Targeted Med Surge Immune

A nurse is providing teaching for a client who has a new prescription for amoxicillin to treat a respiratory infection. Which of the following statements by the client indicates an understanding of the teaching? A. "I will use a backup method of birth control while I am taking this medication" B. "I should take this medication on an empty stomach" C. "I should expect to have constipation while taking this medication" D. "I will keep taking this medication until I feel better"

A. "I will use a backup method of birth control while I am taking this medication" The nurse should inform the client that antibiotics accelerate the elimination of oral contraceptives, making them less effective.

A nurse is caring fora client who reports a skin change on her arm. Which of the following findings should the nurse report to the provider? A. An asymmetrical papule that is pigmented B. A patch of silvery-white scales with a red epidermal base C. A collection of irregular dry papules that are black D. An elevated red lesion that arises from a scar

A. An asymmetrical papule that is pigmented The nurse should identify an asymmetrical papule that is pigmented as an indication of a malignant melanoma. The nurse should report the client's skin change to the provider.

A nurse is providing teaching for a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following should the nurse include in the teaching? A. Avoid crowds B. Expect manifestations to subside in 1-2 weeks C. Increase intake of vitamin D D. Anticipate constipation

A. Avoid crowds The nurse should instruct the client to avoid crowds when taking methotrexate. Methotrexate can cause leukopenia due to bone marrow suppression, which can increase the client's risk for infection.

A nurse is providing teaching for a group of clients regarding prevention of skin cancer. Which of the following risk factors should the nurse include in the teaching? A. Light skin pigmentation B. Psoriasis C. History of frostbite D. Immunodeficiency disorder

A. Light skin pigmentation The nurse should inform the clients that light skin pigmentation is a risk factor for the development of skin cancer.

A nurse is assessing a client who has HIV. Which of the following findings should cause the nurse to suspect that the clients diagnosis has progressed to AIDS. A. Small, purple-colored skin lesions B. Fever and diarrhea lasting longer than 1 month C. Persistent, generalized lymphadenopathy D. CD4-T cells decreased to 750 cells/mm3

A. Small, purple-colored skin lesions The nurse should identify the presence of small, purple-colored skin lesions as an indication that the client has acquired Kaposi's sarcoma, which is an AIDS-defining illness.

A nurse is caring fora client who has neutropenia. Which of the following findings indications a need for intervention? A. The client's granddaughter is visiting and telling him about her first day of kindergarten B. The client has a grilled ham and cheese sandwich, a banana, and yogurt on his lunch tray C. The client's family brings in a silk flower arrangement D. The client's assisstive personnel places paper cups and plastic utensils in his room

A. The client's granddaughter is visiting and telling him about her first day of kindergarten The nurse should limit the client's visitors to healthy adults. A visit from a child who is attending school can place the client at risk for infection due to his immunocompromised status.

A nurse is reviewing the daily laboratory results for a female client who has acute leukemia. Which of the following values is an expected finding? A. WBC count of 21,000 B. Hgb 14 C. Hct 40% D. Platelets 170,000

A. WBC count of 21,000 The nurse should expect a client who has acute leukemia to have an elevated WBC count.

A nurse is caring for a client who has a new prescription for clindamycin to treat acute pelvic inflammatory disease. The nurse should monitor for and report which of the following findings immediately to the provider? A. Watery diarrhea B. Vaginitis C. Furry tongue D. Nausea and vomiting

A. Watery diarrhea The greatest risk to this client is pseudomembranous colitis, which is manifested by watery diarrhea. Therefore, the priority finding is diarrhea. The nurse should report this finding to the provider immediately and discontinue the medication.

A nurse is performing a breast examination on a client who is pregnant. Which of the following findings should the nurse report to the provider? A. Slight asymmetrical breast size B. Breast tissue with an orange-peel appearance C. Nipple inversion of one breast since puberty D. Elevated Montgomery's glands

B. Breast tissue with an orange-peel appearance The nurse should report an orange-peel appearance of the client's skin because this can indicate a blockage of lymph channels, which is a manifestation of advanced breast cancer.

A nurse is providing teaching for a client who is scheduled for a Papanicolaou (Pap) test. The nurse should instruct the client that she is being tested for which of the following? A. Uterine cancer B. Cervical cancer C. Ovarian cysts D. Fibroids

B. Cervical cancer The nurse should inform the client that a Pap test is used to screen for cervical cancer.

A nurse is assessing a client who has systemic lupus erythematous (SLE) which of the following findings should the nurse expect? A. Subcutaneous nodules B. Decreased urine output C. Renal calculi D. Butterfly rash E. Joint inflammation

B. Decreased urine output Decreased urine output, due to kidney damage, is a manifestation of SLE. D. Butterfly rash A scaly rash on the face, commonly known as the "butterfly rash," is a common manifestation of SLE. E. Joint inflammation Joint inflammation is a common manifestation of SLE.

A nurse is providing discharge teaching for a client who is HIV positive. Which of the following instructions should the nurse include in the teaching? A. Clean bathroom surfaces with full-strength bleach B. Discard beverages that have been unrefrigerated for 1 hour C. Wash laundry soiled with a body fluid in warm water D. Work in the garden for exercise

B. Discard beverages that have been unrefrigerated for 1 hour The nurse should instruct the client to discard beverages that have been unrefrigerated for 1 hr. Bacteria can grow in open, unrefrigerated beverages, which places the client at risk for infection.

A nurse in the emergency department is assessing a newly admitted client. Which of the following places is the client at increased risk for contracting hepatitis B? A. Residing in an institutional setting B. Engaging in unprotected sexual intercourse C. Working with hazardous chemical waste materials D. Traveling to a foreign country

B. Engaging in unprotected sexual intercourse A client who engages in unprotected sexual intercourse is at increased risk because hepatitis B is transmitted by sexual contact.

A nurse is caring for a client who has viral pneumonia and a history of COPD. Which of the following findings should the nurse report to the provider? A. Negative blood culture B. Left shift in WBC differential C. Oxygen saturation 93% D. Crackles heard on auscultation

B. Left shift in WBC differential When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is a left shift in the client's WBC differential, which indicates that the pneumonia is of bacterial origin, rather than viral. The left shift can be a manifestation of sepsis, and the nurse should report this finding to the provider.

A nurse is caring for a client who has Hodgkins lymphoma. Which of the following findings should the nurse expect? A. Overgrowth of B-lymphocyte plasma cells B. Reed-Sternberg cells C. Epstein-Barr virus D. Overproduction of blast phase cells

B. Reed-Sternberg cells The nurse should expect to find Reed-Sternberg cells, which are cancer cells specific to a client who has Hodgkin's lymphoma, in the client's lymph nodes.

A nurse is teaching a client who is receiving chemotherapy. The client's laboratory results indicate bone marrow suppression. Which of the following instructions should the nurse include in the teaching? A. "Take aspirin for minor aches and pains" B. "Clean your toothbrush with warm water weekly" C. "Bathe with an antimicrobial soap twice per day" D. "Wear clothing that will minimize sun exposure"

C. "Bathe with an antimicrobial soap twice per day" The nurse should instruct the client to bathe twice per day with an antimicrobial soap to decrease her exposure to micro-organisms. A client who has bone marrow suppression is at increased risk for infection.

A nurse is providing teaching for a client who has systemic lupus erythematous (SLE). Which of the following statements by the client indicates an understanding of the teaching? A. "I should use a sunscreen with an SPF of at least 15" B. "Long-term immunosuppressive therapy could cure this disease" C. "I should wear gloves when it is cold outside" D. "SLE should not affect my lungs or breathing"

C. "I should wear gloves when it is cold outside" Raynaud's phenomenon commonly accompanies SLE and can cause painful vasoconstriction in the client's fingers when exposed to cold temperatures.

A nurse is providing teaching for a client who has an allergy to peanuts. Which of the following instructions is the priority to include in the teaching? A. Inform other health care professionals of the allergy B. Wear a medical identification tag C. Carry an emergency anaphylaxis kit D. Keep a food diary

C. Carry an emergency anaphylaxis kit The greatest risk to the client is injury or death from an anaphylactic reaction. Therefore, the priority instruction for the client is to be prepared for emergency treatment by carrying an emergency anaphylaxis kit.

A nurse is caring for a client who has HIV. Which of the following laboratory findings should suggest to the nurse that medication therapy is effective. A. WBC 3500 B. Lymphocyte 1400 C. Decreased viral load D. Low CD4/CD8 ratio

C. Decreased viral load The nurse should recognize that a client who has HIV and is receiving medication therapy should display a decreasing viral protein amount in the blood, indicating a positive response to the medication therapy.

A nurse is caring for a client who has an elevated prostate-specific antigen level. The nurse should anticipate that the client will undergo which of the following diagnostic tests? A. Palpation of the testes B. Human chorionic gonadotropin level C. Digital rectal examination D. Pelvic ultrasound

C. Digital rectal examination The nurse should recognize that a digital rectal examination is used to determine the size and consistency of the prostate, assisting with the differentiation between benign prostatic hypertrophy and prostate cancer.

A nurse is planning an education program about testicular cancer for a group of male adolescents. Which of the following information should the nurse include? A. Testicular cancer is more common in men older than 65 B. With early treatment, the survival rate is 50% C. Examine the testicles immediately after showering D. Schedule an annual ultrasound to screen for testicular cancer

C. Examine the testicles immediately after showering The client should perform a testicular self-examination on a monthly basis by examining the testicles after a bath or shower to allow for easier palpation.

A nurse is educating a client who is schedules for a kidney transplant. which of the following information regarding hyper acute rejection should the nurse include in the teaching? A. Hyperacute rejection can occur during the first few weeks after the transplant B. If hyperacute rejection occurs, the kidney can become enlarged C. The organ will need to be removed if it occurs D. Immunosuppressive therapy is given to reverse hyperacute rejection

C. The organ will need to be removed if it occurs Removing the transplanted organ is the only treatment for hyperacute rejection, due to the widespread clotting cascade that leads to ischemic necrosis of the transplant kidney.

A nurse is caring for a client who is admitted with enlarged lymph nodes and a fever. To confirm a diagnosis of bacterial pharyngitis, the nurse should anticipate which of the following diagnostic tests? A. Indirect laryngoscopy B. Chest x-ray C. Throat culture D. Monospot test

C. Throat culture The nurse should recognize that a throat culture is used to confirm a diagnosis of bacterial pharyngitis by identifying specific micro-organisms present in the pharynx.

A nurse is providing teaching for a client who has rheumatoid arthritis and reports persistent pain. Which of the following responses by the nurse is appropriate? A. "Take a cool bath in the evening" B. "Exercise every other day" C. "Use pillows to support your joints while in bed" D. "Ask a friend or family member to help with household chores"

D. "Ask a friend or family member to help with household chores" The nurse should instruct the client to allow others to assist with household chores to reduce the risk for joint injury and to give the client the opportunity to rest.

A nurse is planning an education program for a group of high school teachers who will be taking students on a hike. Which of the following information should the nurse include regarding lyme disease? A. "If you get bitten by a tick, you should be tested immediately" B. "If you have a tick embedded in your skin, apply a lit match to remove it" C. "You should wear dark-colored clothing to deter ticks from biting" D. "If you develop pain and stiffness in your joints, you should see your doctor"

D. "If you develop pain and stiffness in your joints, you should see your doctor" The nurse should inform the group that manifestations of stage I Lyme disease include influenza-like symptoms, a "bull's-eye" rash, muscle and joint pain, and stiffness. The nurse should instruct the group to report these findings to a provider.

A nurse is providing care for four clients. Which of the following clients is at greatest risk for pneumonia? A. A school-aged child who has a history of asthma B. A young adult client living in a college dorm C. A middle adult client using an incentive spirometer following surgery D. An older adult client who has dysphagia

D. An older adult client who has dysphagia An older adult client who has dysphagia is at greatest risk for pneumonia due to the increased risk for aspiration when eating.

A nurse is providing teaching for a client who has Hodgkins lymphoma and is undergoing external radiation treatment. Which of the following instructions should the nurse include? A. Use an antibacterial soap to cleanse the skin B. Wash the ink marking off when showering C. Rub the skin with a towel when drying D. Avoid direct sun exposure to the skin

D. Avoid direct sun exposure to the skin The nurse should instruct the client to avoid sun exposure because the client's skin is sensitive to sunburn due to the external radiation.

A nurse is caring for a client who has non-Hodgkins lymphoma and is receiving chemotherapy. Which of the following is the priority assessment finding? A. Loss of body hair B. Report of anorexia C. Mucositis of the oral cavity D. Erythema at the IV insertion site

D. Erythema at the IV insertion site The greatest risk to the client is injury to the tissue due to extravasation of chemotherapy. Erythema at the IV insertion site can indicate extravasation is occurring, which can lead to infection and tissue loss. This is the priority assessment finding.

A nurse is caring for a client who has leukemia and a platelet count of 48,000/mm. Which of the following actions should the nurse take? A. Provide the client with a diet low in vitamin K B. Place the client on contact precautions C. Administer subcutaneous epoetin alfa D. Test the client's urine and stool for occult blood

D. Test the client's urine and stool for occult blood A client who is thrombocytopenic is at risk for occult bleeding. Therefore, the nurse should test the client's urine and stool for occult blood.

A nurse is providing education for the parent of a child about administration guidelines for the human papilloma virus (HPV) vaccine. Which of the following information should the nurse include? A. One dose is administered at birth and another is administered at age 5 B. The vaccine does not protect against males C. The vaccine protects against chlamydia D. Three doses are administered to adolescents who start the series after age 15

D. Three doses are administered to adolescents who start the series after age 15 The nurse should inform the parent that the HPV vaccine is recommended for children beginning at age 11 or 12 years. Children who receive the first dose before age 15 should receive two doses of the HPV vaccine. Adolescents who receive the first dose after age 15 should receive three doses of the HPV vaccine.