Med Surg: Chapter 38: Nursing Management: Patients With Allergic Disorders: PREPU
A client has been having joint pain and swelling in the left foot and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered? A Autoimmune B An exacerbation of a previous disorder C. A cause-and-effect relationship D An alloimmunity disorder
A
A nurse is reviewing how to use an epinephrine auto-injector with a child and parents. The nurse determines that the teaching was successful when the child and parents state that after injection they will hold the pen in place for approximately: A 10 seconds. B 30 seconds. C 60 seconds. D 5 seconds.
A
A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines? A Sedation B Anorexia C Palpitations D Diarrhea
A
A patient has developed severe contact dermatitis with burning, itching, cracking, and peeling of the skin on her hands. What should the patient be instructed to do? A Keep her hands well moisturized. B Maintain the room temperature at 80°F. C Wash her hands with antibacterial soap. D Wear powdered latex gloves.
A
The nurse working in an allergy clinic is preparing to administer skin testing to a client. Which route is the safest for the nurse to use to administer the solution? A Intradermal B Intravenous C Subcutaneous D Intramuscular
A
Fexofenadine trade name is?
Allergra
A client has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client? A A disorder where the body has too many immunoglobulins. B A disorder where killer T cells and autoantibodies attack or destroy natural cells—those cells that are "self." C A disorder where the body does not have enough immunoglobulins. D A disorder where histocompatible cells attack the immunoglobulins.
B
A mother has come to the emergency department (ED) with her 2-year-old who appears to be having a hypersensitivity reaction. The ED nurse knows that a hypersensitivity reaction may be characterized by an immediate reaction beginning within minutes of exposure to an antigen. What condition is an example of such a reaction? A Hay fever B Anaphylactic reaction immediately following a bee sting C Rheumatoid arthritis D Skin reaction from tape adhesive
B
What type of immunoglobulin is most likely involved with allergic reactions? A IgM B IgE C IgG D IgA
B
The nurse is conducting discharge teaching for a client who is being discharged from the emergency department after an anaphylactic reaction to peanuts. Which education should the nurse include in the teaching? Select all that apply. A Desensitization to allergen B Wearing a medical alert bracelet C Use of sedatives to treat reactions D Avoiding allergens
B, D
A nurse is preparing a presentation to a local commununity group about allergic disorders. Which medication would the nurse include as the most common cause of anaphylaxis? A. Iodine contrast agent B. Morphine C. Penicillin D. Aspirin
C
The nurse is planning the care of an 8-year-old boy who has been diagnosed with atopic dermatitis. In the boy's plan of nursing care, what nursing diagnosis should the nurse prioritize? A. Risk for delayed development related to atopic dermatitis B. Chronic pain related to atopic dermatitis C Risk for impaired skin integrity related to atopic dermatitis D Acute pain related to atopic dermatitis
C
Which term refers to an incomplete antigen? A Antigen B Allergen C Hapten D Antibody
C
A nurse is assessing a client who is experiencing an allergic reaction. What will the nurse identify as resulting from the release of histamine? A Constipation B Hypotension C Vasodilation D Pruritus
D
A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch. The nurse is aware that the patient may be having an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure? A 24 hours B 6 hours C 12 hours D 2 hours
D
When evaluating a client's knowledge about use of antihistamines, what statement indicates further education is required? A "Hard candy will relieve my dry mouth." B "This medication may be taken with food." C "I should be careful when driving." D "If I am pregnant, I should take half the dose."
D
Which of the following is the most frequent route of exposure to a latex allergy? A. Parenteral B Inhalation C Mucosal D Cutaneous
D
The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? A Ranitidine B Cimetidine C Omeprazole D Diphenhydramine
D Certain medications are categorized by their action at these receptors. Diphenhydramine (Benadryl) is an example of an antihistamine, a medication that displays an affinity for H1 receptors. Cimetidine (Tagamet) and ranitidine (Zantac) target H2 receptors to inhibit gastric secretions in peptic ulcer diseas
Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? A Bradykinin B Serotonin C Histamine D Prostaglandin
C
A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? A "You need to come back to the clinic to get a different medication since this one is not working for you." B "I am sorry that you are feeling poorly but this is the only medication that will work for your problem." C "The full benefit of the medication may take up to 2 weeks to be achieved." D "You may be immune to the effects of this medication and will need something else in its place."
C
The nurse is completing the intake assessment of a client new to the allergy clinic. The client states that he was taking nose drops six times a day to relieve his nasal congestion. The nasal congestion increased, causing him to increase his usage of the nasal spray to eight times a day. But again the congestion worsened. The nurse communicates to the health care provider that the client experienced A Leukotriene modifier B Atopic dermatitis C Tolerance to nose drops D Rhinitis medicamentosa
D Rhinitis medicamentosa is a rebound reaction from overuse of sympathomimetic nose drops or sprays that worsen the congestion, causing the client to use more of the medication, thereby leading to more nasal congestion.
What education should the nurse provide to the patient taking long-term corticosteroids? A. Corticosteroids are relatively safe drugs with very few side effects. B. The patient should not stop taking the medication abruptly and should be weaned off of the medication. C. The patient should take the medication only as needed and not take it unnecessarily. D. The patient should discontinue using the drug immediately if weight gain is observed.
B
When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area? A. Plantar aspects of the feet B Lower arms C Ankles D. Dorsal aspect of the hand
D
An occupational health nurse is assessing a woman who experienced an anaphylactic reaction to a dip that contained crab during an office celebration. Because the woman promptly self-administered epinephrine, her status has normalized and she is now resting in a colleague's office. What action should the nurse perform? A. Have the woman transported to a nearby emergency department. B. Liaise with the woman's family and arrange for her to return home. C. Encourage the woman to limit her physical activity for the next 24 to 48 hours. D Provide reassurance to limit the woman's anxiety.
A Patients who have experienced anaphylactic reactions and received epinephrine should be transported to the local emergency department for observation and monitoring because of the risk for a "rebound" reaction 4 to 10 hours after the initial allergic reaction. This is a priority over anxiety reduction and activity limitation.
The nurse is obtaining a medication history from a patient with allergic rhinitis. The patient states, "I've been on numerous medications over the years and nothing seems to work. Plus I get so tired and sleepy from them." The nurse documents the medications used in the patient's medical record: Diphenhydramine 50 mg orally twice a day Hydroxyzine 25 mg orally three times a day Chlorpheniramine 4 mg orally every 6 hours Fexofenadine 60 mg orally twice a day When reviewing the list, which medication would the nurse identify as causing the least sedation? A. Diphenhydramine B. Hydroxyzine C. Chlorpheniramine D. Fexofenadine.
D Fexofenadine is a second-generation antihistamine considered "nonsedating." Diphenhydramine, hydroxyzine, and chlorpheniramine are first-generation antihistamines associated with sedation
The nurse is educating a patient with allergic rhinitis about how the condition is induced. What should the nurse include in the education on this topic? A Airborne pollens or molds B Parenteral medications C Topical creams or ointments D Ingested foods
A
The nurse in an allergy clinic is assessing a new patient. The nurse is aware that histamine plays an important role in the immune response and that the effects of histamine can manifest in assessment findings. What response can occur as a result of histamine release? A Decrease secretion of gastric and mucosal cells B Contraction of bronchial smooth muscle C Constriction of small venules D. Dilation of large blood vessels
B Histamine's effects during the immune response include contraction of bronchial smooth muscle, resulting in wheezing and bronchospasm; an increase in secretion of gastric and mucosal cells; dilation of small venules; and constriction of large blood vessels.
The parents of a 3-year-old boy have just been informed that allergy testing suggests their son has multiple food allergies. When providing health education for this family, what subject should the nurse prioritize? A Coping strategies for the lifestyle changes that their son's diagnosis necessitates B The appropriate use of antihistamines in pediatric patients C Alternative nutritional delivery systems D Possible sources of food allergens and strategies for avoiding offending foods
D
