Quiz 4 Chapters 11,13-16

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Which of the following can the nurse tell a patient about antipyretic drugs during fever?

"Antipyretics help to protect the body."

A 16-year-old male client who has been diagnosed with infectious mononucleosis asks the health care provider what caused the condition. The best response would be:

Epstein-Barr virus (EBV)

Which patient is at greatest risk for decreased wound healing?

A 30-year-old patient with type 1 diabetes and a foot ulcer

A nurse is providing care for several clients on a neurological unit of a hospital. With which of the following clients would the nurse be justified in predicting a problem with thermoregulation?

A 66 year old male with damage to his thalamus secondary to a cerebral vascular accident.

A student states, "It seems like helper T cells do a lot more than just 'help' the cellular immunity process". Which of the following responses listed below best conveys an aspect of the role of CD4+ helper T cells in immunity?

"Helper T cells play a major role in stimulating and regulating the whole process."

The nurse is teaching a group of college students about reducing the risk of HIV transmission during sexual relations. The nurse makes which of the following appropriate teaching points?

"If a person has a sexually transmitted disease (STD), there is an increased risk for HIV infection."

A client stepped on a nail at work. The emergency room physician prescribes a tetanus "booster" shot. The client asks the nurse, "If I have already been vaccinated for tetanus why do I need to have another shot?" How should the nurse respond?

"The booster shot will stimulate your immune system's memory, causing an immediate rise in antibodies to protect you from an infection."

A 9-year-old child has been home from summer camp for 2 weeks and complains of sore throat, low-grade fever, and enlarged cervical lymph nodes. After testing, it is determined the child has Epstein-Barr virus (EBV)-associated infectious mononucleosis. The parent asks the nurse how the child acquired this type of infection. Which of the following is the nurse's best response?

"The infection is acquired primarily through contact with infected oral secretions."

The nurse is caring for a client who has just learned that he is HIV positive. The client asks the nurse how long he has been able to infect others. Select the best response by the nurse.

"You can infect others before the HIV antibody is detectable in your blood."

Which clients are showing manifestations of infection? Select all that apply.

A 2-month-old, temperature 38.3°C (100.4°F), lethargy, poor feeding, and cyanosis • A 25-year-old, temperature 40°C (104°F), sweating, shivering, states generalized pain • A 75-year-old, temperature 37.3°C (99.2°F), declining mental status, weakness and fatigue

Which of the following is an example of wound healing by secondary intention?

An infected burn of the arm

Which one of the following is an AIDS-defining condition?

CD4+ count less than 200 cells/microliter of blood

Which of the following is a function of plasma?

Carrying nutrients

A 20-year-old female comes to the clinic for an annual exam. She reports having unprotected sexual intercourse with several men over the last year. Blood tests reveal that she is positive for human papillomavirus. The nurse teaches the patient about which of the following complications that may occur because of the infection?

Cervical cancer

Which of the types of T cells is responsible for destroying pathogens by punching holes in their cell membrane and by secreting cytokines/lymphokines?

Cytotoxic T cells

The nurse is caring for a client who has a low levels of T lymphocytes. The nurse plans care for a client with which of the following?

Decreased immune response

A woman complains to the nurse that she has developed a yeast infection. The woman does not understand how she could get a yeast infection since she has been on antibiotics for a urinary tract infection. What is the rationale for this patient's complaint?

Destroying one type of resident flora (bacteria) can allow over proliferation of another competing type (yeast)

A nurse's hand-off reports states that the patient has pyrexia. The nurse plans care for the patient with which of the following events?

Fever

A 48 year-old man who has been HIV positive for 6 years has just learned that he has been diagnosed with Kaposi sarcoma (KS). Which of the following facts most accurately conveys an aspect of his diagnosis?

He is likely to have lesions on his skin, mouth or GI tract.

An oncologist has ordered a bone marrow biopsy for a client and is explaining the reasons for the test and what the client might expect during the test. Which of the following explanations best reflects an aspect of a bone marrow biopsy?

I need to get samples of the types of blood cells that your body is producing.

Which of the following immunoglobulins (Ig) is released in response to allergy or parasitic infections?

IgE

Three days ago, a mother delivered her full-term infant who had been identified as having an in utero infection. The infant is receiving antibiotic and phototherapy, and the mother is breastfeeding. Which of the following types of immunoglobulins could most reasonably be expected to predominate in the infant's immune system?

IgG, IgA, IgM

Which of the following is the main job of lymphocytes?

Immune reaction

The nurse notes that the client has a decreased neutrophil count. The nurse recognizes that the client is at risk for which of the following?

Infection

The nurse is conducting patient education for a client who is scheduled to undergo diagnostic testing for non-Hodgkin's lymphoma (NHL). The nurse includes information on which of the following?

Lymph node biopsy

A client with pneumonia is admitted with these vital signs: temperature 99.7ºF, pulse 80 beats/min, respirations 18/minute, and BP 120/80 mmHg. Which set of vital signs does the nurse anticipate when the client begins to shiver and requests another blanket several hours later?

T 100.9ºF, P 90/min, R 20/min, BP 126/80 mmHg

Which of the following explains how T lymphocytes and B lymphocytes differ?

T lymphocytes mature in the thymus gland; B lymphocytes mature in the bone marrow.

Which of the following types of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk

Naturally acquired passive immunity

A child has a congenital condition in which the thymus gland is absent. What should the nurse include in the education of care of this patient to the parents?

Observe and report signs and symptoms of infection

The nurse is caring for a client with leukemia that is having difficulty with blood clotting after having several transfusions with packed red blood cells. What does the nurse anticipate infusing for this client to assist with controlling the bleeding?

Platelets

A client in the acute stage of inflammation will experience vasodilation of the arterioles and congestion in the capillary beds. The nurse would assess the client's skin for:

Redness

The first physical line of defense in innate immunity is:

Skin and mucous membranes

The type of hypersensitivity reaction that is mediated by IgG or IgM antibodies directed against target antigens on specific host cell surfaces or tissues is also known as which of the following types of hypersensitivity reaction?

Type II

The nurse is reviewing the complete blood count (CBC) and white blood cell (WBC) differential of a client admitted with lower right abdominal pain. Which laboratory results are the most important for the nurse to communicate to the health care provider?

White blood cells (WBCs) 18,500/µL

A mother is diagnosed with a bacterial infection and is worried that her newborn infant will also contract the infection. Which of the following statements should the nurse include in the teaching plan for the client?

Your newborn has maternal IgG antibodies that were transferred through the placenta before birth, providing some protection from infection.


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