MED SURG IMMUNE AND INFECTIOUS ATI
A nurse is collecting preoperative data from a client who is about to undergo a cholecystectomy. The nurse should identify a risk for latex allergy when the client reports an allergy to which of the following foods? A. Cabbage B. Oatmeal C. Milk D. Bananas
Bananas
A nurse is assisting with the care of a client who has systemic lupus erythematosus (SLE). The client asks the nurse, "What should I do to care for my dry skin?" Which of the following responses should the nurse make? A. "Keep the lesions covered with a light sterile dressing when going outdoors." B. "Rub lesions with a washcloth to dry after washing." C. "Apply lotion twice per day to dry skin." D. "Apply antibiotic cream twice per day to dry skin."
C. "Apply lotion twice per day to dry skin."
A nurse is reinforcing teaching with a client who has tuberculosis about a new prescription for rifampin. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take this medication with food." B. "I need to take a B-complex vitamin while taking this medication." C. "I can expect this medication to turn my skin orange." D. "I can expect this medication to make my vision blurry."
C. "I can expect this medication to turn my skin orange."
A nurse in a provider's office is reinforcing teaching with a client who has a recent diagnosis of rheumatoid arthritis and a new prescription for naproxen tablets. Which of the following statements by the client indicates that further teaching is needed? A. "Once I start this medication, it will take 4 weeks for me to notice relief in my joints" B. "I can take an antacid with this medication for indigestion" C. "I can take this medication with aspirin" D. "The naproxen goes down easier when I crush it and put it in applesauce"
C. "I can take this medication with aspirin"
A nurse is reinforcing teaching about foot care with a client who has diabetes mellitus. Which of the following pieces of information should the nurse include in the teaching? A. "Wear nylon socks with shoes." B. "Wear flip flops instead of going barefoot when you're outside" C. "Apply moisturizing cream between your toes." D. "Wash your feet daily lukewarm water and soap."
"Wash your feet daily using lukewarm water and soap."
A nurse is reinforcing dietary teaching with a client who has AIDs and stomatitis of the mouth. Which of the following instructions should the nurse include the teaching? A. "You can suck on popsicles to numb your mouth." B. "Season food with spices instead of salt." C. "Avoid the use of a straw to drink liquids" D. "Eat foods at hot temperatures"
"You can suck on popsicles to numb your mouth."
A nurse is working with an assistive personnel (AP) assigned to bathe a client who has herpes zoster. The AP asks the nurse if herpes zoster is contagious. Which of the following responses should the nurse make? A. "Adults receive a natural immunity to herpes zoster from casual exposure to children who have had chickenpox." B. "Herpes zoster is not contagious to individual who received an MMR vaccine as an infant." C. "A client who has herpes zoster is not contagious if blisters are present on the skin." D. "Herpes zoster is contagious to people who have never had chickenpox."
"Herpes zoster is contagious to people who have never had chickenpox."
A nurse is caring for a client who tests positive for human immunodeficiency virus (HIV). The client asks the nurse," Should I tell my partner that I am HIV positive?" Which of the following is an appropriate nurse response?" A. "That is your decision alone." B. "I would if I were you." C. It sounds like you are unsure what to say to your partner." D. "Your provider is required by law to notify your patner"
"It sounds like you are unsure what to say to your partner."
A nurse is collecting data from a 66 year old client during a routine physical examination at her first clinic visit. The client does not have her medical records. When the nurse asks if she has received the pneumococcal immunization, the client replies, " I am not sure, but it's been at least 5 years since I had any immunizations." Which of the following responses should the nurse make? A. "Just in case you had the immunization before, we can't give you another." B. "You'll need a series of 3 injections." C. "This immunization is unsafe for people over the age of 65 years old." D. "Let's go ahead with giving you this immunization."
"Let's go ahead with giving you this immunization."
A nurse is reinforcing teaching with a client who has AIDs about the transmission of Pneumocystis jiroveci pneumonia (PCP). Which of the following pieces of information should the nurse include in the teaching? A. "PCP is sextually transmitted from person to person" B. "You were most likely exposed to a contaminated surface such as a drinking glass." C. "PCP results from an impaired immune system" D. "You might have contracted PCP from a family pet."
"PCP results form an impaired immune system"
A nurse is reinforcing teaching with a client who is being treated for genital warts. Which of the following statements indicates that the client understands how to prevent transmission of his sexually transmitted infection (STI)? A. "I will bring in my sexual partner for treatment." B. "Now that I've had my first dose of medicine, I can resume sexual activity." C. "After I have been treated, I don't have to use condoms." D. "Once treatment is complete and I am free of symptoms, I don't have to return to the clinic."
A. "I will bring in my sexual partner for treatment."
A nurse is assisting with planning an educational program for a group of young adults about interventions that reduce the risk of cervical cancer. Which of the following interventions should the nurse include? A. Get the human papillomavirus (HPV) immunization B. Avoid the use of tampons on a routine basis C. Avoid drinking alcohol D. Get a Papanicolaou test every year starting at age 30
A. "Get the human papillomavirus (HPV) immunization
A home health nurse is contributing to the plan of care for a client who is receiving chemotherapy and has neutropenia. Which of the following foods should the nurse include in the client's plan of care? A. Soft boiled eggs B. Brie cheese made with unpasteurized milk C. Cold sandwiches made with deli meat D. Baked chicken
Baked chicken
A nurse is reinforcing teaching with a client who is HIV positive about the early manifestations of acquired immune deficiency syndrome (AIDS). Which of the following statements should the nurse include in the teaching? A. "You can expect a persistent fever and swollen glands." B. "You can expect an elevated white blood cell count." C. "You can expect an increase in blood pressure and edema." D. "You can expect weight gain."
A. "You can expect a persistent fever and swollen glands."
A nurse is reinforcing discharge teaching with a client who has HIV. Which of the following instructions about infection prevention should the nurse include in the teaching? A. Avoid large gatherings of people B. Clean the toothbrush by running through the dishwasher C. Change pet litter boxes with disposable gloves D. Consume fresh fruit and raw vegetables E. Avoid digging in the garden
A. Avoid large gatherings of people B. Clean the toothbrush by running through the dishwasher E. Avoid digging in the garden
A nurse is caring for a client who has a new diagnosis of acute systemic lupus erythematosus (SLE) and is scheduled to begin medication therapy. Which of the following types of medications should the nurse expect to administer? A. Corticosteroids B. Antihistamines C. Antivirals D. Opioids
A. Corticosteroids
A nurse is reinforcing teaching with a female client who has a new diagnosis of systemic lupus erythematosus (SLE) about factors that can trigger an exacerbation of SLE. The nurse should determine that the client requires further teaching when she identifies which of the following as a factor that can exacerbate SLE? A. Exercise B. Pregnancy C. Infection D. Sunlight
A. Exercise
A nurse is reinforcing teaching with an assistive personnel (AP) who is caring for a client with active pulmonary tuberculosis. The client has been placed an airborne precautions and is scheduled for a chest X-ray. Which of the following instructions should the nurse include in the teaching? A. Have the client wear a surgical mask B. Wear a gown for protection form the client's infection C. Ask the radiology staff to perform a portable chest X-ray in the client's room D. Place an N-95 respirator on the client
A. Have the client wear a surgical mask
nurse is reinforcing teaching with a client who has Raynaud's disease. Which of the following pieces of information should the nurse include in the teaching? A. Protect against the cold by wearing layers of clothing B. Begin an exercise program of 2-mile walks once per week C. Increase vitamin A in the diet D. Elevate the hands above heart lever when resting
A. Protect against the cold by wearing layers of clothing
A nurse in a clinic is collecting data from a client who was diagnosed with mononucleosis 2 weeks ago. Which of the following findings should the nurse report to the provider immediately? A. Headache and fatigue B. Swollen lymph nodes in the neck C. Abdominal pain in the left upper quadrant D. Fever and sore throat
Abdominal pain in the left upper quadrant
A nurse is reinforcing teaching with a client who has human immunodeficiency virus (HIV) about how the virus is transmitted. Which of the following statements should the nurse include the teaching? A. "HIV can be transmitted as soon as a person develops manifestations." B. "HIV can be transmitted to anyone who has had contact with infected blood." C. "HIV is transmitted through the respiratory route by droplets." D. "HIV is transmitted only during the active phase of the virus."
B. "HIV can be transmitted to anyone who has had contact with infected blood."
A nurse is reinforcing discharge teaching with the partner of a client who has acquired immune deficiency syndrome (AIDS). Which of the following statements by the client's partner indicates the need for further teaching? A. "I will dispose of soiled tissues in separate plastic bags." B. "I'll clean blood spills immediately with hot water." C. "I know that handwriting is an important preventive measure." D. "I will wash soiled clothes in hot water."
B. "I'll clean blood spills immediately with hot water."
A nurse is reinforcing discharge teaching with a client who has AIDS. Which of the following statements should the nurse include? A. "You can share razors with your partner as long as they are disposable." B. " You should clean bathroom surfaces with a bleach and water solution." C. "You should increase your intake of raw fruits and vegetables." D. "You can continue gardening as long as you wear a mask."
B. "You should clean bathroom surfaces with a bleach and water solution."
A nurse is assisting with the care of a client who is 2 days postoperative. Which of the following findings should alert the nurse that the client is developing an infection? A. Temperature 37.8 C (100 F) B. Erythema at the incision site C. WBC count 9,000/mm^3 D. Pain reported as 6 on a 0 to 10 pain-rating scale
B. Erythema at the incision site
A nurse is collecting data from a client who is experiencing an acute exacerbation of rheumatoid arthritis. The nurse should anticipate that the client's affected joints will require which of the following treatments? A. Assistive device to use when the client is ambulating B. Heat paraffin therapy applied to the client's hands C. Gentle massage of the client's joints D. Active range-of-motion exercises on the client's affected joints
B. Heat paraffin therapy applied to the client's hands
A nurse is caring for a male client who reports a thick urethral discharge. Which of the following actions should the nurse take? A. Contact the client's sexual partners B. Obtain a urethral specimen for culture C. Prepare to administer penicillin to the client D. Obtain blood for a rapid plasma reagin test
B. Obtain a urethral specimen for culture
A nurse is collecting data from a client who has systemic scleroderma. Which of the following findings should the nurse expect? A. Excessive salivation B. Skin tightening C. Periorbital edema D. Alopecia
B. Skin tightening
A nurse is evaluating the injection site for a client who had a Mantoux skin test 48 hours ago. The nurse finds 10 mm of induration with slight redness. Which of the following conclusions should the nurse make? A. The client has active tuberculosis B. The client has been exposed to tuberculosis C. The nurse must re-evaluate the result in 24 hours D. The test is negative for tuberculosis
B. The client has been exposed to tuberculosis
A nurse is reinforcing teaching with a client who has a recent diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following statements by the client indicates an understanding of the teaching? A. "I should limit my exposure to sunlight." B. "I should avoid drinking alcohol." C. I should not smoke." D. "I should my limit of intake of foods that are high in purine."
C. "I should not smoke."
A nurse is reinforcing teaching with a client who tested positive for a dust allergy about reducing her exposure to this allergen. The nurse should determine that the client understands these instructions when she states which of the following? A. "I will begin vacuuming once per week." B. "Carpeting my entire house will be very expensive, but it will be worth it." C. "I will install an electrostatic filter in my furnace." D. "Installing curtains on the windows will help control the dust in the house."
C. "I will install an electrostatic filter in my furnace."
A nurse is reinforcing discharge teaching about foot care with a client who has diabetic neuropathy. Which of the following statements by the client demonstrates an understanding of the teaching? A. "I can use a heating pad on my feet to keep them warm." B. "I can go barefoot as long as I stay inside the house" C. "I will wash my feet daily and apply lotion, except between my toes." D. "I will trim my toenails every morning, rounding the corners."
C. "I will wash my feet daily and apply lotion, except between my toes."
A nurse is assisting with the care of a client who has human immunodeficiency virus (HIV). Which of the following types of isolation should implement to prevent the transmission of HIV? A. Protective isolation B. Droplet precautions C. Standard precautions D. Airborne precautions
C. Standard precautions
A nurse is collecting data from a client who has an exacerbation of herpes zoster. Which of the following manifestations of the client's skin should the nurse expect to see? A. Confluent, honey-colored, crusted lesions B. Large tender nodule located on a hair follicle C. Unilateral, localized, nodular skin lesions D. Fluid-filled vesicular rash in the genital region
C. Unilateral, localized, nodular skin lesions
A nurse is caring for a client with Clostridium difficile who has contact isolations precautions in place. Which of the following actions should the nurse take? A. Instruct visitors to maintain a distance of at lever 1 m (3 feet) from the client B. Wash hands with antimicrobial soap after leaving the client's room C. Use dedicated equipment for the client D. Keep the doors to the client's room closed at all times
C. Use dedicated equipment for the client
A nurse is reinforcing teaching with a client who has a diagnosis of hepatitis A. Which of the following statements by the client indicates an understanding of the teaching? A. "I am unable to donate blood." B. "I will need to get a booster shot of immune serum globulin every year." C. Use dedicated equipment for the client D. "I can get this diseases by getting a tattoo."
C. Use dedicated equipment for the client
A nurse is reinforcing teaching with a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse plan to include in the teaching? A. "Avoid the use of any NSAIDs." B. "Stop taking the corticosteroids when your symptoms resolve." C. "Exposure to ultraviolet light will help control the skin rashes." D. "Monitor your body temperature and report any elevations promptly."
D. "Monitor your body temperature and report any elevations promptly."
A nurse is collecting data from a client who is concerned about the possibility contracting Lyme diseases after being bitten by a tick. For which of the following early manifestations of Lyme diseases should the nurse monitor the client? A. A diffuse maculopapular rash B. Stiff, swollen, painful, joints C. Double vision D. A progressive circular rash
D. A progressive circular rash
A nurse is contributing to the plan of care for a client with AIDS who has developed stomatitis. Which of the following interventions should the nurse recommend for the plan of care? A. Rinse the mouth with chlorhexidine solution every 2 hours B. Limit fluid intake with meals C. Provide oral hygiene with a firm-bristled toothbrush after each meal D. Avoid salty foods
D. Avoid salty foods
A nurse is caring for a client who is suspected to have tuberculosis. Which of the following findings should the nurse expect? A. Recent weight gain B. High fever C. Rhinitis D. Blood -streaked sputum
D. Blood-streaked sputum
A nurse is reinforcing teaching with a client who has genital herpes about self-management. Which of the following instructions should the nurse include in the teaching? A. Use an alcohol-based soap to clean lesions B. Wear a condom during sexual activity when lesions are present C. Take a sitz bath once a day D. Pour running water over the lesions when urinating
D. Pour running water over the lesions when urinating
A nurse is planning care for a client. Which of the following interventions should the nurse include in the plan? A. Advance diet to soft B. Perform active and passive range-of-motion (ROM) exercises twice daily C. Apply compression garments 23 hr daily D. Restrict visitors
D. Restrict visitors
A nurse is preparing to administer a Mantoux skin test to a client. What is the purpose of a Mantoux skin test using purified protein derivative (PPD)? A. To identify whether a client lacks immunity to tuberculosis B. To find out if a client has active tuberculosis C. To decreases the hypersensitivity of the client's reaction to PPD D. To identify whether a client has been infected with Mycobacterium tuberculosis
D. To identify whether a client has been infected with Mycobacterium tuberculosis
A nurse is reviewing the laboratory data of a client who reports manifestations that suggest systemic lupus erythematosus (SLE). The nurse should expect an increase in which of the following parameters for a client who has SLE? A. Platelet count B. RBC counts C. Hct D. Erythrocyte sedimentation ratee (ESR)
Erythrocyte sedimentation rate (ESR)
A nurse is reinforcing teaching with a client about preventing the transmission of hepatitis A. The nurse should identify that hepatitis A is transmitted by which of the following routines? A. Maternal fetal B. Fecal oral contamination C. Genital sexual contact D. Blood to Blood
Fecal oral contamination
A nurse is reinforcing discharge teaching with a client who has a new diagnosis of systemic lupus erythematosus (SLE). Which of the following statements by the client indicates an understanding of the teaching? A. "I should take ibuprofen for my joint pain" B. "I'm thankful that this type of lupus only affects the skin" C. "Each day i should apply a sunblock with a sun protector factor of 15" D. " A mild fever is common with SLE and usually does not require medical intervention"
I should take ibuprofen for my joint pain
A nurse is collecting data from a client who had radioallergosorbent (RAST) testing completed due to seasonal allergies. The nurse should should anticipate an elevation in which of the following laboratory values? A. IgM (immunoglobulin M) B. IgA (immunoglobulin A) C. IgG (immunoglobulin G) D. IgE (immunoglobulin E)
IgE (immunoglobulin E)
A nurse is reinforcing teaching with a client about the manifestations of an allergic reaction. The nurse should explain that the release of histamine causes which of the following reactions? A. Increased mucus secretion B. Bronchial dilation C. Bradycardia D. Vertigo
Increased mucus secretion
A nurse is reinforcing teaching with a client who has systemic lupus erythematosus and a new prescription for prednisone. The nurse should instruct the client to monitor for which of the following findings as an adverse effect of this medications? A. Hypoglycemia B. Tendinitis C. Infection D. Weight loss
Infection
A nurse is assisting with the admission of a client who has manifestations of tuberculosis. Which of the following actions is the nurse's priority? A. Initiate airborne precautions B. Administer antimicrobial therapy C. Tell the client that his infection will be communicable for 2 to 8 weeks after the start of medication therapy D. Reinforce teaching about the manifestations of tuberculosis
Initiate airborne precautions
A nurse is caring for a client who has pseudomembranous colitis due to clostridium difficile infection. Which of the following interventions is the nurse's priority? A. Performing hand hygiene before and after contact with the client B. Reducing the client's anxiety due to isolation procedures C. Assisting the client with making nutritional choices D. Monitoring the client's intake and output
Performing hand hygiene before and after contact with the client
A nurse is collecting data from a client who has Kaposi sarcoma. Which of the following findings should the nurse expect with this condition? A. Nonproductive cough with a fever and shortness of breath B. Lesions on the retina that produce blurred vision C. Onset of progressive dementia D. Reddish purple skin lesions
Reddish-purple skin lesions
A nurse is reviewing the laboratory test results of a client who reports bilateral pain and swelling in her finger joints, with stiffness in the morning. The nurse should recognize that an increase in which of the following laboratory values can indicate arthritis? A. Reticulocyte count B. Rheumatoid factor C. Direct coombs' test D. Platelet count
Rheumatoid factor
A nurse is reinforcing dietary teaching with a client who has AIDS. Which of the following instructions should the nurse include in the teaching? A. Discard leftovers after 8 hours B. Use a separate cutting board for cutting poultry C. Thaw frozen foods at room temperature D. Store cold foods at 10 C (50 F) or less
Use a separate cutting board for cutting poultry
A nurse is reinforcing teaching with a client who has AIDs about preventing infection while at home. Which of the following instructions should the nurse include in the teaching? A. Wash genitalia using an antimicrobial soap B. Rinse dishes with cold water C. Clean toothbrush once per month D. Incorporate raw fruits and vegetables into the diet
Wash genitalia using an antimicrobial soap