Oncology, Allerigies, Immunity, Rheumatic

A client with rheumatoid arthritis arrives at the clinic for a checkup. Which statement by the client refers to the most overt clinical manifestation of rheumatoid arthritis?

"My finger joints are oddly shaped."

A client is experiencing symptoms of rheumatoid arthritis. Which laboratory tests will the nurse expect to be prescribed for this client? Select all that apply.

Erythrocyte count Rheumatoid factor Antinuclear antibody

A client is diagnosed with primary hyperuricemia. Which information in the client's health history will the nurse use to substantiate this diagnosis? Select all that apply.

Has daily intake of shellfish Family history of hyperuricemia

The nurse is discussing the new medication that a client will be taking for treatment of rheumatoid arthritis. Which disease-modifying antirheumatic drug (DMARD) will the nurse educate the client about?

Methotrexate

A nurse is preparing a client with systemic lupus erythematosus (SLE) for discharge. Which instruction should the nurse include in the teaching plan?

Monitor your body temperature

Which term indicates an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?

Tophi

Which joint is most commonly affected in gout?

metatarsophalangeal

Which client is most likely to develop systemic lupus erythematosus (SLE)?

A 27-year-old Black female

The nurse is completing a physical assessment with a client demonstrating signs of rheumatoid arthritis. Which findings will the nurse associate with this condition? Select all that apply.

Bruises Dry eyes Weight loss Thinning hair

A client who has AIDS reports having diarrhea after every meal, and wants to know what can be done to stop this symptom. What should the nurse advise?

Avoid fibrous foods, lactose, fat, and caffeine.

The nurse is obtaining the medical history of a client with Crohn's disease. What medication would the nurse include when asking about what medications the client has taken for suppression of the inflammatory and immune response?

Corticosteroids

The nurse identifies a nursing diagnosis of ineffective airway clearance related to pneumocystis pneumonia and increased bronchial secretions for a client with AIDS. Which of the following would be appropriate for the nurse to include in the client's plan of care?

Assist with chest physiotherapy every 2 to 4 hours.

The nurse practitioner who is monitoring the patient's progression of HIV is aware that the most debilitating gastrointestinal condition found in up to 90% of all AIDS patients is:

Chronic diarrhea.

More than 50% of individuals with this disease develop pernicious anemia:

Common variable immunodeficiency (CVID)

A 25-year-old client receives a knife wound to the leg in a hunting accident. Which type of immunity was compromised?

Natural immunity

A 20-year-old client cut a hand while replacing a window. While reviewing the complete blood count (CBC) with differential, the nurse would expect which cell type to be elevated first in an attempt to prevent infection in the client's hand?

Neutrophils

A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have?

Passive immunity transferred by the mother

Nursing students are reviewing the pathophysiology of human immunodeficiency virus (HIV). They demonstrate understanding of the information when they state which of the following as the form of the genetic viral material?

RNA

A nurse is teaching a client about the side effects of ibuprofen. The client's learning is determined to be effective based on which statement by the patient describing the drug's effect on the immune system?

"Ibuprofen can cause neutropenia, which can increase my risk of infection."

A client reports to a health care provider's office for intradermal allergy testing. Before testing, the nurse provides client teaching. Which client statement indicates a need for further education?

"If I notice tingling in my lips or mouth, gargling may help the symptoms."

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response?

"It is a hyperimmune response to something in the environment that is usually harmless."

A nurse is explaining treatment options to a client diagnosed with an immune dysfunction. Which statement by the client accurately reflects the teaching about current stem cell research?

"Stem cell transplantation has been carried out in humans with certain types of immune dysfunction, and clinical trials using stem cells are underway in clients with a variety of disorders with an autoimmune component."

The nurse receives a phone call at the clinic from the family of a client with AIDS. They state that the client started "acting funny" and reported headache, tiredness, and a stiff neck. Checking the temperature resulted in a fever of 103.2°F. What should the nurse inform the family member?

"The client may have cryptococcal meningitis and will need to be evaluated by the health care provider."

Which of the following cell types are involved in humoral immunity?

B lymphocytes

The nurse is teaching a client about histamine release during an anaphylactic reaction. What does histamine release in anaphylaxis cause?

Nasal congestion

A client is admitted with cellulitis and experiences a consequent increase in white blood cell count. During what process will pathogens be engulfed by white blood cells that ingest foreign particles?

Phagocytosis

What is the function of the thymus gland?

Programs T lymphocytes to become regulator or effector T cells.

The nurse's plan of care for a client with stage 3 HIV addresses the diagnosis of Risk for Impaired Skin Integrity Related to candidiasis. What nursing intervention best addresses this risk?

Providing thorough oral care before and after meals

A nurse is caring for a client with multiple sclerosis. Client education about the disease process includes which explanation about the cause of the disorder?

The immune system recognizes one's own tissues as "foreign."

In its attempt to suppress allergic responses, the body releases several chemicals which have a role in mediating physical reactions. Epinephrine, which interferes with vasoactive chemical release from mast cells, is instrumental in suppressing which type of hypersensitivity response?

type I

The nurse is completing the intake assessment of a client new to the allergy clinic. The client states that he was taking nose drops six times a day to relieve his nasal congestion. The nasal congestion increased, causing him to increase his usage of the nasal spray to eight times a day. But again the congestion worsened. The nurse communicates to the health care provider that the client experienced

Rhinitis medicamentosa

A client is taking ibuprofen for the treatment of osteoarthritis. What education will the nurse give the client about the medication?

Take the medication with food to avoid stomach upset.

A client on antiretroviral drug therapy informs the nurse about sometimes forgetting to take the medication for a few days. What should the nurse inform the client can occur when the medications are not taken as prescribed?

The client is risking the development of drug resistance and drug failure.

A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have?

The nurse ensures a written consent is obtained prior to testing.

Which assessment finding would the nurse expect to document for a client with ataxia-telangiectasis?

Vascular lesions

The nurse explains to a client that immunotherapy initially starts with injections at which interval?

Weekly

The nurse is performing a health history with a new client in the clinic. What is the most common reason for a client to seek medical attention for arthritis?

pain

What is the most common cause of anaphylaxis?

penicillin

The nurse is teaching a client about allergic rhinitis and its triggers. What is the most common trigger for the respiratory allergic response?

plant pollen

The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus? Select all that apply.

semen breast milk blood vaginal secretions

The term used to define the amount of virus in the body after the initial immune response subsides is

viral set point.

When obtaining a health history from a patient with possible abnormal immune function, what question would be a priority for the nurse to ask?

"Have you ever received a blood transfusion?"

A client is informed of having a low white blood cell count and that the client 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?

"White blood cells are produced in the bone marrow."

When a nurse infuses gamma globulin intravenously, the rate should not exceed

3 mL/min

A client is experiencing an acute exacerbation of rheumatoid arthritis. What should the nursing priority be?

Administering ordered analgesics and monitoring their effects

A client has begun sensitivity testing to determine the allergen which caused an anaphylactic reaction 3 weeks ago. In scratch testing, which part of the body is more sensitive to allergens?

Back

Which is usually the most important consideration in the decision to initiate antiretroviral therapy?

CD4+ counts

A client receiving atazanavir requires what priority intervention?

Cardiac assessment

A home care nurse is visiting a client with acquired immune deficiency syndrome (AIDS) at home. During the visit, the nurse observes the caregiver providing care. What action by the caregiver would alert the nurse to the need for additional teaching?

Caregiver cleans the client's anal area without wearing gloves

The nurse is educating a client about the risks of stroke related to the new prescription for a COX-2 inhibitor and what symptoms to report. Which COX-2 inhibitor is the nurse educating the client about?

Celecoxib

Fibromyalgia is a common condition that involves

Chronic fatigue, generalized muscle aching, and stiffness

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about?

Desensitization

A client calls the clinic and asks the nurse if using oxymetazoline nasal spray would be all right to relieve the nasal congestion the client is experiencing due to seasonal allergies. What instructions should the nurse provide to the client to avoid complications?

Do not overuse the medication as rebound congestion can occur.

A patient is experiencing an allergic reaction to a dose of penicillin. What should the nurse look for in the patient's initial assessment?

Dyspnea, bronchospasm, and/or laryngeal edema.

A nurse is caring for a client undergoing evaluation for possible immune system disorders. Which intervention will best help support the client throughout the diagnostic process?

Educate the client about the diagnostic procedures and answer their questions about the possible diagnosis

The nurse is reviewing the diagnostic test findings of a client with rheumatoid arthritis. What would the nurse expect to find?

Elevated erythrocyte sedimentation rate

The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells?

Natural killer cells

The nurse observes diffuse swelling involving the deeper skin layers in a client who has experienced an allergic reaction. The nurse would correctly document this finding as

angioneurotic edema.

The nurse is caring for a client with a new onset of gout. What medication does the nurse anticipate will be ordered by the health care provider?

colchicine

The presence of crystals in synovial fluid obtained from arthrocentesis is indicative of

gout

Atopic allergic disorders are characterized by

hereditary predisposition

A client has had a splenectomy after sustaining serious internal injuries in a motorcycle accident, including a ruptured spleen. Following removal of the spleen, the client will be susceptible to:

infection because the spleen removes bacteria from the blood.

Which immunity type becomes active as a result of infection by a specific microorganism?

naturally acquired active immunity

A client with ataxia-telangiectasia is admitted to the unit. The nurse caring for the client would expect to see what included in the treatment regimen?

IV gamma globulin administration

A client develops a facial rash and urticaria after receiving penicillin. Which laboratory value does the nurse expect to be elevated?

IgE

The nurse is teaching a group of health care workers about latex allergies. What reaction will the nurse teach the workers to be most concerned about with laryngeal edema?

IgE-mediated hypersensitivity

Which immunoglobulin assumes a major role in bloodborne and tissue infections?

IgG

The nurse notes that an older adult was treated for a wound infection and pneumonia within the last 6 months. Which factor will the nurse attribute to this client's illnesses?

Immunosenescence

An elderly client is diagnosed with a respiratory infection. While reviewing age-related changes in the immune system, what would the nurse identify as having contributed to this client's infection?

Impaired ciliary action from exposure to environmental toxins

A nurse is taking the health history of a newly admitted client and asks for a list of the client's current medications. Which medication classification would NOT place the client at risk for impaired immune function?

Inotropics

After teaching a client how to self-administer epinephrine, the nurse determines that the teaching plan has been successful when the client demonstrates which action?

Jabs the autoinjector into the outer thigh at a 90-degree angle

Which substance may be used to lubricate a condom?

K-Y jelly

Which of the following is the most common HIV-related malignancy?

Kaposi's sarcoma

The nurse is aware that the phagocytic immune response, one of the body's responses to invasion, involves the ability of cells to ingest foreign particles. Which of the following engulfs and destroys invading agents?

Macrophages

A nurse is reviewing the dietary history of a client who has experienced anaphylaxis. What would the nurse identify as a common cause of anaphylaxis? Select all that apply.

Milk Eggs Shrimp

A client is diagnosed with multiple site cancers and has received whole-body irradiation. The nurse is concerned about a compromised immune system in this client for which reason?

Radiation destroys lymphocytes.

A client comes to the clinic and informs the nurse that he feels as though he has allergies. What laboratory test results will be a positive indicator for an allergic disorder?

Radioallergosorbent blood test (RAST) of 3

A client with HIV will be started on a medication regimen of three medications. What class of drugs will the nurse instruct the client about?

Reverse transcriptase inhibitors

Which connective tissue disorder is characterized by insoluble collagen being formed and accumulating excessively in the tissues?

Scleroderma

The nurse is caring for a client recovering from a major burn. Burns affect the immune system by causing a loss of large amounts of which of the following?

Serum, which depletes the body's store of immunoglobulins

The nurse is caring for a client who has a diagnosis of human immunodeficiency virus (HIV). Part of this client's teaching plan is educating the client about his or her medications. What is essential for the nurse to include in the teaching of this client regarding medications?

Side effects of drug therapy

Which of the following disorders is characterized by an increased autoantibody production?

Systemic lupus erythematosus (SLE)

A client arrives at the clinic and reports a very sore throat as well as a fever. A rapid strep test returns a positive result and the client is given a prescription for an antibiotic. How did the streptococcal organism gain access to the client to cause this infection?

Through the mucous membranes of the throat

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:

Upper left quadrant of the abdomen.

For each teaching point, click to specify if the instruction addresses skin hydration or itchy skin. Each teaching point may address more than 1 condition.

Use an emollient containing glycerol on the skin after bathing: BOTH Take short showers using a mild soap for cleansing: HYDRATION Wear cotton fabric: ITCHY Wash clothes using a mild detergent: ITCHY Wash clothes using a mild detergent: ITCHY

A diet plan is developed for a client with gouty arthritis. What should the nurse advise the client to limit the intake of?

organ meats

The nurse is evaluating a client's complete blood cell count and differential along with the serum immunoglobulin E (IgE) concentration. Which result might indicate that the client has an allergic disorder?

High IgE concentration

Which body substance causes increased gastric secretion, dilation of capillaries, and constriction of the bronchial smooth muscle?

Histamine

A client who is HIV positive is experiencing severe diarrhea. Which laboratory test result would the nurse expect to find?

Hypokalemia

A hospital client is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test?

Arrange for a portable x-ray machine to be used.

What intervention is a priority when treating a client with HIV/AIDS?

Assessing fluid and electrolyte balance

The nurse is caring for a client with polymyositis. Which type of medication will the nurse explain to this client?

Corticosteroids

This type of T lymphocyte is responsible for altering the cell membrane and initiating cellular lysis. Choose the T lymphocyte.

Cytotoxic T cell

A client suspected of having human immunodeficiency virus (HIV) has blood drawn for a screening test. What is the first test generally run to see if a client is, indeed, HIV positive?

Enzyme-linked immunosorbent assay (ELISA)

A nurse assesses a client in the health care provider's office. Which assessment findings support a suspicion of systemic lupus erythematosus (SLE)?

Facial erythema, pericarditis, pleuritis, fever, and weight loss

A nurse is preparing to give a client an infusion of gamma globulin. The nurse knows to stop the infusion if the client experiences which symptoms? Select all that apply.

Flank pain Shaking chills Tightness in the chest

A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?

For their immunosuppressant effects

When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic?

HIV-1 is more prevalent than HIV-2 subtypes

Which of the following are actions of chemical mediators? Select all that apply.

Minimize blood loss Walling off the pathogen Activating phagocytes Promoting formation of fibrous scar tissue Regeneration of scar tissue.

Which medication classification is known to inhibit prostaglandin synthesis or release?

Nonsteroidal anti-inflammatory drugs (in large doses)

The nurse is taking the health history of a newly admitted client. Which condition would place the client at risk for impaired immune function?

Previous organ transplantation

A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. The next step for the nurse to explain to the client for confirmation of the diagnosis is to perform a:

Western blot test for confirmation of diagnosis.

A nurse is managing the care of a client with osteoarthritis. What is the appropriate treatment strategy the nurse will teach the about for osteoarthritis?

administration of nonsteroidal anti-inflammatory drugs (NSAIDs)

Which allergic reaction is potentially life threatening?

angioedema

The body has several mechanisms to fight disease, one of which is sending chemical messengers. 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?

interferons

The body has several mechanisms to fight disease, one of which is sending chemical messengers. The messengers released by lymphocytes, monocytes, and macrophages have differing roles in the immune response. Which messenger promotes inflammation, fever, and angiogenesis?

interleukins

A client taking abacavir has developed fever and rash. What is the priority nursing action?

Report to the health care provider.

An infant is born to a mother who had no prenatal care during her pregnancy. What type of hypersensitivity reaction does the nurse understand may have occurred?

Rh-hemolytic disease

The nurse is teaching a client newly diagnosed with a peanut allergy about how to manage the allergy. What information should be included in the teaching? Select all that apply.

Wear a medic alert bracelet List symptoms of peanut allergy. Identify ways to manage allergy while dining out. Carry EpiPen autoinjector at all times.