Anaphylaxis and Transplant Review-Prep U

The nurse working on a bone marrow unit knows that it is a priority to monitor which of the following in a client who has just undergone a stem cell transplant? A. Monitor the client's heart rate. B. Monitor the client's toilet patterns. C. Monitor the client closely to prevent infection. D. Monitor the client's physical condition.

C. Monitor the client closely to prevent infection.

The nurse is caring for a female patient who underwent a kidney transplant. The patient appears anxious and tearful and states "My body is going to reject the new kidney; I know I'm going to die." Which of the following is the best response by the nurse? A. "I understand your concerns, let's talk about them." B. "You've waited years for this transplant, you need to think positively." C. "If your body rejects the kidney, you can go back on dialysis; you are not going to die." D. "Don't think like that; I'm certain you will be fine."

A. "I understand your concerns, let's talk about them."

Which of the following allergies is responsible for most severe food allergy reactions? A. Seeds B. Peanuts C. Seafood D. Berries

B. Peanuts

Which of the following interventions is the single most important aspect for the patient at risk for anaphylaxis? A. Wearing of medical alert bracelet B. Prevention C. Use of antihistamines D. Desensitization

B. Prevention

A nurse is teaching a patient who is awaiting a heart transplant. Which of the following statements indicate the patient understands what is required to help minimize rejection? A. "I will need to take three different types of medications for the rest of my life to help prevent rejection." B. "There is no risk of rejection if the donor heart is an exact match." C. "I will receive medication before and during surgery which will eliminate the risk of rejection." D. "I will need medication following surgery to prevent rejection and if my body does not reject the new heart I will not have to take any medication at home."

A. "I will need to take three different types of medications for the rest of my life to help prevent rejection."

What is the most common cause of anaphylaxis? A. Penicillin B. NSAIDS C. Opioids D. Radiocontrast agent

A. Penicillin

A nurse is caring for a client who is awaiting heart transplantation. The client and her family express their concerns about the financial cost of the procedure. Which intervention by the nurse is most appropriate? A. Have the physician speak with the client and family about the costs. B. Tell the client that she will be responsible for all of her costs. C. Contact the social worker and request that she speak with the client and her family about their financial concerns. D. Reassure the client and her family that the cost will be covered.

C. Contact the social worker and request that she speak with the client and her family about their financial concerns.

Which of the following therapies are for patient who have advanced heart failure (HF) after all other therapies have failed? A. Cardiac resynchronization therapy B. Implantable cardiac defibrillator (ICD) C. Heart transplant D. Ventricular access device

C. Heart transplant

A patient with end-stage liver disease who is scheduled to undergo a liver transplant tells the nurse, "I am worried that my body will reject the liver." Which of the following statements is the nurse's best response to the patient? A. "The problem of rejection is not as common in liver transplants as in other organ transplants." B. "You will need to take daily medication to prevent rejection of the transplanted liver. The new liver has a good chance of survival with the use of these drugs." C. "It is easier to get a good tissue match with liver transplants than with other types of transplants." D. "You would not be scheduled for a transplant if there was a concern about rejection."

B. "You will need to take daily medication to prevent rejection of the transplanted liver. The new liver has a good chance of survival with the use of these drugs."

A nurse receives the assignment of the following clients for the shift. Following the report, which client should the nurse see first? A. A client with pinkish mucus discharge in the appliance bag 2 days after an ileal conduit B. A client 3 days after kidney transplant with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L after dialysis C. A client with a sodium level of 135 mEq/L and a potassium level of 3.7 mEq/L 7 days after a kidney transplant D. A client experiencing mild pain from urolithiasis

B. A client 3 days after kidney transplant with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L after dialysis

The nurse is conducting discharge teaching for a patient who is being discharged from the ER after an anaphylactic reaction to peanuts. Which of the following should the nurse include in the teaching? Select all that apply. A. Desensitization to allergen B. Avoiding allergens C. Use of sedatives to treat reactions D. Wearing medical alert bracelet

B. Avoiding allergens D. Wearing medical alert bracelet

A nurse is aware of the need to assess patients' risks for anaphylaxis. What health care procedure constitutes the highest risk for anaphylaxis? A. Rapid administration of intravenous fluids B. Computed tomography with contrast solution C. Administration of the measles-mumps-rubella (MMR) vaccine D. Administration of nebulized bronchodilators

B. Computed tomography with contrast solution

A nursing student is caring for a client with end-stage cardiomyopathy. The client's spouse asks the student to clarify one of the last treatment options available that the physician mentioned. After checking with the primary nurse, the student would most likely discuss which of the following? A. Valvuloplasty B. Heart transplantation C. Xenograft tissue valve D. Annuloplasty

B. Heart transplantation

The nurse is caring for a client being discharged following kidney transplantation. The client is ordered mofetil to prevent organ rejection. Which nursing instruction is essential regarding medication use? A. Administer medication following breakfast daily. B. Administer the medication with an antacid to prevent stomach upset. C. Contact the health care provider at first signs of an infection. D. Sprinkle the contents of the capsule on food.

C. Contact the health care provider at first signs of an infection.

A nurse on a solid organ transplant unit is planning the care of a patient who will soon be admitted upon immediate recovery following liver transplantation. What aspect of nursing care is the nurse's priority? A. Frequent assessment of the patient's psychosocial status B. Administration of antiretroviral medications C. Implementation of infection-control measures D. Close monitoring of skin integrity and color

C. Implementation of infection-control measures

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

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

Loren Fawcett, an 18-year-old college student, arrived at your ED presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. After stabilizing Loren, you speak with her family and assuring them that she will recover. In your nursing management, what was of primary importance in Loren's care upon her admission? A. Encourage fluids to dilute allergen B. Inducing vomiting to rid body of allergen C. Maintaining airway D. No options are correct

C. Maintaining airway

A patient is being discharged after a liver transplant and the nurse is performing discharge education. When planning this patient's continuing care, the nurse should prioritize which of the following risk diagnoses? A. Risk for Unstable Blood Glucose Related to Impaired Gluconeogenesis B. Risk for Injury Related to Decreased Hemostasis C. Risk for Infection Related to Immunosuppressant Use D. Risk for Contamination Related to Accumulation of Ammonia

C. Risk for Infection Related to Immunosuppressant Use

The nurse is assessing a 4-year-old child who has multiple bee stings. Which assessment finding would require immediate action by the nurse? A. Crying with burning pain B. Erythema at sting site C. Heart rate of 100 D. Wheezing on auscultation

D. Wheezing on auscultation

A staff nurse is caring for a client who is a potential heart donor. The client's family is concerned that the recipient will have access to personal donor information. Which response by the nurse demonstrates knowledge of the organ donation process? A. "The recipient is allowed to ask questions about the donor and have them answered." B. "There is never contact between the donor's family and the recipient." C. "It is important that the recipient know where to send Thank-You cards." D. "I will have the transplant coordinator speak with you to answer your questions."

D. "I will have the transplant coordinator speak with you to answer your questions."

A nurse is caring for a client declared brain dead following a motor vehicle accident. When the nurse enters the client's room, his spouse and family are talking with friends about the possibility of organ donation. Which statement by the nurse reflects an ethical practice dilemma? A. "I can ask someone to come by to talk with you and answer any questions you may have." B. "I can come back after you've finished your visit." C. "The health care team will support you in your decision on this difficult subject." D. "If you're thinking about organ donation, my sister is waiting for a kidney transplant. She'd be an excellent recipient. I can give you her phone number."

D. "If you're thinking about organ donation, my sister is waiting for a kidney transplant. She'd be an excellent recipient. I can give you her phone number."

A client is hospitalized with end-stage cardiomyopathy. The physician, nurse, client, and his family discuss the possibility of heart transplantation. After this discussion, the nurse and physician meet to discuss the case. The physician voices concern that the client will not change his lifestyle to accommodate transplantation. Which response by the nurse indicates her role as a client advocate? A. "We know that it isn't easy to make and maintain these kinds of changes." B. "He knows that he will die without a transplant." C. "I'm sure his wife can convince him to quit smoking." D. "With the proper support and education, he could make the necessary changes."

D. "With the proper support and education, he could make the necessary changes."

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? A. Milk B. Beef C. Chicken D. Shrimp E. Eggs

A. Milk D. Shrimp E. Eggs

A nurse is administering a chemotherapeutic medication to a client, who reports generalized itching and then chest tightness and shortness of breath. The nurse immediately A. Stops the chemotherapeutic infusion B. Gives prednisolone (Solu-Medrol) IV C. Administers diphenhydramine (Benadryl) D. Places the client on oxygen by nasal cannula

A. Stops the chemotherapeutic infusion

The nurse is discharging a client who had a fish hook embedded in the eye. The fish hook was removed surgically in the emergency department, but the client currently has no vision in that eye. The surgeon has informed the client that a corneal transplant may restore some vision but the surgery cannot be performed for 6 to 8 weeks and only if no infection occurs. A priority in the teaching plan includes: A. washing hands carefully to keep the area clean and decrease risk of infection. B. eating a healthy diet to promote healing and prevent constipation. C. resting to reduce strain to the eye and promote healing after surgery. D. verbalizing feelings regarding vision loss.

A. washing hands carefully to keep the area clean and decrease risk of infection.

The family of a client, stung by a bee, is rushed the client to the emergency room. The client is experiencing hives and redness at the site. Upon arrival, the client states, "I feel a lump in my throat and I am sweating. I can't breathe! I think I am going to die!" The nurse anticipates which emergency treatment next? A. Have the client in high Fowler's position in the bed. B. Administer an injection of epinephrine stat. C. Administer oxygen 4 liters via nasal cannula. D. Administer Albuterol 2 puffs stat.

B. Administer an injection of epinephrine stat.

After receiving a dose of penicillin, a client develops dyspnea and hypotension. The nurse suspects the client is experiencing anaphylactic shock. What should the nurse do first? A. Administer the antidote for penicillin, as ordered, and continue to monitor the client's vital signs. B. Administer epinephrine, as ordered, and prepare to intubate the client, if necessary. C. Prepare to administer a corticosteroid IV. D. Insert an indwelling urinary catheter and begin to infuse I.V. fluids, as ordered.

B. Administer epinephrine, as ordered, and prepare to intubate the client, if necessary.

Which of the following would the nurse prioritize as the most important action for the patient to take to prevent anaphylaxis? A. Desensitization B. Avoid potential allergens C. Wear a medical alert bracelet D. Carry an emergency kit

B. Avoid potential allergens

The nurse is creating a discharge teaching plan for a patient with a latex allergy. Which of the following should be included? Select all that apply. A. Administration of emergency epinephrine B. Avoidance of latex-based products C. Administration of antihistamines D. Radioallergosorbent testing (RAST)

A. Administration of emergency epinephrine B. Avoidance of latex-based products C. Administration of antihistamines

The nurse is working with a patient who has had an allohematopoietic stem cell transplant (HSCT) and notices a diffuse rash and diarrhea. The nurse contacts the physician to report that the patient has symptoms of which of the following? A. Nadir B. Graft-versus-host disease C. Acute leukopenia D. Metastasis

B. Graft-versus-host disease

A patient with severe combined immunodeficiency disease is receiving immunosuppression therapy to ensure engraftment of depleted bone marrow during transplantation procedures. What is the priority nursing care for this patient? A. Continuous monitoring of cardiac status B. Meticulous infection control precautions C. Daily oral assessment and oral care every 4 hours D. Daily weights and strict monitoring of intake and output

B. Meticulous infection control precautions

You are assessing a 6-year-old little girl in the emergency department (ED) who was brought in by her mother. She was stung by a bee and is allergic to bee venom. The child is now having trouble breathing. She is vasodilated, hypotensive, and has broken out in hives. What do you suspect is wrong with this child? A. She is having an allergic reaction and going into cardiogenic shock. B. She is having an allergic reaction and going into anaphylactic shock. C. She is having an allergic reaction and going into obstructive shock. D. She is having an allergic reaction and going into neurogenic shock.

B. She is having an allergic reaction and going into anaphylactic shock

Which of the following aid in diagnosing the risk of anaphylaxis? A. Peripheral blood smears B. Nasal smear C. Intradermal testing D. Punch biopsy

C. Intradermal testing

A patient who has undergone liver transplantation is ready to be discharged home. Which outcome of health education should the nurse prioritize? A. The patient will monitor for signs of liver dysfunction. B. The patient will obtain measurement of drainage from the T-tube. C. The patient will take immunosuppressive agents as required. D. The patient will exercise three times a week.

C. The patient will take immunosuppressive agents as required.

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately? A. Temperature of 99.2° F (37.3° C) B. Serum sodium level of 135 mEq/L C. Serum potassium level of 4.9 mEq/L D. Urine output of 20 ml/hour

D. Urine output of 20 ml/hour