Heme/HIV, Cancer Immune (Exam 1) Prep U Questions

The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity? A. "You have inherited your parent's immunity to the disease." B. "You are not immune to the disease causing the symptoms." C. "Your symptoms are a result of your body attacking itself." D. "You have antigens to the disease, but they do not prevent the disease."

C. "Your symptoms are a result of your body attacking itself."

A client calls the oncology office nurse and reports nausea and vomiting one week after receiving chemotherapy. What action should the nurse recommend? A. Obtaining acupressure treatments B. Practicing relaxation techniques C. Taking prescribed ondansetron D. Using imagery techniques

C. Taking prescribed ondansetron

Which of the following is the single largest preventable cause of cancer? A. Pesticides B. Tobacco C. Arsenic D. Asbestos

B. Tabacco

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis? A. joint swelling B. pain C. weakness D. stiffness

B. pain

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? A. Neutropenia B. Leukopenia C. Thrombocytopenia D. Anemia

C. Thrombocytopenia A normal platelet count is 140,000 to 400,000/mm3 in adults. Chemotherapeutic agents produce bone marrow depression, resulting in reduced red blood cell counts (anemia), reduced white blood cell counts (leukopenia), and reduced platelet counts (thrombocytopenia). Neutropenia is the presence of an abnormally reduced number of neutrophils in the blood and is caused by bone marrow depression induced by chemotherapeutic agents.

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? A. vigorous physical therapy for the joints. B. administration of monthly intra-articular injections of corticosteroids. C. administration of nonsteroidal anti-inflammatory drugs (NSAIDs) D. administration of opioids for pain control.

C. administration of nonsteroidal anti-inflammatory drugs (NSAIDs)

Cancer has many characteristics. What is one of the most discouraging characteristics of cancer? A. Large size tumors B. Slow growth C. Carcinogenesis D. Metastasis

D. Metastasis Metastasis is one of cancer's most discouraging characteristics because even one malignant cell can give rise to a metastatic lesion in a distant part of the body. Not all cancerous tumors are large in size. Carcinogenesis is the process of malignant transformation and it is not a characteristic of cancer. Cancer grows rapidly, not slowly.

A nurse is providing care for a client who has just been diagnosed as being in the early stage of rheumatoid arthritis. The nurse should anticipate the administration of what medication? A. Hydromorphone B. Allopurinol C. Prednisone D. Methotrexate

D. Methotrexate Once the diagnosis of RA is made, treatment should begin with either a nonbiologic or biologic DMARD. Recommended treatment guidelines include beginning with the nonbiologic DMARDs (methotrexate [Rheumatrex], leflunomide [Arava], sulfasalazine [Azulfidine]), or hydroxychloroquine (Plaquenil) within 3 months of disease onset. Allopurinol is used to treat gout. Opioids are not indicated in early RA. Prednisone is used in unremitting RA.

A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A. Confusion B. Pruritis (itching) C. Altered glucose metabolism D. Nausea and vomiting

D. Nausea and vomiting

A client's blood work reveals a platelet level of 17,000/mm3. When inspecting the client's integumentary system, what finding would be most consistent with this platelet level? A. Petechiae B. Urticaria C. Alopecia D. Dermatitis

A. Petechiae

Which stage of HIV infection is indicated when the results are more than 500 CD4+ lymphocytes/mm? A. Primary infection B. Stage 1 C. Stage 2 D. Stage 3

A. Primary infection A result between 500 and 1500 CD4+ T lymphocytes/mm3 indicates CDC stage 1.

A nurse is visiting the home of a client with AIDS who is experiencing HIV encephalopathy. When developing the plan of care for the client and his caregiver, the nurse identifies the nursing diagnosis of disturbed thought processes related to confusion and disorientation secondary to HIV encephalopathy. Which expected outcome would be most appropriate for the nurse to document on the client's plan of care? A. The client can state that he is at his home. B. The client nods that he understands the instructions. C. The client remains free of any injury when out of bed. D. The client engages in diversional activities.

A. The client can state that he is at his home. The most appropriate outcome for the nursing diagnosis would be that the client can state that he is in his home, which indicates that he is aware of his surroundings and location. Remaining free of injury when out of bed would be appropriate if the nursing diagnosis was risk for injury.

You are a clinic nurse. One of your clients has found she is at high risk for breast cancer. She asks you what can be done to reduce her risk. What is a means of reducing the risk for breast cancer? A. Palliative surgery B. Curative surgery C. Reduction surgery D. Prophylactic surgery

D. Prophylactic surgery Prophylactic or preventive surgery may be done if the client is at considerable risk for cancer. Palliative surgery is done when no curative treatment is available. Curative surgery is performed to cure the disease process. Reduction surgery is a distractor.

A client with acquired immunodeficiency syndrome is admitted with Pneumocystis carinii pneumonia. During a bath, the client begins to cry and says that most friends and relatives have stopped visiting and calling. What should the nurse do? A. Listen and show interest as the client expresses feelings. B. State that his friends' behavior shows they aren't true friends. C. Continue with the bath and tell the client not to worry. D. Ask the physician to obtain a psychiatric consultation.

A. Listen and show interest as the client expresses feelings.

When assessing a client with anemia, which assessment is essential? A. Lifestyle assessments, such as exercise routines B. Health history, including menstrual history in women C. Family history D. Age and gender

B. Health history, including menstrual history in women

A nurse is providing education to a client with iron deficiency anemia who has been prescribed iron supplements. What should the nurse include in health education? A. Limit foods high in fiber due to the risk for diarrhea. B. Iron will cause the stools to darken in color. C. Increase the intake of vitamin E to enhance absorption. D. Take the iron with dairy products to enhance absorption.

B. Iron will cause the stools to darken in color.

A nurse is performing the health history and physical assessment of a client who has a diagnosis of rheumatoid arthritis (RA). What assessment finding is most consistent with the clinical presentation of RA? A. Cool joints with decreased range of motion B. Joint stiffness, especially in the morning C. Visible atrophy of the knee and shoulder joints D. Signs of systemic infection

B. Joint stiffness, especially in the morning In addition to joint pain and swelling, another classic sign of RA is joint stiffness, especially in the morning. Joints are typically swollen, not atrophied, and systemic infection does not accompany the disease. Joints are often warm rather than cool.

The public health nurse is presenting a health promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America? A. Monthly self-breast exams B. Annual colonoscopies C. Smoking cessation D. Monthly testicular exams

C. Smoking cessation The leading causes of cancer death, in order of frequency, are lung, prostate, and colorectal cancer in men and lung, breast, and colorectal cancer in women. Smoking cessation is the health promotion initiative directly related to lung cancer.

Palliation refers to A. the spread of cancer cells from the primary tumor to distant sites. B. the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow. C. relief of symptoms of disease and promotion of comfort and quality of life. D. hair loss.

C. relief of symptoms of disease and promotion of comfort and quality of life.

A client received chemotherapy 24 hours ago. Which precautions are necessary when caring for the client? A. Wear sterile gloves. B. Place incontinence pads in the regular trash container. C. Provide a urinal or bedpan to decrease the likelihood of soiling linens. D. Wear personal protective equipment when handling blood, body fluids, and feces.

D. Wear personal protective equipment when handling blood, body fluids, and feces.

A client with rheumatoid arthritis informs the nurse that since he has been in remission and not having any symptoms, he doesn't need to take his medication any longer. What is the best response by the nurse? A. "It is important that you continue to take your medication to avoid an acute exacerbation." B. "If you don't take your medication, you will become very ill." C. "As long as you are not having symptoms, you can take a medication vacation." D. "Be sure to let the physician know after you stop your medications."

A. "It is important that you continue to take your medication to avoid an acute exacerbation."

A client who has been exposed to the human immunodeficiency virus (HIV) tests negative. Which explanation by the nurse would be most appropriate? A. "Your body may not have developed antibodies yet, so we need to follow up." B. "You're one of the lucky ones who are immune to the virus." C. "You might still go on to develop AIDS even with negative results." D. "Congratulations, a negative result means that you're not infected with the virus."

A. "Your body may not have developed antibodies yet, so we need to follow up."

Which client is more at risk of becoming infected with human immunodeficiency virus (HIV)? A. A person having causal intercourse with multiple partners B. A women who has never had intercourse C. A man who uses sildenafil before having intercourse A woman who has had deliveries after the age of 40

A. A person having casual intercourse with multiple partners

The nurse is aware that the most prevalent cause of immunodeficiency worldwide is A. Malnutrition B. Chronic diarrhea C. Neutropenia D. Hypocalcemia

A. Malnutrition

A child has just been diagnosed with a primary immune deficiency. The parents state, "Oh, no. Our child has AIDS." Which response by the nurse would be most appropriate? A. "Your child's condition is extremely serious. Like AIDS, it will most likely be fatal." B. "Although AIDS is an immune deficiency, your child's condition is different from AIDS." C. "Your child does not have AIDS but this condition puts your child at risk for it later in life." D. "We need to do some more testing before we will know if your child's condition is AIDS."

B. "Although AIDS is an immune deficiency, your child's condition is different from AIDS." Primary immune deficiencies should be not be confused with AIDS. They are not the same condition. In addition, a primary immune disorder does not increase the child's risk for developing AIDS later in life. Primary immune deficiency diseases are serious, but they are rarely fatal and can be controlled. Testing will reveal the evidence of a primary immune disease, not AIDS. AIDS is classified as a seconary immunodeficiency.

When preparing a client with acquired immunodeficiency syndrome (AIDS) for discharge to home, the nurse should be sure to include which instruction? A. "Put on disposable gloves before bathing." B. "Avoid eating foods from serving dishes shared by other family members." C. "Sterilize all plates and utensils in boiling water." D. "Avoid sharing such articles as toothbrushes and razors."

D. "Avoid sharing such articles as toothbrushes and razors."

A nurse is teaching a client about rheumatoid arthritis. Which statement by the client indicates understanding of the disease process? A. "When it clears up, it will never come back." B. "It will never get any better than it is right now." C. "I'll definitely need surgery for this." D. "It will get better and worse again."

D. "It will get better and worse again."

A client newly diagnosed with cancer is scheduled to begin chemotherapy treatment and the nurse is providing anticipatory guidance about potential adverse effects. When addressing the most common adverse effect, what should the nurse describe? A. Pruritis (itching) B. Altered glucose metabolism C. Confusion D. Nausea and vomiting

D. Nausea and vomiting

While asessing a client, the nurse will recognize what as the most obvious sign of anemia? A. Tachycardia B. Flow murmurs C. Jaundice D. Pallor

D. Pallor On physical examination, pallor is the most common and obvious sign of anemia. Other findings may include tachycardia and flow murmurs. Patients with hemolytic anemia may exhibit jaundice and splenomegaly.

A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive? A. Enzyme-linked immunosorbent assay (ELISA) B. Schick C. Western Blot D. Complete blood count (CBC)

A. Enzyme-linked immunosorbent assay (ELISA)

A client with end-stage renal disease has a decreased red blood cell production. What medication can the nurse administer with physician's order that will increase the production of erythrocytes? A. Epoetin alfa B. Pegfilgrastim C. Interleukin 2 D. Filgrastim

A. Epoetin alfa The drug epoetin alfa can be used to stimulate the production of RBCs. Filgrastim and pegfilgrastim promote proliferation of neutrophils. Interleukin 2 stimulates cytokine production by lymphocytes.

Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement? A. Hypertension B. Chest pain C. Behavioral changes D. Decreased cognitive ability

A. Hypertension

After being seen in the oncology clinic, a client with severe bone marrow suppression is admitted to the hospital. The client's cancer therapy consisted of radiation and chemotherapy. When developing the care plan for this client, which nursing diagnosis takes priority? A. Imbalanced nutrition: Less than body requirements B. Anxiety C. Risk for injury D. Risk for infection

D. Risk for infection

A client with an exacerbation of systemic lupus erythematosus (SLE) has been hospitalized on the medical unit. The nurse observes that the client expresses anger and irritation when her call bell isn't answered immediately. What would be the most appropriate response? A. "Would you like to talk about the problem with the nursing supervisor?" B. "You seem like you're feeling angry. Is that something that we could talk about?" C. "Try to remember that stress can make your symptoms worse." D. "I can see you're angry. I'll come back when you've calmed down."

B. "You seem like you're feeling angry. Is that something that we could talk about?"

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods? A. Dairy products B. Beans, dried fruits, and leafy, green vegetables C. Fruits high in vitamin C, such as oranges and grapefruits D. Berries and orange vegetables

B. Beans, dried fruits, and leafy, green vegetables Food sources high in iron include organ meats (e.g., beef or calf liver, chicken liver), other meats, beans (e.g., black, pinto, and garbanzo), leafy and green vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice) enhances the absorption of iron.

Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? A. Sucrose B. Liquids C. Gluten D. Iron and zinc

B. Liquids

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct? A. "OA and RA are very similar. OA affects the smaller joints and RA affects the larger, weight-bearing joints." B. "OA is more common in women. RA is more common in men." C. "OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints." D. "OA affects joints on both sides of the body. RA is usually unilateral."

C. "OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A client with early stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse? A. "The health care provider could prescribe antihypertensive drugs." B. "The health care provider could prescribe antineoplastic drugs." C. "The health care provider could prescribe anti-inflammatory drugs." D. "The health care provider could prescribe antipyretic drugs."

C. "The health care provider could prescribe anti-inflammatory drugs."

The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care? A. ability to perform activities of daily living (ADL) B. a weight gain of 2 pounds C. increased fatigue D. decreased joint pain

C. increased fatigue Fatigue is common with rheumatoid arthritis. Finding a balance between activity and rest is an essential part of the therapeutic regimen. The client is reporting being able to do ADLs and decreased joint pain. The client's weight gain of 2 pounds does not correlate with self-care problems.

A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate? A. "You should discuss that matter with your health care provider." B. "Tell me more about your concerns about this potential diagnosis." C. "SLE is a very serious systemic disorder." D. "The diagnosis won't be based on the findings of a single test but by combining all data found."

D. "The diagnosis won't be based on the findings of a single test but by combining all data found."

The patient diagnosed with thrombocytopenia is at risk for which of the following adverse effects: A. Headache B. Stomatitis C. Diminished reflexes D. Bleeding

D. Bleeding

A nurse is caring for a client with thrombocytopenia. What is the best way to protect this client? A. Maintain accurate fluid intake and output records. B. Encourage the client to use a wheelchair. C. Limit visits by family members. D. Use the smallest needle possible for injections.

D. Use the smallest needle possible for injections. Because thrombocytopenia alters coagulation, it poses a high risk of bleeding. To help prevent capillary bleeding, the nurse should use the smallest needle possible when administering injections.

A nursing instructor is evaluating a student caring for a neutropenic client. The instructor concludes that the nursing student demonstrates accurate knowledge of neutropenia based on which intervention? A. Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential B. Monitoring the client's blood pressure and reviewing the client's hematocrit C. Monitoring the client's heart rate and reviewing the client's hemoglobin D. Monitoring the client's breathing and reviewing the client's arterial blood gases

A. Monitoring the client's temperature and reviewing the client's complete blood count (CBC) with differential Clients with neutropenia often do not exhibit classic signs of infection. Fever is the most common indicator of infection, yet it is not always present. No definite symptoms of neutropenia appear until the client develops an infection. A routine CBC with differential can reveal neutropenia before the onset of infection.

A client who has AIDS is being treated in the hospital and admits to having periods of extreme anxiety. What would be the most appropriate nursing intervention? A. Teach the client guided imagery. B. Increase the client's activity level. C. Collaborate with the client's physician to obtain an order for hydromorphone. D. Give the client more control of her antiretroviral regimen.

A. Teach the client guided imagery.

To combat the most common adverse effects of chemotherapy, a nurse should administer an: A. antiemetic. B. anticoagulant. C. antibiotic. D. antimetabolite.

A. antiemetic.

The lower the client's viral load, A. the longer the survival time. B. the shorter the time to AIDS diagnosis. C. the longer the time immunity. D. the shorter the survival time.

A. the longer the survival time.

A client with systemic lupus erythematosus (SLE) has the classic rash of lesions on the cheeks and bridge of the nose. What term should the nurse use to describe this characteristic pattern? A. Papular rash B. Butterfly rash C. Bull's eye rash D. Pustular rash

B. Butterfly rash

A client with acquired immune deficiency syndrome (AIDS) comes to the clinic reporting difficulty swallowing. The client says, "It hurts so much when I swallow." Inspection reveals creamy white patches in the client's mouth. What will the nurse suspect? A. Clostridium difficile diarrhea B. Candidiasis C. Wasting syndrome D. Cryptococcus neoformans

B. Candidiasis

A nurse is monitoring the client's progression of human immunodeficiency virus (HIV). What debilitating gastrointestinal condition found in up to 90% of all AIDS clients should the nurse be aware of? A. Anorexia B. Chronic diarrhea C. Nausea and vomiting D. Oral candida

B. Chronic diarrhea

Which type of hemolytic anemia is categorized as inherited disorder? A. Autoimmune hemolytic anemia B. Sickle cell anemia C. Cold agglutinin disease D. Hypersplenism

B. Sickle cell anemia Glucose 6-phosphate dehydrogenase deficiency is an inherited abnormality resulting in hemolytic anemia. Autoimmune hemolytic anemia is an acquired anemia. Cold agglutinin disease is an acquired anemia. Hypersplenism results in an acquired hemolytic anemia.

Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group currently have the greatest risk of contracting HIV? A. Blood transfusion recipients B. Recreational drug users C. Gay, bisexual, and other men who have sex with men D. Health care providers

C. Gay, bisexual, and other men who have sex with men

The nurse care plan for a client with AIDS includes the diagnosis of Risk for Impaired Skin Integrity. What nursing intervention should be included in the plan of care? A. Provide total parenteral nutrition (TPN). B. Provide the client with snug clothing at all times. C. Keep the client's bed linens free of wrinkles. D. Maximize the client's fluid intake.

C. Keep the client's bed linens free of wrinkles.

A client newly diagnosed with thrombocytopenia is admitted to the medical unit. After the admission assessment, the client asks the nurse to explain the disease. What potential etiology should the nurse explain to this client? A. Impaired communication between platelets. B. An attack on the platelets by antibodies C. An autoimmune process causing platelet malfunction. D. Decreased production of platelets.

D. Decreased production of platelets.

A client on the oncology unit is receiving carmustine, a chemotherapy agent, and the nurse is aware that a significant side effect of this medication is thrombocytopenia. Which symptom should the nurse assess for in clients at risk for thrombocytopenia? A. Increased weight B. Hot flashes C. Interrupted sleep pattern D. Epistaxis

D. Epistaxis

A nurse who works in an oncology clinic is assessing a client who has arrived for a 2-month follow-up appointment following chemotherapy. The nurse notes that the client's skin appears yellow. Which blood tests should be done to further explore this clinical sign? A. Blood urea nitrogen and creatinine B. Platelet count C. Complete blood count (CBC) D. Liver function tests (LFTs)

D. Liver function tests (LFTs)