Chapter 35, 36, 37, 38 study guide questions and assigned ATI

A nurse is providing teaching for a client who has the system lupus erythematous. Which of the following statements by the client indicates an understanding of the teaching?

" I should wear gloves when it's cold outside"

A nurse is providing teaching for a client who has rheumatoid arthritis and reports persistent pain. Which of the following responses by the nurse is appropriate?

" ask family members to help with household chores"

A nurse is providing discharge teaching for a client who is HIV-positive. Which of the following instruction should the nurse include in the teaching?

"Discard beverages that have been unrefrigerated for one hour"

A nurse is planning education program for a group of high school teachers who will be taking students on a hike. Which of the following info should the nurse include regarding line disease?

"If you develop pain and stiffness in your joints you should see a doctor"

A nurse is providing teaching for a client who has a new prescription of amoxicillin to treat a respiratory infection. Which of the following statements by the client indicates an understanding of these teachings?

"My birth control pills are less affective while I am on this medication"

A nurse is caring for a patient who reports a skin change on her arm. Which of the following findings should the nurse report to the the provider?

An asymmetrical papule that is pigmented

A nurse is providing care for four clients which of the following clients is at the greatest risk for pneumonia?

An older adult client transferred from a long-term care facility who has dysphasia

A nurse is providing teachings for a patient who is scheduled for a Pap test. The nurse should instruct the client that she is being tested for which of the following?

Cervical cancer

A nurse is providing teaching for a patient who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following should the nurse include in the teaching?

Avoid crowds

A nurse is caring for a patient who is receiving chemotherapy and has laboratory data revealing bone marrow suppression. The nurse should include which of the following instructions in the teaching?

Avoid eating fresh fruits and vegetables

White blood cells involved in immunity are primarily produced in ___________?

Bone marrow

The immune system is essentially composed of ___________, ___________, and ________.

Bone marrow, lymphoid tissue, white blood cells

A nurse is performing a breast examination on a client. Which of the following should the nurse report to the Providor?

Breast tissue with an orange peel appearance

What type of medication is Maraviroc?

CCR5 antagonist

What serves as the major laboratory indicator of immune function and prophylaxis for opportunistic infections, and is the strongest predictor of subsequent disease progression and survival?

CD4 + count

A nurse is providing teaching for a patient who has allergy to peanuts. Which of the following instructions is the priority to include in the teaching?

Carry an emergency anaphylaxis kit

What medication is used for leukopenia, and T cell inhibition?

Cyclosporine

What medication is used for agranulocytosis and neutropenia?

Dactinomycin and mustargen

A nurse is assessing a client who has systemic lupus erythematous. Which of the following findings should the nurse expect?

Decreased urine output, butterfly rash, joint inflammation

A nurse is caring for a client who has HIV. Which of the following laboratory findings should suggest to the nurse that medication therapy is effective?

Decreased viral load

A nurse is caring for a patient who has an elevated prostate specific antigen level. The nurse should anticipate that the client will undergo which of the following diagnostic tests?

Digital rectal examination

A nurse is caring for a patient who has Non-Hodgkin's lymphoma and is receiving chemotherapy. Which of the following is the priority assessment finding?

Erythema at the IV insertion site

A nurse is planning an education program about testicular cancer for a group of male adolescents. Which of the following information should the nurse include?

Examine testicles immediately after showering

What type of medication is Enfuvirtide?

Fusion inhibitor

What immunoglobulin prevents absorption of antigens from food?

IgA

What immunoglobulin protects against respiratory infections?

IgA

What immunoglobulin is a possible influence on B-lymphocyte differentiation?

IgD

What immunoglobulin help defend against parasites?

IgE

What immunoglobulin activate complement system?

IgG

What immunoglobulin enhances phagocytosis?

IgG

What immunoglobulin appears in intravascular serum?

IgM

What results from rapid restoration of organisms specific immune responses to infections that cause either the deterioration of a treated infection or new presentation of a subclinical infection?

Immune reconstitution inflammatory syndrome

What medication is used for agranulocytosis, and leukopenia?

Indomethacin and propylthiouracil

What type of medication is Dolutegravir?

Integrase inhibitors

A nurse is providing teaching for a group of patients regarding prevention of skin cancer. Which of the following risk factors should the nurse include in the teaching?

Light skin pigmentation

Granulocytes, which fight invasion by releasing histamine, do not include _____________.

Lymphocytes

The primary cells responsible for recognition of foreign antigens are ___________.

Lymphocytes

What medication is used for leukopenia and aplastic bone marrow?

Methotrexate

White blood cells that function as phagocytes are called ____________.

Monocytes

A deficient immune system response that is congenital in origin would be classified as a ____________disorder.

Natural deficiency

The leukocytes that arrive first at a site where inflammation occurs are _________?

Neutrophils

What medication is Efavirenz?

Non-nucleoside reverse transcriptase inhibitors

What type of medication is Abacavir?

Nucleoside reverse transcriptase inhibitors (NRTIs)

The body's first line of defense is the ___________.

Phagocytic immune response

During the __________ stage of an immune response, lymphocytes interfere with disease by picking up specific antigens from organisms to alter their function.

Proliferation

What medication is Atazanavir?

Protease inhibitor

Antibodies are believed to be a type of ___________.

Protein

A nurse is caring for a patient who has Hodgkin's lymphoma. Which of the following findings should the nurse expect?

Reed-Sternberg virus

A nurse is caring for a client who has viral pneumonia and a history of COPD. Which of the following findings should the nurse report to the provider?

Report a left shift and WBC differential

Primary immunodeficiency's predispose people to three conditions _________, __________, and___________.

Severe infections, autoimmunity, cancer

A nurse is assessing a client who has HIV. Which of the following findings should cause the nurse to suspect that the clients diagnosis has progressed to aids?

Small purple colored skin lesions

Five disorders of common, primary immunodeficiencies are __________, _________, _______, ________,and _____________.

T cell deficits, combined B & T cell deficits, humoral immunity, phagocytic disorders, competent production

What medication is used for transient leukopenia?

Vancomycin

A nurse is caring for a patient who has leukemia and a platelet count of 48,000. Which of the following action should the nurse take?

Test urine and stool for occult blood

A nurse is educating a client who is scheduled for a kidney transplant. Which of the following information regarding hyperacute rejection should the nurse include in the teaching?

The organ will need to be removed if hyperacute rejection occurs

A nurse is caring for a patient who has neutropenia. Which of the following findings indicate a need for intervention?

The patients granddaughter is visiting and telling him about her first day of kindergarten

A nurse is providing education for the parent of a child about administration guidelines for the human papilloma virus vaccine. Which of the following information should the nurse include?

Three doses should be given starting at age 11 or 12

A nurse is caring for a patient who is admitted with enlarged lymph nodes and a fever. To confirm a diagnosis of bacterial pharyngitis, the nurse should anticipate which of the following diagnostic tests?

Throat culture

T lymphocytes, descendants of stem cells, mature in the____________?

Thymus

A nurse in the emergency department is assessing a newly admitted patient. Which of the following places the client at increased risk for contracting hepatitis B?

Unprotected sex

A nurse is reviewing the daily laboratory results for a female client who has a cute leukemia. Which of the following values is an expected finding?

WBC 21,000

A nurse is caring for a client who has a new prescription for clindamycin to treat acute pelvic inflammatory disease. The nurse should monitor for an report which of the following findings immediately to the provider?

Watery diarrhea

A patient who has developed kidney failure is discussing options with the healthcare provider for treatment. What does the nearest understand that can you failure is associated with? a) A deficiency in circulating lymphocytes b) A deficiency in phosphorus c) decreased amount of white blood cells d) increased amount of macrophages

a) A deficiency in circulating lymphocytes

A patient with aids is having a reoccurrence of 10 to 12 loose stools a day. What medication may help this patient to control the chronic diarrhea? a) Octreotide b) rifaximin c) bismuth subsalicylate d) atropine diphenoxylate

a) Octreotide

A patient is diagnosed with pneumocystis pneumonia. What medication is the nurse anticipate educating the patient about for treatment? a) TMP-SMZ b) Cephalexin c) Azithromycin d) Garamycin

a) TMP-SMZ

The nurse is performing a physical assessment for a patient at the clinic and palpates enlarged inguinal lymph nodes on the left. What should the nurse document? Select all that apply a) location b) size c) consistency d) reports of tenderness e) temperature

a) location b) size c) consistency d) reports of tenderness

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 determines the patient is in? a) primary infection b) secondary infection c) tertiary infection d) latent infection

a) primary infection

An older adult patient who is post menopausal informs the nurse that she believes she has developed another urinary track infection. What risk factors do female patients in this age group have to increase the incidence of UTIs? (Select all that apply) a) residual urine b) urinary incontinence c) estrogen deficiency d) decreased function of the thyroid gland e) dry mucous membranes of the vagina

a) residual urine b) urinary incontinence c) estrogen deficiency

A new nursing graduate is working at the hospital in the acute care unit. The preceptor observes the nurse emptying a patient's room drain without gloves on. What important information should the preceptor share with the new graduate about standard precautions? a) standard precautions should be used with all patients to reduce the risk of transmission of blood-borne pathogen's b) Standard precaution should be used only with patients who are HIV-positive to reduce the risk of transmission of HIV virus c) it is only necessary to use gloves when you were emptying reservoirs that have body fluids in them d) if you are careful and do not expose yourself to blood or body fluids, it is not necessary to use gloves all the time

a) standard precautions should be used with all patients to reduce the risk of transmission of blood-borne pathogen's

A patient in the clinic states, "my boyfriend told me he went to the clinic and was treated for gonorrhea". While testing for this sexually-transmitted infection what else should be done for this patient? a) test for HIV without informing the patient b) test for HIV, requiring the patient to sign a permit c) inform the patient that it would be beneficial to test for HIV d) administer treatment for the STI and discharge the patient

a) test for HIV without informing the patient

Patient arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep testand it returns a positive result and the patient is given a prescription for an antibiotic. How did the streptococcal organism gain access to the patient to cause this infection? a) through the mucous membranes of the throat b) through the skin c) breathing in airborne dust d) from being outside in the cold weather and decreasing resistance

a) through the mucous membranes of the throat

The nurse is caring for a patient in the hospital who is receiving a vitamin D supplement. What does the nurse understand is the importance of supplementation with this vitamin? (Select all that apply) a) vitamin D deficiency is associated with increased risk of common cancers b) vitamin D deficiency is associated with increased risk of autoimmune disease c) vitamin D deficiency is associated with increased risk of congenital anomalies d) vitamin D deficiency is associated with increased risk of celiac disease

a) vitamin D deficiency is associated with increased risk of common cancers b) vitamin D deficiency is associated with increased risk of autoimmune disease d) vitamin D deficiency is associated with increased risk of celiac disease

The nurse is discussing sexual activity with a patient recently diagnosed with HIV. The patient states, "as long as I have sex with another person who is already infected, I will be OK." What is the best response by the nurse? a) you should avoid having unprotected sex with a person who is HIV-positive because you can increase the severity of the infection in both you and your partner b) yes; because you are already infected, and won't make a difference if you have sex with a person who is HIV-positive c) I am not sure why you would want to have sex with another person who is HIV-positive. That person may have another sexually transmitted infection d) if you have sex with another person who is HIV-positive, you will develop aids sooner

a) you should avoid having unprotected sex with a person who is HIV-positive because you can increase the severity of the infection in both you and your partner

A patient develops gastrointestinal bleeding from a gastric ulcer that requires blood transfusions. The patient states to the nurse, "I am not going to have a transfusion because I do not want to get aids". What is the best response by the nurse? a) "I understand what you mean, you can never be sure if the blood is tainted" b) " I understand your concern. The blood is screened very carefully for different viruses as well as HIV" c) "if you do not have the blood transfusion, you may not make it through this episode of bleeding" d) "no one has gotten HIV from blood in a long time. You have to have a transfusion"

b) " I understand your concern. The blood is screened very carefully for different viruses as well as HIV

The nurse is obtaining a history from a patient with severe psoriasis. What question would be the most important to assess patient to determine a genetic predisposition? a) "how did you know you developed this disease?" b) "does anyone in your family have more than one autoimmune disease?" c) "how many children do you have?" d) "does your spouse or significant other have an autoimmune disease?"

b) "does anyone in your family have more than one autoimmune disease?"

A patient with HIV has been in on anti-retroviral therapy for six months. The patient comes to the clinic with home medications and the nurse observes that there are too many pills in the container. Which factors are associated with nonadherence to anti-retroviral therapy? Select all that apply a) lives alone b) Active substance abuse c) taking other medication d) depression e) lack of social support

b) Active substance abuse d) depression e) lack of social support

The nurse received a phone call at the clinic from the family member of a patient with aids. The family member states that the patient started acting funny after reporting headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse tell the family member? a) The patient probably has a case of the flu, and you should give Tylenol b) The patient may have cryptococcal meningitis and will need to be evaluated by the physician c) this is one of the side effects from antiretroviral therapy and will require changing the medication d) The patient probably has pneumocystis pneumonia and will need to be evaluated by the physician

b) The patient may have cryptococcal meningitis and will need to be evaluated by the physician

A patient is being treated in the intensive care unit for sepsis related to ventilator associated pneumonia. The patient is on a large dose of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? a) leukocytosis b) bone marrow suppression c) oral thrush d) rash

b) bone marrow suppression

The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop I autoimmune disorders more frequently than men? a) androgen tends to enhance immunity b) estrogen tends to enhance immunity c) testosterone tends to enhance immunity d) leukocytes are increased in females

b) estrogen tends to enhance immunity

An older adult has developed a sacral pressure ulcer. What should the nurse assess in order to ensure adequate one healing and prevent poor outcomes for this patient? Select all that apply a) The patient's ability to perform self wound care b) nutritional status c) caloric intake d) Quality of food ingested e) The amount of carbohydrates the patient ingests

b) nutritional status c) caloric intake d) Quality of food ingested

A patient with HIV develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by pneumocystis jirroveci does the nurse know could occur with this patient? a) Mycobacterium avium complex b) pneumocystis pneumonia c) tuberculosis d) Community acquired pneumonia

b) pneumocystis pneumonia

The nursing instructor is discussing the development of human immune deficiency virus disease with the students. What should the instructor inform the class about helper T cells? a) they are activated on recognition of antigens and stimulate the rest of the immune system b) they attack the antigen directly by altering the cell membrane and causing cell lysis c) they have the ability to decrease be cell production d) they are responsible for recognizing antigens from previous exposure and mounting an immune response

b) they attack the antigen directly by altering the cell membrane and causing cell lysis

An older adult widowed woman informs the nurse that she notices vaginal dryness now that she has become sexually active again. She is not using barrier protection because it makes the dryness worse. What education to the nurse provided to the patient? a) use lambskin condom instead of latex b) vaginal dryness is common in postmenopausal women, and there are creams that can be condom c) because the patient is older, it is not likely that she will acquire HIV d) she should abstain from sexual activity because she is at greatest risk for acquiring HIV

b) vaginal dryness is common in postmenopausal women, and there are creams that can be condom

A patient is infected with HIV after sharing needles with another IV drug abuser. Upon infection with HIV, the immune system response by making antibodies against the virus, usually within how many weeks after infection? a) 1 to 2 weeks b) 3 to 6 weeks c) 3 to 12 weeks d) 6 to 18 weeks

c) 3 to 12 weeks

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? a) molluscum contagiosum b) tuberculosis of the skin c) Kaposi's sarcoma d) seborrheic dermatitis

c) Kaposi's sarcoma

A patient developed an infection while on vacation in central America and is now taking the antibiotic chloramphenicol . What should the patient be monitored for when taking this drug? a) Eosinophilia b) neutropenia c) aplastic anemia d) hypoprothrombinemia

c) aplastic anemia

The nurse is caring for an older adult patient hospitalized with cellulitis of the right lower extremity. Why is it imperative that the nurse continually assess the physical and emotional status of this patient? a) older patients are at risk of developing dementia b) The patient will not respond to the antibiotic treatment as well as the younger patient would c) early recognition and management of factors influencing immune response may decrease morbidity and mortality d) older adult patients develop depression and suicidal tendencies when they are faced with chronic illness

c) early recognition and management of factors influencing immune response may decrease morbidity and mortality

A patient tells the nurse, "I can't believe I have ineffective immune function and I'm getting sick again." I exercise rigorously and compete regularly. What is the best response by the nurse? a) "something must be seriously wrong. You should not be getting sick since you're so healthy" b) "maybe you need to stop exercising so much it can't be good for you" c) "it is possible that you are immunocompromised and may have HIV" d) " rigorous exercise can cause negative affects on immune response"

d) " rigorous exercise can cause negative affects on immune response"

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask? a) "have you ever been treated for a sexually transmitted infection?" b) " when was your last menstrual period?" c) "do you have abdominal pain or discomfort" d) "have you ever received a blood transfusion?"

d) "have you ever received a blood transfusion

A patient is on anti-retroviral therapy for the treatment of HIV. What does the nurse determine would be an adequate CD4 + count to determine the effectiveness of treatment for a patient per year? a) 1 mm3 to 10 mm3 b) 10 mm3 to 20 mm3 c) 20 mm3 to 45 mm3 d) 50 mm3 to 150 mm3

d) 50 mm3 to 150 mm3

A patient with acquired immune deficiency syndrome informs the nurse of difficulty eating and swallowing, and shows the nearest white patches in the mouth. What problem related to age does the nurse understand the patient has developed? a) Microbacterium avium complex b) wasting syndrome c) Kaposi sarcoma d) candidiasis

d) candidiasis

A patient who suffered severe partial thickness burns to the face and trunk is at risk for depletion of essential proteins and immunoglobulins. The stressors associated with this patient's major injury have caused what immune process to occur? a) cortisol is released from the adrenal cortex, which contributes to immunosuppression b) circulating lymphocytes will cause lymph node enlargement and altered lymph drainage c) T lymphocytes are stimulated and produce antibodies d) with the help of macro phages, T lymphocytes recognize the antigen of a foreign invader

d) with the help of macro phages, T lymphocytes recognize the antigen of a foreign invader