Patho Exam #2

A patient is instructed to take diphenhydramine (Benadryl) after an allergic reaction. Which of the following statements by the patient indicates successful teaching concerning the administration of diphenhydramine (Benadryl)?

"I should not drive my car after taking this medication."

A 5 year old child is experiencing itchy, water eyes and an increased respiratory rate with some inspiratory wheezes. He has been outside playing in the yard and trees. The mother asks, "Why does he get like this?" The health care worker's best response is:

"This is what we call a type I hypersensitivity reaction and usually occurs a few minutes after exposure to his allergen. It is primarily caused by mast cells in his body."

A client has been diagnosed with herpes simplex virus. The client states that, "modern medicine produces more and more antivirals every year and so the treatment should be simple." Which of the following statements listed below is the best response?

"Treatment options for viruses are often limited because what destroys viruses often damages your own body cells."

Staphylococcus aureus commonly found in the skin, nares, and other body sites of patients without any signs or symptoms of infection is know as which of the following conditions listed below?

Bacterial colonization

Which description does the nurse recognize fits a client in the prodromal stage of an infection?

Client is experiencing vague symptoms of fatigue and low grade fever

The nurse has just administered a Mantoux test to a client. Select the reaction that best describes the anticipated response.

Delayed-type hypersensitivity

A 50 year old male is admitted to the emergency room after a motorcycle crash. He was not wearing a helmet and has a head injury. He is unconscious with one eye dilated and one constricted. He has a widened pulse pressure. What corticosteroid will be administered parenterally?

Dexamethasone (Decadron)

Sexually transmitted infections (STIs) are typically spread by which of the following mechanisms?

Direct contact

Which of the following responses of the adaptive immune system provides protection against virus-infected cells?

Distinct antigenic properties allow T cells to isolate specific organisms

A female client is prescribed a first-generation antihistamine for her allergies. The nurse would expect her to experience what adverse effect?

Dry mouth

Which cells block the entry of microbes and destroy them by secreting antimicrobial enzymes, proteins, and peptides within the mucous membrane linings of the gastrointestinal, respiratory, and urogenital tract?

Epithelial

When explaining what is occurring when their child has an acute bronchial asthma attack, the nurse will emphasize that which mediator is primarily responsible for the bronchial constriction?

Histamine

The nurse is caring for a client who has just returned to the unit after having a craniotomy. What drug does the nurse anticipate that the physician will order for this client?

IV dexamethasone

A client experiences an allergic reaction. Select the immunoglobulin that would bind to mast cells and release histamine.

IgE

You are performing a shift assessment of a patient receiving methylprenisolone. Which of the following symptoms should be reported as a possible side effect of the drug?

Impaired wound healing

A nurse would instruct a client to take an oral glucocorticoid at which time?

In the morning

Type III hypersensitivity immune responses can be harmful when the immune complex deposits in tissue activate which of the following that can directly damage area tissues?

Inflammation

Select the phases that make up the reaction of the complement system

Initial activation, amplification of inflammation, and membrane attack response

A patient has a tumor of the spinal cord. The patient is administered a corticosteroid. What effect will the corticosteroid have on the tumor?

It will assist in decreasing the edema at the site of the tumor

A nurse is working on a community project that will teach first responders how to be prepared for a pandemic flu. Select the priority intervention from the following statements.

Limit person-to-person transmission

Adaptive immune responses, also called acquired or specific immunity, are composed of which of the following and their products?

Lymphocytes

The mediators involved in type I hypersensitivity allergic responses are released from which of the following?

Mast cells

When explaining the rationale for alternate-day administration of corticosteroids, you would include which of the following explanations?

Minimize the suppression of normal adrenal function

Which disorder does the nurse know is considered to be an autoimmune disease?

Myasthenia gravis

Which of the following helps the innate immune system differentiate between body cells and foreign substances?

Pattern recognition receptors identify structures not shared by body tissues

There are two criteria that have to be met in order for a diagnosis of an infectious disease to occur. What are these two criteria?

Recovery of probably pathogen and documentation of signs and symptoms compatible with an infectious process

When describing the effects of second generation antihistamines, which of the following would the nurse address as being decreased?

Sedation

The mechanism by which humans recognize self-cells from non-self (antigens) cells is called:

Self-tolerance

The first physical line of defense in innate immunity is:

Skin and mucous membranes

A 15 year old patient is prescribed an antihistamine for allergic rhinitis. However, antihistamines used to treat allergic reactions may themselves cause allergy. The nurse needs to educate the patient to be aware of symptoms suggesting allergy. Which of the following is an allergic reaction to antihistamines?

Skin rash and urticaria

International travel has contributed to increased prevalence and incidence of nonindigenous diseases by increasing which of the following?

Source of infection

Which of the following is a secondary lymphoid structure located high in the left abdominal cavity?

Spleen

The home health nurse is making a plan of care for a new patient who is taking oral prednisolone. What suggestion may decrease the nausea related to oral administration of prednisolone?

Take with a meal

Second generation H1 antagonists cause less CNS depression because they are selective for peripheral H1 receptors and because of which other property?

They do not cross the blood brain barrier

Which of the following is the main purpose of the complement system in the presence of invading microorganisms?

To attack and destroy antigens

The nurse is doing discharge teaching when the patient asks the nurse why their prednisone has been ordered on alternate days. What would be the nurse's best response?

To minimize adverse effects

Allergic rhinitis is inflammation of the nasal mucosa caused by a type I hypersensitivity reaction to inhaled allergens. True or false?

True

Patients with drug allergies should wear a medical alert bracelet identifying the drug. True or false?

True

What causes the inflammation of nasal mucosa that is seen in allergic rhinitis?

Type I hypersensitivity reaction to inhaled allergens

A client has developed a hypersensitivity reaction resulting in the formation and deposition of insoluble antigen-antibody complexes that cause serum sickness and acute glomerulonephritis. The nurse would document this as:

Type III hypersensitivity reaction

A genetically determined hypersensitivity to common environmental allergens causes _______ reactions, such as:

atopic; urticaria

A 20 year old woman calls the clinic at 5 pm and reports to the nurse that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 pm. She wants to know what she should do. The nurse will instruct her to:

forget about the morning dose and take the evening dose

They physician has ordered a daily dose of corticosteroid for a patient. What should the nurse teach the patient about the time to take a daily dose of a corticosteroid?

8:00 AM

While learning about corticosteroids in pharmacology class a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's best response?

A disease with an inflammatory component

An 81 year old female patient in a subacute medical unit of a hospital has developed an oral Candida albicans infection. Which of the following phenomena would the patient's nurse suspect as a key contributing factor to her infection?

Antibiotic therapy that eliminated normal bacterial flora

Mismatched blood transfusion reaction with hemolysis of blood cells is an example of type II, ______ mediated hypersensitivity reaction

Antibody

A client is applying to nursing school and has come to the clinic with a request to be tested for immunity to hepatitis B. Which type of testing would be the best to determine immunity?

Antibody titer

Which of the following factors is considered during serology testing?

Antibody titers

Substances foreign to the host that can stimulate an immune response are known as:

Antigens

A patient is scheduled to receive 1 unit of packed red blood cells. The patient states that she has had an allergic reaction to a transfusion in the past. What medication will assist in preventing a reaction to the packed red blood cell transfusion?

Antihistamine