Immunologic and Infectious Diseases EAQ

The nurse instructs a human immunodeficiency (HIV)-positive client about ways to prevent infections. During a follow-up visit, which statement made by the client indicates a need for more education? "I reuse cups after washing them." "I wash my hands with tap water after gardening." "I rinse my toothbrush in liquid laundry bleach every week." "I wash my armpits, groin, and genitals with antimicrobial soap twice a day."

B An HIV-positive client should refrain from digging in soil and performing gardening activities. Soil contains several infectious microorganisms. In unavoidable circumstances, the client should wear gloves and wash hands thoroughly with antimicrobial soap after gardening.

Which medication will the nurse administer that prevents cellular infection with human immunodeficiency virus (HIV)? Maraviroc Nelfinavir Delavirdine Emtricitabine

A Maraviroc is a medication used to prevent an HIV infection by blocking the CCR5 receptors on the CD4+ T cells. It also prevents cellular HIV infections.

What should the nurse expect to assess in a client with a type IV delayed hypersensitivity reaction? Select all that apply. Edema Bruising Ischemia Induration Tissue damage

A C D E A type IV delayed hypersensitivity reaction consists of edema, ischemia, induration, and tissue damage at the site. Bruising is not a typical occurrence in a type IV delayed hypersensitivity reaction.

After providing epinephrine to a client experiencing an anaphylactic reaction, which second-line drugs should the nurse prepare to provide? Select all that apply. Dopamine Norepinephrine Dexamethasone Diphenhydramine hydrochloride Hydrocortisone sodium succinate

C D E

The laboratory test reports of a client reveal the presence of human leukocyte antigen (HLA-B27). Which diagnosis will the nurse most likely observe written in the client's electronic medical record? Temporalarteritis Reiter's syndrome Advanced cirrhosis Systemic lupus erythematosus (SLE)

B

While conducting a health interview with a client who has human immunodeficiency virus, the nurse inquires about papilledema and the presence of exudates. Which body system may the nurse be assessing? Ocular Respiratory Neurological Cardiovascular

A

A client reports sustaining an insect bite. The initial symptoms were edema and itching at the site of the bite. Which immunological reaction may have occurred? Anaphylaxis Atopic reaction Goodpasture syndrome Systemic lupus erythematosus

A Anaphylaxis occurs when the mediators of injury are released systemically after an insect bite or when a drug is injected. The initial symptoms (in this case, edema and itching) may occur at the site of exposure to the allergen.

A nurse is caring for a client with an impaired immune system. Which blood protein associated with the immune system is important for the nurse to consider? Albumin Globulin Thrombin Hemoglobin

B

A client is admitted with dysphasia, dry mouth, drooping eyelids, blurred vision, vomiting, and diarrhea, and within 24 hours develops bilateral cranial nerve impairment and descending weakness. Which bioterrorism agent results in these clinical manifestations? Plague Anthrax Botulism Smallpox

C

A nurse is precepting a senior-level nursing student. Which statement made by the nursing student assures the preceptor that the student understands the importance of sepsis screening? Blood cultures are required to diagnosis sepsis. An oral temperature of 96.4° F (35.8° C) is not an indicator of sepsis. A primary healthcare provider's prescription is required to screen for sepsis. Sepsis mortality is affected greatly by treatments performed in the first 6 hours.

D

A client's laboratory report shows the presence of bone marrow suppression, reflected by a decreased number of thrombocytes. After reviewing the client's medical history, the practical nurse finds that the client has been undergoing therapy with an antiproliferative immunosuppressant drug. Which medication may have caused the client's condition? Citalopram Daclizumab Methyldopa Azathioprine

D Azathioprine is an antiproliferative drug that may cause bone marrow suppression and thrombocytopenia (a decrease in the number of thrombocytes).

Blackwater fever occurs in some clients with malaria. Which response should the nurse assess in this client? Dark red urine Low-grade fever Clay-colored diarrhea Coffee-ground emesis

A

The significant other of a client who is dying of acquired immunodeficiency syndrome (AIDS) tells the nurse, "Life is not worth living without my partner." What should the nurse plan to do to help the significant other cope with the impending death? Involve the significant other's support system. Explore the significant other's psychotic thoughts. Suggest a bereavement group to the significant other. Reinforce the current self-image of the significant other.

A

Which leukocyte is responsible for the allergic response? Basophils Monocytes Eosinophils Macrophages

A Basophils stimulate the inflammation of allergy and hypersensitivity reactions.

A student nurse is teaching a client about preventive measures for Lyme disease. Which instruction given by the student nurse indicates a need for correction? "Wear dark colored dresses." "Wear closed shoes or boots." "Tuck your shirt into your pants." "Bathe immediately after being in an infested area."

A Lyme disease is a vector-borne disease caused by the spirochete Borrelia burgdorferi and results from the bite of an infected deer tick, also known as the blacklegged tick.

A client is admitted to the emergency department with allergic rhinitis and asthma. The laboratory report shows histamines and prostaglandins. Which type of hypersensitivity reaction may have occurred? Type I Type II Type III Type IV

A Type I hypersensitivity reactions (immediate hypersensitivity reactions) involve the immunoglobulin E (IgE)-mediated release of histamines and other mediators from mast cells and basophils.

The client's laboratory report shows localized vasodilation and transudation of fluid. The nurse interprets these findings as erythema and a wheal. Which condition may be present in the client? Urticaria Angioedema Allergic rhinitis Contact dermatitis

A Urticaria is a cutaneous reaction to systemic allergens that occurs in atopic people. Histamine causes localized vasodilation (erythema), transudation of fluid (wheal), and flaring.

The nursing instructor determines that the student nurse understands the type(s) of hepatitis that most commonly are spread by consuming contaminated food and water or by fecal contamination if the student identifies which of these diseases? Select all that apply. Hepatitis A Hepatitis B Hepatitis C Hepatitis D Hepatitis E

A E Hepatitis A and E most commonly are spread through the fecal-oral route. Hepatitis B most commonly is spread through the sharing of needles and through unprotected sex.

While assessing a client with acquired immunodeficiency syndrome (AIDS), the nurse suspects the client has developed histoplasmosis. Which symptoms in the client support the nurse's suspicion? Select all that apply. Cough Seizures Confusion Difficulty with speech Enlarged lymph nodes

A E Histoplasmosis is a respiratory infection caused by Histoplasma capsulatum, which progresses to widespread infection in a client with AIDS.

Which medication will cause the nurse to monitor the client closely for hemolytic anemia? Tacrolimus Methyldopa Azathioprine Procainamide

B Hemolytic anemia is an autoimmune disorder in which red blood cells are destroyed and removed from the bloodstream before the end of their normal life span. It may result after administration of methyldopa.

A client is diagnosed with gastroenteritis. What does the nurse determine is the basic intention underlying the unique dietary management for this client? Provide optimal amounts of all important nutrients. Increase the amount of bulk and roughage in the diet. Eliminate chemical, mechanical, and thermal irritation. Promote psychological support by offering a wide variety of foods.

C

The nurse instructs the son of an older client about age-related immune system changes and associated care measures. Which statement made by the son during a follow-up visit indicates a need for further instruction? "My parent has a private room at home." "My parent has received the pneumococcal vaccination recently." "My parent comes in for check-ups only whenever he or she has a fever." "My parent has been given a second dose of the pertussis vaccination."

C

Which is an example of indirect contact transmission of microorganisms? Kissing Deer tick Dirty hands Contaminated water

C Indirect contact transmission involves the transfer of microorganisms from a source to a host by passive transfer from a contaminated article or hands.

After assessing a client with rheumatoid arthritis, the nurse suspects Sjögren's syndrome. Which manifestations are consistent with Sjögren's syndrome? Select all that apply. Iritis Scleritis Xerostomia Baker's cyst Keratoconjunctivitis sicca

C D Sjögren's syndrome, commonly associated with advanced rheumatoid arthritis, includes such symptoms as xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes).

A client reports pain during urination and a profuse, yellowish-green penile discharge. After an assessment, the primary healthcare provider schedules the client for a nucleic acid amplification test (NAAT). Which organism may be the cause of the client's condition? Escherichia coli Treponema pallidum Mycoplasma hominis Neisseria gonorrhoeae

D

A nurse is caring for a 26-year-old client recently diagnosed with human immunodeficiency virus (HIV) and has a CD4 count of 150. The client needs an update on immunizations and asks which ones are needed. Which vaccines are required to comply with the recommended immunization schedule for a client with HIV? Influenza; measles, mumps, rubella (MMR); varicella; and hepatitis A vaccines Pneumococcal, MMR, influenza, and varicella vaccines Diphtheria, tetanus, hepatitis A, and hepatitis C vaccines Tetanus, hepatitis B, influenza, and pneumococcal vaccines

D