Chapter 30 Alterations in Immune Function

Which nursing intervention is priority when caring for a child with HIV? A. Administer prescribed medications. B. Assist the child with daily activities. C. Assess pain after invasive procedures. D. Review laboratory CD4 counts daily.

A. Administer prescribed medications.

Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply. A. Impaired skin integrity related to skin barrier function B. Delayed growth related to chronicity of immune disorder C. Ineffective breathing pattern related to allergic bronchospasm D. Anxiety related to continuing or uncontrolled allergic response E. Powerlessness related to difficulty determining cause of allergy

A. Impaired skin integrity related to skin barrier function D. Anxiety related to continuing or uncontrolled allergic response E. Powerlessness related to difficulty determining cause of allergy

The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply. A. Pneumococcal vaccination can be given. B. The child should receive live vaccines only. C. The human papillomavirus vaccine should not be given. D. The varicella vaccine should not be given if the child is symptomatic. E. If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.

A. Pneumococcal vaccination can be given. D. The varicella vaccine should not be given if the child is symptomatic. E. If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.

7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. The is having trouble breathing. Which type of hypersensitivity response is the child experiencing? A. Type I: anaphylaxis B. Type II: cytotoxic response C. Type III: immune complex D. Type IV: cell-mediated hypersensitivity

A. Type I: anaphylaxis

The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen? A. "The antihistamine will help the nasal swelling I am having." B. "Corticosteroids help the inflammation that goes along with an allergy." C. "I can stop taking my steroids as soon as I feel better in a couple of days." D. "I may have to undergo intradermal testing to determine what I am allergic to." E. "Once we figure out what I am allergic to, it is important for me to avoid that allergen."

B. "Corticosteroids help the inflammation that goes along with an allergy." D. "I may have to undergo intradermal testing to determine what I am allergic to." E. "Once we figure out what I am allergic to, it is important for me to avoid that allergen."

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching? A. "I must not feed my child eggs in any form." B. "I can use the egg white when baking, but not the yolk." C. "1 tsp yeast and 1/4 cups warm water is a substitute in baked goods." D. "1.5 Tbsp each water and oil plus 1 tsp baking powder equals one egg in a recipe."

B. "I can use the egg white when baking, but not the yolk."

The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education? A. "I will make sure my daughter always has her EpiPen® with her all the time." B. "If we need to use the EpiPen® we will need to notify her physician's office the next business day." C. "I have found a website that makes medical alert bracelets in my daughter's favorite color." D. "The grey part of the EpiPen® should never be removed until right before we use it."

B. "If we need to use the EpiPen® we will need to notify her physician's office the next business day."

An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE? A. "SLE is a rheumatic disease that mostly affects my joints." B. "SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms." C. "If my SLE has been found early enough in the disease process, there is a good chance that medication can cure it." D. "SLE only affects my skin. It seldom causes problems in any other organs."

B. "SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms."

The nurse is instructing parents on how atopic disorders affect the child. For which disorder would the nurse provide information and counseling? Select all that apply. A. Serum sickness B. Allergic rhinitis C. Asthma D. Eczema E. Hay fever

B. Allergic rhinitis C. Asthma D. Eczema E. Hay fever

A young client is admitted to the hospital directly from the clinic. The physician suspects a problem with the child's immune system. What test does the nurse anticipate the physician will order for this client? A. Urine analysis B. Blood analysis C. EKG D. X-ray

B. Blood analysis

The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply. A. The child's pulse is 52 beats per minute. B. The child states that his tongue feels "too big" for his mouth. C. The child has developed hives on his face and trunk. D. The child states he feels like he might "throw up". E. The child states that he feels like he might faint.

B. The child states that his tongue feels "too big" for his mouth. C. The child has developed hives on his face and trunk. D. The child states he feels like he might "throw up". E. The child states that he feels like he might faint.

The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply. A. Two or more new episodes of acute otitis media in 1 year. B. Two or more episodes of severe sinusitis in 1 year. C. Failure to thrive in an infant. D. Two or more serious infections such as sepsis. E. History of infections requiring IV antibiotics to clear.

B. Two or more episodes of severe sinusitis in 1 year. C. Failure to thrive in an infant. D. Two or more serious infections such as sepsis. E. History of infections requiring IV antibiotics to clear.

A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon? A. It causes a permanent increase in nasal secretions. B. It causes reflux of gastric contents into the esophagus. C. It causes an increase in nasal secretions after an initial decrease. D. It causes a decrease in histamine release after an initial increase.

C. It causes an increase in nasal secretions after an initial decrease.

The nurse is caring for a pediatric client who has a compromised immune system. When reviewing laboratory results, which bone marrow component identifies a dysfunction in bone marrow production? Select all that apply. A. Macrophages B. Antigens C. T lymphocytes D. B lymphocytes E. Haptens

C. T lymphocytes D. B lymphocytes

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse? A. The child should not have information about their health provided at this age. B. Children at this age should have full disclosure of their condition. C. When providing health information to a child of this age it should be simplistic and at the child's level of understanding. D. Once a child is apprised of their health concerns they do not normally experience any after affects.

C. When providing health information to a child of this age it should be simplistic and at the child's level of understanding.

A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl? A. "Do you notice any wheezing when you breathe or a runny nose?" B. "Do you have any shoulder pain or abdominal tenderness?" C. "Have you noticed any new bruising or different color patterns on your skin?" D. "Have you noticed any hair loss or redness on your face?"

D. "Have you noticed any hair loss or redness on your face?"

The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? A. 1900/mm3 B. 1700/mm3 C. 1500/mm3 D. 1300/mm3

D. 1300/mm3 Normal is 1500/mm3 in the infant, so anything below that number may indicate that the therapy is not effective.

The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority? A. Administer a corticosteroid. B. Ask if the child has allergies. C. Evaluate fluid volume status. D. Assess lung sounds bilaterally.

D. Assess lung sounds bilaterally.

Nursing students correctly label the group of cells whose job is to ingest, engulf, andneutralize pathogens as: A. macrophages. B. immunogens. C. immunoglobins. D. red blood cells.

A. macrophages.

A nursing instructor teaching a class about immunity asks the students to identify the organs of the immune system. Which would the nursing instructor want them to include? (Select all that apply.) A. lymph nodes B. bone marrow C. thymus D. liver E. spleen F. tonsils

A. lymph nodes B. bone marrow C. thymus E. spleen F. tonsils