unit 5 adaptive quiz
A client asks the nurse, "Should I tell my partner that I just found out I'm HIV positive?" How should the nurse respond? a-"You are having difficulty deciding what to say." b-"This is a decision you alone can make." c-"Do not tell your partner unless asked." d-"Tell your partner that you don't know how you became sick."
a
Which complication of anaphylactic shock in the adolescent client is most important for the nurse to detect early? a-Laryngeal edema b-Urticaria c-Tachycardia d-Restlessness
a
An ambulatory client with relapsing-remitting multiple sclerosis is to receive every-other-day injections of interferon beta-1a. What adverse effects does the nurse explain may occur when taking this medication? Select all that apply. a-Depression b-Constipation c-Flulike symptoms d-Increased heart rate e-Decreased perspiration
a,b, c.d
What clinical manifestations does a nurse expect a client with systemic lupus erythematosus (SLE) most likely to exhibit? Select all that apply. a-Joint pain b-Facial rash c-Pericarditis d-Weight gain e-Hypotension
a,b,c
A practical nurse teaches a client with rheumatoid arthritis about precautions to be taken during the intake of methotrexate. Which statements made by the client indicates effective learning? Select all that apply. a-"I should drink lots of water." b-"I should take the drug with food." c-"I should get an eye test every six months." d-"I should rinse out my mouth thoroughly after eating." e-"I should not plan to become pregnant."
a,c,de
What assessment findings indicate that a client is experiencing an allergic reaction to antibiotic therapy? Select all that apply. a-Pruritus b-Confusion c-Wheezing d-Muscle aches e-Bronchospasm
a,c,e
A client with Crohn's disease is admitted to the hospital with abdominal pain, fever, poor skin turgor, and diarrhea, with 10 stools in the past 24 hours. Which signs are evidence that the client probably is dehydrated? Select all that apply. a-Moist skin b-Sunken eyes c-Decreased apical pulse d-Dry mucous membranes e-Increased blood pressure
b,d
A nurse is assessing two clients. One client has ulcerative colitis and the other client has Crohn's disease. Which is more likely to be identified in the client with ulcerative colitis than the client with Crohn's disease? a-Involvement starting distally with rectal bleeding that spreads continuously up the colon b-Inclusion of transmural involvement of the small bowel wall c-Correlation with increased malignancy because of malabsorption syndrome d-Pathology beginning proximally with intermittent plaques found along the colon
d
An adolescent has been admitted with symptoms of fatigue, intermittent fever, weight loss, and arthralgia, and the diagnosis is systemic lupus erythematous. What does the nurse know is the best intervention at this time? a-Education about diet, rest, and exercise b-Implementation of corticosteroids c-Sun avoidance and calcium supplements d-Avoidance of destructive coping mechanisms
d
What intervention should be included in the nursing plan of care to help a 10-year-old girl live with Crohn disease? a-Recommending several rest periods throughout the day b-Emphasizing that high-residue foods be included in the diet c-Assuring her that when she reaches puberty she may discontinue her medication d-Encouraging her to express feelings while focusing on the ways she is like her friends
d
A client with an acute exacerbation of rheumatoid arthritis is in severe pain and tells the nurse, "The only time I am pain free is when I lie perfectly still." What complication should the nurse explain can be prevented by exercising every day? a-Shortening of the muscles b-Paresthesias of the feet c-Development of osteoblasts d-No answer text provided.
flexion amd extension
A nurse is evaluating a client who has been receiving medical intervention for the diagnosis of Crohn disease. Which expected outcome is most important for this client? a-Gains a half pound per week b-Does skin care c-Takes oral fluids d-Experiences less abdominal cramping
a
A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client? a-Use standard precautions. b-Employ airborne precautions. c-Plan interventions to limit direct contact. d-Discourage long visits from family members.
a
A nurse is eliciting a health history from a client with ulcerative colitis. What factor does the nurse consider to be most likely associated with the client's colitis? a-Genetic predisposition b-Food allergy c-Infectious agent d-Autoimmune response
a
Which statement regarding rheumatoid arthritis is true? a-It is a systemic condition b-It affects the hips and knees. c-It involves bone spur formation. d-It affects males and females equally.
a
A client exhibits blurred and double vision and muscular weakness, and diagnostic tests are prescribed. The client is informed that a diagnosis of multiple sclerosis (MS) has been made. The client becomes visibly upset. How should the nurse respond? a-"That must have really shocked you. Tell me what the healthcare provider told you about it." b-"You should see a psychiatrist who will help you cope with this overwhelming news." c-"Don't worry; early treatment often alleviates symptoms of the disease." d-"You should be glad that we caught it early so it can be cured."
a
A client has a diagnosis of multiple sclerosis and is currently in remission. The client is a parent of two active preschoolers. What should the nurse encourage the client to do? a-Develop a flexible schedule for completion of routine daily activities. b-Plan a schedule of specific times each day that will be set aside for playtime with the children. c-While in remission, provide support to other people with multiple sclerosis who also have young children. d-Meet with a self-help group for people with the diagnosis of multiple sclerosis.
a
A client is admitted to the hospital with a diagnosis of Crohn's disease. What is most important for the nurse to include in the teaching plan for this client? a-Meeting nutritional needs b-Controlling constipation c-Preventing increased weakness d-Anticipating a sexual alteration
a
A client is newly diagnosed with multiple sclerosis. The client is obviously upset with the diagnosis and asks, "Am I going to die?" What is the nurse's best response? a-"The prognosis is variable; most individuals experience remissions and exacerbations." b-"Most individuals with your disease live a normal life span." c-"Is your family here? I would like to explain your disease to all of you." d-"Why don't you speak with your health care provider? You probably can get more details about your disease."
a
A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client engages in angry outbursts and places excessive demands on the staff. One day an unlicensed assistive personnel (UAP) tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." What is the best response by the nurse? a-"The client's frightened and taking it out on the staff. Let's think of approaches we can take." b-"You need to try to be patient. The client is going through a lot right now." c-"I'll talk with the client. Maybe I can figure out the best way for us to handle this." d-"Just ignore it and get on with your work. I'll assign someone else to take a turn."
a
A client with an acute episode of ulcerative colitis is admitted to the hospital. When reviewing the client's laboratory results, the nurse identifies that the client's blood chloride level is decreased. What is the most efficient way this can be corrected? a-Intravenous therapy b-Low-residue diet c-Oral electrolyte solution d-Total parenteral nutrition (TPN)
a
A client with human immunodeficiency virus (HIV) infection reports fatigue, fever, and night sweats. Which stage of HIV infection does the nurse suspect? a-Early HIV infection b-Initial exposure c-Primary HIV infection d-Asymptomatic HIV infection
a
A client with multiple sclerosis is informed that it is a chronic progressive neurologic condition. The client asks the nurse, "Will I experience pain?" What is the nurse's best response? a-"Pain is not a characteristic symptom of this condition." b-"Tell me about your fears regarding pain." c-"Analgesics will be prescribed to control the pain." d"Let's make a list of the things you need to ask your primary healthcare provider.
a
A client with rheumatoid arthritis asks the nurse about ways to decrease morning stiffness. What should the nurse suggest? a-Taking a hot tub bath or shower in the morning b-Wearing loose but warm clothing c-Planning a short rest break periodically d-Avoiding excessive physical stress and fatigue
a
A client with rheumatoid arthritis has been taking a steroid medication for the past year. For which complication of prolonged use of this medication should the nurse assess the client? a-Decreased white blood cells b-Increased C-reactive protein c-Increased sedimentation rate e-Decreased serum glucose levels
a
A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statement? a-"I need to have my blood work checked periodically." b-"I need to balance exercise with rest." c-"I need to change positions slowly." d-"I need to take the medication between meals."
a
A client with systemic lupus erythematosus (SLE) is at 39 weeks gestation. What does the nurse anticipate regarding this client? a-A need to discontinue the client's salicylate therapy b-A large-for-gestational age newborn c-The possible need for postpartum dialysis d-Greater prominence of the butterfly-shaped rash
a
After many years of coping with ulcerative colitis, a client makes the decision to have a colectomy as advised by the primary healthcare provider. Which is most likely the significant factor that impacted on the client's decision? a-Surgical treatment cures ulcerative colitis. b-It is temporary until the colon heals. c-Ulcerative colitis can progress to Crohn disease. d-Without surgery, eating table foods is contraindicated.
a
After multiple bee stings a client experiences an anaphylactic reaction. The nurse determines that the symptoms the client is experiencing are caused by what? a-Bronchial constriction and decreased peripheral resistance b-Respiratory depression and cardiac arrest c-Decreased cardiac output and dilation of major blood vessels d-Constriction of capillaries and decreased peripheral circulation
a
An adolescent visits the allergy clinic because of seasonal environmental allergies, and blood is drawn for testing. Which laboratory finding indicates to the nurse that an allergic response is in progress? a-Increased eosinophil level b-Decreased platelet count c-Increased lymphocyte count d-Decreased immunoglobulin level
a
As an acute episode of rheumatoid arthritis subsides, active and passive range-of-motion exercises are taught to the client's spouse. The nurse should teach that direct pressure should not be applied to the client's joints because doing so may precipitate what? a-Pain b-Swelling c-Nodule formation d-Tophaceous deposits
a
Steroid therapy is prescribed for a client with an exacerbation of ulcerative colitis. The nurse evaluates that teaching is effective when the client identifies which times for the medication schedule? a-In the early morning with food b-At bedtime with a snack c-One hour before or two hours after eating d-Three times a day with meals
a
The nurse explains to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is made based on what? a-Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests b-Performance of high-risk sexual behaviors c-Evidence of extreme weight loss and high fever d-Identification of an associated opportunistic infection
a
The nurse is caring for a client with rheumatoid arthritis. When should the nurse expect the client to experience increased pain and limited movement of the joints? a-In the morning on awakening b-After assistive exercise c-When the room is cool d-When the latex fixation test is positive
a
The nurse is counseling an a woman who is HIV positive on precautions to be followed. Which statement by the client indicates the need for further counseling? a-"I will get a pelvic examination every 12 months." b-"I will avoid smoking and have nutritious food." c-"I will undergo regular screening for syphilis, gonorrhea, and other vaginal infections." d-"I will use female condoms if my partner refuses to use condoms."
a
The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). What does the nurse expect to find? a-A decrease in CD4 T cells b-An increase in thymic hormones c-An increase in immunoglobulin E d-A decrease in the serum level of glucose-6-phosphate dehydrogenase
a
The nurse observes that a client who is on intravenous medication is experiencing an anaphylactic reaction. What is the priority nursing intervention in this situation? a-Stop intravenous medication and administer epinephrine. b-Elevate lower extremities of the client. c-Start normal saline infusion immediately. d-Report to the primary healthcare provider immediately.
a
The nursing staff has a team conference on acquired immunodeficiency syndrome (AIDS) and discusses the routes of transmission of the human immunodeficiency virus (HIV). The discussion reveals that there is no risk of exposure to HIV when an individual does what? a-Makes a donation of a pint of whole blood b-Has intercourse with just the spouse c-Uses a condom each time there is sexual intercourse d-Limits sexual contact to those without HIV antibodies
a
What is the nurse's primary consideration when caring for a client with rheumatoid arthritis? a-comfort b-surgery c-education d-motivation
a
What should the nurse take into consideration when planning nursing care for a client experiencing an acute episode of rheumatoid arthritis? a-Bony ankylosis of a joint is irreversible and causes immobility. b-Inflammation of the synovial membrane rarely occurs. c-Complete immobility is desired during the acute phase of inflammation. d-Redness and swelling of a joint signify that irreversible damage has occurred.
a
When assessing the oral cavity of a newly admitted client with acquired immunodeficiency syndrome (AIDS), the nurse identifies areas of white plaque on the client's tongue and palate. What is the nurse's initial response? a-Document the presence of the lesions, describing their size, location, and color. b-Scrape an area of one of the lesions and send the specimen for a biopsy. c-Instruct the client to perform meticulous oral hygiene at least once daily. d-Consider that these lesions are universally found in clients with AIDS and require no treatment.
a
When comparing ulcerative colitis and Crohn's disease, a nurse considers that they are similar yet dissimilar in many ways. What clinical manifestation is common to clients with Crohn's disease and not to clients with ulcerative colitis? a-Right lower quadrant pain b-Diarrhea c-Weight loss d-Decreased hematocrit
a
Which first line medication would the nurse state is used to treat anaphylactic reactions? a-Epinephrine b-Norepinephrine c-Dexamethasone d-Diphenhydramine
a
Which manifestation should a client with rheumatoid arthritis taking meloxicam report to the health care provider? a-Skin rash b-Nosebleeds c-Oral lesions d-Metallic taste in the mouth
a
Which nursing intervention would be beneficial to a client with human immunodeficiency virus (HIV) infection who is experiencing fatigue? a-Scheduling ample periods of rest b-Recommending high-fiber foods c-Recommending dry and salty foods d-Encouraging fluid intake of more than 2,500 mL/day
a
Which statement is true regarding ulcerative colitis? a-Ulcerative colitis may cause rectal bleeding and abdominal cramping. b-Ulcerative colitis may occur anywhere along the gastrointestinal tract. c-The stool of a client with ulcerative colitis contains an excess amount of fats. d-Inflammation in clients with ulcerative colitis may extend through all layers of the bowel.
a
A nurse is caring for a client with a diagnosis of acquired immunodeficiency syndrome (AIDS). The IV infiltrates and needs to be restarted. What is necessary to protect the nurse when restarting the IV? Select all that apply. a-Mask b-Gown c-Gloves d-Face Shield e-Hand Hygiene
a,b,c,d,e
A nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). What recommendations are essential for the nurse to include? Select all that apply. a-Eat foods high in vitamin C. b-Take your temperature daily. c-Balance periods of rest and activity. d-Use a strong soap when washing the skin. e-Expose the skin to the sun as often as possible.
a.b.c