Weekly Exam #6 - Immune and Skin Disorders
A diagnosis of AIDS is made when an HIV - infected patient has a. a CD4 + T cell count below 200 / μL b. a high level of HIV in the blood and saliva c. lipodystrophy with metabolic abnormalities d. oral hairy leukoplakia an infection caused by Epstein Barr virus
A
A mother and her two children have been diagnosed with pediculosis corporis at a healthcare center. An appropriate measure to treat this condition is a. applying pyrethrins to the body b. topical application of griseofulvin c. moist compresses applied frequently d. administration of systemic antibiotics
A
Important patient teaching after a chemical peel includes a. avoidance of sun exposure b. application of firm bandages c. limitation of vigorous exercise d. use of moist heat to relieve discomfort
A
The most common cause of secondary immunodeficiencies is a. drugs b. stress c. malnutrition d. human immunodeficiency virus
A
The nurse is alerted to possible anaphylactic shock immediately after a patient has received IM penicillin by the development of a. edema and itching at the injection site b. sneezing and itching of the nose and eyes c. a wheal-and-flare reaction at the injection site d. chest tightness and production of thick sputum
A
Transmission of HIV from an infected person to another most often occurs because of a. unprotected anal or vaginal sexual intercourse b. low levels of virus in the blood and high levels of CD4 + T cells c. transmission from mother to infant during labor and delivery and breastfeeding d. sharing eating utensils, dry kissing hugging using toilet seats, or shaking hands
A
When teaching a patient with melanoma about this disorder, the nurse recognizes that the patient's prognosis is most dependent on a. the thickness of the lesion b. the degree of asymmetry in the lesion c. the amount of ulceration in the lesion d. how much the lesion has spread superficially
A
Which strategy can the nurse teach the patient to eliminate the risk for HIV transmission? a. Using sterile equipment to inject drugs b. Cleaning equipment used to inject drugs c. Taking lamivudine ( Epivir ) during pregnancy d. Using latex or polyurethane barriers to cover genitalia during sexual contact
A
A nurse is caring for a client who has severe acute respiratory syndrome (SARS). The nurse knows that health care professionals are required to report communicate and infectious diseases. Which of the following illustrate the rationale for reporting? (select all that apply) a. planning and evaluating control and prevention strategies b. determining public health priorities c. ensuring proper medical treatment d. identifying endemic disease e. monitoring for common-source outbreaks
A, B, C, E
Emerging and reemerging infections affect health care by (select all that apply) a. reevaluating vaccine practices b. revealing antimicrobial resistance c. limiting antibiotics to those with life-threatening infection d. challenging researchers to discover new antimicrobial therapies
A, B, D
Which safe sun practices would the nurse include in the teaching plan for a patient who has photosensitivity (select all that apply)? a. Wear protective clothing b. Apply sunscreen liberally and often c. Emphasize the short - term use of a tanning booth d. Avoid exposure to the sun, especially during midday e. Wear any sunscreen as long as it is bought at a drugstore
A, B, D
A charge nurse is reviewing with a newly hired nurse the difference in manifestations of a localized versus a systemic infection. Which of the following are manifestations of a systemic infection? (select all that apply) a. fever b. malaise c. edema d. pain or tenderness e. increase in pulse and respiratory rate
A, B, E
A nurse is providing information about a new prescription for corticosteroid cream to a client who has mild psoriasis. Which of the following instructions should the nurse include? (select all that apply) a. apply an occlusive dressing after application b. apply three to four times a day c. wear gloves after application to lesions on the hands d. avoid applying to skin folds e. use medication continuously over a period of several months
A, C, D
Interventions to prevent healthcare-associated infections include (select all that apply) a. following hand-washing protocols b. limiting visitors to persons over age 18 c. placing high-risk patients in private rooms d. decontaminating equipment used for patient care e. appropriately using personal protective equipment
A, D, E
A nurse is caring for a client who has a WBC count of 20,000/mm^3. The nurse should conclude that the client has which of the following? a. neutropenia b. leukocytosis c. left shift d. leukopenia
B
A nurse is caring for a client who has contact dermatitis and has a new prescription for diphenhydramine. For which of the following adverse effect should the nurse monitor? a. elevated blood glucose levels b. anorexia c. increased salivation d. insomnia
B
A nurse is educating a client on the use of calcipotriene topical medication for the treatment of psoriasis. Which of the following laboratory values should the nurse monitor? a. potassium b. calcium c. sodium d. chloride
B
A nurse is teaching a client who has a history of psoriasis about photochemotherapy and ultraviolet light (PUVA) treatments. Which of the following instructions should the nurse include in the teaching? a. apply vitamin A cream before each treatment b. administer a psoralen medication before the treatment c. use this treatment every evening d. remove the scales gently following each treatment
B
During the assessment of a patient, you note an area of red, sharply defined plaques covered with silvery scales that are mildly itchy on the patient's knees and elbows You would describe this finding as a. lentigo b. psoriasis c. actinic keratosis d. seborrheic keratosis
B
HIV antiretroviral drugs are used to a. cure acute HIV infection b. decrease viral RNA levels c. treat opportunistic diseases d. decrease symptoms in terminal disease
B
The nurse determines that a patient with which disorder is most at risk for spreading the disease? a. Tinea pedis b. Impetigo on the face c. Candidiasis of the nails d. Psoriasis on the palms and soles
B
Which statements about metabolic side effects of ART are true ( select all that apply)? a. These are annoying symptoms that are ultimately harmless b. ART-related body changes include fat redistribution and peripheral wasting c. Lipid problems include increases in triglycerides and decreases in high - density cholesterol d. Insulin resistance and hyperlipidemia can be treated with drugs to control glucose and cholesterol e. Compared to uninfected people insulin resistance and hyperlipidemia are harder to treat in HIV - infected patients
B, C, D
A nurse is preparing to administer a scratch test to a client who has possible food and environmental allergies. Which of the following actions should the nurse perform prior to the procedure? (select all that apply) a. cleanse the client's skin with povidone-iodine b. ask the client about previous reactions to allergens c. ask the client about medications taken over the past several days d. inform the client to expect itching at one site e. obtain emergency resuscitation equipment
B, C, D, E
A nurse is contributing to the plan of care for a client who is being admitted to the facility with a suspected diagnosis of pertussis. Which of the following interventions should the nurse include? (select all that apply) a. place the client in a room that has negative air pressure of at least six exchanges per hour b. wear a mask when providing care within 3 ft of the client c. place a surgical mask on the client if transportation to another department is unavoidable d. use sterile gloves when handling soiled linens e. wear a gown when performing care that might result in contamination from secretions
B, C, E
In a person having an acute rejection of a transplanted kidney, what would help the nurse understand the course of events (select all that apply)? a. A new transplant should be considered b. Acute rejection can be treated with OKT3 c. Repeated episodes of acute rejection can lead to chronic rejection d. Corticosteroids are the most successful drugs used to treat acute rejection e. Acute rejection is common after a transplant and can be
B, C, E
In teaching a patient who is using topical corticosteroids to treat acute dermatitis, the nurse should tell the patient that (select all that apply) a . the cream form is the most efficient system of delivery b . short - term use of topical corticosteroids usually does not cause systemic side effects c . use a glove to apply small amounts of creams or ointments to prevent further infection d . abruptly stopping the use of topical corticosteroids may cause the dermatitis to reappear e . systemic side effects from topical corticosteroids are likely if the patient is malnourished
B, D
A common site for the lesions associated with atopic dermatitis is the a. buttocks b. temporal area c. antecubital space d. plantar surface of the feet
C
A nurse is caring for a client who has a suspected viral skin lesion. Which of the following laboratory findings should the nurse expect to review to confirm this diagnosis? a. potassium hydroxide (KOH) b. diascopy c. tzanck smear report d. biopsy
C
A nurse is instructing a client on home care after a culture for a bacterial infection and cellulitis. Which of the following information should the nurse include? a. bathe daily with moisturizing soap b. apply antibacterial topical medication to the crusted exudate c. apply warm compresses to the affected area d. cover affected area with snug-fitting clothing
C
A nurse is providing discharge instruction to a client who had a skin biopsy with sutures. The nurse should identify that which of the following client statements indicates that the teaching has been effective? a. "I can expect redness around the site for 5 to 7 days" b. "I will most likely have a fever for the first few days" c. "I should apply an antibiotic ointment to the area" d. I will make a return appointment in 3 days for removal of my sutures"
C
A nurse is providing teaching to a client about a new prescription for clotrimazole topical cream. Which of the following statements should the nurse include? a. "It reduces the discomfort of herpetic infection but does not cure the infection" b. "This is a cream to treat a bacterial infection" c. "Apply the topical medication for up to 2 weeks after the fungal lesions are gone" d. "Apply the cream to lesions while they are moist"
C
A nurse is providing teaching to the guardian of a chid who has contact dermatitis. Which of the following information should the nurse include? a. use fabric softener dryer sheets when drying the child's clothing b. apply a warm, dry compress to the rash area c. place the child in a bath with colloidal oatmeal d. leave the child's hands uncovered during the night
C
A nurse is reviewing the laboratory findings of a client who has measles. The nurse should expect to find an increase in which of the following types of WBCs? a. neutrophils b. basophils c. lymphocytes d. eosinophils
C
A patient is undergoing plasmapheresis for treatment of systemic lupus erythematosus. The nurse explains that plasmapheresis is used in treatment to a. remove T lymphocytes in her blood that are producing antinuclear antibodies b. remove normal particles in her blood that are being damaged by autoantibodies c. exchange her plasma that contains antinuclear antibodies with a substitute fluid d. replace viral-damaged cellular components of her blood with replacement whole blood
C
During HIV infection a. reverse transcriptase helps HIV fuse with the CD4 + T cell b. HIV RNA uses the CD4 + T cell's mitochondria to replicate c. the immune system is impaired predominantly by the eventual widespread destruction of CD4 + T cells d. a long period of dormancy develops during which HIV cannot be found in the blood and there is little viral replication
C
Opportunistic diseases in HIV infection a. are usually benign b. are generally slow to develop and progress c. occur in the presence of immunosuppression d. are curable with appropriate drug interventions
C
The reason newborns are protected for the first 3 months of life from bacterial infections is because of the maternal transmission of a. IgA b. IgE c. IgG d. IgM
C
A nurse in a clinic is preparing to obtain a skin specimen from a client who has a suspected herpes infection. Which of the following actions should the nurse take? (select all that apply) a. scrape the site with a wooden tongue depressor b. use a razor to cut the scabbed area to obtain the specimen c. use a cotton-tipped application to obtain fluid from the lesion d. place specimen in a potassium hydroxide (KOH) solution tube e. place specimen tube on ice after obtaining sample
C and E
A nurse is caring for a client who has had a cough for 3 weeks and is beginning to cough up blood. The client has manifestations of which of the following conditions. a. allergic reaction b. ringworm c. systemic lupus erythematosus d. tuberculosis
D
A nurse is for a client who reports a severe sore throat, pain while swallowing, and swollen lymph nodes. The client is experiencing which of the following stages of infection? a. prodromal b. incubation c. convalescence d. illness
D
Association between HLA antigens and diseases is most commonly found in what disease conditions? a. Cancers b. Infectious diseases c. Neurologic diseases d. Autoimmune disorders
D
In a type I hypersensitivity reaction the primary immunologic disorder appears to be a. binding of IgG to an antigen on a cell surface b. deposit of antigen-antibody complexes in small vessels c. release of cytokines used to interact with specific antigens d. release of chemical mediators from IgE - bound mast cells and basophils
D
Screening for HIV infection generally involves a. detecting CD8 + cytotoxic T cells in saliva b. laboratory analysis of saliva to detect CD4 + T cells c. analysis of lymph tissues for the presence of HIV RNA d. laboratory analysis of blood to detect HIV antigen and/or antibody
D
The function of monocytes in immunity is related to their ability to a. stimulate the production of T and B lymphocytes b. make antibodies after exposure to foreign substances c. bind antigens and stimulate natural killer cell activation d. capture antigens by phagocytosis and present them to lymphocytes
D
The nurse tells a friend who asks him to administer his allergy shots that a. it is illegal for nurses to administer injections outside of a medical setting b. he is qualified to do it if the friend has epinephrine in an injectable syringe provided with his extract c. avoiding the allergens is a more effective way of controlling allergies, and allergy shots are not usually effective d. immunotherapy should only be administered in a setting where emergency equipment and drugs are available
D
What accurately describes rejection after transplantation? a. Hyperacute rejection can be treated with OKT3 b. Acute rejection can be treated with sirolimus or tacrolimus c. Chronic rejection can be treated with tacrolimus or cyclosporine d. Hyperacute reaction can be avoided if crossmatching is done before transplantation
D
What is the most appropriate nursing intervention to help an HIV - infected patient adhere to a treatment regimen? a. Set up a drug pillbox for the patient every week b. Give the patient a video and a brochure to view and read at home c. Tell the patient that side effects of ART are bad but that they go away d. Assess the patient's routines and find adherence cues that fit into the patient's life circumstances
D
