PrepU Immunity
A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure?
Amniocentesis
The health care provider has ordered promethazine (Phenergan) for a client who is having a severe allergic reaction. The nurse is aware that this medication is also used to treat what condition?
Nausea and vomiting
The nurse explains to the client that a biopsy of the enlarged lymph node is important because, if Hodgkin's disease is present, the histologic examination will reveal which of the following?
Reed-Sternberg cells.
Which of the following is the most frequent route of exposure to a latex allergy?
Cutaneous
A child with primary immune deficiency is about to receive an infusion of IVIG. What is the most appropriate premedication to minimize the reaction?
Diphenhydramine
A nurse is giving a talk to high school students about preventing the spread of human immunodeficiency virus (HIV). What does the nurse identify as ways in which HIV is spread? Select all that apply.
Transfusion of contaminated blood Perinatally from mother to fetus Sharing contaminated needles Through breastfeeding Exposure to blood and body fluids through sexual contact
Nursing students are reviewing information about chemical mediators released during an allergic response. The students demonstrate understanding of the material when they identify which substance as a primary mediator?
Prostaglandins
A 10-year-old boy has been brought to the emergency department (ED) by ambulance in apparent anaphylaxis after accidentally eating a snack bar that contained peanuts. The ED nurse should be aware that this patient's signs and symptoms are attributable to:
A massive release of histamine
Which immunoglobin occurs most frequently in plasma and is the major immunoglobulin synthesized during secondary response?
IgG
The nurse is working with a client who has had an allohematopoietic stem cell transplant (HSCT). The nurse notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the client has symptoms of
graft-versus-host disease.
Different medications are used to treat the differing causes of nausea and vomiting. Antihistamines may be effective in the treatment of nausea and vomiting created by:
motion sickness.
A client is experiencing flu-like symptoms related to immune stimulant therapy. Which instructions would be most appropriate for the client?
"Drink plenty of fluids throughout the day."
A 12-month-old child is seen in the neighborhood clinic for a regular checkup. Which statement by the child's mother about the influenza vaccine reflects the need for more teaching?
"The Haemophilus influenzae vaccine my child has already received helps protect against some forms of the flu."
The nurse is working with an 18-year-old client who recently immigrated and who did not receive childhood immunizations. The client is "catching up" on immunizations and is scheduled to receive a measles, mumps and rubella (MMR) vaccine today. What should the nurse teach the client about potential adverse effects?
"You might feel a bit unwell or get a slight fever after receiving your immunization."
A nurse is providing health teaching about pediatric immunizations to the parents of a child. Which of the following is the most appropriate information for the nurse to give the parents about immunizations?
"Your child may need medication for a low-grade fever."
The nurse is caring for a newborn of a mother with human immunodeficiency virus (HIV). What is the priority for the nurse to complete following delivery?
Bathe the newborn thoroughly
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?
Rh-hemolytic disease
What is an adverse effect of excessive immunosuppression?
Serious infection
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?
Serum IgE level
A 6-month-old infant visits the pediatric clinic for a well-baby checkup. The infant's father asks what the common health problems are for this age. The nurse's reply includes:
food allergies.
During flu season, a nurse is teaching clients about the chain of infection. What components are considered "links" in this chain? Select all that apply.
infectious agent portal of entry susceptible host
At a sexual health workshop for older teenagers, the nurse discusses the human papillomavirus (HPV). Which statements made by the participants lead the nurse to believe teaching was successful? Select all that apply.
"By getting the HPV vaccine, this infection can be prevented." "The HPV vaccine can be given to girls and boys as young as 9 years old." "Women between the ages of 13 and 26 can receive the vaccination series." "The HPV vaccines will help prevent cervical cancer."
Choose the options that will assist nurses in overcoming some of the barriers to having children fully immunized. Select all that apply.
Checking the immunization status of siblings who accompany the child who has the healthcare appointment Using every health contact with the child (hospital, urgent care, emergency, and well-child visits) to check status/administer vaccines Using combination vaccines to reduce the number of injections children receive
Which type of lymphocyte is responsible for cellular immunity?
T lymphocyte
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis?
The injection area swells if the client has developed antibodies against the antigen.
A primigravida 21-year-old client at 24 weeks' gestation has a 2-year history of HIV. As the nurse explains the various options for delivery, which factor should the nurse point out will influence the decision for a vaginal birth?
The viral load
A 7-year-old has been diagnosed with bacterial meningitis. Who should receive chemoprophylaxis?
all household contacts and close contacts
Which assessment should be conducted by the nurse before the nurse administers tuberculin intradermal injection?
checking for documented allergies to food or drugs
A pregnant client has an Rh-negative blood type. Following the birth of the client's infant, the nurse administers her Rho(D) immune globulin. The purpose of this is to:
prevent maternal D antibody formation.
A client's exposure to an infectious microorganism has stimulated the client's immune response, including activation of effector (cytotoxic) T cells. These cells will help to eliminate pathogens by:
releasing cytokines that will destroy the foreign cells.
When planning home care for a 3-year-old child with eczema, what should the nurse teach the mother to remove from the child's environment at home?
stuffed animals
The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education?
"Humoral immunity is generally functional at birth."
A group of students are reviewing class material about lymphoid tissue. The students demonstrate a need for additional teaching when they identify this as lymphoid tissue?
Histamine
A client that is HIV+ has been diagnosed with Pneumocystis pneumonia caused by P. jiroveci. What medication does the nurse expect that the client will take for the treatment of this infection?
Trimethoprim-sulfamethoxazole
Most of the drugs that affect the immune system are not recommended for use in children or have not been tested in children.
True
A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?
doxycycline
The nurse is caring for a client with possible immune deficiency. Which subjective data would be most indicative?
"Just as I get over a virus, it seems that I get another."
The pediatric nurse is teaching a group of parents about the safe and effective management of fevers in children. What teaching point should the nurse include?
"There are certainly dangers with a high fever, but a slightly increased body temperature can actually improve your child's immune response."
Which statements best indicates the client understands recommended vaccines following the 65th birthday?
A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age
A nurse educator is preparing to discuss immunodeficiency disorders with a group of fellow nurses. What would the nurse identify as the most common secondary immunodeficiency disorder?
AIDS
The nurse is caring for a client receiving antiviral medications to treat HIV. What laboratory study should the nurse monitor most closely to determine the effectiveness of the medications?
CD4 count
Which of the following reflect the pathophysiology of cutaneous signs of HIV disease?
Immune function deterioration
A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. Which of the following would the nurse identify as a common cause of anaplhylaxis? Select all that apply?
Milk Eggs Shrimp
A client is scheduled for a renal angiography. Which of the following would be appropriate before the test?
Monitor the client for an allergy to iodine contrast material.
A patient had unprotected sex with an HIV-infected person and arrives in the clinic requesting HIV testing. Results determine a negative HIV antibody test and an increased viral load. What stage does the nurse determine the patient is in?
Primary infection
A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?
Pruritus
When describing the use of vaccines to a local community group, what would the nurse include?
Vaccines are used to provide active immunity.
The majority of patient with primary immunodeficiency are in which age group?
Younger than 20
The nurse is teaching a client about rheumatic disease. What statement best helps to explain autoimmunity?
"Your symptoms are a result of your body attacking itself."
The nurse is caring for a child with HIV. The doctor will most likely order which test to monitor the child's progress?
Lymphocyte immunophenotyping T-cell quantification
Which type of vaccine uses the client's own cancer cells, which are killed and prepared for injection back into the client?
Autologous
A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient?
Erythropoietin
The nurse is caring for a child who is receiving a skin test to determine the presence of allergies. A positive skin test for one particular allergen shows the mediation of which type of immune globulin?
IgE
A nurse is receiving post-exposure prophylaxis for hepatitis B. What would the nurse most likely receive?
Immune globulin
When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is most important regarding the schedule for administration?
It is administered at 12 to 15 months.
A client is exposed to a viral infection. What role will interferon most likely play during this exposure?
It will interfere with virus replication.
The nurse assesses the client and observes reddish-purple to dark blue macules, plaques, and nodules. The nurse recognizes that these manifestations are associated with which condition?
Kaposi sarcoma
A client's immune response include phagocytosis of the bacteria that have infected the client. What cells are capable of performing this role in the immune response?
Monocytes
The nurse working the medical-surgical floor knows that the nitroblue tetrazolium reductase (NTR) test is used to diagnose immunodeficiency disorders related to
Phagocytic cells
A client's blood test results are: white blood cell (WBC) count is 1,000/μl; hemoglobin (Hb) level, 14 g/dl; hematocrit (HCT), 42%. Which goal is most important for this client?
Prevent infection
