Unit 3 Practice Questions

A client has been taking glucocorticoids to control rheumatoid arthritis. Which laboratory abnormality is the client at risk for as a result of taking this medication? A. Increased serum glucose B. Decreased serum sodium C. Elevated serum potassium D. Increased white blood cells

A

A client is coming to the emergency department with a severe anaphylactic reaction. In preparation for the client's arrival, the nurse would anticipate performing which intervention first? A. Assess for airway patency. B. Call the Rapid Response Team. C. Establish intravenous access to infuse fluids rapidly. D. Document the client's response and closely monitor. Submit

A

A client who is human immunodeficiency virus (HIV)-positive has had a tuberculin skin test (TST). The nurse notes a 7-mm area of induration at the site of the skin test and interprets the result as which finding? A. Positive B. Negative C. Inconclusive D. Need for repeat testing

A

In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which assessment findings would the nurse consider acceptable responses? Select all that apply. A. Control of symptoms during periods of emotional stress B. Normal white blood cell, platelet, and neutrophil counts C. Radiological findings that show no progression of joint degeneration D. An increased range of motion in the affected joints 3 months into therapy E. Inflammation and irritation at the injection site 3 days after the injection is given F. A low-grade temperature on rising in the morning that remains throughout the day

A, B, C, D

What actions would the nurse take when caring for a client having an anaphylactic medication reaction? Select all that apply. A. Assess vital signs. B. Administer oxygen. C. Ensure a patent airway. D. Contact the primary health care provider (PHCP). E. Continue the medication but monitor closely and note the reaction in the chart.

A, B, C, D

A client begins experiencing wheezing, anxiety, swelling, and hives after eating shellfish and is brought to the emergency department. Which immediate action would the nurse implement? A. Administer epinephrine. B. Maintain a patent airway. C. Administer a corticosteroid. D. Apply a MedicAlert bracelet. Submit

B

A patient is diagnosed with systemic lupus erythematosus (SLE). The laboratory reports show increased neutrophils and monocytes. Which type of hypersensitivity reaction might have occurred in the patient? A. Type I B. Type II C. Type III D. Type IV

C

The nurse determines that a client is having a transfusion reaction. After the nurse stops the transfusion, which action would be taken next? A. Remove the intravenous (IV) line. B. Run a solution of 5% dextrose in water. C. Run normal saline at a keep-vein-open rate. D. Obtain a culture of the tip of the catheter device removed from the client.

C

A client with a severe allergic reaction is prescribed intravenous corticosteroids. The nurse would expect that which desired effect will be achieved? A. Pain relief B. Enhanced immunity C. Increased serum glucose D. Decreased inflammation

D

A patient diagnosed with anaphylaxis is treated with a beta agonist to decrease bronchospasms. Which assessment finding indicates effective outcome of the treatment? A. Peripheral capillary oxygen saturation (SPO2) 92% B. Pulse rate 112 beats/min C. Blood pressure 80/45 mm Hg D. Respiratory rate 16 breaths/min

D

A test for the presence of rheumatoid factor is performed in a client with a diagnosis of rheumatoid arthritis (RA). What result would the nurse anticipate in the presence of this disease? A. Neutropenia B. Hyperglycemia C. Antigens of immunoglobulin A (IgA) D. Unusual antibodies of the IgG and IgM type

D

A client with active tuberculosis demonstrates less-than-expected interest in learning about the prescribed medication therapy. The nurse assesses that this client may ultimately need which intervention as a last resort? A. Directly observed therapy B. More medication instructions C. Involvement of the family in teaching D. Reinforcement by the primary health care provider

A

A patient client with a hemoglobin of 6.2 g/dL who has type A blood receives blood from a donor with type AB blood. Which type of hypersensitivity reaction will most likely be seen in this patient? A. Type I B. Type II C. Type III D. Type IV

B

What client scenario has the greatest risk of developing systemic lupus erythematosus? A. 54 year old Caucasian male living in the southwestern United States. B. 78 year old Latin American female living in the northwestern United States. C. 28 year old Asian American male living in the northeastern United States. D. 20 year old African American female living in the southeastern United States.

D

The nurse is performing an admission assessment on a client with tuberculosis (TB) and is collecting subjective and objective data. Which finding would the nurse expect to note? A. High fever B. Flushed skin C. Complaints of weight gain D. Complaints of night sweats

D

A client with rheumatoid arthritis who had a total knee arthroplasty tells the nurse that there is pain with extension of the knee. The nurse would perform which action? A. Administer an analgesic. B. Immobilize the knee temporarily. C. Notify the primary health care provider. D. Put the client's knee through full passive range of motion. Submit

A

A client with tuberculosis (TB) asks the nurse about precautions to take after discharge to prevent infection of others. The nurse's response to the client's question is based on which correct understanding of TB transmission? A. The disease is transmitted by droplet nuclei. B. Clothing and sheets need to be bleached after each use to kill the TB nuclei. C. Deep pile carpet collects TB bacteria and needs to be removed from the home. D. The client needs to specifically maintain enteric precautions to prevent transmission.

A

The nurse is gathering subjective and objective data from a client with a diagnosis of suspected rheumatoid arthritis (RA). The nurse would expect to note which early signs and symptoms of RA? Select all that apply. A. Fatigue B. Weight gain C. Restlessness D. Morning stiffness E. Pain with movement only

A, D

The nurse provides instructions to a client with bilateral deformities of the joints of the fingers due to rheumatoid arthritis. When providing teaching about the disease process, the nurse would inform the client that the changes are most likely due to what type of response? A. Allergic B. Metabolic C. Endocrine D. Autoimmune

D

A client with pulmonary tuberculosis (TB) is on airborne isolation precautions. Which item(s) is essential for the nurse to wear? A. Gloves only B. Fluid shield mask C. Gown, mask, and gloves D. High-efficiency particulate air (HEPA) filter mask

D -N95

A client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, which is most important for the nurse to assess? A. The injection site for itching and edema B. The white blood cell counts and platelet counts C. Whether the client is experiencing fatigue and joint pain D. Whether the client is experiencing a metallic taste in the mouth and a loss of appetite

B

A client diagnosed with tuberculosis (TB) is distressed over fatigue and the loss of physical stamina. What would the nurse tell the client? A. This is expected and will last for at least 1 year. B. This is expected, and the client would gradually increase activity as tolerated. C. This is an unexpected finding with TB, but it would resolve within 1 month. D. This is a short-lived problem that would be gone within 1 week after beginning medication therapy.

B

A client is brought to the emergency department by the spouse after a reaction to eating peanuts. It was later determined that the client experienced an anaphylactic reaction. Which statement regarding an anaphylactic reaction should the client and spouse be aware of as a safety precaution for the future? A. Anaphylaxis is a localized response only. B. Anaphylaxis is a serious and immediate hypersensitivity reaction. C. If the client does not get better within 30 minutes, then call 911. D. The client would stop breathing in an anaphylactic reaction.

B

The nurse in an ambulatory clinic is preparing to administer a tuberculin skin test to a client who may have been exposed to a person with tuberculosis (TB). The client reports having received the bacillus Calmette-Guérin (BCG) vaccine before moving to the United States from a foreign country. Which interpretation would the nurse make? A. The client has no risk of acquiring TB and needs no further workup. B. The client is at increased risk for acquiring TB and needs immediate medication therapy. C. The client's test result will be negative, and a sputum culture will be required for diagnosis. D. The client's test result will be positive, and a chest x-ray study will be required for evaluation.

D Mrs.Plott ppt says: person that have bacilli Calmette-Guerin immunization may show a false-positive PPT test and will require further testing (CXR or blood testing)

The nurse reviews the medication history of a client and notes that the client is taking leflunomide. During assessment of the client, the nurse would ask which question to determine the effectiveness of this medication. A. "Do you have any joint pain?" B. "Are you having any diarrhea?" C. "Are you experiencing heartburn?" D. "Do you have frequent headaches?"

A

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse would interpret these results as which finding? A. Positive B. Negative C. Inconclusive D. Definitive and requiring a repeat test

A

The nurse has instructed a client diagnosed with tuberculosis about how to prevent the spread of infection after discharge from the hospital. The nurse determines that the client needs further teaching if the client makes which statement? A. "I need to use disposable plates, forks, and knives." B. "I need to cough into tissues and throw them away carefully." C. "It's important to cover my mouth if I laugh, sneeze, or cough." D. "It's very important to wash my hands after I touch my mask, tissues, or body fluids."

A -tuberculosis is transmitted by droplet, it cannot be carried on clothing, eating utensils, or other possessions

The nurse is preparing a list of home care instructions for a client who has been hospitalized and treated for tuberculosis. Which instructions would the nurse include on the list? Select all that apply. A. Activities should be resumed gradually. B. Avoid contact with other individuals, except family members, for at least 6 months. C. A sputum culture is needed every 2 to 4 weeks once medication therapy is initiated. D. Respiratory isolation is not necessary, because family members already have been exposed. E. Cover the mouth and nose when coughing or sneezing and put used tissues in plastic bags. F. When one sputum culture is negative, the client is no longer considered infectious and usually can return to former employment.

A, C, D, E -answer D ??

The nurse is performing an assessment on a client who complains of fatigue, weakness, muscle and joint pain, anorexia, and photosensitivity. Systemic lupus erythematosus (SLE) is suspected. What would the nurse further assess for that also is indicative of SLE? A. Ascites B. Emboli C. Facial rash D. Two hemoglobin S genes

C

The nurse reads that a client's tuberculin skin test is positive and notes that previous tests were negative. The client becomes upset and asks the nurse what this means. The nurse would base the response on which interpretation? A. Systemic tuberculosis B. Pulmonary tuberculosis C. Exposure to tuberculosis D. No evidence of tuberculosis

C

The nurse working on a medical respiratory nursing unit is caring for several clients with respiratory disorders. The nurse would determine that which client on the nursing unit is at the lowest risk for infection with tuberculosis? A. An uninsured person who is homeless B. A newly immigrated person from Asia C. A person who is an inspector for the U.S. Postal Service D. An older adult admitted from a long-term care facility

C

The nurse places a hospitalized client with active tuberculosis in a private, well-ventilated isolation room. In addition, which action would the nurse take before entering the client's room? A. Wash hands and don a surgical mask. B. Wash hands and wear a gown and gloves. C. Wash hands and place a high-efficiency particulate air (HEPA) respirator mask over the nose and mouth. D. The nurse needs no precautions. The client is instructed to cover the mouth and nose when coughing.

C -N95 for us to know

A client is suspected of having systemic lupus erythematosus (SLE). On reviewing the client's record, the nurse would expect to note documentation of which characteristic sign of SLE? A. Fever B. Fatigue C. Skin lesions D. Elevated red blood cell count

C -might ask her about this question because she said fatigue is a big one but I wonder if skin lesions comes first because of the butterfly rash ??

A complete blood cell count is performed on a client with systemic lupus erythematosus (SLE). The nurse suspects that which finding will be reported with this blood test? A. Increased neutrophils B. Increased red blood cell count C. Increased white blood cell count D. Decreased numbers of all cell types

D

The nurse is caring for a client with tuberculosis (TB) who is fearful of the disease and anxious about the prognosis. In planning nursing care, the nurse would incorporate which intervention as the best strategy to assist the client in coping with the illness? A. Allow the client to deal with the disease in an individual fashion. B. Ask family members whether they wish a psychiatric consultation. C. Encourage the client to visit with the pastoral care department's chaplain. D. Provide reassurance that continued compliance with medication therapy is the most proactive way to cope with the disease.

D

The nurse has provided a client with tuberculosis (TB) instructions on proper handling and disposal of respiratory secretions. The nurse determines that the client demonstrates understanding of the instructions when the client makes which statement? A. "I will discard used tissues in a plastic bag." B. "I need to wash my hands at least 4 times a day." C. "I will brush my teeth and rinse my mouth once a day." D. "I will turn my head to the side if I need to cough or sneeze."

A

The nurse is reading a tuberculin skin test for a client with no documented health problems. The site has no induration and a 1-mm area of ecchymosis. How would the nurse interpret the result? A. Positive B. Negative C. Uncertain D. Borderline

B

The clinic nurse administers a tuberculin skin test to a client. The nurse tells the client to return to the clinic for the results in how long? A. 6 to 12 hours B. 12 to 24 hours C. 24 to 28 hours D. 48 to 72 hours

D

The nurse is caring for a client diagnosed with tuberculosis (TB). Which assessments, if made by the nurse, are consistent with the usual clinical presentation of TB? Select all that apply. A. Cough B. Dyspnea C. Weight gain D. High-grade fever E. Chills and night sweats

A, B, E

The nurse has provided instructions to a client with a diagnosis of rheumatoid arthritis about measures to protect the joints. Which statement by the client indicates a need for further instruction? A. "I need to slide objects rather than lifting them." B. "I would try not to remain in the same position for a long period of time." C. "I need to use large joints instead of small joints when performing activities." D. "Pain or fatigue is expected, and I would try to continue with the activity if this occurs."

D

The nurse is monitoring a client with anemia who is receiving a blood transfusion. After 30 minutes of the infusion, the client begins to have chills and back pain. The temperature is 100.1° F (37.8° C). What action would the nurse take first? A. Assess the client for other symptoms. B. Slow the blood transfusion and monitor the client's vital signs. C. Remind the client that these are expected reactions to a blood transfusion. D. Discontinue the infusion and start an infusion of normal saline using new tubing.

D

Which nursing interventions are essential to perform when caring for a client with a severe anaphylactic reaction? Select all that apply. A. Administer oxygen B. Maintain a patent airway C. Administer prescribed IV fluids D. Monitor closely for hypotension E. Administer prescribed corticosteroids F. Educate the family on avoiding allergens

A, B, C, D, E

A client with a history of asthma comes to the emergency department complaining of itchy skin and shortness of breath after starting a new antibiotic. What is the first action the nurse would take? A. Place the client on 100% oxygen and prepare for intubation. B. Assess for anaphylaxis and prepare for emergency treatment. C. Teach the client about the relationship between asthma and allergies. D. Obtain an arterial blood gas and immunoglobulin E (IgE) blood level. Submit

B

Which clinical manifestation is most common in a client diagnosed with systemic lupus erythematosus (SLE)? Select all that apply. A. pruritus and burning skin pain B. presence of vesicles and bullae C. butterfly shaped facial rash D. fever over 100 F (37.7 C) E. swollen, painful joints

C, D, E

The community health nurse is conducting an educational session with community members regarding the signs and symptoms associated with tuberculosis. The nurse informs the participants that tuberculosis is considered as a diagnosis if which signs and symptoms are present? Select all that apply A. Dyspnea B. Headache C. Night sweats D. A bloody, productive cough E. A cough with the expectoration of mucoid sputum

A, C, D, E