PrepU Immunological
Which blood test confirms the presence of antibodies to HIV? -Enzyme-linked immunosorbent assay (ELISA) -p24 antigen -Erythrocyte sedimentation rate (ESR) -Reverse transcriptase
Enzyme-linked immunosorbent assay (ELISA)
Which type of phagocytic disorder occurs when white blood cells cannot initiate an inflammatory response to infectious organisms? -Panhypoglobulinemia -Telangiectasia -Agammaglobulinemia -Hyperimmunoglobulinemia
Hyperimmunoglobulinemia
The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system? -Cytokines -Lymphoid tissues -Red blood cells -Stem cells
Lymphoid tissues
The nurse is completing a physical assessment with an older adult client. Which findings indicate to the nurse that the client is experiencing age-related changes to the immune system? Select all that apply. -Muscle cramps -Pain with voiding -Diarrhea -Crepitus -Skin tears
Pain with voiding Diarrhea Skin tears
Which would be inaccurate information pertaining to SCID? -It is one of the most common causes of primary immunodeficiencies. -This disease affects B cells and T cells. -The incidence is unknown. -The inheritance of SCID can be autosomal dominant.
The inheritance of SCID can be autosomal dominant.
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity -The body produces inappropriate or exaggerated responses to specific antigens. -A deficiency results from improper development of immune cells or tissues. -The normal protective immune response attacks the body, damaging tissues. -The body overproduces immunoglobulins.
The normal protective immune response attacks the body, damaging tissues.
In a client infected with human immunodeficiency virus (HIV), CD4+ levels are measured to determine the: -resistance to antigens. -presence of opportunistic infections. -level of the viral load. -extent of immune system damage.
extent of immune system damage.
Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that: -eliminate cancer cells. -increase the efficacy of antibiotics. -filter bacteria from tissue fluid. -program T lymphocytes.
filter bacteria from tissue fluid
Which of the following cell types are involved in humoral immunity? -Memory T lymphocyte -Helper T lymphocyte -B lymphocytes -Suppressor T lymphocyte
B lymphocytes
A client with acquired immune deficiency syndrome (AIDS) comes to the clinic reporting difficulty swallowing. The client says, "It hurts so much when I swallow." Inspection reveals creamy white patches in the client's mouth. What will the nurse suspect? -Clostridium difficile diarrhea -Cryptococcus neoformans -Wasting syndrome -Candidiasis
Candidiasis
The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: -Nausea and vomiting. -Oral candida. -Anorexia. -Chronic diarrhea.
Chronic diarrhea.
A nurse is explaining treatment options to a client diagnosed with an immune dysfunction. Which statement by the client accurately reflects the teaching about current stem cell research? -"Stem cell clinical trials have only been attempted in clients with acquired immune deficiencies, but plans are underway to begin human cloning using embryonic stem cells." -"Stem cell transplantation has been discontinued based on concerns about safety, efficacy, resource allocation, and human cloning." -"Currently, stem cell transplantation has only been performed in the laboratory, but future research with embryonic stem cell transplants for humans with immune dysfunction has been promising." -"Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."
"Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."
The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? -"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider." -"The client probably has pneumocystis pneumonia and will need to be evaluated by the health care provider." -"This is one of the side effects from antiretroviral therapy and will require changing the medication." -"The client probably has a case of the flu and you should give acetaminophen."
"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."
A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive? -Enzyme-linked immunosorbent assay (ELISA) -Complete blood count (CBC) -Western Blot -Schick
Enzyme-linked immunosorbent assay (ELISA)
A healthcare worker has been exposed to the blood of an HIV-positive client and is awaiting the results of an HIV test. In the meantime, what precautions must the healthcare worker take to prevent the spread of infection? -Quit their job and get admitted to a hospital or a cancer treatment center. -Follow the same sexual precautions as someone who has been diagnosed with AIDS. -Limit interactions with people who are already HIV infected. -Limit interactions with people who are not HIV infected.
Follow the same sexual precautions as someone who has been diagnosed with AIDS.
The nurse is preparing a teaching plan for a client with an immunodeficiency. What aspect would the nurse emphasize as most important? -Adherence to prophylactic medication administration -Incorporation of treatment regimens into daily patterns -Frequent and thorough handwashing -Identifying the signs and symptoms of infection
Frequent and thorough handwashing
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic? -means of transmission -HIV-1 is more prevalent than HIV-2 subtypes -the fact that it is a mutated virus originally thought to be bovine in nature -cure rate
HIV-1 is more prevalent than HIV-2 subtypes
Which of the following indicates that a client with HIV has developed AIDS? -Weight loss of 10 lb over 3 months -Severe fatigue at night -Pain on standing and walking -Herpes simplex ulcer persisting for 2 months
Herpes simplex ulcer persisting for 2 months
A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen? -Platelet administration -IV gamma globulin administration -Thymus grafting -Factor VIII administration
IV gamma globulin administration
The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses? -Reduced vitamin intake -Polypharmacy -Decline in self-care activities -Immunosenescence
Immunosenescence
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. What would the nurse expect to be started? -Immunosuppressive agents -Anticoagulation -Chest physiotherapy -Antibiotic therapy
Immunosuppressive agents
A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which medication classification would NOT place the client at risk for impaired immune function? -Antineoplastic agents -Inotropics -Adrenal corticosteroids -Antimetabolites
Inotropics
Which of the following is the most common HIV-related malignancy? -Pancreatic carcinoma -B-cell lymphoma -Kaposi's sarcoma -Cervical carcinoma
Kaposi's sarcoma
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? -Gluten -Liquids -Sucrose -Iron and zinc
Liquids
A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: -Lymphocytes migrate to areas of the lymph node -Antibodies are released into the bloodstream -Antibodies reside in the plasma -B-lymphocytes respond to a specific antigen
Lymphocytes migrate to areas of the lymph node
The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents? -Basophils -Neutrophils -Macrophages -Eosinophils
Macrophages
The nurse is aware that the most prevalent cause of immunodeficiency worldwide is -Malnutrition -Hypocalcemia -Chronic diarrhea -Neutropenia
Malnutrition
A parent has brought a child to the clinic for a wellness check. While talking with the nurse, the parent asks the nurse to suggest a diet that will maximize the immune function of growing children. What dietary pattern should the nurse suggest? -Diet rich in amino acids and essential fatty acids -Diet rich in potassium, magnesium, and sodium -Moderate diet that is balanced and varied -Diet rich in iron, zinc, and vitamin E
Moderate diet that is balanced and varied
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wart-like lesions on my vagina. This is happening quite often." Which nursing action is the priority for this client? -Recommend abstinence or safer-sex practices. -Provide a prescribed topical antifungal agent to treat the client's vaginal infection. -Offer information on human immunodeficiency virus (HIV) testing. -Refer the client to a support group with others experiencing the same symptoms.
Offer information on human immunodeficiency virus (HIV) testing.
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have? -Naturally acquired active immunity -Passive immunity transferred by the mother -Artificially acquired active immunity -There is no immunity passed down from mother to child.
Passive immunity transferred by the mother
A client is diagnosed with severe combined immunodeficiency (SCID). What would the nurse expect to integrate into the client's plan of care? -Preparation for bone marrow transplantation -Administration of granulocyte colony-stimulating factors -Preparation for a thymus graft -Administration of antifungal agents
Preparation for bone marrow transplantation
The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function? -Surgical removal of the appendix -Previous organ transplantation -Surgical history of a partial gastrectomy -Negative history for radiation therapy
Previous organ transplantation
What is the function of the thymus gland? -Programs B lymphocytes to become regulator or effector B cells -Produces stem cells -Programs T lymphocytes to become regulator or effector T cells -Develops the lymphatic system
Programs T lymphocytes to become regulator or effector T cells
The nurse is caring for a client with a suspected immune system disorder. What test would be ordered if a deficiency or excess of immunoglobulins was suspected? -Protein electrophoresis -Plasmapheresis -T-cell and B-cell assays -Enzyme-linked immunosorbent assay
Protein electrophoresis
Which condition is associated with impaired immunity relating to the aging client? -Incidence of autoimmune disease decreases -Skin becomes thicker -Antibody production increases -Renal function decreases
Renal function decreases
The nurse administers an injection to a client with AIDS. When finished, the nurse attempts to recap the needle and sustains a needlestick to the finger. What is the priority action by the nurse? -Fill out a risk management report. -Report the incident to the supervisor. -Call the lab to draw the nurse's blood. -Obtain counseling.
Report the incident to the supervisor
Which adverse effect(s) should the nurse closely monitor in a client who has secondary immunodeficiencies due to immunosuppressive therapy? -Rheumatoid arthritis -Respiratory or urinary system infections -Cardiac dysrhythmias and heart failure -Depression, memory impairment, and coma
Respiratory or urinary system infections
Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as the form of the genetic viral material? -Ribonucleic acid (RNA) -Deoxyribonucleic acid (DNA) -Glycoprotein envelope -Viral core
Ribonucleic acid (RNA)
A new nursing graduate is working at the hospital in the medical-surgical unit. The preceptor observes the nurse emptying a patient's wound drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions? -Standard precautions should only be used with patients who are HIV positive to reduce the risk of transmission of the HIV virus. -If you are careful and do not expose yourself to blood or body fluids, it is not necessary to use gloves all of the time. -It is only necessary to use gloves when you are emptying reservoirs that have body fluids in them. -Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens.
Standard precautions should be used with all patients to reduce the risk of transmission of bloodborne pathogens.
A nurse is teaching a community group about healthy lifestyles. A participant asks about how to maintain a healthy immune system. The nurse informs the group that which factor will positively affect the immune system? -Poor nutritional status -Strong family and community connections -Residential exposure to radiation -Rigorous, competitive exercise
Strong family and community connections
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis? -The injection area will become painful with in duration if the client has antibodies against the antigen. -The injection area swells if the client has developed antibodies against the antigen. -The client will have a productive cough. -The injection area will break out in a fine macular rash.
The injection area swells if the client has developed antibodies against the antigen.
A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have? -The nurse will call the client with the results of the test. -The nurse will inform the client that the results will have to be reported to the Centers for Disease Control and Prevention (CDC). -The nurse should send the client to have the blood drawn without informing him about the specific screening test. -The nurse ensures a written consent is obtained prior to testing.
The nurse ensures a written consent is obtained prior to testing
A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits what behavior? -The nurse wears face protection, gloves, and a gown when irrigating a wound. -The nurse places a used needle and syringe in the puncture-resistant container without capping the needle. -The nurse performs hand hygiene with a waterless antiseptic agent after removing a pair of soiled gloves. -The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.
The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.
Which statement accurately reflects current stem cell research? -Stem cell transplantation has been performed in the laboratory only. -Stem cell transplantation cannot restore immune system functioning. -Clinical trials are underway only in clients with acquired immune deficiencies. -The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.
The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? -interferons -tumor necrosis factor -interleukins -colony-stimulating factor
interferons
he body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger promotes inflammation, fever, and angiogenesis? -tumor necrosis factor -colony-stimulating factors -interferons -interleukins
interleukins
Which immunity type becomes active as a result of infection by a specific microorganism? -naturally acquired active immunity -artificially acquired passive immunity -artificially acquired active immunity -naturally acquired passive immunity
naturally acquired active immunity
A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? -"When you take this drug, eat a high-fat meal immediately afterwards." -"It doesn't matter if you take this drug with or without food." -"You should take the drug with an antacid." -"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."
"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."
The nurse is teaching the client who has an immunodeficiency disorder how to avoid infection at home. Which statement indicates that additional teaching is needed? -"I will be sure to eat lots of fresh fruits and vegetables every day." -"I will avoid contact with people who are sick or who have recently been vaccinated." -"I will make sure to have my own toothbrush and tube of toothpaste at home." -"I will wash my hands whenever I get home from work."
"I will be sure to eat lots of fresh fruits and vegetables every day."
A patient is on highly active antiretroviral therapy (HAART) for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year? -10 mm3 to 20 mm3 -1 mm3 to 10 mm3 -50 mm3 to 150 mm3 -20 mm3 to 45 mm3
50 mm3 to 150 mm3
Which of the following is the first barrier method that can be controlled by the woman? -Diaphragm -Female condom -Birth control pills -IUD
Female condom
A nurse is preparing to give a client an infusion of gamma globulin. The nurse knows to stop the infusion if the client experiences which symptoms? Select all that apply. -Fatigue -Flank pain -Shaking chills -Hunger -Tightness in the chest
Flank pain Shaking chills Tightness in the chest
Which immunoglobulin assumes a major role in bloodborne and tissue infections? IgG IgA IgM IgD
IgG
Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis? -Eczema -Vascular lesions -Thrombocytopenia -Thrush
Vascular lesions
A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? -administration of monthly intra-articular injections of corticosteroids. -administration of nonsteroidal anti-inflammatory drugs (NSAIDs) -administration of opioids for pain control. -vigorous physical therapy for the joints.
administration of nonsteroidal anti-inflammatory drugs (NSAIDs)
A client is informed of having a low white blood cell count and that the client is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? -"White blood cells are produced in the thymus gland." -"White blood cells are produced in the lymphatic tissue." -"White blood cells are produced in the plasma." -"White blood cells are produced in the bone marrow."
"White blood cells are produced in the bone marrow."
More than 50% of individuals with this disease develop pernicious anemia: -DiGeorge syndrome -Bruton disease -Nezelof syndrome -Common variable immunodeficiency (CVID)
-
Which of the following is accurate regarding acquired immunity? Select all that apply. -A nonspecific immunity present at birth -Also know as innate immunity -Can develop by contracting a disease -Usually develops as a result of exposure to an antigen through immunization -An immunologic response acquired during life but not present at birth
-An immunologic response acquired during life but not present at birth -Usually develops as a result of exposure to an antigen through immunization -Can develop by contracting a disease
A client is beginning highly active antiretroviral therapy (HAART). The client demonstrates an understanding of the need for follow up when scheduling a return visit for viral load testing at which time? -6 weeks -24 weeks -12 weeks -18 weeks
6 weeks
A client is given a nursing diagnosis of social isolation related to withdrawal of support systems and stigma associated with AIDS. Which outcomes would indicate that the nurse's plan of care was effective? Select all that apply. -Client demonstrates beginning participation in events and activities. -Client demonstrates practices to reduce the risk transmission to others. -Client verbalizes feelings related to the changes imposed by the disease. -Client demonstrates knowledge of safer sexual practices. -Client identifies appropriate sources of assistance and support.
Client demonstrates beginning participation in events and activities. Client verbalizes feelings related to the changes imposed by the disease. Client identifies appropriate sources of assistance and support.
A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse of having several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? -Call the pharmacy and let them know the client has several drug allergies. -Administer the medications that the physician ordered. -Give the client one medicine at a time and observe for allergic reactions. -Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.
Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.
The nurse is obtaining the medical history of a client with Crohn's disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? -Nonsteroidal anti-inflammatory -Angiotensin-converting enzyme inhibitors (ACE-I) -Corticosteroids -Diuretics
Corticosteroids
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. -Suppressor T cell -Cytotoxic T cell -Memory T cell -Helper T cell
Cytotoxic T cell
An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack the antigen directly by altering the cell membrane and causing cell lysis. Which cells should be isolated? -B cells -Helper T cells -Macrophages -Cytotoxic T cells
Cytotoxic T cells
A nurse is assessing a client with Kaposi's sarcoma. What initial sign does the nurse know to look for during assessment? -Deep purple cutaneous lesions -Venous stasis and phlebitis formation -Lymphedema of the lower extremities -Severe joint pain
Deep purple cutaneous lesions
Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment? -Past substance abuse -Active substance abuse -Depression -Lack of social support
Past substance abuse
A client with common variable immunodeficiency (CVID) comes to the ED reporting tingling and numbness in the hands and feet, muscle weakness, fatigue, and chronic diarrhea. An assessment reveals abdominal tenderness, weight loss, and loss of reflexes. A gastric biopsy shows lymphoid hyperplasia of the small intestine and spleen as well as gastric atrophy. Based on these findings, what common secondary problem has this client developed? -Sickle cell anemia -Hyperthyroidism -Gastric ulcer -Pernicious anemia
Pernicious anemia
A nurse knows that more than 50% of clients with CVID develop the following disorder. -Pernicious anemia -Chronic diarrhea -Neutropenia -Hypocalcemia
Pernicious anemia
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? -T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. -T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. -T-cell and B-cell lymphocytes react to the body's lack of B12 . -T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.
T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm3, and the client has been diagnosed with Pneumocystis pneumonia. What does this indicate to the nurse? -The client has another infection present that is causing a decrease in the T4-cell count. -The client has advanced HIV infection. -The client's T4-cell count has decreased due to the Pneumocystis pneumonia. -The client has converted from HIV infection to AIDS.
The client has converted from HIV infection to AIDS.
A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection? -From being outside in the cold weather and decreasing resistance -Through the mucous membranes of the throat -Through the skin -Breathing in airborne dust
Through the mucous membranes of the throat
A 38-year-old client has begun to suffer from rheumatoid arthritis and is being assessed for disorders of the immune system. The client works as an aide at a facility that cares for children infected with AIDS. Which is the most important factor related to the client's assessment? -Diet -Age -Home environment -Use of other drugs
Use of other drugs
Telangiectasia is the term that refers to -Uncoordinated muscle movement -Vascular lesions caused by dilated blood vessels -Inability to understand the spoken word -Difficulty swallowing
Vascular lesions caused by dilated blood vessels
What test will the nurse assess to determine the client's response to antiretroviral therapy? -Viral load -Enzyme immunoassay -Complete blood count -Western blotting
Viral load
Which term defines the balance between the amount of HIV in the body and the immune response? -Viral set point -Window period -Viral clearance rate -Primary infection stage
Viral set point
A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: -neutrophils and monocytes. -plasma cells and memory cells. -lymphokines and suppressor T cells. -regulator T cells and helper T cells.
neutrophils and monocytes
Which tests tell the physician what the viral load is in a client with HIV/AIDS? Select all that apply. -polymerase chain reaction -Western blot -ELISA test -p24 antigen test -T4/T8 ratio
polymerase chain reaction p24 antigen test
The lower the client's viral load, -the longer the time immunity. -the shorter the time to AIDS diagnosis. -the longer the survival time. -the shorter the survival time.
the longer the survival time.
Ataxia refers to -vascular lesions caused by dilated blood vessels. -difficulty swallowing. -uncoordinated muscle movement. -inability to understand spoken words.
uncoordinated muscle movement.
A client with a history of gout experiences an attack every 2 to 3 months despite losing weight and stopping all alcohol intake. Which question will the nurse ask when assessing this client? -"Have you reduced the amount of daily exercise?" -"Are you taking frequent rest periods throughout the day?" -"Are you taking the medication as prescribed?" -"Have you increased your intake of fat-soluble vitamins?"
"Are you taking the medication as prescribed?"
An older adult with rheumatoid arthritis limits going out with others because of the need to use a cane. Which response will the nurse make to this client? -"Invite people over to your home instead." -"Look at the cane as maintaining your independence." -"Everyone will get older at some time." -"It must be hard to get older."
"Look at the cane as maintaining your independence."
The nurse is teaching a newly diagnosed client about systemic lupus erythematosus(SLE). What statement by the client indicates the teaching was successful? -"This disorder is more common in men in their thirties and forties than in women." -"SLE has very specific manifestations that make diagnosis relatively easy." -"The belief is that it is an autoimmune disorder with an unknown trigger." -"The symptoms are primarily localized to the skin but may involve the joints."
"The belief is that it is an autoimmune disorder with an unknown trigger."
A client suspected of having systemic lupus erythematosus (SLE) is being scheduled for testing. The client asks which of the tests ordered will determine positivity for the disorder. Which statement by the nurse is most accurate? -"The diagnosis won't be based on the findings of a single test but by combining all data found." -"Tell me more about your concerns about this potential diagnosis." -"SLE is a very serious systemic disorder." -"You should discuss that matter with your health care provider."
"The diagnosis won't be based on the findings of a single test but by combining all data found."
A client with early-stage rheumatoid arthritis asks the nurse what the client can do to help ease the symptoms of the disease. What would be the best response by the nurse? "The doctor could prescribe anti-inflammatory drugs." "The doctor could prescribe antineoplastic drugs." "The doctor could prescribe antihypertensive drugs." "The doctor could prescribe antipyretic drugs."
"The doctor could prescribe anti-inflammatory drugs."
A client with gout has been advised to lose weight. The client informs the nurse of plans to go on a "guaranteed rapid weight loss" plan that involves fasting and heavy exercise. Which response would be most appropriate? -"Make sure to eat some fat occasionally with all that exercise." -"The fasting is okay, but make sure you drink fluids when exercising." -"Try combining the fasting with moderate exercise." -"There might be some difficulties with your plan and fasting."
"There might be some difficulties with your plan and fasting."
A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan? -"Monitor your body temperature." -"Exposure to sunlight will help control skin rashes." -"Corticosteroids may be stopped when symptoms are relieved." -"There are no activity limitations between flare-ups."
-"Monitor your body temperature."
The nurse is planning teaching for a client with gout. Which topics will the nurse include in the teaching? Select all that apply. -Limiting exercise -Avoiding purine-rich foods -Decreasing alcohol intake -Restricting the intake of water -Weight loss
-Avoiding purine-rich foods -Decreasing alcohol intake -Weight loss
The nurse is preparing a teaching tool about the pathophysiology of systemic lupus erythematosus (SLE). Which immunoregulatory disturbance factors will the nurse include in this tool? Select all that apply. -Genetic -Immunological -Psychosocial -Environmental -Hormonal
-Genetic -Immunological -Environmental -Hormonal
A client with rheumatoid arthritis wants to try nonpharmacologic approaches to control the pain and stiffness. Which approaches will the nurse suggest that might improve the client's comfort and mobility? Select all that apply. -Massage -Chiropractic adjustments -Imagery -Golfing -Self-hypnosis
-Massage -Chiropractic adjustments -Imagery -Self-hypnosis
The nurse is performing discharge teaching for a client with rheumatoid arthritis. What teachings are priorities for the client? Select all that apply. -Dressing changes -Safe exercise -Assistive devices -Medication dosages and side effects -Narcotic safety
-Safe exercise -Assistive devices -Medication dosages and side effects
As part of the assessment process for a client suspected of having gout, the nurse evaluated the client's serum uric acid levels. Select the value that is considered above the saturation point for crystal formation. -4.0 mg/dL (0.24 mmol/L) -6.8 mg/dL (0.40 mmol/L) -3.2 mg/dL (0.19mmol/L) -5.4 mg/dL (0.32 mmol/L)
6.8 mg/dL (0.40 mmol/L)
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? -Naturally acquired active immunity -Activation of the complement system -Stimulation of colony-stimulating factors -A cell-mediated response
A cell-mediated response
A nurse educator is preparing to discuss immunodeficiency disorders with a group of fellow nurses. What would the nurse identify as the most common secondary immunodeficiency disorder? -DAF -CVID -AIDS -SCID
AIDS
A client with acquired immune deficiency syndrome (AIDS) is brought to the clinic by a family member. The family member tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? -Distal sensory polyneuropathy (DSP) -Cytomegalovirus (CMV) -AIDS dementia complex (ADC) -Candidiasis
AIDS dementia complex (ADC)
A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do? -Intubate the client. -Perform an electrocardiogram (ECG). -Assess the client's vital signs. -Administer epinephrine.
Administer epinephrine
When do most perinatal HIV infections occur? -After exposure during delivery -Through breastfeeding -Through casual contact -In utero
After exposure during delivery
A client diagnosed with arthritis doesn't want to take medications. Physical therapy and occupational therapy have been consulted for nonpharmacologic measures to control pain. What might physical and occupational therapy include in the care plan to help control this client's pain? -An exercise routine that includes range-of-motion (ROM) exercises -Acupuncture -Cold therapy -Heat therapy and nonsteroidal anti-inflammatory medications (NSAIDs)
An exercise routine that includes range-of-motion (ROM) exercises
A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action? -Administer fluids 100 mL/hour IV. -Assess blood urea nitrogen and creatinine. -Encourage the client to drink more fluids. -Assess liver function tests.
Assess blood urea nitrogen and creatinine.
What is the priority intervention for a client who has been admitted repeatedly with attacks of gout? -Insert a Foley catheter -Place client on bed rest -Increase fluids -Assess diet and activity at home
Assess diet and activity at home
A client comes into the emergency department reporting difficulty walking and loss of muscle control in the arms. Once the nurse begins the physical examination, which assessment should be completed if an immune dysfunction in the neurosensory system is suspected? -Assess for ataxia using the finger-to-nose test and heel-to-shin test -Review the urinalysis report for hematuria -Assess joint mobility using passive range of motion. -Assess for hepatosplenomegaly by measuring abdominal girth
Assess for ataxia using the finger-to-nose test and heel-to-shin test
A home care nurse is visiting a client with acquired immune deficiency syndrome (AIDS) at home. During the visit, the nurse observes the caregiver providing care. What action by the caregiver would alert the nurse to the need for additional teaching? -Caregiver disposes of syringe and needle in a metal coffee can with lid. -Caregiver cleans the client's anal area without wearing gloves -Caregiver washes hands before and after providing care to the client. -Caregiver uses a dilute bleach solution to clean up a urine spill.
Caregiver cleans the client's anal area without wearing gloves
The nurse intervenes to assist the client with fibromyalgia to cope with which symptoms? -Diminished vision, chronic fatigue, and reduced appetite -Generalized muscle aching, mood swings, and loss of balance -Chronic fatigue, generalized muscle aching, and stiffness -Pain, viral infection, and tremors
Chronic fatigue, generalized muscle aching, and stiffness
Which of the following is a plasma protein associated with the immunologic reaction? -Prostaglandins -Leukotrienes -Cytokines -Complement
Complement
A client with osteoarthritis asks for information concerning activity and exercise. When assisting the client, which concept should be included? -The time of day when exercise is performed isn't important. -Exercising immediately upon awakening allows the client to participate in activities when he has the greatest amount of energy. -Exercising in the evening before going to bed is beneficial. -Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.
Delaying exercise for at least 1 hour after awakening allows the client to participate in exercise after some of the morning-related stiffness has subsided.
Which assessment finding(s) are likely to cause noncompliance with antiretroviral treatment? Select all that apply. -Depression -Active substance abuse -Past substance abuse -Lack of social support
Depression Active substance abuse Lack of social support
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find? -Elevated erythrocyte sedimentation rate -Increased albumin levels -Increased C4 complement -Increased red blood cell count
Elevated erythrocyte sedimentation rate
A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout? -Increased AST and ALT -Elevated white blood count -Decreased hemoglobin and hematocrit -Elevated uric acid levels
Elevated uric acid levels
Which is an appropriate nursing intervention in the care of the client with osteoarthritis? -Provide an analgesic after exercise -Encourage weight loss and an increase in aerobic activity -Avoid the use of topical analgesics -Assess for gastrointestinal complications associated with COX-2 inhibitors
Encourage weight loss and an increase in aerobic activity
A client is suspected of having an immune system disorder. The health care provider wants to perform a diagnostic test to confirm the diagnosis. What test should the nurse prepare the client for? -Complete chemistry panel -Plasmapheresis -T-and C-cell assays -Enzyme-linked immunosorbent assay
Enzyme-linked immunosorbent assay
A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? -Photosensitivity, polyarthralgia, and painful mucous membrane ulcers -Facial erythema, pericarditis, pleuritis, fever, and weight loss -Hypothermia, weight gain, lethargy, and edema of the arms -Weight gain, hypervigilance, hypothermia, and edema of the legs
Facial erythema, pericarditis, pleuritis, fever, and weight loss
Which assessment suggests to the nurse that a client with systemic lupus erythematous is having renal involvement? -Behavioral changes -Hypertension -Decreased cognitive ability -Chest pain
Hypertension
A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find? -Hypernatremia -Urine specific gravity of 1.010 -Hypokalemia -Proteinuria
Hypokalemia
A client is being discharged from the hospital after being diagnosed with and treated for systemic lupus erythematosus (SLE). What would the nurse not say when teaching the client and family information about managing the disease? -Avoid sunlight and ultraviolet radiation. -Maintain a well-balanced diet and increase fluid intake to raise energy levels and promote tissue healing. -If you have problems with a medication, you may stop it until your next physician visit. -Pace activities.
If you have problems with a medication, you may stop it until your next physician visit.
Which points should be included in the medication teaching plan for a client taking adalimumab? -The medication is administered intramuscularly. -It is important to monitor for injection site reactions. -The medication is given at room temperature. -The client should continue taking the medication if fever occurs.
It is important to monitor for injection site reactions.
A client has a serum study that is positive for the rheumatoid factor. What will the nurse tell the client about the significance of this test result? -It is diagnostic for systemic lupus erythematosus. -It is specific for rheumatoid arthritis. -It is suggestive of rheumatoid arthritis. -It is diagnostic for Sjögren's syndrome.
It is suggestive of rheumatoid arthritis.
Which joint is most commonly affected in gout? -Ankle -Tarsal area -Metatarsophalangeal -Knee
Metatarsophalangeal
A patient is suspected of having myositis. The nurse prepares the patient for what procedure that will confirm the diagnosis? -Muscle biopsy -Magnetic resonance imaging (MRI) -Computed tomography (CT) -Bone scan
Muscle biopsy
A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised? -Natural immunity -Specific immunity -Adaptive immunity -Passive immunity
Natural immunity
The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells? -Natural killer cells -Interleukins -Cytokines -Interferons
Natural killer cells
A child is brought to the clinic with a rash and is subsequently diagnosed with measles. The parent reports also having had measles as a young child. What type of immunity to measles develops after the initial infection? -Artificially acquired active immunity -Artificially acquired passive immunity -Naturally acquired active immunity -Naturally acquired passive immunity
Naturally acquired active immunity
A client with rheumatoid arthritis reports joint pain. What intervention is a priority to assist the client? -Ice packs -Opioid therapy -Nonsteroidal anti-inflammatory drugs -Surgery
Nonsteroidal anti-inflammatory drugs
Which medication classification is known to inhibit prostaglandin synthesis or release? -Antibiotics (in large doses) -Antineoplastic agents -Nonsteroidal anti-inflammatory drugs in large doses -Adrenal corticosteroids
Nonsteroidal anti-inflammatory drugs in large doses
The nurse is completing the physical assessment of a client with systemic lupus erythematosus (SLE). Which finding will the nurse recognize is most likely to indicate that the client is experiencing a change to the cardiovascular system because of the condition? -Jugular vein distention -Bounding peripheral pulses -Peripheral edema -Pericardial friction rub
Pericardial friction rub
The nurse is caring for a client with palindromic rheumatism. The nurse knows that this type of rheumatism can lead to which diagnosis? -Scleroderma -Systemic lupus erythematosus -Fibromyalgia -Rheumatoid arthritis
Rheumatoid arthritis
A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? -Bathing or hygiene self-care deficit -Complicated grieving -Ineffective cerebral tissue perfusion -Risk for injury
Risk for injury
The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following? -Plasma, which depletes the body's store of calcitonin -Serum, which depletes the body's store of immunoglobulins -Plasma, which depletes the body's store of catecholamines -Serum, which depletes the body's store of glucagon
Serum, which depletes the body's store of immunoglobulins
Which of the following disorders is characterized by an increased autoantibody production? -Scleroderma -Polymyalgia rheumatic -Systemic lupus erythematosus (SLE) -Rheumatoid arthritis (RA)
Systemic lupus erythematosus (SLE)
A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication? -Since the medication is able to be obtained over the counter, it has few side effects. -Take the medication on an empty stomach in order to increase effectiveness. -Take the medication with food to avoid stomach upset. -Inform the health care provider if there is ringing in the ears.
Take the medication with food to avoid stomach upset.
The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells? -They are activated on recognition of antigens and stimulate the rest of the immune system. -They have the ability to decrease B-cell production. -They attack the antigen directly by altering the cell membrane and causing cell lysis. -They are responsible for recognizing antigens from previous exposure and mounting an immune response.
They are activated on recognition of antigens and stimulate the rest of the immune system.
A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test? -Western blot assay -p24 antigen capture assay -OraSure test -Nucleic acid sequence-based amplification
Western blot assay
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a: -Western blot test for confirmation of diagnosis. -polymerase chain reaction test for confirmation of diagnosis. -T4-cell count for confirmation of diagnosis. -p24 antigen test for confirmation of diagnosis.
Western blot test for confirmation of diagnosis.
The nurse is reviewing the medication administration record of the client. Which medication would lead the nurse to suspect that the client is suffering from an acute attack of gout? -colchicine -methotrexate -prednisone -penicillamine
colchicine
A client has experienced increasing pain and progressing inflammation of the hands and feet. The rheumatologist has prescribed NSAID use to treat the condition. What client education is most important for the nurse to address with the use of these medications? -activity restrictions -loading-dose schedule -dietary restrictions -common adverse effects
common adverse effects
The nurse is discussing life management with the client with rheumatoid arthritis in a health clinic. What assessment finding indicates the client is having difficulty implementing self-care? -decreased joint pain -increased fatigue -ability to perform activities of daily living (ADL) -a weight gain of 2 pounds
increased fatigue
The nurse is performing a health history with a new client with fibromyalgia. What will the nurse expect to assess as the most common finding associated with fibromyalgia? -butterfly facial rash -jaw locking -Heberden nodes -widespread chronic pain
widespread chronic pain
