Immunity and metabolism text 4660

Which of the following is the most common HIV-related malignancy? Kaposi's sarcoma B-cell lymphoma Cervical carcinoma Pancreatic carcinoma

Kaposi's sarcoma

cirrhosis

a chronic liver disease characterized by fibrotic changes, the formation of dense connective tissue within the liver, subsequent degenerative changes, and loss of functioning cells

antihistamine

medication that opposes the action of histamine

A patient is suspected of having myositis. The nurse prepares the patient for what procedure that will confirm the diagnosis? Bone scan Computed tomography (CT) Magnetic resonance imaging (MRI) Muscle biopsy

muscle biopsy

endoscopic variceal ligation (EVL)

procedure that uses a modified endoscope loaded with an elastic rubber band passed through an overtube directly onto the varix (or varices) to be banded to ligate the area and stop bleeding

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? Western Blot Schick Enzyme-linked immunosorbent assay (ELISA) Complete blood count (CBC)

Enzyme-linked immunosorbent assay (ELISA)

A nurse is caring for a client with cirrhosis. The nurse assesses the client at noon and discovers that the client is difficult to arouse and has an elevated serum ammonia level. The nurse should suspect which situation? The client's hepatic function is decreasing. The client didn't take his morning dose of lactulose (Cephulac). The client is relaxed and not in pain. The client is avoiding the nurse.

The client's hepatic function is decreasing.

A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test? Western blot assay OraSure test p24 antigen capture assay Nucleic acid sequence-based amplification

Western blot assay

orthotopic liver transplantation (OLT)

grafting of a donor liver into the normal anatomic location, with removal of the diseased native liver

A nurse is assesing a client with Kaposi's sarcoma. What initial sign does the nurse know to look for during assessment? Severe joint pain Lymphedema of the lower extremities Deep purple cutaneous lesions Venous stasis and phlebitis formation

Deep purple cutaneous lesions

ascites

an albumin-rich fluid accumulation in the peritoneal cavity

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider? colchicine probenecid anturane allopurinol

colchicine

Type 4 hypersensitivity

delayed-type an immune reaction in which T-cell-dependent macrophage activation and inflammation cause tissue injury. This type of reaction to the subcutaneous injection of antigen is often used as an assay for cell-mediated immunity

What education should the nurse provide to the patient taking long-term corticosteroids? The patient should not stop taking the medication abruptly and should be weaned off of the medication. The patient should take the medication only as needed and not take it unnecessarily. Corticosteroids are relatively safe drugs with very few side effects. The patient should discontinue using the drug immediately if weight gain is observed.

The patient should not stop taking the medication abruptly and should be weaned off of the medication.

fulminant hepatic failure

sudden, severe onset of acute liver failure that occurs within 8 weeks after the first symptoms of jaundice

A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? Sign a refusal of blood transfusion form so the client will not receive the transfusion. Bank autologous blood. Ask people to donate blood. Using volume expanders in case blood is needed.

Bank autologous blood.

A client with acquired immune deficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed? MAC Wasting syndrome Kaposi's sarcoma Candidiasis

Candidiasis

jaundice

condition where the body tissues, including the sclerae and the skin, become tinged yellow or greenish-yellow, due to high bilirubin levels

Type 2 hypersensitivity

cytotoxic occurs when the system mistakenly identifies a normal constituent of the body as foreign may be the result of a cross-reacting antibody, possibly leading to cell and tissue damage. Examples: myasthenia gravis, goodpasture syndrome

The nurse is administering intravenous vancomycin. What will the nurse initially assess the client for if an allergic reaction occurrs? dyspnea, bronchospasm, and/or laryngeal edema hypotension and tachycardia the presence and location of pruritus the severity of cutaneous warmth and flushing

dyspnea, bronchospasm, and/or laryngeal edema

eosinophil

granular leukocyte

Which term refers to an incomplete antigen? Hapten Allergen Antigen Antibody

hapten

The nurse is working with a client with allergies. What will the nurse use to confirm allergies and decrease the risk of anaphylaxis? intradermal testing nasal smear punch biopsy peripheral blood smears

intradermal testing

Ac client with a lengthy history of alcohol addiction is diagnosed with cirrhosis. The nurse emphasizes that the principal goal of cirrhosis therapy is: preserving liver function. curing the illness. restoring fat-soluble vitamin absorption. increasing alcohol tolerance.

preserving liver function.

Histamine

substance in the body that causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication? Take the medication on an empty stomach in order to increase effectiveness. Since the medication is able to be obtained over the counter, it has few side effects. Take the medication with food to avoid stomach upset. Inform the health care provider if there is ringing in the ears.

Take the medication with food to avoid stomach upset.

A client has been diagnosed with HIV and has been placed on antiretroviral therapy. What does the nurse inform the client will be required for determining the progression of the disease as well as guiding drug therapy? The client will be required to stop the medication for 2 weeks and then have laboratory studies drawn to determine if the antiretroviral therapy has cured the disease. Viral load and T4-cell counts will be performed every 2 to 3 months. More antiretroviral medication will be added every 2 to 3 months. The Western blot test will be monitored every 6 months to see if the virus is still present.

Viral load and T4-cell counts will be performed every 2 to 3 months.

leukotrienes

a group of chemical mediators that initiate the inflammatory response

Bradykinin

a substance that stimulates nerve fibers and causes pain

Hypersensitivity

abnormal heightened reaction to a stimulus of any kind

Type 1 hypersensitivity

anaphylactic reaction most severe type characterized by edema in many tissues, including the larynx, and is often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases immediate reaction beginning within minutes of exposure to an antigen primary chemical mediators are responsible for symptoms Clinical symptoms are determined by the amount of the allergen, the amount of mediator released, the sensitivity of the target organ, and the route of allergen entry may include both local and systemic anaphylaxis.

Total parental nutrition (TPN) should be used cautiously in clients with pancreatitis because such clients: cannot tolerate high-glucose concentration. are at risk for gallbladder contraction. are at risk for hepatic encephalopathy. can digest high-fat foods.

cannot tolerate high-glucose concentration.

hepatic encephalopathy

central nervous system dysfunction frequently associated with elevated ammonia levels that produce changes in mental status, altered level of consciousness, and coma

A client is diagnosed with atopic dermatitis and asks the nurse why the skin is so dry and itchy. What is the nurse's best response? Large amounts of histamine in the skin Changes in lipid content Decrease in serum IgE levels Increased basophils

change in lipid content

A patient develops gastrointestinal bleeding from a gastric ulcer and requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I don't want to get AIDS." What is the best response by the nurse? "I understand what you mean, you can never be sure if the blood is tainted." "I understand your concern. The blood is screened very carefully for different viruses as well as HIV." "If you don't have the blood transfusions, you may not make it through this episode of bleeding." "No one has gotten HIV from blood in a long time. You have to have the transfusion."

"I understand your concern. The blood is screened very carefully for different viruses as well as HIV."

The nurse is instructing a male client about safer sexual behaviors. Which client statement indicates a need for additional instruction? "I will apply baby oil to lubricate the condom." "I should use a new condom each time I have sex." "My partner and I should avoid manual-anal intercourse." "After having sex, I should hold onto the condom when pulling out."

"I will apply baby oil to lubricate the condom."

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? "You need to come back to the clinic to get a different medication since this one is not working for you." "You may be immune to the effects of this medication and will need something else in its place." "The full benefit of the medication may take up to 2 weeks to be achieved." "I am sorry that you are feeling poorly but this is the only medication that will work for your problem."

"The full benefit of the medication may take up to 2 weeks to be achieved."

The nurse tells the client that if exposure to an allergen occurs around 8:00 AM, then the client should expect a mild or moderate reaction by what time? 10:00 AM 11:00 AM 1:00 PM 3:00 PM

10:00 AM

The nurse is evaluating the plan of care for a client with an allergic disorder who has a nursing diagnosis of deficient knowledge related to measures for allergy control. What client statement will indicate to the nurse that the outcome has been met? Client states the need for coughing and deep breathing. Client demonstrates appropriate coping strategies for dealing with a chronic disorder. Client identifies methods for reducing exposure risk to allergens. Client reports an absence of symptoms associated with the allergy.

Client identifies methods for reducing exposure risk to allergens.

The nurse is performing an admission assessment on a patient with AIDS. When assessing the patient's gastrointestinal (GI) system what is most likely to be the priority nursing diagnosis? Imbalanced nutrition: more than body requirements Diarrhea Bowel incontinence Constipation

Diarrhea

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? Diphenhydramine Omeprazole Cimetidine Ranitidine

Diphenhydramine

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment? Dyspnea, bronchospasm, and/or laryngeal edema. Hypotension and tachycardia The presence and location of pruritus The severity of cutaneous warmth and flushing

Dyspnea, bronchospasm, and/or laryngeal edema.

What test should the nurse prepare the client for that will locate stones that have collected in the common bile duct? Colonoscopy Abdominal x-ray Cholecystectomy Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP)

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care? Reports ability to perform ADLs Reports decreased joint pain Shows increased joint flexibility Has a weight gain of 5 pounds

Has a weight gain of 5 pounds

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? Histamine Bradykinin Serotonin Prostaglandin

Histamine

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

Hypertension

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action? Avoids massaging the injection site after administration Jabs the autoinjector into the outer thigh at a 90-degree angle Pushes down on the grey release cap to administer the medication Maintains pressure on the auto-injector for about 30 seconds after insertion

Jabs the autoinjector into the outer thigh at a 90-degree angle

While conducting a physical examination of a client, which of the following skin findings would alert the nurse to the possibility of liver problems? Select all that apply. Jaundice Petechiae Ecchymoses Cyanosis of the lips Aphthous stomatitis

Jaundice Petechiae Ecchymoses

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

Liquids

Which of the following are common sites of visceral involvement of Kaposi's sarcoma? Select all that apply. Lymph nodes Gastrointestinal tract Lungs Brain Heart

Lymph nodes Gastrointestinal tract Lungs

Which joint is most commonly affected in gout? Metatarsophalangeal Tarsal area Ankle Knee

Metatarsophalangeal

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"? Be sure to use the nasal spray for at least 10 days to ensure the stuffiness is gone. Use the medication every 4 hours to prevent congestion from recurring. Drink plenty of fluids. Only use the nasal spray for 3 to 4 days once every 12 hours.

Only use the nasal spray for 3 to 4 days once every 12 hours.

The nurse administers an injection to a client with AIDS. When finished, the nurse attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? Obtain counseling. Call the lab to draw the nurse's blood. Fill out a risk management report. Report the incident to the supervisor.

Report the incident to the supervisor.

Which acts as a potent vasoconstrictor and causes bronchial smooth muscle to contract? Bradykinin Serotonin Prostaglandin Platelet-activating factor

Serotonin

Which of the following medications would the nurse expect the physician to order for a client with cirrhosis who develops portal hypertension? Spironolactone (Aldactone) Kanamycin (Kantrex) Lactulose (Cephulac) Cyclosporine (Sandimmune)

Spironolactone (Aldactone)

A nurse is implementing appropriate infection control precautions for a client who is positive for human immunodeficiency virus (HIV). The nurse demonstrates a need for a review of transmission routes by identifying which body fluid as a means of transmission? Urine Semen Blood Breast milk

Urine

While interviewing a client with an allergic disorder, the client tells the nurse about an allergy to animal dander. The nurse knows that animal dander is what type of substance? Immunoglobulin Complete protein antigen Chemical mediator T-lymphocyte

complete protein antigen

angioneurotic edema

condition characterized by urticaria and diffuse swelling of the deeper layers of the skin (i.e., angioedema)

constructional apraxia

inability to draw figures in two or three dimensions

haoten

incomplete antigen

fetor hepaticus

sweet, slightly fecal odor to the breath, presumed to be of intestinal origin; prevalent with the extensive collateral portal circulation in chronic liver disease

atopy

term often used to describe immunoglobulin E-mediated diseases (i.e., atopic dermatitis, asthma, and allergic rhinitis) with a genetic component

sclerotherapy

the injection of substances into or around esophagogastric varices to cause constriction, thickening, and hardening of the vessel and stop bleeding

IgG

the most common, present in all body fluids, binds to viruses and bacteria

xenograft

transplantation of organs from one species to another

atopic dermatitis

type I hypersensitivity involving inflammation of the skin evidenced by itching, redness, and a variety of skin lesions

prostaglandins

unsaturated fatty acids that have a wide assortment of biologic activity

The balance between the amount of HIV in the body and the immune response is the viral load test. viral set point. window period. anergy.

viral set point

The nurse is assisting the physician with a procedure to remove ascitic fluid from a client with cirrhosis. What procedure does the nurse ensure the client understands will be performed? Thoracentesis Abdominal paracentesis Abdominal CT scan Upper endoscopy

Abdominal paracentesis

An important message for any nurse to communicate is that drug-induced hepatitis is a major cause of acute liver failure. The medication that is the leading cause is: Acetaminophen Ibuprofen Dextromethorphan Benadryl

Acetaminophen

What is the priority intervention for a client who has been admitted repeatedly with attacks of gout? Assess diet and activity at home Place client on bed rest Increase fluids Insert a Foley catheter

Assess diet and activity at home

The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: Anorexia. Chronic diarrhea. Nausea and vomiting. Oral candida.

Chronic diarrhea

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about? Sublingual-swallow immunotherapy (SLIT) Desensitization Sublingual-topical immunotherapy (STIT) Resensitization

Desensitization

IgM

blood and lymph fluid, first antibody made by body to fight a new infection

serotonin

chemical mediator that acts as a potent vasoconstrictor and bronchoconstrictor

Mast cells

connective tissue cells that contain heparin and histamine in their granules

erythema

diffuse redness of the skin

portal hypertension

elevated pressure in the portal circulation resulting from obstruction of venous flow into and through the liver 2 major consequences of this are ascites and varices

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid? cromolyn sodium fluticasone zileuton fexofenadine

fluticasone

IgE

found in lungs, skin, and mucous membranes

urticaria

hives

type 3 hypersensitivity

immune complex involves immune complexes that are formed when antigens bind to antibodies complexes are cleared from the circulation by phagocytic action. If these type III complexes are deposited in tissues or vascular endothelium, two factors contribute to injury: the increased amount of circulating complexes and the presence of vasoactive amines As a result, there is an increase in vascular permeability and tissue injury.

asterixis

involuntary flapping movements of the hands may be seen in stage II encephalopathy

The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess? low back pain increased urine output red, butterfly-shaped facial rash patchy hair loss on the scalp

low back pain

B cells

lymphocyte cells that are important in producing circulating antibodies

T cells

lymphocyte cells that can cause graft rejection, kill foreign cells, or suppress production of antibodies

The nurse is teaching a client about histamine release during an anaphylactic reaction. What does histamine release in anaphylaxis cause? nasal congestion feeling of impending doom urinary urgency stomach cramps

nasal congestion

Fibromyalgia is a common condition that involves chronic fatigue, generalized muscle aching, and stiffness. pain, viral infection, and tremors. diminished vision, chronic fatigue, and reduced appetite. generalized muscle aching, mood swings, and loss of balance.

chronic fatigue, generalized muscle aching, and stiffness.

rheumatoid arthritis (RA)

chronic systemic inflammatory disease caused by environmental and genetic factors. Immune complexes cause exacerbation which leads to connective tissue destruction. Affects synovial tissue, especially in small joints, and can lead to deformities and pain, Inflammation, tenderness, stiffness in the joints. Muscle atrophy occurs after several years. Scar tissue build up and deformity is common.

A nurse is caring for a client with a warm and painful toe from gout. What medication will the nurse administer? aspirin furosemide colchicine calcium gluconate

colchicine

IgA

found in mucous membranes, respiratory and GI tract, saliva, and tears

A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines? Diarrhea Anorexia Palpitations Sedation

sedation

Allergen

substance that causes manifestations of allergy

Assessment findings for RA

Physical and emotional stress Impedes blood flow from tissue (ischemia) and necrosis. It is usually aching and sore in the morning. Bilateral small joints are affected with moderate pain for 30 min. Fatigue, weakness, anorexia, and anemia can occur because of the RA.

The nurse completes a history and physical assessment on a client with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital with respiratory complications. The nurse knows to assess for what common infection (80% occurence) in persons with AIDS? Cytomegalovirus Legionnaire's disease Mycobacterium tuberculosis Pneumocystis pneumonia

Pneumocystis pneumonia

The nurse is caring for a client with cirrhosis. Which assessment findings indicate that the client has deficient vitamin K absorption caused by this hepatic disease? Dyspnea and fatigue Ascites and orthopnea Purpura and petechiae Gynecomastia and testicular atrophy

Purpura and petechiae

A client with cirrhosis has portal hypertension, which is causing esophageal varices. What is the goal of the interventions that the nurse will provide? Cure the cirrhosis. Treat the esophageal varices. Reduce fluid accumulation and venous pressure. Promote optimal neurologic function.

Reduce fluid accumulation and venous pressure.

A client taking abacavir has developed fever and rash. What is the priority nursing action? Administer acetaminophen. Document the information. Report to the health care provider. Administer lidocaine cream for the rash.

Report to the health care provider.

Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as containing the genetic viral material? Deoxyribonucleic acid (DNA) Ribonucleic acid (RNA) Viral core Glycoprotein envelope

Ribonucleic acid (RNA)

A nurse is preparing a discharge teaching plan for a client with atopic dermatitis. Which instruction should the nurse include in the teaching plan? Wear only synthetic fabrics. Use a topical skin moisturizer daily. Bathe only three times per week. Keep the thermostat above 75° F (23.9° C).

Use a topical skin moisturizer daily.