EAQ P&R

which type of hypersensitivity reaction occurs when the clients sensitized T cytotoxic cells are involved as the mediators of injury

type IV

which causative agent is common to both hyperthermia and hypothermia?

alcohol

which client condition would the triage nurse classify as the lowest priority of care? select all that apply

cystitis cold symptoms

which type of hepatitis virus spreads through contaminated food and water?

hepatitis A virus

which service provided by the public health nurse through the local health department would support primary prevention of human immunodeficiency virus (HIV)? select all that apply

1. provide information about safe sex practices through local venues 2. support community level initiatives to impact traditions, norms, and beliefs regarding sexuality

which observation by the nurse indicates a client with pneumonia is able to use an incentive spirometer correctly? elect all that apply

1. records the volume of the air inspired 2. performs 10 breaths per session every hour 3. takes a long, slow, deep breath keeping the mouthpiece in place

which option is an example of actively acquired specific immunity? select all that apply

1. recovery from measles 2. recovery from chickenpox 3. immunization with live or killed vaccines

which assessment finding supports the diagnosis of neuroleptic malignant syndrome in a client with schizophrenia being treated with haloperidol? select all that apply

1. rigidity 2. sweating 3. temperature 105.8

according to the five level triage system, in which order of priority would the clients with various conditions receive care?

1. severe respiratory distress 2. gynecologic disorder 3. closed extremity trauma 4. minor burns

which action would be the focus of nursing care for a client admitted with tetanus caused by a puncture wound?

decreasing external stimuli

which medication is most beneficial to the client with sickle cell anemia receiving a blood transfusion regimen and experiencing cardiac dysrhythmias due to iron overdose toxicity?

deferoxamine

which statement made by the nurse regarding the prevention of HIV transmission by health workers is correct? select all that apply

1. if i perform exposure-prone procedures, i should know my HIV antibody status 2. i should identify exposure-prone procedures by institutions where they are performed 3. if i have exudative lesions or weeping dermatitis, i should not perform direct client care or handle client care equipment

which nursing action would the nurse implement during the primary survey of the emergency assessment process for a client? select all that apply

1. immobilizing the cervical spine 2. preparing for chest tube insertion 3. applying direct pressure to a wound

which assessment data related to the clients airway would indicate the need for priority intervention by the nurse? select all that apply

1. dyspnea 2. agonal breaths 3. inability to speak

which side effect would the nurse monitor for in a client receiving a calcineurin inhibitor to prevent organ rejection? select all that apply

1. hirsutism 2. gingival hyperplasia 3. nephrotoxicity

the health care provider suspects a client has tuberculosis and prescribes a purified protein derivative (PPD) test, chest X-ray, and sputum culture. prioritize implementation of the ordered interventions

1. institue airborne precautions 2. chest xray 3. skin test 4. sputum specimen 5. notify the department of health

which clinical manifestation would the nurse monitor for when administering lymphocyte immune globulin? select all that apply

1. leukopenia 2. tachycardia 3. serum sickness

which action transmits the human immunodeficiency virus (HIV)? select all that apply

1. sharing syringe needles 2. breast feeding a newborn 3. anal intercourse

which rationale supports the nurses instructions to a client to speak with the health care provider before self medicating with over the counter decongestants?

can cause urinary retention

which clinical manifestation would the nurse associate with the development of histoplasmosis in the client with aids? select all that apply

cough enlarged lymph nodes

which action is the nurses response when assessment of the oral cavity of a client with acquired immunodeficiency syndrome reveals areas of white plaque on the tongue and palate?

document the presence of the lesions, describing their size, locator, number and color

which impending problem would the nurse suspect when caring for a client with bloody urine in the indwelling catheter collection bag, after an emergency cesarean birth?

surgical trauma to the bladder

in which order would the nurse assess and provide care to the clients with various conditions in the emergency department

1. overdose of opioids with a respiratory rate of 8 breaths per minute 2. multiple trauma from a motor vehicle accident 3. abdominal pain rated as a 7 on a numeric pain scale 4. leg laceration requiring sutures

which response would a nurse monitor for when a client is receiving furosemide to relieve edema? select all that apply

1. weight loss 2. excessive loss of potassium ions

the nurse is providing care to a client with ascites secondary to liver failure. which intervention is appropriate to include in the clients care? select all that apply

1. low sodium diet 2. daily abdominal girth measurements 3. daily weights

which action would the nurse implement for a client who has overdosed on barbiturates? select all that apply

1. maintain airway 2. give activated charcoal 3. give intravenous fluids

which role requires the nurse to prioritize when implementing a primary nursing model of client care? select all that apply

1. manager 2. advocate 3. decision maker 4. care coordinator

which medication prevents the binding of human immunodeficiency virus to a clients cells? select all that apply

1. maraviroc 2. enfuvirtide

which medication would the nurse anticipate teaching the mode of action and side effects for when treating a client with psoriasis? select all that apply

1. methoxsalen 2. anthralin 3. calcipotriene

which preferred medication will the nurse administer to a client hospitalized with pneumococcal pneumonia?

ceftriaxone

which prescribed medication would the nurse teach a clean with Lyme disease who presents with dyspnea, dizziness, and facial paralysis?

ceftriaxone

the nurse reviews the prescriptions of multiple adolescents with genital herpes simplex infections. which clients medication regimen would require correction?

client B (17 yr old, negative pregnancy test. suppression therapy. valacyclovir, 500mg orally bid)

which sexually transmitted infection is caused by human papilloma virus?

condylomata acuminata

which assessment finding of a client with chronic pain who has been prescribed opioid treatment indicates the need for a priority nursing intervention? select all that apply

1. level 3 sedation 2. respiratory rate of 8 breaths per minute

which statement indicates understanding after the nurse provides discharge teaching to a client with aids and a low white blood cell count? select all that apply

1. my roommate will take care of our cats litter box 2. i will rinse my toothbrush in bleach once a week 3. i will use a different cup every time i have a drink 4. i will wash my hands thoroughly after shaking hands with anyone

which intervention would the nurse implement in the management of a clients botulism infection? select all that apply

1. planning for nutrition and rehabilitation support 2. disposal of suspected contaminated food sources

which condition contraindicates oxytocin induction?

active genital herpes infection

which medication would the nurse anticipate administering to a client receiving cisplatin therapy who developed tumor lysis syndrome?

allopurinol

a client who is in labor is admitted 30 hours after her membranes ruptured. which condition is this client at increased risk for?

chorioamnionitis

which client is at an increased risk for hospital acquired pneumonia

client who was admitted to the hospital 5 days ago for abdominal pain

which client would the nurse suspect as having a type IV hypersensitivity reaction when providing care for four clients with hypersensitivity reactions?

client with erythema and edema after 24 hours

which organism would the nurse suspect is responsible when a client with HIV reports dyspnea on exertion, increased heart rate, a persistent dry cough, and a persistent low grade fever with bilateral crackers auscultated in the lower lung loves?

pneumocystis jiroveci

which statement reflects a clients active immunity response to an infection acquired from traveling abroad?

protein substances are formed within the body to neutralize antigens

when caring for a woman with a probable tubal pregnancy, which clinical manifestation requires immediate intervention?

sudden onset of knifelike pain in one of the lower quadrants

which complication would the nurse anticipate finding during the assessment of a client admitted with a diagnosis of severe procidentia (prolapse of the uterus)?

ulcerations

which condition would the nurse suspect when the blood report of a client with a fungal infection reveals the presence of immunoglobulin M (IgM) and IgG antibodies with the skin test response of erythema and edema within 3 hours after planting? select all that apply

1. rheumatoid arthritis 2. acute glomerulonephritis 3. systemic lupus erythematosus

which client condition is an example of a cell mediated immunity? select all that apply

1. tuberculosis 2. graft rejection 3. contact dermatitis

which prescribed medication would the nurse administer to clients receiving induction therapy to prevent rejection of a transplanted organ?

atgam

which condition presents with elevate immunoglobulin E (IgE) levels, positive allergic skin test reactivity, and widespread skin vesicles?

atopic dermatitis

when admitting a client with acute coronary syndrome (ACS) to the telemetry unit after cardiac catheterization and percutaneous intervention (PCI), which action would the nurse take first?

attach the cardiac monitor

which type of hypersensitivity reaction is present in a client with a body temperature of 102, severe joint pain, rashes on the extremities, and enlarged lymph nodes from serum sickness?

immune complex-mediated reaction

which technique would the nurse use in attempting to glove the second hand when donning sterile gloves?

insert gloved fingers under cuff of second glove and lift glove; then slide ungloved hand into glove

a client who is obese has an abdominal cholecystectomy. how would the nurse plan to alleviate tension on the surgical wound after surgery?

maintaining nasogastric tube patency

which medication prevents cellular infection in clients with human immunodeficiency virus

maraviroc

which type of medication would the nurse administer to a client with rhinitis secondary to an antigen immunoglobulin (IgE) reaction?

mast cell stabilizing

which action for nutritional needs would the nurse take for a depressed client who has been sitting alone in a chair most of the day and displays no interest in eating?

start with the client during meals

which nursing intervention would be the priority for a lien with urine output of 250mL in 24 hours, blood osmolality of 310, and a systolic blood pressure of 90?

request an increase in the intravenous fluid rate from the health care provider

during which week of gestation would a ruptured tubal pregnancy most commonly occur?

6th

which finding would the nurse be most concerned about when reviewing the chart of a client scheduled for an amniocentesis?

B negative blood type

which intervention would the nurses perform first for a client with acute abdominal pain form pelvic inflammatory disease?

obtain a urinalysis

which disease would the nurse suspect when a client with AIDS reports painless, white, raised lesions on the lateral aspect of the tongue?

oral hairy leukoplakia

which clinical manifestation would the nurse observe in a client experiencing anaphylactic shock from a type I latex allergic reaction? select all that apply

stridor hypotension dyspnea

which preventable childhood communicable disease may lead to encephalitis

varicella

when a critically ill client has a pulmonary artery catheter inserted, which measurement provides the most useful information about the clients left ventricular pressure?

pulmonary artery wedge pressure

which instruction would the nurse provide to a client receiving brachytherapy for prostate cancer to prevent injury?

refrain from close contact with others

which statement indicates the nurse has a correct understanding of interleukin-2? select all that apply

1. the cytokine enhances natural killer cells 2. the cytokine is used to treat virus malignancies 3. the cytokine stimulates differentiation of t-lymphocytes

which documented diagnosis would the nurse observe in the clients electronic medical record when laboratory tests reveal the presence of human leukocyte antigen (HLA-B27)?

renters syndrome

the emergency department nurse would provide immediate care based on priority to the client with which condition

repeated tonic clonic seizures

which type of hypersensitivity reaction would a nurse be concerned about when the laboratory results of a client with a pulmonary hemorrhage and glomerulonephritis reveal the presence of IgG antibodies?

cytotoxic

which clinical manifestation would the nurse expect when assessing a client with type IV delayed hypersensitivity reaction? select all that apply

1. edema 2. ischemia 3. induration 4. tissue damage

which anti tubercular medication may increase a clients risk for gout? select all that apply

1. ethambutol 2. pyrazinamide

which clinical manifestation supports the nurses suspicion of a jarisch-herxheimer reaction after initiating antibiotic therapy on a client with syphillis? select all that apply

1. fever with shaking chills 2. generalized aches 3. pain at the injection site

which condition involves a cytotoxic hypersensitivity reaction? select all that apply

1. graves disease 2. myasthenia graves 3. immune thrombocytopenic purpura

which home visit observation indicates the client with acquired immunodeficeincy syndrome (AIDS) integrated acute care discharge teachings? select all that apply

1. toothbrush soaking in laundry bleach 2. washed dishes with warm, soapy water before using 3. applied gloves before weeding a houseplant

which parental statement indicates effective learning regarding management of nocturnal enuresis in a 6 year old child? select all that apply

1. i should avoid giving my child fluids after dinner 2. i should encourage my child to drink lots of water during the day 3. i should wake my child at the same time every night to use the bathroom

which immunoglobulin crosses the placenta?

IgG

which finding supports the nurses conclusion that a client is in the primary stage of syphilis? select all that apply

1. ulcers on the hands and lips 2. firm and enlarged lymph nodes

which clinical manifestation would the nurse observe in a client diagnosed with blackwater fever secondary to malaria

dark red urine

which type of cells are deficient in DiGeorge syndrome?

T cells

which symptoms would support the nurses suspicion that a child has mumps

fever swelling of the parotid gland

which evaluation method is the most effective way for the nurse to evaluate the teachers knowledge of hand washing techniques after a program for teachers about infection control and hand washing techniques

watch the teachers demonstrate infection control techniques

which action would the nurse implement when providing care for a client with malaria?

provide nutrition between paroxysms

which cellular response may have occurred in a client exhibiting the clinical manifestations of a type I hypersensitivity reaction?

allergic rhinitis

which ophthalmic conditions can cause a client to have photophobia? select all that apply

1. chalazion 2. trachoma 3. keratoconjunctivitis sicca

which action would the nurse take first after noting a flat line on a clients cardiac monitor?

assess the clients pulse

which action would the nurse take when providing care for a client suspected of having ebola virus?

avoid contact with all body fluids and discharges

which client is at the greatest risk for a postpartum infection?

a woman who required catheterization after voiding less than 75ml

which clinical manifestation is consistent with sjogren syndrome? select all that apply

1. xerostomia 2. keratoconjunctivitis sicca

which medication is the first line medication used to treat a client with mild diarrhea who is diagnosed with a clostridium difficile infection?

metronidazole

the nurse is caring for a client who had a gastroscopy. which response indicates a major complications associated with this procedure?

abdominal distention

which action would the nurse take first for a client who is in active labor and experiences sudden vaginal bleeding and increased uterine tone without relaxation between contractions?

assess the fetal heart rate, uterine activity and blood pressure

a client is scheduled for surgery to repair an irreducible (incarcerated) hernia. which nursing intervention is priority?

assessing the clients bowel movements

which disease requires implementation of droplet precautions? select all that apply

pertussis diphtheria

when a client reports a sudden onset of chest pain that feels like a pressure or weight on their chest, which action would the nurse take first?

check blood pressure and heart rate

which action would the nurse immediately implement for a client with moderate hypothermia? select all that apply

1. administer heated oxygen 2. position the client supine 3. apply external heat with heating blankets

which statements made by the nursing student demonstrate adequate knowledge about the etiology of hypothermia and administration of different treatments? select all that apply

1. blood infusion causes hypothermia 2. neuromuscular blocking agents causes hypothermia

in which order would the nurse perform the actions when inspecting the chest of a client twist a suspected heart attack after a fire?

1. inspect the chest for paradoxical chest movements 2. palpate the sternum, clavicles, and ribs 3. auscultate breath sounds and heart sounds 4. evaluate the client for rib fractures, pulmonary contusion, blunt cardiac injury, and hemothorax 5. obtain a chest x ray and 12 lead ECG

which initial nursing intervention is the most appropriate for a client who survived a fire in the hospital and is found to have neck trauma, dyspnea, gasping breathing, and is unable to speak? select all that apply

1. performing jaw-thrust maneuver 2. preparing to assist in performing endotracheal intubation

which intervention would be a priority for the nurse to implement to promote client safety directly after esophagogastroduodenoscopy (AGD)? select all that apply

1. positioning to prevent aspiration 2. monitoring for signs of perforation

which physiologic response to bronchiolitis would the nurse expect to observe on the pediatric intensive care unit? select all that apply

1. wheezing 2. sternal retractions 3. nasal flaring 4. prolonged expiratory phase

which type of fracture does the client admitted to the emergency department after a bomb blast who is given a yellow tag most likely have?

compound fracture

intravenous magnesium sulfate therapy is instituted for a client with severe preeclampsia who has a blood pressure of 170/110, a pulse of 108 bpm, and a respiratory rate of 24. eight hours later her blood pressure is 150/110, pulse is 98, respiratory rate is 10 and the knee jerk reflex is absent. which action would the nurse take in response to these findings?

stop the infusion of magnesium sulfate and notify the primary health care provider

the doctor has written an order for a contraction stress test. the presence of which condition would prompt the nurse to question the order?

vaginal bleeding

which nursing intervention would be a priority in the care of clients with frostbite

warming the frostbite area in water bath

which result would the nurse expect to find when reviewing the serum screening testes of a client with acquired immunodeficiency syndrome?

a decrease in CD4 T cells

which clinical finding in a newly postpartum client requires immediate investigation?

a slow trickle of blood from the vagina

which priority emergency assessment would the nurse perform on a client with bomb blast injuries? select all that apply

1. airway 2. breathing 3. circulation 4. exposure or environmental control

a primary health care provider prescribes carboprost tomethamine (hematite) to be administered to a postpartum client with intractable vaginal bleeding. the nurse should notify the provider of which current condition in the clients medical history?

history of asthma

when evaluating the condition of a client with burns to the upper body, which finding would alert the nurse of a potential respiratory obstruction?

hoarse quality to the voice

which is the priority nursing action when a loop of umbilical protrudes from the vagina after rupture of a clients membranes?

holding the presenting part away from the cord

which organism would the nurse associate with a client reporting a fever, headache, extreme tiredness, dry cough, sore throat, runny nose, muscle aches, nausea, vomiting and diarrhea?

influenza virus

which action would the nurse instruct the UAP to perform to prevent hip dislocation in a client recovering from a total hip arthroplasty via posterior approach?

insert abduction pillow between legs

which medication class helps HIV from incorporating its genetic material into the clients cell?

integrase inhibitors

which are signs and symptoms of withdrawal that might be seen in a postpartum client with a history of opioid abuse?

irritability and muscle tremors

which medication would the nurse expect to be prescribed first to reduce the symptoms of a female client who reports severe cramping, pain, backache, anxiety, mood swings and a migraine headache?

sertraline

which type of hypersensitivity reaction will occur in the client who mistakenly received ABO incompatible blood from a donor?

Type II

which type of hypersensitivity reaction is associated with systemic lupus erythematous (SLE)?

Type III

which medication, when administered after a liver transplant, has a potential adverse effect of decreasing a clients hemoglobin and thrombocyte counts?

azathioprine

which medication inhibits purine synthesis and suppresses cell mediated and humoral immune responses? select all that apply

azathioprine mycophenolate mofetil

which client would the nurse determine has a risk for developing meningitis, hearing loss, and generalized paresis?

client A- gummas on the skin, nose, mouth, and bones

for which client would the nurse need to contact the health care provider based upon the clients condition and treatment after reviewing the medication reconciliation documents of four clients?

client A.

which clinical manifestation supports a clients diagnosis of cryptosporidiosis? select all that apply

diarrhea weight loss

a postpartum client is being treated with subcutaneous enoxaparin for deep vein thrombosis of the left calf. which client cue is of most concern to the nurse?

dyspnea

which information would the nurse provide to the parent of an adolescent who is going to be a foreign exchange student and asks why the child must have a tetanus toxoid immunization?

longer lasting active immunity

when providing care for a client during the first few hours after admission to the burn unit with full thickness burns of the trunk and head, which goal is the nurses priority during the emergent phase of this injury?

managing fluid loss

which medication would cause the nurse to monitor a client closely for hemolytic anemia?

methyldopa

which organism is a common opportunistic infection in a client infected with human immunodeficiency virus?

oropharyngeal candidiasis

which type of immunity would be conferred when the nurse prepares to administer diphtheria antitoxin to an unvaccinated child post exposure?

passive artificial

which stage of the human immunodeficiency virus disease is present in the client with a laboratory report revealing a CD4+ T cell count of 520 according to CDC?

stage 1

which medication may be used to treat the condition depicted in the image? (toes)

terbinafine

which condition would the nurse keep in mind while performing a rewarming procedure for a client with severe hypothermia

the client should be monitored for after drop during rewarming

which intervention would the nurse include in the plan of care of an older adult line with decreased cell division in the epidermal layer of the skin? select all that apply

1. advise the client to prevent skin trauma 2. advise the client to protect open areas of skin

which primary intervention would the nurse perform on a diabetic client who survives a fire, but has a head injury, tachycardia, and pale and ashen-colored skin? select all that apply

1. administering cool intravenous fluids 2. placing the client in a cool environment 3. managing and maintaining airway breathing circulation

which priority intervention would the nurse follow when caring for a client with malignant hyperthermia? select all that apply

1. administer 100% oxygen 2. prepare for endotracheal incubation 3. stop all inhalation anesthetic agents

which curative treatment would a nurse administer for a client reporting severe nighttime itching with burrows in the flexor surfaces of the wrists and in the anterior axially folds

permethrin 5% topical lotion

which medication may have caused a clients admission to the hospital for treatment of a peptic ulcer, osteoporosis, and hypertension?

methylprednisolone

which is a risk factor for postpartum hemorrhage

multiple gestation pregnancy

which factor in a clients history suggests a risk for preterm labor?

multiple urinary tract infections

which medication may cause severe neutropenia and thrombocytopenia in a client?

mycophenolate mofetil

a clients laboratory findings revealed increased levels of serum alkaline phosphatase and urinary hydroxyproline. which condition will the nurse observe in the clients electronic medical chart

osteitis deformans

a client who has missed two menstrual periods arrives at the prenatal clinic with vaginal bleeding and one sided lower quadrant pain. which condition would the nurse suspect?

ectopic pregnancy

the nurse is caring for a postpartum client with preeclampsia being managed with a magnesium sulfate infusion. which is the priority nursing assessment?

eliciting deep tendon reflexes

which medication would the nurse anticipate the primary health care provider will prescribe for a client with HIV2 infection who is prescribed rilpivirine therapy?

emtricitabine

which process would the nurse explain that cetuximab inhibits when teaching a client with colorectal cancer?

epidermal growth factor receptors

during their initial visit to the prenatal clinic, a couple asks the nurse whether the woman should have an amniocentesis for genetic studies. which factor indicates that an amniocentesis may be indicated?

family history of genetic abnormalities

which medication would the nurse anticipate administering to a client who reports fever, cough, muscle aches, night sweats, and chest pain with a laboratory report indicating the presence of coccidioides organisms in the respiratory tract?

fluconazole

which complication is a result of clostridium welchii entering a clients wound and causing crepitus?

gangrene

which early sign of infection would the nurse expect when assessing teenage with a tentative diagnosis of primary syphilis?

genital lesion

which postpartum client is at the highest risk for disseminated intravascular coagulation (DIC)?

gravida I who has had an intrauterine fetal death

which schizophrenia medication can lead to a prolongation of the QT interval in a client? select all that apply

haloperidol thioridazine chlorpromazine

which clinical manifestation would the nurse observe for when reviewing examination and diagnostic data about a client with malaria? select all that apply

hyperthermia splenomegaly

which health concern would be the nurses highest priority to monitor after the removal of clothing from a client with burn trauma?

hypothermia

which clinical manifestation may indicate a client has systemic lips erythematous (SLE)? select all that apply

pericarditis discoid lesions pleural effusions

a postpartum client receiving a continuous heparin infusion for a deep vein thrombosis has an activate partial thromboplastin time (aPTT) of 128 seconds. which action would the nurse take in response to this situation?

interrupt the infusion and notify the primary health care provider of the aPTT result

which statement describes the mechanism of action of maraviroc?

it blocks the C-C chemokine receptor type 5 (CCR5) receptor on CD4+ T cells

which intervention regarding skin care would the nurse include in a teaching plan for the client with scleroderma?

keep skin lubricated with lotion

which prescribed medication would the nurse anticipate administering to a client who tested positive for human epidermal growth factored has a diagnosis of advanced breast cancer?

lapatinib

which stage of syphilis is the client experiencing when there are not any clinical manifestations?

latent

which client condition would the triage nurse classify as needing immediate care? select all that apply

active hemorrhage substernal chest pain

the nurse is caring for a client with cirrhosis of the liver. the nurse anticipates a prescription for neomycin enemas based on which abnormal laboratory test?

ammonia level

which hypersensitivity condition would the nurse suspect when a client presents with cutaneous lesions, swelling of the face, eyelids, and lips form dilation and engorgement of the capillaries but no observable welts or vesicles?

angioedema

a clients infusion of vesicant intravenous solution through a short peripheral catheter leaks into their extravascular tissue. after stopping the infusion and disconnecting the administration set, which action would the nurse take next?

aspirate the medication form a short peripheral catheter

while assessing a client during the fourth stage of labor, the nurse notes that the perineal pad is soaked with approximately 75mL of loch rub .which nursing action is the priority?

assess the uterine fundus

which medication classification is commonly used to treat clients needing immunosuppressant therapy but has the potential long term side effects of neurotoxicity, lymphoma, hepatotoxicity, and hypertension?

calcineurin inhibitors

which clinical manifestation, commonly associated with pyrexia, would the nurse monitor for in a client who develops pyrexia 3 days after surgery? select all that apply

tachypnea increased pulse rate

which medication inhibits organ transplant rejection by stopping the secretion of IL-2? select all that apply

tacrolimus cyclosporine

which medication may be coadministered with mycophenolate mofetil as treatment for late graft loss in a client with a renal transplant? select all that apply

tacrolimus cyclosporine

once a client admitted with shock secondary to severe gastrointestinal bleeding is stabilized, which action would the nurse take?

take a blood sample for laboratory tests

a client has a blood pressure of 90/50 during her first visit to the prenatal clinic. on a subsequent visit, at 34 weeks gestation, her blood pressure is 120/76. which would the nurse conclude might have caused the change?

the possible development of preeclampsia

which clients prescribed medication places them at the lowest risk for developing hepatotoxicity?

client C daclizumab

which client would the nurse suspect as being in the last stage of syphilis?

client D gummas on the skin

which complications would the nurse expect in relation to lead toxicity? select all that apply

1. anemia 2. proteinuria 3. encephalopathy

which information would a nurse provide regarding varicella

communicable until all vesicles are dry

which client statement indicates teaching about protease inhibitors was effective?

protease inhibitors prevent viral replication and release of viral particles

which organism would the nurse teach immigrants is the case of smallpox?

variola virus

which prescribed medication would the nurse anticipate initiating for a client with a clostridium difficile associated disease? select all that apply

1. fidaxomicin 2. metronidazole 3. vancomycin

which clinical manifestation would a client exhibit during the fulminant stage of inhalation anthrax? select all that apply

1. hypotension 2. bilateral pleural effusion 3. temperature of 104 4. septic shock

which event indicates a need to suggest testing of a client for the human immunodeficiency virus (HIV)? select all that apply

1. diagnosed with tuberculosis in 1985 2. received blood transfusions in 1980 during total hip replacement surgery 3. engaged in sexual relations with someone of the same sex for several years

which function of leukocytes is involved in the inflammation process? select all that apply

1. destruction of bacteria and cellular debris 2. release of vasoactive amines during allergic reactions

which medication, when prescribed for a client after a kidney transplant surgery, may require the client to visit a dentist? select all that apply

1. everolimus 2. cyclosporine

which growth and developmental change indicates increased maturity during the school age stage of development? select all that apply

1. an increase in leg length in relation to height 2. a decrease in head circumference in relation to standing height 3. decreased waist circumference in relation to standing height

which instruction would the nurse teach when initiating a client with tuberculosis on rifampin? select all that apply

1. avoid drinking alcohol as long as you are on this medication 2. notify your provider immediately if you develop a yellow appearance to your skin 3. your soft contact lenses will become permanently stained because of this medication

which instruction by the nurse will be beneficial to the client prescribed pyrazinamide for tuberculosis? select all that apply

1. avoid drinking alcoholic beverages while taking this medication 2. drink at least 8 ounces of water with each dose of the medication

which statement regarding the mechanisms of antiviral medications to control human immunodeficiency virus (HIV) infections would the nurse question?

saquinavir blocks the fusion between HIV and the host cell

which potential complication of severe preeclampsia may result from severe hypertension?

stroke

which conditions increase the risk for postpartum hemorrhage? select all that apply

1. twin birth 2. over distended bladder 3. retained placental fragments

which educational statement from the nurse will be beneficial for the client with tuberculosis

1. avoid exposure to any inhalation irritants 2. eat foods that are rich in protein and vitamins C and B 3. cover the mouth and nose with a tissue when coughing or sneezing

which prescribed medication would the nurse expect as maintenance therapy for a client with a kidney transplant? select all that apply

1. azathioprine 2. prednisone

which statement would the nurse use regarding isoniazid when teaching a client with tuberculosis? select all that apply

1. be sure to take the medication on an empty stomach 2. take daily multiple vitamins that contain B complex 3. report darkening of your urine or a yellowish skin discoloration

in which order would the nurse perform the following interventions for a client with injuries from a motor vehicle accident?

1. control external bleeding 2. elevate the injured limb 3. apply ice packs 4. monitor for temperature elevation

which orders are appropriate for a client with mild preeclampsia? select all that apply

1. daily weight 2. monitor deep tendon reflexes

arrange the sequencing required to stimulate antibody mediated immunity

1. exposure of antigen 2. antigen recognition 3. sensitization 4. antibody production 5. antibody- antigen binding 6. antigen elimination

a client at 36 weeks gestation has gained 5 lb in the previous week and has a pronounced increase in blood pressure. which is the initial intervention upon admission of the client to the high risk unit?

providing a dark, quiet room with minimal stimuli

which action would the nurse use when administering the allergen to a client who experiences severe anaphylactic reactions to insect venom when beginning allergen therapy?

rotating the sites for each injection

which clinical manifestation is associated with sjogren syndrome? select all that apply a

tooth decay corneal ulcers vaginal dryness

which class of TB would the nurse suspect when caring for a client who sustained a significant reaction to the tuberculin skin test and has negative findings on bacteriologic studies with X-ray findings and clinical evidence for TB being negative?

class 2

which action would the nurse implement regarding the public health implications of a 16 year old adolescent diagnosed with gonorrhea?

identifying and locating the clients sexual contacts

which type of hepatitis develops into a chronic form of the disease? select all that apply

Hepatitis B Hepatitis C Hepatitis D

which instruction would the nurse be given to decrease the risk of seroconversion while taking combination antiretroviral therapy after a needle stick?

start medication within 24 to 36 hours

which medication is useful in reducing the flu like syndrome associated with use of monoclonal antibody therapy? select all that apply

1. acetaminophen 2. diphenhydramine 3. methylprednisolone

which symptom may be experienced by a client diagnosed with stage 2 syphilis? select all that apply

1. alopecia 2. weight loss 3. mucous patches in the mouth

the registered nurse teaches the nursing student about antipsychotic medicaments. which statements made by the nursing student need a correction? select all that apply

1. antipsychotic medications only benefit clients with psychotic symptoms 2. antipsychotic medications are always used to treat bipolar disorder

which action would the nurse implement when assessing a client with a new diagnosis of syphilis? select all that apply

1. ask the client about medication allergies 2. examine the clients lymph nodes for enlargement 3. gather information about any ulcers or rashes 4. ask about the clients sexual activity and protection metho

which nursing action would be the priory when providing care for a trauma client with a penetrating wound after the completion of the secondary surgery? select all that apply

1. documenting the clients care 2. administering tetanus prophylaxis to the client

arrange the steps involved in a type I allergic reaction into the correct sequence

1. exposure to the allergen 2. activation of B lymphocytes 3. sensitization of immunoglobulin E (IgE) antibodies 4. attachment to the mast cells 5. release of chemical mediators

which statements made by the nurse indicate accurate awareness about the condition associated with hypothermia? select all that apply

1. hypothermia can often be misdiagnosed because it mimics other disorders 2. near drowning increases evaporative heat loss to 25 itemizes greater than normal

which immunodeficiency disorder affects polymorphonuclear leukocytes and monocytes? select all that apply

1. job syndrome 2. chronic granulomatous disease

which nutritional intervention would the nurse include when planning care for a client with acquired immunodeficiency syndrome (AIDS)? select all that apply

1. offer ice chips throughout the day 2. instruct on the use of oral anti fungal medication 3. collaborate with the dietician for small, frequent meals 4. schedule routine mouth care, avoiding alcohol based mouthwashes

in which order would the nurse perform interventions for a client in the emergency department with facial trauma, dyspnea, cyanosis, and external bleeding?

1. perform jaw thrust maneuver 2. administer supplemental oxygen 3. apply direct pressure with a sterile dressing 4. measure clients level of consciousness 5. remove the clients clothing to perform a thorough physical examination

which instruction regarding the use of fluticasone nasal spray is appropriate for client teaching? select all that apply

1. use the medication on a regular basis, not PRN 2. clear the nasal passages before using the medication 3. discontinue use of the medication if nasal infection develops

which statement would be made by the nurse teaching a client about the use of tampons? select all that apply

1. wash your hands before inserting a tampon 2. use sanitary napkins at night 3. report any physical changes while using a tampon

which instruction would the nurse provide a client prescribed rifampin for tuberculosis? select all that apply

1. you should report any yellow tinge to your skin 2. your soft contact lenses will be stained permanently 3. you should report any increased tendency to bruising or bleeding

a client at 24 weeks' gestation arrives at the clinic for a routine examination. she tells the nurse, "i feel puffy all over". in light of this statement, which is the nurses most important assessment?

obtaining her blood pressure

the results of a second trimester fetal sonogram reveal a small for gestational age fetus and a low lying placenta. the nurse recognizes that these result increase the patients risk for which diagnosis?

placenta previa

which statement describes the role of the plasma cell in the antigen-antibody response?

produces antibodies against the sensitizing antigen

which response would the nurse suspect is being experiencing by a client employed by a company manufacturing latex gloves who reports developing skin dryness, pruritus, and fissures 2 days ago and development of severe skin redness and inflammation in the past 24 hours?

type IV contact dermatitis reaction

which organism would the nurse suspect when a client presents with a circumscribed, hypertrophic, flesh colored papule on the skin and reports pain upon lateral compression for the papule?

verruca vulgaris