Med-Surg ATI Quiz: Immune and Infections

A nurse is reinforcing teaching with a female client who has a new diagnosis of systemic lupus erythematosus (SLE) about factors that can trigger an exacerbation of SLE. The nurse should determine that the client requires further teaching when she identifies which of the following as a factor that can exacerbate SLE? A. Exercise B. Pregnancy C. Infection D. Sunlight

A. Exercise Rationale: SLE is a chronic autoimmune disease that develops when the immune system becomes hyperactive and attacks healthy body tissue. This attack results in generalized inflammation and the manifestations associated with the specific involved tissues. Most clients who have SLE can follow an exercise program to increase the aerobic capacity of cells and improve immune function, and the client should develop such a program with her provider's assistance. This client needs additional teaching about the importance of exercise to keep her muscles and joints active. Due to hormonal changes, pregnancy can exacerbate SLE. The nurse should advise the client of the risks. If the client becomes pregnant, she should be monitored closely for renal and cardiovascular effects. Infections, especially streptococcal or viral infections, stress the body and can trigger an exacerbation of SLE. In addition, many clients who have SLE take steroids, placing them at higher risk for infection. Exposure to sunlight and artificial ultraviolet light is the leading cause of SLE exacerbations, especially the characteristic skin lesions and butterfly rash. Clients should use a sunscreen with a high solar protection factor (SPF), and cover their skin with appropriate clothing and hats when they must be exposed to sunlight.

A nurse is reinforcing teaching with an AP who is caring for a client who has active pulmonary tuberculosis, was placed on airborne precautions, and is scheduled for a chest x-ray. Which of the following instructions should the nurse include in the teaching? A. Have the client wear a surgical mask B. Wear a gown for protection from the client's infection C. Ask the radiology staff to perform a portable chest x-ray in the client's room D. Place an N-95 respirator on the client

A. Have the client wear a surgical mask Rationale: The AP should instruct the client to wear a surgical mask. The mask will protect anyone who comes into contact with the client, including the AP. The nurse does not need to wear a gown during transport of the client. A gown is needed if there is a risk for contamination of clothing, such as during suctioning of the client's airway. It is not necessary to avoid transporting the client to another department. The AP should wear an N9-5 respirator when caring for a client who has tuberculosis. However, the client is not required to wear an N-95 respirator.

A nurse is reinforcing teaching to a client who is being treated for genital warts. Which of the following statements indicated the client understands how to prevent transmission of his STI? A. I will bring my sexual partner in for treatment B. Now that I have had my first does of medicine, I can resume sexual activity C. Once I have been treated, it is no longer necessary to use condoms D. Once treatment is complete and I am free from symptoms, I don't have to return to the clinic

A. I will bring my sexual partner in for treatment Rationale: The client should bring his partner in to be screened for genital warts and treated. The client who has an STI should abstain from sexual intercourse until lesions are healed to prevent the spread of infection or reinfection. The client should use condoms when resuming sexual activity to prevent the spread of infection and reinfection. After the treatment is complete, a follow-up examination and reculture should be performed at least once to confirm a complete cure and to prevent relapse.

A nurse is reinforcing teaching with a client about the manifestations of an allergic reaction. the nurse should explain that the histamine release causes which of the following reactions? A. Increased mucus secretion B. Bronchial dilation C. Bradycardia D. Vertigo

A. Increased mucus secretion Rationale: The nurse should instruct the client that increased mucus secretion is a manifestation of histamine release. Histamine is the neurotransmitter the body produces during an allergic reaction. With histamine release, the client experiences bronchospasm and bronchial constriction, not bronchial dilation. A rapid, weak pulse can occur as a result of anaphylaxis, a severe allergic reaction. Bradycardia is not a manifestation of histamine release. Antihistamines are used to treat vertigo, as in the treatment of Ménière's disease. However, vertigo is not a manifestation of histamine release

A nurse is reinforcing teaching with a client who has Raynaud's disease. Which of the following information should the nurse include in the teaching? A. Protect against the cold by wearing layers of clothing B. Begin an exercise program of 2-mile walks once per week C. Increase Vitamin A in diet D. Elevate the hands above heart level when resting

A. Protect against the cold by wearing layers of clothing Rationale: Clients who have Raynaud's disease are prone to attacks during cold weather. Extreme cold can lead to tissue damage. Therefore, the client needs to be protected with layers of clothing to promote warmth and increase circulation to the extremities. Clients who have Raynaud's disease should walk 30 min several times each day to promote circulation. A client who has Raynaud's disease should alternate periods of exercise with periods of rest. Vitamin A promotes growth and development of bones and teeth and is necessary for night vision. There is no indication for this client to increase vitamin A in the diet. Elevating an extremity increases blood return to the heart, which further decreases the amount of circulating blood volume in the extremities, so it is not recommended for clients who have Raynaud's disease.

A nurse is reinforcing teaching with a client who has AIDS about preventing infection while at home. Which of the following instructions should the nurse include in the teaching? A. Wash genitalia using an antimicrobial soap B. Rinse dishes with cold water C. Clean toothbrush once per month D. Incorporate raw fruits and vegetables into your diet

A. Wash genitalia using an antimicrobial soap Rationale: The nurse should instruct the client to bathe daily using an antimicrobial soap to prevent the spread of infection. If bathing is not possible, washing the genitalia using an antimicrobial soap is recommended. Dishes should be washed using hot, sudsy water. The client's toothbrush should be cleaned once per week by running it through the dishwasher or rinsing it with bleach. Raw fruits and vegetables should be avoided due to the bacteria they carry.

A nurse is reinforcing teaching with a client who is HIV positive about the early manifestations of AIDS. Which of the following statements should the nurse include in the teaching? A. You can expect a persistent fever and swollen glands B. You can expect an elevated white blood cell count C. You can expect an increase in blood pressure and edema D. You can expect weight gain

A. You can expect a persistent fever and swollen glands Rationale: Clients who have AIDS can have persistent fever, swollen glands, diarrhea, weight loss, along with fatigue. These manifestations indicate the onset of AIDS. Clients who have AIDS are more likely to have a decreased WBC count as a result of the HIV virus destroying CD4-T-cells. This decrease in the client's WBC and CD4-T-cell count is the primary reason that clients who have AIDS are at increased risk for infection. Clients who have AIDS can have hypotension, not hypertension due to an adrenal insufficiency. These manifestations are indicative of heart failure. Clients who have AIDS can have weight loss, not weight gain, because of an alteration in metabolism.

A nurse is reinforcing discharge teaching with the partner of a client who has acquired immunodeficiency syndrome (AIDS). Which of the following statements by the client's partner indicates the need for further teaching? A. "I will dispose spoiled tissues in separate plastic bags" B. "I'll clean up blood spills immediately with hot water" C. I know that hand washing is an important preventive measure" D. "I will wash soiled clothes in hot water"

B. "I'll clean up blood spills immediately with hot water" Rationale: The client's partner should clean blood or potentially contaminated body substances with a bleach solution and wear gloves when coming into contact with blood products. The client's partner should use a separate plastic bag to dispose soiled tissues. Any items that cannot be disposed of in the toilet should be kept in a closed plastic bag until trash disposal. The client's partner should implement measures such as hand washing to prevent the spread of infection. The client's partner should wash soiled clothes in hot water along with 1 cup of bleach to clean clothing.

A nurse is assisting with the care of a client who is 2 days postoperative. Which of the following findings should alert the nurse that the client is developing an infection? A. Temperature 100 F B. Erythema at the incision site C. WBC count 9,000/mm3 D. Pain reported as a 6 on a 0 to 10 pain rating scale

B. Erythema at the incision site Rationale: Redness, or erythema, at the incision site is an initial manifestation of a wound infection and requires intervention by the nurse. A temperature of 37.8° C (100° F) is within the expected reference range and does not indicate the client is developing an infection. This WBC count is within the expected reference range and does not indicate the client is developing an infection. The expected reference range for WBC count is between 5,000 to 10,000/mm3. A pain level of 6 on a 0 to 10 scale for a client who is 2 days postoperative without any other significant findings does not indicate the client is developing an infection. The client should be medicated for pain promptly.

A nurse is reinforcing teaching with an assistive personnel about standard precautions wen caring for a client who has vancomycin resistant Enterococcus of the urine. Which of the following PPE should the nurse recommend the AP to use when caring for this client? A. Mask B. Gloves C. Eye glasses D. Shoe covering

B. Gloves Rationale: The nurse should don clean gloves when caring for a client who has vancomycin-resistant enterococcus of the urine. This protects the nurse from coming in contact with bodily fluids contaminated with the bacteria of the client. The nurse should wear a mask to prevent splashing or spraying of blood or bodily fluids in the face. This type of PPE is not needed when caring for a client who has VRE of the urine. The nurse should wear protective eyewear to prevent splashing or spraying of blood or bodily fluids in the eyes. This type of PPE is not needed when caring for a client who has VRE of the urine. The nurse should apply shoe covers before entering a treatment area or surgical suite. This prevents bacteria from entering these areas and contaminating the sterile environment, as well as the equipment. This type of PPE is not needed when caring for a client who has VRE of the urine.

A nurse is reinforcing teaching with a client who has human immunodeficiency virus about how the virus is transmitted. Which of the following statements should the nurse include in the teaching? A. HIV can be transmitted as soon as a person develops manifestations B. HIV can be transmitted to anyone who has had contact with infected blood C. HIV is transmitted through the respiratory route through droplets D. HIV is transmitted only during the active phase of the virus

B. HIV can be transmitted to anyone who has had contact with infected blood Rationale: The concentration of the virus is highest in blood but has also been isolated in other body fluids, including sputum, saliva, cerebrospinal fluid, urine, and semen. Clients who have HIV are cautioned to practice safe sex, avoid donating blood, and abstain from sharing needles with others. HIV can be transmitted before a person develops manifestations. The virus is commonly transmitted during the time at which a person is asymptomatic and unaware of having the virus. HIV has not been found to be transmitted through the respiratory route. Although the virus has been isolated in sputum, it is not a disease of airborne or droplet transmission. Evidence has indicated that HIV is transmitted only through intimate sexual contact, parenteral exposure to infected blood or blood products, sharing of contaminated needles, and perinatal transmission from mother to neonate. HIV can be transmitted at any time; there are no active or inactive phases of this infection.

A nurse is collecting data from a client who is experiencing acute exacerbation of rheumatoid arthritis. The nurse should anticipate that the client's affected joints will require which of the following treatments? A. An assistive device to use when the client is ambulating B. Heat paraffin therapy applied to the client's hands C. Gentle massage on the client's joints D. Active range-of-motion exercises on the client's affected joints

B. Heat paraffin therapy applied to the client's hands Rationale: The nurse should anticipate the use of heat paraffin to be prescribed as a nonpharmacologic intervention. The elevated ESR indicates an acute inflammatory process due to the client's rheumatoid arthritis. The use of the warm paraffin relieves the stiffness of the client's joints, as well providing comfort. Clients who have rheumatoid arthritis do not need assistive devices. An assistive device is only needed when severe loss of range-of-motion occurs. Massage can aggravate inflammation. Most clients have a tendency to rub inflamed, aching joints, but should be taught instead to massage over surrounding muscles, not over joints. During exacerbations of rheumatoid arthritis, active range-of-joint motion exercises should not be performed; only passive or isometric exercises are indicated.

A nurse is reviewing the laboratory results for a client who reports bilateral pain and swelling in her finger joints, with stiffness in the morning. The nurse should recognize that an increase in which of the following laboratory values can indicate arthritis? A. Reticulocyte count B. Rheumatoid factor C. Direct Coomb's test D. Platelet count

B. Rheumatoid factor Rationale: An increase in the client's rheumatoid factor can indicate rheumatoid arthritis or other connective tissue diseases. An increase in the client's reticulocyte count can indicate chronic loss of blood, not arthritis. An increase in the client's direct Coombs' test can indicate the presence of antibodies to RBCs, not arthritis. An increase in the client's platelet count can indicate polycythemia, not arthritis.

A nurse is collecting data from a client who has systemic scleroderma. Which of the following findings should the nurse expect? A. Excessive salivation B. Skin tightening C. Periorbital edema D. Alopecia

B. Skin tightening Rationale: Scleroderma is a chronic disease that can cause thickening, hardening, or tightening of the skin, blood vessels, and internal organs. There are two types of scleroderma: localized scleroderma, which mainly affects the skin, and systemic scleroderma, which can affect internal organs. The manifestations include skin changes, Raynaud's phenomenon, arthritis, muscle weakness, and dry mucous membranes. With scleroderma, the body produces and deposits too much collagen, causing thickening and hardening. In addition to the client's skin and subcutaneous tissues becoming increasingly hard and rigid, the extremities stiffen and lose mobility. Contractures develop with advanced systemic scleroderma unless clients follow a regimen of range-of-motion and muscle-strengthening exercises. Clients who have systemic scleroderma experience decreased salivation, which increases the risk of dental caries and gum disease. Clients who have scleroderma develop ankle and pedal edema due to the constriction of blood vessels as a result of renal failure. Clients who have scleroderma can lose hair in affected areas; however, alopecia is not a finding associated with systemic scleroderma.

A nurse is reinforcing teaching with a client who has a recent diagnosis of Raynaud's disease about preventing the onset of manifestations. Which of the following statements by the client indicates an understanding of the teaching? A. "I should limit my exposure to sunlight" B. "I should avoid drinking alcohol" C. "I should not smoke" D. "I should limit my intake of foods high in purine"

C. "I should not smoke" Rationale: Raynaud's disease is a disorder of the blood vessels that supply blood to the skin and cause the distal extremities to feel numb and cool in response to cold temperatures or stress. During a Raynaud's attack, these arteries narrow, limiting blood circulation to affected areas. Strong emotion or exposure to the cold causes these areas to become white, due to a lack of blood flow in the area. They then turn blue, as tiny blood vessels dilate to allow more blood to remain in the tissues. When the flow of blood returns, the area becomes red and then later returns to normal color. This can cause tingling, swelling and painful throbbing. The attacks can last from minutes to hours. If the condition progresses, blood flow to the area could become permanently decreased causing the fingers to become thin and tapered, with smooth, shiny skin and slow-growing nails. If an artery becomes blocked completely, gangrene or ulceration of the skin can occur. Smoking cessation (not just reduction) is an action the client should take to prevent the onset of the manifestations of Raynaud's disease. Clients who have Raynaud's disease have poor blood circulation to the distal extremities. Exposure to sunlight increases warmth and blood flow to the clients' extremities. Although drinking alcohol can interfere with some medications and illnesses, it does not relate to the progression of Raynaud's disease. Foods high in purine, such as organ meats, are contraindicated for clients who have gout, but not Raynaud's disease.

A nurse is reinforcing teaching with a client who has tested positive for an allergy to dust about how to reduce her exposure to the allergen. The nurse should determine that the client understands how to reduce her exposure to this allergen when she states which of the following? A. "I will begin vacuuming once a week" B. "Carpeting the entire house will be very expensive, but it will be worth it" C. "I will install an electrostatic filter in my furnace" D. "Installing curtains on the windows will help control the dust in the house"

C. "I will install an electrostatic filter in my furnace" Rationale: The nurse should instruct the client to install an electrostatic filter in her furnace to control the amount of dust in the home environment. The nurse should instruct the client to vacuum daily to decrease the amount of dust in the client's environment. The nurse should instruct the client that carpeting should be removed from as many rooms as possible, especially from the bedroom or any other common areas where the client spends time. Carpet accumulates large amounts of dust in the client's environment. The nurse should instruct the client to remove curtains within the house and replace them with pull shades. Pull shades accumulate less dust than curtains and can be easier to clean.

A nurse is assisting with the care of a client who has SLE. The client asks the nurse, "What should I do to care for my dry skin?" Which of the following responses should the nurse make? A. Keep the lesions covered with a light sterile dressing when going outdoors B. Rub lesions with a washcloth to dry after washing C. Apply lotion twice per day to dry skin D. Apply antibiotic cream twice per day to dry skin

C. Apply lotion twice per day to dry skin Rationale: The nurse should instruct the client to apply a lotion twice daily to dry skin. Topical corticosteroid creams, not antibiotic creams, are indicated for cutaneous manifestations of SLE. The nurse should instruct the client to gently pat, not rub, the lesions to dry. The nurse should instruct the client to wear a hat and protective clothing when outside. However, covering SLE lesions with a sterile dressing when outdoors is unnecessary. Most often, the lesions are dry and scaly, not open and draining.

A nurse is reinforcing teaching with a client who has tuberculosis about a new prescription of rifampin. Which of the following statements by the client indicates an understanding of the teaching? A. I should take this medication with food B. I need to take a B-complex vitamin while taking this medication C. I can expect this medication to turn my skin orange D. I can expect this medication to make my vision blurry

C. I can expect this medication to turn my skin orange Rationale: The nurse should instruct the client to expect his skin and or urine to turn a reddish-orange tinge due to taking rifampin. Vision changes, such as blurry vision, reduced color changes or a reduced visual field can be an adverse effect of taking ethambutol and should be reported to the provider immediately. Isoniazid should be taken with a B-complex vitamin, not rifampin. Isoniazid can deplete the body of this vitamin. Rifampin should be taken on an empty stomach. Food can interact with the absorption of the medication.

A nurse in a provider's office is reinforcing teaching with a client who has a new diagnosis of rheumatoid arthritis and a new prescription for naproxen tablets. Which of the following statements by the client requires further testing? A. This medication will take 4 weeks for me to notice relief in my joints B. I can take an antacid with this medication for indigestion C. I can take this medication with aspirin D. The naproxen goes down easier when I crush it and put it in applesauce

C. I can take this medication with aspirin Rationale: The nurse should instruct the client to avoid taking this medication with any other NSAIDs, such as aspirin, because this can increase the risk for bleeding and gastrointestinal ulceration. Naproxen tablets can be crushed or swallowed whole. Medications that are enteric-coated or have sustained-release properties should not be crushed. NSAIDs, such as naproxen, can cause serious adverse gastrointestinal upset, such as nausea, vomiting, and indigestion. An antacid is commonly prescribed to take with this medication. The therapeutic effects of naproxen will not be evident until 3 to 4 weeks of taking the medication.

A nurse is reinforcing teaching with a client who has a diagnosis of hepatitis A. Which of the following statements by the client indicates an understanding of the teaching? A. I am unable to donate blood B. I will need to get a booster shot of immune serum globulin every year C. I should stop eating raw clams D. I can get this disease by getting a tattoo

C. I should stop eating raw clams Rationale: Hepatitis A is transmitted via the fecal-oral route through consumption of contaminated fruits, vegetables, water, milk, or uncooked shellfish. Individuals who eat raw or steamed shellfish are at increased risk for acquiring Hepatitis A. Hepatitis B can be transmitted by shared needles or unclean tattoo equipment. Hepatitis A is transmitted through fecal contamination or contaminated food and water. Passive immunity to hepatitis A can be conferred for 6 to 7 weeks by the administration of immune serum globulin during the incubation period if the treatment is instituted within 2 weeks of exposure. A booster shot every year is not required. There is no danger of contracting any form of hepatitis or any other bloodborne pathogen from the sterile, single-donor blood collection process used at blood banks.

A nurse is caring for a client who tests positive for the human immunodeficiency virus. The client asks the nurse, "Should I tell my partner that I am HIV positive?" Which of the following is an appropriate nursing response? A. That is your decision alone B. I would if I were you C. It sounds like you are unsure of what to say to your partner D. Your provider is required by law to inform your partner

C. It sounds like you are unsure of what to say to your partner Rationale: This response uses the therapeutic communication tools of clarifying and restatement. It identifies that the client is unsure about if or how to approach the issue of being HIV positive with his partner, a common concern of clients due to fear of rejection. This response shows that the nurse is open to further communication with the client and encourages his expression of feelings.

A nurse is reinforcing teaching with a client who has AIDS about the transmission of Pneumocystis jiroveci pneumonia (PCP). Which of the following information should the nurse include in the teaching? A. PCP is sexually transmitted from person to person B. You were most likely exposed to a contaminated surface, such as a drinking glass C. PCP results from an impaired immune system D. You might have contracted PCP from a family pet

C. PCP results from an impaired immune system Rationale: The nurse should explain that the organism that causes PCP exists as part of the normal flora of the lungs and develops into a fungus. It becomes an aggressive pathogen when the immune system is compromised and the infection results from an impaired immune system. Toxoplasmosis can be transmitted through cat feces; however, PCP is not contracted from family pets. PCP is not transmitted through a contaminated surface, such as a drinking glass. HIV can be transmitted through sexual contact; however, PCP is not sexually transmitted from person to person.

A nurse is assisting with the care of a client who has HIV. Which of the following isolation should the nurse implement to prevent transmission of HIV? A. Protective isolation B. Droplet precautions C. Standard precautions D. Airborne precautions

C. Standard precautions Rationale: Standard precautions should be implemented with every client, to prevent the spread of infection transmitted by direct or indirect contact with infectious blood or body fluids. Because HIV is spread through blood and body fluids, standard precautions are appropriate. Airborne precautions are measures taken to prevent the spread of diseases transmitted by the air. HIV is not spread by the air; therefore, airborne precautions are not necessary. Droplet precautions prevent transmission of infectious diseases over short distances via air droplets. HIV is not spread by air droplets; therefore, droplet precautions are not necessary. Protective isolation keeps a client who is immunocompromised from acquiring communicable infections prevalent in the hospital setting. This does not prevent the transmission of HIV.

A nurse is collecting data from a client who has an exacerbation of herpes zoster. Which of the following manifestations of the client's skin should the nurse expect to see? A. Confluent, honey-colored, crusted lesions B. Large tender nodule located on a hair follicle C. Unilateral, localized, nodular skin lesions D. A fluid-filled vesicular rash in the genital region

C. Unilateral, localized, nodular skin lesions Rationale: Herpes zoster, or shingles, results from the reactivation of a dormant varicella virus. It is the acute, unilateral inflammation of the dorsal root ganglion. The infection typically develops in adults and produces localized vesicular lesions confined to a dermatome. It produces unilateral, localized, nodular skin lesions. Confluent (gathered together), honey-colored, crusted lesions are typically associated with impetigo. This describes a furuncle or bacterial infection on a hair follicle. This manifestation indicates genital herpes, which is caused by the herpes simplex virus.

A nurse is collecting data from a client who is concerned about the possibility of contracting Lyme disease after being bitten by a tick. For which of the following early manifestations of Lyme disease should the nurse monitor the client for? A. A diffuse maculopapular rash B. Stiff, swollen, painful joints C. Double vision D. A progressive, circular rash

D. A progressive, circular rash Rationale: Early Lyme disease is characterized by fever, influenza-like manifestations, and erythema migrans, a distinct progressive circular (or bull's-eye) rash that often develops at the bite site, but can also develop at other sites, such as the thighs and knees. Double vision is a manifestation of disseminated (late-stage) Lyme disease. Dyspnea is a manifestation of stage II (early disseminated) Lyme disease. A diffuse maculopapular rash is not a manifestation of Lyme disease. Manifestations of Lyme disease include a localized, flat or slightly raised rash.

A nurse is preparing to administer a Mantoux skin test to a client. The nurse should inform the client that the purpose of a Mantoux skin test using purified protein derivative (PPD) is to do which of the following actions? A. Identify if a client lacks immunity to tuberculosis B. Find out if a client has active tuberculosis C. Decrease the hypersensitivity of the client's reaction to PPD D. Identify if the client has been infected with mycobacterium tuberculosis

D. Identify if the client has been infected with mycobacterium tuberculosis Rationale: The nurse should inform the client that the Mantoux skin test is used to identify individuals who have been infected with mycobacterium tuberculosis. PPD is used for the Mantoux skin test. It is not a vaccine and therefore, cannot be used to decrease hypersensitivity to purified protein derivative. The Mantoux skin test does not differentiate between those who have active and those who have dormant tuberculosis. The Mantoux skin test is not a serum titer and cannot be used to identify immune status. There is no immunity to tuberculosis.

A nurse is collecting data from a client who had radioallergosorbent (RAST) testing completed due to seasonal allergies. The nurse should anticipate an elevation in which of the following laboratory values? A. IgM B. IgA C. IgG D. IgE

D. IgE Rationale: RAST testing involves measuring the quantity of IgE, an immunoglobulin, present in serum after exposure to specific antigens selected on a basis of the client's symptom history. An elevated IgE indicates a positive response and is common among clients who have a history of allergic manifestations, anaphylaxis, and asthma. An elevated IgG indicates the production of antibodies to all types of infections, especially blood borne and tissue infections. An elevated IgA is associated with autoimmune diseases and chronic infections. An elevated IgM is associated with a bacterial or viral infection. IgM produces antibodies to protect the body against infections.

A nurse is reinforcing teaching with a client who has systemic lupus erythematosus (SLE). Which of the following instructions should the nurse plan to include in the teaching? A. Avoid the use of any NSAIDs B. Stop taking the corticosteroids when the symptoms resolve C. Exposure to ultraviolet light will help control the skin rashes D. Monitor your body temperature and report elevations promptly

D. Monitor your body temperature and report elevations promptly Rationale: SLE is a chronic autoimmune disorder that can affect any organ of the body. With SLE, the body's immune system becomes hyperactive, forming antibodies that attack tissues and organs, including the skin, joints, kidneys, brain, heart, lungs, and blood. SLE is characterized by periods of exacerbation and remissions. The nurse should teach the client to monitor body temperature and report any elevations promptly, as fever can suggest either an exacerbation or a potentially life-threatening infection. SLE can affect any organ of the body, including the skin. Any source of ultraviolet light, including exposure to the sun, can cause an exacerbation of this disease. Corticosteroids are typically required, at least in minimal doses, on a chronic basis for clients who have SLE. If the client were to stop taking the corticosteroids, she would need to taper off under the provider's direction. Corticosteroids can suppress adrenal gland function and abruptly stopping them can lead to adrenal insufficiency, a potentially life-threatening condition. NSAIDs are commonly used to treat the inflammation, joint discomfort, and fevers that might accompany an exacerbation of SLE.

A nurse is reinforcing teaching with a client who has genital herpes about self-management. Which of the following instructions should the nurse include in the teaching? A. Use an alcohol-based soap to clean lesions B. Wear a condom during sexual activity when lesions are present C. Take a sitz bath once per day D. Pour running water over the lesions when urinating

D. Pour running water over the lesions when urinating Rationale: The nurse should instruct the client to pour running water over the lesions when urinating to relieve discomfort. The nurse should instruct the client to use a mild soap to clean lesions and then pat dry with a towel. The nurse should instruct the client to avoid sexual activity when lesions are present. The nurse should instruct the client to take three to four sitz baths daily to relieve discomfort.

A nurse is collecting data from a client has Kaposi's sarcoma. Which of the following findings should the nurse expect with this condition? A. A nonproductive cough with fever and shortness of breath B. Lesions of the retina that produce blurred vision C. Onset of progressive dementia D. Reddish-purple skin lesions

D. Reddish-purple skin lesions Rationale: Kaposi's sarcoma is commonly associated with AIDS and manifests as hyperpigmented multicentric lesions that can be firm, flat, raised, or nodular. Following biopsy, the lesions are treated with radiation and/or chemotherapy. Onset of progressive dementia describes an AIDS-dementia complex that can occur, as the HIV infection affects the nervous system. Dementia is not a manifestation of Kaposi's sarcoma. Blurred vision, as a result of lesions on the retina, is not a manifestation of Kaposi's sarcoma. A nonproductive cough accompanied by fever and shortness of breath are findings associated with multiple opportunistic respiratory infections that clients who are immunocompromised are at risk for developing. A nonproductive cough is not a manifestation of Kaposi's sarcoma.