NUR 172

Based on the nurse's base knowledge of primary immunodeficiencies, how would the nurse complete this statement? Primary immunodeficiencies A) develop as a result of treatment with antineoplastic agents. B) develop early in life after protection from maternal antibodies decreases. C) disappear with age. D) occur most commonly in the aged population.

B) develop early in life after protection from maternal antibodies decreases.

Decades ago, before the role of the tonsils and adenoids was better understood, it was typical after repeated bouts with tonsillitis to have a tonsillectomy and adenoidectomy. Today it is understood that the tonsils and adenoids are lymphoid tissues that: A) program T lymphocytes. B) filter bacteria from tissue fluid. C) increase the efficacy of antibiotics. D) eliminate cancer cells.

B) filter bacteria from tissue fluid.

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger enables cells to resist viral replication and slow viral replication? A) interleukins B) interferons C) tumor necrosis factor D) colony-stimulating factor

B) interferons

The nurse is assessing a client with a history of ankylosing spondylitis. What will the nurse most commonly assess? A) increased urine output B) low back pain C) red, butterfly-shaped facial rash D) patchy hair loss on the scalp

B) low back pain

Which immunity type becomes active as a result of infection by a specific microorganism? A) artificially acquired active immunity B) naturally acquired active immunity C) naturally acquired passive immunity D) artificially acquired passive immunity

B) naturally acquired active immunity

A client is to have a hip replacement in 3 months and does not want a blood transfusion from random donors. What option can the nurse discuss with the client? A) Sign a refusal of blood transfusion form so the client will not receive the transfusion. B) Ask people to donate blood. C) Bank autologous blood. D) Use volume expanders in case blood is needed.

C) Bank autologous blood.

The nurse teaches the client that reducing the viral load will have what effect? A) Shorter survival B) Shorter time to AIDS diagnosis C) Longer survival D) Longer immunity

C) Longer survival

A client has been receiving chemotherapy to treat cancer. Which assessment finding suggests that the client has developed stomatitis? A) White, cottage cheese-like patches on the tongue B) Rust-colored sputum C) Red, open sores on the oral mucosa D) Yellow tooth discoloration

C) Red, open sores on the oral mucosa

A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. What should the nurse educate the patient is a major side effect of antihistamines? A) Palpitations B) Diarrhea C) Sedation D) Anorexia

C) Sedation

The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which statement describes the clinical manifestations of this reaction? A) Symptoms occur within minutes after exposure to latex. B) Symptoms can be eliminated by changing glove brands. C) Symptoms are localized to the area of exposure, usually the back of the hands. D) Symptoms worsen when hand lotion is applied before donning latex gloves.

C) Symptoms are localized to the area of exposure, usually the back of the hands.

The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses? A) Decline in self-care activities B) Polypharmacy C) Reduced vitamin intake D) Immunosenescence

D) Immunosenescence

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse? A) Emission of abnormal proteins B) Cells colonizing to distant body parts C) Random, rapid growth of the tumor D) Tumor pressure against normal tissues

D) Tumor pressure against normal tissues

In a client infected with human immunodeficiency virus (HIV), CD4+ levels are measured to determine the: A) level of the viral load. B) resistance to antigens. C) presence of opportunistic infections. D) extent of immune system damage.

D) extent of immune system damage.

A patient has enlarged lymph nodes in his neck and a sore throat. This inflammatory response is an example of a cellular immune response whereby: A) Lymphocytes migrate to areas of the lymph node B) Antibodies are released into the bloodstream C) B-lymphocytes respond to a specific antigen D) Antibodies reside in the plasma

A) Lymphocytes migrate to areas of the lymph node

The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following? A) Serum, which depletes the body's store of immunoglobulins B) Plasma, which depletes the body's store of calcitonin C) Plasma, which depletes the body's store of catecholamines D) Serum, which depletes the body's store of glucagon

A) Serum, which depletes the body's store of immunoglobulins

A client with AIDS is admitted to the hospital with severe diarrhea and dehydration. The physician suspects an infection with Cryptosporidium. What type of specimen should be collected to confirm this diagnosis? A) Stool specimen for ova and parasites B) Sputum specimen for acid fast bacillus C) Urine specimen for culture and sensitivity D) Blood specimen for electrolyte studies

A) Stool specimen for ova and parasites

A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection? A) Through the mucous membranes of the throat B) Through the skin C) From being outside in the cold weather and decreasing resistance D) Breathing in airborne dust

A) Through the mucous membranes of the throat

T-cell deficiency occurs when which gland fails to develop normally during embryogenesis? A) Thymus B) Pituitary C) Adrenal D) Thyroid

A) Thymus

The nurse is caring for a client with ankylosing spondylitis. Which educational information will the nurse provide to this client? A) Use of analgesics B) Use of cough suppressants C) Use of laxatives D) Use of diuretics

A) Use of analgesics

The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply. A) blood B) semen C) vaginal secretions D) urine E) breast milk

A) blood B) semen C) vaginal secretions E) breast milk

A client visits the employee health department because of mild itching and a rash on both hands. What will the employee health nurse focus on during the assessment interview? A) chemical and latex glove use B) life stressors the nurse may be experiencing C) laundry detergent or bath soap changes D) medication allergies

A) chemical and latex glove use

Which of the following protective responses begin with the B lymphocytes? A) Recognition B) Phagocytic C) Cellular D) Humoral

D) Humoral

A client with a history of gout experiences an attack every 2 to 3 months despite losing weight and stopping all alcohol intake. Which question will the nurse ask when assessing this client? A) "Are you taking the medication as prescribed?" B) "Have you increased your intake of fat-soluble vitamins?" C) "Are you taking frequent rest periods throughout the day?" D) "Have you reduced the amount of daily exercise?"

A) "Are you taking the medication as prescribed?"

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response? A) "It is a hyperimmune response to something in the environment that is usually harmless." B) "It means you are very sensitive to something inside of yourself." C) "It is a muted response to something in the environment." D) "It is a harmless reaction to something in the environment."

A) "It is a hyperimmune response to something in the environment that is usually harmless."

The lethal tumor dose is defined as the dose that will eradicate what percentage of the tumor yet preserve normal tissue? A) 95% B) 85% C) 75% D) 65%

A) 95%

A child has just been diagnosed with a primary immune deficiency. The parents state, "Oh, no. Our child has AIDS." Which response by the nurse would be most appropriate? A) "Your child does not have AIDS but this condition puts your child at risk for it later in life." B) "Although AIDS is an immune deficiency, your child's condition is different from AIDS." C) "Your child's condition is extremely serious. Like AIDS, it will most likely be fatal." D) "We need to do some more testing before we will know if your child's condition is AIDS."

B) "Although AIDS is an immune deficiency, your child's condition is different from AIDS."

A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch. The nurse is aware that the patient may be having an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure? A) 6 hours B) 2 hours C) 12 hours D) 24 hours

B) 2 hours

Which is a sign or symptom of septic shock? A) Hypertension B) Altered mental status C) Warm, moist skin D) Increased urine output

B) Altered mental status

A client taking abacavir has developed fever and rash. What is the priority nursing action? A) Administer acetaminophen. B) Report to the health care provider. C) Administer lidocaine cream for the rash. D) Document the information.

B) Report to the health care provider.

An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occurred? A) Rheumatoid arthritis B) Rh-hemolytic disease C) Bacterial endocarditis D) Lupus erythematosus

B) Rh-hemolytic disease

A nurse is taking the health history of a newly admitted client. Which of the following conditions would NOT place the client at risk for impaired immune function? A) History of radiation therapy B) Surgical removal of the appendix C) Previous organ transplantation D) Surgical history of a splenectomy

B) Surgical removal of the appendix

Kaposi sarcoma (KS) is diagnosed through A) visual assessment B) biopsy C) computed tomography D) skin scraping

B) biopsy

A client with AIDS has been tested for cytomegalovirus (CMV) with positive titers. What severe complication should the nurse be alert for with cytomegalovirus? A) fatigue B) blindness C) diarrhea

B) blindness

The physician is attending to a 72-year-old client with a malignant brain tumor. The physician recommends immediate radiation therapy. What is a reason for the physician's recommendation? A) To destroy marginal tissues B) To remove the tumor from the brain C) To prevent the formation of new cancer cells D) To analyze the lymph nodes involved

C) To prevent the formation of new cancer cells

The spleen acts as a filter for old red blood cells, holding a reserve of blood in case of hemorrhagic shock. It is also an area where lymphocytes can concentrate. It can become enlarged (splenomegaly) in certain hematologic disorders and cancers. To assess an enlarged spleen, the nurse would palpate the area of the: A) Upper mediastinum. B) Lower margin around the liver. C) Upper left quadrant of the abdomen. D) Lower right abdomen.

C) Upper left quadrant of the abdomen.

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis? A) administration of monthly intra-articular injections of corticosteroids. B) administration of opioids for pain control. C) administration of nonsteroidal anti-inflammatory drugs (NSAIDs) D) vigorous physical therapy for the joints.

C) administration of nonsteroidal anti-inflammatory drugs (NSAIDs)

A nurse is caring for a client with prostate cancer and assesses bleeding gums and hematuria. What serum indicator should the nurse relate the bleeding? A) neutrophil count of 40% B) lymphocyte count of 30% C) platelet count of 60,000/mm3 D) reticulocyte count of 1%

C) platelet count of 60,000/mm3

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer? A) Nizatidine B) Cimetidine C) Omeprazole D) Diphenhydramine

D) Diphenhydramine

A client comes into the emergency department reporting difficulty walking and loss of muscle control in the arms. Once the nurse begins the physical examination, which assessment should be completed if an immune dysfunction in the neurosensory system is suspected? A) Assess for ataxia using the finger-to-nose test and heel-to-shin test B) Assess for hepatosplenomegaly by measuring abdominal girth C) Assess joint mobility using passive range of motion. D) Review the urinalysis report for hematuria

A) Assess for ataxia using the finger-to-nose test and heel-to-shin test