NU372 HESI Prep: Immunologic system and infectious disease

When inquiring about papilledema and the presence of exudates, which body system may the nurse be assessing in a client with human immunodeficiency virus (HIV)? A. Ocular B. Respiratory C. Neurologic D. Cardiovascular

A. Ocular Rationale: Exudates and pailledema are conditions that involve the eyes (ocular system). A respiratory system assessment might reveal crackles, wheezing, or a productive or nonproductive cough. Assessment of the neurologic system includes determine the presence of sensory

On which body system would the nurse focus when assessing a client with suspected Goodpasture syndrome? A. Renal B. Neurological C. Cardiovascular D. Musculoskeletal

A. Renal Rationale: Goodpasture syndrome is an autoimmune disorder in which autoantibodies attack the glomerular basement membrane and neutrophils. The organs with the most damage are the kidneys. A person with the disorder may have kidney problems, which manifest as glomerulonephritis that may rapidly progress to complete kidney failure. Goodpasture syndrome does not affect the neurological, cardiovascular, or musculoskeletal systems.

Which dietary changes would the nurse suggest to the client with diarrhea associated with human immunodeficiency virus (HIV)? Select all that apply. One, some, or all responses may be correct. A. "Eat more fatty food." B. "Eat much less roughage." C. "Drink two cups of coffee daily." D. "Eat more spicy and sweet food." E. "Drink plenty of fluids between meals."

B. "Eat much less roughage." E. "Drink plenty of fluids between meals." Rationale: Clients infected with HIV often suffer from diarrhea. Roughage should be limited in the diet of a client who has diarrhea associated with HIV disease, because it is not easy digestible. Drinking plenty of fluids helps compensate for the fluid loss. Fatty foods are avoided because they alter the process of digestion. Coffee is avoided because it stimulates the gastrointestinal tract and leads to diarrhea. Spicy and sweet foods are avoided because they trigger the gastrointestinal tract and acidify the stomach contents that lead to diarrhea.

A client with Lyme disease presents with dyspnea, dizziness, and facial paralysis. Which prescribed medication would the nurse teach this client ? A. Amoxicillin B. Ceftriaxone C. Doxycylcine D. Erythromycin

B. Ceftriaxone Rationale: Lyme disease is a systemic infectious disease caused by the spirochete Borrelia burgdorferi. It results from the bite of an infected deer tick, also known as the backlogged tick. Stage II of Lyme disease is characterized by dizziness, dyspnea, and facial paralysis, and may be treated with ceftriaxone. Amoxicillin, doxycycline, and erythromycin are prescribed to treat localized stage I Lyme disease.

Which diagnostic test determines the specific cause of a client's allergic reaction? A. Perform eosinophil count B. Perform white blood cell count C. Perform radioimmunosorbent test (RIST) D. Perform enzyme-linked immosorbent assay (ELISA)

C. Perform radioimmunosorbent test (RIST) Rationale: The blood levels of immunoglobulin E (IgE) directed against a specific allergen can be estimated by the RIST. RIST is helpful to diagnose a specific cause for an allergic reaction. The eosinophil count increases in cases of allergic reactions; however, this count cannot ascertain a specific cause for the allergy. The white blood cell count can help determine the presence of an allergy but not the cause. The serum IgE levels are measured by the ELISA test; this test only indicates the presence of an allergy.

Client A - Chlamydia - Azithromycin Client B - Genital herpes - Benzathine penicillin G Client C - Genital warts - Imiquimod Client D - Gonorrhea - Doxycyline Based on the medication chart, the nurse would need to notify the health care provider regarding which client?

Client B Rationale: Genital herpes is an acute, recurring, incurable viral infection caused by herpes simplex virus. Antiviral drugs such as acyclovir and famciclovir are used to treat genital herpes, not benzathine penicillin G, which is an antibiotic. Client B's prescription indicates a need for correction, so the nurse would notify the health care provider. Chlamydia is a sexually transmitted infection caused by Chlamydia trachomatis. Azithromycin is used to treat chlamydia. Genital warts are treated with imiquimod. Gonorrhea is treated with doxycycline.

Which instructions regarding the use of fluticasone nasal spray are appropriate for client teaching? Select all that apply. One, some, or all responses may be correct. A. Use the medication on a regular basis, not PRN B. Clear the nasal passages before using the medication. C. Discontinue use of the medication. D. E.

A. Use the medication on a regular basis, not PRN. B. Clear the nasal passages before using the medication. C. Discontinue use of the medication if nasal infection develops.

A client's sputum smears for acid-fast bacilli (AFB) are positive and requires transmission-based airborne precautions. Which instruction would the nurse teach when orienting the client's visitors? A. All visitors must wear a gown and gloves. B. Wear a particulate respiratory mask when in the room. C. Avoid touching objects in the client's room. D. Limit contact with the client's nonexposed family members.

B. Wear a particulate respiratory mask when in the room. Tubercle bacilli are transmitted through air currents; therefore personal protective equipment, such as a particulate respirator that filters out organisms as small as 1 µm, is necessary. Gowns and gloves are not necessary. Tuberculosis is spread by airborne microorganisms; gloves are necessary only when touching articles contaminated with respiratory secretions. It is only necessary to avoid contact with objects in the client's room that are contaminated with respiratory secretions. Limiting contact with the client's nonexposed family members is unnecessary.

A client reports disturbed sleep due to allergic pruritus. Which medication would help the client sleep and treat the allergic symptoms? A. Cetrizine B. Fexofenadine C. Desloratadine D. Chlropheniramine

D. Chlorpheniramine Rationale: Chlorpheniramine is an antihistamine that helps manage allergic symptoms by preventing vasodilation and decreasing allergic symptoms. Sedation is a side effect of chlorpheniramine; therefore this medication is prescribed to clients experiencing sleep issues due to allergic symptoms. Cetirizine effectively blocks histamine from binding to receptors and has less sedating potential. Fexofenadine and desloratadine are also less sedating antihistamine medications.

Which would the nurse instruct the unlicensed assistive personnel (UAP) to perform to prevent hip dislocation in a client recovering from a total hip arthroplasty via posterior approach? A. Raise heels off the bed. B. Change positions slowly. C. Use a gait belt during ambulation. D. Insert abduction pillow between legs.

D. Insert abduction pillow between legs. Rationale: The nurse will instruct the UAP to insert an abduction pillow between the legs of a client recovering from total hip arthroplasty via posterior approach to prevent dislocation of the hip. Raising the heels prevents skin breakdown. Changing positions slowly prevents injury from orthostatic hypotension. Using a gait belt during ambulation decreases the risk for falls.