Quiz 2 PU

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 fruit and vegetables every day"

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response?

"It is a hyperimmune response to something in the environment that is usually harmless."

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"

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?

"Take the medication with food to avoid stomach upset"

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."

A client with a discoid facial rash caused by systemic lupus erythematosus (SLE) asks why a urine sample is needed. Which response will the nurse make to the client?

"The lupus can affect your kidney function"

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?

"There might be some difficulties with your plan and fasting"

A parent of a child who has been having frequent bouts of tonsillitis brings the child back to the clinic for another sore throat. The parent asks the nurse, "What are tonsils good for anyway?" What is the best response by the nurse?

"These tissues filter bacteria from tissue fluid."

A client is to receive intravenous immunoglobulin (IVIG). The infusion is started at 10 a.m. The nurse would be alert for signs and symptoms of an anaphylactic reaction during which time frame?

10:30 to 11:00am

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?

AIDS

Which of the following refers to fixation of a joint?

Ankylosis

Which of the following procedures involves a surgical fusion of the joint?

Arthrodesis

A client with Sjogren's syndrome is experiencing xerostomia. Which information will the nurse provide to help alleviate this client's problem? Select all that apply.

Avoid smoking Eat small, frequent meals Omit spicy and salty foods Limit alcohol intake

A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client?

Bank autologous blood

While taking the health history of a newly admitted client, the nurse reviews general lifestyle behaviors. What strategies would have a positive effect on the immune system?

Biofeedback, relaxation, hypnosis

A client asks the nurse how their rheumatoid arthritis is diagnosed. The nurse knows that which finding from diagnostic tests can be used to diagnose rheumatoid arthritis?

Boney erosions on XRAY

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?

Cell-mediated

Which microorganism is known to cause retinitis in people with HIV/AIDS?

Cytomegalovirus

A patient with HIV has been on antiretroviral therapy (ART) for 6 months. The patient comes to the clinic with home medications and the nurse observes that there are too many pills in the container. What does the nurse know about the factors associated with nonadherence to ART? (Select all that apply.)

Depression Active substance abuse Lack of social support

A nurse is caring for a client who is HIV positive and is taking zidovudine. Which side effects should the nurse expect in this client?

Diarrhea and abdominal pain

During the immune response, cytotoxic cells bind to invading cells, destroy the targeted invader, and release lymphokines to remove the debris. Which type of T-cell lymphocyte is cytotoxic?

Effector T cells

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

Facial erythema, pericarditis, pleuritis, fever, weight loss

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.

Flank pain Shaking chills Tightness in the chest

Which immunoglobulin assumes a major role in bloodborne and tissue infections?

IgG

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?

Immunosenecense

An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, what would the nurse identify as having contributed to this client's infection?

Impaired ciliary action from exposure to environmental toxins

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?

Increased fatigue

Phagocytic dysfunction is characterized by the following. Choose all that apply.

Increased incidence of bacterial infections Chronic eczemoid dermatitis

What does the nurse understand will result if the patient has a deficiency in the normal level of complement?

Increased susceptibility to infection

Proteins formed when cells are exposed to viral or foreign agents that are capable of activating other components of the immune system are referred to as

Interferons

The nurse is completing a health history with a client in a clinic. What assessment finding best correlates with a diagnosis of osteoarthritis?

Joint stiffness that increases with activity

While caring for a patient with pneumocystis pneumonia, the nurse assesses flat, purplish lesions on the back and trunk. What does the nurse suspect these lesions indicate?

Kaposi's sarcoma

A client asks the nurse how to identify rheumatoid nodules with rheumatoid arthritis. What characteristic will the nurse include?

Located over bony prominences

What type of cytokine will attract neutrophils and monocytes to remove debris?

Lymphokines

A client with acquired immune deficiency syndrome (AIDS) is exhibiting shortness of breath, cough, and fever. What type of infection will the nurse most likely suspect?

Pneumocystis jiroveci

A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?

Primary infection

What is the function of the thymus gland?

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

The nurse is assessing a client who has had rheumatoid arthritis for several years. What clinical manifestation will the nurse expect to find in a client?

Small joint involvement

The nurse is providing education for a client with a new diagnosis of rheumatoid arthritis (RA). Which statement will the nurse include in the discussion with the client? Select all that apply.

Swelling of joints will occur, causing pain You can expect warmth in your joints Redness can occur in the skin at joints A symptom of RA will be pain on both sides

A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?

The client is risking the development of drug resistance and drug failure

The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which statement correctly describes the process of autoimmunity?

The normal protective immune response attacks the body, damaging tissues.

Which statement accurately reflects current stem cell research?

The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells.

The spleen acts as a filter for old red blood cells, holding a reserve of blood in case of hemorrhagic shock. It is also an area where lymphocytes can concentrate. It can become enlarged (splenomegaly) in certain hematologic disorders and cancers. To assess an enlarged spleen, the nurse would palpate the area of the:

Upper left quadrant

What test will the nurse assess to determine the client's response to antiretroviral therapy?

Viral load

Which term defines the balance between the amount of HIV in the body and the immune response?

Viral set point

The nurse is planning teaching for a client with gout. Which topics will the nurse include in the teaching? Select all that apply.

Weight loss Decreasing alcohol intake Avoiding purine-rich foods

When a nurse infuses gamma globulin intravenously, the rate should not exceed

3 mL/min

A client is infected with human immunodeficiency virus (HIV) after sharing needles with another intravenous (IV) drug abuser. Upon infection with HIV, the immune system responds by making antibodies against the virus, usually within how many weeks after infection?

3 to 12 weeks

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

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic?

HIV-1 is more prevalent than HIV-2 subtypes

A client with rheumatoid arthritis (RA) is taking methotrexate. Which assessment findings indicate to the nurse that the client is experiencing side effects of this medication? Select all that apply.

Hair loss Skin rash GI distress Frequent infections

Which of the following indicates that a client with HIV has developed AIDS?

Herpes simplex ulcer persisting for 2 months

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?

Lymphoid tissues

There are major differences between primary and secondary immunodeficiencies. Select the most accurate statement the nurse would use to explain the cause of a secondary immunodeficiency?

"Your immune system was most likely affected by an underlying disease process"

A client is prescribed a disease-modifying antirheumatic drug that is successful in the treatment of rheumatoid arthritis but has side effects, including retinal eye changes. What medication will the nurse anticipate educating the client about?

Hydrochloroquine

A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell?

Lymphocyte

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 the area of the lymph nodes

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand?

Neutrophils

A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include:

Neutrophils and monocytes

Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment?

Past substance abuse

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?

Serum, which depletes the body's store of immunoglobulins

A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis?

Stool specimen for ova and parasites

Which intervention should the nurse implement to manage pain for the client with rheumatoid arthritis? Select all that apply.

Support joints with splints and pillows Provide diversional activities Provide opportunities for the client to verbalize feelings

The nurse is gathering objective data for a client at the clinic reporting arthritic pain in the hands. The nurse observes that the fingers are hyperextended at the proximal interphalangeal joint with fixed flexion of the distal interphalangeal joint. What does the nurse recognize this deformity as?

Swan neck deformity