Exam 1 (NURS 240)
Tyler Harris, a 5-year-old male, has recovered from an anaphylactic reaction which brought him to the ED 3 weeks ago. Tyler has begun sensitivity testing to determine the allergen which caused his anaphylactic reaction. In scratch testing, which part of the body is more sensitive to allergens? a) Upper arm b) Back c) Forearm d) Chest
Back
Which type of disorder produces recurrent and persistent infection of the soft tissue, lungs, and other organs? a) T-cell deficiency b) B-cell deficiency c) Complement deficiency d) Primary phagocytic disorder
Primary phagocytic disorder
This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte. a) Cytotoxic T cell b) Suppressor T cell c) Helper T cell d) Memory T cell
cytotoxic T cell
A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications? a) Give the client one medicine at a time and observe for allergic reactions. b) Administer the medications that the physician ordered. c) Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive. d) Call the pharmacy and let them know the client has several drug allergies.
Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.
Which findings best correlate with a diagnosis of osteoarthritis? a) Erythema and edema over the affected joint b) Anorexia and weight loss c) Joint stiffness that decreases with activity d) Fever and malaise
Joint stiffness that decreases with activity
The nurse is aware that a delayed-type hypersensitivity reaction is an example of an immune response. The T lymphocytes involved in this type of reaction are: a) Helper T cells. b) Memory T cells. c) Killer T cells. d) Suppressor T cells.
Killer T cells
A client is prescribed montelukast as part of his treatment plan for an allergic disorder. The nurse understands that this drug belongs to which class? a) Leukotriene-receptor antagonist b) Nonsedating antihistamine c) Mast cell stabilizer d) Corticosteroid
Leukotriene-receptor antagonist
The nursing students are learning about the immune system in their anatomy and physiology class. What would these students learn is a component of the immune system? a) Red blood cells b) Lymphoid tissues c) Cytokines d) Stem cells
Lymphoid tissues
Activation of a natural immunity response is enhanced by physical and chemical barriers. Which of the following is a physical barrier, which the nurse knows can be altered by illness, nutrition, or lifestyle? a) Mucus b) Enzymes in saliva c) Cilia of the respiratory tract d) Acidic gastric secretions
cilia of the respiratory tract
A client with a history of allergic rhinitis comes to the clinic for an evaluation. The client is prescribed triamcinolone. Which of the following would the nurse include when teaching the client about this drug? a) Be aware that some nasal burning and itching may occur. b) Use ice chips to alleviate the symptoms of dry mouth. c) Place the prescribed number of drops into the conjunctiva. d) Take the drug orally before, with, or after meals.
Be aware that some nasal burning and itching may occur.
What severe complication does the nurse monitor for in a patient with ataxia-telangiectasia? a) Acute kidney injury b) Neurologic dysfunction c) Chronic lung disease d) Overwhelming infection
overwhelming infection
The nurse is caring for a young patient who has agammaglobulinemia. The nurse is teaching the family how to avoid infection at home. Which statement by the family indicates that additional teaching is needed? a) "I will avoid letting my child drink any juice that has been sitting out for more than an hour." b) "I will let my neighbor have my pet iguana." c) "I will apply lotion following every bath to prevent dry skin." d) "I can take my child to the beach, as long as we play in the sand rather than swim in the water."
"I can take my child to the beach, as long as we play in the sand rather than swim in the water."
Maximum intensity of histamine occurs within which time frame following antigen contact? a) 45 minutes b) 30 minutes c) 15 minutes d) 5 minutes
15 minutes
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? a) DAF b) SCID c) AIDS d) CVID
AIDS
A patient is prescribed an oral corticosteroid for 2 weeks for relief of asthma symptoms. The nurse instructs the patient that side effects include which of the following? a) Hypoglycemia b) Hypotension c) Diuresis d) Adrenal suppression
Adrenal suppression
The nurse practitioner treating a patient with allergic rhinitis decides pharmacologic therapy would be helpful. Which of the following is she most likely to prescribe? a) Afrin b) Sudafed c) Allegra d) Rhinocort
Allegra
A client is diagnosed with rheumatoid arthritis, an autoimmune disorder. When teaching the client and family about autoimmune disorders, the nurse should provide which information? a) Advanced medical intervention can cure most autoimmune disorders. b) Autoimmune disorders include connective tissue (collagen) disorders. c) Autoimmune disorders are distinctive, aiding differential diagnosis. d) Clients with autoimmune disorders may have false-negative but not false-positive serologic tests.
Autoimmune disorders include connective tissue (collagen) disorders.
The nurse is caring for a postrenal transplantation client taking cyclosporine (Sandimmune). The nurse notes an increase in one of the client's vital signs and the client is complaining of a headache. What vital sign is MOST LIKELY increased? a. Pulse b. Respirations c. Blood pressure d. Pulse oximetry
Blood pressure
A patient with paroxysmal hemoglobinuria, a deficiency of complement proteins, is complaining of headache and weakness of the right arm and leg. Based on these symptoms, for which health complication should the nurse assess with this patient? a) Rheumatoid arthritis b) Cerebral venous thrombosis c) Bacterial meningitis d) Edema formation in the subcutaneous tissues of the extremities
Cerebral venous thrombosis
The nurse is caring for a patient with an immunodeficiency disorder. What cardinal symptoms of immunodeficiency does the nurse recognize while caring for this patient? (Select all that apply.) a) Poor response to the treatment with antibiotics b) Vomiting c) Nonproductive cough d) Chronic or recurrent severe infections e) Chronic diarrhea
Chronic diarrhea Chronic or recurrent severe infections Poor response to the treatment with antibiotics
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder? a) To decrease the body's risk of infection b) So the client has strong drug therapy c) For their immunosuppressant effects d) Because an autoimmune disease is a neoplastic disease
For their immunosuppressant effects
The nurse is preparing a teaching plan for a client with an immunodeficiency. Which of the following would the nurse emphasize as most important? a) Identifying the signs and symptoms of infection b) Frequent and thorough handwashing c) Adherence to prophylactic medication administration d) Incorporation of treatment regimens into daily patterns
Frequent and thorough handwashing
A client who is human immunodeficiency virus seropositive has been taking stavudine (d4T, Zerit). The nurse should monitor which MOST closely while the client is taking this medication? a. Gait b. Appetite c. Level of consciousness d. Gastrointestinal
Gait
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____. a) Cure rate of the virus b) The fact that it is a mutated virus originally thought to be bovine in nature c) HIV-1 is more prevalent than HIV-2 subtypes d) Means of transmission
HIV-1 is more prevalent than HIV-2 subtypes
Which of the following is the most common joint affected in gout? a) Ankle b) Knee c) Metatarsophalangeal d) Tarsal area
Metatarsophalangeal
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) Eggs b) Shrimp c) Chicken d) Milk e) Beef
Milk Eggs Shrimp
Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Which interventions should the nurse include when administering this medication? SELECT ALL THAT APPLY a. Restrict fluid intake b. Monitor liver function studies c. Instruct the client to avoid alcohol d. Administer the medication with an antacid e. Instruct the client to avoid exposure to the sun f. Administer the medication on an empty stomach
Monitor liver function studies Instruct the client to avoid alcohol Instruct the client to avoid exposure to the sun
Histamine release in anaphylaxis causes which of the following? a) Urinary urgency b) Nasal congestion c) Stomach cramps d) Feeling of impending doom
Nasal congestion
The nurse is caring for a client who has been taking a sulfonamide and should monitor for signs/symptoms of which side/adverse effects of the medication? SELECT ALL THAT APPLY a. Ototoxicity b. Palpitations c. Nephrotoxicity d. Bone marrow depression e. Gastrointestinal (GI) effects f. Increased white blood cell (WBC) count
Nephrotoxicity Gastrointestinal (GI) effects Increased white blood cell (WBC) count
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? a) Erythrocyte sedimentation rate b) Serum IgE level c) Eosinophil count d) White blood cell count
Serum IgE level
The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet, an antiviral medication. The nurse should monitor the results of which laboratory study while the client is taking this medication? a. CD4 cell count b. Lymphocyte count c. Serum albumin level d. Serum creatinine level
Serum creatinine level
The nurse is working with a colleague who has a delayed hypersensitivity (type IV) allergic reaction to latex. Which of the following statements 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.
Symptoms are localized to the area of exposure, usually the back of the hands.
T-cell and B-cell lymphocytes are the primary participants in the immune response. What do they do? a) T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person. b) T-cell and B-cell lymphocytes respond to the body's invasion by macrophages. c) T-cell and B-cell lymphocytes react to the body's lack of B12 . d) T-cell and B-cell lymphocytes distinguish harmful treatments from curative treatments.
T-cell and B-cell lymphocytes distinguish harmful substances and ignore those natural and unique to a person.
The client with acquired immunodeficiency syndrome and pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The client develops a temperature of 101 F. The nurse continues to assess the client, knowing that this sign most likely indicates which condition? 1. That the dose of the medication is too low 2. That the client is experiencing toxic effects of the medication 3. That the client has developed inadequacy of thermoregulation 4. That the client has developed another infection caused by leukopenic effects of the medication
That the client has developed another infection caused by leukopenic effects of the medication
The nurse is teaching a client who has been diagnosed with Hashimoto's thyroiditis. Which of the following statements correctly describes the process of autoimmunity? a) A deficiency results from improper development of immune cells or tissues. b) The body overproduces immunoglobulins. c) The normal protective immune response attacks the body, damaging tissues. d) The body produces inappropriate or exaggerated responses to specific antigens.
The normal protective immune response attacks the body, damaging tissues.
The nursing instructor is discussing the development of human immunodeficiency disease (HIV) with the students. What should the instructor inform the class about helper T cells? a) They have the ability to decrease B-cell production. b) They are activated on recognition of antigens and stimulate the rest of the immune system. c) They attack the antigen directly by altering the cell membrane and causing cell lysis. d) They are responsible for recognizing antigens from previous exposure and mounting an immune response.
They are activated on recognition of antigens and stimulate the rest of the immune system.
A major manifestation of Wiskott-Aldrich syndrome includes which of the following? a) Episodes of edema b) Ataxia c) Thrombocytopenia d) Bacterial infection
Thromboctyopenia
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. What type of hypersensitivity did Loren exhibit? a) Type I b) Type III c) Type IV d) Type II
Type I
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) Lower margin around the liver. b) Upper left quadrant of the abdomen. c) Upper mediastinum. d) Lower right abdomen.
Upper left quadrant of the abdomen.
Which of the following is a contraindication for immunotherapy? a) Allergic asthma b) Use of a beta-blocker c) Conjunctivitis d) Allergic rhinitis
Use of a beta-blocker
What test will the nurse assess to determine the patient's response to antiretroviral therapy? a) Western blot b) EIA enzyme immunoassay c) CBC d) Viral load
Viral load
A client with suspected HIV has had two positive enzyme-linked immunosorbent assay tests. What diagnostic test would be run next? a) Polymerase chain reaction b) T4/T8 ratio c) Western Blot d) ELISA
Western Blot
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? a) A cell-mediated response b) Activation of the complement system c) Stimulation of colony-stimulating factors d) Naturally acquired active immunity
a cell mediated response
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? a) A cell-mediated response b) Naturally acquired active immunity c) Activation of the complement system d) Stimulation of colony-stimulating factors
a cell mediated response
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? a) Stimulation of colony-stimulating factors b) A cell-mediated response c) Activation of the complement system d) Naturally acquired active immunity
a cell-mediated response
The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which of the following is the term used to define any substance capable of inducing a specific immune response and of reacting with the products of that response? a) Antibodies b) Lymphocytes c) Antigens d) Lymphokines
antigens
A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? a) Leukocytosis b) Bone marrow suppression c) Rash d) Oral thrush
bone marrow suppression
A patient is being treated in the intensive care unit for sepsis related to ventilator-associated pneumonia. The patient is on large doses of three different antibiotics. What severe outcome should the nurse monitor for in the lab studies? a) Rash b) Oral thrush c) Leukocytosis d) Bone marrow suppression
bone marrow suppression
Tyler Harris, a 5-year-old male, is a client in the pediatric unit of the hospital where you practice nursing. Tyler is recovering from an anaphylactic reaction to an allergen which brought him to the ED. His mother is quite concerned with the potential reoccurrence of Tyler's reaction. In your discussion with Mrs. Harris, what is one strategy she can use to narrow down the possible allergen? a) Clinical manifestations generally correlate with route of exposure. b) Clinical manifestations generally correlate with respiratory symptoms. c) Clinical manifestations generally correlate with skin reactions. d) Clinical manifestations generally correlate with systemic effects.
clinical manifestations generally correlate with route of exposure
A nurse practitioner working in a dermatology clinic explained to a group of nursing students that the pathophysiology of an allergic response involves a chain of events that includes responses from lymphocytes, IgE, mast cells, and basophils. The nurse mentioned that the most important chemical mediator involved in the response is: a) Serotonin. b) Prostaglandins. c) Leukotrienes. d) Histamine.
histamine
A patient is scheduled to receive an intravenous immunoglobulin (IVIG) infusion. He asks the nurse about the infusion's administration and its adverse effects. Which of the following choices should the nurse instruct this patient to report immediately? a) Tickle in the throat b) Sneezing c) Mouth sores d) Constipation
tickle in the throat
Which interventions apply in the care of a client at high risk for allergic response to a latex allergy? a. use nonlatex gloves b. use medications from glass ampules c. place the client in a private room only d. keep a latex safe supply cart available in the client's area e. avoid the use of medication vials that have rubber stoppers d. use a blood pressure cuff from an electronic devic
use nonlatex gloves use medications from glass ampules keep a latex safe supply cart available in the client's area avoid the use of medication vials that have rubber stoppers
A client reports to a physician's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which client statement indicates a need for further education? a) "I may experience itching and irritation at the site of the testing." b) "The test may be mildly uncomfortable." c) "If I notice tingling in my lips or mouth, gargling may help the symptoms." d) "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."
A client is informed that his white blood cell count is low and that he is at risk for the development of infections. The client asks, "Where do I make new white blood cells?" What is the best response by the nurse? a) "White blood cells are produced in the thymus gland." b) "White blood cells are produced in the plasma." c) "White blood cells are produced in the bone marrow." d) "White blood cells are produced in the lymphatic tissue."
"White blood cells are produced in the bone marrow."
There are major differences between primary and secondary immunodeficiencies. Select the most accurate statement the nurse would use to explain the cause of a secondary immunodeficiency. a) "Your immune system was most likely affected by an underlying disease process." b) "You will now be more likely to develop cancer in the future." c) "Your condition will predispose you to frequent and recurring infections." d) "Your diagnosis was inherited."
"Your immune system was most likely affected by an underlying disease process."
While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? a) 5% to 10% b) 1% to 3% c) 15% to 40% d) 3% to 4%
15% to 40%
A patient with common variable immunodeficiency (CVID) is extremely fatigued and not feeling well. What lab test does the nurse anticipate the patient will have to detect a common development related to the disease? a) B12 level b) Glucose level c) Blood urea nitrogen (BUN) and creatinine d) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT)
B12 level
Amikacin (Amikin) is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the health care provider (HCP) IMMEDIATELY if which occurs? a. Nausea b. Lethargy c. Hearing loss d. Muscle aches
Hearing loss
A 38-year-old female patient has begun to suffer from rheumatoid arthritis. She is also being assessed for disorders of the immune system. She works as an aide at a facility that cares for children infected with AIDS. Which of the following is the most important factor related to the patient's assessment? a) Her use of other drugs b) Her age c) Her home environment d) Her diet
Her use of other drugs
Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? a) Histamine b) Serotonin c) Prostaglandin d) Bradykinin
Histamine
The nurse provides home care instructions to a client with SLE and tells the client about methods to manage fatigue. Which statement by the client indicates a need for further instructions? a. I should take hot baths because they are relaxing b. I should sit whenever possible to conserve my energy. c. I should avoid long periods of rest because it causes joint stiffness d. I should do some exercises, such as walking, when I am not fatigued.
I should take hot baths because they are relaxing
The body has several mechanisms to fight disease, one of which is sending chemical messengers. Specifically, 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) Colony-stimulating factor c) Tumor necrosis factor d) Interferons
Interferons
A client develops an anaphylactic reaction after receiving morphine sulfate. The nurse should plan to institute which actions? Select All That Apply. a. administer oxygen b. quickly assess the client's respiratory status c. document the event, interventions, and the client's response d. leave the client briefly to contact a health care provider. e. keep the client supine regardless of the blood pressure readings. d. start an IV infusion of D5W and administer a500mL bolus
administer oxygen quickly assess the client's respiratory status document the event, interventions, and the client's response
A client has been having joint pain and swelling in the left foot and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered? a) An exacerbation of a previous disorder b) An alloimmunity disorder c) Autoimmune d) A cause-and-effect relationship
autoimmune
A client who is being treated for complications related to acquired immunodeficiency disorder syndrome (AIDS) is receiving interferon parenterally as adjunctive therapy. Why does the nurse understand this route is being used? a) The medication will work more rapidly parenterally. b) The taste of the medication is not palatable. c) The medication, given orally, will cause diarrhea. d) Digestive enzymes destroy its protein structure.
digestive enzymes destroy its protein structure
When assessing the skin of a client with allergic contact dermatitis, the nurse would most likley expect to find irritation at which area? a) Lower arms b) Ankles c) Dorsal aspect of the hand d) Plantar aspects of the feet
dorsal aspect of the hand
Which of the following is an appropriate nursing intervention in the care of the patient with osteoarthritis? a) Encourage weight loss and an increase in aerobic activity b) Provide an analgesic after exercise c) Avoid the use of topical analgesics d) Assess for the gastrointestinal complications associated with COX-2 inhibitors
encourage weight loss and an increase in aerobic activity
Which of the following body substances causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle? a) Bradykinin b) Serotonin c) Histamine d) Prostaglandin
histamine
Which of the following protective responses begin with the B lymphocytes? a) Phagocytic b) Recognition c) Cellular d) Humoral
humoral
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? a) Lymphocyte b) Monocyte c) Neutrophil d) Basophil
lymphocyte
A client is diagnosed with human immunodeficiency virus (HIV). After recovering from the initial shock of the diagnosis, the client expresses a desire to learn as much as possible about HIV and acquired immunodeficiency syndrome (AIDS). When teaching the client about the immune system, the nurse states that humoral immunity is provided by which type of white blood cell? a) Monocyte b) Lymphocyte c) Neutrophil d) Basophil
lymphocyte
A 6-year-old experienced an allergic reaction to shellfish. The nurse practitioner gave the mother a booklet that includes teaching points about food allergies. The nurse reminded the mother to be vigilant for mild systemic reactions such as: a) Bronchospasm. b) Shortness of breath. c) Wheezing and coughing. d) Nasal congestion and sneezing.
nasal congestion and sneezing
A 25-year-old man receives a knife wound to the leg in a hunting accident. Which of the following types of immunity was compromised? a) Adaptive immunity b) Passive immunity c) Natural immunity d) Specific immunity
natural immunity
A nursing instructor is giving a lecture on the immune system. Which of the following cells will the instructor include in her discussion on phagocytosis? a) Regulator T cells and Helper T cells b) Lymphokines and Suppressor T cells c) Plasma cells and memory cells d) Neutrophils and monocytes
neutrophils and monocytes
T-cell deficiency occurs when which of the following glands fails to develop normally during embryogenesis? a) Thymus b) Thyroid c) Adrenal d) Pituitary
thymus
There are several types of reactions to latex. The nurse knows to be most concerned about laryngeal edema with the following reaction: a) IgE-mediated hypersensitivity. b) Allergic contact. c) IgG antibodies. d) Irritant contact.
IgE-mediated hypersensitivity
At 39 weeks' gestation, a pregnant female, visits her physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the patient for an emergency C section. The patient is very concerned about the health of her unborn child. Based on the knowledge of the immune system, the delivery room nurse explains about which of the following immunoglobulins that will be increased in the fetus at the time of birth and actively fighting the infection? a) IgD b) IgG c) IgA d) IgM
IgG
A client is to receive intravenous immunoglobulin (IVIG). The infusion is started at 10 a.m. The nurse would be alert for signs and symptoms of an anaphylactic reaction during which time frame? a) 11:30 a.m. to 12:00 p.m. b) 11:00 to 11:30 a.m. c) 10:30 to 11:00 a.m. d) 12:30 p.m. to 1:30 p.m.
10:30 to 11:00 a.m.
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) 24 hours b) 2 hours c) 12 hours d) 6 hours
2 hours
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) 24 hours c) 12 hours d) 2 hours
2 hours
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: a) 4:00 PM. b) 2:00 PM. c) 10:00 PM. d) 6:00 PM.
2:00 PM
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? a) 1.5 mL/min b) 6 mL/min c) 3 mL/min d) 10 mL/min
3mL/min
The nurse is instructing client's about the importance of taking the shingles vaccine. Which client would benefit from this vaccine? a) A 24-year-old client who is pregnant b) A 32-year-old client who has never had chickenpox c) A 17-year-old client who will be attending college and living in a dormitory d) A 65-year-old client who had chicken pox when he was 12 years old
A 65-year-old client who had chicken pox when he was 12 years old
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. Which of the following would the nurse expect to be started? a) Anticoagulation b) Immunosuppressive agents c) Chest physiotherapy d) Antibiotic therapy
Immunosuppressive agents
Phagocytic dysfunction is characterized by the following. Choose all that apply. a) Rapid heartbeat b) Chronic eczematoid dermatitis c) Increased incidence of bacterial infections d) Manifestation of underlying disease processes e) Immunity to infection with herpes simplex
Increased incidence of bacterial infections Chronic eczematoid dermatitis
A patient is receiving gold sodium thiomalate (Myochrysine) for the treatment of RA. What does the nurse understand about the action of this compound? a) Inhibits platelet aggregation b) Inhibits lysosomal enzymes c) Inhibits T- and B-cell activity d) Inhibits DNA synthesis
Inhibits T- and B-cell activity
A client has had a kidney transplant performed for end-stage kidney disease. What type of immune response that T-cell lymphocytes perform is related to this type of surgery? a) A cell-mediated response b) Stimulation of colony-stimulating factors c) Activation of the complement system d) Naturally acquired active immunity
a cell-mediated response
A patient with common variable immunodeficiency (CVID) comes to the ED with complaints of tingling and numbness in the hands and feet, muscle weakness, fatigue, and chronic diarrhea. An assessment reveals abdominal tenderness, weight loss, and loss of reflexes. A gastric biopsy shows lymphoid hyperplasia of the small intestine and spleen as well as gastric atrophy. Based on these findings, what common secondary problem has this patient developed? a) Hyperthyroidism b) Sickle cell anemia c) Gastric ulcer d) Pernicious anemia
pernicious anemia
A patient is suspected to have an immunodeficiency disorder. The physician orders a nitroblue tetrazolium reductase (NTR) test to diagnose this patient. What does the nurse suspect that this disorder is related to? a) T lymphocytes b) B lymphocytes c) Complement d) Phagocytic cells
phagocytic cells
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? a) Bradykinin b) Leukotrienes c) Prostaglandins d) Serotonin
prostaglandins
The nurse is conducting allergy skin testing on a client. Which postprocedure interventions are most appropriate for the nurse to perform? Select all that apply. a. record site, date, and time of the test b. give the client a list of potential allergns if identified c. edtimate he size of wheal d. tell the client to return only if wheal develops e. have the client wait for 1-2 post injection to leave the office
record site, date, and time of the test give the client a list of potential allgerns if identified
A client will be taking the tumor necrosis factor inhibitor, infliximab (Remicade), for the treatment of rheumatoid arthritis. Prior to beginning this therapeutic regimen, what screening should the client have? a) Screening for peptic ulcer disease b) Screening for syphilis c) Screening for rubella d) Screening for tuberculosis
screening for tuberculosis
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) Sedation b) Palpitations c) Anorexia d) Diarrhea
sedation
A nurse is teaching a community group about healthy lifestyles. A participant asks about how to maintain a healthy immune system. The nurse informs the group that which of the following factors will positively affect the immune system? a) Residential exposure to radiation b) Strong family and community connections c) Rigorous, competitive exercise d) Poor nutritional status
strong family and community connections
Reproductive health education for women who are HIV-positive includes recommending which of the following contraceptives? a) A diaphragm b) Oral estrogen contraceptives c) The female condom d) An intrauterine device (IUD)
the female condom
Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis? a) Thrush b) Thrombocytopenia c) Eczema d) Vascular lesions
vascular lesions
A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which of the following medication classifications would NOT place the client at risk for impaired immune function? a) Antimetabolites b) Adrenal corticosteroids c) Inotropics d) Antineoplastic agents
Inotropics
The nurse caring for a client who is taking an amino-glycoside should monitor the client for which adverse effects of the medication? SELECT ALL THAT APPLY a. Seizures b. Ototoxicity c. Renal toxicity d. Dysrhythmias e. Hepatotoxicity
Ototoxicity Renal toxicity Dysrhythmias
Which of the following statements describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex? a) They occur within minutes after exposure to latex. b) They can be eliminated by changing glove brands or using powder-free gloves. c) They are localized to the area of exposure, usually the back of the hands. d) They may worsen when hand lotion is applied before donning latex gloves.
They are localized to the area of exposure, usually the back of the hands.
A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct? a) "OA and RA are very similar. OA affects the smaller joints and RA affects the larger, weight-bearing joints." b) "OA is more common in women. RA is more common in men." c) "OA affects joints on both sides of the body. RA is usually unilateral." d) "OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."
"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."
A nurse is reviewing treatment options with parents of an infant born with severe combined immunodeficiency disease (SCID). The nurse recognizes that the parents understand the teaching based on which of the following statements? a) "Hematopoietic stem cell transplantation (HSCT) cannot be performed until the age of 5 years." b) "We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling." c) "The only treatment option is thymus gland transplantation." d) "We can ask our family members to donate blood for stem cell harvesting."
"We could have our 10-year-old daughter tested, as the ideal stem cell donor is a human leukocyte antigen (HLA)-identical sibling."
A nurse is preparing to adminster intravenous immunoglobulin (IVIG) to a client. Which of the following would the nurse expect to administer 30 minutes prior to the infusion to prevent an allergic reaction? Select all that apply. a) Ranitidine b) Acetaminophen c) Odansetron d) Diphenhydramine e) Corticosteroid
Acetaminophen Diphenhydramine Corticosteroid
The nurse practitioner working in a health clinic at an over-55 retirement community would recommend HIV testing based on the following primary rationale: a) Age-related immune system changes increase the risks of infections for older adults. b) Older gay men, feeling less inhibited by social mores, tend to have multiple sex partners. c) Older adults may have received HIV-infected blood transfusions before 1985. d) Older adults, who are sexually active don't use condoms.
Age-related immune system changes increase the risks of infections for older adults.
A client has breast cancer. The nurse is concerned about a compromised immune system in this client for which of the following reasons? a) Excess circulating hemoglobin b) Deficient circulating antibodies c) Excess circulating lymphocytes d) Antineoplastic drug therapy
Antineoplastic drug therapy
Which of the following is associated with impaired immunity relating to the aging patient? a) Decrease in inflammatory cytokines b) Breakdown and thinning of the skin c) Increase in humoral immunity d) Increase in peripheral circulation
Breakdown and thinning of the skin
Agammaglobulinemia is also known as which of the following? a) Common variable immunodeficiency (CVID) b) Bruton's disease c) Wiskott-Aldrich syndrome d) Nezelof syndrome
Bruton's disease
The nurse is administering a sympathomimetic drug to a patient. What areas of concern does the nurse have when administering this drug? (Select all that apply.) a) Causes bronchodilation b) Causes laryngospasm c) Causes bronchoconstriction d) Dilates the muscular vasculature e) Constricts integumentary smooth muscle
Causes bronchodilation Constricts integumentary smooth muscle Dilates the muscular vasculature
Which of the following would be consistent with the diagnosis of rheumatoid arthritis? a) Decreased ESR b) Cloudy synovial fluid c) Increased red blood cell count d) Increased C4 complement component
Cloudy synovial fluid
The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hyperuricemia. Select the agent of first choice when an acute inflammatory attack begins. a) Benemid b) Aloprim c) Anturane d) Colchicine
Colchicine
The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. Which of the following would the nurse expect to find? a) Increased C4 complement b) Elevated erythrocyte sedimentation rate c) Increased albumin levels d) Increased red blood cell count
Elevated erythrocyte sedimentation rate
A nurse assesses a client in the physician's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)? a) Weight gain, hypervigilance, hypothermia, and edema of the legs b) Facial erythema, pericarditis, pleuritis, fever, and weight loss c) Photosensitivity, polyarthralgia, and painful mucous membrane ulcers d) Hypothermia, weight gain, lethargy, and edema of the arms
Facial erythema, pericarditis, pleuritis, fever, and weight loss
Which of the following would a nurse be least likely to identify as a cause of secondary immunodeficiency? a) Diabetes b) Genetics c) Burns d) Chronic stress
Genetics
Which of the following immunoglobulins assumes a major role in blood-borne and tissue infections? a) IgG b) IgD c) IgA d) IgM
IgG
A client with severe combined immunodeficiency is to receive a hematopoietic stem cell transplant. Which of the following would the nurse expect to be started? a) Chest physiotherapy b) Anticoagulation c) Antibiotic therapy d) Immunosuppressive agents
Immunosuppressive agents
All of the following are symptoms of osteoarthritis, except? a) Deep, aching pain with motion early in the disease b) Morning stiffness that lasts at least 1 hour. c) Limited joint motion d) Instability of weight-bearing joints
Morning stiffness that lasts at least 1 hour.
Which of the following are usually the first choice in the treatment of rheumatoid arthritis (RA)? a) Disease-modifying antirheumatic drugs (DMARDS) b) Glucocorticoids c) Tumor necrosis factor (TNF) blockers d) Nonsteroidal anti-inflammatory drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Which of the following medication classifications are known to inhibit prostaglandin synthesis or release? a) Antibiotics (in large doses) b) Adrenal corticosteroids c) Nonsteroidal antiinflammatory drugs (NSAIDs) in large doses d) Antineoplastic agents
Nonsteroidal antiinflammatory drugs (NSAIDs) in large doses
A patient is suspected to have an immunodeficiency disorder. The physician orders a nitroblue tetrazolium reductase (NTR) test to diagnose this patient. What does the nurse suspect that this disorder is related to? a) B lymphocytes b) T lymphocytes c) Complement d) Phagocytic cells
Phagocytic cells
Which type of contact dermatitis requires light exposure in addition to allergen contact? a) Irritant b) Photoallergic c) Allergic d) Phototoxic
Photoallergic
A client has had several diagnostic tests to determine if he has systemic lupus erythematosus (SLE). What result is very specific indicator of this diagnosis? a) Positive Anti-Sm antibodies b) Positive Anti-dsDNA antibody test c) Positive ANA titre d) Elevated ESR
Positive Anti-dsDNA antibody test
A nurse is assessing a client who is experiencing an allergic reaction. Which of the following would the nurse identify as resulting from the release of histamine? a) Constipation b) Hypotension c) Vasodilation d) Pruritus
Pruritus
A client comes to the clinic with a rash. While inspecting the client's skin, the nurse determines that the rash is medication-related based on which of the following? a) Rash has several large raised areas. b) Rash is pale in color. c) Rash is localized to a body area. d) Rash has developed gradually.
Rash has several large raised areas.
Nursing assessment for tinnitus, gastric intolerance, and bleeding is important for patient who take which class of medications for a rheumatic disease? a) Immunosuppressive b) Antimalarials c) Salicylates d) COX-2 inhibitors
Salicylates
A major manifestation of Wiskott-Aldrich syndrome includes which of the following? a) Episodes of edema b) Thrombocytopenia c) Bacterial infection d) Ataxia
Thrombocytopenia
A client has undergone a kidney transplant. The nurse is concerned about a compromised immune system in this client for which of the following reasons? a) Use of anti-rejection drugs b) Deficient circulating antibodies c) Excess circulating lymphocytes d) Excess circulating hemoglobin
Use of anti-rejection drugs
The nurse observes diffuse swelling involving the deeper skin layers in a patient who has experienced an allergic reaction. The nurse would correctly document this finding as which of the following? a) Urticaria b) Contact dermatitis c) Angioneurotic edema d) Pitting edema
angioneurotic edema
The nurse is reviewing the medication administration record of the client. Which of the following medications would lead the nurse to suspect that the client is suffering from an acute attack of gout? a) penicillamine b) prednisone c) colchicine d) methotrexate
colchicine
Which of the following suggests to the nurse that the client with systemic lupus erythematous is having renal involvement? a) Behavioral changes b) Chest pain c) Decreased cognitive ability d) Hypertension
hypertension
Osteoarthritis is known as a disease that a) affects young males. b) requires early treatment because most of the damage appears to occur early in the course of the disease. c) is the most common and frequently disabling of joint disorders. d) affects the cartilaginous joints of the spine and surrounding tissues.
is the most common and frequently disabling of joint disorders.
DiGeorge syndrome is an example of which immunodeficiency? a) Complement production b) Combined B- and T-cell defects c) Primary T cell d) Plasma cell
primary T cell
In teaching clients with osteoarthritis about their condition, it would be important for the nurse to focus on: a) Strategies for remaining active b) Prevention of joint deformity c) DMARDs therapy d) Detection of systemic complications
strategies for remaining active
Which type of hypersensitivity reaction involves immune complexes formed when antigens bind to antibodies? a) Type IV b) Type I c) Type II d) Type III
type III
A nurse practitioner is managing the care of a patient who has gout. Choose the medication that she would prescribe as the drug of choice to prevent tophi formation and promote tophi regression. a) Uloric b) Zyloprim c) Anturane d) Benemid
zyloprim
The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the health care provider if which elevated result is noted? a. Serum protein level b. Blood glucose level c. Serum amylase level d. Serum creatinine level
Serum amylase level
