at the Red Cross."
"The laboratory will remove plasma from the withdrawn blood and replace it with fresh-frozen plasma." -Plasma infusion provides the deficient enzyme.
To form a platelet plug, platelets are attracted to the damaged vessel. What then occurs within the blood vessel? Thrombosis Adhesion of the platelets Thromboxane A2 Fibrinolysis
Adhesion of the platelets
The pathologist notes that the client has Reed-Sternberg cells. He knows that these cells are a diagnostic hallmark for which disorder? Follicular lymphoma Burkitt lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma
Hodgkin lymphoma
Which immunoglobulin is primarily found in secretions and has a primary function of providing local immunity on mucosal surfaces? IgA IgG IgM IgD
IgA
Which function is the main job of lymphocytes? Immune reaction Phagocytosis Apoptosis Degranulation
Immune reaction
The administration of intravenous immunoglobulin to complement the host's immune system is what type of therapy? Antiviral Bactericidal Immunotherapy Antiparasitic
Immunotherapy
A woman experiences a viral infection while pregnant. Which type of immunity does an infant have at birth against this infection? Tolerance Passive Active Adaptive
Passive
A client complains of general malaise and fatigue and has a mild fever. The nurse would evaluate this stage of disease as the: Convalescent stage Incubation stage Prodromal stage Resolution stage
Prodromal stage
A client is being evaluated for atopic dermatitis possibly caused by a latex-related allergic reaction. The nurse will review which lab results to determine if an allergy is present? Neutrophils Serum IgG Serum IgE Basophils
Serum IgE IgE binds to mast cells and basophils and is involved in parasitic infections, as well as allergic and hypersensitivity reactions. Serum IgE causes the symptoms of allergic reactions and is elevated in type 1 hypersensitivity disorders.
Stem cell transplantation has been shown to provide potential cures for diseases such as aplastic anemia and the leukemias. What are the sources of stem cells used for transplant? Bone marrow and immature neural cells Peripheral blood and yellow bone marrow Peripheral blood cells and immature embryonic cells Umbilical cord blood and bone marrow
Umbilical cord blood and bone marrow
A client is suspected of having an infectious disease. Which laboratory technique(s) can be used to identify the specific infectious agent? Select all that apply. culture serology detection of antigens white blood cell (WBC) differential white blood cell (WBC) count
culture serology detection of antigens
A fomite is a/an: natural antibiotic. tick-like ectoparasite. natural disinfectant. infection transfer agent.
infection transfer agent
An important function of the thymus is: to serve as a center for antibody production by immune cells. removal of foreign material from lymph before it enters the bloodstream. to filter antigens from the blood and respond to systemic infections. the production of mature, immunocompetent T lymphocytes.
the production of mature, immunocompetent T lymphocytes.
A nurse is instructing a client on the long-term use of antibiotics and antibiotic resistance. Which statement by the client indicates that the teaching has been successful? "Bacteria can undergo genetic mutations that lead to resistance to antibiotics." "Due to superinfections, fewer new antibiotics have been produced." "The antibiotics increase the immune system's ability to fight infection." "Because of the risk of antibiotic resistance, I cannot take antibiotics for longer than 21 days."
"Bacteria can undergo genetic mutations that lead to resistance to antibiotics."
A client is newly diagnosed with impaired platelet function, thrombocytopathia. Which question is most appropriate for the nurse to ask in order to determine the possible cause of this problem? "Do you have a family history of hemophilia?" "Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?" "Have you recently vacationed out of the country?" "Have you recently been exposed to any organic pesticides?"
"Have you been taking aspirin or any nonsteroidal anti-inflammatory drugs (NSAIDs)?" The use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) is the most common cause of impaired platelet function. Aspirin produces irreversible acetylation of platelet cyclooxygenase activity and consequently the synthesis of TXA2, which is required for platelet aggregation. In contrast to the effects of aspirin, the inhibition of cyclooxygenase by other NSAIDs is reversible and lasts only for the duration of drug action.
A 23-year-old female client has been diagnosed with von Willebrand disease following a long history of "heavy periods" and occasional nosebleeds. Which of the client's statements demonstrates a sound understanding of the new diagnosis? "I'm really disappointed that I won't be able to play sports anymore." "I'll make sure to take acetaminophen instead of aspirin when I get aches and pains." "I read on a website that I might have to get blood transfusions from time to time." "I hope my insurance covers the injections that I'll need to help my blood clot."
"I'll make sure to take acetaminophen instead of aspirin when I get aches and pains."
A client stepped on a nail at work. The emergency room physician prescribes a tetanus "booster" shot. The client asks the nurse, "If I have already been vaccinated for tetanus why do I need to have another shot?" How should the nurse respond? "If you have questions about your treatment, I will ask the physician to come back in and talk to you." "The booster shot will stimulate your immune system's memory, causing an immediate rise in antibodies to protect you from an infection." "Your initial vaccination is outdated so you are no longer immune to tetanus." "Tetanus can mutate and form a new strain; therefore yearly vaccinations are recommended."
"The booster shot will stimulate your immune system's memory, causing an immediate rise in antibodies to protect you from an infection."
A child has been home from camp for 2 weeks and reports a sore throat, low-grade fever, and enlarged cervical lymph nodes. After testing, it is determined the child has Epstein-Barr virus (EBV)-associated infectious mononucleosis. The parent asks, "How did my child acquire this type of infection?" Which is the best response by the nurse? "The child may have acquired the infection when bitten by a mosquito." "The infection is acquired primarily through contact with infected oral secretions." "The infection is acquired primarily through contacted with infected blood." "The only way to acquire this infection is if the child was kissing another person."
"The infection is acquired primarily through contact with infected oral secretions."
The staff development nurse is teaching a class of orientees about care of the geriatric client. Which statement is accurate about red blood cell changes with aging? "The location of bone cells involved in red cell production shifts toward the axial skeleton." "During a stress reaction, red cells of older adults are replaced as promptly as those of their younger counterparts." "The decline in hemoglobin levels in older adults is greater in women than men." "Anemia in older adults is treated by placing them all on erythropoietin."
"The location of bone cells involved in red cell production shifts toward the axial skeleton."
A 24-year-old pregnant client presents to the clinic for her second prenatal visit. The results of her ELISA test are positive. Which statement by the nurse projects the best way to counsel this client? "You are HIV positive. There are measures we can take to prevent transmission to the baby." "We will need to wait for the Western Blot results to confirm the diagnosis of HIV." "There is a good chance this is a false positive result. We can repeat it to confirm." "We will need to inform your partner to be tested for HIV as soon as possible."
"We will need to wait for the Western Blot results to confirm the diagnosis of HIV."
A school nurse is teaching high school students about human immunodeficiency virus (HIV) in the context of the school's sexual health curriculum. Which statement by a student would the nurse need to correct or clarify? "Condoms provide good protection from contracting HIV." "Drugs for HIV reduce the virus in your body, but they do not get rid of it." "Yearly testing is the best way to prevent contracting or spreading HIV." "The incidence of heterosexual people getting HIV is increasing."
"Yearly testing is the best way to prevent contracting or spreading HIV."
A client develops an immunodeficiency disorder after receiving chemotherapy for the treatment of lung cancer. The client asks the nurse if he was born with this deficiency. What is the nurse's best response? "You have developed a secondary immunodeficiency disorder as a result of your chemotherapy." "You were probably born with an immunodeficiency disorder and it remained dormant until you began receiving chemotherapy." "You must have caught this disorder from another person." "The immunodeficiency disorder is a result of your body's rejection of the chemotherapy."
"You have developed a secondary immunodeficiency disorder as a result of your chemotherapy."
Shortly after being diagnosed with HIV, a client has begun highly active antiretroviral therapy (HAART). The client asks, "My doctor tells me that my viral load is going down. What does that mean?" The nurse's best response is: "Your HAART medications are working to slow the progression of the disease." "You are developing drug resistance and may need to have your medications adjusted." "Your medications are going to decrease your ability to transmit the virus to your sexual partners." "This means that you are in the long-term nonprogressive stage of HIV."
"Your HAART medications are working to slow the progression of the disease."
What is the length of time from infection with the AIDS virus to seroconversion? immediately approximately 1 week 1 to 3 months 10 to 12 years
1 to 3 months
The nurse is reviewing the client's laboratory report. Select the report that represents a normal value for leukocytes. 6500 cells/mL (6.5 ×109/L) 2000 cells/mL (2.0 ×109/L) 12,000 cells/mL (12.0 ×109/L) 13,500 cells/mL (13.5 ×109/L)
6500 cells/mL (6.5 ×109/L)
Which individual most clearly demonstrates the processes of innate immunity? A boy who is experiencing heat and swelling of his skinned knuckle A woman who is experiencing rejection of a donor liver after transplantation A man who is complaining of itching and is sneezing because he is allergic to pollen A man whose blood work indicates increased antibody titers during his acute illness
A boy who is experiencing heat and swelling of his skinned knuckle
Which person should the charge nurse assign as a roommate for a client diagnosed with aplastic anemia? A client with bacterial pneumonia A client in traction with a broken femur A client with viral meningitis A client with impetigo
A client in traction with a broken femur
Which client has the highest risk of contracting an opportunistic infection? A client who has had HIV for 10 years and has a platelet count of 200/mL A client who has had HIV for 30 years and has a CD4+ count of 1000 cells/μL A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL A client who recently contracted HIV with a viral load of 1 million copies/mL
A client who has had HIV for 3 years and has a CD4+ count of 50 cells/μL
The nursing is reviewing assessment data of four clients. Which client is at greatest risk for developing pernicious anemia? A client who has undergone partial gastrectomy A client of Italian heritage who had a colonoscopy A client who is recovering from a laparoscopic surgical procedure A client diagnosed with a neoplastic disorder
A client who has undergone partial gastrectomy
Sometimes the host's white blood cells are unable to eliminate the microorganism, but the body is able to contain the dissemination of the pathogen. What is this called? Acne Lesion Pimple Abscess
Abscess
The nurse evaluating a client's blood work determines that a client has an increased risk for infection based on which lab result? Absolute neutrophil count of 1100/μL (1.1 x 109/L) Absolute neutrophil count of 1000/μL (1.0 x 109/L) Absolute neutrophil count of 800/μL (0.80 x 109/L) Absolute neutrophil count of 1200/μL (1.2 x 109/L)
Absolute neutrophil count of 800/uL The absolute neutrophil count is supposed to be 1000/μL and neutropenia or a low neutrophil count is less than 1000/μL, placing the client at risk for infection, as nuetrophils play a critical role in fighting infection
A client diagnosed with systemic lupus erythematosus (SLE) has been experiencing a low neutrophil count. How would this type of neutropenia be classified? Acquired, autoimmune secondary neutropenia Congenital, alloimmune neonatal neutropenia Congenital, cyclic neutropenia Acquired, drug-related neutropenia
Acquired, autoimmune secondary neutropenia
An infant is suspected of having a severe primary immunodeficiency disease. Which effect on the infant makes early detection a priority? The infant may develop food allergies. The infant may have developmental delays. The infant is at risk for cardiovascular disease. Administering live attenuated virus vaccines can be fatal.
Administering live attenuated virus vaccines can be fatal.
In reference to infectious disease, a client cannot be a/an: Reservoir Carrier Host Agent
Agent
A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms? Bacterial infection Allergic reaction Fungal infection Viral infection
Allergic reaction
A client comes to the clinic with a runny nose and scratchy throat. The nurse is evaluating the white blood cell count, which shows an elevated number of white blood cells and an increased percentage of eosinophils. What is the most likely cause of the symptoms? Viral infection Fungal infection Allergic reaction Bacterial infection
Allergic reaction
Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body? Alters vitamin K, reducing its ability to participate in the coagulation of the blood Increases prothrombin Increases vitamin K-dependent factors in the liver Increases procoagulant factors
Alters vitamin K, reducing its ability to participate in the coagulation of the blood -Warfarin (coumadin) acts by decreasing prothrombin and other pro coagulation factors. it alters vitamin K in a manner that reduces its ability to participate in the synthesis of the vit K-dependent coagulation factors in the liver
The cells that mediate humoral immunity do so because they are capable of producing: Platelets Stem cells Helper T cells Antibodies
Antibodies
A dental assistant comes to the clinic with reports of a rash on her hands that feel like they are coming from the gloves being worn. The nurse observes both hands with crusted and thickened areas. What type of education does the nurse anticipate providing to the client? Take an antihistamine daily for 10 days to eliminate the allergens. Apply a topical corticosteroid and avoid further contact with latex-containing products. Wash the hands in hot soapy water to remove any powder from the gloves after being worn. Use alcohol based cleaning products on the hands.
Apply a topical corticosteroid and avoid further contact with latex-containing products. Type IV hypersensitivity reactions to latex gloves are the most common form of latex allergy seen. In this form of allergy, people usually develop a contact dermatitis to one of the chemical additives rather than the latex proteins within 48 to 96 hours of exposure. The contact dermatitis often affects the dorsum of the hands and is characterized by a vesicular, pruritic rash. When glove contact is continued, the area becomes crusted and thickened. Treatment is with topical corticosteroids during the acute phase and avoidance of all latex-containing products.
In primary immune thrombocytopenia purpura (ITP), the client has which type of disorder that primarily destroys which blood component? Autoimmune; platelets Alloimmune; factor VIII Allergic; fibrinogen Immunoglobulin; B cells
Autoimmune; platelets Splenic destruction of platelets is involved in the pathogenesis of ITP. Bone marrow function is not affected and ITP is not caused by deformed platelets. Binding of antibodies to platelet factor 4 occurs in cases of heparin-induced thrombocytopenia.
A nurse is preparing her client for a blood transfusion. She knows that a client with type A blood is said to have which type of antibodies?
B
Sputum samples from a client with pneumonia contain an infective agent that has a peptidoglycan cell wall, expresses endotoxins, replicates readily in broth and on agar, grows in clusters, has pili, and does not stain when exposed to crystal violet. This client's pneumonia has what etiology? Mycoplasmal Bacterial Viral Chlamydial
Bacterial
Which type of white blood cells are related to the connective tissue mast cells and respond in allergic and hypersensitivity reactions? Basophils Granulocytes B lymphocytes Neutrophils
Basophils
The nurse is assessing an 83-year-old adult client for signs and symptoms of anemia. What normal, age-related change increases this client's risk for anemia? Up to 20% of the RBCs in older adults are incapable of carrying oxygen. Blood cells are not replaced as quickly as they are in younger clients. Gastrointestinal "microbleeds" are common after age 75. Aplastic anemia is common in older adults and the risks increase with each decade.
Blood cells are not replaced as quickly as they are in younger clients.
A client was involved in an auto accident and suffered massive internal injuries that resulted in a large blood loss. Select the type of anemia the client is at greatest risk to develop. Hemolytic Aplastic Blood loss Iron deficiency
Blood loss The clinical manifestations and red blood cell changes associated with blood loss anemia depend on the rate of hemorrhage and whether the bleeding loss is internal or external. The effects of acute blood loss are mainly due to loss of intravascular volume, which can lead to cardiovascular collapse and shock. Hemolytic anemia is characterized by the premature destruction of red blood cells. The usual reason for iron deficiency in adults in the Western world is chronic blood loss. Aplastic anemia describes a disorder of pluripotential bone marrow stem cells.
Select the option that best describes the production of T lymphocytes. Myocardial tissue → bone marrow → lymph nodes Plasma cells → lymph nodes → arteries Bone marrow → plasma cells → lymph nodes Bone marrow → thymus → lymph nodes
Bone marrow → thymus → lymph nodes
The nurse caring for a client in the early stage of multiple myeloma would anticipate the client to report which symptom? Pathologic fractures Hypercalcemia Kidney failure Bone pain
Bone pain Bone pain is one of the first symptoms to occur in approximately 75% of all individuals diagnosed with multiple myeloma. Multiple myeloma presents primarily in the bones and bone marrow. The other choices are also signs and symptoms of the disease; however, they appear later as the disease progresses.
Which is considered a function of plasma? Carrying nutrients Eliminating plasma proteins Manufacturing hormones Producing waste products
Carrying nutrients
An older adult client arrives with garbled speech, unilateral facial drooping, and weakness and unfortunately dies. Laboratory work reveals hematocrit of 54% (0.54). Which complication of polycythemia could most likely be associated with this client's death? Anaphylactic reaction Acute leukemia Infection and sepsis Cerebral thrombosis
Cerebral thrombosis
Clients with lung disease can develop polycythemia as a result of which condition? Hyperventilation Decreased blood viscosity Excessive respiratory fluid loss Chronic hypoxia
Chronic hypoxia
Which types of leukemias originate from the B cells? Select all that apply. Chronic lymphocytic leukemia Chronic myelogenous leukemia Acute lymphocytic leukemia Acute myelogenous leukemia
Chronic lymphocytic leukemia Acute lymphocytic leukemia
A client's laboratory report shows the presence of the Philadelphia chromosome. Which diagnosis should the nurse suspect the client has developed? Hairy cell leukemia Non-Hodgkin lymphoma Chronic lymphocytic leukemia (CLL) Chronic myelogenous leukemia (CML)
Chronic myelogenous leukemia (CML)
Which description does the nurse recognize fits a client in the prodromal stage of an infection? Client is experiencing vague symptoms of fatigue and low grade fever. Client's symptoms specific to the disease are evident. Client has been exposed, but is experiencing no apparent symptoms. Residual symptoms of the disease are present in the client's body.
Client is experiencing vague symptoms of fatigue and low grade fever.
A nurse working in an emergency department is assigned to triage the following clients. Which client should the nurse evaluate first? Client with a clotting deficiency who has ankle swelling after twisting an ankle Client with thrombocytopenia who has oozing after having a tooth extracted Client with a history of anemia who has had nausea and diarrhea for 24 hours Client who has chemotherapy-induced neutropenia (decrease in neutrophil levels) and a temperature of 101.2°F (38.4°C)
Client who has chemotherapy-induced neutropenia (decrease in neutrophil levels) and a temperature of 101.2°F (38.4°C)
Which client would be diagnosed with wasting syndrome? Client with HIV a CD4+ T-cell count of 1000 cells/μL, Kaposi sarcoma, and nausea and vomiting for more than 2 weeks Client with HIV, fever, diarrhea, and significant involuntary weight loss Client with AIDS with pneumonia, chronic fever, and chronic fatigue Client with chronic fatigue syndrome, no fever and herpes simplex, and candidiasis around the oral mucosa
Client with HIV, fever, diarrhea, and significant involuntary weight loss
A hospital client was swabbed on admission for antibiotic-resistant organisms and has just been informed that methicillin-resistant Staphylococcus aureus (MRSA) is present in his groin. The client has a normal core temperature and white blood cell count. This client is experiencing: Infection Colonization Inflammation Proliferation
Colonization Colonization describes the act of establishing a presence, a step required in the multifaceted process of infection; infection describes the presence and multiplication within a host of another living organism. However, this client displays no signs of infection, inflammation, or proliferation of the microorganism.
The nurse is caring for a client who is HIV positive and is newly diagnosed with Mycobacterium tuberculosis (TB). Which manifestations does the nurse associate with TB? Select all that apply. Cough Fever Weight gain Rash Night sweats
Cough Fever Night sweats Most people who have TB present with fever, night sweats, cough, and weight loss. Rash is not a symptom.
Thrombocytosis is used to describe elevations in the platelet count above 1,000,000/μL. It is either a primary or a secondary thrombocytosis. Secondary thrombocytosis can occur as a reactive process due to: Aganglionic megacolon Lyme disease Crohn disease Hirschsprung disease
Crohn's disease The common underlying causes of secondary thrombocytosis include tissue damage due to surgery, infection, cancer, and chronic inflammatory conditions such as rheumatoid arthritis and Crohn's disease. Lyme disease, caused by a tick bite, does not cause thrombocytosis. Hirschsprung disease and megacolon are the same thing, and they are not inflammatory conditions.
Normally, there is a relatively constant number of each type of circulating blood cell. What regulates the number of each type of blood cell? Cytokines Hematopoietic system Pluripotent stem cells Immune system
Cytokines
Once T helper cells are activated, they secrete which substance that activates and influences nearly all of the other cells of the immune system? Complement proteins Bradykinins Cytokines Leukotrienes
Cytokines
The nurse is caring for a client who has a low level of T lymphocytes. The nurse plans care for a client with: Infection Decreased immune response Anemia Decreased hematocrit
Decreased immune response T lymphocytes differentiate to form CD4+ helper T cells, which serve to orchestrate the immune response. A client with low levels of T lymphocytes will have decreased immune response, which the nurse should consider when planning the client's care.
A nurse is caring for a newborn that has developed a low platelet count. What could be the cause? Increased pluripotent stem cell division Decreased thrombopoietin (TPO) Decreased spleen function Increased megakaryocytes
Decreased thrombopoietin (TPO)
A nurse working in an ambulatory care unit is working with a client who has recently been diagnosed with a V Leiden mutation. The nurse tells the client the importance of smoking cessation to avoid: Deep vein thrombosis (DVT) Essential hypertension Coronary artery disease Pulmonary hypertension
Deep-vein thrombosis (DVT) Factor V Leiden mutation increase the risk of DVT because physiological anticoagulants have an increased difficulty inactivation of the mutated factor V gene. The inability to inactivate the factor V Leiden gene contributes to an increase in thrombotic complications, including DVT.
A newborn has a clotting disorder that results in the body being unable to produce fibrin. Which of the following could be the cause? Increase in the number of megakaryocytes Deficiency of fibrinogen Decreased spleen function Iron deficiency
Deficiency of fibrinogen Fibrinogen is a soluble protein that polymerizes to form the insoluble protein fibrin during blood clotting.
A nurse is caring for a client recently admitted to the emergency department with drug-induced thrombocytopenia and a platelet count of 50,000/μL. The client's medications include quinidine, sulfamethoxazole/trimethoprim, esomeprazole, and oral contraceptives. The nurse anticipates which initial course of treatment? Platelet monitoring Discontinuation of all medications Platelet transfusion Initiation of heparin
Discontinuation of all medications
A client is admitted to the hospital with a diagnosis of deep vein thrombosis and started on intravenous heparin therapy. Seven days later, the client's lab values identify a rapid decrease in platelets. The health care provider recognizes this as: Immune thrombocytopenic purpura (ITP) Thrombotic thrombocytopenic purpura (TTP) Drug-induced thrombocytopenia Hemolytic-uremic syndrome (HUS)
Drug-induced thrombocytopenia -Drug-associated thrombocytopenia presents with a rapid fall in the platelet count within 2-3 days of resuming a drug of 7or more days after initiating a drug for the first time-The platelet count rises rapidly after the drug is discontinued
A client has been placed on sulfamethoxazole/trimethoprim as treatment for community-acquired methicillin-resistant Staphylococcus aureus (MRSA) for 10 days. After taking the medication for 8 days, the client comes to the health care provider's office complaining of multiple nosebleeds over the past day. Laboratory work shows a platelet count of 80,000/μL. The nurse practitioner suspects which condition? Drug-induced thrombocytopenia Hypersplenic thrombocytopenia Drug-induced thrombocytosis Antiphospholipid syndrome
Drug-induced thrombocytopenia Many drugs have the potential to induced an antigen-antibody response including the formation of immune complexes that target and destroy platelets causing thrombocytopenia, which leads to increased bleeding. Bactrim is a sulfa-containing antibiotic that can cause this reaction. The reaction typically occurs around day 7 with people who have never taken the drug before and on days 2 to 3 for people who have taken the drug before. Thrombocytopenia resolves quickly once the drug is discontinued.
The nurse is conducting a staff in-service program on non-Hodgkin lymphomas. The nurse should include that essentially all people with Burkitt lymphoma have evidence of infection with: HTLV-1 Helicobacter pylori HIV EBV
EBV
A nurse is evaluating the laboratory values of a client who developed a hemorrhage during surgery. Which hematology laboratory results would the nurse expect to find? Hemoglobin 13.2 g/dL (132 g/L) Hematocrit of 45% (0.45) Elevated reticulocyte count Decreased white blood cell (WBC) count
Elevated reticulocyte count
Which leukocyte is correctly matched with its function within the body? Basophil—engulfs antigens Monocyte—releases heparin Eosinophil—allergic reaction Lymphocyte—phagocytosis
Eosinophil—allergic reaction
Severe acute respiratory syndrome (SARS), a highly transmissible respiratory infection, crossed international borders in the winter of 2002. What terms are used to describe the outbreak of SARS? Nosocomial and endemic Pandemic and nosocomial Regional and endemic Epidemic and pandemic
Epidemic and pandemic
Which colony-stimulating factor (CSF) is given to clients with end-stage renal disease to help with chronic anemia? Filgrastim Erythropoietin (EPO) Interleukin Thrombopoietin (TPO)
Erythropoietin (EPO)
A client has been diagnosed with inherited hypercoagulability. Select the most likely cause. Myocardial infarction Hyperestrogenic state Factor V gene mutation Prolonged immobility
Factor V gene mutation -Of the inherited cause of hyper coagulability, mutation in the factor V gene and prothrombin gene are the most common. - Among the acquired or secondary factors that lead to increased coagulation and thrombosis are venous stasis due to prolonged bed rest and immobility, myocardial infarction, cancer, hyperestrogenic states, and oral contraceptives
A pregnant woman at her first prenatal visit reports to the nurse that she is always tired. The nurse knows that fatigue is one symptom of anemia. What other manifestations of anemia should the nurse assess for? Select all that apply. Faintness Ruddy skin Bradycardia Dim vision
Faintness dim vision In anemia, the oxygen-carrying capacity of hemoglobin is reduced, causing tissue hypoxia. Tissue hypoxia can give rise to fatigue, weakness, dyspnea, and sometimes angina. Hypoxia of brain tissue results in headache, faintness, and dim vision. The redistribution of the blood from cutaneous tissues or a lack of hemoglobin causes pallor of the skin, mucous membranes, conjunctiva, and nail beds. Tachycardia and palpitations may occur as the body tries to compensate with an increase in cardiac output. Ruddy skin and bradycardia are not signs or symptoms of anemia.
The nurse's plan of care for a client with multiple myeloma should include interventions to prevent: GI bleed Urinary tract infections Fractures Diarrhea
Fractures
Which nursing interventions would be a priority when caring for a newborn who is receiving phototherapy for high bilirubin levels? Select all that apply. Applying sunscreen to prevent ultraviolet radiation Keeping diapers dry and clean Frequent monitoring of temperature Putting lotion on infant's skin frequently to prevent drying/cracking of skin Maintaining oral intake to prevent dehydration
Frequent monitoring of temperature Maintaining oral intake to prevent dehydration
Which of the following would be considered an example of transmitting an infection from person-to-person through shared inanimate objects (fomites)? Tuberculosis from inhalation of air after a cough Typhoid fever from traveling to a third-world country HIV from a contaminated IV drug user needle Malaria from mosquito bites
HIV from a contaminated IV drug user needle
Which organism causes peptic ulcers? Helicobacter pylori Salmonella typhimurium Escherichia coli Staphylococcus aureus
Helicobacter pylori
A client has recently received a pneumococcal vaccine and the client's B cells are consequently producing antibodies. Which cells may enhance this production of antibodies? Helper T cells Cytotoxic T cells Regulatory T cells Natural killer cells
Helper T cells
Which substance, when deficient, results in a diagnosis of anemia? Platelets Folic acid Hemoglobin Blood plasma
Hemoglobin Anemia is a condition of an abnormally low number of circulating red blood cells or hemoglobin level, or both. It is not a disease but a manifestation of a disease process or alteration in body function.
The client is an average-sized adult and has abnormal microcytic hypochromic red blood cells due to a long-term, chronic disease. Which complete blood count (CBC) result is characteristic of this type of anemia? Hemoglobin 7.8 g/dL (78 g/L) Hematocrit 44% (0.44) Reticulocytes 1.5% (0.015) Band cells 700/µL (0.7 ×109/L)
Hemoglobin 7.8 g/dL (78 g/L)
A nurse is assessing a client who displays pale skin and nail beds. Which laboratory data should the nurse evaluate? Hemoglobin level Erythrocyte sedimentation rate White blood cell count Neutrophil count
Hemoglobin level
The emergency department nurse is concerned that the client's snake bite may trigger disseminated intravascular coagulation (DIC). If this should occur, which clinical manifestations would be seen? Headaches Hemorrhage Hypertension Platelet loss
Hemorrhage
In the ICU, a postsurgical client has developed sepsis and is being treated with multiple medications. During the mid-morning assessment, which finding leads the nurse to suspect the client may be developing a complication called disseminated intravascular coagulation (DIC)? Decreased O2 saturation and diminished breath sounds in lower lobes Nausea and vomiting Urine from the Foley catheter is bloody Hemorrhage from the surgical site requiring deep pressure dressings Headaches associated with light sensitivity
Hemorrhage from the surgical site requiring deep pressure dressing
A nurse is caring for a client receiving heparin therapy. Five days after the start of therapy the nurse notices a sudden decrease in the platelet count. Which complication of heparin therapy can cause platelets to decrease? Anaphylaxis Heparin-induced thrombocytopenia Thrombotic microangiopathies Disseminated intravascular coagulation
Heparin-induced thrombocytopenia -10% of people treated w/ heparin develop a mild thrombocytopenia 2-5 days after starting the drug. It is caused by an immune rxn against heparin + platelet factor 4
A client with acute leukemia has developed gout and asks the nurse, "Why did this happen?" Which response is most accurate? High uric acid levels Too much alcohol consumption Diet with too many carbohydrates Anorexia and muscle wasting
High uric acid levels
A lymph node biopsy pathology report notes the presence of Reed-Sternberg cells on a client suspected of having a lymphoma. The nurse interprets the report as indicating: Non-Hodgkin lymphoma Hodgkin lymphoma Leukemia Multiple myeloma
Hodgkin lymphoma Hodgkin lymphoma is a specialized form of lymphoma that features the presence of an abnormal cell called a Reed-Sternberg cell. Burkitt and follicular lymphomas are types of non-Hodgkin lymphoma
A client is suffering from the effects of the opportunistic infection, Cryptosporidium parvum. An important nursing intervention would be to encourage which action? Weight-bearing exercise Ambulation Hydration Deep breathing and coughing
Hydration
The nurse is assisting a new mother with breastfeeding. What does the nurse understand is a primary secretory immunoglobulin (Ig) that is found in the colostrum? IgM IgD IgE IgA
IgA After birth, the neonate receives IgG antibodies from the mother in breast milk or colostrum. Therefore, infants are provided with some degree of protection from infection for approximately 3 to 6 months, giving their own immune systems time to mature. IgA is primarily a secretory Ig that is found in saliva, tears, colostrum (i.e., first milk of a nursing mother), and bronchial, gastrointestinal, prostatic, and vaginal secretions. Its primary function is in local immunity on mucosal surfaces. IgA prevents the attachment of viruses and bacteria to epithelial cells.
Which immunoglobulin (Ig) is released in response to allergy or parasitic infections?
IgE
Which immunoglobulin (Ig) is the most abundant of circulating antibodies? IgA IgG IgM IgE
IgG
The nurse is caring for a pediatric client who will be having bone marrow aspiration from the posterior iliac crest. The parent asks why the sternum is not used to obtain the sample as this is the site used for another relative. How does the nurse respond? The health care provider makes a decision based on test results, so the iliac crest was determined best for your child. Although the sternum is often used in adults, we avoid it in children as we do not want them to see the needle. Children tend not to be cooperative for the procedure and may grab the equipment, so using the iliac crest is safer. In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.
In children, the sternal bone marrow cavity is much more shallow, increasing risk for damage to underlying organs.
A client is admitted to the emergency department with a diagnosis of polycythemia. The nurse plans to assess for symptoms related to which problem? Increased blood viscosity Increased risk of infection Inability to form blood clots Decreased ability to carry oxygen to the cells
Increased blood viscosity
A client attending a health fair asks how anthrax will be treated in the event of a bioterrorism attack. How should the nurse respond? If an individual has anthrax, the individual will need infusion of antitoxins. Individuals who are exposed will be isolated and given antibiotics. Everyone should have an emergency supply of antibiotics to take in case of an attack. Anthrax is a virus that spreads by spores that can be inactivated with disinfectants.
Individuals who are exposed will be isolated and given antibiotics.
The nurse is teaching a new mother about caring for her baby and reducing the risk for infection. On what principle does the nurse base the knowledge of passive immunity? Infants are protected at birth from infection by maternal IgG. Infants are protected at birth from infection by maternal IgA. Infants are protected at birth from infection by maternal IgD. Infants are protected at birth from infection by maternal IgM.
Infants are protected at birth from infection by maternal IgG.
A client has been admitted for immune thrombocytopenic purpura. The client has not responded to corticosteroid treatment. The priority nursing intervention for this client would include which treatment measure? Insert a Foley catheter to monitor hourly urine output. Insert an intravenous catheter, so immune globulin can be administered in a timely manner. Prepare a surgical permit for an emergency splenectomy. Place the client in isolation, so the skin rashes will not spread to other clients.
Insert an intravenous catheter, so immune globulin can be administered in a timely manner.
The nurse is assessing a client diagnosed with anemia and notes that the client's skin and mucous membranes are pale. The nurse interprets this as: Changes in blood viscosity Tissue hypoxia to the brain Insufficient hemoglobin Presence of systolic murmur
Insufficient hemoglobin The redistribution of the blood from cutaneous tissues or a lack of hemoglobin causes pallor of the skin, mucous membranes, conjunctiva, and nail beds. Tissue hypoxia to the brain causes headache, faintness, and dim vision but is not the direct cause of pallor. Changes in blood viscosity may lead to a systolic murmur.
A client has begun taking acyclovir, an antiviral medication, to control herpes simplex outbreaks. What is this drug's mechanism of action? Elimination of exotoxin production Interference with viral replication processes Inhibition of viral adhesion to cells Antagonism of somatic cell binding sites
Interference with viral replication processes Acyclovir, like most antiviral drugs, interferes with normal viral replication. Antiviral drugs do not normally affect adhesion, and viruses are not associated with the production of exotoxins.
The rate at which hemoglobin is synthesized depends on availability of which substance? Iron Glucose Oxygen Calcium
Iron
The nurse is teaching a client infected with the flu about viruses. Which explanation would the nurse use to describe a viral infection? It is caused by a hypersensitivity reaction to a biologic agent. It occurs when an irritant causes an inflammatory response. It is an infection with an intracellular pathogen. It is caused by a defect in the immune system.
It is an infection with an intracellular pathogen.
Which type of macrophages are found in the liver? Microglial cells Monocytes Histiocytes Kupffer cells
Kupffer cells
A client's bone marrow study report reveals the findings of blast cells in the bone marrow. What does the nurse interpret this as indicating? Non-Hodgkin disease Leukemia Neutropenia Hodgkin disease
Leukemia
A client is experiencing fatigue and laboratory results reveal: Hct 40% (0.40); Hgb 8 g/dL (80 g/L); WBC 8000 (8 x 109/L); and platelets 175,000/ µL (175 ×109/L). The nurse would interpret these results as indicative of which diagnosis? High platelets/thrombocytosis Low white blood cell (WBC) count/granulocytopenia High hematocrit/polycythemia Low hemoglobin/anemia
Low hemoglobin/anemia
A young adult client presents with an enlarged, firm cervical lymph node on the right side of the neck. Palpation of the node is painless. The nurse should document this assessment finding and anticipate preparing the client for which diagnostic procedure to confirm diagnosis? Lymph node biopsy Watchful waiting and close monitoring of the node over the following weeks Bone marrow transplant (BMT) Radioactive isotope insertion
Lymph node biopsy
An infection control nurse is conducting research on the activation of chemokines of the immune system and is identifying anatomical locations where primary immune responses are initiated. Which locations should be included in the research study? Select all that apply. Lymph nodes Tonsils Peyer patches Spleen Liver
Lymph nodes Spleen Tonsils Peyer patches Chemokines are a subset of cytokines that consist of small protein molecules involved in both immune and inflammatory responses. They are responsible for directing leukocyte migration to areas of injury and to locations where primary immune responses are initiated such as lymph nodes, the spleen, Peyer patches, and the tonsils.
A pregnant client gets immunized for influenza while in the second trimester. What response occurs in the newborn after birth with regard to protection from the flu? The newborn will have to receive immunization against influenza to have any immunity. Maternal vaccination may offer fetal and neonatal passive immunity against the flu. The newborn will not require further immunization against the flu for at least 12 months. Only the mother will receive the benefits of immunization.
Maternal vaccination may offer fetal and neonatal passive immunity against the flu.
While caring for a pediatric client admitted with a viral infection, the nurse knows that which type of cell will be the child's primary defense against the virus? Leukotrienes Natural killer (NK) cells Complement Bradykinin
Natural killer (NK) cells
Which type of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk? Naturally acquired active immunity Naturally acquired passive immunity Artificially acquired active immunity Artificially acquired passive immunity
Naturally acquired passive immunity
A nurse sends a blood sample to the lab for analysis. Assuming the sample is normal, the nurse anticipates which white blood cells (WBCs) will account for the highest percentage? Monocytes Lymphocytes Eosinophils Neutrophils
Neutrophils
A client is admitted to the hospital with an elevated temperature and flank pain. When reviewing the complete blood count (CBC), which level is the most important for the nurse to communicate to the health care provider? Monocytes 3% Platelets 150,000/mL (150,000 x 109/L) Neutrophils 85% Hemoglobin 12.6 g/dL (126 g/L)
Neutrophils 85%
When a white blood cell with differential count reveals an acute infection, which statement is correct regarding the client's neutrophils? Neutrophils are not present during an acute infection that produces fever. Neutrophils are only responsive in an allergic or parasitic infection. There are fewer neutrophils in the blood than other white blood cells. Neutrophils are the first white blood cell to elevate in an acute infection.
Neutrophils are the first white blood cell to elevate in an acute infection.
Typical symptoms seen in the latent period of HIV infection include which of the following? No signs or symptoms Skin lesions Night sweats Gastrointestinal problems
No signs or symptoms
A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus. The nurse explains to the woman that the infection is caused by a common organism that normally does not cause infection in someone with a healthy immune system. This type of infection is called what? HIV infection Opportunistic infection Autoimmune infection Suppression infection
Opportunistic infection
The entrance of a microbe into an individual's vascular space has initiated opsonization. Which statement explains this process? Opsonization releases proteins that stimulate cell production by the bone marrow. Opsonization involves lysis of intracellular microbes by cytotoxic T cells. Opsonization stimulates B cells by helper T cells. Opsonization coats a microbe to activate phagocytosis recognition.
Opsonization coats a microbe to activate phagocytosis recognition.
The entrance of a microbe into an individual's vascular space has initiated opsonization. Which statement explains this process? Opsonization stimulates B cells by helper T cells. Opsonization involves lysis of intracellular microbes by cytotoxic T cells. Opsonization releases proteins that stimulate cell production by the bone marrow. Opsonization coats a microbe to activate phagocytosis recognition.
Opsonization coats a microbe to activate phagocytosis recognition.
Which statement correctly identifies the role of the C3b subcomponent of the complement system? Dilates arterioles Lyses cells Opsonizes microbes to facilitate phagocytosis Induces rapid degranulation of mast cells
Opsonizes microbes to facilitate phagocytosis
The nurse is caring for an infant with DiGeorge syndrome. Which organ does the nurse know will be underdeveloped or absent? Pituitary gland and thyroid gland Kidney and bladder Parathyroid and thymus glands Liver and spleen
Parathyroid and thymus glands
A 75-year-old client with a history of heart valve replacement arrives at the outpatient clinic with multiple red pinpoint lesions. The nurse identifies the lesions as: Erythema Purpura Petechiae Ecchymoses
Petechiae
A nurse is reviewing a client's complete blood count (CBC) which indicates thrombocytopenia. Based on this result, which action should the nurse include in the plan of care? Place the client on bleeding precautions. Increase intake of iron-rich foods. Encourage increased oral fluids. Place the client on contact isolation.
Place the client on bleeding precautions.
The nurse is caring for a client with leukemia who is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding? Ringer's lactate solution Platelets Albumin Whole blood
Platelets
Progenitor cells, or parent cells, for the production of myeloid and lymphoid cells are derived from: Pluripotent stem cells Myeloproliferative cells Unipotent cells Multipotential progenitor cells
Pluripotent stem cells A small population of cells called pluripotent stem cells are capable of providing progenitor cells, or parent cells, for myelopoiesis and lymphopoiesis, processes by which myeloid and lymphoid blood cells are made. Unipotent cells are the progenitors for each of the blood cell types and come from pluripotent stem cells. Multipotential progenitor cells act as parent cells for multiple types of blood cells. Myeloproliferative cells do not exist.
A client tells the nurse that the doctor told her she has too many red blood cells accompanied by elevated white cells and platelet counts. The nurse recognizes this as: Aplastic anemia Pernicious anemia Polycythemia vera Hemolytic anemia
Polycythemia vera Polycythemia vera is a neoplastic disease of the pluripotent cells of the bone marrow characterized by an absolute increase in total red blood cell mass accompanied by elevated white cell and platelet counts. In polycythemia vera, the clinical manifestations are hypertension, headache, dizziness, inability to concentrate, and some difficulty with hearing and vision because of decreased cerebral blood flow. Venous stasis gives rise to a plethoric appearance or dusky redness, even cyanosis, particularly of the lips, fingernails, and mucous membranes. Because of the increased concentration of blood cells, the person may experience itching and pain in the fingers or toes, and the hypermetabolism may induce night sweats and weight loss.
What is the main effect of HIV infection? Poor helper T-cell function Poor suppressor T-cell function Poor B-cell function Poor natural killer cell function
Poor helper T-cell function
Which anatomical site would the nurse expect to monitor when caring for an adult client who has just had a bone marrow aspiration performed? Antecubital space Head of the femur Posterior iliac crest Radial artery
Posterior iliac crest
The nurse is preparing a client with suspected leukemia for a bone marrow and biopsy. What preferred site will the nurse be sure is accessible for the physician? Cervical spinous process Posterior iliac crest Anterior femur Clavicle
Posterior iliac crest Usually, the posterior iliac crest is used in all people older than 12 to 18 months of age. Other sites include the anterior iliac crest, sternum, and spinous processes T10 through L4. The sternum is not commonly used in children because the cavity is too shallow and there is danger of mediastinal and cardiac perforation. The rate at which hemoglobin is
In the usual course (stages) after a pathogen has entered the host body, the stage when the host initially develops the appearance of signs/symptoms like a mild fever and body aches is: Prodromal Incubation Convalescence Acute
Prodromal
A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this client? Bone marrow or stem cell transplantation Surgery, whole-blood transfusion, and chemotherapy Antiviral medications Radiation, chemotherapy, and biotherapy
Radiation, chemotherapy, and biotherapy NHL is normally treated with either radiation (early stage) or radiation and chemotherapy (later stages). Because most people who present with indolent lymphoma have disseminated disease at the time of diagnosis, combination chemotheapy, biotherapy, and adjuvant radiation therapy are recommended. Antivirals, blood transfusion, surgery, bone marrow transplantation, and stem cell transplantations are not common treatment modalities for NHLs.
The mother of an infant born with profound intellectual disability and hearing loss tells the nurse that she had a viral infection in the first trimester of pregnancy. The nurse identifies which congenital infection as the cause of the fetal defects? Mumps Rubella Roseola Measles
Rubella
A 26-year-old client has an absolute neutrophil count of less than 500 cells/mm3 (0.50 x 109/L) Which interpretation of this lab value is accurate? Severe neutropenia Mild neutropenia Slight neutropenia Normal neutrophil count
Severe neutropenia
The first physical line of defense in innate immunity is: Plasma proteins Neutrophils Skin and mucous membranes Specialized lymphocytes
Skin and mucous membranes
A client's history and physical documents the presence of an indolent lymphoma. The nurse plans care for which type of lymphoma? Diffuse Slow-growing Aggressive Encapsulated
Slow-growing
The practitioner carefully monitors his client who exhibits hemoglobin S (HbS) genes. The practitioner know that the client is predisposed to life-threatening infection due to damage by HbS to which organ? Lungs Spleen Pancreas Heart
Spleen
When red blood cells age, which organ is responsible for their destruction? Liver Kidneys Red bone marrow Spleen
Spleen
A 25-year-old female client with primary antiphospholipid syndrome is discussing the possibility of becoming pregnant. The nurse shares which possible complication(s) that can occur as a result of this syndrome? Select all that apply. spontaneous miscarriage gestational diabetes premature birth prolonged labor placental insufficiency
Spontaneous miscarriage Premature delivery Placental insufficiency Primary antiphospholipid syndrome involves autoantibodies that attack protein-binding phospholipids causing an increase in coagulation. Clotting factors are also increased during pregnancy and can contribute to the development of ischemia and thrombosis of the placental blood vessels that interferes with the ability to sustain a healthy pregnancy to term.
Chronic lymphocytic leukemia (CLL) commonly causes hypogammaglobulinemia. This makes clients with CLL more susceptible to infection. What is the most common infectious organism that attacks clients with CLL? Pseudomonas aeruginosa Escherichia coli Mycobacterium tuberculosis Staphylococcus aureus
Staphylococcus aureus
A client is suspected of having a parasitic infection with roundworms. For what laboratory testing will the nurse prepare the client to most rapidly identify this infection? Stool exam for ova Cell culture Antibody titer Gene sequencing
Stool exam for ova
Which statement explains how T lymphocytes and B lymphocytes differ? T lymphocytes secrete antibodies; B lymphocytes provide cellular response to antigens. T lymphocytes are helpers that assist B lymphocytes to amplify the lysis of antigens. T lymphocytes recognize bacteria; B lymphocytes recognize viruses and cancer. T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.
T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.
The nurse is admitting a client who is documented to be in the terminal blast crisis phase of chronic myelogenous leukemia (CML). What interpretation should the nurse make, given this information? The CML has evolved to chronic lymphocytic leukemia. The CML is in remission. The CML is indolent. The CML has evolved to acute leukemia.
The CML has evolved to acute leukemia.
A client with iron-deficiency anemia asks, "What does this low mean corpuscular volume (MCV) level mean?" Which response by the nurse is most accurate? This means your blood will thicken rapidly. The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells. This means that you have a lot of fluid in your vessels diluting your red blood cells. This means that your red blood cells are pale in color.
The MCV is one red blood cell (RBC) index that indicates your RBCs are small cells.
A nurse is caring for a child diagnosed with DiGeorge syndrome with thymic hypoplasia. Which immune response would the nurse anticipate in this child? The child will be at an increased risk for developing allergic reactions. The degree of thymic hypoplasia will determine how the immune system is affected. The child with thymic hypoplasia will be at increased risk of infection. The child should not experience any change in immune response.
The child with thymic hypoplasia will be at increased risk of infection.
The treatment prescribed for an autoimmune disorder is primarily dependent upon what? The age and gender of the client The presence of existing chronic disorders and the client's medical history The current manifestations of the disease and the mechanisms that cause the disease process Corticosteroids is always the first line of treatment.
The current manifestations of the disease and the mechanisms that cause the disease process
A newborn has been lethargic, is not nursing well, and is basically looking ill. Following lab tests, it has been found that the newborn has IgM present in his blood. How should the nurse interpret this finding? IgM is usually only found in saliva so the specimen must be contaminated. The presence of IgM suggests the infant has a current infection. IgM in the blood means the infant may be allergic to breast milk. All newborns have IgM in their blood so this is a normal finding.
The presence of IgM suggests the infant has a current infection.
A 42-year-old male client recently diagnosed with liver cancer is noted as at high risk for bleeding abnormalities. The nurse recognizes this risk as a result of: the reduction of clotting factors synthesized in the liver. increased amounts of vitamin K being produced in the liver. a vitamin C deficiency in the diet. weakening of the organ walls as a result of inflammation.
The reduction of clotting factors synthesized in the liver -In liver disease: synthesis of clotting factors is reduced and bleeding may result. -Vit. K would not be produced in large amounts of active form in a diseased liver.-Vit. C deficiency in the diet would not contribute to increased bleeding
The nurse is teaching a client about how a vaccine can help create immunity to a virus. What information does the nurse provide? Vaccines affect T lymphocytes, which then attack the virus at the cellular level. The vaccine lays dormant in the body until exposed to the virus; it is then activated. The vaccine attaches to DNA of lymphocytes, making them attack the virus. The vaccine causes B lymphocytes to create antibodies against the virus.
The vaccine causes B lymphocytes to create antibodies against the virus.
A nurse assessing a client with an acute exacerbation of polycythemia vera notes coolness to the right leg and foot, pale color, and an absent right pedal pulse. Based on these findings the nurse suspects that the client has developed which complication? Edema in the right leg Infection in the right leg Thrombosis in the right leg Compartment syndrome in the right leg
Thrombosis in the right leg
An infant from parents of Mediterranean decent has been diagnosed with a severe form of β-thalassemia anemia. The nurse caring for this infant knows that the infant will most likely receive which medical treatment? Iron sulfate supplements Transfusion therapy Warfarin, a blood thinner to decrease clot formation Stem cell transplant
Transfusion therapy
The type of hypersensitivity reaction that is mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues is also known as which type of hypersensitivity reaction? Type I Type II Type III Type IV
Type II
A client seeks treatment in the clinic for exposure to poison ivy with a rash over the right arm and hand. The nurse is aware that what toxin is found in the oils on poison ivy that is responsible for eliciting an allergic reaction? Urushiol Kupffer cells Streptococcus pneumonia Lymphocytes
Urushiol
What is the most common mode of transmission of HIV? Vaginal and anal intercourse Occupational exposure Mother to newborn via perinatal transmission Blood transfusion Infection from shared needles
Vaginal and anal intercourse
An HIV-positive mother passes the virus to her infant during delivery. This type of transmission is known as: Heterozygous transmission Vesicle transmission Horizontal transmission Vertical transmission
Vertical transmission
The nurse is caring for a client who is a strict vegetarian; the client is at greatest risk for the development of: Folic acid deficiency anemia Blood loss anemia Vitamin B12 deficiency anemia Microcytic anemia
Vitamin B12 deficiency anemia Vitamin B12 is found in all foods of animal origin. Dietary deficiency is rare and usually found only in strict vegetarians who avoid all dairy products as well as meat and fish. The hallmark of vitamin B12 deficiency is megaloblastic anemia. The other options are not affected by the client being a vegetarian.
A client with an apparent clotting disorder is admitted to hospital. His health record reveals that he has been treated for complications of chronic alcoholism for the past 10 years. The nurse should suspect what cause of his clotting disorder? Vitamin K deficiency Hemophilia Von Willebrand disease Immune thrombocytopenic purpura (ITP)
Vitamin K deficiency Vitamin K, a fat-soluble vitamin, is necessary for the synthesis of factors II, VII, IX, and X, prothrombin, and protein C. With likely hepatitis from chronic alcohol abuse, the client cannot absorb the necessary vitamin K for normal clotting to occur. Von Willebrand disease, hemophilia, and ITP will all cause clotting disorders but for different reasons.
A 67-year-old client diagnosed with myasthenia gravis will likely display which clinical manifestations as a result of autoantibodies ultimately blocking the action of acetylcholine, resulting in destruction of the receptors? Weakness of the eye muscles, difficulty in swallowing and slurred speech, impaired gait. Tremor of hands/arms, rigidity of the arms, shuffling gait. Short-term memory lapses, problems with orientation, a lack of drive or initiative. Facial droop, slurred speech, weakness on one side of the body.
Weakness of the eye muscles, difficulty in swallowing and slurred speech, impaired gait.
A 20-year-old male presents at the clinic complaining of severe fatigue, night sweats, and fever. While taking the client's history, he reports having multiple sexual partners and unprotected sex. HIV/AIDS is suspected. What diagnostic test would be ordered to confirm the diagnosis? Eastern blot assay Complete metabolic panel ALEA Western blot assay
Western blot assay
The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider? White blood cells (WBCs) 18,500/µL (18.50 x 109/L) Platelet count 168,000/µL (186,000 x 109/L) Basophils 2/µL Monocytes 4%
White blood cells (WBCs) 18,500/µL (18.50 x 109/L)
Which diagnostic test results are abnormal? Select all that apply. Bands: 3% (0.03) White blood cells: 2.8 × 109/µL (2.8 × 109/L) Red blood cells: 6.6 × 103/µL (6.6 × 1012/L) Platelets: 500 ×103/µL (500 × 109/L) Basophils: 1% (0.01)
White blood cells: 2.8 × 109/µL (2.8 × 109/L) Red blood cells: 6.6 × 103/µL (6.6 × 1012/L) Platelets: 500 ×103/µL (500 × 109/L)
A nurse is caring for a client who has sustained severe trauma and has developed disseminated intravascular coagulation (DIC). The nurse will explain this complication to the family based on which physiologic principle? Bleeding due to structurally weak vessels resulting from vitamin C deficiency Impaired platelet function due to vitamin K deficiency Widespread coagulation and bleeding in the vascular compartment Thrombocytosis as a result of widespread infection
Widespread coagulation and bleeding in the vascular compartment
A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which statement should the nurse include in the teaching plan for the client? Since the newborn immune system is not mature your infant cannot contract the infection. Your infant will require a vaccination to avoid getting the infection. Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection. Since you are not immune to this infection, your infant is also at risk for contracting the infection.
Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection.
A client has been experiencing anemia and thrombocytopenia. Subsequent diagnostic testing has revealed the presence of immature granulocyte types and the Philadelphia chromosome. This client is likely to experience: hyperuricemia. a high risk of pathologic bone fractures. a prolonged chronic phase of leukemia. a self-limiting infection with the Epstein-Barr virus.
a prolonged chronic phase of leukemia.
A client asks the nurse how a broad-spectrum antibiotic works. The best response would be that they are active against: a wide variety of viruses. a wide variety of Gram-positive and Gram-negative bacteria. only Gram-positive infections. only gram-negative infections.
a wide variety of Gram-positive and Gram-negative bacteria.
The nursing caring for a 62-year-old client with diffuse large B-cell lymphoma plans care based on the knowledge that this client's lymphoma is: indolent. aggressive. encapsulated. rare.
aggressive Diffuse, large B-cell lymphomas are a heterogenous group of aggressive germinal or postgeminal center neoplasms. They evolve rapidly, are multifocal, nodal, and extranodal. They are rapidly fatal if left untreated.
A 10-month-old infant has begun to take his first steps and his mother has brought him for assessment because of swelling in his ankles and knees. The mother also states that he was eager to walk but has now regressed and cries when she tries to encourage it. The clinician should: order testing to rule out disseminated intravascular coagulation (DIC). prescribe a trial of desmopressin acetate (DDAVP) to rule out von Willebrand disease. administer vitamin K STAT. assess the child for signs and symptoms of hemophilia A.
assess the child for signs and symptoms of hemophilia A. The child's presentation is characteristic of hemophilia A, not DIC or von Willebrand disease. Vitamin K does not affect the physiology of hemophilia.
The nurse is planning a prevention program for infectious mononucleosis. The best target audience for the program is: parents of preschool children. older adults living in a senior apartment building. college students living in a dorm. employees of a large factory.
college students living in a dorm.
Treponema pallidum is a spirochete bacterium that causes syphilis. Which of the following is the mechanism that spreads T. pallidum from human to human?
direct physical contact
A female client comes to the clinic with symptoms of fatigue and heavy menses over the past 6 months. Laboratory tests reveal a microcytic hypochromic anemia. Based on these results, the nurse anticipates teaching the client about which type of anemia? anemia related to kidney disease aplastic anemia iron-deficiency anemia sickle-cell anemia
iron-deficiency anemia
While explaining immunity to a client, the nurse responds, "The body's internal organs are protected from pathogens because: our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response." the tonsils store a large amount of natural killer cells at that location." the actions of the cytokines in the mouth can act on different cell types at the same time it is fighting pathogens." we have special glands that can secrete cytokines on a moment's notice."
our mucosal tissue contains all the necessary cell components to fight a pathogen with an immune response."
A nurse is assessing a client and finds these results: Areas of bruising (purpura) on the client's arms and legs Pinpoint hemorrhages (petechiae) on the legs Pinpoint hemorrhages (petechiae) in the mouth Platelets level of 90,000/μL (90 ×109/L) What condition should the nurse suspect the client is exhibiting? Thrombocytosis Thrombocytopenia Leukopenia Neutropenia
thrombocytopenia -Thrombocytopenia: refers to a decrease in the number of circulating platelets to a level less than 100,00/mcL. -Cutaneous bleeding is seen as purple areas of brushing (purpora) and pinpoint hemorrhages (petechiae) in dependent areas where the capillary pressure is higher
Many different proteins, enzymes, and hormones are involved in maintaining hemostasis. Which protein is required for platelet adhesion? Growth factors von Willebrand factor Ionized calcium Platelet factor 4
von Willebrand factor
