med surge immunologic systems infections
A nurse is caring for a client with a diagnosis of acute salpingitis. Which condition most commonly causing inflammation of the fallopian tubes should the nurse include when planning a teaching program for this client? 1 Syphilis Correct 2 Gonorrhea 3 Hydatidiform mole 4 Spontaneous abortion
Gonorrhea frequently is an ascending infection that affects the fallopian tubes. Syphilis, if untreated, may spread to the nervous system via the blood; it usually does not cause ascending infection of the fallopian tubes. Hydatidiform mole is an aberrant growth; it will not cause inflammation of the fallopian tubes. A spontaneous abortion should not cause inflammation of the fallopian tubes.
Which type of cytokine is used to treat anemia related to chronic kidney disease? 1 α-Interferon 2 Interleukin-2 3 Interleukin-11 Correct 4 Erythropoietin
Erythropoietin is used to treat anemia related to chronic kidney disease. α-Interferon is used to treat hairy cell leukemia or malignant melanoma. Interleukin-2 is used to treat metastatic renal carcinoma. Interleukin-11 is used to prevent thrombocytopenia after chemotherapy.
Which intervention is most likely to decrease mortality in the septic client? 1 Oxygen Correct 2 Antibiotics 3 Vasopressors 4 Intravenous fluids
Of the interventions listed, administering antibiotics is the only intervention that fights the source of the problem. Intravenous fluids, oxygen, and vasopressors are necessary, but are designed to sustain the body until the antibiotic can kill the pathogen.
A mother with the diagnosis of acquired immunodeficiency syndrome (AIDS) states that she has been caring for her baby even though she has not been feeling well. What important information should the nurse determine? 1 If she has kissed the baby Correct 2 If the baby is breast-feeding 3 When the baby last received antibiotics 4 How long she has been caring for the baby
Epidemiologic evidence has identified breast milk as a source of human immunodeficiency virus (HIV) transmission. Kissing is not believed to transmit HIV. When the baby last received antibiotics is unrelated to transmission of HIV. HIV transmission does not occur from contact associated with caring for a newborn.
An older client with a history of congestive heart failure expresses concern about potential exposure to tuberculosis. The client states that a roommate at the extended care facility where the client resides sleeps a lot, coughs a great deal, and sometimes spits up blood. What is the primary reason that the nurse pursues more information about the roommate? 1 Death from tuberculosis is on the increase 2 The roommate is causing the client to be anxious Correct 3 Older adults with chronic illness are affected adversely by tuberculosis 4 The roommate most likely is preventing the client from getting proper sleep
The client's cardiac condition and age make the client vulnerable to communicable diseases. In the United States, death from tuberculosis is declining because of improved drug therapy. (Canada: According to the Public Health Agency of Canada, 1,607 new active and re-treatment (latent) TB cases were reported to the Canadian Tuberculosis Reporting System in 2011, but TB is no longer common in the overall Canadian population.) The nurse's primary concern is to prevent the spread of infection. The issues of client anxiety and potential sleep disturbance should be addressed later; they are not the greatest concern at this time.
Which immunomodulatory is beneficial for the treatment of clients with multiple sclerosis? 1 Interleukin 2 2 Interleukin 11 Correct 3 Beta interferon 4 Alpha interferon
Beta interferon is an immunomodulator that is administered in the treatment of multiple sclerosis. Interleukin 11 is used in the prevention of thrombocytopenia after chemotherapy. Interleukin 2 is used for the treatment of metastatic renal cell carcinoma and metastatic melanoma. Alpha interferon is administered for the treatment of hairy cell leukemia, chronic myelogenous leukemia, and malignant melanoma.
A child is diagnosed with hepatitis A. The client's parent expresses concern that the other members of the family may get hepatitis because they all share the same bathroom. What is the nurse's best reply? 1 "I suggest that you buy a commode exclusively for your child's use." 2 "Your child may use the bathroom, but you need to use disposable toilet covers." 3 "You will need to clean the bathroom from top to bottom every time a family member uses it." Correct 4 "All family members, including your child, need to wash their hands after using the bathroom."
Hepatitis A is spread via the fecal-oral route; transmission is prevented by proper hand washing. Buying a commode exclusively for the child's use is unnecessary; cleansing the toilet and washing the hands should control the transmission of microorganisms. It is not feasible to clean "from top to bottom" each time the bathroom is used. The use of disposable toilet covers is inadequate to prevent the spread of microorganisms if the bathroom used by the child also is used by others. Hand washing by all family members must be part of the plan to prevent the spread of hepatitis to other family members.
A client has been admitted to the hospital with a diagnosis of methicillin-resistant Staphylococcus aureus (MRSA) in the urine. The client has a urinary catheter in place. No private rooms are available. Which room assignment would be most appropriate for this client? 1 Roommate has a urinary catheter. 2 Roommate is bedridden and uses a bedpan for urination. Correct 3 Roommate has MRSA in the urine. The roommate is ambulatory, but confused. 4 Roommate is alert and oriented with a diagnosis of pneumonia but practices good hygiene when using the bathroom.
If a private room is not available, the client may be placed in a room with another client who has the same active infection with the same microorganism if no other infection is present. The roommate with a urinary catheter, who is bedridden, or who has pneumonia does not indicate MRSA in the urine.
A client has a tuberculin purified protein derivative test as part of a yearly physical examination. The area of induration is 10 mm within 48 hours after having the test. What does the nurse conclude about the client based on this response? 1 The client has contracted clinical tuberculosis. 2 The client has passive immunity to tuberculosis. Correct 3 The client has been exposed to the tubercle bacillus. 4 The client has developed a resistance to the tubercle bacillus
Induration measuring 10 mm or more in diameter is interpreted as significant; it does not indicate that active tuberculosis is present. About 90% of individuals who have significant induration do not develop the disease. Exposure to the tubercle bacillus indicates exposure; infection can be past or present. Passive immunity occurs when the body plays no part in the preparation of the antibodies; a positive tuberculin purified protein derivative indicates the presence of antibodies, not how they were formed. Developing a resistance to the tubercle bacillus reaction indicates exposure, not resistance.
What are the mediators of injury in IgE-mediated hypersensitivity reactions? Select all that apply. Incorrect 1 Cytokines Correct 2 Mast cells Correct 3 Histamines 4 Neutrophils Correct 5 Leukotrienes
Mast cells, histamines, and leukotrienes are the mediators of injury in IgE-mediated hypersensitivity reactions. Cytokines are the mediators of injury in the delayed type of hypersensitivity reaction. Neutrophils are the mediators of injury in the immune-complex type of hypersensitivity reaction.
Which leukocytes should the nurse include when teaching about antibody-mediated immunity? Select all that apply. Incorrect 1 Monocyte Correct 2 Memory cell 3 Helper T cell Correct 4 B-lymphocyte 5 Cytotoxic T cell
Memory cells and B-lymphocytes are involved in antibody-mediated immunity. Monocytes are involved in inflammation. Helper T cells and cytotoxic T cells are involved in cell-mediated immunity.
What is the mechanism of action of penicillin? 1 Prevents reproduction of the pathogen Correct 2 Inhibits cell wall synthesis of the pathogen 3 Inhibits nucleic acid synthesis of the pathogen 4 Injures the cytoplasmic membrane of the pathogen
Penicillin is an antimicrobial medication that inhibits cell wall synthesis of the susceptible pathogen. Gentamicin is an antimicrobial medication that prevents the reproduction of the susceptible pathogen. Actinomycin is an antimicrobial medication that inhibits nucleic acid synthesis of the susceptible pathogen. Antifungal agents injure the cytoplasmic membrane of the susceptible pathogen.
Which parameter should the nurse consider while assessing the psychologic status of a client with acquired immune deficiency syndrome (AIDS)? 1 Sleep pattern 2 Severity of pain 3 Cognitive changes Correct 4 Presence of anxiety
Presence of anxiety should be considered while assessing the psychologic status of a client with AIDS. Sleep patterns and severity of pain are related to the assessment of activity and rest, a physical status. Cognitive changes are related to the assessment of neurologic status.
The nurse is educating a client about protease inhibitors. What statement about protease inhibitors is true? Correct 1 Protease inhibitors prevent viral replication. 2 Protease inhibitors prevent the interaction between viral material and the CD4+ T-cell. 3 Protease inhibitors prevent viral and host genetic material integration. 4 Protease inhibitors prevent the clipping of the viral strands into small functional pieces.
Protease inhibitors act by preventing viral replication and release of viral particles. NRTIs inhibits the transformation of viral single-stranded ribonucleic acid into host double-stranded deoxyribonucleic acid (DNA) by the action of the enzyme reverse transcriptase. Entry inhibitor drugs prevent the binding of the virus to the CD4 receptors. Integrase inhibitor drugs prevent the integration of viral material into the host's DNA by the action of the enzyme integrase.
What is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs)? Correct 1 Removing the catheter 2 Keeping the drainage bag off of the floor 3 Washing hands before and after assessing the catheter 4 Cleansing the urinary meatus with soap and water daily
Research demonstrates that decreasing the use of indwelling urinary catheters is the most important intervention to prevent hospital-acquired catheter-associated urinary tract infections (CAUTIs). Keeping the drainage bag off the floor, washing hands before and after assessing the catheter, and cleansing the urinary meatus daily with soap and water will help reduce infections; however, these are not the most important interventions to prevent CAUTIs.
Which diseased condition associated with the client's heart is an example of an autoimmune disease? 1 Uveitis Correct 2 Rheumatic fever 3 Myasthenia gravis 4 Graves' disease
Rheumatic fever is a heart disorder that is an example of an autoimmune disease. Uveitis is an eye disorder that is an example of an autoimmune disease. Myasthenia gravis is a muscle disorder that is an example of an autoimmune disease. Graves' disease is an endocrine disorder that is an example of an autoimmune disease.
Which manifestations may indicate a client has systemic lupus erythematosus (SLE)? Select all that apply. Correct 1 Pericarditis 2 Esophagitis 3 Fibrotic skin Correct 4 Discoid lesions Correct 5 Pleural effusions
SLE is a chronic, progressive inflammatory connective tissue disorder that can cause major organs and systems to fail. Pericarditis is a cardiovascular manifestation of SLE. Discoid lesion is a skin manifestation that is a key indicator of the presence of SLE. Pleural effusion, a pulmonary manifestation, is a key indicator of the presence of SLE. Esophagitis is one of the gastrointestinal manifestations of systemic sclerosis. Fibrotic skin is one of the skin manifestations of systemic sclerosis.
Which are examples of a type IV hypersensitivity reaction? Select all that apply. Correct 1 Poison ivy allergic reaction Correct 2 Sarcoidosis 3 Myasthenia gravis 4 Rheumatoid arthritis 5 Systemic lupus erythematosus
Sarcoidosis and poison ivy reactions are examples of type IV hypersensitivity reactions. In type IV hypersensitivity, the inflammation is caused by a reaction of sensitized T cells with the antigen and the resultant activation of macrophages due to lymphokine release. Myasthenia gravis is an example of a type II or cytotoxic hypersensitivity reaction. Rheumatoid arthritis and systemic lupus erythematosus are examples of type III immune complex-mediated reactions.
A client presents with sneezing; lacrimation; swelling with an airway obstruction; and pruritus around the eyes, nose, throat, and mouth. The nurse interprets these findings as a Type I hypersensitivity reaction. Which disease might have occurred in the client? 1 Angioedema Correct 2 Allergic rhinitis 3 Contact dermatitis 4 Goodpasture syndrome
Sneezing; lacrimation; swelling with an airway obstruction; and pruritus around the eyes, nose, throat, and mouth are symptoms of a hypersensitivity reaction resulting in allergic rhinitis. This reaction is a type I hypersensitivity reaction mediated by immunoglobulin E. Angioedema is a localized cutaneous lesion similar to urticaria, but it involves a deeper layer of the skin and the submucosa. Contact dermatitis is an example of a delayed hypersensitivity reaction. The skin lesions appear erythematous and are covered with papules, vesicles, and bullae.
Which virus can cause encephalitis in adults and children? Incorrect 1 Rubella virus 2 Parvovirus 3 Rotaviruses Correct 4 West Nile virus
The West Nile virus causes encephalitis. German measles is caused by rubella. Gastroenteritis is caused by parvovirus. Rotavirus also causes gastroenteritis.
What is the function of IgG in the body? 1 Activates the degranulation of mast cells Correct 2 Activates the classic complement pathway 3 Prevents upper respiratory tract infections Incorrect 4 Prevents lower respiratory tract infections
The classic complement pathway is activated by the IgG and IgM antibodies. IgE antibodies cause a degranulation of mast cells. IgA antibodies are found largely in mucous membrane secretions and play an important role in preventing upper and lower respiratory tract infections.
Which type of delayed hypersensitivity reaction can be assessed in the client pictured in the image?
The client is having contact dermatitis [1] [2] of the skin to rubber boots. This is a clinical example of a delayed hypersensitivity reaction, a type IV reaction. This is also called a cell-mediated immune response. Anaphylactic reactions are type I reactions that occur only in susceptible people who are highly sensitized to specific allergens. Hemolytic transfusion reactions are type II reactions that occur when a recipient receives ABO-incompatible blood from a donor. Tissue damage will occur in type III reactions, which are immune-complex reactions that usually occur secondary to antigen-antibody complexes.
A nurse is reviewing the laboratory reports of four clients. Which client's laboratory report indicates acquired immunodeficiency syndrome (AIDS)? 1 Client 1 2 Client 2 Correct 3 Client 3 4 Client 4
The diagnosis of AIDS requires that the person should be HIV positive and have either a CD4+ T-cell count of less than 200 cells/mm3 (200 cells/uL) or less than 14% or an opportunistic infection. Therefore client 3, with a CD4+ T-cell count of less than 200 cells/mm3 (200 cells/uL) and who is HIV positive, is having AIDS-defining illness. A healthy client usually has at least 800 to 1000 CD4+ T-cells per cubic millimeter (mm3) of blood. This number is reduced in the client with HIV disease. Client 1, with a CD4+ T-cell count of 750 cells/mm3 and HIV positive, does not have AIDS. Client 2, with a CD4+ T-cell count of 550 cells/mm3 and HIV positive, does not have AIDS. Client 4, having a CD4+ T-cell count of 450 cells/mm3 and HIV positive does not have AIDS.
Which symptoms are common during the fulminant stage of inhalation of anthrax? Select all that apply. Correct 1 Dyspnea 2 Dry cough Correct 3 Diaphoresis 4 Mild chest pain Correct 5 High temperature
The fulminant stage of inhalation of anthrax is manifested by dyspnea, diaphoresis, and a high body temperature. The prodromal stage of inhalation of anthrax is manifested by a dry cough and mild chest pain.
The nurse is reviewing the medication charts of four clients prescribed with cytokines. Which client's medication chart indicates the nurse needs to intervene? 1 Client A 2 Client B Correct 3 Client C 4 Client D
The nurse should intervene in the client taking anakinra. Colony-stimulating factors such as filgrastim and pegfilgrastim are effective in treating chemotherapy-induced neutropenia in client C. Anakinra is used to treat rheumatoid arthritis. All the rest are correct treatments. Cytokines are the soluble factors secreted by white blood cells that act as messengers between the cell types. Cytokines instruct cells to alter their proliferation, differentiation, secretion, and activity from immunomodulatory effects. Etanercept is used in the treatment of rheumatoid arthritis in client A and should not be questioned. Interleukin 11 (platelet growth factor) such as oprelvekin helps to prevent chemotherapy-induced thrombocytopenia in client B and should not be questioned. Aldesleukin is interleukin-2 that reduces metastatic melanoma in client D and metastatic renal cell carcinoma and should not require follow up.
Which is the first medication approved to reduce the risk of human immunodeficiency virus (HIV) infection in unaffected individuals? Correct 1 Truvada 2 Abacavir 3 Cromolyn 4 Methdilazine
Truvada is the first medication approved to reduce the risk of HIV infection in unaffected individuals who are at a high risk of HIV infection. Abacavir is administered to treat HIV infection and is a reverse transcriptase inhibitor. Cromolyn is administered in the management of allergic rhinitis and asthma. Methdilazine, an antihistamine, is administered to treat the skin and provide relief from itching.
Place the pathophysiologic process of tuberculosis infection in its correct order. Incorrect1.Granulomatous inflammation becomes surrounded by collagen, fibroblasts, and lymphocytes. Incorrect2.Areas of caseation undergo resorption, degeneration, and fibrosis. Incorrect3.Necrotic areas calcify or liquefy. Incorrect4.Caseation necrosis occurs in the center of the lesion. Incorrect5.Granulomatous inflammation is created by tuberculosis bacillus in lungs.
Tuberculosis is a highly communicable disease caused by Mycobacterium tuberculosis. The process of infection in tuberculosis starts by formation of granulomatous inflammation by tuberculosis bacillus in lungs. This granulomatous inflammation then becomes surrounded by collagen, fibroblasts, and lymphocytes. The necrotic tissue then turns into a granular mass, called a caseation necrosis, which occurs in the center of the lesion. Then the areas of caseation undergo resorption, degeneration, and fibrosis. Finally, the necrotic areas undergo calcification or liquefaction.
The nurse is providing discharge instructions to a client who is recovering from an acute case of viral hepatitis. Which statement by the client indicates a need for further education? 1 "I will avoid alcohol." 2 "I will eat small frequent meals." Correct 3 "I will take acetaminophen for pain rather than aspirin." 4 "I will eat foods high in carbohydrates, moderate in fats, and moderate in proteins."
Acetaminophen is damaging to the liver and is contraindicated in clients with hepatitis. Clients should avoid alcohol, eat small frequent meals, and eat foods high in carbohydrates and moderate in fats and protein.
Which cells are affected in DiGeorge syndrome? Correct 1 T-cells 2 B-cells 3 Monocytes Incorrect 4 Polymorphonuclear cells
DiGeorge syndrome is a primary immune deficiency disorder in which T-cells are affected. The B-cells are affected in Bruton's X-linked agammaglobulinemia; common variable hypogammaglobulinemia; and selective IgA, IgM, and IgG deficiency. Monocytes and polymorphonuclear cells are affected in chronic granulomatous disease and Job syndrome.
What should be used to clean needles and syringes between intravenous drug users (IDUs)? Correct 1 Bleach 2 Hot water 3 Ammonia Incorrect 4 Rubbing alcohol
Intravenous drug users (IDUs) should be instructed to fill syringes with household bleach and shake the syringe for 30 to 60 seconds. Hot water, ammonia, or rubbing alcohol are not used to disinfect used syringes.
Which is the most common opportunistic infection in a client infected with human immunodeficiency virus (HIV)? Correct 1 Oropharyngeal candidiasis 2 Cryptosporidiosis 3 Toxoplasmosis encephalitis 4 Pneumocystis jiroveci pneumonia
Oropharyngeal candidiasis is the most common infection associated with HIV because the immune system can no longer control Candida fungal growth. Pneumocystis jiroveci pneumonia (PCP) is the more common in a client infected with AIDs. It causes tachypnea and persistent dry cough. Cryptosporidiosis, an intestinal infection caused by Cryptosporidium organisms, presents in clients with AIDS as does toxoplasmosis encephalitis, which is caused by Toxoplasma gondii and is acquired through contact with contaminated cat feces or by ingesting infected undercooked meat.
Which malnutrition condition may predispose a client to secondary immunodeficiency?
Cachexia is a nutrition disorder that may occur due to wasting of muscle mass and weight, resulting in secondary immunodeficiency disorder. Cirrhosis, diabetes mellitus, and Hodgkin's lymphoma also lead to secondary immunodeficiency disorder, but these are not malnutrition disorders.
Which sexually transmitted infection is caused by Chlamydia trachomatis? Correct 1 Cervicitis 2 Gonorrhea 3 Genital warts 4 Genital herpes
Cervicitis is caused by Chlamydia trachomatis. Gonorrhea is a sexually transmitted infection caused by Neisseria gonorrhoeae. Genital warts are caused by the Human papillomavirus. Genital herpes is caused by the Herpes simplex virus.
For which illness should airborne precautions be implemented? 1 Influenza Correct 2 Chickenpox 3 Pneumonia Incorrect 4 Respiratory syncytial virus
Chickenpox is known or suspected to be transmitted by air. Diseases that are known or suspected to be transmitted by droplet include influenza and pneumonia. A disease that is known or suspected to be transmitted by direct contact is respiratory syncytial virus.
Which virus is responsible for causing infectious mononucleosis in clients? 1 Parvovirus 2 Coronavirus 3 Rotavirus Correct 4 Epstein-Barr virus
Epstein-Barr virus is responsible for mononucleosis and possibly Burkitt's lymphoma. Parvovirus and rotavirus cause gastroenteritis. Corona virus causes upper respiratory tract infections.
Which disease is caused by Escherichia coli? 1 Tetanus Correct 2 Peritonitis 3 Diphtheria 4 Food poisoning
Escherichia coli causes peritonitis. Clostridium tetani causes tetanus. Corynebacterium diphtheria causes diphtheria. Clostridium botulinum causes food poisoning.
A client treated with antitubercular medications reports vision changes. Which medication may be responsible for the client's condition? 1 Isoniazid 2 Rifampin 3 Pyrazinamide Correct 4 Ethambutol
Ethambutol, an antitubercular drug, can cause optic neuritis when given in high doses. Isoniazid may cause liver toxicity, and the client may report darkening of urine. Rifampin reduces the effectiveness of oral contraceptives, and the client may have to use an additional method of contraception. Pyrazinamide may cause kidney problems.
Which statement is true regarding Sjögren's syndrome? 1 Sjögren's syndrome increases lacrimation. 2 Sjögren's syndrome increases body secretions. Incorrect 3 Sjögren's syndrome decreases the risk for infection. Correct 4 Sjögren's syndrome decreases the digestion of carbohydrates.
Sjögren's syndrome decreases the digestion of carbohydrates because of insufficient secretion of saliva. Sjögren's syndrome decreases lacrimation. Sjögren's syndrome also decreases body secretions and saliva, therefore increasing the risk of infection.
The nurse is teaching a post-radiation therapy client regarding proper skin care to the radiation treatment area. Which statement made by the client indicates the nurse needs to follow up? 1 "I will avoid wearing tight-fitting clothing." 2 "I will avoid using adhesive bandages." 3 "I will avoid exposing the area to cold temperatures." Correct 4 "I will avoid rinsing the area with the saline solution."
A client who underwent radiation therapy should rinse the radiation treatment area with saline solution to prevent infection. Therefore the nurse should follow up to correct the misconception of not using saline. Tight-fitting clothing such as brassieres and belts should be avoided in the area of the treatment field. The use of adhesive bandages should be avoided and should not be used unless permitted by the radiation therapist. The radiation treatment area should not be exposed to cold temperatures.
A client with localized redness and swelling due to a bee sting reports intense local pain, a burning sensation, and itching. What would be the most appropriate nursing action? Correct 1 Applying cold compresses to the affected area 2 Ensuring the client keeps the skin clean and dry Incorrect 3 Monitoring for neurological and cardiac symptoms 4 Advising the client to launder all clothes with bleach
A client with a bee sting may have localized redness, swelling, pain, and itching due to an allergic reaction. The nurse should apply cold compresses to the affected area to reduce the pain in the client. A client with Candida albicans infection should keep his or her skin clean and dry to prevent further fungal infections. A client with a Borrelia burgdorferi infection may suffer from cardiac, arthritic, and neurologic manifestations. Therefore the nurse has to monitor for these symptoms. Direct contact may transmit a Sarcoptes scabiei infection; the nurse should make sure that the client's clothes are bleached to prevent the transmission of the infection.
A client receiving cisplatin therapy has developed tumor lysis syndrome (TLS). Which medication should the nurse administer to treat the TLS? 1 Mesna 2 Flavoxate Correct 3 Allopurinol 4 Aprepitant
Allopurinol should be administered to this client to promote purine excretion. Cisplatin is a nephrotoxic agent that is used in clients with cancer. TLS is the precipitation of metabolites (purine and potassium) of cell breakdown. Mesna and flavoxate are used to treat hemorrhagic cystitis in clients on chemotherapy; mesna is a protectant while flavoxate manages symptoms. Aprepitant is used to prevent nausea and vomiting in a client on the day of chemotherapy.
Which type of immunity will clients acquire through immunizations with live or killed vaccines? 1 Natural active immunity Correct 2 Artificial active immunity 3 Natural passive immunity 4 Artificial passive immunity
Artificial active immunity is acquired through immunization with live or killed vaccines. Natural active immunity is acquired when there is natural contact with antigens through a clinical infection. Natural passive immunity is acquired through the transfer of colostrums from mother to child. Artificial passive immunity is acquired by injecting serum from an immune human.
Which client has the highest risk for human immunodeficiency virus (HIV) infection? 1 A client who is involved in mutual masturbation Incorrect 2 A client who undergoes voluntary prenatal HIV testing Correct 3 A client who shares equipment to snort or smoke drugs 4 A client who engages in insertive sex with a non-infective partner
Clients who use equipment to snort (straws) and smoke (pipes) drugs are at the highest risk for becoming infected with HIV as their judgment may be impaired regarding the high-risk behaviors. Safe activities that prevent the risk of contracting HIV include mutual masturbation, masturbation, and other activities that meet the "no contact" requirements. A client who undergoes perinatal HIV voluntary testing may reduce the chances of getting infected. Insertive sex between partners who are not infected with HIV are not at risk of becoming infected with HIV.
The bacteria Clostridium botulinum causes which condition in a client? 1 Upper respiratory tract infection 2 Toxic shock syndrome 3 Urinary tract infection Correct 4 Food poisoning with progressive muscle paralysis
Clostridium botulinum bacteria causes food poisoning with progressive muscle paralysis. Toxic shock syndrome is caused by the bacteria Staphylococcus aureus. Many viruses and bacteria can cause upper respiratory tract infection but Clostridium is not one of them. Klebsiella-Enterobacter organisms most likely cause urinary tract infections.
Which term describes the practice of placing clients with the same infection in a semi-private room? 1 Isolating Correct 2 Cohorting 3 Colonizing 4 Cross-referencing
Cohorting is the practice of grouping clients who are colonized or infected with the same pathogen. Isolating is limiting the exposure to individuals with an infection. Colonizing refers to the development of an infection in the body. Cross-referencing has nothing to do with an infectious process.
Which complication will the nurse suspect in a client with genital herpes disease? 1 Infertility Correct 2 Cold sores 3 Reactive arthritis 4 Bartholin's abscess
Cold sores are the autoinoculation of the virus to extragenital sites, such as the fingers and lips. It is a complication of genital herpes disease. Infertility and reactive arthritis are the complications of chlamydial infection. Bartholin's abscess is a complication of gonorrhea.
Which sexually transmitted disease is caused by the human papilloma virus? 1 Gonorrhea Incorrect 2 Genital herpes 3 Chlamydia infection Correct 4 Condylomata acuminata
Condylomata acuminata is a sexually transmitted disease caused by the human papilloma virus. Gonorrhea is caused by Neisseria gonorrhoeae. Genital herpes is causes by the herpes simplex virus. Chlamydia infection is caused by Chlamydia trachomatis.
Which sexually transmitted disease is treated with antiviral drugs? 1 Syphilis 2 Gonorrhea Correct 3 Genital herpes 4 Chlamydial infection
Genital herpes is a sexually transmitted disease caused by herpes simplex virus. Therefore antiviral drugs are used to treat this condition. Bacteria cause syphilis, gonorrhea, and chlamydial infections.
Which organ-specific autoimmune disorder is associated with a client's kidney? 1 Graves' disease 2 Addison's disease Correct 3 Goodpasture syndrome Incorrect 4 Guillain-Barré syndrome
Goodpasture syndrome is an autoimmune disorder associated with the client's kidney. Graves' disease and Addison's disease are autoimmune disorders associated with the endocrine system. Guillain-Barré syndrome is an autoimmune disorder associated with the central nervous system.
What is a manifestation of tertiary syphilis? 1 Chancre 2 Alopecia Correct 3 Gummas 4 Condylomata lata
Gummas which are chronic, destructive lesions affecting the skin, bone, liver, and mucous membranes occur during tertiary syphilis. A chancre appears during primary syphilis. Alopecia and condylomata lata occur during secondary syphilis.
Which immunoglobulin crosses the placenta? 1 IgE 2 IgA Correct 3 IgG 4 IgM
IgG is the only immunoglobulin that crosses the placenta. IgE is found in the plasma and interstitial fluids. IgA lines the mucous membranes and protects body surfaces. IgM is found in plasma; this immunoglobulin activates due to the invasion of ABO blood antigens.
The nurse suspects that a client with inhalation anthrax is in the fulminant stage of the disease. Which symptom supports the nurse's conclusion? 1 Fever 2 Dry cough Correct 3 Hematemesis 4 Mild chest pain
Inhalation anthrax is a bacterial infection caused by Bacillus anthracis. This disease has two stages of illness, the prodromal stage and the fulminant stage. The symptom of the fulminant stage is hematemesis. The symptoms of the prodromal stage are fever, dry cough, and mild chest pain.
Which organism is responsible for causing Lyme disease in clients? 1 Phthirus pubis 2 Sarcoptes scabiei Correct 3 Borrelia burgdorferi 4 Pediculushumanus var. corporis
Lyme disease is a bacterial infection caused by Borrelia burgdorferi, which is transmitted by ticks. Phthirus pubis causes pediculosis. Scabies is caused by Sarcoptes scabiei. Pediculushumanus var. corporis also causes pediculosis.
The nurse suspects that a client is in the chronic persistent stage of Lyme disease. Which symptoms support the nurse's suspicion? Select all that apply. Correct 1 Arthritis 2 Dyspnea 3 Dizziness Correct 4 Chronic fatigue Incorrect 5 Erythema migrans
Lyme disease is a systemic infectious disease caused by the spirochete Borrelia burgdorferi. The symptoms of the chronic persistent stage are arthritis and chronic fatigue. Dyspnea and dizziness are the symptoms of the early disseminated stage. Erythema migrans is observed in the localized stage.
The nurse has administered lymphocyte immunoglobulin to a client. Which side effects are most likely to occur? Select all that apply. Correct 1 Leukopenia 2 Peptic ulcer Correct 3 Tachycardia Correct 4 Serum sickness 5 Urinary infection
Lymphocyte immunoglobulin is an immunosuppressant directed against T-lymphocytes. Tachycardia, leukopenia, and serum sickness are side effects associated with lymphocyte immunoglobulin therapy. Peptic ulcers may occur when corticosteroids are injected. A urinary infection may occur when an immunosuppressant such as belatacept is administered.
What does the nurse explain to a client that a positive diagnosis for human immunodeficiency virus (HIV) infection is based on? 1 Performance of high-risk sexual behaviors 2 Evidence of extreme weight loss and high fever 3 Identification of an associated opportunistic infection Correct 4 Positive enzyme-linked immunosorbent assay (ELISA) and Western blot tests
Positive ELISA and Western blot tests confirm the presence of HIV antibodies that occur in response to the presence of the HIV. Performance of high-risk sexual behaviors places someone at risk but does not constitute a positive diagnosis. Evidence of extreme weight loss and high fever do not confirm the presence of HIV; these adaptations are related to many disorders, not just HIV infection. The diagnosis of just an opportunistic infection is not sufficient to confirm the diagnosis of HIV. An opportunistic infection (included in the Centers for Disease Control and Prevention surveillance case definition for acquired immunodeficiency syndrome [AIDS]) in the presence of HIV antibodies indicates that the individual has AIDS.
Which complication is associated with Pott's disease? 1 Peritonitis 2 Bacterial meningitis 3 Generalized lymphadenopathy Correct 4 Destruction of intervertebral discs
Pott's disease is tuberculosis (TB) of the spine, which can lead to destruction of intervertebral discs. Abdominal TB can cause peritonitis. Central nervous system TB can cause severe bacterial meningitis. Generalized lymphadenopathy can be caused by miliary tuberculosis.
Which organism causes malaria? 1 Vibrio Correct 2 Sporozoa 3 Ringworm 4 Spirochetes
Sporozoa such as Plasmodium malariae cause malaria. Vibrio are curved-rod-shaped bacteria; these microorganisms causes cholera. Ringworm such as tinea corporis may cause mycotic infections. Spirochetes are spiral-shaped bacteria; these microorganisms may cause leprosy and syphilis.
A client diagnosed with osteomyelitis is being discharged. Which statement indicates a need for further teaching? Incorrect 1 "I will take the antibiotic at the same time every day." Correct 2 "I will take the antibiotic regularly until my symptoms subside." 3 "I will take the antibiotic with food if I develop gastric distress when on the antibiotic." 4 "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath."
The antibiotic should be taken as prescribed for the full length of treatment. The client should not discontinue the medication when symptoms subside. The statements "I will take the antibiotic at the same time every day," "I will take the antibiotic with food if I develop gastric distress when on the antibiotic," and "I will notify my healthcare provider and stop taking the medication if I develop a rash or shortness of breath" demonstrate understanding of the discharge instructions.
The nurse is reviewing blood screening tests of the immune system of a client with acquired immunodeficiency syndrome (AIDS). What does the nurse expect to find? Correct 1 A decrease in CD4 T cells 2 An increase in thymic hormones 3 An increase in immunoglobulin E 4 A decrease in the serum level of glucose-6-phosphate dehydrogenase
The human immunodeficiency virus (HIV) infects helper T-cell lymphocytes; therefore 300 or fewer CD4 T cells per cubic millimeter of blood or CD4 cells accounting for less than 20% of lymphocytes is suggestive of AIDS. The thymic hormones necessary for T-cell growth are decreased. An increase in immunoglobulin E is associated with allergies and parasitic infections. A decrease in the serum level of glucose-6-phosphate dehydrogenase is associated with drug-induced hemolytic anemia and hemolytic disease of the newborn.
What causes medications used to treat AIDS to become ineffective? 1 Taking the medications 90% of the time Correct 2 Missing doses of the prescribed medications 3 Taking medications from different classifications 4 Developing immune reconstitution inflammatory syndrome (IRIS)
The most important reason for the development of drug resistance in the treatment of AIDS is missing doses of drugs. When doses are missed, the blood drug concentrations become lower than what is needed to inhibit viral replication. The virus replicates and produces new particles that are resistant to the drugs. Taking the medications 90% of the time prevents medications from becoming ineffective. Taking medications from different classes prevents the drugs from becoming ineffective. Immune reconstitution inflammatory syndrome (IRIS) occurs when T-cells rebound with medication therapy and become aware of opportunistic infections.
Which diseases may occur due to rickettsial infections? Select all that apply. 1 Leprosy 2 Lyme disease Correct 3 Epidemic typhus 4 West Nile fever Correct 5 Rocky Mountain spotted fever
Typhoid fever and Rocky Mountain spotted fever are caused by rickettsial infections. Spirochetes and Mycobacterium leprae cause leprosy. Borrelia burgdorferi cause Lyme disease. The West Nile virus causes West Nile fever.
What determines if a client will develop AIDS from an HIV infection? 1 Level of IgM in the blood Correct 2 The number of CD4+ T-cells available 3 Presence of antigen-antibody complexes 4 Speed with which the virus invades the RNA
Whether HIV becomes AIDS depends upon the number of CD4+ T-cells. IgM and the presence of antigen-antibody complexes have no effect on HIV. The speed with which HIV invades the RNA has no impact on the future development of AIDS.
Which is a leukotriene modifier used to manage and prevent allergic rhinitis? Correct 1 Zileuton 2 Ephedrine 3 Scopolamine 4 Cromolyn sodium
Zileuton is a leukotriene modifier used to manage and prevent allergic rhinitis. Ephedrine is an ingredient in decongestants used to treat allergic rhinitis. Scopolamine is an anticholinergic used to reduce secretions. Cromolyn sodium is a mast cell stabilizing drug used to prevent mast cell membranes from opening when an allergen binds to IgE.