Nurs 107 Prep U Chapter 33 Assessment and Management of Patients with Allergic Disorders

Which is usually the most important consideration in the decision to initiate antiretroviral therapy? HIV RNA ELISA Western blotting assay CD4+ counts

CD4+ counts

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

Diphenhydramine

A patient received epinephrine in response to an anaphylactic reaction at 10:00 AM. The nurse knows to observe the patient for a "rebound" reaction that may occur as early as: 4:00 PM. 6:00 PM. 2:00 PM. 10:00 PM.

2:00 PM.

When evaluating a client's knowledge about use of antihistamines, what statement indicates further education is required? "This medication may be taken with food." "Hard candy will relieve my dry mouth." "I should be careful when driving." "If I am pregnant, I should take half the dose."

"If I am pregnant, I should take half the dose."

The nurse tells the client that if exposure to an allergen occurs around 8:00 AM, then the client should expect a mild or moderate reaction by what time? 1:00 PM 11:00 AM 10:00 AM 3:00 PM

10:00 AM

A nurse comes to the employee health center for evaluation and is diagnosed with allergic contact dermatitis related to latex. What manifestation would the nurse most likely exhibit? Rhinitis Blistering Laryngeal edema Angioedema

Blistering

When assessing the skin of a client with allergic contact dermatitis, the nurse would most likely expect to find irritation at which area? Ankles Lower arms Dorsal aspect of the hand Plantar aspects of the feet

Dorsal aspect of the hand

A protease inhibitor, an antiretroviral agent that can be taken without regard to meals is: Lexiva. Kaletra. Viracept. Norvir.

Lexiva.

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? Symptoms worsen when hand lotion is applied before donning latex gloves. Symptoms occur within minutes after exposure to latex. Symptoms are localized to the area of exposure, usually the back of the hands. Symptoms can be eliminated by changing glove brands.

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

A client is prescribed an oral corticosteroid for 2 weeks to relieve asthma symptoms. The nurse educates the client about side effects, which include adrenal suppression. diuresis. hypoglycemia. hypotension.

adrenal suppression.

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, which part of the body is more sensitive to allergens? back chest forearm upper arm

back

Client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What action is of primary importance upon admission? encourage fluids to dilute allergen None of the options is correct. induce vomiting to rid body of allergen maintain airway

maintain airway

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. What would the nurse identify as a common cause of anaphylaxis? Select all that apply. Beef Chicken Shrimp Eggs Milk

Milk Eggs Shrimp

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about? Sublingual-swallow immunotherapy (SLIT) Desensitization Sublingual-topical immunotherapy (STIT) Resensitization

Desensitization

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? Because an autoimmune disease is a neoplastic disease To decrease the body's risk of infection So the client has strong drug therapy For their immunosuppressant effects

For their immunosuppressant effects

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? Lupus erythematosus Rheumatoid arthritis Rh-hemolytic disease Bacterial endocarditis

Rh-hemolytic disease

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? life stressors the nurse may be experiencing chemical and latex glove use medication allergies laundry detergent or bath soap changes

chemical and latex glove use

The nurse is working in an allergy clinic with a client with tuberculosis. What other reaction is a type IV hypersensitivity disorder? anaphylaxis contact dermatitis allergic rhinitis atopic dermatitis

contact dermatitis

The nurse is administering intravenous vancomycin. What will the nurse initially assess the client for if an allergic reaction occurs? hypotension and tachycardia the presence and location of pruritus the severity of cutaneous warmth and flushing dyspnea, bronchospasm, and/or laryngeal edema

dyspnea, bronchospasm, and/or laryngeal edema

The nurse is talking to a group of community volunteers about food allergies. What are the foods that cause the most severe allergic reactions and result in the highest client death rates? peanut and tree nuts milk and chocolate berries and seeds seafood

peanut and tree nuts

After receiving a dose of penicillin, a client develops dyspnea and hypotension and the nurse suspects the client is experiencing anaphylactic shock. What is the nurse's first action? Administer epinephrine, as ordered. Continue to monitor the client's vital signs. Insert an indwelling urinary catheter. Page an anesthesiologist immediately.

Administer epinephrine, as ordered.

A client seeks medical attention for the development of a rash on the hands. Which assessment findings indicate to the nurse that the client is experiencing irritant contact dermatitis? Select all that apply. Burning Blisters Crust formation Edema Redness

Burning Edema Redness

The nurse is evaluating the plan of care for a client with an allergic disorder who has a nursing diagnosis of deficient knowledge related to measures for allergy control. What client statement will indicate to the nurse that the outcome has been met? Client demonstrates appropriate coping strategies for dealing with a chronic disorder. Client identifies methods for reducing exposure risk to allergens. Client states the need for coughing and deep breathing. Client reports an absence of symptoms associated with the allergy.

Client identifies methods for reducing exposure risk to allergens.

A client presents to the clinic with reports of itching and hives after taking an aspirin this morning. What medication does the nurse anticipate administering that blocks histamine receptors? Flunisolide Pseudoephedrine hydrochloride Beclomethasone dipropionate Diphenhydramine

Diphenhydramine

Which term refers to an incomplete antigen? Antibody Antigen Hapten Allergen

Hapten

When describing the effects of treatment for phagocytic cell disorders, which of the following would the nurse include as being the most successful? Antibiotic therapy Hematopoietic stem cell transplantation Gene therapy Use of granulocyte transfusions

Hematopoietic stem cell transplantation

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action? Avoids massaging the injection site after administration Maintains pressure on the auto-injector for about 30 seconds after insertion Pushes down on the grey release cap to administer the medication Jabs the autoinjector into the outer thigh at a 90-degree angle

Jabs the autoinjector into the outer thigh at a 90-degree angle

What is the most common cause of anaphylaxis? Penicillin Opioids NSAIDs Radiocontrast agent

Penicillin

What are expected client outcomes the nurse would include in a plan of care for a client with allergic rhinitis? Select all that apply. The client develops cachexia The client controls outdoor precipitating factors The client's lungs will have occasional crackles or rhonchi The client will wear a dampened mask if dust is a problem The client reports no symptoms of peripheral tingling

The client controls outdoor precipitating factors The client reports no symptoms of peripheral tingling The client will wear a dampened mask if dust is a problem

A client develops contact dermatitis in response to adhesive tape used to secure a dressing. The nurse interprets this reaction as an example of which type of hypersensitivity? Type II Type IV Type I Type III

Type IV

A nurse is preparing a discharge teaching plan for a client with atopic dermatitis. Which instruction should the nurse include in the teaching plan? Keep the thermostat above 75° F (23.9° C). Wear only synthetic fabrics. Bathe only three times per week. Use a topical skin moisturizer daily.

Use a topical skin moisturizer daily.

A client reports to a health care provider's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which client statement indicates a need for further education? "I'll go directly to the pharmacy with my EpiPen prescription." "If I notice tingling in my lips or mouth, gargling may help the symptoms." "I may experience itching and irritation at the site of the testing." "The test may be mildly uncomfortable."

"If I notice tingling in my lips or mouth, gargling may help the symptoms."

The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as contact dermatitis. urticaria. pitting edema. angioneurotic edema.

angioneurotic edema.

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. What is the best response by the nurse? "The full benefit of the medication may take up to 2 weeks to be achieved." "I am sorry that you are feeling poorly but this is the only medication that will work for your problem." "You need to come back to the clinic to get a different medication since this one is not working for you." "You may be immune to the effects of this medication and will need something else in its place."

"The full benefit of the medication may take up to 2 weeks to be achieved."

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve the nasal congestion the client is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications? Report white patches in the mouth because the medication can cause a fungal infection. Taper the dose when discontinuing the medication. Do not operate machinery or drive while using the medication. Do not overuse the medication as rebound congestion can occur.

Do not overuse the medication as rebound congestion can occur.

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? Histamine Prostaglandin Bradykinin Serotonin

Histamine

A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen? Thymus grafting Factor VIII administration IV gamma globulin administration Platelet administration

IV gamma globulin administration

The nurse working in an allergy clinic is preparing to administer skin testing to a client. Which route is the safest for the nurse to use to administer the solution? Intravenous Intramuscular Subcutaneous Intradermal

Intradermal

A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. What will the nurse include when teaching the client about this drug? Use ice chips to alleviate the symptoms of dry mouth. Be aware that some nasal burning and itching may occur. Take the drug orally before, with, or after meals. Place the prescribed number of drops into the conjunctiva.

Be aware that some nasal burning and itching may occur.

Which of the following is the most frequent route of exposure to a latex allergy? Cutaneous Inhalation Mucosal Parenteral

Cutaneous

Which cells present the antigen to T cells and initiate the immune response? Macrophages Hapten B cells Antigens

Macrophages

A client has had a "stuffy nose" and obtained an oxymetazoline nasal spray. What education should the nurse provide to the client in order to prevent "rebound congestion"? Be sure to use the nasal spray for at least 10 days to ensure the stuffiness is gone. Use the medication every 4 hours to prevent congestion from recurring. Only use the nasal spray for 3 to 4 days once every 12 hours. Drink plenty of fluids.

Only use the nasal spray for 3 to 4 days once every 12 hours.

Which intervention is the single most important aspect for the client at risk for anaphylaxis? Wearing a medical alert bracelet Prevention Desensitization Use of antihistamines

Prevention

The nurse teaches the client with allergies about anaphylaxis, including which statement? Anaphylactoid (anaphylaxis-like) reactions are commonly fatal. The most common food item that causes anaphylaxis is chocolate. Systemic reactions include urticaria and angioedema. The most common cause of anaphylaxis is penicillin.

The most common cause of anaphylaxis is penicillin.

The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid? zileuton fluticasone fexofenadine cromolyn sodium

fluticasone

A nurse is working in a dermatology clinic with clients who have allergies. What is the most important chemical mediator involved in the allergic response? prostaglandins leukotrienes serotonin histamine

histamine

A patient with a history of allergies comes to the clinic for an evaluation. The following laboratory test findings are recorded in a patient's medical record: Total serum IgE levels: 2.8 mg/mL White blood cell count: 5,100/cu mm Eosinophil count: 4% Erythrocyte sedimentation rate: 20 mm/h The nurse identifies which result as suggesting an allergic reaction? Erythrocyte sedimentation rate Eosinophil count Serum IgE level White blood cell count

Serum IgE level

The nurse is working with a client with allergies. What will the nurse use to confirm allergies and decrease the risk of anaphylaxis? punch biopsy nasal smear intradermal testing peripheral blood smears

intradermal testing

A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit? type II type I type IV type III

type I

The nurse is educating a patient with allergic rhinitis about how the condition is induced. What should the nurse include in the education on this topic? Parenteral medications Topical creams or ointments Airborne pollens or molds Ingested foods

Airborne pollens or molds

A patient has been diagnosed with an allergy to peanuts. What is a priority for this patient to carry at all times? A medical alert bracelet An EpiPen An oral airway An H1 blocker

An EpiPen

A client receiving antiretroviral therapy reports "not urinating enough." What is the nurse's best action? Assess liver function tests. Assess blood urea nitrogen and creatinine. Encourage the client to drink more fluids. Administer fluids 100 mL/hour IV.

Assess blood urea nitrogen and creatinine.

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? Palpitations Sedation Anorexia Diarrhea

Sedation

The majority of patient with primary immunodeficiency are in which age group? 51 to 60 41 to 50 20 to 40 Younger than 20

Younger than 20

The parents of a child with contact dermatitis are asking questions about the reaction within the immune system. What description regarding contact dermatitis as a type IV hypersensitivity reaction is accurate? the immediate release of chemical mediators the involvement of immune complexes formed when antigens bind to antibodies a delayed-type hypersensitivity that is mediated by T cells a cross-reacting antibody that mistakes a normal constituent of the body as foreign

a delayed-type hypersensitivity that is mediated by T cells

Which allergic reaction is potentially life threatening? None of the listed allergic reactions is potentially life threatening. angioedema urticaria contact dermatitis

angioedema

The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as contact dermatitis. urticaria. angioneurotic edema. pitting edema.

angioneurotic edema.

The nurse is preparing to infuse gamma-globulin intravenously (IV). When administering this drug, the nurse knows the speed of the infusion should not exceed what rate? 3 mL/min 1.5 mL/min 6 mL/min 10 mL/min

3 mL/min

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment? The presence and location of pruritus Hypotension and tachycardia The severity of cutaneous warmth and flushing Dyspnea, bronchospasm, and/or laryngeal edema.

Dyspnea, bronchospasm, and/or laryngeal edema.

The nurse is completing the intake assessment of a client new to the allergy clinic. The client states that he was taking nose drops six times a day to relieve his nasal congestion. The nasal congestion increased, causing him to increase his usage of the nasal spray to eight times a day. But again the congestion worsened. The nurse communicates to the health care provider that the client experienced Rhinitis medicamentosa Leukotriene modifier Atopic dermatitis Tolerance to nose drops

Rhinitis medicamentosa

The nurse explains to a client that immunotherapy initially starts with injections at which interval? Bi-monthly Daily Monthly Weekly

Weekly

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response? animal dander plant pollen mold spores dust mites

plant pollen

The nurse is teaching a group of health care workers about latex allergies. What reaction will the nurse teach the workers to be most concerned about with laryngeal edema? IgE-mediated hypersensitivity allergic contact irritant contact IgG antibodies

IgE-mediated hypersensitivity

What education should the nurse provide to the patient taking long-term corticosteroids? The patient should not stop taking the medication abruptly and should be weaned off of the medication. The patient should take the medication only as needed and not take it unnecessarily. Corticosteroids are relatively safe drugs with very few side effects. The patient should discontinue using the drug immediately if weight gain is observed.

The patient should not stop taking the medication abruptly and should be weaned off of the medication.