chapter 25 PREP U

"In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear."

The mother of a 5-year-old child with allergies to a variety of foods including eggs, milk, peanuts and shellfish, asks if her child will "always have these problems". What response by the nurse is most accurate?

Every 30 minutes

The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency?

renal

The nurse is administering the drug cyclophosphamide to a child who has severe systemic lupus erythematosus (SLE). What body system is the nurse most concerned about regarding adverse effects of this drug immediately after administration?

Eye inflammation

The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess?

"Do not insert anything in the rectum."

The nurse is caring for a 6-month-old infant with Wiskott-Aldrich syndrome. Which teaching does the nurse provide the parent?

Protease inhibitors

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen?

flat with legs slightly elevated

The nurse is caring for a child who experiences an anaphylactic shock reaction. Which of the following positions would be the most appropriate in which to place this child?

Discontinue the infusion.

The nurse is caring for a child who is receiving an intravenous immunoglobulin treatment. The client calls the nurse and reports she vomited. What action should be completed first?

Application of moist heat

The nurse is caring for a child with rheumatoid arthritis. Which of the following is an appropriate non-pharmacological measure to reduce the joint pain associated this disease?

Handwashing is the main way to limit the transmission of disease.

The nurse is explaining the importance of handwashing after using the toilet to parents of young children. Which is the most important reason for this practice?

1300/mm3

The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level?

cover open wounds

The nurse is planning to discharge a child with HIV infection. Which of the following discharge instruction should be included for this child and her family?

IgE

The nurse is preparing educational materials for a group of new parents about allergic reactions. Which specific immunoglobulin should the nurse emphasize as being responsible for these types of reactions?

diphenhydramine

The nurse is preparing to administer IVIG to a child who has not received the medication before. What medication should the nurse expect to administer prior to the infusion?

Provide education to sexually active females about proper condom usage.

The nurse is providing education regarding 2030 Health Goals to reduce the incidence of acquired immunodeficiency syndrome (AIDS) within the community. Which goal will the nurse choose as a primary prevention strategy?

I need to wear sunscreen in the summer to prevent rashes."

The nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. Which response by the girl indicates a need for further teaching?

"I can use the egg white when baking, but not the yolk."

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching?

Positive antinuclear antibody (ANA) Thrombocytopenia Leukopenia

The nurse is reviewing the laboratory test results of a child who is suspected of having systemic lupus erythematosus (SLE). What would the nurse identify as supporting this diagnosis? Select all that apply.

"The ELISA method detects antibodies so a person may have a false negative test for up to six months after exposure.

The nurse is speaking with a teenager who has requested HIV testing. Which is the best statement by the nurse regarding HIV testing?

"We'll need to prepare him and ourselves for a bone marrow transplant."

The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency (SCID). Which statement by the parents best indicates that they understand their child's condition?

Children who are coughing.

The nurse is teaching a child care class for mothers of young children. The nurse tells the parent that the most common mode of transmission of infectious disease is:

"If our child does not have a positive rheumatoid factor, our child does not have the disease."

The nurse is teaching the parents of a child with a suspected diagnosis of juvenile idiopathic arthritis about the disease. Which statement by the parents demonstrates the need for further teaching?

"It is to help prevent transmission of the disease to your infant."

The nurse is working with a pregnant client who is HIV positive and has been prescribed oral zidovudine. Which statement by the nurse explains the primary rationale for taking this medication?

25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh

The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. To administer this injection safely, the nurse chooses which of the following needles (size and length), injection type, and injection site?

Haemophilus influenza type B

The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. Provided that a separate injection site is used for all injections, the nurse also may give which of the following immunizations during the same well-child appointment? 1. Varicella

"Immunizations may be killed or modified organisms." "Immunizations prevent some types of bacterial infections." "Many vaccines are given in the form of an injection."

The nurse provides client teaching to parents of a newborn who have questions about immunizations. Which comment(s) by the parents demonstrate knowledge of immunizations? Select all that apply.

The nurse should encourage the child to talk with his parents about his medications.

The parents of a 10-year-old with HIV have never told their child that he has the virus. The child asks the nurse why he is "on so many medications." What action should the nurse take?

Contact the health care provider to request treatment.

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate?

The UAP takes a rectal temperature on the client.

The registered nurse (RN) and unlicensed assistive personnel (UAP) are caring for a pediatric client with an immune disorder receiving a stem cell transplant. Which action by the UAP will cause the RN to intervene?

Determining if her throat itches

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important?

IgE

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin?

varicella vaccine

Which of the following immunizations should a child with acquired immune deficiency syndrome (AIDS) not receive?

Expiration date

Which of the following is important to check prior to the administration of a vaccine?

Give the antibiotic for the full ten days.

A 2-year-old child with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc three times daily by mouth for ten days for otitis media. To guard against antibiotic resistance, the nurse instructs the parent to:

Give the infant the flu vaccination but withhold the others.

A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the 4-month-old was exposed to a brother who has the flu. In this case, the nurse will:

ineffective protection related to impaired humoral defenses

A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority?

X-linked agammaglobulinemia Wiskott-Aldrich syndrome X-linked hyper-IgM syndrome

A nursing student is reviewing information about primary immunodeficiencies. The student demonstrates understanding of the material by identifying which immunodeficiencies as affecting only males? Select all that apply.

serum blood testing

A pediatric client is admitted to the hospital. The primary health care provider suspects a problem with the child's immune system. The nurse anticipates preparing this client for which test initially?

"Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily."

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent?

"Breastfeeding will increase your newborn's risk of contracting HIV."

A pregnant client who is HIV positive asks the nurse if she will be able to breastfeed the newborn. Which response by the nurse is most appropriate?

IgG

A premature infant is at greater risk for infection than are full-term infants because of a reduced number of which immunoglobulin?

Eczema

What would the nurse expect to find in a male infant with Wiskott-Aldrich syndrome?

Elastoplast

A child with myelomeningocele has a latex allergy. Which product should not be used for a dressing change for this child?

risk for infection

A nurse is planning care for a child with human immunodeficiency virus (HIV). Which of the following nursing diagnoses should take highest priority for this child?

Administer albuterol via a nebulizer.

After administering epinephrine to a client in anaphylactic shock, which action will the nurse perform?

Exposure to allergen Rapid immune response Vasodilation Bronchoconstriction Circulatory collapse

Place in correct order the steps in the anaphylactic response.

polymerase chain reaction (PCR).

The most accurate screening test for the presence of HIV antigen in young children is:

Have epinephrine available.

The nurse is administering the prescribed intravenous immunoglobulin to a 10-year-old boy. What step would be most important for the nurse to do?

bananas

The nurse is providing teaching for the parents of a child with a latex allergy. The nurse tells the client to avoid which food?

erythrocyte sedimentation rate (ESR)

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated?

pineapples cherries bananas

A child is diagnosed with a latex allergy. When developing the teaching plan for this child, the nurse would include what foods to avoid? Select all that apply.

Exposure to blood and body fluids through sexual contact Sharing contaminated needles Transfusion of contaminated blood Perinatally from mother to fetus Through breastfeeding

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.

Zidovudine

A nurse is providing care to a child with HIV who is prescribed therapy with a nucleoside reverse transcriptase inhibitor. What would the nurse expect to administer?

cellular immunity recognizes antigens

After teaching a class about humoral and cellular immunity, the nurse recognizes that the additional teaching is needed when the class states that:

Discusses the body changes with a peer

An adolescent has systemic lupus erythematosus (SLE). Which of the following actions by the teen indicates acceptance of the body changes that occur because of SLE?

Polymerase chain reaction (PCR) test

An infant born to a mother who was HIV positive was tested at birth and found to be negative. The infant is scheduled for follow-up testing. Which test would the nurse expect to be performed?

adolescent with polyarticular disease

The nurse is reviewing the results of a rheumatoid factor test of several clients diagnosed with juvenile idiopathic arthritis. Which client would be most likely to demonstrate a positive rheumatoid factor?

Contact the employee health department in the facility and obtain latex-free products for the nurse technician.

One of the nurse technicians is showing symptoms of latex sensitivity. Which of the following is the best action by the nurse?

The child states that his tongue feels "too big" for his mouth. The child has developed hives on his face and trunk. The child states he feels like he might "throw up". The child states that he feels like he might faint.

The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply.

Elimination diet

The nurse is helping the parents of a toddler identify foods that are causing allergic symptoms in the child. Which strategy should the nurse encourage the parents to use?

"Corticosteroids help the inflammation that goes along with an allergy." "I may have to undergo intradermal testing to determine what I am allergic to." "Once we figure out what I am allergic to, it is important for me to avoid that allergen."

The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen?

Offered generous amounts of fluids frequently.

The hospital admitting nurse is taking a history on a child's illness from the parents. The nurse concludes that the parents treated their 6-year-old child appropriately for a fever related to otitis media when they report that they:

"The best way is to eliminate the food from the diet and then look for improvement."

The mother of a child with a possible food allergy asks the nurse for information about how to test for it. Which response by the nurse would be most appropriate?

Instruct the child be brought to the emergency department promptly.

The mother of a child with myasthenia gravis has called the clinic and reports her child appears very anxious and the child's heart is beating very fast. What action by the nurse is indicated?

"If my child has gastrointestinal upset, my child is not having anaphylactic shock."

The nurse is speaking with the parent of a child who has experienced an allergic reaction to peanuts. Which statement by the parent would indicate a need for further education?

"Humoral immunity is generally functional at birth."

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education?

Nausea, vomiting, diarrhea Urticaria, angioedema Bronchospasm Hypoxia Seizures

The nursing instructor is describing the events of anaphylaxis. Place the assessment findings in the order that they would occur from first to last.

"Has your child ever been tested for a peanut allergy?"

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond?

"Maternal antibodies crossed the placenta and that prevented infections until now."

The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate?

"Has she ever had penicillin before?"

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant?

Weight appropriate for height

When reviewing the history of a child with suspected primary immunodeficiency, what would the nurse be least likely to find?

IgG

When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns?

IgM

When teaching about primary and secondary humoral responses, what should the nurse identify as the immunoglobin that is first to appear in the serum?

A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C)

Which client will the nurse assess first after receiving shift report?

Vitamins

he nurse caring for a child with HIV infection conducts periodic dietary analysis. Which of the following do children with HIV often lack?

Zidovudine

The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication?

Include the child when discussing foods that contain peanuts.

The nurse is caring for a school-age child recently diagnosed with an allergy to peanuts. Which nursing action is a priority?

4 to 7 weeks

The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age?

Administer immunosuppressive medications as ordered. Monitor the client for signs and symptoms of graft versus host disease. Provide oral care at least every shift, but more often as needed. Perform meticulous hand hygiene and ensure all visitors follow these precautions.

The nurse is completing a care plan for a child who has recently had a bone marrow transplant. Which nursing interventions should the nurse include in the care plan? Select all that apply.

"The medication disrupts the virus life cycle of HIV. This prevents the disease from progressing."

The nurse is administering nevirapine to an adolescent client diagnosed with HIV. The client asks the nurse how this medication helps fight HIV. How should the nurse respond?

sweating salivation urinary incontinence

The nurse is administering pyridostigmine to a client with myasthenia gravis. Which signs and symptoms would alert the nurse that the client may be receiving too high of a dose of the medication? Select all that apply.

Fruit juice Rice milk Soy milk

A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? Select all that apply.

Methotrexate

A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression?

administer a beta-2 adrenergic agonist

A child is in the emergency department with an asthma exacerbation. Upon auscultation, the nurse is unable to hear air movement in the lungs. What action should the nurse take first?

passive immunity

A child who has not had a tetanus immunization steps on a rusty nail. The child needs immediate protection from tetanus. Which of the following should be given to the child at this time?

shake the vial after reconstituting it

A child with hypogammaglobulinemia is to receive intravenous immunoglobulin (IVIG). What action would not be correct to take?

joint pain

A child with systemic lupus erythematosus is receiving high-dose corticosteroid therapy over the long term. The nurse would instruct the parents and child to report:

"Immune responses can be genetic and run in the family."

A child's mother asks the nurse how likely it is the child will develop asthma because the child's father has asthma. Which response by the nurse is most appropriate?

Document the finding in the client's medical record.

A client is being admitted to the medical unit for exacerbation of symptoms of systemic lupus erythematosus (SLE). When assessing the client, the nurse notices a butterfly-shaped rash across the client's cheeks and bridge of the nose. Which action by the nurse is most appropriate?

T cells

A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify what as being involved in cellular immunity?

Explain that if her child contracts measles, mumps, or rubella, there could be very serious and permanent complications from these diseases.

A mother refuses to have her child immunized with the measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. The nurse's most appropriate response to this mother is to:

The child develops severe shaking, chills, and fever.

A nurse has begun an infusion of intravenous immunogloblin (IVIG) to a child who has combined immunodeficiency disease. In which of the following situations should this infusion be stopped?

By 6 months of age

A nurse instructor is teaching pregnant women how HIV can spread from mother to fetus without treatment. For the untreated child who contracts HIV through placental transmission, when will the child test positive for HIV?

Peaches Plums Carrots Tomatoes

A nurse is assessing a child who may have a latex allergy. The nurse asks the child about allergic reactions to certain foods. Which foods if identified by the child as experiencing an allergic reaction would help support the suspected latex allergy? Select all answers that apply.

"She is allowed by law to carry her EpiPen with her; I will talk to school authorities."

A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate?

Eggs Shrimp Peanuts

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which foods would the nurse most likely include? Select all that apply.

Immunization or exposure to the natural disease.

A nurse is providing education to a group of young mothers. The nurse would explain that as children grow, they develop immunity through:

Immune systems that are not fully mature at birth.

A nurse is providing information to a group of new mothers. The nurse would explain that newborns and young infants are more susceptible to infection because they have:

Lower number of natural killers

A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which of the following does the nurse's best response address?

elevated blood pressure

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern?

corticosteroid therapy

The nurse is assessing a child with a complex medical history that includes fatigue, Raynaud phenomenon, anemia, and photosensitivity. The nurse should anticipate that this child may require which treatment?

a child diagnosed with six episodes of acute otitis media during the previous year a child with oral candidiasis (thrush) that is unresolved with treatment a child admitted to the hospital three times within the last year with pneumonia a child who has taken antibiotics for the last 3 months without evidence of the infection clearing

The nurse is assessing children in a physician's office. Which children may have a primary immunodeficiency? Select all that apply.

Ensure the child has not taken diphenhydramine in the past week.

The nurse is assisting with skin testing on a pediatric client with allergies. What will the nurse do first?

Albuterol

The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer what medication for bronchospasm as ordered?

"We may note our child has a fever above 103°F (39.5°C) for a couple weeks and should monitor our child's temperature." "We need to administer medication to decrease inflammation and pain in our child." "We should encourage swimming as an activity for our child."

The nurse is caring for a child diagnosed with juvenile idiopathic arthritis. Which statement(s) by the parents demonstrates an understanding of how to care for their child with this disease? Select all that apply.

"The medication is best absorbed with the vitamin C in citrus juices."

The nurse is providing family education about the administration of cyclosporine A. Which response by the family indicates a need for further teaching?

Administer the medication with food. Monitor laboratory results for an increase in liver enzymes. Monitor laboratory results for a decrease in renal function.

The nurse is caring for a child who is receiving naproxen for treatment of juvenile idiopathic arthritis. What intervention(s) should the nurse include in this client's care plan? Select all that apply.

They decrease renal function

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action?

muscle weakness shortness of breath rash unusual bleeding

The nurse is caring for a client with HIV who is receiving abacavir for treatment. What signs and symptoms will require the nurse to notify the physician? Select all that apply.

sexual contact.

The nurse is explaining patterns of incidence and transmission of HIV to a group of adolescent girls. She explains that the risks for this population are much higher because of the possibility of both vertical and horizontal transmission. Horizontal transmission refers to transmission of the disease during:

humoral; bacterial

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens.

Screening for HIV

The nurse is instructing a group of women of childbearing age about human immunodeficiency virus (HIV) during pregnancy. What would be a priority recommendation in this setting?

Grasps EpiPen with black tip pointing downward Forms a fist around the EpiPen Pulls off the gray safety release Jabs the EpiPen firmly into the outer thigh at a 90-degree angle Holds EpiPen in place for 10 seconds Massages site for 10 seconds after removing EpiPen

The nurse is observing a child demonstrate the use of an EpiPen. The nurse determines that the child has performed the procedure correctly. Place the steps in the proper sequence that was demonstrated by the child.

"I am a little nervous because I know my child could have a severe reaction during testing." "We will be here in the exam room for quite a while I'm guessing." "If my child is allergic to any of the substances there will be a raised red area at the reaction site."

The nurse is performing the intake assessment on a child about to undergo allergy skin testing. Which statements by the parent would demonstrate to the nurse that the parent understands the procedure? Select all that apply.

Ensure a pair of hemostats are at the bedside. Monitor pulse oximetry readings. Assess lungs as directed by the physician or as the client's condition warrants. Maintain chest tube bottle in an upright position and below the level of the chest.

The nurse is planning care for a child with a pneumothorax. The nurse adds the nursing diagnosis, "Risk for injury related to potential dislodgement of chest tube" to the care plan. When writing the care plan, what should the nurse be sure to include as interventions?

Persistent oral thrush Chronic cough Extensive eczema

The nurse is preparing an informational brochure about risk factors for immune disorders. Which disease process can indicate a potential underlying immunologic disorder? Select all that apply.

BUN Serum creatinine

The nurse is preparing to administer IVIG to an adolescent. Prior to administration, which baseline lab values does the nurse need to review? Select all that apply.

Acute otitis media, one episode every 3 to 4 weeks over the past year. Recurrent deep abscess of the thigh Oral candidiasis (thrush), persistent over the past 6 to 7 months

The nurse is reviewing the medical history of a 4-year-old child. What would the nurse identify as potentially indicative of a primary immunodeficiency? Select all that apply.

proper hand hygiene

The nurse is teaching parents how to prevent the spread of infectious disease. Which of the following is the most important health promotion strategy for all age groups of children?

"We cannot go wrong with barbeque and french fries."

The nurse is teaching the parents of a 4-year-old client with a peanut allergy about dietary restrictions. Which response by the parents indicates a need for further teaching?

Give the child an epinephrine injection.

The nurse on a pediatric unit finds a child having extreme shortness of breath, a swollen tongue, and urticaria on the face and neck. The nurse notices the lunch tray to have a half-eaten peanut butter and jelly sandwich. Which action will the nurse take first?

Wheezing Urticaria Serum sickness

The nurse receives a call from a parent whose toddler received a prescription for amoxicillin one teaspoon every 8 hours. The child has received 2 doses and the parent is noticing unusual symptoms. Which symptoms may indicate a severe penicillin allergy? Select all that apply.

"We'll need to bring her back in for some lab tests after she starts methotrexate." "Swimming sounds like a good exercise for her." "A warm bath before bed might help her sleep better."

The young girl has been diagnosed with juvenile idiopathic arthritis (JIA) and has been prescribed methotrexate. Which statements by the child's parent indicates that adequate learning has occurred? Select all that apply.

Encourage the child to wear a medical alert bracelet for penicillin.

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority?

Ineffective protection Risk for imbalanced nutrition, less than body requirements Pain

While performing an assessment of a patient who is immunocompromised, the nurse notes the child to have thrush in the mouth, tenderness over the spleen upon palpation, and a white blood cell count of 3,000. Which nursing diagnoses will the nurse include in the care plan of this child based on these findings? Select all that apply.

"Any kind of fruit is acceptable."

While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching?

"Since I am 13, it would be unusual for me to be diagnosed. Younger kids usually get it." "I should have not spent so much time in the sun. That may have been what caused me to get lupus."

A 13-year-old female adolescent is being evaluated for lupus. Which statement(s) by the adolescent indicates a need for further education regarding this disease? Select all that apply.

Acquired immunity

Children under age 6 years are at greater risk for infection due to underdeveloped:

Naturally develop antibodies.

The nurse explains to new parents that as healthy children are exposed to more infections, they:

"If we need to use the EpiPen® we will need to notify her physician's office the next business day."

The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education?

Swimming

Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis?

egg whites

Which food component is most likely to cause an immediate allergic reaction?

T cells B cells Phagocytes

Which immune cells are disrupted when a child is infected with human immunodeficiency virus (HIV)? Select all that apply.

aminophylline

Which medication is a respiratory stimulant?

Obtain a careful health history.

Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000/mm3, and 10% eosinophils?

oil-based hand creams

Which of the following products should a nurse avoid when caring for a child with a latex allergy?

Swimming

A school-age child with rheumatoid arthritis asks the nurse to recommend an exercise activity. Which of the following would be the most appropriate for the nurse to recommend?

Assessing patency of the airway

The nurse is caring for a child who is beginning to show signs and symptoms of anaphylaxis. Which intervention would be the priority?

"Zidovudine decreases the chance my child will transmit HIV to others."

The nurse is caring for a child with HIV currently taking zidovudine. Which statement by the parent would be the most concerning?

lymphocyte immunophenotyping T-cell quantification

The nurse is caring for a child with HIV. The doctor will most likely order which test to monitor the child's progress?

The child reports stiffness in the joints that is worse in the morning. redness and warmth in the affected joint swelling noted in the affected joint

The nurse is caring for a child with an elevated erythrocyte sedimentation rate, a hemoglobin level of 9.3 g/dL (93 g/L), and a positive antinuclear antibody. What would the nurse expect to identify when assessing this child? Select all that apply.

Gently roll the vial to mix the medication.

The nurse is preparing to administer an intravenous immunoglobulin infusion. While reconstituting the product according the manufacturer's instructions, the nurse knows to take which step for proper preparation?

Anticipatory grieving

Which of the following nursing diagnoses would the nurse anticipate for a family who has a child with acquired immune deficiency syndrome (AIDS)?

The diluents provided

Which of the following should the nurse use when reconstituting vaccines?

corticosteroids nonsteroidal anti-inflammatory drugs (NSAIDs)

Which treatments are common to both systemic lupus erythematosus and juvenile idiopathic arthritis? Select all that apply.

Altered family coping related to new presentation of significant illness Altered comfort related to severity of new illness Inadequate adherence to medication regimen related to side effects Inadequate nutrition related to side effects of medication Delayed growth and development related to frequent infections

A school-aged child, who is allergic to bee stings, states, "I think I was stung by a bee outside." Which intervention by the school nurse is most appropriate?

Assess the client for signs of anaphylactic shock

A school-aged child, who is allergic to bee stings, states, "I think I was stung by a bee outside." Which intervention by the school nurse is most appropriate?

"We don't want to face the fact that it is likely our child contracted HIV through sexual contact or IV drug use."

A 16-year-old patient has just been diagnosed with HIV. Which statement by the parent indicates understanding of the diagnosis?

Wiskott-Aldrich syndrome.

A 6-month-old boy has been admitted to the hospital with severe bloody diarrhea. The nurse notes petechiae and eczema with signs of secondary infection. As the nurse documents the boy's history, the parents report easy bruising and prolonged bleeding after circumcision. Based on these findings, the nurse suspects a diagnosis of:

Ask if any medications were given before arriving to the ER.

A 7-year-old client presents to the emergency room (ER) after experiencing an allergic reaction to a bee sting. The client is breathing and able to verbally communicate. The nurse notes the client's pulse 90 beats/minute, respirations are 23 breaths/minute, blood pressure is 100/60 mm Hg, lungs are clear. Which nursing action is priority?

premedicate with acetaminophen or diphenhydramine.

The nurse is preparing to administer intravenous immunoglobulin (IVIG) for a child who has not had an IVIG infusion in over 10 weeks. The nurse knows to first:

Take baseline vital signs and monitor the vital signs during the infusion. Prepare to give acetaminophen to the child. Prepare to give diphenhydramine to the child.

The nurse is preparing to administer the child's dose of intravenous immune globulin (IVIG). Which actions should the nurse take? Select all that apply.

"If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it."

The nurse is providing a class for a group of childcare providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction?

"We should be sure to administer the medication on an empty stomach so the medication will be absorbed better." "If the medication doesn't seem to be working, we can stop giving it to our child at any time."

The nurse is providing discharge instructions for a client taking a corticosteroid. Which statements by the parents alert the nurse that clarification of instructions is needed?

"It is important I avoid triggers." "Getting a flu shot will be important." "I am going to incorporate a short nap into my daily routine."

The nurse is providing education to a 16-year-old who has recently been diagnosed with myasthenia gravis. Which statement(s) by the adolescent indicates an understanding of the information provided? Select all that apply.

Administer prescribed medications.

Which nursing intervention is priority when caring for a child with HIV?

"If my child shows signs of an upper respiratory infection I will contact our physician right away." "We love to take family vacations to Florida, but we will have to find a new vacation spot." "I picked up our child's medical alert bracelet today."

The nurse is providing discharge teaching to the client with myasthenia gravis. Which statements by the parents of the client demonstrate knowledge of proper care? Select all that apply.

has polyarticular JIA.

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child: