Immunological HESI
A client receiving cisplatin therapy has developed tumor lysis syndrome (TLS). Which medication should the nurse administer to treat the TLS?
Allopurinol
Which medication will cause the nurse to monitor the client closely for hemolytic anemia?
methyldopa
What assessment findings indicate that an older client is at risk for developing an infection? Select all that apply.
thin skin weak cough sluggish bowel indwelling catheter
The nurse is caring for a hospitalized immunosuppressed client. Which interventions will be beneficial for safe and effective care of this client? Select all that apply.
Avoid using supplies from common areas Encourage activity at an appropriate level Use alcohol-based hand rubs before touching the client
An older client reports severe muscle weakness and dysphagia. The primary healthcare provider also observes periorbital edema with a lilac eyelid rash in the client. Which autoimmune disease will the nurse most likely see documented in the client's electronic medical record?
Dermatomyositis
The nurse has administered lymphocyte immunoglobulin to a client. Which side effects are most likely to occur? Select all that apply
Leukopenia Tachycardia Serum sickness
The nurse has administered lymphocyte immunoglobulin to a client. Which side effects are most likely to occur? Select all that apply.
Leukopenia Tachycardia Serum sickness
The laboratory report of a client reveals the presence of 350 cells/mm3 (350 cells/uL) of CD4+ T-cell count. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client?
Stage 2
A client newly diagnosed with human immunodeficiency virus (HIV) comments to a nurse, "There are so many rotten people around. Why couldn't one of them get HIV instead of me?" What is the nurse's best response?
"It seems unfair that you contracted this disorder."
A client on immunosuppressive therapy is diagnosed with a peptic ulcer. Which medication might have led to this condition?
Prednisone
A client presents with red, inflamed skin covered with papules, vesicles, and bullae from a type IV hypersensitivity reaction. Which condition/disease will the nurse most likely observe written in the client's electronic medical record?
Contact dermatitis
A client presents with a localized bacterial infection of mucous membranes. Which organism is most likely responsible for this condition in the client?
Corynebacterium diphtheria
The laboratory results of a client with a pulmonary hemorrhage and glomerulonephritis reveal the presence of IgG antibodies. Which type of hypersensitivity reaction should a nurse suspect?
Cytotoxic reaction
Which manifestations indicate the prodromal stage in a client with inhalation anthrax? Select all that apply.
Fatigue Mild chest pain Dry harsh cough
A client with acquired immunodeficiency syndrome (AIDS) is suspected to be infected with Cryptococcus neoforman. Which symptoms in the client support the nurse's suspicion? Select all that apply.
Fever Seizures Confusion
Which client may have a type II hypersensitivity reaction?
Goodpasture syndrome
A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination?
Gown and gloves when giving direct care
The primary health care provider prescribes contact precautions for a client with hepatitis A. What nursing interventions are required for contact precautions?
Gown and gloves when handling articles contaminated by urine or feces
A client has a body temperature of 102.8° F along with chills; dysuria; urethral discharge; and a boggy, tender prostate. Which organism is responsible for this condition?
e coli
A nurse is reviewing the physical examination and laboratory tests of a client with malaria. Which important clinical indicators should the nurse watch for when reviewing data about this client? Select all that apply.
hyperthermia splenomegaly
During an acquired immunodeficiency syndrome (AIDS) education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement?
ignorance related to condom use
What does a shift to the left indicate in the white blood cell count differential?
immature neutrophils in blood
Which drugs are used for the treatment of clients with rheumatoid arthritis that inhibit tumor necrosis factor-A? Select all that apply.
infliximab etanercept golimumab
Which client statement indicates effective teaching about an automatic epinephrine injector to self-treat for insect stings? Select all that apply.
inject into thigh keep with you at all times replace before expiration
The diagnostic report of a client indicates a positive specific treponemal antibody test. The signs and symptoms of syphilis are absent. What does the nurse infer from this finding?
latent
Which organism causes Hansen's disease?
Mycobacterium leprae
The nurse is caring for a client on antiretroviral therapy who has Pneumocystis jiroveci pneumonia. Which action is priority?
Providing adequate oxygen for the client.
A client with rheumatoid arthritis is receiving etanercept therapy. Which instruction should the nurse share with the client
Report site reaction
What is the mechanism of action of penicillin?
inhibits cells wall synthesis
A client with tuberculosis is prescribed rifampin. What does the nurse teach the client about this medication? Select all that apply.
"Avoid drinking alcohol while you are on this drug." "Report immediately if you find a yellow appearance to the skin." "Your soft contact lenses will become permanently stained with this drug."
A client cannot understand how syphilis was contracted because there has been no sexual activity for several days. Which length of time associated with the incubation of syphilis should the nurse include in the teaching plan?
2-6 weeks
Which dietary changes does the nurse suggest for a client who has diarrhea associated with human immunodeficiency virus (HIV disease)? Select all that apply.
"Eat much less roughage." "Drink plenty of fluids between meals."
The nurse notes that a client is not adhering to prescribed antibiotic therapy. Which reason should the nurse document?
"I left my pills in the bedroom and I forgot to take them with breakfast."
A nurse is counseling a client with tuberculosis regarding isoniazid (INH) therapy. Which statement made by the client indicates the nurse needs to follow up?
"I should apply sunscreen and wear sun-protective clothing while going outside."
A registered nurse is teaching a student nurse regarding the interventions for a client with human immunodeficiency virus (HIV) infection. Which statement by the student nurse indicates the nurse needs to follow up?
"I should avoid large crowds"
The nurse is teaching a client regarding the usage of antibiotics. Which statement made by the client indicates effective teaching?
"I should not take antibiotics to treat the flu."
The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further education?The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further education?
"I will take acetaminophen for pain rather than aspirin."
A female client is upset with her diagnosis of gonorrhea and asks the nurse, "What can I do to prevent getting another infection in the future?" Which is the most practical response the nurse can give to someone who plans to be sexually active?
"Insist that your partner use a condom."
A registered nurse is teaching a nursing student about the various mechanisms that antiviral drugs use to control human immune deficiency (HIV) infections. Which statement made by the nursing student needs correction?
"Saquinavir blocks the fusion between HIV and the host cell."
A nurse is precepting a senior-level nursing student. The preceptor knows the nursing student understands the concept of screening for sepsis when the student makes what statement?
"Sepsis mortality is affected greatly by treatments performed in the first 6 hours."
A client with tuberculosis is prescribed isoniazid. What statements should the nurse tell the client? Select all that apply.
"Take the drug on an empty stomach." "Take daily multiple vitamins that contain B-complex." "Report darkening of the urine or a yellowish skin discoloration."
What should the nurse explain as the reason a client prescribed corticosteroid therapy for a chronic health problem develops frequent infections?
"They affect antigen-antibody immunity."
A client with tuberculosis asks the nurse about the communicability of the disease. Which is the best response by the nurse?
"Untreated active tuberculosis is communicable."
A registered nurse is evaluating the statements of a nursing student providing instructions to the partner of a client with Ebola. Which instruction given by the nursing student needs correction?
"You should be careful because the Ebola virus spreads through the air."
A nurse is assessing clients who are to be given the smallpox vaccination. Which client should the nurse remove from the immunization line for medical counseling?
45-year-old woman with breast cancer
A tuberculin skin test with purified protein derivative (PPD) tuberculin is performed as part of a routine physical examination. When does the nurse instruct the client to make an appointment so the test can be read?
48 to 72 hours
A client presents with sneezing; lacrimation; swelling with an airway obstruction; and pruritus around the eyes, nose, throat, and mouth. The nurse interprets these findings as a Type I hypersensitivity reaction. Which disease might have occurred in the client?
Allergic rhinitis
A client's diagnosis reports indicate the presence of syphilis, but the clinical manifestations of syphilis are absent in the client. Which stage of syphilis is the client in?
Latent
The nurse is reviewing the medication charts of four clients prescribed with cytokines. Which client's medication chart indicates the nurse needs to intervene?
Anakinra
A client presents with cutaneous lesions with swelling in the face, eyelids, and lips from dilation and engorgement of the capillaries. No welts or vesicles are observed. Which condition most likely has occurred in the client?
Angioedema
Arrange the sequence of steps required to stimulate antibody-mediated immunity in its correct sequence
Antibody-mediated immunity reactions start when new antigens invade the human body. After exposure, the antigen is recognized by the macrophages. Next virgin B lymphocytes are sensitized to the new antigen. After this action, B lymphocytes produce antibodies. These antibodies then bind to the antigen and an immune complex is formed. The binding of antibodies causes cellular events and results in the elimination of the antigen.
The nurse is providing induction therapy to a client to prevent rejection after an organ transplant. Which medication will the nurse most likely administer?
Atgam
In clients with Goodpasture syndrome, what is the pathophysiology of this syndrome?
Auto-antibodies attack the glomerular basement membrane and neutrophils
Which nursing action helps reduce the development of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA)?
Bathing clients with chlorhexidine gluconate (CHG) solution
A client has undergone scratch testing but the causative allergen is yet to be identified. What would be the next step to confirm a strongly suspected allergen?
Begin intradermal testing
Which finding in the client's laboratory report enables the nurse to conclude that the client has a stage 3 human immunodeficiency (HIV) infection according to the Centers for Disease Control and Prevention (CDC) classification? Select all that apply.
CD4 T 150, 12% and Kaposi's
A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. What does the nurse explain to the client regarding the diagnostic criterion for acquired immunodeficiency syndrome (AIDS)?
CD4 T less than 200
While assessing a client with presence of neurotoxicity, lymphoma, and hypertension, the medical history reveals that the client is on immunosuppressant drug therapy. Which drug class might have caused these conditions?
Calcineurin inhibitors
Why should the nurse instruct a client to discuss the use of over-the-counter decongestants with a healthcare provider before taking them?
Can cause urinary retension
A client with Lyme disease presents with dyspnea, dizziness, and facial paralysis. Which medication may be included in the prescription?
Ceftriaxone
The nurse is reviewing the laboratory reports of a client who has sustained a significant reaction to the tuberculin skin test but has negative findings on bacteriologic studies. The reports further reveal the absence of x-ray findings compatible with tuberculosis (TB) and clinical evidence of TB. Which class of TB does the nurse suspect?
Class 2
While caring for a client with an intravenous cannula, the nurse assesses the site and finds that it red, swollen, and warm with purulent drainage near the insertion site. Which nursing intervention provides client comfort?
Cleaning the site with alcohol by expressing the drainage
A client in the emergency department states, "I was bitten by a raccoon while I was fixing a water pipe in the crawl space of my basement." Which is the most effective first-aid treatment for the nurse to use for this client?
Cleansing the wound with soap and water
The nurse is taking care of four clients with human immunodeficiency virus (HIV) infections. Which client's condition should the nurse report to the primary healthcare provider within 24 hours after observation?
Client A- Burning, Itching, and discharge from the eyes
The nurse is preparing a teaching plan for clients receiving antitubercular medications. Which teaching plan needs correction?
Clients taking Isoniazid should take the drug with food
A client developed acute herpes zoster and was treated with antiviral medication within 72 hours of the appearance of the rash. The client is reporting persistent pain 1 week later. What does the nurse identify as the cause of the posttherapeutic neuralgia?
Damage to the nerves
A client has been prescribed tacrolimus for immunosuppressant therapy. Which drug safety alert should the nurse mention?
Do not consume grapefruit or grapefruit juice.
The nurse educates a client on decreasing the risk of developing antibiotic-resistant infections. Which statement made by the nurse will be most significant?
Do not skip any dose of your antibiotics
When assessing the oral cavity of a newly admitted client with acquired immunodeficiency syndrome (AIDS), the nurse identifies areas of white plaque on the client's tongue and palate. What is the nurse's initial response?
Document the presence of the lesions, describing their size, location, and color.
The nurse suspects that a client with inhalation anthrax is in the prodromal stage of disease. Which symptoms support the nurse's conclusion? Select all that apply.
Dry cough Mild chest pain
A nurse is caring for a client who has acute malaria. Which complication should the nurse monitor the client for?
Electrolyte imbalances
A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client?
Eliminate chemical, mechanical, and thermal irritation.
A client has colorectal cancer and is receiving cetuximab. Which process does cetuximab inhibit?
Epidermal growth factor receptors (EGFRs)
A client treated with antitubercular medications reports vision changes. Which medication may be responsible for the client's condition?
Ethambutol
Which antitubercular medications may increase a client's risk for gout? Select all that apply.
Ethambutol Pyrazinamide
Upon assessment of a client's foot, the nurse discovers the following (see image). Which virus is associated with the condition indicated? (plantar's wart)
HPV
What is important nursing care for pediatric clients with leukemia on chemotherapeutic protocols?
Having them avoid contact with infected persons
A client with jaundice reports fatigue, abdominal pain, loss of appetite, dark urine, nausea, and vomiting. Which pathogen is most likely responsible for the client's condition?
Hepatitis C
A client with jaundice reports fatigue, abdominal pain, loss of appetite, dark urine, nausea, and vomiting. Which pathogen is most likely responsible for the client's condition?
Hepatitis C Virus
A hospitalized client is on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA). Which statement by an unlicensed assistive personnel (UAP) (Canada: continuing care assistant, CCA) indicates a need for further teaching?
I will remove the gown, then the gloves, before washing my hands
Which type of delayed hypersensitivity reaction can be assessed in the client pictured in the image?
IV
A client reports fever, headache, extreme tiredness, dry cough, sore throat, runny nose, muscle aches, nausea, vomiting, and diarrhea. Which organism is responsible for this condition?
Influenza virus
A nurse is developing a teaching plan for a client with scleroderma. What should the nurse include about skin care?
Keep skin lubricated with lotion
A client with scleroderma reports having difficulty chewing and swallowing. What should the nurse recommend to safely facilitate eating?
Mechanical soft diet
A client with mild diarrhea is diagnosed with a Clostridium difficile infection. Which is the first-line drug that would be used to treat this condition?
Metronidazole
Which medication should the nurse anticipate being prescribed for a client with C. difficile-associated disease (CDAD)? Select all that apply.
Metronidazole Vancomycin Fidaxomicin Ciprofloxacin
Which leukocyte values should be assessed to determine the adequacy of a client's response to inflammation? Select all that apply.
Monocytes Neutrophils Macrophages
A client's laboratory report shows severe neutropenia and thrombocytopenia. Which medication may have caused this condition?
Mycophenolate mofetil
A client with acquired immunodeficiency syndrome (AIDS) reports painless, white, raised lesions on the lateral aspect of the tongue. Which disease does the nurse suspect?
Oral hairy leukoplakia
A client with P. jiroveci pneumonia (PCP) infection arrives at the hospital for a follow-up visit. The laboratory report shows the CD4+ T-cell count as 150. Which medication will be most beneficial for this client?
Pentamidine isethionate
What should be done to ascertain the specific cause of a client's allergic reaction?
Perform radioimmunosorbent test (RIST)
Indicate the first step involved in the disposal of sharp wastes of a client with acquired immunodeficiency syndrome (AIDS).
Place the waste in a puncture-resistant container
What steps would the nurse take to manage a client's botulism infection? Select all that apply.
Planning for nutrition and rehabilitation support Disposal of suspected contaminated food source
What is the role of the plasma cell in the antigen-antibody response?
Produces antibodies against the sensitizing antigen
A client who has been living in another country for 10 years is undergoing diagnostic testing to identify the causative organisms of the infection that has been acquired. When caring for this client, what should the nurse recall about active immunity?
Protein substances are formed within the body to neutralize antigens
What should the nurse identify as responses to the release of histamine during a type I rapid hypersensitivity reaction? Select all that apply.
Pruritus Erythema Nasal mucus secretion Conjunctival mucus secretion
The primary healthcare provider prescribes antiviral medication to a human immune deficiency virus-positive client to inhibit the viral enzyme that helps insert viral DNA into human DNA. Which drug is being administered?
Raltegravir
Which medications act by binding with integrase enzyme and prevent human immunodeficiency virus (HIV) from incorporating its genetic material into the client's cell? Select all that apply.
Raltegravir Elvitegravir
Which are examples of actively acquired specific immunity? Select all that apply.
Recovery from measles Recovery from chickenpox Immunization with live or killed vaccines
A nurse observes that an unlicensed assistive personnel (UAP) did not use a bag impervious to liquid for contaminated linen from a client who is on contact precautions. What is the nurse's best way to handle this situation?
Review transmission-based precautions with the UAP
A nurse is educating a client with human immunodeficiency virus (HIV) about self-management. Which suggestion by the nurse benefits the client?
Rinse your mouth with normal saline after every meal.
Which throat manifestations are the key features for a client with acute viral pharyngitis? Select all that apply
Scant or no tonsillar exudate Slight erythema of the pharynx and tonsils
While assessing a client with acquired immunodeficiency syndrome (AIDS), the nurse suspects that the client has developed cryptococcosis. Which clinical manifestations support the nurse's suspicion of a cryptococcosis infection? Select all that apply
Seizures Blurred vision Neurologic deficits
A registered nurse is evaluating a new nurse who is preparing to administer intravenous fluids to a client. Which action made by the new nurse indicates the registered nurse needs to intervene?
Shaving at insertion site
A client reports hair loss, joint pain, and a facial rash. The nurse documents the presence of a butterfly rash on the face in the client's medical record. Which disorder does the nurse suspect?
Systemic lupus erythematosus
The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further education?
Take acetaminophen rather than aspirin
A nurse is caring for a 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) and has a CD4 count of 150. The client needs an update on immunizations and asks which ones are needed. Which vaccines are required to comply with the recommended immunization schedule for a client with HIV?
Tetanus, hepatitis B, influenza, and pneumococcal vaccines
Which symptoms are observed in a client with Sjögren's syndrome? Select all that apply.
Tooth decay Corneal ulcers Vaginal drynes
A client in the gynecology unit has edema and a sore throat. Upon assessment, a nurse finds that the client has a body temperature of 101° F and a blood pressure reading of 80/60 mmHg. Which condition would the nurse suspect?
Toxic Shock Syndrome
A client with acquired immunodeficiency syndrome (AIDS) reports speech, gait, and vision difficulty. The nurse observes the client is confused and lethargic. Which microorganism is most likely responsible for this condition?
Toxoplasma gondii
The nurse is advising a client with acquired immunodeficiency syndrome (AIDS) to avoid the consumption of undercooked meat. Which infection can be prevented in the client by following this measure?
Toxoplasmosis encephalitis
Which conditions in clients are examples of cell-mediated immunity? Select all that apply.
Tuberculosis Graft rejection Contact dermatitis
A client's laboratory report reveals an antigen-immunoglobulin (IgE) reaction. The nurse suspects the presence of allergic rhinitis. Which type of medication would treat this condition?
mast cell stabilizer
A client has received ABO-incompatible blood from a donor by mistake. Which type of hypersensitivity reaction will occur in the client?
Type II
A client who works manufacturing latex gloves presents with dryness, pruritus, fissuring, and cracking of the skin followed by redness and inflammation about 24 hours after contact. The nurse identifies it as an allergic reaction. Which condition most likely has occurred?
Type IV contact dermatitis reaction
During an assessment, a nurse suspects that a client is in the primary stage of syphilis. Which findings support the nurse's conclusion? Select all that apply.
Ulcers on the hands and lips Firm and enlarged lymph nodes
While assessing a client with acquired immunodeficiency syndrome, the nurse suspects that the client has developed cryptosporidiosis. Which symptoms support the nurse's suspicion? Select all that apply.
Weight loss Diahrrea
A client with bubonic plague has a body temperature of 103° F associated with chills, swollen glands, headache, and weakness. Which microorganism is most likely responsible for the client's condition?
Yersinia pestis
The nurse is teaching a post-radiation therapy client regarding proper skin care to the radiation treatment area. Which statement made by the client indicates the nurse needs to follow up?
avoid using saline solution
What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)?
complimentary therapy
While assessing a client with acquired immunodeficiency syndrome (AIDS), the nurse suspects the client has developed histoplasmosis. Which symptoms in the client support the nurse's suspicion? Select all that apply.
cough enlarged lymphs
Which skin infection is illustrated in the image? (serious shoulder sore)
cutaneous anthrax
A client with radiation therapy for neck cancer reports, "I feel a lump while swallowing and foods get stuck." What does the nurse document in the client's medical history?
dysphagia
What are the clinical manifestations during the fulminant stage in a client with inhalation anthrax? Select all that apply.
pleural effusion, temp 104, septic shock
Which test result should a nurse review to determine if the antibiotic prescribed for the client will be effective?
sensitivity
The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further education?
take acetaminophen
The nurse performs a skin test on a client who has a mosquito bite. The client shows wheal and flare reaction post-skin test. Which type of hypersensitivity reaction most likely has occurred?
type 1
A pregnant woman presents with a body temperature of 103 °F, cough, headache, muscle aches, chest pain, severe joint pain and night sweats and is diagnosed with coccidioidomycosis. Which medication will the nurse most likely observe prescribed on the medication administration record?
Amphotericin B
Which action should the nurse take when caring for a client who is suspected as having the Ebola virus?
Avoid contact with all body fluids and discharges
A client with tuberculosis is prescribed rifampin. What does the nurse teach the client about this medication? Select all that apply.
Avoid drinking alcohol while you are on this drug." "Report immediately if you find a yellow appearance to the skin." "Your soft contact lenses will become permanently stained with this drug."
A primary healthcare provider has prescribed pyrazinamide to a client with tuberculosis. Which instruction by the nurse will be beneficial to the client? Select all that apply.
Avoid drinking alcoholic beverages." "Drink at least 8 ounces of water with the medication."
The nurse is caring for a client with human immunodeficiency virus (HIV) infection. Which clinical manifestations in the client should be immediately reported to the primary healthcare provider?
Blood in urine
A client reports a cold and a whooping sound with the cough. Which organism is responsible for this condition?
Bordetella pertussis
A nurse employed in an outpatient radiology department is reviewing safety precautions with staff members. What explanation does the nurse provide to explain the reason radium is stored in lead containers?
Lead functions as a barrier
The nurse is caring for a client who is receiving treatment via intrathecal therapy. The client reports a headache and neck stiffness. Upon assessment, the nurse finds that the client's body temperature is 103 °F. Which condition should the nurse suspect in the client?
meningitis
