Lymphatic System

Thrombocytopenia results when there is excess bleeding as a result of trauma, injury, or surgery. The nurse should check the platelet count in patients with these conditions. The baseline reading that is of concern and requires continued monitoring, but does not warrant instituting bleeding precautions, is a count of: 120,000/mm3. 20,000/mm3. 60,000/mm3. 85,000/mm3.

120,000/mm3.

A client is given a dose of ketorolac, a nonsteroidal anti-inflammatory drug for complaints of abdominal pain. Ten minutes after receiving the medication, the client's eyes, lips, and face begin to swell, and the nurse hears stridor. What priority measure should the nurse prepare to do? Perform an electrocardiogram (ECG). Intubate the client. Administer epinephrine. Assess the client's vital signs.

Administer epinephrine.

Sara Roxbury, a 22-year-old graduate student, is undergoing sensitivity testing to define the allergen which is causing her so much difficulty. In your client education before the procedure begins, you indicate the various routes in which an allergen can be introduced. Which of the following is an allergen introduction route? Injection Inhalation Ingestion All options are correct

All options are correct

A client with advanced leukemia is responding poorly to treatment. The nurse finds the client tearful and trying to express feelings, but he is clearly having difficulty. What is the nurse's most appropriate action? Tell the client that the nurse understands how he or she is feeling. Offer to call pastoral care. Give the client privacy and leave the room. Ask if the client would like the nurse to sit with him while he collects thoughts.

Ask if the client would like the nurse to sit with him while he collects thoughts.

The nurse is caring for a client whose most recent laboratory values reveal a neutrophil level of 21,000 mm3. When preparing to assess the client, the nurse should prioritize what assessment? Assessing the client for signs and symptoms of infection Assessing the client's activity level and functional status Assessing the client for indications of internal or external hemorrhage Assessing the client for signs of venous thromboembolism

Assessing the client for signs and symptoms of infection

A teenaged client has been brought to the clinic by his mother and is suspected of having an immune system disorder. What tests would the nurse expect to be ordered for this young client? Complete chemistry panel Complete blood count with differential Sedimentary rate Cerebral spinal fluids aspiration

Complete blood count with differential

The nurse is reviewing a client's laboratory results and notes that her hemoglobin level is 15 g/dL. What action should the nurse take next? Record the result and recommend a retest in 6 weeks. Notify the physician because the client requires further testing. Ask the client if she has had excessive menstruation or is lacking iron in her diet. Document the finding as normal.

Document the finding as normal

An 89-year-old client is preparing to leave the physician's office. The nurse is discussing with the client some strategies for ingesting iron to combat her iron-deficient anemia. Which of the following are among the nurse's strategies? Take iron with an antacid to avoid stomach upset. Taking iron pills with milk aids in absorption. Drink liquid iron preparations with a straw. Avoid vitamin C - it prevents absorption.

Drink liquid iron preparations with a straw.

A public health nurse is preparing an educational campaign to address a recent local increase in the incidence of HIV infection. The nurse should prioritize what intervention? Educational programs that focus on control and prevention Lifestyle actions that improve immune function Screening programs for youth and young adults Appropriate use of standard precautions

Educational programs that focus on control and prevention

Which of the following is the first barrier method that can be controlled by the woman? IUD Diaphragm Female condom Birth control pills

Female condom

A clinic nurse is caring for a client admitted with AIDS. The nurse has assessed that the client is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication? HIV encephalopathy B-cell lymphoma Wasting syndrome Kaposi's sarcoma

HIV encephalopathy

A clinic nurse is caring for a client admitted with AIDS. The nurse has assessed that the client is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication? Wasting syndrome B-cell lymphoma Kaposi's sarcoma HIV encephalopathy

HIV encephalopathy

A client with lymphadenitis has developed persistent swelling of the affected area. What would be important information for the nurse to teach this client? How to do exercises to increase blood flow in the area How to apply ice to the affected area How to apply an elastic sleeve or stocking How to dependently do activities of daily living

How to apply an elastic sleeve or stocking

The body has several mechanisms to fight disease, one of which is sending chemical messengers. Specifically, the messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? Colony-stimulating factor Tumor necrosis factor Interferons Interleukins

Interferons

The nurse working in an allergy clinic is preparing to administer skin testing to a client. Which route is the safest for the nurse to use to administer the solution? Subcutaneous Intravenous Intramuscular Intradermal

Intradermal

A patient who has long-term packed RBC (PRBC) transfusions has developed symptoms of iron toxicity that affect liver function. What immediate treatment should the nurse anticipate preparing the patient for that can help prevent organ damage? Anticoagulation therapy Iron chelation therapy Therapeutic phlebotomy Oxygen therapy

Iron chelation therapy

The nurse is performing an assessment for a client with anemia admitted to the hospital to have blood transfusions administered. Why would the nurse need to include a nutritional assessment for this patient? It may indicate deficiencies in essential nutrients. It will determine what type of anemia the patient has. It is part of the required assessment information. It is important for the nurse to determine what type of foods the patient will eat.

It may indicate deficiencies in essential nutrients.

A nurse cares for a client with myelodysplastic syndrome (MDS). Which assessment finding does the nurse recognize is the most common finding with this condition? Macrocytic anemia Proliferative anemia Microcytic anemia Hemolytic anemia

Macrocytic anemia

A child is brought to the clinic with a rash. The child is diagnosed with measles. The mother tells the nurse that she had the measles when she was a little girl. What immunity to measles develops after the initial infection? Artificially acquired passive immunity Naturally acquired active immunity Artificially acquired active immunity Naturally acquired passive immunity

Naturally acquired active immunity

A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever? Thrombocytopenia Pancytopenia Neutropenia Anemia

Neutropenia

The home health nurse is caring for a patient with multiple myeloma. What does the nurse know is a priority issue to be managed in a patient with multiple myeloma? Nutrition Coping Stress Pain

Pain

Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets? Anemia Thrombocytopenia Leukopenia Pancytopenia

Pancytopenia

In the surgical group where you practice nursing, knowledge regarding hematopoiesis is used frequently in regards to client post-surgical care. Which of the following is true for the variation in the normal number of erythrocytes? People who live at higher altitudes have a decreased number of erythrocytes Women have more erythrocytes than men Infants have fewer erythrocytes than adults People who engage in strenuous activity have an increased number of erythrocytes

People who engage in strenuous activity have an increased number of erythrocytes

Which is a symptom of severe thrombocytopenia? Dyspnea Inflammation of the tongue Inflammation of the mouth Petechiae

Petechiae

A client with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the client's care plan? Protective isolation and vigilant use of standard precautions Provision of a high-calorie, low-texture diet and appropriate oral hygiene Including the family in planning the client's activities of daily living Monitoring and treating the client's pain

Protective isolation and vigilant use of standard precautions

The nurse is obtaining objective data from a client with lymphangitis of the left arm. What does the nurse expect to find when collecting this data from the client? Red streaks following the course of the lymph channels Cold, clammy arm Pulsatile mass in the axilla Weeping and oozing of fluid from the arm

Red streaks following the course of the lymph channels

The nurse is working at a blood donation clinic. What teaching should the nurse provide to the donor immediately after blood donation? Sit up promptly after the needle is removed. Hold the involved arm below the heart. Remain for observation after eating and drinking. Remove the band-aid after 5 minutes.

Remain for observation after eating and drinking

A nurse cares for several mothers and babies in the postpartum unit. Which mother does the nurse recognize as being most at risk for a febrile nonhemolytic reaction? Rh-positive mother; Rh-negative child Rh-negative mother; Rh-negative child Rh-negative mother; Rh-positive child Rh-positive mother; Rh-positive child

Rh-negative mother; Rh-positive child

A nurse caring for a client who has an immunosuppressive disorder knows that continual monitoring of the client is critical. What is the primary rationale behind the need for continual monitoring? So that the client's functional needs can be met immediately So that early signs of impending infection can be detected and treated So that the nurse's documentation can be thorough and accurate So that medications can be given as prescribed and signs of adverse reactions noted

So that early signs of impending infection can be detected and treated

The nurse should recognize a client's risk for impaired immune function if the client has undergone surgical removal of which of the following? Pancreas Spleen Thyroid gland Kidney

Spleen

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? Blood specimen for electrolyte studies Urine specimen for culture and sensitivity Stool specimen for ova and parasites Sputum specimen for acid fast bacillus

Stool specimen for ova and parasites

Which type of lymphocyte is responsible for cellular immunity? Plasma cell Basophil B lymphocyte T lymphocyte

T lymphocyte

A client is prescribed 325 mg/day of oral ferrous sulfate. What does the nurse include in client teaching? Decrease intake of fruits and juices Take 1 hour before breakfast Take with dairy products Decrease intake of dietary fiber

Take 1 hour before breakfast

A client who has AIDS is being treated in the hospital and admits to having periods of extreme anxiety. What would be the most appropriate nursing intervention? Give the client more control of her antiretroviral regimen. Teach the client guided imagery. Increase the client's activity level. Collaborate with the client's physician to obtain an order for hydromorphone.

Teach the client guided imagery.

A client has been diagnosed with AIDS and tuberculosis (TB). A nursing student asks the nurse why the client's skin test for TB is negative if the client's physician has diagnosed TB. The nurse's correct reply is which of the following? The solution used for the skin test was probably outdated. The client's immune system cannot mount a response to the skin test. The client has only mild TB, which is not enough to cause a reaction. The skin test was improperly performed.

The client's immune system cannot mount a response to the skin test.

A child has been diagnosed with a severe walnut allergy after suffering an anaphylactic reaction. What is the nurse's priority for health education? The need to vigilantly maintain the child's immunization status The need to begin immunotherapy as soon as possible The need for the child to avoid all foods that have a high potential for allergies The need for the parents to carry an epinephrine pen

The need for the parents to carry an epinephrine pen

A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits what behavior? The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure. The nurse wears face protection, gloves, and a gown when irrigating a wound. The nurse performs hand hygiene with a waterless antiseptic agent after removing a pair of soiled gloves. The nurse places a used needle and syringe in the puncture-resistant container without capping the needle.

The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.

A patient with severe environmental allergies is scheduled for the first in a planned series of immunotherapy injections. What should be included in teaching the patient about the injection? Therapeutic failure occurs if the symptoms to the allergen do not decrease after 3 months. The injection will cure the response to the allergen within 6 to 8 weeks. The patient will remain in the clinic to be monitored for 30 minutes following the injection. Injections are usually administered twice weekly.

The patient will remain in the clinic to be monitored for 30 minutes following the injection.

Which statement accurately reflects current stem cell research? Stem cell transplantation cannot restore immune system functioning. Stem cell transplantation has been performed in the laboratory only. The stem cell is known as a precursor cell that continually replenishes the body's entire supply of both red and white cells. Clinical trials are underway only in clients with acquired immune deficiencies.

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

A patient, newly diagnosed with thrombocytopenia, is admitted to the medical unit. After the admission assessment the patient asks the nurse to explain the disease. What should the nurse explain to the patient about this condition? There could be decreased white blood cell production. There could be elevated platelet production. There could be an attack on the platelets by the antibodies There could be decreased production of platelets

There could be decreased production of platelets

A client is volunteering to donate blood for the second time and was mailed a letter telling him that he has type AB blood. If the client requires a blood transfusion in the future, what type of blood must he receive? They can only receive blood from persons with type A blood. They can only receive blood from persons with type B blood. They can only receive blood from persons with type O blood if the RH factor is positive. They can receive blood from persons with any type of blood if the RH factor is compatible.

They can receive blood from persons with any type of blood if the RH factor is compatible.

After receiving chemotherapy for lung cancer, a client's platelet count falls to 98,000/mm3. What term should the nurse use to describe this low platelet count? Thrombocytopenia Anemia Leukopenia Neutropenia

Thrombocytopenia

The nurse is caring for a client with Hodgkin's disease who has developed anemia. What would the nurse expect to be ordered for this client? A break in chemotherapy Increased rest and fluid Transfusions Lower doses of radiation

Transfusions

The nurse is caring for a client with hypovolemic anemia who is now in hypovolemic shock. What indication does the nurse have that the client is having inadequate renal perfusion? Hematuria Blood pressure of 90/60 mm Hg Jaundice of the sclera Urine output of 15 mL/hour

Urine output of 15 mL/hour

A client comes to the clinic and states he has "broken out in hives and itching since eating strawberries this morning." The client states he has never had problems with strawberries before. What is the best response by the nurse? "We will probably be admitting you to the hospital; this could cause respiratory arrest." "It is possible to develop an allergic reaction to something you have had prior exposure to previously." "Are you sure that you haven't had an allergic reaction before; this doesn't seem possible." "It is probably not the strawberries that you are having an allergy to if you have eaten them before."

"It is possible to develop an allergic reaction to something you have had prior exposure to previously."

An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurse's best response? "It's possible that your baby could contract HIV, either before, during, or after delivery." "Your physician is likely the best one to ask that question." "If the baby is HIV positive there is nothing that can be done until it is born, so try your best not to worry about it now." "There is no way to know that for certain, but we do know that your baby has a one in four chance of being born with HIV."

"It's possible that your baby could contract HIV, either before, during, or after delivery."

A client is taking the immunosuppressant medication, azathioprine (Imuran), for the treatment of Crohn's disease. What statement made by the client demonstrates an understanding of the side effects of this medication? "I will notify the doctor if I am not having a bowel movement daily." "I will stop taking my medication if I notice any side effects and then notify the doctor." "I will drink at least 3 L of fluid per day." "I will notify the doctor if I have a fever or any other signs of infection."

"I will notify the doctor if I have a fever or any other signs of infection."

A client with pernicious anemia is receiving parenteral vitamin B12 therapy. Which client statement indicates effective teaching about this therapy? "I will receive parenteral vitamin B12 therapy for the rest of my life." "I will receive parenteral vitamin B12 therapy until my vitamin B12 level returns to normal." "I will receive parenteral vitamin B12 therapy monthly for 6 months to a year." "I will receive parenteral vitamin B12 therapy until my signs and symptoms disappear."

"I will receive parenteral vitamin B12 therapy for the rest of my life."

A clinic nurse has been charged with the responsibility of teaching avoidance strategies to an adult patient who has allergic rhinitis. What measure should the nurse recommend to this patient? "Make sure that there are never air drafts in your home." "Keep your windows open to ensure adequate air circulation." "If possible, make sure that no one smokes tobacco in your home." "Avoid the use of air conditioning whenever possible."

"If possible, make sure that no one smokes tobacco in your home."

The nurse is providing care for a client who has experienced a type I hypersensitivity reaction. What client is having this type of reaction? A client with a skin reaction resulting from adhesive tape A client with a diagnosis of myasthenia gravis An older adult with rheumatoid arthritis A child with an anaphylactic reaction after a bee sting

A child with an anaphylactic reaction after a bee sting

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 muted response to something in the environment." "It is a harmless reaction to something in the environment." "It is a hyperimmune response to something in the environment that is usually harmless." "It means you are very sensitive to something inside of yourself."

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

During a mumps outbreak at a local school, a patient, who is a school teacher, is exposed. She has previously been immunized for mumps. What type of immunity does she possess? Humoral immunity Acquired immunity Natural immunity Phagocytic immunity

Acquired immunity

Which of the following signs would the nurse recognize as signs of thrombocytopenia? Select all that apply. Fever Sore throat Bleeding of the gums Dark, tarry stools Oozing from injection sites

Bleeding of the gums Oozing from injection sites Dark, tarry stools

What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease (SCID)? Antibiotics Radiation therapy Removal of the thymus gland Bone marrow transplantation

Bone marrow transplantation

A client is being treated for DIC and the nurse has prioritized the nursing diagnosis of Risk for Deficient Fluid Volume Related to Bleeding. How can the nurse best determine if goals of care relating to this diagnosis are being met? Closely monitor intake and output. Assess for edema. Assess the client's level of consciousness frequently. Assess skin integrity frequently.

Closely monitor intake and output.

A volunteer wanting to donate blood for the first time wishes to know more about the various blood groups. The nurse educating the volunteer regarding the blood groups should mention which of the following as the determining factor that classifies blood into groups A, B, AB, and O? Clumping of blood cells Presence or absence of D antigen factor Presence of B and T lymphocytes Combinations of antigens and antibodies

Combinations of antigens and antibodies

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. Memory T cell Cytotoxic T cell Suppressor T cell Helper T cell

Cytotoxic T cell

A client's current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells? Suppressor T cells Memory T cells Complement T cells Cytotoxic T cells

Cytotoxic T cells

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to: acidosis because the spleen maintains acid-base balance. anemia because the spleen produces red blood cells. infection because the spleen removes bacteria from the blood. bleeding because the spleen synthesizes vitamin K.

infection because the spleen removes bacteria from the blood.

What types of cells are the primary targets of the healthy immune system? Select all that apply. cancerous cells foreign cells infectious cells typical cells

infectious cells foreign cells cancerous cells

A client comes to the clinic to obtain HIV test results. The physician states that the client has a CD4 cell count of 300 cells/mm3 and a high viral load. What will the physician discuss with the client? initiation of antiretroviral therapy administration of an antifungal medication to prevent the development of an opportunistic fungal infection follow-up testing to determine whether therapy is warranted at this time. initiation of antibiotic therapy to prevent the development of an opportunistic infection

initiation of antiretroviral therapy

A male client is having sexual relations with another male as well as using methamphetamine, and has contracted HIV. The nurse is concerned that this client: may develop AIDS in a shorter period of time. is a drug addict and needs to stop using. may infect other people because of his drug use. will remain HIV positive for a longer period of time.

may develop AIDS in a shorter period of time.

Which immunity type becomes active as a result of infection by a specific microorganism? naturally acquired active immunity artificially acquired active immunity artificially acquired passive immunity naturally acquired passive immunity

naturally acquired active immunity

The nurse is caring for a teenage girl who has had an anaphylactic reaction after being stung by a wasp. The nurse is providing patient teaching prior to the patient's discharge. In the event of an anaphylactic reaction, the nurse informs the patient that she should self-administer epinephrine in what site? Thigh Forearm Deltoid muscle Abdomen

Thigh

A patient was tested for HIV using enzyme immunoassay (EIA) and results were positive. The nurse should expect the primary care provider to order what test to confirm the EIA test results? Another EIA test Western blot test CD4/CD8 ratio Viral load test

Western blot test

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be alright to relieve the nasal congestion he is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications? Taper the dose when discontinuing the medication. Do not overuse the medication as rebound congestion can occur. Do not operate machinery or drive while using the medication. Report white patches in the mouth because the medication can cause a fungal infection.

Do not overuse the medication as rebound congestion can occur.

The nurse observes the laboratory studies for a client in the hospital with fatigue, feeling cold all of the time, and hemoglobin of 8.6 g/dL and a hematocrit of 28%. What finding would be an indicator of iron-deficiency anemia? Erythrocytes that are macrocytic and hyperchromic Erythrocytes that are microcytic and hypochromic An increased number of erythrocytes Clustering of platelets with sickled red blood cells

Erythrocytes that are microcytic and hypochromic

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic? means of transmission HIV-1 is more prevalent than HIV-2 subtypes cure rate the fact that it is a mutated virus originally thought to be bovine in nature

HIV-1 is more prevalent than HIV-2 subtypes

A home health nurse is caring for a client with multiple myeloma. What intervention should the nurse prioritize when addressing the client's severe bone pain? Implementing distraction techniques Teaching the client to use NSAIDs effectively Helping the client manage the opioid analgesic regimen Educating the client about the effective use of hot and cold packs

Helping the client manage the opioid analgesic regimen

Which term refers to the percentage of blood volume that consists of erythrocytes? Erythrocyte sedimentation rate (ESR) Differentiation Hemoglobin Hematocrit

Hematocrit

Which blood cell type is matched correctly with its function? B lymphocyte: Secretes immunoglobulin T lymphocyte: Humoral immunity Leukocyte: Fights infection Plasma cell: Cell-mediated immunity

Leukocyte: Fights infection

A client is prescribed montelukast as part of a treatment plan for an allergic disorder. The nurse understands that this drug belongs to which class? Nonsedating antihistamine Corticosteroid Mast cell stabilizer Leukotriene-receptor antagonist

Leukotriene-receptor antagonist

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: Antibodies reside in the plasma Lymphocytes migrate to areas of the lymph node B-lymphocytes respond to a specific antigen Antibodies are released into the bloodstream

Lymphocytes migrate to areas of the lymph node

The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has? Non-Hodgkin lymphoma Hodgkin lymphoma Chronic myeloid leukemia Multiple myeloma

Multiple myeloma

The nurse is working with a client with allergic rhinitis. What medication does the nurse anticipate will be prescribed to treat the allergic rhinitis? budesonide oxymetazoline pseudoephedrine fexofenadine

fexofenadine

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid? fexofenadine fluticasone cromolyn sodium zileuton

fluticasone

Which type of white blood cell (WBC) is the most numerous? Neutrophil Eosinophil Basophil Lymphocyte

Neutrophil

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? B cells Neutrophils Monocytes Eosinophils

Neutrophils

A client diagnosed with systemic lupus erythematosus comes to the emergency department with severe back pain. The client is taking prednisone daily and reported feeling pain after manually opening the garage door. What adverse effect of long-term corticosteroid therapy is most likely responsible for the pain? Muscle wasting Truncal obesity Hypertension Osteoporosis

Osteoporosis

A 16-year-old has been brought to the emergency department by his parents after falling through the glass of a door. The fall resulted in a 6-cm laceration of the right antecubital. The nurse caring for this patient knows that the site of the injury will have an invasion of what? Apoptosis Phagocytic cells Interferon Cytokines

Phagocytic cells

As a result of a needlestick injury, a hospital nurse has experienced percutaneous exposure to the blood of a client who is HIV-positive. The nurse has informed the supervisor and identified the client. What action should the nurse take next? Apply a hydrocolloid dressing to the wound site. Flush the wound site with chlorhexidine. Follow up with the nurse's primary care provider. Report to the emergency department or employee health department.

Report to the emergency department or employee health department.

A client asks a nurse, "What can I use to decrease my risk of exposure to HIV?" What will the nurse include as effective in reducing the risk of HIV exposure? Select all that apply. Dental dams Sexual abstinence Polyurethane female condoms Latex male condoms Lambskin condoms

Sexual abstinence Latex male condoms Polyurethane female condoms Dental dams

Laboratory and diagnostic test results have returned for a client with suspected lymphangitis. Which of the following would be most likely for the nurse to review in the results? Pseudomonas Escherichia coli Streptococcus Staphylococcus

Streptococcus

A nurse is admitting a client with immune thrombocytopenic purpura to the unit. In completing the admission assessment, the nurse must be alert for what medications that potentially alter platelet function? Select all that apply. Sulfa-containing medications Penicillins Antihypertensives Aspirin-based drugs NSAIDs

Sulfa-containing medications Aspirin-based drugs NSAIDs

A male patient has come into the free clinic asking to be tested for HIV infection. The patient asks the nurse how the test works. The nurse responds that if the testing shows antibodies to the AIDS virus are present in the blood, this indicates what? The patient is immune to HIV. The patient may have unprotected intercourse because he is not infected with HIV. The patient has been infected with HIV. AIDS is inactive in the body.

The patient has been infected with HIV.

An adult client reports that it is taking longer than usual for minor cuts and injuries to clot. Which of the following questions would the nurse most likely ask the client? "Do you have a history of allergy or asthma?" "Are you regularly taking aspirin?" "Have you been tested for hemophilia?" "Are you eating sugary foods lately?"

"Are you regularly taking aspirin?"

The mother of two young children has been diagnosed with HIV and expresses fear of dying. How should the nurse best respond to the client? "You need to maintain hope because you may live for several years." "You'll learn much about the promise of a cure for HIV." "Would you like me to have the chaplain come speak with you?" "Can you tell me what concerns you most about dying?"

"Can you tell me what concerns you most about dying?"

Two units of PRBCs have been prescribed for a client who has experienced a GI bleed. The client is highly reluctant to receive a transfusion, stating, "I'm terrified of getting AIDS from a blood transfusion." How can the nurse best address the client's concerns? "The chances of contracting AIDS from a blood transfusion are exceedingly low." "HIV was eradicated from the blood supply in the early 2000s." "That did happen in some high-profile cases in the20th century, but it is no longer a possibility." "All donated blood is treated with antiretroviral medications before it is used."

"The chances of contracting AIDS from a blood transfusion are exceedingly low."

A client is informed that his white blood cell count is low and that he is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? "White blood cells are produced in the thymus gland." "White blood cells are produced in the plasma." "White blood cells are produced in the lymphatic tissue." "White blood cells are produced in the bone marrow."

"White blood cells are produced in the bone marrow."

Which client is not a candidate for blood donation according to the American Heart Association? 86 year old male with blood pressure 110/70 mmHg 50 year old female with pulse 95 beats/minute 26 year old female with hemoglobin 11.0 g/dL 18 year old male weighing 52 kg.

26 year old female with hemoglobin 11.0 g/dL

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? 6 to 18 weeks 1 to 2 weeks 3 to 6 weeks 3 to 12 weeks

3 to 12 weeks

A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician? 5.0 g/dL 10.2 g/dL 13.0 g/dL 11.4 g/dL

5.0 g/dL

The nurse is instructing clients about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? A 32-year-old client who has never had chickenpox A 24-year-old client who is pregnant A 17-year-old client who will be attending college and living in a dormitory A 65-year-old client who had chicken pox when he was 12 years old

A 65-year-old client who had chicken pox when he was 12 years old

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)? A 52-year-old patient with acute kidney injury A 24-year-old female taking oral contraceptives A 40-year-old patient with a history of hypertension A 72-year-old patient with a history of cancer

A 72-year-old patient with a history of cancer

The nurse is assisting the physician to control the bleeding for a client who has had an insertion of a vascular access. What can the nurse obtain for the physician to use to control the bleeding? A fibrin sponge Albumin Injection of alpha globulins Injection of beta globulins

A fibrin sponge

A client was tested for HIV as part of a screening process and has just been told that the results were positive. What anticipatory guidance should the nurse provide to the client? The client will be retested for HIV in 6 weeks and in 3 months A follow-up test will be promptly performed to confirm the result Antiretroviral therapy will begin within 3 months The client will be monitored for signs and symptoms of HIV infection to determine if treatment is necessary

A follow-up test will be promptly performed to confirm the result

A client with AIDS has become forgetful with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms? AIDS dementia complex (ADC) distal sensory polyneuropathy (DSP) cytomegalovirus (CMV) candidiasis

AIDS dementia complex (ADC)

Traditionally, HIV infection has been a danger for specific population groups who engaged in risky behaviors. Recently, incidence has spread to groups who are not typically thought to be in danger of contracting HIV. Which population group in the United States has HIV infection rates eight times higher than whites? African-Americans Hispanics No option is correct. Asians

African-Americans

A client requires ongoing treatment and infection-control precautions because of an inherited deficit in immune function. The nurse should recognize that this client most likely has what type of immune disorder? A primary immune deficiency A rheumatic disorder An autoimmune disorder A gammopathy

An autoimmune disorder

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population? Anemia Leukemia Lymphopenia Thalassemia

Anemia

A public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population? Lymphopenia Thalassemia Anemia Leukemia

Anemia

A gardener sustained a deep laceration while working and requires sutures. The date of the client's last tetanus shot was over 10 years ago. Based on this information, the client will receive a tetanus immunization which will allow for the release of what? Phagocytes Antibodies Cytokines Antigens

Antibodies

When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following? He has not been infected with HIV. Antibodies to HIV are not present in his blood. Antibodies to HIV are present in his blood. He is immune to HIV.

Antibodies to HIV are not present in his blood.

Which nursing intervention should be incorporated into the plan of care to manage the delayed clotting process in a client with leukemia? Monitor temperature at least once per shift. Implement neutropenic precautions. Apply prolonged pressure to needle sites or other sources of external bleeding. Eliminate direct contact with others who are infectious.

Apply prolonged pressure to needle sites or other sources of external bleeding.

When an attenuated toxin is administered to a client, the B-cell lymphocytes create memory cells that recognize the antigen if it invades the body at a future time. What kind of immunity is this? Artificially acquired active immunity Naturally acquired active immunity Natural immunity Passive immunity

Artificially acquired active immunity

A client is scheduled for a bone marrow aspiration and is extremely apprehensive about having the procedure done. The nurse explains that there may be a feeling of pressure or discomfort when puncturing the bone. What intervention can the nurse provide to assist with this concern? Inform the client that he will not be able to move and will have to tolerate the discomfort for 20 minutes. Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it. Suggest chewing gum or eating candy in order to focus on something other than the discomfort. Inform the client that if he is concerned that he will move when the bone is punctured, soft wrist restraints can be used if the client approves.

Assist the client with focused imagery to avoid focusing on the procedure and any discomfort associated with it.

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise? Avoid fibrous foods, lactose, fat, and caffeine. Increase intake of iron and zinc. Consume large, high-fat meals. Reduce food intake.

Avoid fibrous foods, lactose, fat, and caffeine.

A patient describes numbness in the arms and hands with a tingling sensation. The patient also frequently stumbles when walking. What vitamin deficiency does the nurse determine may cause some of these symptoms? Folate Thiamine Iron B12

B12

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? Sign a refusal of blood transfusion form so the client will not receive the transfusion. Ask people to donate blood. Bank autologous blood. Using volume expanders in case blood is needed.

Bank autologous blood.

A patient with a diagnosis of common variable immunodeficiency begins to develop thick, sticky, tenacious sputum. The patient has a history of episodes of pneumonia at least one time per year for the last 10 years. What does the nurse suspect the patient is developing? Emphysema A pulmonary neoplasm Bronchiectasis Pulmonary edema

Bronchiectasis

A nurse educator is explaining that patients with primary immunodeficiencies are living longer than in past decades because of advances in medical treatment. This increased longevity is associated with an increased risk of what? Pulmonary fibrosis Chronic obstructive pulmonary disease Cancer Dementia

Cancer

The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is: Nausea and vomiting. Oral candida. Anorexia. Chronic diarrhea.

Chronic diarrhea.

A nurse reviews the laboratory results of a client with polycythemia vera. Which findings will the nurse find? Select all that apply. Decreased erythropoietin Decreased platelets Increased hemoglobin Decreased leukocytes Increased erythropoietin

Decreased erythropoietin Increased hemoglobin

The nurse is obtaining information from a client with Crohn's disease about his medication history. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response? Nonsteroidal anti-inflammatory Diuretics Corticosteroids Angiotensin-converting enzyme inhibitors (ACE-I)

Corticosteroids

A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring? Anaphylactic reaction Sensitization Delayed hypersensitivity response An immediate hypersensitivity response

Delayed hypersensitivity response

All the following items are related to cancer. Which does not affect the immune system? Radiation treatment Chemotherapy Diagnostic tests for cancer Altered production of lymphocytes

Diagnostic tests for cancer

The nurse is performing an admission assessment on a patient with AIDS. When assessing the patient's gastrointestinal (GI) system what is most likely to be the priority nursing diagnosis? Bowel incontinence Constipation Imbalanced nutrition: more than body requirements Diarrhea

Diarrhea

The nurse is caring for a client with external bleeding. What is the nurse's priority intervention? Direct pressure Pressure point control Application of a tourniquet Elevation of the extremity

Direct pressure

A nurse is preparing a client for allergy skin testing. What precautionary step is most important for the nurse to follow? The nurse should administer albuterol 30 to 45 minutes prior to the test. Emergency equipment should be readily available. The client must not have received an immunization within 7 days. Prophylactic epinephrine should be given before the test

Emergency equipment should be readily available.

Which blood test confirms the presence of antibodies to HIV? Enzyme immunoassay (EIA) Erythrocyte sedimentation rate (ESR) Reverse transcriptase p24 antigen

Enzyme immunoassay (EIA)

Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply. Experiences prolonged bleeding from an obvious injury. Feels discomfort in the stomach. Rarely bruises. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels fatigued with normal activities.

Experiences prolonged bleeding from an obvious injury. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels fatigued with normal activities.

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? To decrease the body's risk of infection For their immunosuppressant effects Because an autoimmune disease is a neoplastic disease So the client has strong drug therapy

For their immunosuppressant effects

A nurse is exposed to hepatitis B. Hospital protocol is that the staff nurse report to the emergency department for the administration of what substance to provide passive acquired immunity? Measles-mumps-rubella vaccine Albumin Antibiotics Gamma globulin

Gamma globulin

A client with Hodgkin's disease has bilateral lymph nodes that are affected with extension through the spleen as well as affecting the bone marrow. What stage of the disease does the nurse recognize the client is in? IV II I III

IV

The nurse is caring for a patient with a hematologic disorder. The patient asks the nurse where the body forms blood cells. Where should the nurse tell the patient that blood cells are formed? In the liver In the bone marrow In the spleen In the kidneys

In the bone marrow

A client with a family history of allergies has suffered an allergic response based on a genetic predisposition. This atopic response is usually mediated by what immunoglobulin? Immunoglobulin G Immunoglobulin E Immunoglobulin A Immunoglobulin M

Immunoglobulin E

The nurse educating a client with anemia is describing the process of RBC production. When the client's kidneys sense a low level of oxygen in circulating blood, what physiologic response is initiated? Increased stem cell synthesis Decreased respiratory rate Increased production of erythropoietin Arterial vasoconstriction

Increased production of erythropoietin

Albumin is important for the maintenance of fluid balance within the vascular system. Albumin is produced by which of the following? Large intestine Kidney Liver Pancreas

Liver

The nurse is caring for a client who has developed scar tissue in many of the areas that normally produce blood cells. What organs can become active in blood cell production by the process of extramedullary hematopoiesis? Liver and spleen Spleen and kidneys Kidneys and pancreas Pancreas and liver

Liver and spleen

HIV is harbored within which type of cell? Lymphocyte Platelet Erythrocyte Nerve

Lymphocyte

A woman has been diagnosed with breast cancer and is being treated aggressively with a chemotherapeutic regimen. As a result of this regimen, she has an inability to fight infection due to the fact her bone marrow is unable to produce a sufficient amount of what? Capillaries Cytoblasts Antibodies Lymphocytes

Lymphocytes

A client's absolute neutrophil count (ANC) is 440/mm3 but the nurse's assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this client? Maintaining a sterile care environment Timely administration of antibiotics Meticulous hand hygiene Provision of a nutrient-dense diet

Meticulous hand hygiene

The body responds to infection by increasing the production of white blood cells (WBCs). The nurse should evaluate the differential count for what type of WBCs, which are the first WBCs to respond to an inflammatory event? Basophils Neutrophils Monocytes Eosinophils

Neutrophils

A client was admitted to the hospital with a pathologic pelvic fracture. The client informs the nurse that he has been having a strange pain in the pelvic area for a couple of weeks that was getting worse with activity prior to the fracture. What does the nurse suspect may be occurring based on these symptoms? Leukemia Multiple myeloma Hemolytic anemia Polycythemia vera

Multiple myeloma

A nurse cares for a client with iron-deficiency anemia. Which treatment will the nurse anticipate the client receiving? Intravenous iron supplementation Immunoglobulin therapy Chemical chelation therapy Oral iron supplementation

Oral iron supplementation

The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about? Creatinine level of 1.0 mg/dL WBC count of 4,200 cells/uL Hematocrit of 38% Platelet count of 9,000/mm3

Platelet count of 9,000/mm3

The client is planned to have a splenectomy. The nurse should prepare which medication to administer to this client? Aspirin Immunoglobulin G (IgG) Pneumococcal vaccine Factor VIII

Pneumococcal vaccine

The parents of a 3-year-old boy have just been informed that allergy testing suggests their son has multiple food allergies. When providing health education for this family, what subject should the nurse prioritize? Coping strategies for the lifestyle changes that their son's diagnosis necessitates The appropriate use of antihistamines in pediatric patients Possible sources of food allergens and strategies for avoiding offending foods Alternative nutritional delivery systems

Possible sources of food allergens and strategies for avoiding offending foods

Which condition is associated with impaired immunity relating to the aging client? Incidence of autoimmune disease decreases Skin becomes thicker Antibody production increases Renal function decreases

Renal function decreases

An older adult client who is postmenopausal informs the nurse that she believes she has developed another urinary tract infection (UTI). What risk factors do female clients in this age group have? Select all that apply. Estrogen deficiency Dry mucous membranes of the vagina Residual urine Urinary incontinence Decreased function of the thyroid gland

Residual urine Urinary incontinence Estrogen deficiency

A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? Ineffective cerebral tissue perfusion Risk for injury Bathing or hygiene self-care deficit Complicated grieving

Risk for injury

A hospital educator is reiterating the importance of Standard Precautions to a group of nursing students who will soon begin a clinical rotation on the unit. Which of the following statements best describes the application of Standard Precautions? Standard Precautions should be used when providing care for any patient who has a white blood cell (WBC) count of 10.8 × 109/L or greater. Standard Precautions should be applied to patients regardless of diagnosis or presumed infectious status. Standard Precautions should be applied in the care of any patient who has an actual or suspected primary or secondary immunodeficiency. Standard Precautions should be used in the care of any patient whose diagnosis is attributable to an infectious process.

Standard Precautions should be applied to patients regardless of diagnosis or presumed

Which term is used to refer to a primitive cell that is capable of self-replication and differentiation? Spherocyte Stem cell Band cell Reticulocyte

Stem cell

The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response? T-cell lymphocytes survey proteins in the body and attack the invading antigens. Toxins of invading antigens are neutralized. The invading antigens link together (agglutination). The invading antigens precipitate.

T-cell lymphocytes survey proteins in the body and attack the invading antigens.

A client is being treated for the effects of a longstanding vitamin B12 deficiency. What aspect of the client's health history would most likely predispose her to this deficiency? The client is a vegan. The client donated blood 60 days ago. The client frequently smokes marijuana. The client has irregular menstrual periods.

The client is a vegan.

A client will be having a hysterectomy and wants her daughter to donate the blood for directed donor donation. What factor would eliminate her daughter from donating the blood? The daughter is 15 years of age. The daughter weighs 124 lb. The daughter is negative for HIV. The physician has been notified of the procedure.

The daughter is 15 years of age.

The nurse is inspecting the tonsils for a client with a fever and sore throat. The nurse observes purulent exudate on the surface of the tonsils. What does this finding indicate to the nurse? Thrush Tonsillitis Filariasis An abscess

Tonisillitis

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 of the abdomen. Lower margin around the liver. Upper mediastinum. Lower right abdomen.

Upper left quadrant of the abdomen.

A client's primary infection with HIV has subsided and an equilibrium now exists between HIV levels and the client's immune response. This physiologic state is known as what? Latent stage Window period Static stage Viral set point

Viral set point

The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron? Vitamin E Vitamin B6 Vitamin C Vitamin B12

Vitamin C

A young couple visits the nurse practitioner stating that they want to start a family. The husband states that his brother died of a severe infection at age 6 months. He says he never knew what was wrong but his mother had him undergo "blood testing" as a child. Based on these statements, what health problem should the nurse practitioner suspect? X-linked agammaglobulinemia Drug-induced thrombocytopenia Aplastic anemia Severe neutropenia

X-linked agammaglobulinemia

A client visits the employee health department because of mild itching and a rash on both hands. What will the employee health nurse focus on during the assessment interview? medication allergies life stressors the nurse may be experiencing laundry detergent or bath soap changes chemical and latex glove use

chemical and latex glove use

he nurse knows the best strategy for latex allergy is corticosteroids. antihistamines. epinephrine from an emergency kit. avoidance of latex-based products.

avoidance of latex-based products.

A client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults? stomatitis glossitis dementia ataxia

dementia

A client has a known allergy to peanuts, meaning that the client's immune system has identified peanuts as a foreign invader and has produced specific cells to attack if the client should come in contact with peanuts again. The formation of these specific cells is known as: cell-mediated response. inflammatory response. memory response. humoral response.

humoral response.

A client who has Hodgkin's disease should have their bed in high-Fowler's position whenever practical to: increase lung expansion. reduce cervical edema. anticipate the need for the airway management. detect compromised ventilation.

increase lung expansion.

A nurse is reviewing a client's morning laboratory results and notes a left shift in the band cells. Based on this result, the nurse can interpret that the client may be developing anemia. may be developing an infection. has leukopenia. has thrombocytopenia.

may be developing an infection.

Vitamin B and folic acid deficiencies are characterized by production of abnormally large erythrocytes called monocytes. megaloblasts. mast cells. blast cells.

megaloblasts

The lower the client's viral load, the shorter the survival time. the longer the time immunity. the shorter the time to AIDS diagnosis. the longer the survival time.

the longer the survival time.

A client with multiple food and environmental allergies tells the nurse that he is frustrated and angry about having to be so watchful all the time and wonders if it is really worth it. What would be the nurse's best response? "Let's find a quiet spot and I'll teach you a few coping strategies." "Do you think that maybe you could be managing things more efficiently?" "That's the same way that most clients who have a chronic illness feel." "I can only imagine how you feel. Would you like to talk about it?"

"I can only imagine how you feel. Would you like to talk about it?"

A nurse is working with a client who was diagnosed with HIV several months earlier. This client will be considered to have AIDS when the CD4+ T-lymphocyte cell count drops below what threshold? 325 cells/mm3 of blood 450 cells/mm3 of blood 75 cells/mm3 of blood 200 cells/mm3 of blood

200 cells/mm3 of blood

The nurse is preparing to administer the recommended dose of intravenous gamma-globulin for a 60-kg male client. How many grams will the nurse administer? 30 g 90 g 60 g 15 g

30 g

A client calls the clinic and informs the nurse that her boyfriend was diagnosed with infectious mononucleosis and wonders how long it would be before she got it. What does the nurse inform the client that the incubation period is for infectious mononucleosis? 7 to 10 days 50 to 70 days 30 to 50 days 3 days

30-50 days

A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? "You should take the drug with an antacid." "When you take this drug, eat a high-fat meal immediately afterwards." "It doesn't matter if you take this drug with or without food." "Be sure to take this drug about 1/2 hour before or 2 hours after you eat."

"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."

A 70-year-old client has recently been diagnosed with lymphoma and asks what may have contributed to this illness. Which of the following statements from the nurse would be most accurate? "Previous infection with varicella, before there were immunizations against it, may have contributed to this development." "Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning." "Lymphoma commonly develops in older adults because their circulation and blood-vessel functioning are weaker than in younger people." "People of all age groups are at the same risk for lymphoma."

"Lymphoma incidence increases with age because of cumulative exposures to carcinogens

A home health nurse is reinforcing health education with a patient who is immunosuppressed and his family. What statement best suggests that the patient has understood the nurse's teaching? "My family needs to understand when I can go get the seasonal flu shot." "My family needs to understand that I'll probably need lifelong treatment." "I need to understand how to give my platelet transfusions." "I need to know how to treat my infections in a home setting."

"My family needs to understand that I'll probably need lifelong treatment."

An adolescent client diagnosed with infectious mononucleosis asks the nurse if he will keep getting the disease. What is the best response by the nurse? "One episode produces immunity, but the virus remains for a lifetime." "Once you get the virus, it will infect you when your immune system is compromised." "After having the disease, the virus dissipates and is gone forever." "Once you have the symptoms of the virus, it will go away within a week and there will be no further episodes."

"One episode produces immunity, but the virus remains for a lifetime."

The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member? "The client may have cryptococcal meningitis and will need to be evaluated by the health care provider." "The client probably has a case of the flu and you should give acetaminophen." "The client probably has pneumocystis pneumonia and will need to be evaluated by the health care provider." "This is one of the side effects from antiretroviral therapy and will require changing the medication."

"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? "The full benefit of the medication may take up to 2 weeks to be achieved." "I am sorry that you are feeling poorly but this is the only medication that will work for your problem." "You may be immune to the effects of this medication and will need something else in its place." "You need to come back to the clinic to get a different medication since this one is not working for you."

"The full benefit of the medication may take up to 2 weeks to be achieved."

Family members of an immunocompromised client have asked the nurse why antibiotics are not being given to the client in order to prevent infection. How should the nurse best respond? "Antibiotics can never prevent an infection; they can only cure an infection that is fully developed." "Antibiotics cannot resolve infections in people who are immunocompromised." "If an antibiotic is given to prevent a bacterial infection, the client is at risk for a viral infection." "Using antibiotics to prevent infections can cause the growth of drug-resistant bacteria."

"Using antibiotics to prevent infections can cause the growth of drug-resistant bacteria."

A nurse has participated in organizing a blood donation drive at a local community center. Which of the following individuals would most likely be disallowed from donating blood? A man who donated blood 4 months ago A woman who has type 1 diabetes A woman whose blood pressure is 88/51 mm Hg A man who is 81 years of age

A woman whose blood pressure is 88/51 mm Hg

A client with sickle cell crisis is admitted to the hospital in severe pain. While caring for the client during the crisis, which is the priority nursing intervention? Administering and evaluating the effectiveness of opioid analgesics Encouraging the client to ambulate immediately Limit foods that contain folic acid Limiting the client's intake of oral and IV fluids

Administering and evaluating the effectiveness of opioid analgesicsAdministering and evaluating the effectiveness of opioid analgesics

Traditionally, HIV infection has been a danger for specific population groups who engaged in risky behaviors. Recently, incidence has spread to groups who are not typically thought to be in danger of contracting HIV. Which population group in the United States has HIV infection rates eight times higher than whites? Asians Hispanics No option is correct. African-Americans

African-Americans

When do most perinatal HIV infections occur? Through casual contact After exposure during delivery In utero Through breastfeeding

After exposure during delivery

The infection control nurse is presenting an inservice for the staff on the immune reaction of the body. The nurse understands that the clumping effect that occurs when an antibody acts like a cross-link between two antigens is termed what? Agglutination. Cellular immune response. Humoral response. Phagocytic immune response.

Agglutination.

A male patient is prescribed antihistamines. He asks the nurse about antihistamine administration and its adverse effects. Which of the following choices should the nurse instruct this patient to avoid? Seafood Alcohol Exposure to sunlight Application of skin moisturizers

Alcohol

The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation? Allopurinol Asparaginase Filgrastim Hydroxyurea

Allopurinol

A client who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this client's needs for physical activity? Collaborate with the physical therapist to arrange for stair exercises. Teach the client to perform deep breathing and coughing exercises. Assist the client to a chair during awake times, as tolerated. Teach the client about the risks of immobility and the benefits of exercise.

Assist the client to a chair during awake times, as tolerated.

A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? Call the pharmacy and let them know the client has several drug allergies. Administer the medications that the physician ordered. Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. Give the client one medicine at a time and observe for allergic reactions.

Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.

A patient with end-stage kidney disease (ESKD) has developed anemia. What laboratory finding does the nurse understand to be significant in this stage of anemia? Calcium level of 9.4 mg/dL Creatinine level of 6 mg/100 mL Potassium level of 5.2 mEq/L Magnesium level of 2.5 mg/dL

Creatinine level of 6 mg/100 mL

A 66-year-old man underwent a successful partial gastrectomy for the treatment of stomach cancer 3 years ago. The man had a scheduled follow-up appointment with his primary caregiver and had blood work completed. The results of the man's blood work indicated anemia. The nurse who is contributing to the patient's care should recognize that this patient's anemia may be attributable to what factor? Infection Paralytic ileus A recurrence of the man's cancer Decreased vitamin B12 absorption

Decreased vitamin B12 absorption

A client asks the nurse about the importance of taking supplements to maximize immune function. The client is healthy and does not have any medical problems. What is the best information to give to the client? You should take a variety of vitamin and mineral supplements to maximize immune function. Adopt a vegetarian diet and omit all meats, and you will maximize immune function. Eating a moderate diet that is balanced and varied will maximize immune function. Instead of taking supplements, eat a lot of fruits and vegetables, and this will help maximize immune function

Eating a moderate diet that is balanced and varied will maximize immune function.

A client with severe anemia is admitted to the hospital. Because of religious beliefs, the client is refusing blood transfusions. The nurse anticipates pharmacologic therapy with which drug to stimulate the production of red blood cells? Epoetin alfa Eltrombopag Sargramostim Filgrastim

Epoetin alfa

Which of the following reports from the client during the health history would lead the nurse to suspect that the client has a disorder of the hematopoietic or lymphatic system? Select all that apply. Experiences prolonged bleeding from an obvious injury. Rarely bruises. Feels fatigued with normal activities. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels discomfort in the stomach.

Experiences prolonged bleeding from an obvious injury. Has unexplained blood loss, as in rectal bleeding, nosebleeds, bleeding gums, or vomiting blood. Feels fatigued with normal activities.

The LPN is following a plan of care for a client who is being treated for hypovolemic anemia and is at risk for hypovolemic shock. The nurse assesses vital signs and O2 saturation and observes the saturation at 89% for 3 minutes. What should the first action by the nurse be? Give oxygen per nasal cannula Place the client in the supine position. Prepare to assist with intubation. Notify the charge nurse.

Give oxygen per nasal cannula

Which of the following protective responses begin with the B lymphocytes? Cellular Humoral Phagocytic Recognition

Humoral

Which of the following protective responses begin with the B lymphocytes? Recognition Cellular Humoral Phagocytic

Humoral

The nursing instructor is talking with the students about the care of a patient with multiple myeloma who is experiencing bone destruction. What would the instructor tell the students the patient should be assessed for signs of? Elevated RBC count. Elevated serum viscosity. Hyperproteinaemia. Hypercalcaemia.

Hypercalcaemia

What immunoglobulin is present in small amounts and is thought to be related to allergic responses? IgA IgM IgE IgG

IgE

A student nurse is having difficulty understanding the function of globulins. What information can the client provide to the student regarding the function of globulins? Immunologic agents Transport of oxygen to the tissues Destruction of invading organisms Precursors to clot formation

Immunologic agents

A client with a history of dermatitis takes corticosteroids on a regular basis. The nurse should assess the client for which of the following complications of therapy? Thrombocytopenia Anemia Agranulocytosis Immunosuppression

Immunosuppression

A client who has AIDS has been admitted for the treatment of Kaposi sarcoma. What nursing diagnosis should the nurse associate with this complication of AIDS? Impaired Skin Integrity Related to Kaposi Sarcoma Impaired Swallowing Related to Kaposi Sarcoma Diarrhea Related to Kaposi Sarcoma Risk for Disuse Syndrome Related to Kaposi Sarcoma

Impaired Skin Integrity Related to Kaposi Sarcoma

You are writing a plan of care for an AIDS patient that was admitted to the hospital. What goal would be appropriate for this patient? Decreased comfort. Activity intolerance. Decreased socialisation. Improved nutritional status.

Improved nutritional status.

A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive? Antimicrobial therapy Induction therapy Supportive therapy Standard therapy

Induction therapy

A patient is admitted to the unit with Pneumocystis pneumonia (PCP). The patient has acquired immunodeficiency syndrome (AIDS). Which nursing diagnosis has the highest priority for this patient? Ineffective airway clearance. Imbalanced nutrition: Less than body requirements. Impaired oral mucous membranes. Activity intolerance.

Ineffective airway clearance.

A nurse is planning the care of a client with a diagnosis of sickle cell disease who has been admitted for the treatment of an acute vaso-occlusive crisis. What nursing diagnosis should the nurse prioritize in the client's plan of care? Ineffective thermoregulation related to hypothalamic dysfunction Functional urinary incontinence related to urethral occlusion Ineffective tissue perfusion related to thrombosis Risk for disuse syndrome related to ineffective peripheral circulation

Ineffective tissue perfusion related to thrombosis

A client is receiving chemotherapy for cancer. The nurse reviews the client's laboratory report and notes that he has thrombocytopenia. To which nursing diagnosis should the nurse give the highest priority? Activity intolerance Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI Impaired tissue integrity Impaired oral mucous membranes

Ineffective tissue perfusion: Cerebral, cardiopulmonary, GI

A nurse practitioner is assessing a client who has a fever, malaise, and a white blood cell count that is elevated. What principle should guide the nurse's management of the client's care? Infection is the most likely cause of the client's change in health status. The client should undergo diagnostic testing for multiple myeloma. The client is exhibiting signs and symptoms of leukemia. There is a need for the client to be assessed for lymphoma.

Infection is the most likely cause of the client's change in health status.

An immunocompromised client is being treated in the hospital. The nurse's assessment reveals that the client's submandibular lymph nodes are swollen, a finding that represents a change from the previous day. What is the nurse's most appropriate action? Monitor the client's vital signs q2h for the next 24 hours. Administer a PRN dose of acetaminophen as ordered. Implement standard precautions in the client's care. Inform the client's primary care provider of this finding.

Inform the client's primary care provider of this finding.

A client is being treated in the hospital for hypovolemia related to a bleeding peptic ulcer. The nurse obtains a blood pressure reading of 88/62 mm Hg, heart rate of 112 beats/minute, and a respiratory rate of 24 breaths/minute. What is the first action by the nurse? Administer blood. Administer a colloid solution. Insert two large-bore intravenous catheters. Notify the physician.

Notify the physician.

The client is receiving chemotherapy for a diagnosis of lymphosarcoma. The client experiences nausea. What measures should the nurse suggest to help the client reduce the feeling of nausea? Offer clear liquids such as carbonated beverages, water, and ice pops. Advise bed rest as much as possible. Apply ice to the skin for brief periods. Administer immunosuppressive drugs.

Offer clear liquids such as carbonated beverages, water, and ice pops.

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"? Drink plenty of fluids. Use the medication every 4 hours to prevent congestion from recurring. Be sure to use the nasal spray for at least 10 days to ensure the stuffiness is gone. Only use the nasal spray for 3 to 4 days once every 12 hours.

Only use the nasal spray for 3 to 4 days once every 12 hours.

A 6-month-old infant has been diagnosed with X-linked agammaglobulinemia and the parents do not understand why their baby did not develop an infection during the first months of life. The nurse should describe what phenomenon? Cell-mediated immunity in infants Phagocytosis Opsonization Passive acquired immunity

Passive acquired immunity

The nurse completes a history and physical assessment on a client with acquired immune deficiency syndrome (AIDS) who was admitted to the hospital with respiratory complications. The nurse knows to assess for what common infection (80% occurrence) in persons with AIDS? Mycobacterium tuberculosis Pneumocystis pneumonia Legionnaire's disease Cytomegalovirus

Pneumocystis pneumonia

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function? Surgical removal of the appendix Previous organ transplantation Surgical history of a partial gastrectomy Negative history for radiation therapy

Previous organ transplantation

The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client? Increase mobility. Promote safety. Encourage adequate nutrition. Provide adequate hydration.

Promote safety

The nurse knows to follow the CDC's guidelines for Standard Precautions while caring for patients regardless of known or unknown infectious status. The nurse is aware that barrier protection is not necessary for which body fluid? Amniotic Sweat Pleural Synovial

Sweat

Will Gleason, a 57-year-old bartender, has an appointment with a physician in the primary care group where you practice nursing. Mr. Gleason presents with weeping lower extremity edema, his skin is thickened and brawny. This condition has been present for four weeks and he is seeking treatment. What treatment would you expect the physician to order? Physical therapy Antibiotic treatment Symptomatic treatment Surgery

Symptomatic treatment

An oncology nurse is providing health education for a client who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia? The different leukemias all involve the development of cancer in the lymphatic system. The different leukemias all involve unregulated proliferation of white blood cells. The different leukemias all have unregulated proliferation of red blood cells and decreased bone marrow function. The different leukemias all result in a decrease in the production of white blood cells.

The different leukemias all involve unregulated proliferation of white blood cells.

A 60-year-old client with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize? The importance of daily physical activity The need to ensure that vaccinations are up to date The need to avoid shellfish and raw foods The importance of adhering to the prescribed drug regimen

The importance of adhering to the prescribed drug regimen

A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this? The interactions that occur between T cells and B cells The movement of B cells in and out of lymph nodes The universal role of the complement system The differentiation between different types of T cells

The interactions that occur between T cells and B cells

A client's family member asks what hematopoiesis is. What should the nurse tell the family member? The making of red blood cells and lymph The production of lymphatic fluid in the body The manufacture and development of blood cells The development of lymph in the bone marrow

The manufacture and development of blood cells

A patient is taking prednisone 60 mg per day for the treatment of an acute exacerbation of Crohn's disease. The patient has developed lymphopenia with a lymphocyte count of less than 1,500 mm3. What should the nurse monitor the client for? Bleeding Abdominal pain Diarrhea The onset of a bacterial infection

The onset of a bacterial infection

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, which part of the body is more sensitive to allergens? chest forearm upper arm back

back

A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wart-like lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding? using a medicated douche in order to keep the vaginal pH normal testing the client for the presence of HIV having the client abstain from sexual activity for 6 weeks while the medication is working instructing the client to wear cotton underwear

testing the client for the presence of HIV

Parents arrive to the clinic with their young child and inform the nurse the child has just been diagnosed with sickle cell disease. The parents ask the nurse how this could have happened and which one of them is the carrier. What is the best response by the nurse? "The trait is passed down through the mother." "The child must inherit two defective genes, one from each parent." "It is an acquired, not a hereditary disorder." "Most likely, the father is the carrier of the gene."

"The child must inherit two defective genes, one from each parent."

When teaching a client with sickle cell disease about strategies to prevent crises, what measures should the nurse recommend? Maximizing physical activity and taking OTC iron supplements Limiting psychosocial stress and eating a high-protein diet Avoiding cold temperatures and ensuring sufficient hydration Using prophylactic antibiotics and performing meticulous hygiene

Avoiding cold temperatures and ensuring sufficient hydration

An older adult client presents to the health care provider's office and reports exhaustion. The nurse, aware of the most common hematologic condition affecting the elderly, knows that which laboratory values should be assessed? Thrombocyte count RBC count Levels of plasma proteins WBC count

RBC count

The nurse is collecting data for a client who has been diagnosed with iron-deficiency anemia. What subjective findings does the nurse recognize as symptoms related to this type of anemia? "I have difficulty breathing when walking 30 feet." "I feel hot all of the time." "I have a difficult time falling asleep at night." "I have an increase in my appetite."

"I have difficulty breathing when walking 30 feet."

The nurse should provide further teaching about post bone-marrow biopsy procedures when the client makes which statement? "I should not take aspirin-containing products for pain relief." "I will keep the sterile dressing on until my doctor tells me it's okay to remove it." "I may feel some aching in my hip for 1-2 days." "I'll ask someone to drive me home when I awake from general anesthesia."

"I'll ask someone to drive me home when I awake from general anesthesia."

The nurse is assigned to care for a client with polycythemia vera. When the nurse encourages the client to drink 3 L of fluid per day, the client states, "Why do I have to drink so much?" What is the best response by the nurse? "It will help your heart beat regularly and effectively." "It helps adequately hydrate you and ensures a sufficient urine production." "We don't want you to get dehydrated." "It will help restrict blood circulation."

"It helps adequately hydrate you and ensures a sufficient urine production."

Dennis Morgan, a 49-year-old chef, is a client of the primary care group where you practice nursing. Dennis has been studying up on blood cell production since the development of his blood disorder. At each appointment, he tries to fool you, his nurse, with blood cell trivia. His latest question: "Which of the following cell types are produced from pluripotential stem cells?" Your response is: Erythrocytes All options are correct. Lymphocytes Platelets

All options are correct.

A client has an increased number of eosinophils. Which of the following disorders would the nurse expect the client to have? Liver failure Hemophilia Allergy Pediculosis pubis

Allergy

Which of the following nursing interventions should be incorporated into the plan of care to manage the delayed clotting process in a patient with leukemia? Implement neutropenic precautions. Monitor temperature at least once per shift. Eliminate direct contact with others who are infectious. Apply prolonged pressure to needle sites or other sources of external bleeding.

Apply prolonged pressure to needle sites or other sources of external bleeding.

A client has just been admitted to the unit with a diagnosis of Hodgkin's disease. When doing the initial assessment, what pertinent questions should the nurse ask the client to help determine the correct nursing diagnosis? Are you experiencing fever, chills, or night sweats? Have you ever experienced fractures? Do you use artificial respirators? Have you ever had a blood transfusion?

Are you experiencing fever, chills, or night sweats?

When teaching a client with iron deficiency anemia about appropriate food choices, the nurse encourages the client to increase the dietary intake of which foods? Fruits high in vitamin C, such as oranges and grapefruits Berries and orange vegetables Beans, dried fruits, and leafy, green vegetables Dairy products

Beans, dried fruits, and leafy, green vegetables

Which of the following is a symptom of Cooley's anemia? Dyspnea Bronzing of the skin Inflammation of the mouth Inflammation of the tongue

Bronzing of the skin

A 75-year-old woman visited her health care provider for an annual check-up. She told the doctor that she feels exhausted all the time and barely has the energy to go out of her home, run errands, and visit friends. The nurse expects that the health care provider will order which of the following lab studies based on the most common hematologic condition affecting the elderly? Thrombocyte count Level of B lymphocytes Complete blood count White blood count

Complete blood count

A night nurse is reviewing the next day's medication administration record (MAR) of a hospital client who has hemophilia. The nurse notes that the MAR specifies both oral and subcutaneous options for the administration of a PRN antiemetic. What is the nurse's best action? Reassess the client's need for antiemetics. Ensure that the day nurse knows not to give the antiemetic. Remove the subcutaneous route from the client's MAR. Contact the prescriber to have the subcutaneous option discontinued.

Contact the prescriber to have the subcutaneous option discontinued.

A nurse cares for a client with a hematological disorder and malnutrition. What is the nurse's best understanding of how the client's nutritional status may worsen the client's hematological condition? Decreased fat stores lead to decreased ability for red blood cells Decreased calories lead to decreased immune response Decreased carbohydrates lead to decreased oxygen affinity of the hemoglobin Decreased protein stores lead to decreased immune response

Decreased protein stores lead to decreased immune response

The nurse is caring for a client in the hospital who is being treated for Hodgkin's disease and is taking a chemotherapeutic regimen in the hospital's oncology unit. When reviewing the client's medication history, what regimen does the nurse recognize as the drugs in the treatment of Hodgkin's disease? Enalapril, atenolol, verapamil, lovastatin Doxorubicin, bleomycin, vinblastine, dacarbarine Ceftriaxone, furosemide, rifampin, ibuprofen Albuterol, ipratropium, methylprednisolone, acetylcysteine

Doxorubicin, bleomycin, vinblastine, dacarbarine

An adult client has been diagnosed with iron-deficiency anemia. What nursing diagnosis is most likely to apply to this client's health status? Fatigue related to decreased oxygen-carrying capacity Acute pain related to uncontrolled hemolysis Risk for infection related to tissue hypoxia Risk for deficient fluid volume related to impaired erythropoiesis

Fatigue related to decreased oxygen-carrying capacity

A teenaged client with hemophilia sustains a leg laceration after falling off of his skateboard and is brought to the emergency department. The laceration is bleeding profusely even with direct pressure to the site. What does the nurse anticipate will be ordered for administration to control bleeding? A crystalloid solution such as lactated Ringer's Albumin A colloid solution such as hetastarch (Hespan) Fresh frozen plasma

Fresh frozen plasma

The nurse is caring for a client with lymphedema of the left arm in the clinic. The nurse measures a circumference of the affected extremity 4 cm larger in circumference than the opposite limb, and the client complains of feeling a heaviness and pain. There is limited movement of the left arm. What would the nurse grade and document this lymphedema as? Grade III (Severe) Grade I (Mild) Grade II (Moderate) Grade IV (Grossly edematous)

Grade II (Moderate)

A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host? Acute respiratory distress syndrome Graft-versus-host disease Remission Bone marrow depression

Graft-versus-host disease

A client diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this client's care plan, what potential complication should the nurse address? Hemorrhage Arteritis Pancreatitis Liver dysfunction

Hemorrhage

A nurse is caring for a client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client? Pallor, bradycardia, and reduced pulse pressure Sore tongue, dyspnea, and weight gain Pallor, tachycardia, and a sore tongue Angina pectoris, double vision, and anorexia

Pallor, tachycardia, and a sore tongue

You are the nurse assessing a patient with multiple myeloma. What should you keep in mind that patients with multiple myeloma are at risk for? Pathologic bone fractures. Acute heart failure. Chronic liver failure. Hypoxaemia.

Pathologic bone fractures

A client with von Willebrand disease (vWD) has experienced recent changes in bowel function that suggest the need for a screening colonoscopy. What intervention should be performed in anticipation of this procedure? The client should be admitted to the surgical unit on the day before the procedure. The client should be given necessary clotting factors before the procedure. The client should not undergo the normal bowel cleansing protocol prior to the procedure. The client should receive a unit of fresh-frozen plasma 48 hours before the procedure.

The client should be given necessary clotting factors before the procedure.

A patient with a diagnosis of HIV exhibits a decreased level of T lymphocytes. What consequence does this state present for this patient? The patient is particularly susceptible to infection. The patient has diminished oxygen-carrying capacity. The patient will be unable to maintain hemostasis. The patient will be incapable of mounting a response to allergens.

The patient is particularly susceptible to infection.

Which statement best describes the function of stem cells in the bone marrow? They produce antibodies against foreign antigens. They produce all blood cells. They are active against hypersensitivity reactions. They defend against bacterial infection.

They produce all blood cells.

A nurse cares for clients with hematological disorders and notes that women are diagnosed with hemochromatosis at a much lower rate than men. What is the primary reason for this? Women have lower hemoglobin levels Women rarely manifest the gene expression Women require grater folic acid supplementation Women lose iron through menstrual cycles

Women lose iron through menstrual cycles

A nurse in the ED is caring for a trauma client following a motor vehicle accident. The client's blood donor card indicates type AB blood. People with type AB blood are: only able to receive type O blood. only able to receive type A and type B blood. universal recipients. universal donors.

universal recipients.

A nurse is reviewing components of complex decongestive physiotherapy with a client about to undergo the treatment. Which of the following would the nurse accurately identify as aspects of this procedure? Select all that apply. Proximal-to-distal massage of edematous areas to facilitate lymphatic drainage into collateral vessels Care and maintenance of skin and nails that are vulnerable to secondary complications Passive exercises to promote lymphatic circulation and maintain functional use of the limb Application of compression dressings to relieve edema by reducing the excess volume of fluid in the interstitial space Elevation of the affected limb

Application of compression dressings to relieve edema by reducing the excess volume of fluid in the interstitial space Care and maintenance of skin and nails that are vulnerable to secondary complications

A nurse in a long-term care facility is admitting a new resident who has a bleeding disorder. When planning this resident's care, the nurse should include what action?? Providing the client with a high-fiber diet Housing the resident in a private room Implementing of a plan for fall prevention Implementing a passive ROM program to compensate for activity limitation

Implementing of a plan for fall prevention

A client has been living with a diagnosis of anemia for several years and has experienced recent declines in her hemoglobin levels despite active treatment. What assessment finding would signal complications of anemia? Fever and signs of hyperkalemia Venous ulcers and visual disturbances Shortness of breath and peripheral edema Epistaxis and gastroesophageal reflux

Shortness of breath and peripheral edema

A nurse is documenting skin findings in a client with lymphedema. Which of the following descriptions would be most consistent with the expected presentation? Cyanotic Jaundice Brawny Rubor

Brawny