Questions for MedSurg2 Exam 4

A patient who has developed kidney failure is discussing options with the physician for treatment. What does the nurse understand that kidney failure is associated with? A. A deficiency in circulating lymphocytes B. A deficiency in phosphorous C. Decreased amount of WBCs D. Increased amount of macrophages

A. A deficiency in circulating lymphocytes

What treatment option does the nurse anticipate for the patient with severe combined immunodeficiency disease? A. Bone marrow transplantation B. Antibiotics C. Radiation therapy D. Removal of the thymus gland

A. Bone marrow transplantation

A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?

Artificially acquired active immunity

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 preparing to infuse gamma-globulin IV. When administering this drug, the nurse knows the speed of the infusion should not exceed what rate? A. 1.5 mL/min B. 2 mL/min C. 6 mL/min D. 10 mL/min

B 2 mL/min

The nurse is preparing to administer the recommended dose of inntravenous gammaglobulin for a 60-kg male patient. How many grams will the nurse administer? A. 15 g B. 30 g C. 60 g D. 90 g

B. 30 g

An infant that is 10 hours postdelivery is observed to have tetanic contractions. What symptom does the nurse recognize can indicate DiGeorge syndrome? A. Chronic diarrhea B. Hypocalcemia C. Neutropenia D. Pernicious anemia

B. Hypocalcemia

A patient developed an infection while on vaation in Central America and is not taking the antibiotic chloramphenicol. What should the patient be monitored for when taking this drug? A. Eosinophilia B. Neutropenia C. Aplastic anemia D. Hypoprothrombinemia

C. Aplastic anemia

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

CD4 counts

The treatment of gout involves managing the acute inflammatory stage, preventing flare-ups, and controlling hypruricemia. Select the agent of first choice when an acute inflammatory attack begins.

Colchicine

A patient with CVD is extremely fatigued and not feeling well. What lab test does the nurse anticipate the patient will have to detect a common development related to the disease? A. AST and ALT B. BUN and creatinine C. Glucose level D. B12 level

D. B12 level

A patient has dilated cardiomyopathy and has just found out he will be receiving a heart. What medication does the patient understand he will have to take for the duration of his life to help suppress the immune system to prevent rejection of the new heart? A. Infliximab (Remicade) B. Etanercept (Enbrel) C. Adalimumab (Humira) D. Cyclosporine (Sandimmune)

D. Cyclosporine (Sandimmune)

What chemical is released by cytotoxic T cells?

Lymphokine

After teaching a group of students about systemic lupus erythematosus, the instructor determines that the teaching was successful when the students state which of the following?

The belief is that an autoimmune disorder with an unknown trigger

Diagnostic testing is an essential part of assessment to determine the cause of rhinitis. Which of the following is the most conclusive test for this condition?

Total serum IgE test

The nurse is obtaining a history from a patient with severe psoriasis. What question would be most important to ask this patient to determine a genetic presdisposition? A. How did you know you developed this disease? B. Does anyone in your family have more than one autoimmune disease? C. How many children do you have? D. Does your spouse or significant other have an autoimmune disease?

B. Does anyone in your family have more than one autoimmune disease?

The nurse is caring for a female patient who has an exacerbation of lupus erythematosus. What does the nurse understand is the reason that females tend to develop autoimmune disorders more frequently than men? A. Androgen tends to enhance immunity B. Estrogen tends to enhance immunity C. Testosterone tends to enhance immunity D. Leukocytes are increased in females

B. Estrogen tends to enhance immunity

The nurse is caring for an older adult patient hospitalized with celluitis of the right lower extremity. Why is it imperative that the nurse continually asses the physical and emotional status of the patient? A. Older patient are at risk of developing dementia B. The patient will not respond to the antibiotic treatment as well as a younger patient would C. Early recognition and management of factors influencing immune response may decrease morbidity and mortality D. Older adult patients develop depression and suicidal tendencies when they are faced with chronic illness

C. Early recognition and management of factors influencing immune response may decrease morbidity and mortality

The nurse is caring for a patient in the hospital who is receiving a vitamin D supplement. What does the nurse understand is the importance if supplementation with this vitamin? Select all that apply A. Vitamin D deficiency is associated with increased risk of common cancers B. Vitamin D deficiency is associated with increased risk of autoimmune disease C. Vitamin D deficiency is associated with increased risk of congenital anomalies D. Vitamin D deficiency is associated with increased risk of inflammatory disorders E. Vitamin D deficiency is associated with increased risk of celiac disease

A. Vitamin D deficiency is associated with increased risk of common cancers B. Vitamin D deficiency is associated with increased risk of autoimmune disease D. Vitamin D deficiency is associated with increased risk of inflammatory disorders

An older adult has developed a sacral pressure ulcer. What should the nurse assess in order to ensure adequate wound healing and prevent poor outcomes for this patient? Select all that apply A. The patient's ability to perform her own wound care B. Nutritional status C. Caloric intake D. Quality of food ingested E. The amount of carbohydrates the patient ingests

B. Nutritional status C. Caloric intake D. Quality of food ingested

What severe complication does the nurse monitor for in a patient with ataxia-telangiectasia? A. Acute kidney injury B. Chronic lung disease C. Neurologic dysfunction D. Overwhelming infection

D. Overwhelming infection

A patient is suspected to have an immunodeficiency disorder. The physician orderes a nitroblue tetrazolium reductase (NTR) test to diagnose this patient. What does the nurse suspect that this disorder is related to? A. Complement B. B lymphocytes C. T lymphocytes D. Phagocytic cells

D. Phagocytic cells

The nurse is caring for a patient with an immunodeficiency disorder. What cardinal symptoms of immunodeficiency does the nurse recognize while caring for this patient? Select all that apply A. Chronic diarrhea B. Nonproductive cough C. Chronic or recurrent severe infections D. Poor response to the treatment with antibiotics E. Vomiting

A. Chronic diarrhea C. Chronic or recurrent severe infections D. Poor response to the treatment with antibiotics

What does the nurse understand will result if the patient has a deficiency in the normal level of complement? A. Increased susceptibility to infection B. Decreased in vascularity to the extremities C. Development of congestive heart failure D. Risk of stroke

A. Increased susceptibility to infection

An older adult patient who is postmenopausal informs the nurse that she believes she has developed another UTI. The nurse understands that postmenopausal females are at greater risk for UTIs. What risk factors do female patients in this age group have? Select all that apply A. Residual urine B. Urinary incontinence C. Estrogen deficiency D. Decreased function of the thyroid gland E. Dry mucous membranes of the vagina

A. Residual urine B. Urinary incontinence C. Estrogen deficiency

A patient arrives at the clinic and informs the nurse that she has a sore throat as well as a fever. A rapid strep test returns a positive result and the patient is given a prescription for an antibiotic. How did the streptococcal organism gain access to the patient to cause this infection? A. Through the mucous membranes of the throat B. Through the skin C. Breathing in airborne dust D. From being outside in the cold weather and decreasing resistance

A. Through the mucous membranes of the throat

A nurse is assessing a patient with primary immunodeficiency. Afterward, she documents that the patient is experiencing ataxia. Which of the following statements explains the documentation? A. The patient has vascular lesions caused by dilated blood vessels B. The patient has an inability to understand the spoken word C. The patient has uncoordinated muscle movements D. The patient has difficulty swallowing

C. The patient has uncoordinated muscle movements

A patient who suffered severe partial thickness burns to the face and trunk is at risk for depletion of essential proteins and immunoglobulins. The stressors associated with this patient's major injury have caused what immune process to occur? A. Cortisol is released from the adrenal cortex, which contributes to immunosuppression B. Circulating lymphcytes will cause lymph node enlargement and altered lymph drainage C. T lymphocytes are stimulated and produce antibodies D. With the help of macrophages, B-lymphocytes recognize the antigen of a foreign invader

D. With the help of macrophages, B-lymphocytes recognize the antigen as a foreign invader

The nurse is administering an infusion of gamma-globulin to a patient in the hospital. When should the nurse discontinue the infusion? Select all that apply A. When the patient complains of flank pain B. When the patient begins to have shaking chills C. When the patient complains of tightness in the chest D. When the patient voids 30 mL an hour E. When the patient complains of nausea

A. When the patient complains of flank pain B. When the patient begins to have shaking chills C. When the patient complains of tightness in the chest