Immunity Practice Questions

The nurse is caring for a child with a severe peanut allergy who is enrolled in a clinical trial for epicutaneous immunotherapy. The parent asks, "How will this be done?" How should the nurse respond? "Your child will be given an oral peanut protein formulation." "A patch with the allergen will be placed on the skin daily." "Your child will be exposed to peanuts and receive an injection that reduces the amount of histamine that is released." "Your child will be exposed to the allergen with a subcutaneous injection."

"A patch with the allergen will be placed on the skin daily."

The nurse is interviewing an adolescent to determine the risk of HIV transmission. Which question by the nurse would be least therapeutic? "Have you discussed use of barrier contraception to prevent HIV transmission?" "Would you feel more comfortable having your sexual partner present?" "Have you considered that there are other methods of maintaining closeness in a relationship that do not increase your risk of HIV?" "Are you aware that HIV and AIDS results from promiscuous sexual activity?"

"Are you aware that HIV and AIDS results from promiscuous sexual activity?"

A patient with systemic lupus erythematosus (SLE) is diagnosed with thrombocytopenia. The nurse teaches the patient to avoid aspirin and NSAIDs. The patient asks, "Why can't I take aspirin for my joint pain?" Which response by the nurse is accurate? "Aspirin will increase your risk of bleeding." "Aspirin will worsen the symptoms of SLE." "Aspirin is not effective for pain management." "Aspirin increases the risk of blood clotting."

"Aspirin will increase your risk of bleeding."

A patient who is HIV positive informs the nurse about being pregnant. Which instruction should the nurse give to the patient? "Continue taking antiretroviral therapy." "Refrain from taking any medications." "Seek medical attention from a geneticist." "I recommend you obtain an abortion."

"Continue taking antiretroviral therapy."

The nurse is preparing to administer an measles-mumps-rubella (MMR) booster to a 28-year-old female patient. Which question should the nurse ask prior to administration? "Are you around young children frequently?" "Could you be pregnant or are you planning to get pregnant?" "Are you allergic to eggs?" "Have you had your flu vaccine yet this year?"

"Could you be pregnant or are you planning to get pregnant?"

A patient is undergoing diagnostic testing to determine immune system function. Which question should the nurse ask during the health history portion of the assessment? "Are you a vegan?" "Does anyone in your family have an immune disorder?" "How tall are you?" "Do you have any infections right now that you know of?"

"Does anyone in your family have an immune disorder?"

The nurse is conducting a health history of a patient suspected of having systemic lupus erythematosus (SLE). Which question should the nurse ask in the focused assessment? "Do you have any allergies?" "Have you traveled out of the country in the past year?" "Have you been prescribed any new medications over the past year?" "Have you recently experienced any illness?"

"Have you been prescribed any new medications over the past year?"

The nurse is teaching a patient diagnosed with systemic lupus erythematosus about immunosuppressive therapy. Which patient statement demonstrates an understanding of the side effects? "I don't have to use contraception because I am more than 40 years old." "I will call the medical office if I develop fever or chills." "I will take my medications first thing in the morning on an empty stomach to help with medication absorbtion." "I can take aspirin for joint pain because nothing is wrong with my kidneys."

"I will call the medical office if I develop fever or chills."

The nurse is evaluating a patient's ability to manage an allergic anaphylactic reaction. Which patient statement indicates that further teaching is needed? "I will make sure my EpiPen kit is immediately available." "I will seek medical attention if I have to use my EpiPen." "I will seek medical attention if my EpiPen does not work." "I will carry a medical alert card in my wallet."

"I will carry a medical alert card in my wallet."

A nurse is teaching a patient about taking antibiotics. Which patient statement effective teaching? "I will wean off the drug slowly." "I will avoid drinking too much water." "I will stop taking the medicine once I feel better." "I will not chew or crush the tablets."

"I will not chew or crush the tablets."

The nurse is caring for a child who presented with hives on the anterior and posterior trunk. Which statement by the child may be an indicator of an emergent hypersensitivity reaction? "My skin is so itchy." "My tongue feels funny." "My stomach feels sick." "My head does not feel good."

"My tongue feels funny."

The nurse is caring for a patient with an autoimmune dysfunction. The patient asks, "Are there any treatments that can target my specific disease?" Which response by the nurse is accurate? "Targeted biologic therapies are not well tolerated for autoimmune disorders." "Targeted biologic therapies are inconvenient to dispense." "Targeted biologic therapies can be tailored to individual patients." "Targeted biologic therapies are really expensive."

"Targeted biologic therapies can be tailored to individual patients."

A patient with systemic lupus erythematosus (SLE) wants to know the options for contraceptives to prevent pregnancy. Which response by the nurse is appropriate for this patient? "The estrogen in oral contraceptives has been known to trigger an acute exacerbation of SLE." "Condoms are not recommended because of latex allergies associated with SLE." "The only form of contraception appropriate for you is abstinence." "Women with SLE have trouble conceiving, so you don't have to worry about contraception."

"The estrogen in oral contraceptives has been known to trigger an acute exacerbation of SLE."

A patient diagnosed with systemic lupus erythematosus (SLE) asks what caused the disease. Which response by the nurse is the most accurate? "The cause can be different in different people." "You will have to ask your healthcare provider that question." "The exact cause of SLE is not known." "It is caused by abnormal, overactive functioning of the immune system."

"The exact cause of SLE is not known."

The nurse is teaching a patient prescribed a leukotriene modifier for treatment of asthma. Which information by the nurse describes the effects of leukotriene modifiers? "The medication will dry up your nasal secretions." "The medication has a bronchodilator effect to help you breathe better." "This medication may make you feel drowsy." "The medication will reduce inflammation and nasal congestion."

"The medication will reduce inflammation and nasal congestion."

when do IgM levels increase in babies?

9 months

A nurse is admitting a child who has severely symptomatic HIV. Which of the following findings should the nurse expect? SATA A> Kaposi's sarcoma B. Hepatitis C. Wasting syndrome D. Pulmonary candidiasis E. Cardiomyopathy

A C D

A nurse is preparing to administer enfuvirtide to a client. Which of the following actions should the nurse plan to perform? SATA A. Administer the drug subcutaneously B. Discard the unused portion C. Roll the vial gently to reconstitute the solution D. Inject the solution at room temperature E. Expect a cloudy solution

A C D

A nurse is administering an Measles-Mumps-Rubella (MMR) vaccination to a child. Which type of immunity does this provide? Passive Natural Innate Active

Active

1. A nurse is developing a plan of care for a client who recently diagnosed with HIV. The client states, "I don't plan on giving up sex just because I am HIV positive." Based on this date, which nursing diagnosis is the priority for this client? a. Risk for infection b. Deficient knowledge c. Death anxiety d. Social isolation

B

A nurse is caring for a client who has WBC count of 20,000mm3. The nurse should conclude that the client has which of the following? A. Neutropenia B. Leukocytosis C. Left shift D. Leukopenia

B

A nurse is caring for a client who has a new prescription for ritonavir and zidovudine therapy to treat HIV-1. The nurse should inform the client that zidovudine is prescribed with ritonavir for which of the following reasons? A. To prevent an infusion reaction B. To increase platelet production C. To protect healthy cells from the toxic effects of ritonavir D. To prevent drug resistance

D

A nurse is caring for a client who is taking ritonavir, a protease inhibitor to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication? A. Increased TSH level B. Decreased ALT level C. Hypoglycemia D. Hyperlipidemia

D

A nurse is caring for a client who underwent RAST testing due to seasonal allergies. The nurse should anticipate an elevation in which of the following immunoglobulin laboratory values? A. IgM B. IgA C. IgG D. IgE

D

A nurse is performing a preoperative assessment of a client about to undergo a cholecystectomy. The nurse should identify a risk for a latex allergy when the client reports an allergy to which of the following foods? A. Cabbage B. Oatmeal C. Milk D. Bananas

D

drug that has adverse effect of Stevens-Johnson syndrome

Delavirdine

enfuvirtide drug class

HIV fusion inhibitor

______antibody results from secondary to exposure to the foreign antigen and is responsible for antivral and antibacterial activity

IgG

Which potential problem is the priority for the nurse to address while charting a plan of care for a patient with a hypersensitivity reaction? Impaired skin integrity Ineffective airway clearance Acute pain Altered nutrition

Ineffective airway clearance

The nurse is planning care for a patient with discoid systemic lupus erythematosus. Which intervention should the nurse include? Instruct the patient to report fever and chills. Teach the patient to monitor for ankle edema. Instruct the patient to limit the use of cosmetics. Teach the patient about the importance of proper hand hygiene.

Instruct the patient to limit the use of cosmetics.

The nurse is caring for a patient who has recently received a stem cell transplant. The patient presents to the clinic with clinical symptoms of graft-versus-host disease. Which finding should the nurse anticipate during the assessment of the patient? Splenomegaly Bronchoconstriction Jaundice Proteinuria

Jaundice

The nurse is caring for a patient at risk for hemolysis due to an allergic reaction. Which assessment finding would indicate that the patient is experiencing a hemolytic reaction? Pallor Jaundiced skin Edematous nasal mucosa Slow wound healing

Jaundiced skin

The nurse is reviewing the medical record of a patient diagnosed with severe, persistent asthma exacerbated by seasonal allergies. Which medication should the nurse expect on the patient's medication record? Antihistamine Leukotriene modifier Calcium channel blocker Epinephrine pen

Leukotriene modifier

Which collaborative intervention should a nurse expect to implement for a patient with systemic lupus ertythramatosis (SLE) and anemia? Platelet transfusion Medication that stimulates red cell production Immunosuppressant agent Disease-modifying antirheumatic drug

Medication that stimulates red cell production

Which nursing intervention is the priority for the nurse to include in the plan of care for the patient diagnosed with systemic lupus erythemtosis (SLE)? Monitoring intake and output. Monitoring dietary intake. Monitoring weight. Monitoring medication use.

Monitoring intake and output.

become directly incorporated into HIV DNA chain's reverse transcriptase, which is necessary to take the HIV virus' RNA and insert it into the host cell's DNA...directly interfere with replication of HIV virus by stopping growth of DNA strand

NNRTI

drug class of zidovudine

NRTI

A patient presents with a history of systemic lupus erythematosus (SLE) and reports "painful swollen joints." Which prescribed medication should the nurse anticipate? Antimalarial drug Immunosuppressive agent Topical corticosteroid Nonsteroidal anti-inflammatory drug (NSAID)

Nonsteroidal anti-inflammatory drug (NSAID)

The nurse is caring for a patient with AIDS who reports painful mouth sores related to candidiasis. The patient is losing weight due to the sores and a poor appetite. Which nursing intervention is appropriate for this patient? Administering parenteral nutrition Providing tube feedings Administering megestrol Offering soft foods

Offering soft foods

A patient is undergoing a skin test to assist with diagnosis of a hypersensitivity reaction. Which action should the nurse take when the healthcare provider orders a prick test? Place a patch with the allergen on the skin Puncture the skin through the diluted allergenic extract Inject the allergen extract intradermally Instruct the patient to swallow a pill with the allergen

Puncture the skin through the diluted allergenic extract

examples of type III hypersensitivity reaction

RA, serum sickness, SLE, post-streptococcal glomerulonephritis

what are the three types of lymphocytes?

T cells B cells NK cells

A patient with inflamed lymph nodes asks the nurse, "Why are my lymph nodes enlarged?" Which information provided to the patient is correct? The lymph nodes serve as a site for maturation of the T-cells. The lymph nodes ingest foreign bodies from the blood. The lymph nodes help to filter foreign antigens from the lymph. The lymph nodes protect the body from inhaled or ingested foreign antigens.

The lymph nodes help to filter foreign antigens from the lymph.

The nurse is prioritizing care for a patient with AIDS that presents with malabsorption related to wasting syndrome. Which collaborative intervention would most benefit this patient to improve their nutritional status? Diet high in protein Enteral tube feedings Total parenteral administration Oral nutritional supplements

Total parenteral administration

Ten minutes after the start of infusion, a patient complains of itching. The nurse observes that the lips and tongue are swollen. Which type of reaction should the nurse document in the patient's medical record? Type II Type III Type I Type IV

Type I

A patient is experiencing a hypersensitivity response triggered by hayfever. Which type of hypersensitivity response should the nurse anticipate? Type I Type II Type III Type IV

Type I response

A patient is admitted to the emergency department with red, itchy patches on both legs that appeared 24 hours after returning from an overnight camping trip. Which type of hypersensitivity response does the nurse expect the patient to be experiencing? Type I Type IV Type III Type II

Type IV

Which factor best explains the increase in HIV and AIDS in older adults? Tattoos Polypharmacy Sharing of needles Unprotected sexual activity

Unprotected sexual activity

where are histocytes located?

body tissue (skin)

what is the function of Natural Killer (NK) Cells

cytotoxicity (killing of tumor cells, fungi, viral-infected cells, and foreign tissue)

_________ class treats HIV diseases that is advanced, or when there is resistance to other types of drugs

entry and fusion inhibitors

what are the three types of granulocytes?

neutrophils eosinophils basophils

The nurse asks a patient who reports frequent infections about sleep patterns. The patient admits to only sleeping 4-5 hours at night and asks, "Why is that relevant?" Which response by the nurse is accurate? "People who don't get enough non-REM sleep can have immunosuppression." "I can have the doctor who works in our sleep study lab explain it to you in detail." "People who don't get enough non-REM sleep can have bone marrow suppression." "It's part of the wellness assessment questions. There is no impact of sleep on immune function."

"People who don't get enough non-REM sleep can have immunosuppression."

The mother of a 2-month-old breast-fed infant asks why the child needs immunizations since the mother is already passing along antibodies as protection to the child. Which response by the nurse is the most appropriate? "To protect against any infections, your infant must receive all the immunizations as scheduled." "The immunity that your baby received from you is going to disappear over time." "Breastfeeding will protect your baby against all infections." "Breastfeeding must be continued until 10 months in order to convey the best possible immunity."

"The immunity that your baby received from you is going to disappear over time."

A patient is prescribed plasmapheresis for treatment of glomerulonephritis. The patient asks the nurse, "Why does my blood need to go through a machine?" Which response by the nurse is accurate? "The machine removes the antigens that are causing your illness from your blood." "The machine replaces your red blood cells with new ones." "The machine removes the harmful components in the plasma." "The machine will remove the antibodies from your blood."

"The machine removes the harmful components in the plasma."

1. The nurse is reviewing the laboratory results of a client who is newly diagnosed with AIDS. Which result would be considered potentially problematic and should be reported to the client's HCP? a. CD4 cell count of 195/mm3 b. Viral load 6500 copies/mL c. Negative tuberculin skin test d. WBC count of 6500/mm3

A

A nurse is caring for a client who is suspected of having HIV. The nurse should identify that which of the following diagnostic tests and laboratory values are used to confirm HIV infection? SATA A. Western blot B. Indirect immunofluorescence assay C. CD 4+ T-lymphocyte count D. HIV RNA quanitification test E. CSF analysis

A B

A nurse is caring for a client who has a prescription for maraviroc therapy. The nurse should instruct the client to report which of the following adverse effects? SATA A. Paresthesia B. Cough C. Tinnitus D. Jaundice E. Fever

A B D E

A nurse in an outpatient clinic is assessing a client who reports night sweats and fatigue. The client reports having a cough along with nausea and diarrhea. Their temperature is 100.6F orally. The client is concerned about the possibility of having HIV. Which of the following actions should the nurse take? SATA A. Perform a physical assessment B. Determine when manifestations began C. Teach the client about HIV transmission D. Draw blood for HIV testing E. Obtain a sexual history

A B E

The nurse is teaching a group of college students ways to prevent contracting HIV. Which should the nurse include as an effective way to prevent HIV transmission? Refraining from drinking from the same glass after others Limiting the number of people with whom they share needles Abstinence from any sexual activity Meticulous hand washingafter using restroom

Abstinence from any sexual activity

ACID mnemonic

Allergic (type I) Cytotoxic (type II) Immune complex deposition (type III) Delayed or cell-mediated (TYpe IV)

Which diagnostic test should the nurse anticipate to be ordered as most specific for systemic lupus erythematosus (SLE)? CT scan with contrast Complete blood count (CBC) Anti-DNA antibody testing Erythrocyte sedimentation rate (ESR)

Anti-DNA antibody testing

The nurse is preparing a presentation for colleagues on factors involved in immunity. Which information should be included to explain why an older adult may be more prone to infections? Hypersensitivity response is increased. Antibody response to foreign antigens is diminished. Insulin susceptibility is increased. Autoantibodies are less common.

Antibody response to foreign antigens is diminished.

A nurse is caring for a pediatric patient who is not uptodate with the recommended vaccines. Which action by the nurse is most appropriate? Ask the parents why the child is not up to date with the recommended vaccines. Inform the parents that vaccination is a requirement of the practice and the child's school. Draw up the missing vaccines for administration during this visit. Prepare a packet of patient education to give to the parents about the safety of vaccinations.

Ask the parents why the child is not up to date with the recommended vaccines.

The nurse is caring for a patient who presents with symptoms of urticaria on both hands. Which disease in the patient's history is considered as a risk factor related to this hypersensitivity reaction? Hepatitis A Atrial fibrillation Acute kidney injury Asthma

Asthma

The nurse is providing discharge instructions for a patient with systemic lupus erythematosus (SLE). Which information should the nurse include? Avoid exposure to sunlight. Limit exercise. Treat infections with sulfonamides. Avoid flu vaccine.

Avoid exposure to sunlight.

1. A nurse is assessing a client who has SLE. Which of the following findings is the highest priority for the nurse to report to the provider? a. Client report of feelings of depression b. Presence of peripheral edema c. Dry, raised rash on the face d. Joint pain in hands and knees

B

1. A nurse is caring for a client diagnosed with discoid lupus erythematosus. The nurse is collaborating with this client to set goals for the nursing plan of care. Based on the information given here, which of the following would be an appropriate goal for this client? a. Learn strategies to cope with death and the dying process b. Remain compliant with a sun protection plan c. Gain weight to be within 10lbs of normal for height d. Report pain no higher than 4 on a scale of 0-10

B

1. Three weeks after receiving a donor liver, a client begins to experience fever, tachycardia, RUQ pain, and increased accumulation of fluid in the abdomen. The transplanted liver also becomes dangerously enlarged. In this scenario, the client is likely experiencing which of the following conditions? a. Hyperacute rejection b. Acute rejection c. Delayed rejection d. Chronic rejection

B

A nurse is preparing to transfuse a unit of packed RBCs to a client who has severe anemia. Which of the following interventions can prevent an acute hemolytic reactions? A. Ensure that the client has a patent IV line before obtaining blood product from the refrigerator B. Obtain help from another nurse to confirm the correct client and blood product C. Take a complete set of vital signs before beginning transfusion and periodically during the transfusion D. Stay with the client for the 15 to 30 min of the transfusion.

B

A nurse is providing discharge teaching to the partner of a client who has acquired immune deficiency syndrome (AIDS). Which of the following statements by the client's partner indicates a need for further teaching? A. "I will dispose of soiled tissues in separate plastic bags." B. "I'll clean up blood spills immediately with hot water." C. "I know that handwashing is an important preventive measure." D. "I will wash soiled clothes in hot water."

B

A nurse is teaching a client who has HIV about how the virus is transmitted. Which of the following should the nurse include in the teaching? A. "HIV can be transmitted as soon as a person develops manifestations." B. "HIV can be transmitted to anyone who has had contact with infected blood." C. "HIV is transmitted through the respiratory route via droplets." D "HIV is transmitted only during the active phase of the virus."

B

A nurse is teaching a group of adolescents about HIV/AIDS. Which of the following statements should the nurse include in the teaching? A. "You can contract HIV through casual kissing." B. "HIV is transmitted through IV substance use." C. "HIV is now curable if caught in the early stages." D. "Medications inhibit transmission of HIV virus."

B

The nurse is planning care for a patient with active systemic lupus erythematosus (SLE) who is pregnant. Which assessment should the nurse include to monitor for complications specific to pregnancy? Respiratory function Blood pressure Cardiac function Renal function

Blood pressure

1. A client asks the nurse whether there are any conditions that can exacerbate systemic lupus erythematosus. Which response by the nurse is the most appropriate? a. "Conditions that cause hypotension often worsen SLE." b. "GI upset is often associated with SLE exacerbation." c. "Pregnancy is often associated with worsening of SLE." d. "Fever is a known trigger for SLE exacerbation."

C

1. A nurse is caring for a client who has HIV and is one-day post-operative following an appendectomy. The nurse should wear a gown as PPE when taking which of the following actions? a. Holding the patient's hand while talking to them at bedside b. Administering an intermittent IV bolus medication c. Completing a dressing change d. Administering an IM injection

C

1. A nurse is caring for a client who is experiencing leukocytosis. When providing care to this client, which action by the nurse is most appropriate? a. Instructing the client on the use of an electric razor and soft toothbrush b. Evaluating the client for bleeding and bruising c. Assessing the client for the source of infection d. Placing the client in reverse or protective isolation

C

1. A nurse is caring for a client who is to start taking cyclosporine following a kidney transplant. The nurse should instruct the client that which of the following foods can have an adverse interaction with this medication? a. Pepperoni b. Orange juice c. Grapefruit juice d. Smoked salmon

C

1. A nurse is caring for a client with HIV who just learned she is several weeks pregnant. The client states that she is concerned about how her HIV diagnosis might affect the health of her child. Which of the following statements should the nurse include in her teaching for this client? a. "One way to reduce the risk of transmitting the virus to your child is to opt for vaginal birth rather than caesarean." b. "Although infants can acquire HIV from their mothers at birth, the virus cannot cross the placenta during pregnancy." c. "Most HIV medications are safe during pregnancy, and taking them can reduce the risk of transmitting the virus to the fetus." d. "Women with HIV are no more likely than uninfected women to experience miscarriage or fetal loss."

C

1. A nurse is caring for a client with systemic lupus erythematosus who is taking hydroxychloroquine. When providing care for this client, the nurse should monitor for which adverse effect associated with this medication? a. Pulmonary fibrosis b. Renal toxicity c. Retinal toxicity d. Cushingoid effects

C

A nurse is administering IV acyclovir to a client who has varicella. Which of the following actions should the nurse take? A. Administer a stool softener B. Decrease fluid intake following infusion C. Infuse acyclovir over 1 hr D. Monitor for hypotension

C

A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should expect a prescription for which of the following medications? A. Epinephrine B. Lorazepam C. Furosemide D. Diphenhydramine

C

A nurse is caring for a client who had an activated partial thromboplastin (aPTT) greater than 1.5 time the expected reference range. Which of the following blood products should the nurse prepare to transfuse? A. Whole blood B. Platelets C. Fresh frozen plasms D. Packed red blood cells

C

A nurse is caring for a client who has HIV. The client asks the nurse, "Should i tell my partner that I am HIV positive?" Which of the following statements should the nurse provide? A. "That is your decision alone." B. "I would if I were you." C. "It sounds like you are unsure what to say to your partner." D. "Your provider is required by law to notify your partner."

C

A nurse is providing preoperative teaching for a client who requests autologous donation in preparation for a schedule orthopedic surgical procedure. Which of the following statements should the nurse include in the teaching? A. "You should make an appointment to donate blood weeks prior to the surgery." B. "If you need an autologous transfusion, the blood your brother donates can be used." C. "You can donate blood each week if your hemoglobin is stable."

C

A nurse is teaching a client with SLE who has a new prescription for prednisone. The nurse should instruct the client to monitor for which of the following adverse effects of this medication? A. Hypoglycemia B. Tendinitis C. Infection D. Weight loss

C

A nurse should recognize that enfuvirtide can be prescribed to clients who have which of the following conditions? A. Advanced prostate cancer B. Primary brain tumors C. Advanced HIV D. Metastatic ovarian cancer

C

You're administering cyclophosphamide and mesna (Mesnex) to a patient. Mesna, a chemoprotective agent, helps prevent which of the following adverse reactions to cyclophosphamide? A. Retinopathy B. Seizure activity C. Hemorrhagic cystitis D. Cardiotoxicity

C

A nurse is admitting a child who has HIV. The nurse should identify which of the following findings as an indication that the child is in the mildly symptomatic category of HIV? SATA A. Herpes zoster B. Anemia C. Oral candidiasis D. Hepatomegaly E. Lymphadenopathy

C D E

A nurse is monitoring a client who began receiving a unit of packed RBCs 10 min ago. Which of the following findings should the nurse identify as an indication of febrile transfusion reaction? SATA A. Temperature change from 98.6F pretransfusion to 99.0F B. Current BP 178/80mmHg C. Heart rate change from 99/min pretransfusion to 120/min D. Client report of itching E. Client appears flushed

C E

The nurse notices that the latest laboratory report of a patient with a history of HIV indicates a CD4 T-cell count of less than 200/mm3. Which condition should the nurse assess for during the patient's examination? Rheumatoid arthritis Dysmenorrhea Psoriasis Candidiasis

Candidiasis

Which information is important for the nurse to consider when caring for children with allergic reactions? Food allergies are rare in children. Breastfeeding is a risk factor in the development of food allergies. Children are at higher risk for respiratory distress. Children quickly outgrow peanut allergies.

Children are at higher risk for respiratory distress.

The nurse is caring for a patient with severe diarrhea related to wasting syndrome and antiretroviral therapy. The nurse develops a plan of care to address altered fluid volume related to multiple diarrheal stools. Which intervention is most appropriate for the nurse to implement? Collaborate with healthcare prescriber to administer intravenous fluids. Meet with nutritionist to discuss ways to increase fiber in diet. Implement independent nursing intervention to provide skin care to perineal area Collaborate with healthcare prescriber to discontinue the use of antiretroviral medication.

Collaborate with healthcare prescriber to administer intravenous fluids.

The nurse suspects that the patient may have systemic lupus erythematosus when a butterfly rash and splinter hemorrhages are found during the assessment. Which other clinical finding supports the nurse's suspicion? Atopic dermatitis Varicosities Neuropathy Conjunctivitis

Conjunctivitis

The nurse is reviewing the chart of a patient diagnosed with poison ivy. Which hypersensitivity reaction should the nurse anticipate finding upon assessment of the exposed area? Atopic dermatitis Contact dermatitis Erythema multiforme Hives

Contact dermatitis

The nurse is providing care to a patient with a disorder of the immune system that causes inflammation. Which pharmacologic therapy should the nurse anticipate administering? Corticosteroid Influenza vaccine Antibiotics Immunoglobulins

Corticosteroid

1. A nurse in a clinic is assessing a client who has AIDS and a significantly decreased CD4 T-cell count. The nurse should recognize that the client is at risk for developing which of the following infectious oral conditions? a. Halitosis b. Gingivitis c. Xerostomia d. Candidiasis

D

1. A nurse is creating home instructions for a client who has immunodeficiency. Which of the following statements by the client indicates an understanding of the teaching? a. "I will limit the use of emollient skin cream to once a week." b. "I will expect to have a mild, occasional fever." c. "I might experience harmless white patches in my mouth." d. "I will avoid people who have just receiving a live vaccine."

D

1. The nurse is assessing a client who is receiving IV antibiotics. Which item in the client's health history increases the risk for experiencing a hypersensitivity reaction? a. 26 years of age b. Caucasian race c. Concurrent chronic illness d. Previous antibiotic therapy

D

1. The nurse is planning care for an adolescent client who has systemic lupus erythematosus. Which action by the client indicates the implemented plan of care is appropriate? a. Refusing to attend school b. Refraining from attending social functions c. Discussing skin changes with a doctor d. Discussing skin changes with a good friend

D

1. The nurse is providing care to a client with a compromised immune system. Which independent nursing intervention is appropriate for the nurse to include in the client's plan of care? a. Recommending gene transfer therapy b. Prescribing prophylactic antibiotic therapy c. Administering corticosteroids per order d. Educating the client on the importance of a nutritious diet

D

A nurse is assessing a client who has Kaposi's sarcoma. Which of the following findings should the nurse expect? A. nonproductive cough, fever, and shortness of breath B. Lesions on the retina that produce blurred vision C. Onset of progressive dementia D. Reddish-purple skin lesions

D

A nurse is reviewing the lab data of a client who reports manifestations suggesting SLE. The nurse should expect an increase in which of the following parameters for the client who has SLE? A. Platelet count B. RBC count C. Hct D. ESR

D

The nurse is assessing a patient who is undergoing diagnostic testing to determine immune system function. Which data should the nurse collect during the health history portion of the nursing assessment? Observing for stiffness during movement Palpating the joints Inspecting the skin for bruising Determining genetic component to immune deficiencies

Determining genetic component to immune deficiencies

The nurse is assessing a patient with systemic lupus erythematosus (SLE) suspected of having pericarditis. Which assessment findings should the nurse anticipate when auscultating heart sounds? Ventricular gallop S4 heart sound Friction rub Heart murmur

Friction rub

The nurse is teaching a patient with HIV who wishes to pursue complementary therapies to decrease the side effects of antiretroviral therapies. Which complementary therapy should the nurse instruct the patient to avoid? Meditation therapy Garlic supplements Vitamin supplements Aroma therapy

Garlic supplements

_____antibody is found in the secretions of the respiratory, GI, and GU tracts

IgA

The nurse is planning to teach a class on complementary and alternative therapies for immune system disorders. Which treatment should the nurse include? Hematopoietic stem-cell transplantation Immune stimulation with vitamin A Genetransfer therapy Intravenous immunoglobulins

Immune stimulation with vitamin A

stops synthesis of DNA strand, competes with reverse transcriptase to bind at receptor sites--decreases availability of enzyme

NRTI

The nurse is preparing to administer didanosine, a nucleoside reverse-transcriptor inhibitor, to a patient who is HIV positive. Which assessment finding would cause the nurse to hold the dose of medication? Peripheral neuropathy Thrombocytopenia CD4 count of less than 250/mm3 Nausea and vomiting

Nausea and vomiting

prevent enzyme that breaks up large polyproteins into smaller proteins that cause HIV virus to continue to mature and grow

Protease inhibitors

Which intervention is appropriate for treating imbalanced nutrition in a patient with HIV? Providing a low-calorie diet Providing total parenteral nutrition Providing supplementary vitamins Encouraging the patient to eat only when hungry

Providing supplementary vitamins

The nurse is caring for a patient with AIDS who presents with a diagnosis of Kaposi sarcoma. Which manifestation should the nurse expect to find during the physical assessment? Elevated alkaline phosphatase Purplish-red skin lesions A productive cough White bumps in the mouth

Purplish-red skin lesions

Which collaborative laboratory test should the nurse anticipate the for a patient to determine food allergies? Type and screen Complement assay Radioallergosorbent test (RAST) WBC count and differential

Radioallergosorbent test (RAST)

The nurse is admitting an older adult patient to the hospital with systemic lupus erythematosus. Which is the priority action for the nurse prior to developing a prescribed treatment plan with the healthcare team? Assessment of the patient's support system Assessment of the patient's ability to remain compliant with the treatment plan Evaluation of the patient's knowledge of the disease Reconciliation of the patient's medications

Reconciliation of the patient's medications

The nurse is caring for an older patient who reports joint pain. Assessment reveals a diffuse rash, arthralgia, and lymphadenopathy. The patient is receiving penicillin for acute glomerulonephritis. Based on the nurse's assessment findings, which hypersensitivity should the nurse suspect? Serum sickness Graft-versus-host disease Contact dermatitis Anaphylactic reaction

Serum sickness

The nurse is caring for a patient with Kaposi sarcoma due to AIDS. Which assessment would be most appropriate for the nurse to include in the plan of care? Nausea and vomiting Breath sounds Skin integrity Presence of a cough

Skin integrity

painful red and purple skin rash that spreads rapidly and includes development of blisters on the skin and in the mouth

Stevens-Johnson Syndrome

Prior to receiving a blood transfusion, the patient's vital signs are T 97.6°F, R 18 breaths/min, P 72 beats/min, BP 124/70 mmHg. The nurse rechecks the patient's vital signs 15 minutes after initiation of the blood transfusion. The vital signs obtained are as follows: T 99.5°F, R 20 breaths/min, P 84 beats/min, BP 128/74 mmHg. Which nursing action should be implemented immediately? Decrease the rate of the transfusion Increase the rate of the normal saline Stop the blood transfusion Continue to infuse the blood at the prescribed rate

Stop the blood transfusion

The nurse is caring for a patient with rheumatoid arthritis who has been prescribed a corticosteroid. Which information should the nurse include when teaching the patient about this medication? Stop taking when symptoms are relieved An allergic reaction cannot result from this medication Take with milk or a snack to avoid gastrointestinal distress Renal problems are not a concern

Take with milk or a snack to avoid gastrointestinal distress

A nurse is caring for a patient with impaired skin integrity. While reviewing laboratory data, the nurse notes the patient's IgM is elevated. How should the nurse interpret this data? The patient has an allergic reaction The patient has cancer The patient has a parasitic disease The patient has an infection

The patient has an infection

The nurse is preparing discharge instructions for a patient who experienced an unknown anaphylactic reaction. Which is the priority outcome for the patient? The patient will help determine substances that cause hypersensitivity by keeping a journal. The patient will keep a medical alert card in his or her wallet at all times. The patient will describe proper self-administration of medications. The patient will keep two epinephrine auto-injectors available at all times.

The patient will describe proper self-administration of medications.

example of type II hypersensitivity reaction

blood transfusion reaction, hemolytic anemia, rheumatic heart disease, graft rejection, Goodpasture syndrome

where do B cells mature?

bone marrow

where are eosinophils located?

circulatory system, respiratory tract, GI tract

binds with CCR5 to block fusion

entry inhibitor

maraviroc drug class

entry inhibitor

clients on protease inhibitors need what monitored?

glucose, cholesterol, triglyceried levels

drug class of raltegravir

integrase inhibitors

where are Kupffer cells located?

liver

where are secondary or peripheral lymphoid structures?

lymph nodes, spleen, tonsils, intestinal lymphoid tissue, and lymphoid tissue in other organs

function of basophils

release of chemotactic substances

the ability to stimulate specific immune system components

specific reactivity

function of monocytes and macrophages

trapping and phagocytosis of foreign substances and cellular debris, secretion of interleukin-1 to stimulate lymphocyte growth

A patient states to the nurse, "My doctor ordered a prick test to see if I am allergic to pet dander. How will you perform the test?" Which response by the nurse will provide the patient with the correct information? "I will be puncturing the skin through the diluted allergenic extract." "I will be placing a patch with the allergen on the skin." "I will be injecting the allergen extract intradermally." "I will give you a pill with the allergen to swallow."

"I will be puncturing the skin through the diluted allergenic extract."

The nurse is teaching the parent of a young child with a peanut and dairy allergy. The parent says, "He is such a picky eater—what am I supposed to feed him?" Which response by the nurse provides the most beneficial solution? "He can eat whatever he would like as long he is gaining weight and growing." "Let him eat the things he likes that do not contain nuts or dairy." "I will provide you a list of nutritious foods and have a dietician speak with you." "I will ask your healthcare provider to speak with you to provide further direction."

"I will provide you a list of nutritious foods and have a dietician speak with you."

The nurse is teaching a patient with systemic lupus erythematosus (SLE) how to decrease the risk of infection and cardiovascular disease. Which statement made by the patient indicates an understanding of the teaching? "I will exercise more." "I will comply with my treatment plan." "I will avoid public areas." "I will quit smoking."

"I will quit smoking."

The nurse is planning to teach a patient who has systemic lupus erythematosus (SLE) how to care for the open ulcers on their nose and mouth. Which statement should the nurse include in the teaching? "Avoid excessive exposure to the sun until the sores have healed." "I would like to go over hand washing techniques with you." "You can rinse your mouth with saline water to prevent ulcers in your mouth." "You can cover those sores with makeup."

"I would like to go over hand washing techniques with you."

The nurse is performing a physical assessment on a child who presents with flu-like symptoms. The nurse confirms the mother's finding of a small lump behind the child's right ear. The mother states, "I'm very worried about this." Which is an appropriate response by the nurse? "It's nothing to be concerned about. I see this in young children all the time." "We need to arrange for more diagnostic testing, such as an MRI or CT scan." "This could be an early sign of cancer. Let's talk to the doctor about a biopsy." "It is common for children to have swollen lymph nodes when they are fighting off a viral infection."

"It is common for children to have swollen lymph nodes when they are fighting off a viral infection."

A patient recently diagnosed with systemic lupus erythematosus asks the nurse, "Should I expect my condition to get progressively worse?" Which response by the nurse is accurate? "It is likely that your condition will be cured." "It is likely that you will experience periods of remission and exacerbation." "It is likely that your condition will get progressively worse." "It is likely that your condition will go into permanent remission."

"It is likely that you will experience periods of remission and exacerbation."

A nurse isassessing a 35-year-old patient who asks, "Do I need any vaccinations today?" Which response by the nurse is best? "No, you had all of your vaccinations when you were a child." "No, vaccinations aren't as effective in the adult population." "Yes, you will definitely need a few immunizations to catch up." "Let's review your vaccination history and see if you need any boosters."

"Let's review your vaccination history and see if you need any boosters."

A patient admitted to the hospital is diagnosed with Pneumocystis jiroveci pneumonia and AIDS. The patient informs the nurse of having a negative HIV test 2 years ago after having unprotected sex and asks how this could happen. Which response by the nurse is accurate? "There is a time frame between exposure and seroconversion where the test will be negative." "Which diagnostic test did your healthcare provider use? There are some that are more effective than others." "I would contact your former healthcare provider that prescribed the test 2 years ago and followup." "The diagnostic test may have been defective and given you a false negative result."

"There is a time frame between exposure and seroconversion where the test will be negative."

The nurse is caring for a patient with AIDS who has come to the clinic for an HIV viral load test. The patient asks, "What is a viral load test?" Which response by the nurse is accurate? "This test is used to detect HIV antibodies." "This test measures the amount of actively replicating HIV." "This test is the most widely used screening test for HIV infection." "This test detects anemia, leukopenia, and thrombocytopenia."

"This test measures the amount of actively replicating HIV."

The nurse is caring for an obstetrical patient hospitalized with an exacerbation of systemic lupus erythematosus. The patient asks, "Why are you monitoring my blood pressure so closely?" Which is the nurse's best response? "To prevent a butterfly rash on the face" "To avoid sharp chest pain that worsens with coughing" "To diffuse discoid lesions" "To prevent or minimize risk of preeclampsia"

"To prevent or minimize risk of preeclampsia"

A patient asks the nurse whether they should continue to exercise when dealing with seasonal allergies. Which response by the nurse is appropriate? "Only if you enjoy exercising—it has no effect on the immune system." "No, it is important to rest and avoid excess activity to minimize allergy symptoms." "Yes, regular strenuous exercise is good for the immune system." "Yes, moderate exercise can have a positive effect on the immune system."

"Yes, moderate exercise can have a positive effect on the immune system."

The nurse is providing teaching to a patient who has experienced an anaphylactic reaction after eating shrimp. Which statement by the nurse provides the patient with the most accurate information? "You only need to avoid eating shellfish, such as clams and oysters." "You can consume finned ocean fish." "You should avoid eating all seafood, until allergy skin testing is done." "Avoid eating all crustaceans, such as shrimp, lobster, and crab."

"You should avoid eating all seafood, until allergy skin testing is done."

A patient with AIDS asks the nurse why they seem to get bronchitis so often. Which response by the nurse is most appropriate? "Are you still smoking cigarettes?" "Bronchitis is caused by a bacterial infection, and AIDS is from a virus, so I don't think there is a connection." "Your infection-fighting cells are diminished because of AIDS." "Taking extra vitamin C usually helps ward off infections."

"Your infection-fighting cells are diminished because of AIDS."

1. A nurse is preparing a client who has AIDS for discharge. Which of the following statements should the nurse include in the discharge instruction? a. "Prevent the spread of infection with good household cleaning practices." b. "Disinfect equipment contaminated with blood or body fluids for twenty-four hours." c. "Make sure to consume large amounts of sushi, oysters, and shellfish for adequate protein intake." d. "Burn soiled dressings."

A

1. A nurse who works in the ED is providing care for a group of clients. Which client demonstrates a declining immune response that typically occurs with the aging process? a. An 88 year old client with pneumonia who has a temperature of 99.5F b. A 70 year old client who has swelling and redness around an abdominal incision from an open appendectomy c. A 58 year old client who complains of redness and itching after developing a rash from contact with poison ivy d. A 56 year old client who has 8mm induration at the site of PPD skin test administer 72 hrs earlier

A

1. The client enters the outpatient clinic and states to the triage nurse, "I think I have the flu. I'm so tired, I have no appetite, and everything hurts. The triage nurse assesses the client and finds a butterfly rash over the bridge of the nose and on the cheeks. Based on this data, which diagnosis should the nurse anticipate? a. Systemic lupus erythematosus b. Discoid lupus erythematosus c. Rheumatoid arthritis d. Hyperacute organ rejection syndrome

A

1. The nurse is caring for a client with history of latex allergies. The client develops audible wheezing, pruritis, urticaria, and signs of angioedema. Which of the following is the priority intervention for this client? a. Administer epinephrine 1:1000 by subcutaneous injection per the healthcare provider's orders b. Collect a detailed history from the client regarding the history of latex allergies c. Teach the client regarding use of a kit that contains treatment for allergic reactions d. Administer diphenhydramine by mouth every 4 hours per the healthcare provider's orders

A

1. The nurse obtains initial vital signs on a patient 2 weeks posttransplant who presents for follow-up monitoring to the outpatient transplant clinic. Which assessment finding by the nurse requires immediate action? a. Tenderness over graft site b. Serum creatinine over 1mg/dL c. Hemoglobin of 9.2gm/dL d. BP of 100/60

A

1. Which of the following statements is false and should not be included in client teaching about how to reduce the risk of contracting HIV? a. Clients should use the withdrawal method and contraceptive pills to prevent transmission of HIV b. The only totally safe sex practices are abstinence; long-term, mutually monogamous sexual relations between uninfected individuals; and mutual masturbation without direct contact c. When possible, autologous transfusion is a good risk reduction strategy for clients who are undergoing surgery d. Clients should use condoms during every sexual encounter involving vaginal, oral, or anal intercourse

A

A nurse is assessing a client who is 1 week postoperative following a living donor kidney transplant. Which of the following findings indicates the client is experiencing acute kidney rejection? A. BP 160/90mmHg B. Creatinine 0.8mg/dL C. Sodium 137mg/dL D. Urinary output 100mL/hr

A

A nurse is caring for a client who has a new prescription for delavirdine therapy to treat HIV-1. The nurse should instruct the client to report which of the following adverse reactions to the drug? A. Rash B. Insomnia C. Rhinitis D. Alopecia

A

A nurse is caring for a client who is prescribed zidovudine. Which of the following laboratory values should the nurse report to the provider? A. Hemoglobin 7.1g/dL B. RBC 5.2/mm3 CNeutrophil 57% D. Triglycerides 125mg/dL

A

A nurse is instructing a client how to self-administer enfuviritide. Which of the following instructions should the nurse include? A. "Allow the vial to sit until the solution is completely clear and without particulates." B. "After reconstituting with sterile water, vigorously shake the vial to mid the solution." C. "Use the medication immediately upon removing from the refrigerator." D. "Use the same location for five injections before rotating to a new site."

A

A nurse is planning care for a client who has acute SLE and is scheduled to begin treatment for systemic manifestations. Which of the following types of medications should the nurse plan to administer? A. Corticosteroids B. Antimalarials C. Antidepressants D. Opioids

A

A nurse is preparing to administer a transfusion of 300mL of pooled platelets to a client who has severe thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames? A. Within 30 min/unit B. Within 60 min/unit C. Within 2 hr/unit D. Within 4hr/unit

A

A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to a child. The nurse should recognize that the MMR vaccine provides which of the following types of immunity? A. Artificial active immunity B. Active C. Passive D. Artificial passive immunity

A

A nurse is providing a client who has HIV about the early manifestations of AIDS. Which of the following statements should the nurse include in the teaching? A. "You can expect a persistent fever and swollen glands." B. "You can expect an elevated WBC count." C. "You can expect increased BP and edema." D. "You can expect weight gain."

A

A nurse is providing dietary teaching for a client with AIDS who has stomatitis of the mouth. Which of the following instructions should the nurse include in the teaching? A. "You can suck on popsicles to numb your mouth." B. "Season food with spices instead of salt." C. "Avoid the use of a straw to drink liquids." D. "Eat foods at hot temperatures."

A

A nurse is providing discharge teaching to a client who has AIDS about preventing infection while at home. Which of the following instructions should the nurse include in the teaching? A. "Wash your genitalia using an antimicrobial soap." B. "Rinse your dishes with cold water." C. "Clean your toothbrush once per month." D. "Incorporate raw fruits and vegetables into your diet."

A

A nurse is providing discharge teaching to a client who has a new diagnosis of systemic lupus erythematosus (SLE). Which of the following statements by the client indicates an understanding of the teaching? A. "I will need to take methotrexate, even if I'm in remission." B. "I'm thankful that this type of lupus only affects the skin." C. "Each day, I should apply a sunblock with a sun protection factor of 15." D. "A mild fever is common with SLE and usually does not require treatment."

A

A nurse is teaching a client about immunizations. Which of the following information should the nurse include in the teaching? A. "You should receive a tetanus booster every 10 years" B. "You should not receive the influenza immunization if you have a common cold." C. "You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." D. "As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old."

A

A nurse is teaching a client about maraviroc. Which of the following instructions should the nurse include? A. "It is important to report any noticeable rash immediately as it may indicate an issue with your liver." B. "Make sure you take this medication without any other medications first thing in the morning." C. "You might experience flu-like symptoms for which you can take any over-the-counter medication." D. "The side effects of this medication are minimal, so you can continue to work and drive as normal."

A

A nurse is teaching a client about recommended immunizations. Which of the following immunizations should the nurse recommend the client receive starting at 50 years of age? A. Herpes zoster vaccine B. HPV C. Pneumococcal vaccine D. Hib

A

A nurse is teaching a client who has Raynaud's disease. Which of the following pieces of information should the nurse include in the teaching? A. Protect against the cold by wearing layers of clothing. B. Begin an exercise program of 2 mile walks once per week C. Increase vitamin A in the diet D. Elevate the hands above heart level when resting

A

A nurse is teaching a female client with a new diagnosis of SLE about factors that can trigger an exacerbation of SLE. The nurse should determine that the client requires further teaching if she identifies which of the following as an exacerbation factor? A. Exercise B. Pregnancy C. Infection D. Sunlight

A

A nurse is teaching about the manifestations of an allergic reaction. The release of histamine causes which of the following reactions? A. Increased mucus secretion B. Bronchial dilation C. Bradycardia D. Vertigo

A

A nurse is teaching the guardian of a 4 month old infant about recommended immunizations for the infant. Which of the following immunizations should the nurse include? A. Haemophilus influenzae type B vaccine (Hib) B. Varicella vaccine C. Meningococcal conjugate vaccine (MCV4) D. Tetanus-diphtheria-acellular pertussis vaccine (Tdap)

A

A nurse is discussing gout with a client who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? SATA A. Diuretic use B. Obesity C. Deep sleep deprivation D. Depression E. Cardiovascular disease

A B E

A nurse is providing discharge teaching to a client who has HIV. Which of the instructions about infection prevention should the nurse include? SATA A. Avoid large gatherings of people B. Clean toothbrush by running through the dishwasher C. Change pet litter boxes with disposable gloves D. Consume fresh fruit and raw vegetables E. Avoid digging in the garden

A B E

A nurse is teaching a parent of a child who has HIV. Which of the following information should the nurse include? SATA A. Obtain yearly influenza vaccination B. Monitor a fever for 24 hr before seeking medical care C. Avoid individuals who have colds D. Provide nutritional supplements E. Administer aspirin for pain

A C D

A nurse is transfusing a unit of packed red blood cells (PRBCs) to a client who has anemia due to chemotherapy. The client reports a sudden headache and chills. The client's temperature is 2F higher than the baseline reading. In addition to notifying the provider, which of the following actions should the nurse take? SATA A. stop the transfusion B. Place the client in an upright position with feet down C. Remove the blood bag and tubing from the IV catheter D. Obtain a urine specimen E. Infuse dextrose 5% in water through the IV

A C D

A client is about to start taking ritonavir to treat HIV-1 infection. Which of the following instructions should you include when talking with the client about taking this drug? SATA A. Expect periodic blood glucose testing B. Take it on an empty stomach C. Watch for and report jaundice D. Increase weight-bearing activity E. Expect periodic cholesterol testing

A C D E

A nurse is caring for a client who is receiving a blood transfusion. Which of the following actions should the nurse plan to take if an allergic transfusion reaction is suspected? SATA A. Stop the transfusion B. Monitor for hypertension C. Maintain an IV infusion with 0.9% sodium chloride D. Position the client in an upright position with the feet lower than the heart. E. Administer diphenhydramine

A C E

A nurse is reviewing the plan of care for a client who systemic lupus erythematosus (SLE). The client reports fatigue, joint tenderness, swelling, and difficulty urinating. Which of the following laboratory findings should the nurse anticipate? SATA A. Positive ANA titer B. Increased hemoglobin C. 2+ urine protein D. Increased serum C3 and C4 E. Elevated BUN

A C E

1. A nurse is working in a summer camp for children. One of the children comes to the clinic with several bee stings. Which clinical manifestations would necessitate injecting the child with epinephrine? SATA a. Skin that is cold and clammy to the touch b. Skin that is warm and dry to the touch c. Hyperverbal behavior d. Agitation and confusion e. Facial swelling

A D E

A nurse is assessing a client for HIV. The nurse should identify that which of the following are risk factors associated with this virus? SATA A. Perinatal exposure B. Pregnancy C. Monogamous sex partner D. Older adult woman E. Occupational exposure

A D E

A nurse is caring for a client who take several antiretroviral medications, including the NRTI zidovudine, to treat HIV infection. The nurse should monitor for which of the following adverse effects of zidovudine? SATA A. Fatigue B. Blurred vision C. Ataxia D. Hyperventilation E. Vomiting

A D E

1. The nurse is caring for a client with AIDS who is on antiretroviral therapy. The client complains of nausea, fever, severe diarrhea, and anorexia. Which of the following prescribed medications does the nurse anticipate in order to relieve the anorexia and stimulate the client's appetite? SATA a. Dronabinol b. Zidovudine c. Abacavir d. Ciprofloxacin e. Megestrol

A E

The nurse is assigned to care for four patients today. Which patient is most likely to question a new diagnosis of HIV? A 60-year-old who is healthy and asymptomatic A 40-year-old male with Pneumocystis jiroveci pneumonia A 50-year-old female with arthralgia and lymphadenopathy A 30-year-old male who presents with Kaposi sarcoma

A 60-year-old who is healthy and asymptomatic

Which action by the nurse is the most appropriate for treating a patient experiencing severe anaphylactic reaction while in the acute care setting? Administer epinephrine intravenously Give oral diphenhydramine (Benadryl) Administer epinephrine subcutaneously Apply epinephrine directly to the site of entry

Administer epinephrine intravenously

A patient states, "I am having trouble breathing and I feel like there is a ton of pressure on my chest. I don't know what brought this on, I was just down in the basement, cleaning." The patient has no medical history and the vital signs are T 99°F, R 24 breaths/min, BP 92/48 mmHg, P 102 beats/min, O2 saturation 93%. Based on the information obtained, which hypersensitivity should the nurse suspect the patient is experiencing? Allergic rhinitis Bronchitis Pneumonia Allergic asthma

Allergic asthma

A nurse is caring for a client who has SLE and is experiencing an episode of Raynaud's phenomenon. Which of the following findings should the nurse anticipate? A. Swelling of joints of the fingers B. Pallor of toes with cold exposure C. Feet that become reddened with ambulation D. Client report of intense feeling of heat in the fingers

B

A nurse is conducting dietary teaching for a client who has AIDS. Which of the following instructions should the nurse include in the teaching? A. Discard leftovers after 8hr B. Use a separate cutting board for poultry C. Thaw frozen foods at room temperature D. Store cold foods at 50F or less

B

A nurse is preparing to administer packed RBCs to a client who had a Hgb of 8g/dL. Which of the following actions should the nurse plan to take during the first 15 min of the transfusion? A. Obtain consent from the client for the transfusion B. Assess for an acute hemolytic reaction C. Explain the transfusion procedure to the client D. Obtain blood culture specimens to send to the lab

B

You are caring for a client who is pregnant is HIV-positive. Which of the following drugs helps prevent the transfer of HIV to the fetus? A. Anastrozole B. Zidovudine C. Tamoxifen D. Trastuzamab

B

A nurse is preparing to administer a scratch test to a client who has possible food and environmental allergies. Which of the following actions should the nurse perform prior to the procedure? SATA A. Cleanse the client's skin with povidone-iodine B. Ask the client about previous reactions to allergens C. Ask the client about medications taken over the past several days D. Inform the client to expect itching at one site E. Obtain emergency resuscitation equipment

B C D E

A nurse is caring for a client who has a new prescription for enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the adverse reactions of this medication? SATA A. Bleeding B. Pneumonia C. Cerebral edema D. Localized erythema E. Hypotension

B D E

A school nurse is assessing a child who has been stung by a bee. The child's hand is swelling, and the nurse notes that the child is allergic to insect stings. Which of the following findings should the nurse expect if the child develops anaphylaxis? SATA A. Bradycardia B. Nausea C. Hypertension D. Urticaria E. Stridor

B D E

A nurse is caring for a client who has HIV. Which of the following types of isolation should the nurse implement to prevent the transmission of HIV? A. Protective isolation B. Droplet precautions C. Standard precautions D. Airborne precautions

C

A nurse is caring for a client who has SLE and is concerned about skin lesions on her face and neck. The client asks the nurse, "What should I do about these spots?" Which of the following responses should the nurse give? A. "Keep the lesions covered with a light sterile dressing when going outdoors." B. "Rub lesions with a washcloth to dry after washing." C. Apply moisturizer after bathing the lesions with warm water." D. "Apply antibiotic cream twice per day until scabs form on the lesions."

C

A nurse is reviewing the laboratory findings of a client who has measles. The nurse should expect to find an increase in which of the following types of WBCs? A. Neutrophils B. Basophils C. Lymphocytes D. Eosinophils

C

A nurse is teaching a client who has AIDS about the transmission of Pneumocystis jiroveci pneumonia (PCP). Which of the following pieces of information should the nurse include in the teaching? A. "PCP is sexually transmitted from person to person." B. "You were most likely exposed to a contaminated surface such as a drinking glass." C. "PCP results from an impaired immune system." D. "You might have comtracted PCP from a family pet."

C

A nurse is teaching a client who has SLE about self-care. Which of the following statements by the client indicates an understanding of the teaching? A. "I should limit my time to 10 minutes in the tanning bed." B. "I will apply powder to any skin rash." C. "I should use a mild hair shampoo." D. "I will inspect my skin once a month for rashes."

C

A nurse is teaching a client who has a new prescription for combination oral NRTIs (abacavir, lamivudine, and dolutegravir) for treatment of HIV. Which of the following statements should the nurse include? A. "These medications work by blocking HIV entry into cells." B. "These medications work by weakening the cell wall of the HIV virus." C. "These medications work by inhibiting enzymes to prevent HIV replication." D. "These medications work by preventing protein synthesis within the HIV cell."

C

A nurse is teaching a client who is beginning highly active antiretroviral therapy (HAART) for HIV infection about ways to prevent medication resistance. Which of the following information should the nurse teach the client about resistance? A. Taking low dosages of antiretroviral medication minimizes resistance B. taking one antiretroviral medication at a time minimizes resistance C. Taking medication at the same times daily without missing doses minimizes resistance D. Changing the medication regimen when adverse effects occur minimizes resistance

C

A nurse is teaching a client who tested positive for an allergy to dust. The nurse should determine that the client understands how to reduce her exposure to this allergen through which of the following statements? A. "I will begin vacuuming once a week." B. "Carpeting the entire house will be very expensive, but it will be worth it." C. I will put a mattress cover on my bed." D. "Installing curtains on the windows will help control the dust in my house."

C

A nurse is teaching a client who was recently diagnosed with Raynaud's disease about preventing the onset of manifestations. Which of the following statements by the client indicates an understanding of the teaching? A. "I should limit my exposure to sunlight." B. "I should avoid drinking alcohol." C. "I should not smoke." D. "I should limit intake of foods that are high in purine."

C

The nurse is teaching a patient with a latex allergy. Which latex-containing product at home should the nurse encourage the patient to avoid? Plastic food wrap Chewing gum Toothbrush bristles Trash can liners

Chewing gum

A patient with HIV was prescribed zidovudine about a month ago to manage the disease. Which laboratory test should the nurse monitor to assess for dose-limiting side effects of this medication? Complete blood count CD4 count ELISA test Viral load

Complete blood count

A patient with systemic lupus erythematosus reports of weakness, fatigue, and poor concentration. Based on the patient's symptoms, the nurse suspects the patient may have anemia. Which diagnostic test should the nurse anticipate to be ordered? Erythrocyte sedimentation rate (ESR) Complete blood count (CBC) Anti-DNA antibody testing Serum complement levels

Complete blood count (CBC)

1. A nurse is admitting a pediatric client to the hospital with a ventriculoperitoneal shunt malfunction. When gathering the history, the nurse learns that the client receiving the shunt at birth after a meningocele repair. Based on this data, which product should be avoided when providing care to this client? a. Synthetic rubber gloves b. Polyethylene gloves c. Non-powdered nitrile gloves d. Latex gloves

D

1. A nurse is caring for a pediatric client who is receiving an infusion of IV antibiotic at the ambulatory clinic. Which clinical manifestation indicates that the client is experiencing a type I hypersensitivity reaction? a. Fever b. Joint pain c. Erythema d. Hypotension

D

A nurse is assessing a 66 year old client during a routine physical examination. This is the client's first clinic visit, and she does not have her medical records. When the nurse asks if she has received the pneumococcal immunization, the client replies, "I am not sure, but it's been at least 5 years since I've had any immunizations." Which of the following responses should the nurse provide? A. "In case you had the immunization before, we can't give you another one." B. "You'll need a series of 3 injections." C. "This immunization is unsafe for people over the age of 65 years old." D. "Let's go ahead and give you this immunization."

D

A nurse is assessing a client who has a new diagnosis of SLE. Which of the following findings should the nurse expect? A. Weight gain B. Petechiae on thighs C. Systolic murmor D. Alopecia

D

A nurse is assessing a preschooler who has HIV. Which of the following manifestations should the nurse expect? A. Generalized petechiae B. Jaundice C. Obesity D. Chronic diarrhea

D

A nurse is caring for a child who has AIDS. Which of the following isolation precautions should the nurse implement? A. Contact B. Airborne C. Droplet D. Standard

D

A nurse is planning care for a client who has AIDS and has developed stomatitis. Which of the following interventions should the nurse include in the plan of care? A. Rinse the mouth with chlorhexidine solution every 2hr B. Limit fluid intake with meals C. Provider oral hygiene with a firm-bristled toothbrush after each meal D. Avoid salty foods

D

A nurse is planning discharge teaching for a client who has SLE. Which of the following instructions should the nurse include? A. "Avoid the use of NSAIDs." B. "Stop taking the corticosteroids when your symptoms resolve." C. "Exposure to ultraviolet light will help control your skin rashes." D. "Monitor your body temperature and report any elevations promptly."

D

A nurse is providing teaching for a client who has stage 2 HIV disease and is having difficulty maintaining a normal weight. Which of the following statements by the client should indicate to the nurse an understanding of the teaching? A. "I will choose a diet high in fat to help gain weight." B. "I will be sure to eat three large meals daily." C. "I will drink up to 1 L of liquid each day." D. "I will add high-protein foods to my diet."

D

A nurse is providing teaching for a client who has stage 3 HIV disease. Which of the following statements by the client should indicate to the nurse an understanding of the teaching? A. "I will wear gloves while changing the pet litter box." B. "I will rinse raw fruits with water before eating them." C. "I will wear a mask when around family members who are ill." D. "I will cook vegetables before eating them."

D

A nurse preceptor is observing a newly licensed nurse on the unit who is preparing to administer a blood transfusion to an older adult client. Which of the following actions by the newly licensed nurse indicates an understanding of the procedure? A. Inserts an 18 gauge IV catheter in the client B. Verifies blood compatibility and expiration date of the blood with an assistive personnel C. Administers dextrose 5% in 0.9% sodium chloride IV with the transfusion D. Obtains vital signs every 15 min throughout the procedure

D

A nurse should recognize that maraviroc is used in the treatment of which of the following conditions? A. Diabetes mellitus B. Meningeal infection C. Pancreatitis D. Chemokine receptor 5 (CCR5)-tropic HIV-1

D

A nurse should recognize that raltegravir is used to treat clients who have which of the following conditions? A. Hairy cell leukemia B. Thyroid cancer C. Kaposi's sarcoma D. Resistant HIV

D

You should monitor this client for which of the following indications of an adverse reaction to cyclophosphamide? A. Gynecomastia B. Dilated pupils C. Bradycardia D. Fever

D

A nurse is caring for a patient who sustained a puncture wound from a rusty piece of metal. Which should be the nurse's first action?. Assess patient for clinical manifestations of tetnus. Administer the tetanus immunization. Determine if and when the patient had a tetanus vaccine. Administer tetanus immunoglobulin followed by tetanus vaccine.

Determine if and when the patient had a tetanus vaccine.

An patient with HIV is being treated with highly active antiretroviral therapy (HAART) and protease inhibitors (PI) therapy. Laboratory results indicate increased triglycerides. The nurse should recognize that the patient is at risk for which conditions? Kidney disease and lung cancer Skin cancer and pneumonia Stomach cancer and lymphoma Elevated cholesterol and diabetes

Elevated cholesterol and diabetes

The nurse is caring for an adolescent who has experienced alopecia as a result of the medication used to treat the patient's systemic lupus erythematosus. Which activity should the nurse recommend to assist the patient in coping with the alopecia? Contact a social worker to set up home schooling. Encourage the patient to find methods to explain the side effects of treatment. Recommend that the patient takes a break from treatment. Suggest that the patient wear a wig or a hat.

Encourage the patient to find methods to explain the side effects of treatment.

The nurse is teaching a patient with latex allergy the importance of when to seek medical attention after exposure. Which situation should the nurse include? If the patient experiences flu-like symptoms If the patient comes in contact with latex If the patient develops hives If the patient develops a runny nose

If the patient develops hives

A nurse is caring for a child with pale nasal mucosa, runny nose, and itchy eyes. The nurse suspects that the child has seasonal allergies. Which blood test should the nurse anticipate to confirm the diagnosis? DNA polymerase chain reaction test Western blot ELISA IgE

IgE

Antibody activated in Type I hypersensitivity reactions

IgE

The nurse is assessing the laboratory data for a patient experiencing a type 1 hypersensitivity reaction. Which laboratory data should the nurse evaluate for confirmation? IgM IgG IgA IgE

IgE

_____antibody response is longer and stronger than that of the other immunoglobulins

IgG

what is the major immunoglobulin?

IgG

antibody activated in type II hypersensitivity reactions

IgG, IgM

antibody activated in type III hypersensitivity reactions

IgG, IgM

______antibody activates the complement system by destroying antigenic substances

IgM

______antibody produces antibody activity against rheumatoid factors, gram-negative organisms, and ABO blood group

IgM

antibody that is produced 48-72hr after antigen enters the body--responsible for primary immunity

IgM

five types of immunoglobulins

IgM IgG IgA IgD IgE

A nurse is caring for a patient who works as a "high-powered" corporate attorney. The patient complains of stress and frequent colds. Which is the priority nursing diagnosis for this patient? Impaired immunity secondary to high stress Potential for nutritional deficits secondary to stress. Insomnia related to poor immune system functioning Potential for anxiety and depression related to job situation.

Impaired immunity secondary to high stress

The nurse is caring for a hospitalized patient with a decreased CD4 T-cell count. Which nursing action is the priority? Requesting a referral for counseling Teaching regarding safer sex Planning diet and nutrition Implementing careful infection control measures

Implementing careful infection control measures

The nurse is teaching a patient who has systemic lupus erythematosus self care measures while taking a corticosteroid. Which is the priority in the nurse's teaching session? Implementing hand washing and other infection prevention methods Applying sunblock and wearing long sleeves for protection from sun exposure Allowing for frequent rest periods between activities Exercising in the shower to help ease morning stiffness in the joints

Implementing hand washing and other infection prevention methods

A pregnant woman with a latex allergy is admitted to the hospital for delivery. Which latex precaution should the nurse implement? Cover IV fluid bags so they do not come in contact with the patient Avoid using gloves as much as possible Place a latex allergy sign outside the patient's door There are no interventions necessary; hospital products are latex free

Place a latex allergy sign outside the patient's door

The nurse is caring for a patient with systemic lupus erythematosus who is hospitalized during an exacerbation. The patient is receiving cytotoxic and antineoplastic medications. Which is the nurse's priority goal for this patient? Maximizing mobility Preventing infections Assisting with pain management Providing psychological support

Preventing infections

In which situation will a healthcare worker be at risk for HIV infection? Cleaning the patient's room Inhalation of airborne droplets Prolonged blood contact on damaged skin Urine contact with damaged skin

Prolonged blood contact on damaged skin

A patient experiencing an acute exacerbation of systemic lupus erythematosus (SLE) states, "I have gained 6 pounds in the past 3 days and my ankles are swollen." Based on the patient's statement, which system should the nurse presume has been affected? Renal system Respiratory system Cardiovascular system Lymphatic system

Renal system

The nurse is speaking with a patient who reports being sick frequently. The nurse notes that the patient is slightly overweight. Which is an independent intervention by the nurse to help improve immune function? Encourage bedrest throughout the day. Review dietary intake and provide nutritional counseling. Take NSAIDs as needed for fever. Encourage use of prophylactic antibiotics.

Review dietary intake and provide nutritional counseling.

A patient with systemic lupus erythematosus has erythematous fingertip lesions. Which is the priority nursing diagnosis for this patient? Risk for ineffective peripheral tissue perfusion Risk for infection Altered skin integrity Risk for disturbed body image

Risk for infection

A patient is suspected of having an autoimmune disorder. Which diagnostic test should the nurse question as inappropriate for this patient? Immunoglobulin levels Serotonin levels Polymerase chain reaction Complete blood count

Serotonin levels

The nurse is teaching the patient with systemic lupus erythematosus methods to prevent infection. Which instruction should the nurse include? Foods associated with a low-fat and high-carbohydrate diet Smoking avoidance Vitamin supplementation Stress reduction techniques

Smoking avoidance

The nurse is preparing a presentation regarding HIV. Which location regarding where most cases of HIV are occurring does the nurse include? Eastern Europe Sub-Saharan Africa Latin America Asia

Sub-Saharan Africa

antibody activated in type IV hypersensitivity reaction

T helper cells

examples of type IV hypersensitivity

TB skin tests, transplant rejection, contact dermatitis (poison ivy)

Which clinical manifestation of a hypersensitivity reaction should the nurse monitor for in a patient receiving a blood transfusion? Temperature 101.6ºF Respirations 22 breaths/min Blood pressure156/80 mmHg Pulse 92 beats/min

Temperature 101.6ºF

Which statement describes the initial cellular change that occurs with HIV infection? The HIV virus within cells triggers antibodies to be produced to its proteins, causing seroconversion. The HIV virus produces new RNA and forms virions that are unable to reproduce outside the cell. The HIV virus DNA is integrated into host cell DNA, which reproduces during normal cellular replication. The HIV virus sheds its protein coat and uses reverse transcriptase to convert viral RNA to DNA.

The HIV virus sheds its protein coat and uses reverse transcriptase to convert viral RNA to DNA.

A patient presents to the clinic and states, "I think I have poison ivy because my skin is very red and itchy. I was out hiking the other day and came in contact with it." Which further assessment finding should the nurse anticipate at the site of the exposure? Thickening effect on the skin Numerous pustules Skin lesions Disseminated hives

Thickening effect on the skin

The school nurse is teaching a group of adolescents about HIV transmission. Which risk factor is imperative to include in the presentation for this age group? Mutual masturbation with direct contact is a low risk sexual practice. Sharing needles for drug injection is safe if both individuals are HIV negative. Sex is safe if the relationship is monogamous. To be protected, condoms must be worn for vaginal, oral, and anal intercourse.

To be protected, condoms must be worn for vaginal, oral, and anal intercourse.

The community health nurse is planing to conduct teaching sessions at local community centers to promote safer sex and prevention of sexually transmitted infections. Which group would benefit most from HIV education due to an increased risk of contracting HIV? Children under the age of 13 Causcasian women age 25-35 years of age Heatlhcare workers Transgender individuals

Transgender individuals

what is the function of T cells?

activation of T and B cells, control of viral infection and destruction of cancer cells, involvement in hypersensitivity reactions and graft tissue rejection

Example of a type I hypersensitivity reaction

allergic rhinitis, asthma, systemic anaphylaxis, bee stings, latex

where are primary or central lymphoid structures located?

bone marrow and thymus gland

Where are Natural Killer (NK) Cells located?

circulatory system

where are basophils located?

circulatory system

where are monocytes located?

circulatory system

where are neutrophils located?

circulatory system

Where are B cells located?

circulatory system and spleen

where are T cells located?

circulatory system, lymph system, and tissues

prevents fusion of lipid membrane of the virus to the CD4-T cell to prevent viral entry and replication

entry/fusion inhibitors

the ability to stimulate a specific immune response

immunogenicity

only treatment for clients who have HIV-1 that has become resistant to other HIV drugs

integrase inhibitor

stops HIV replication by disrupting integrase step

integrase inhibitor

what are the two types of monocytes?

macrophages dendritic cells

can you use enfurvitide in a lactating client?

no

is efavirenz safe for pregnancy?

no

delavirdine drug class

non-nucleoside reverse transcriptase inhibitor (NNRTI)

group of drugs that prevent maternal HIV transmission to fetus (vertical transmission)

nuceloside reverse transcriptase inhibitors (NRTIs)

function of neutrophils

phagocytosis and chemotaxis

function of eosinophils

phagocytosis and protection against parasites involvement in allergic response

what is the function of B cells?

production of antibodies (immunoglobulins) to specific antigens

what is the function of primary or central lymphoid structures

production of immune cells; sites for cell maturation

ritonavir drug class

protease inhibitor

treat both HIV-1 and HIV-2 in combination with at least one reverse transcriptase inhibitor to prevent resistance

protease inhibitors (PI)

three enzymes necessary for HIV replication

reverse transcriptase protease integrase

what is the function of secondary or peripheral lymphoid structures?

sites for activation of immune cells by antigens

where do T cells mature?

thymus gland