Medsurg CAQ #7

A nurse is caring for a client with pruritic lesions from an IgE-mediated hypersensitivity reaction. Which mediator of injury is involved? 1 Histamine 2 Cytokine 3 Neutrophil 4 Macrophage

1

What is the most commonly reported sexually transmitted infection (STI)? 1 Syphilis 2 Chlamydia 3 Gonorrhea 4 Herpes simplex

2

Which organs are affected by Candida albicans? Select all that apply. 1 Ears 2 Lungs 3 Vagina 4 Mouth 5 Intestines

3, 4, 5

Which virus can cause encephalitis in adults and children? 1 Rubella virus 2 Parvovirus 3 Rotaviruses 4 West Nile virus

4

Which virus is responsible for causing infectious mononucleosis in clients? 1 Parvovirus 2 Coronavirus 3 Rotavirus 4 Epstein-Barr virus

4

Which immunoglobulin crosses the placenta? 1 IgE 2 IgA 3 IgG 4 IgM

3

Which cells are affected in DiGeorge syndrome? 1 T-cells 2 B-cells 3 Monocytes 4 Polymorphonuclear cells

1

Which autoimmune disease affects the central nervous system? 1 Uveitis 2 Celiac disease 3 Multiple sclerosis 4 Goodpasture syndrome

3

Which is a leukotriene modifier used to manage and prevent allergic rhinitis? 1 Zileuton 2 Ephedrine 3 Scopolamine 4 Cromolyn sodium

1

What are the symptoms of tuberculosis? Select all that apply. 1 Fatigue 2 Nausea 3 Weight gain 4 Low-grade fever 5 Increased appetite

1, 2, 4

Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply. 1 Dyspnea 2 Dry cough 3 Diaphoresis 4 Mild chest pain 5 High temperature

1, 3, 5

A mother with the diagnosis of acquired immunodeficiency syndrome (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine? 1 If she has kissed the baby 2 If the baby is breast-feeding 3 When the baby last received antibiotics 4 How long she has been caring for the baby

2

Why would a client with acquired immunodeficiency syndrome (AIDS) be administered pregabalin? 1 To reduce neuropathic pain 2 To reduce cognitive difficulty 3 To reduce swallowing difficulty 4 To reduce muscle and joint pain

1

Which conditions in clients are examples of cell-mediated immunity? Select all that apply. 1 Tuberculosis 2 Graft rejection 3 Allergic rhinitis 4 Contact dermatitis 5 Anaphylactic shock

1, 2, 4

A client has a body temperature of 102.8° F along with chills; dysuria; urethral discharge; and a boggy, tender prostate. Which organism is responsible for this condition? 1 Escherichia coli 2 Candida albicans 3 Trichomonas vaginalis 4 Condylomata acuminate

1

The nurse suspects that a client with inhalation anthrax is in the fulminant stage of the disease. Which symptom supports the nurse's conclusion? 1 Fever 2 Dry cough 3 Hematemesis 4 Mild chest pain

3

Which type of hypersensitivity reaction is present in a client with a body temperature of 102 °F, severe joint pain, rashes on the extremities, and enlarged lymph nodes from serum sickness? 1 Delayed reaction 2 Cytotoxic reaction 3 Immediate reaction 4 Immune complex-mediated reaction

4

Which type of hepatitis virus spreads through contaminated food and water? 1 Hepatitis A virus 2 Hepatitis B virus 3 Hepatitis C virus 4 Hepatitis D virus

1

Which drug can be administered via the intramuscular route to treat anaphylaxis? 1 Epinephrine 2 Methdilazine 3 Phenylephrine 4 Mycophenolate mofetil

1

Which diseases may occur due to rickettsial infections? Select all that apply. 1 Leprosy 2 Lyme disease 3 Typhoid fever 4 West Nile fever 5 Rocky Mountain spotted fever

3, 5

A client expresses concern that because of supply and demand there is no vaccine available for the annual flu vaccine. What is the nurse's best reply? 1 "It's unfortunate, but there was such a limited supply available." 2 "There are many others who also were unable to get a flu vaccine." 3 "It doesn't matter because the vaccine is for just one particular strain." 4 "There are other things you can do to prevent the flu, such as hand washing."

4

The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). What does the nurse expect to find? 1 A decrease in CD4 T cells 2 An increase in thymic hormones 3 An increase in immunoglobulin E 4 A decrease in the serum level of glucose-6-phosphate dehydrogenase

1

Which autoantigens are responsible for the development of Crohn's disease? 1 Crypt epithelial cells 2 Thyroid cell surface 3 Basement membranes of the lungs 4 Basement membranes of the glomeruli

1

Which bacteria colonies are commonly found in a client's large intestine? 1 Escherichia coli 2 Neisseria gonorrhoeae 3 Staphylococcus aureus 4 Haemophilus influenzae

1

Which sexually transmitted infection is caused by Chlamydia trachomatis? 1 Cervicitis 2 Gonorrhea 3 Genital warts 4 Genital herpes

1

Which skin infection is caused by bacteria? 1 Folliculitis 2 Candidiasis 3 Herpes zoster 4 Dermatophytosis

1

Which organism is responsible for the condition illustrated in the image? 3156449191 1 Candida albicans 2 Epstein-Barr virus 3 Toxoplasma gondii 4 Human herpes virus-8

4

Which sexually transmitted disease is caused by the human papilloma virus? 1 Gonorrhea 2 Genital herpes 3 Chlamydia infection 4 Condylomata acuminata

4

What are the symptoms of tuberculosis? Select all that apply. 1 Diarrhea 2 Anorexia 3 Weight gain 4 Hemoptysis 5 Night sweats

2, 4, 5

Which diseases can be transmitted by air? Select all that apply. 1 Scabies 2 Measles 3 Pediculosis 4 Chicken pox 5 Tuberculosis

2, 4, 5

A nurse is educating a client with human immunodeficiency virus (HIV) about self-management. Which suggestion by the nurse benefits the client? 1 "Limit your daily fluid intake." 2 "Eat more roughage." 3 "Rinse your mouth with normal saline after every meal." 4 "Maintain a 4-to-5-hour gap in between meals."

3

Which dietary changes does the nurse suggest for a client who has diarrhea associated with human immunodeficiency virus (HIV disease)? Select all that apply. 1 "Eat more fatty food." 2 "Eat much less roughage." 3 "Drink two cups of coffee daily." 4 "Eat more spicy and sweet food." 5 "Drink plenty of fluids between meals."

2, 5

Which sexually transmitted disease is treated with antiviral drugs? 1 Syphilis 2 Gonorrhea 3 Genital herpes 4 Chlamydial infection

3

A client who underwent chemotherapy has leukopenia. Which instruction from the nurse will be beneficial for the client? 1 "You should avoid exposure to the sun." 2 "You should eat high-fiber foods and increase fluid intake." 3 "You should avoid large crowds and people with infections." 4 "You should consume iron supplements and erythropoietin."

3

Which antimicrobial medication acts on susceptible pathogens by inhibiting nucleic acid synthesis? 1 Penicillin 2 Actinomycin 3 Erythromycin 4 Cephalosporin

2

Which autoimmune disease is directly related to the client's central nervous system? 1 Rheumatic fever 2 Multiple sclerosis 3 Myasthenia gravis 4 Goodpasture syndrome

2

Which complication will the nurse suspect in a client with genital herpes disease? 1 Infertility 2 Cold sores 3 Reactive arthritis 4 Bartholin's abscess

2

Which cytokine stimulates the liver to produce fibrinogen and protein C? 1 Interleukin-1 2 Interleukin-6 3 Thrombopoietin 4 Tumor necrosis factor

2

Which disease is caused by Escherichia coli? 1 Tetanus 2 Peritonitis 3 Diphtheria 4 Food poisoning

2

Which hypersensitivity reaction may occur in a newborn with hemolytic disease? 1 Type I 2 Type II 3 Type III 4 Type IV

2

A client has been admitted to the hospital with a diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) in the urine. The client has a urinary catheter in place. No private rooms are available. Which room assignment would be most appropriate for this client? 1 Roommate has a urinary catheter. 2 Roommate is bedridden and uses a bedpan for urination. 3 Roommate has MRSA in the urine. The roommate is ambulatory, but confused. 4 Roommate is alert and oriented with a diagnosis of pneumonia but practices good hygiene when using the bathroom.

3

What is the most effective strategy for preventing the transmission of infection? 1 Wearing gloves and a gown 2 Applying face mask and a gown 3 Applying a face mask and gloves 4 Wearing gloves and hand hygiene

4

A primary healthcare provider has prescribed isoniazid to a client with tuberculosis. Which instruction by the nurse will be most beneficial to the client? 1 "You should take the drug on an empty stomach." 2 "Your soft contact lenses will be stained permanently." 3 "You must use an additional method of contraception." 4 "You need to drink at least 8 ounces of water with the medication."

1

A nurse employed in an outpatient radiology department is reviewing safety precautions with staff members. What explanation does the nurse provide to explain the reason radium is stored in lead containers? 1 Lead functions as a barrier. 2 Radium is a heavy substance. 3 Heat is produced as radium disintegrates. 4 Lead prevents disintegration of the radium.

1

A nurse is caring for a client who is human immunodeficiency virus (HIV) positive. Which complication associated with this diagnosis is most important for the nurse to teach prevention strategies? 1 Infection 2 Depression 3 Social isolation 4 Kaposi sarcoma

1

A client with bubonic plague has a body temperature of 103° F associated with chills, swollen glands, headache, and weakness. Which microorganism is most likely responsible for the client's condition? 1 Yersinia pestis 2 Bordetella pertusis 3 Mycobacterium tuberculosis 4 Corynebacterium diphtheria

1

Which are examples of a type IV hypersensitivity reaction? Select all that apply. 1 Poison ivy allergic reaction 2 Sarcoidosis 3 Myasthenia gravis 4 Rheumatoid arthritis 5 Systemic lupus erythematosus

1, 2

Which throat manifestations are the key features for a client with acute viral pharyngitis? Select all that apply. 1 Petechiae on the soft palate 2 Scant or no tonsillar exudate 3 Slight erythema of the pharynx and tonsils 4 Severe hyperemia of the pharyngeal mucosa 5 Erythema of the tonsils with yellow exudates

2, 3

The echoviruses can cause which diseases in clients? Select all that apply. 1 Parotitis 2 Gastroenteritis 3 Mononucleosis 4 Aseptic meningitis 5 Burkitt's lymphoma

2, 4

What criteria should the nurse consider when determining if an infection should be categorized as a health care-associated infection? 1 Originated primarily from an exogenous source 2 Is associated with a drug-resistant microorganism 3 Occurred in conjunction with treatment for an illness 4 Still has the infection despite completing the prescribed therapy

3

What is a manifestation of tertiary syphilis? 1 Chancre 2 Alopecia 3 Gummas 4 Condylomata lata

3

The bacteria Clostridium botulinum causes which condition in a client? 1 Upper respiratory tract infection 2 Toxic shock syndrome 3 Urinary tract infection 4 Food poisoning with progressive muscle paralysis

4

What causes condylomata acuminate? 1 Chlamydia 2 Gonorrhea 3 Herpes simplex 4 Human papillomavirus (HPV)

4

What does the nurse explain to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is based on? 1 Performance of high-risk sexual behaviors 2 Evidence of extreme weight loss and high fever 3 Identification of an associated opportunistic infection 4 Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests

4

A client with an upper respiratory infection asks the nurse why the health care provider did not prescribe an antibiotic. What would be the best response from the nurse? 1 "I don't know. I will ask the health care provider for a prescription." 2 "Antibiotics are used to treat viruses and you have a bacterial infection." 3 "Antibiotics are ineffective for treating the bacteria that cause upper respiratory infections." 4 "Upper respiratory infections generally are caused by viruses and therefore should not be treated with antibiotics."

4

Which medication is beneficial for a client with pertussis? 1 Antibiotics 2 Antihistamines 3 Corticosteroids 4 Bronchodilators

1

Which organism is responsible for causing dermatitis related to a sexually transmitted infection? 1 Phthirus pubis 2 Candida albicans 3 Campylobacter jejuni 4 Ureaplasma urealyticum

1

The nurse suspects that a client is in the chronic persistent stage of Lyme disease. Which symptoms support the nurse's suspicion? Select all that apply. 1 Arthritis 2 Dyspnea 3 Dizziness 4 Chronic fatigue 5 Erythema migrans

1, 4

What are the clinical manifestations during the fulminant stage in a client with inhalation anthrax? Select all that apply. 1 Septic shock 2 Harsh cough 3 Mild chest pain 4 Pleural effusion 5 Body temperature of 104 °F

1, 4, 5

A client with erythematous papules in the interdigital spaces reports severe itching at night. Which insect is responsible for this condition? 1 Phthirus pubis 2 Sarcoptes scabiei 3 Pediculus humanus 4 Borrelia burgdorferi

2

The nurse is counseling a client infected with human immunodeficiency virus (HIV) regarding prevention of HIV transmission. Which statement by the client indicates the nurse needs to follow up? 1 "I should abstain from sexual activity." 2 "I can safely have anal sex without any barriers." 3 "I should get HIV counseling if planning for pregnancy." 4 "I will use condoms while having sexual intercourse."

2

Which organism causes malaria? 1 Vibrio 2 Sporozoa 3 Ringworm 4 Spirochetes

2

Which term describes the practice of placing clients with the same infection in a semi-private room? 1 Isolating 2 Cohorting 3 Colonizing 4 Cross-referencing

2

Which type of immunoglobulin is present in tears, saliva, and breast milk? 1 IgE 2 IgA 3 IgG 4 IgM

2

Which body system should the nurse focus on when assessing a client with suspected Goodpasture's syndrome? 1 Renal 2 Neurologic 3 Cardiovascular 4 Musculoskeletal

1

Which cytokine is used to treat multiple sclerosis? 1 β-Interferon 2 Interleukin-2 3 Erythropoietin 4 Colony-stimulating factor

1

Which cytokine medication is administered to treat chemotherapy-induced neutropenia? 1 Filgrastim 2 Oprelvekin 3 Aldesleukin 4 Darbepoetin alfa

1

Which diseased condition associated with the client's heart is an example of an autoimmune disease? 1 Uveitis 2 Rheumatic fever 3 Myasthenia gravis 4 Graves' disease

2

Which is the first medication approved to reduce the risk of human immunodeficiency virus (HIV) infection in unaffected individuals? 1 Truvada 2 Abacavir 3 Cromolyn 4 Methdilazine

1

Which is the most common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? 1 Oropharyngeal candidiasis 2 Cryptosporidiosis 3 Toxoplasmosis encephalitis 4 Pneumocystis jiroveci pneumonia

1

Which malnutrition condition may predispose a client to secondary immunodeficiency? 1 Cachexia 2 Cirrhosis 3 Diabetes mellitus 4 Hodgkin's lymphoma

1

Which sexually transmitted infection (STI) is caused by Treponema pallidum? 1 Syphilis 2 Gonorrhea 3 Genital warts 4 Vulvovaginitis

1

Which type of continuing care should a client expect if discharged home with an infusion device to continue treatment for a leg wound? 1 Home care 2 Rehabilitation 3 Skilled nursing care 4 Outpatient therapy

1

Why should the nurse instruct a client to discuss the use of over-the-counter decongestants with a healthcare provider before taking them? 1 Can cause nasal dryness 2 Can cause urinary retention 3 May cause blood pressure to decrease 4 May reduce the need for glaucoma medication

2

What functions of leukocytes are involved in inflammation? Select all that apply. 1 Destruction of bacteria and cellular debris 2 Selective attack and destruction of non-self cells 3 Release of vasoactive amines during allergic reactions 4 Secretion of immunoglobulins in response to a specific antigen 5 Enhancement of immune activity through secretion of various factors, cytokines, and lymphokines

1, 3

Which conditions result in humoral immunity? Select all that apply. 1 Tuberculosis 2 Atopic diseases 3 Bacterial infection 4 Anaphylactic shock 5 Contact dermatitis

2, 3, 4

A nurse is teaching a client about human immunodeficiency virus (HIV). What are the various ways HIV is transmitted? Select all that apply. 1 Mosquito bites 2 Sharing syringe needles 3 Breastfeeding a newborn 4 Dry kissing the infected partner 5 Anal intercourse

2, 3, 5

What are the mediators of injury in IgE-mediated hypersensitivity reactions? Select all that apply. 1 Cytokines 2 Mast cells 3 Histamines 4 Neutrophils 5 Leukotrienes

2, 3, 5

Which leukocytes should the nurse include when teaching about antibody-mediated immunity? Select all that apply. 1 Monocyte 2 Memory cell 3 Helper T cell 4 B-lymphocyte 5 Cytotoxic T cell

2, 4

While assessing a client with acquired immunodeficiency syndrome, the nurse suspects that the client has developed cryptosporidiosis. Which symptoms support the nurse's suspicion? Select all that apply. 1 Seizures 2 Diarrhea 3 Confusion 4 Weight loss 5 Blurred vision

2, 4

Which medication should the nurse anticipate being prescribed for a client with C. difficile-associated disease (CDAD)? Select all that apply. 1 Penicillin 2 Fidaxomicin Ciprofloxacin 3 Ciprofloxacin 4 Metronidazole 5 Vancomycin

2, 4, 5

Which medications are administered to inhibit purine synthesis and suppress cell-mediated and humoral immune responses? Select all that apply. 1 Sirolimus 2 Azathioprine 3 Cyclophosphamide 4 Methylprednisolone 5 Mycophenolate mofetil

2, 5

A client with tuberculosis is prescribed rifampin. What does the nurse teach the client about this medication? Select all that apply. 1 "Avoid drinking alcohol while you are on this drug." 2 "Report immediately if you find a yellow appearance to the skin." 3 "Wear a protective clothing and sunscreen when going out in sunlight." 4 "Your soft contact lenses will become permanently stained with this drug." 5 "Immediately consult your physician if you find reddish orange tinge in your urine."

1, 2, 4

What should the nurse identify as responses to the release of histamine during a type I rapid hypersensitivity reaction? Select all that apply. 1 Pruritus 2 Erythema 3 Fibrotic changes 4 Nasal mucus secretion 5 Conjunctival mucus secretion

1, 2, 4, 5

Which leukocyte values should be assessed to determine the adequacy of a client's response to inflammation? Select all that apply. 1 Monocytes 2 Neutrophils 3 Plasma cells 4 T-helper cells 5 Macrophages

1, 2, 5

Which medications are useful to treat psoriasis? Select all that apply. 1 Psoralen 2 Anthralin 3 Isotretinoin 4 Clindamycin 5 Calcipotriene

1, 2, 5

A nurse is teaching a health class about human immunodeficiency virus (HIV). Which basic methods are used to reduce the incidence of HIV transmission? Select all that apply. 1 Using condoms 2 Using separate toilets 3 Practicing sexual abstinence 4 Preventing direct casual contacts 5 Sterilizing the household utensils

1, 3

What is an example of a type I hypersensitivity reaction? 1 Anaphylaxis 2 Serum sickness 3 Contact dermatitis 4 Blood transfusion reaction

1

What is the causative organism for syphilis? 1 Treponema pallidum 2 Campylobacter jejuni 3 Trichomonas vaginalis 4 Chlamydia trachomatis

1

Which type of hypersensitivity reaction will occur when the client's T cytotoxic cells are involved as the mediators of injury? 1 Type I 2 Type II 3 Type III 4 Type IV

4

Which skin infection is illustrated in the image? 3203037619 1 Scabies 2 Pediculosis 3 Herpes zoster 4 Cutaneous anthrax

4

What is a common characteristic of Sjögren's syndrome (SS)? 1 Dry eyes 2 Muscle cramping 3 Urinary tract infection 4 Elevated blood pressure

1

A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action? 1 Applying cold compresses to the affected area 2 Ensuring the client keeps the skin clean and dry 3 Monitoring for neurological and cardiac symptoms 4 Advising the client to launder all clothes with bleach

1

A nurse discusses the potential for cross-contamination with the nursing assistants on a surgical unit. What does the nurse explain that standard precautions are designed to do? 1 Decrease the risk of transmitting unidentified pathogens 2 Be used when clients are suspected of having a communicable disease 3 Ensure that hygiene practices by clients are performed in a universal way 4 Create categories in which certain additional precautions must be followed

1

A nurse is caring for a client with a negative-pressure wound treatment device. What should the nurse explain to the client about how this system helps prevent a wound infection? 1 Removes excess fluid 2 Prevents gas exchange 3 Promotes local circulation 4 Increases the growth of granulation tissue

1

A nurse is caring for a client with acquired immunodeficiency syndrome (AIDS). What precautions should the nurse take when caring for this client? 1 Use standard precautions. 2 Employ airborne precautions. 3 Plan interventions to limit direct contact. 4 Discourage long visits from family members.

1

A client with tuberculosis is prescribed isoniazid. What statements should the nurse tell the client? Select all that apply. 1 "Take the drug on an empty stomach." 2 "Report any changes in vision to your primary healthcare physician." 3 "Take daily multiple vitamins that contain B-complex." 4 "Wear protective clothing when going outdoors during the day." 5 "Report darkening of the urine or a yellowish skin discoloration."

1, 3, 5

Which statements indicate a nurse has a correct understanding of interleukin-2? Select all that apply. 1 It enhances natural killer cells. 2 It produces an antiviral effect. 3 It is used to treat various malignancies. 4 It is used as an anti-inflammatory agent. 5 It stimulates differentiation of T-lymphocytes.

1, 3, 5

A client undergoing tuberculosis therapy reports eye pain that worsens when moving the eyes with decreased color vision. Which medication most likely is responsible for the client's condition? 1 Rifampin 2 Isoniazid 3 Ethambutol 4 Pyrazinamide

3

A hospitalized client is on contact precautions for methicillin-resistant Staphylococcus aureus (MRSA). Which statement by an unlicensed assistive personnel (UAP) (Canada: continuing care assistant, CCA) indicates a need for further teaching? 1 "I will put on gloves and a gown before entering the room." 2 "I will wash my hands before entering and leaving the room." 3 "I will remove the gown, then the gloves, before washing my hands." 4 "I will leave a thermometer, blood pressure cuff, and stethoscope in the room for use for this client only."

3

An older client with a history of congestive heart failure expresses concern about potential exposure to tuberculosis. The client states that a roommate at the extended care facility where the client resides sleeps a lot, coughs a great deal, and sometimes spits up blood. What is the primary reason that the nurse pursues more information about the roommate? 1 Death from tuberculosis is on the increase 2 The roommate is causing the client to be anxious 3 Older adults with chronic illness are affected adversely by tuberculosis 4 The roommate most likely is preventing the client from getting proper sleep

3

During an acquired immunodeficiency syndrome (AIDS) education class a client states, "Vaseline works great when I use condoms." Which conclusion about the client's knowledge of condom use can the nurse draw from this statement? 1 An understanding of safer sex 2 An ability to assume self-responsibility 3 Ignorance related to correct condom use 4 Ignorance concerning the transmission of human immunodeficiency virus (HIV)

3

The primary health care provider prescribes contact precautions for a client with hepatitis A. What nursing interventions are required for contact precautions? 1 Private room with the door closed 2 Gown, mask, and gloves for all persons entering the room 3 Gown and gloves when handling articles contaminated by urine or feces 4 Gowns and gloves only when handling the client's soiled linen, dishes, or utensils

3

The nurse suspects that a client with inhalation anthrax is in the prodromal stage of disease. Which symptoms support the nurse's conclusion? Select all that apply. 1 Hypoxia 2 Cyanosis 3 Dry cough 4 Hypotension 5 Mild chest pain

3, 5

A child is diagnosed with hepatitis A. The client's parent expresses concern that the other members of the family may get hepatitis because they all share the same bathroom. What is the nurse's best reply? 1 "I suggest that you buy a commode exclusively for your child's use." 2 "Your child may use the bathroom, but you need to use disposable toilet covers." 3 "You will need to clean the bathroom from top to bottom every time a family member uses it." 4 "All family members, including your child, need to wash their hands after using the bathroom."

4

A nurse is planning to provide discharge teaching to the family of a client with acquired immunodeficiency syndrome (AIDS). Which statement should the nurse include in the teaching plan? 1 "Wash used dishes in hot, soapy water." 2 "Let dishes soak in hot water for 24 hours before washing." 3 "You should boil the client's dishes for 30 minutes after use." 4 "Have the client eat from paper plates so they can be discarded."

1

The laboratory results of a client with a pulmonary hemorrhage and glomerulonephritis reveal the presence of IgG antibodies. Which type of hypersensitivity reaction should a nurse suspect? 1 Cytotoxic reaction 2 Immediate reaction 3 Immune-complex reaction 4 Delayed hypersensitivity reaction

1

The nurse is caring for a client with human immunodeficiency virus (HIV) infection. Which clinical manifestations in the client should be immediately reported to the primary healthcare provider? 1 Blood in the urine 2 New or productive cough 3 Vomiting accompanied by fever 4 Burning, itching, and discharge from the eyes

1

The nurse is educating a client about protease inhibitors. What statement about protease inhibitors is true? 1 Protease inhibitors prevent viral replication. 2 Protease inhibitors prevent the interaction between viral material and the CD4+ T-cell. 3 Protease inhibitors prevent viral and host genetic material integration. 4 Protease inhibitors prevent the clipping of the viral strands into small functional pieces.

1

Which age-related effects on the immune system are seen in the older client? 1 Increased autoantibodies 2 Increased expression of IL-2 receptors 3 Increased delayed hypersensitivity reaction 4 Increased primary and secondary antibody responses

1

Which drug treats hay fever by preventing leukotriene synthesis? 1 Zileuton 2 Cromolyn sodium 3 Chlorpheniramine 4 Diphenhydramine

1

A client presents with cutaneous lesions with swelling in the face, eyelids, and lips from dilation and engorgement of the capillaries. No welts or vesicles are observed. Which condition most likely has occurred in the client? 1 Urticaria 2 Angioedema 3 Atopic dermatitis 4 Systemic lupus erythematosus (SLE)

2

A client with rheumatoid arthritis is receiving etanercept therapy. Which instruction should the nurse share with the client? 1 Report chest pain 2 Report site reaction 3 Report blurry vision 4 Report difficulty in breathing during infusion

2

A registered nurse is educating a client with acquired immune deficiency syndrome about safe sexual practices. Which statement made by the client indicates a need for further education? 1 "I should use a dental dam during oral sex." 2 "I can participate in anal intercourse safely without using condoms." 3 "I should ask my partner to use a female condom while engaging in sexual activity." 4 "I should use condoms even while receiving highly active antiretroviral therapy (HAART)."

2

The nurse notes that a client is not adhering to prescribed antibiotic therapy. Which reason should the nurse document? 1 "I skipped some doses because I don't like to take pills." 2 "I left my pills in the bedroom and I forgot to take them with breakfast." 3 "I saw on television what the side effects are and decided to not take the pills." 4 "I had to choose between getting my prescription filled and paying the heating bill."

2

Which organism is responsible for causing Lyme disease in clients? 1 Phthirus pubis 2 Sarcoptes scabiei 3 Borrelia burgdorferi 4 Pediculushumanus var. corporis

3

What steps would the nurse take to manage a client's botulism infection? Select all that apply. 1 Reduce food and water supply for rodents 2 Wound cleansing and management of lesions 3 Planning for nutrition and rehabilitation support 4 Disposal of suspected contaminated food source 5 Standard, contact, and airborne precautions for the client

3, 4

A client in the gynecology unit has edema and a sore throat. Upon assessment, a nurse finds that the client has a body temperature of 101° F and a blood pressure reading of 80/60 mmHg. Which condition would the nurse suspect? 1 Cervicitis 2 Vulvovaginitis 3 Genital herpes 4 Toxic shock syndrome (TSS)

4

A client reports disturbed sleep due to itching caused by an allergy. Which medication would be prescribed to help the client sleep well and treat the allergic symptoms? 1 Cetirizine 2 Fexofenadine 3 Desloratadine 4 Chlorpheniramine

4

A client with acquired immunodeficiency syndrome (AIDS) reports painless, white, raised lesions on the lateral aspect of the tongue. Which disease does the nurse suspect? 1 Oral thrush 2 Genital herpes 3 Kaposi sarcoma 4 Oral hairy leukoplakia

4

The nurse is teaching a post-radiation therapy client regarding proper skin care to the radiation treatment area. Which statement made by the client indicates the nurse needs to follow up? 1 "I will avoid wearing tight-fitting clothing." 2 "I will avoid using adhesive bandages." 3 "I will avoid exposing the area to cold temperatures." 4 "I will avoid rinsing the area with the saline solution."

4

Which is the first antibody formed after exposure to an antigen? 1 IgA 2 IgE 3 IgG 4 IgM

4

What is the function of IgG in the body? 1 Activates the degranulation of mast cells 2 Activates the classic complement pathway 3 Prevents upper respiratory tract infections 4 Prevents lower respiratory tract infections

2

When donning sterile gloves, how should the second glove be handled? 1 Grasp by cuff and place on remaining hand. 2 Place sterile glove under cuff, and slide hand in glove. 3 Grasp inside second glove and place on nondominant hand. 4 Don glove on nondominant hand first, then hold below waist and slide on.

2

A client is admitted with systemic lupus erythematosus (SLE). The laboratory report shows the presence of neutrophils and monocytes as mediators of injury. Which type of hypersensitivity reaction most likely occurred in the client? 1 Type I 2 Type II 3 Type III 4 Type IV

3

A client is diagnosed with herpes genitalis. What should the nurse do to prevent cross-contamination? 1 Institute droplet precautions. 2 Arrange transfer to a private room. 3 Wear a gown and gloves when giving direct care. 4 Close the door and wear a mask when in the room.

3

What is the role of shark cartilage in the management of human immunodeficiency (HIV) and acquired immunodeficiency syndrome (AIDS)? 1 Shark cartilage enhances immunity 2 Shark cartilage reduces oral thrush 3 Shark cartilage is a complementary therapy 4 Shark cartilage is a nutritional supplement

3

Which bacteria causes toxic shock syndrome in female clients? 1 Treponema pallidum 2 Streptococcus faecalis 3 Staphylococcus aureus 4 Neisseria gonorrhoeae

3

Which client has the highest risk for human immunodeficiency virus (HIV) infection? 1 A client who is involved in mutual masturbation 2 A client who undergoes voluntary prenatal HIV testing 3 A client who shares equipment to snort or smoke drugs 4 A client who engages in insertive sex with a non-infective partner

3

Which intervention is most likely to decrease mortality in the septic client? 1 Oxygen 2 Antibiotics 3 Vasopressors 4 Intravenous fluids

2

Which stage of HIV would a client with a CD4+ T-cell count of 325 cells/mm3 be classified? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

2

Which type of immunity will clients acquire through immunizations with live or killed vaccines? 1 Natural active immunity 2 Artificial active immunity 3 Natural passive immunity 4 Artificial passive immunity

2

Why would a client with acquired immunodeficiency syndrome (AIDS) be prescribed diphenoxylate hydrochloride? 1 To manage pain 2 To manage diarrhea 3 To manage candidal esophagitis 4 To manage behavioral problems

2

Which type of cytokine is used to treat anemia related to chronic kidney disease? 1 α-Interferon 2 Interleukin-2 3 Interleukin-11 4 Erythropoietin

4

Which type of hypersensitivity reaction is associated with rheumatoid arthritis? 1 Delayed 2 Cytotoxic 3 IgE-mediated 4 Immune-complex

4

Which viral infection will cause the nurse to observe for warts? 1 Pox virus 2 Rhabdovirus 3 Epstein-Barr virus 4 Papillomavirus

4

What is the mechanism of action of penicillin? 1 Prevents reproduction of the pathogen 2 Inhibits cell wall synthesis of the pathogen 3 Inhibits nucleic acid synthesis of the pathogen 4 Injures the cytoplasmic membrane of the pathogen

2

What is the role of the plasma cell in the antigen-antibody response? 1 Makes an antigen harmless without destroying it 2 Produces antibodies against the sensitizing antigen 3 Produces antibodies after an exposure to a known antigen 4 Clumps antibody-antigens linkages together to form immune complexes

2

A client is concerned about contracting malaria while visiting relatives in Southeast Asia. What should the nurse teach the client to avoid to prevent malaria? 1 Mosquito bites 2 Untreated water 3 Undercooked food 4 Overpopulated areas

1

A client's laboratory report reveals a CD4+ T-cell count of 520 cells/mm3. According to the Centers for Disease Control and Prevention (CDC), which stage of human immunodeficiency virus (HIV) disease is present in the client? 1 Stage 1 2 Stage 2 3 Stage 3 4 Stage 4

1

What is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs)? 1 Removing the catheter 2 Keeping the drainage bag off of the floor 3 Washing hands before and after assessing the catheter 4 Cleansing the urinary meatus with soap and water daily

1

What should be used to clean needles and syringes between intravenous drug users (IDUs)? 1 Bleach 2 Hot water 3 Ammonia 4 Rubbing alcohol

1

Which dietary modifications can help improve the nutritional status of a client with acquired immunodeficiency syndrome (AIDS)? 1 Refraining from consuming fatty foods 2 Refraining from consuming frequent meals 3 Refraining from consuming high-calorie foods 4 Refraining from consuming high-protein foods

1

Which medication should be immediately started when a client has an anaphylactic attack? 1 Isoproterenol 2 Diphenhydramine HCl 3 Hydrocortisone sodium succinate 4 Methylprednisolone sodium succinate

1

Which organism causes smallpox? 1 Variola virus 2 Yersinia pestis 3 Bacillus anthracis 4 Clostridium botulinum

1

Which conditions may result from immunoglobulin IgE antibodies on mast cells reacting with antigens? Select all that apply. 1 Asthma 2 Hay fever 3 Sarcoidosis 4 Myasthenia gravis 5 Rheumatoid arthritis

1, 2

What are the clinical manifestations of inhalation anthrax? Select all that apply. 1 Fever 2 Fatigue 3 Rhinitis 4 Dry cough 5 Sore throat

1, 2, 4, 5

A client diagnosed with osteomyelitis is being discharged. Which statement indicates a need for further teaching? 1 "I will take the antibiotic at the same time every day." 2 "I will take the antibiotic regularly until my symptoms subside." 3 "I will take the antibiotic with food if I develop gastric distress when on the antibiotic." 4 "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath."

2

A client with multiple myeloma who is receiving chemotherapy has a temperature of 102.2° F (39° C). The temperature was 99.2° F (37.3° C) when it was taken 6 hours ago. What is a priority nursing intervention in this case? 1 Assess the amount and color of urine; obtain a specimen for a urinalysis. 2 Administer the prescribed antipyretic and notify the primary health care provider. 3 Note the consistency of respiratory secretions and obtain a specimen for culture. 4 Obtain the respirations, pulse, and blood pressure; recheck the temperature in 1 hour.

2

A client's sputum smears for acid-fast bacilli (AFB) are positive, and transmission-based airborne precautions are prescribed. What should the nurse teach visitors to do? 1 Put on a gown and gloves. 2 Wear a particulate respirator mask. 3 Avoid touching objects in the client's room. 4 Limit contact with the client's nonexposed family members.

2

A nurse identifies 12 mm of induration at the site of a tuberculin purified protein derivative (PPD) test when a client returns to the health office to have it read. What does the nurse explain to the client about this test? 1 Test result is negative and no follow-up is needed 2 Result indicates a need for further tests and a chest x-ray 3 Test was used for screening and a Tine test now will be given 4 Skin test is inconclusive and will have to be repeated in 6 weeks

2

A spouse of a client with pulmonary tuberculosis (TB) receives a tuberculin skin test. The nurse reads the test and identifies an area of induration greater than 10 mm. What does this result indicate to the nurse? 1 No further action is required. 2 Additional tests are necessary. 3 Repeating the skin test is indicated. 4 Results are positive, indicating infection.

2

The nurse is caring for a client with a respiratory tract infection that started with a common cold but has progressed to whooping cough. The client also has coughing fits that last for several minutes. Which organism is responsible for the client's condition? 1 Bacillus anthracis 2 Bordetella pertussis 3 Streptococcus pneumoniae 4 Mycobacterium tuberculosis

2

What causes medications used to treat AIDS to become ineffective? 1 Taking the medications 90% of the time 2 Missing doses of the prescribed medications 3 Taking medications from different classifications 4 Developing immune reconstitution inflammatory syndrome (IRIS)

2

What determines if a client will develop AIDS from an HIV infection? 1 Level of IgM in the blood 2 The number of CD4+ T-cells available 3 Presence of antigen-antibody complexes 4 Speed with which the virus invades the RNA

2

A client has a tuberculin purified protein derivative test as part of a yearly physical examination. The area of induration is 10 mm within 48 hours after having the test. What does the nurse conclude about the client based on this response? 1 The client has contracted clinical tuberculosis. 2 The client has passive immunity to tuberculosis. 3 The client has been exposed to the tubercle bacillus. 4 The client has developed a resistance to the tubercle bacillus.

3

A client scheduled for surgery has a history of methicillin-resistant Staphylococcus aureus (MRSA) since developing an infection in a surgical site 9 months ago. The site is healed, and the client reports having received antibiotics for the infection. What should the nurse do to determine if the infecting organism is still present? 1 Notify the infection control officer. 2 Inform the operating room of the MRSA. 3 Obtain an order to culture the client's blood. 4 Call the surgeon for an infectious disease consultation.

3

A nurse is counseling a client who has gonorrhea. What additional fact about gonorrhea, besides the fact that it is highly infectious, should the nurse teach this client? 1 It is easily cured. 2 It occurs very rarely. 3 It can produce sterility. 4 It is limited to the external genitalia.

3

What is the mechanism of action of norepinephrine in managing anaphylaxis? 1 Norepinephrine blocks the effects of histamine 2 Norepinephrine inhibits the degranulation of mast cells 3 Norepinephrine increases blood pressure and cardiac output 4 Norepinephrine rapidly stimulates alpha- and beta-adrenergic receptors

3

What type of hypersensitivity reaction is the cause of systemic lupus erythematosus? 1 Type I 2 Type II 3 Type III 4 Type IV

3

Which client organ is protected by microglial cells? 1 Lung 2 Liver 3 Brain 4 Kidney

3

Which immunomodulatory is beneficial for the treatment of clients with multiple sclerosis? 1 Interleukin 2 2 Interleukin 11 3 Beta interferon 4 Alpha interferon

3

Which leukocyte releases vasoactive amines during a client's allergic reactions? 1 Neutrophil 2 Monocyte 3 Eosinophil 4 Macrophage

3

Which organ-specific autoimmune disorder is associated with a client's kidney? 1 Graves' disease 2 Addison's disease 3 Goodpasture syndrome 4 Guillain-Barré syndrome

3

Which process does the IgD immunoglobulin support? 1 Manifestation of allergic reactions 2 Protection of the body's mucous surfaces 3 Differentiation of the B-lymphocytes 4 Provision of the primary immune response

3

Which sexually transmitted disease is caused by a virus? 1 Syphilis 2 Gonorrhea 3 Genital warts 4 Chlamydial infection

3

Which type of immunity is acquired through the transfer of colostrum from the mother to the child? 1 Natural active immunity 2 Artificial active immunity 3 Natural passive immunity 4 Artificial passive immunity

3

Why is a Neisseria gonorrhoeae infection particularly troublesome for a female client? 1 The medication is expensive. 2 It is difficult to treat with antibiotics. 3 Symptoms are often overlooked. 4 Treatment has many adverse effects.

3

A client who abused intravenous drugs was diagnosed with the human immunodeficiency virus (HIV) several years ago. What does the nurse explain to the client regarding the diagnostic criterion for acquired immunodeficiency syndrome (AIDS)? 1 Contracts HIV-specific antibodies 2 Develops an acute retroviral syndrome 3 Is capable of transmitting the virus to others 4 Has a CD4+T-cell lymphocyte level of less than 200 cells/µL (60%)

4

A school nurse is asked to develop a program for teachers about infection control especially focusing on hand washing technique. What is the most effective way for the nurse to evaluate what the teachers have learned? 1 Observe the teachers lecturing the children. 2 Give an objective written final examination to the teachers. 3 Schedule a seminar for the teachers to share their knowledge. 4 Watch the teachers demonstrate infection control techniques to the rest of the class.

4

After several years of unprotected sex, a client is diagnosed as having acquired immunodeficiency syndrome (AIDS). The client states, "I'm not worried because they have a cure for AIDS." What is the best response by the nurse? 1 "Repeated phlebotomies may be able to rid you of the virus." 2 "You may be cured of AIDS after prolonged pharmacologic therapy." 3 "Perhaps you should have worn condoms to prevent contracting the virus." 4 "There is no cure for AIDS, but there are drugs that can slow down the virus."

4

What finding in the client is a sign of allergic rhinitis? 1 Presence of high-grade fever 2 Reduced breathing through the mouth 3 Presence of pinkish nasal discharge 4 Reduced transillumination on the skin over the sinuses

4

What is the function of a client's natural killer cells? 1 Secrete immunoglobulins in response to the presence of a specific antigen 2 Heighten selectively and destroy non-self cells, including virally infected cells 3 Enhance immune activity through secretion of various factors, cytokines, and lymphokines 4 Attack non-selectively on non-self cells, especially mutated and malignant cells

4

Which complication is associated with Pott's disease? 1 Peritonitis 2 Bacterial meningitis 3 Generalized lymphadenopathy 4 Destruction of intervertebral discs

4

Which disease is caused by Coronaviruses? 1 Pertussis 2 Inhalation anthrax 3 Coccidioidomycosis 4 Severe acute respiratory syndrome

4

Which laboratory test will be elevated in a client with inflammatory arthritis? 1 Leukocyte count 2 Hemoglobin and hematocrit 3 Blood urea nitrogen and creatinine 4 Erythrocyte sedimentation rate (ESR)

4

Which parameter should the nurse consider while assessing the psychologic status of a client with acquired immune deficiency syndrome (AIDS)? 1 Sleep pattern 2 Severity of pain 3 Cognitive changes 4 Presence of anxiety

4

Which statement is true regarding Sjögren's syndrome? 1 Sjögren's syndrome increases lacrimation. 2 Sjögren's syndrome increases body secretions. 3 Sjögren's syndrome decreases the risk for infection. 4 Sjögren's syndrome decreases the digestion of carbohydrates.

4