Prep U Practice Questions (Immunity)
A nurse is preparing a client for a computed tomography (CT) scan that requires infusion of radiopaque dye. Which question is the most important for the nurse to ask? - "When did you last have something to eat or drink?" - "When did you last take any medication?" - "Are you allergic to seafood or iodine?" - "How much do you weigh?"
"Are you allergic to seafood or iodine?" Explanation: Seafood and the radiopaque dye used in CT contain iodine. To prevent an allergic reaction to the radiopaque dye, the nurse should ask the client about allergies to seafood or iodine before the CT scan. Because fasting is unnecessary before a CT scan, the nurse doesn't need to obtain information about the client's last food and fluid intake. The client's last dose of medication and current weight also are irrelevant.
The nurse has completed education for a client about an antibiotic prescribed by the healthcare provider. Which statement by the client indicates an understanding of the proper use of the medication? - "I will take the medication until I feel better." - "I will stop the medication if I don't think it is helping." - "I will take the medication until it is all gone." - "I will stop the medication when my symptoms go away."
"I will take the medication until it is all gone." Explanation: It is important to teach the client to take the medication as ordered, until it is all gone. If not, the infection may return and/or advance. The medication should not be stopped when the client feels better or when the symptoms go away. The client should call the healthcare provider if the client doesn't feel it is helping.
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? - Acquired immunity - Natural immunity - Phagocytic immunity - Humoral immunity
Acquired immunity Explanation: Acquired immunity usually develops as a result of prior exposure to an antigen, often through immunization. When the body is attacked by bacteria, viruses, or other pathogens, it has three means of defense. The first line of defense, the phagocytic immune response, involves the WBCs that have the ability to ingest foreign particles. A second protective response is the humoral immune response, which begins when the B lymphocytes transform themselves into plasma cells that manufacture antibodies. The natural immune response system is rapid, nonspecific immunity present at birth.
The nurse is caring for a male client who is scheduled for a neurologic examination that uses a radiopaque dye. Before the test, the nurse assesses the allergy history of the client and find the client is allergic to seafood. What does the nurse relate the allergy to seafood as? - An allergy to antihistamines - An allergy to radiation exposure - An allergy to morphine - An allergy to iodine
An allergy to iodine Explanation: Because some contrast media contain iodine, the nurse checks the client's history for previous allergic reactions to radiographic dyes, iodine, or seafood. Seafood allergies indicate an allergy to iodine. Therefore, the nurse will have to manage the allergic reaction of the client by administering antihistamines or any other medications suggested by the physician. Alternatively, the physician may suggest another neurologic examination test that does not require the use of a radiopaque dye. Allergy to seafood does not indicate an allergy to morphine or radiation exposure.
The daughter of a 79-year-old woman asks the nurse why her mother gets so many infections. The daughter states, "My mother has always been healthy, but now she has pneumonia. Last month she got cellulitis from a bug bite she scratched. The month before that was some other infection. How come she seems to get sick so often now?" What is the nurse's best response? - As people get older, their immune system does not respond as well as it did when they were younger. - About the time we are 75 or 76 years old, our immune system quits working. - Your mother just seems to be prone to getting infections. - Your mother gets infections frequently because she wants attention from you.
As people get older, their immune system does not respond as well as it did when they were younger. Explanation: Aging is characterized by a declining ability to adapt to environmental stresses. One of the factors thought to contribute to this problem is a decline in immune responsiveness. This includes changes in cell-mediated and humoral immune responses. Older adults tend to be more susceptible to infections, have more evidence of autoimmune and immune complex disorders than younger persons, and have a higher incidence of cancer.
A child allergic to insect stings presents to the school nurse stating, "A bee stung me on the playground." Which action by the nurse is priority? - Notify the client's caregivers and primary health care provider - Assess the client's airway and breathing rate - Administer epinephrine subcutaneously to the client - Locate the stinger and remove it with tweezers
Assess the client's airway and breathing rate Explanation: The nurse would be concerned that the client may experience an anaphylactic reaction and would first assess the client's airway and breathing. If needed, the nurse would then administer epinephrine, a vasopressor which reverses the effects of histamine, which can cause severe bronchospasm and edema in clients. The nurse would assess the site and remove the stinger and notify caregivers and the primary health care provider once the client is determined to be stable.
A nurse observes a physician sneeze into the physician's hand when walking to an examination room. The physician does not wash the hands before entering the room to examine the next client. What is the nurse's first priority? - Tell the physician to wash the hands before examining the client. - Assume the physician knows whether the physician is contagious. - Have the client wash the hands after the doctor's examination. - Tell the client to come back if symptoms of sneezing begin.
Tell the physician to wash the hands before examining the client. Explanation: The nurse's priority is the safety of the client and other clients that will visit the physician's office. The nurse should tell the doctor to wash the hands. The nurse has an obligation to intervene and to take action to protect the client. The other options are not correct because they address neither the safety of the client nor the initial problem of the doctor not washing the hands. Infection prevention and control practices apply to everyone.
Reusable blood pressure cuffs and single-use disposable blood pressure cuffs are both available for use in the emergency department. In order to conserve resources, for which client would a clean, reusable blood pressure cuff be appropriate? - an 8-year-old male client diagnosed with pertussis - an 87-year-old female client in the emergency department for chest pain - a 30-year-old client who was in a motor vehicle collision and has multiple open bleeding wounds - a 47-year-old client with an abscess and diagnosed with MRSA to previous abscesses
an 87-year-old female client in the emergency department for chest pain Explanation: The reusable blood pressure cuff would be appropriate for a client without any infection control or isolation concerns, as it is a cost-effective option for the client with chest pain. Disposable single-use items are most costly, but are necessary for clients who require isolation or infection-control measures, including the clients with pertussis and (methicillin-resistant Staphylococcus aureus (MRSA). Age and gender are not considerations in the decision-making process of using a disposable or reusable blood pressure cuff. The client who was in a motor vehicle collision and has multiple, bleeding wounds would also require a disposable cuff, due to the bodily fluids (blood) that would saturate a reusable cuff, making it difficult to clean and reuse.
A nurse is teaching a group of nursing assistants about infection-control measures. What is the priority information to include in this teaching? - proper use of gloves - administration of antibiotics - hand-washing techniques - assignment of private rooms
hand-washing techniques Explanation: Hand washing is the first line of intervention for preventing the spread of infection and therefore is the priority for this teaching. Wearing gloves and assigning private rooms for clients may also decrease the spread of infection and should be implemented according to standard precautions. Antibiotics should be initiated when a causative organism is identified, but would not be in the scope of practice for a nursing assistant.
The nurse is caring for a client with a fungal infection. The healthcare provider's prescription states the administration of fluconazole "b.i.d." How will the nurse administer the medication? - every other day - twice daily - as needed - with food
twice daily Explanation: "B.i.d." is a commonly used abbreviation that means "twice a day." The abbreviation "e.o.d." indicates a medication is to be taken every other day; use of this abbreviation is discouraged due to high risk of error. The abbreviation "p.r.n." or "PRN" indicates a medication is to be taken as needed. Although the abbreviation "cib" may be used to indicate a medication is to be taken with food, this instruction should be written out in full.