UNIT 10
The nurse working in the emergency department is asked to explain allergy testing to a client who experienced an allergic reaction to an unknown allergen. Which test indicates the quantity of allergen necessary to evoke an allergic reaction? Serum-specific IgE test Provocative testing Scratch test Intradermal test
Serum-specific IgE test
The lower the client's viral load, the shorter the time to AIDS diagnosis. the longer the survival time. the shorter the survival time. the longer the time immunity.
the longer the survival time.
A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What type of hypersensitivity did this client exhibit? type I type II type III type IV
type I pg559
client with multiple food and environmental allergies tells the nurse that he is frustrated and angry about having to be so watchful all the time and wonders if it is really worth it. What would be the nurse's best response? "I can only imagine how you feel. Would you like to talk about it?" "Let's find a quiet spot and I'll teach you a few coping strategies." "That's the same way that most clients who have a chronic illness feel." "Do you think that maybe you could be managing things more efficiently?"
"I can only imagine how you feel. Would you like to talk about it?"
The nurse is providing health education to the parents of a toddler who has been diagnosed with food allergies. What should the nurse teach this family about the child's health problem? "Food allergies are a life-long condition, but most families adjust quite well to the necessary lifestyle changes." "Consistent use of over-the-counter (OTC) antihistamines can often help a child overcome food allergies." "Make sure that you carry a steroid inhaler with you at all times, especially when you eat in restaurants." "Many children outgrow their food allergies in a few years if they avoid the offending foods."
"Many children outgrow their food allergies in a few years if they avoid the offending foods."
A patient with HIV has been on antiretroviral therapy (ART) for 6 months. The patient comes to the clinic with home medications and the nurse observes that there are too many pills in the container. What does the nurse know about the factors associated with nonadherence to ART? (Select all that apply.) Lives alone Active substance abuse Taking other medication Depression Lack of social support
Active substance abuse Depression Lack of social support
A client presents to the emergency department in anaphylactic shock after a bee sting. What should the nurse do? Select all that apply. Administer Diphenhydramine. Insert an intravenous line. Give metoprolol. Have respiratory therapy provide an albuterol treatment. Monitor international normalized ratio (INR) level.
Administer Diphenhydramine. Insert an intravenous line. Have respiratory therapy provide an albuterol treatment.
A client with HIV infection has begun experiencing severe diarrhea. What is the most appropriate nursing intervention to help alleviate the diarrhea? Administer antidiarrheal medications on a scheduled basis, as prescribed. Encourage the client to eat three balanced meals and a snack at bedtime. Increase the client's oral fluid intake. Encourage the client to increase his or her activity level.
Administer antidiarrheal medications on a scheduled basis, as prescribed.
A client is distressed and frustrated reporting severe, ongoing fatigue that doesn't subside with rest. The nurse explains that chronic fatigue syndrome results from: All options are correct. immune system dysregulation. a combination of immune defects and viral assaults. impaired activation of three neuroendocrine structures: the hypothalamus, pituitary gland, and adrenal glands.
All options are correct.
A junior nursing student is having an observation day in the operating room. Early in the day, the student reports eye swelling and dyspnea to the OR nurse. What should the nurse suspect? Cytotoxic reaction due to contact with the powder in the gloves Immune complex reaction due to contact with anesthetic gases Anaphylaxis due to a latex allergy Delayed reaction due to exposure to cleaning products
Anaphylaxis due to a latex allergy
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 washes hands before and after providing care to the client. Caregiver cleans the client's anal area without wearing gloves Caregiver disposes of syringe and needle in a metal coffee can with lid. Caregiver uses a dilute bleach solution to clean up a urine spill.
Caregiver cleans the client's anal area without wearing gloves
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: Anorexia. Chronic diarrhea. Nausea and vomiting. Oral candida.
Chronic diarrhea.
A nurse is preparing to administer a scheduled dose of IVIG to a patient who has a diagnosis of severe combined immunodeficiency disease (SCID). What medication should the nurse administer prior to initiating the infusion? Diphenhydramine Ibuprofen Hydromorphone Fentanyl
Diphenhydramine
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. Hypotension and tachycardia The presence and location of pruritus The severity of cutaneous warmth and flushing
Dyspnea, bronchospasm, and/or laryngeal edema.
A client's natural immunity is enhanced by processes that are inherent in the physical and chemical barriers of the body. What is a chemical barrier that enhances natural immunity? Cell cytoplasm Interstitial fluid Gastric secretions Cerebrospinal fluid
Gastric secretions
The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count? Less than 200/mm3 Between 200 to 350/mm3 Between 350 to 499/mm3 Greater than 500/mm3
Greater than 500/mm3
x The nurse is reviewing the medical record of a client who is positive for human immunodeficiency virus (HIV). The nurse notes that the client is classified as HIV asymptomatic based on which CD4+ T lymphocyte count? Less than 200/mm3 Between 200 to 350/mm3 Between 350 to 499/mm3 Greater than 500/mm3
Greater than 500/mm3
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by which characteristic? means of transmission HIV-1 is more prevalent than HIV-2 subtypes the fact that it is a mutated virus originally thought to be bovine in nature cure rate
HIV-1 is more prevalent than HIV-2 subtypes
At 39 weeks' gestation, a pregnant client visits the physician for a scheduled prenatal checkup. The physician determines that the fetus has developed an infection in utero and sends the client for an emergency cesarean delivery. The client is very concerned about the health of her unborn child. Based on knowledge of the immune system, the delivery room nurse explains about which immunoglobulin that will be increased in the fetus at the time of birth and will be actively fighting the infection? IgG IgA IgM IgD
IgG
A client with a family history of allergies has suffered an allergic response based on a genetic predisposition. This atopic response is usually mediated by what immunoglobulin? Immunoglobulin A Immunoglobulin M Immunoglobulin G Immunoglobulin E
Immunoglobulin E
The nurse is creating a care plan for a client suffering from allergic rhinitis. What outcome should the nurse identify? Appropriate use of prophylactic antibiotics Safe injection of corticosteroids Improved skin integrity Improved coping with lifestyle modifications
Improved coping with lifestyle modifications
A client has been admitted to the emergency department with signs of anaphylaxis following a bee sting. The nurse knows that if this is a true allergic reaction the client will present with what alteration in laboratory values? Increased eosinophils Increased neutrophils Increased serum albumin Decreased blood glucose
Increased eosinophils
A client with AIDS is admitted to the hospital with AIDS-related wasting syndrome and AIDS-related anorexia. What drug has been found to promote significant weight gain in clients with AIDS, by increasing body fat stores? Psyllium Momordica charantia Megestrol Ranitidine
Megestrol
A teenager is diagnosed with cellulitis of the right knee and fails to respond to oral antibiotics. He then develops osteomyelitis of the right knee, prompting a detailed diagnostic workup that reveals a phagocytic disorder. This patient faces an increased risk of what complication? Thrombocytopenia HIV/AIDS Neutropenia Hemophilia
Neutropenia
A client with HIV is admitted to the hospital because of chronic severe diarrhea. The nurse caring for this client should expect the health care provider to prescribe what medication for the management of the client's diarrhea? Azithromycin Octreotide acetate Levofloxacin Clarithromycin
Octreotide acetate
A nurse would identify that a colleague needs additional instruction on standard precautions when the colleague exhibits what behavior? The nurse wears face protection, gloves, and a gown when irrigating a wound. The nurse performs hand hygiene with a waterless antiseptic agent after removing a pair of soiled gloves. The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure. The nurse places a used needle and syringe in the puncture-resistant container without capping the needle.
The nurse puts on a second pair of gloves over soiled gloves while performing a bloody procedure.
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 of supplementation with this vitamin? (Select all that apply.) Vitamin D deficiency is associated with increased risk of common cancers. Vitamin D deficiency is associated with increased risk of autoimmune disease. Vitamin D deficiency is associated with increased risk of congenital anomalies. Vitamin D deficiency is associated with increased risk of inflammatory disorders. Vitamin D deficiency is associated with increased risk of celiac disease.
Vitamin D deficiency is associated with increased risk of common cancers. Vitamin D deficiency is associated with increased risk of autoimmune disease. Vitamin D deficiency is associated with increased risk of inflammatory disorders.
A client has undergone diagnostic testing for human immunodeficiency virus (HIV) using the enzyme immunoassay (EIA) test. The results are positive and the nurse prepares the client for additional testing to confirm seropositivity. The nurse would prepare the client for which test? Western blot assay OraSure test p24 antigen capture assay Nucleic acid sequence-based amplification
Western blot assay
A nurse is planning the assessment of a client who is exhibiting signs and symptoms of an autoimmune disorder. The nurse should be aware that the incidence and prevalence of autoimmune diseases is known to be higher among what group? Young adults Native Americans/First Nations Women Hispanics
women
A client tells the nurse, "You know I have AIDS. I still cannot afford to tell my employer because they will probably cancel my health insurance, then what would I do?" What is the best response by the nurse? "An employer cannot cancel your currently active health insurance on the basis of AIDS." "I just would not tell them. It is none of their business." "You have to tell them, it is not your right to allow them exposure to you. What if you give it to someone?" "I understand your dilemma, but I think you should tell them. I would want to know."
"An employer cannot cancel your currently active health insurance on the basis of AIDS."
A client is infected with human immunodeficiency virus (HIV) after sharing needles with another intravenous (IV) drug abuser. Upon infection with HIV, the immune system responds by making antibodies against the virus, usually within how many weeks after infection? 1 to 2 weeks 3 to 6 weeks 3 to 12 weeks 6 to 18 weeks
3 to 12 weeks
A patient is on highly active antiretroviral therapy (HAART) for the treatment of HIV. What does the nurse know would be an adequate CD4 count to determine the effectiveness of treatment for a patient per year? 1 mm3 to 10 mm3 10 mm3 to 20 mm3 20 mm3 to 45 mm3 50 mm3 to 150 mm3
50 to 150
The client with AIDS has a respiratory infection from Pneumocystis carinii and a nursing diagnosis of impaired gas exchange written in the plan of care. Which of the following indicates that the expected outcome of care has not yet been achieved? A. Client limits fluid intake B. Client has clear breath sounds C. Client expectorates secreations easily
A
Which type of infection control does an extremely ill hospitalized patient with AIDS require? A. Blood and body fluid precautions B. Respiratory isolation C. Reverse isolation D. Contact isolation
A
A client was tested for HIV as part of a screening process and has just been told that the results were positive. What anticipatory guidance should the nurse provide to the client? The client will be retested for HIV in 6 weeks and in 3 months Antiretroviral therapy will begin within 3 months A follow-up test will be promptly performed to confirm the result The client will be monitored for signs and symptoms of HIV infection to determine if treatment is necessary
A follow-up test will be promptly performed to confirm the result
A nurse is reviewing the immune system before planning an immunocompromised client's care. How should the nurse characterize the humoral immune response? Specialized cells recognize and ingest cells that are recognized as foreign. T lymphocytes are assisted by cytokines to fight infection. Lymphocytes are stimulated to become cells that attack microbes directly. Antibodies are made by B lymphocytes in response to a specific antigen.
Antibodies are made by B lymphocytes in response to a specific antigen.
A client with a diagnosis of primary immunodeficiency disease informs the nurse that he has been experiencing a new onset of a dry cough and occasional shortness of breath. After determining that the client's vital signs are within reference ranges, what action should the nurse take? Administer a nebulized bronchodilator. Perform oral suctioning. Assess the client for signs and symptoms of infection. Teach the client deep breathing and coughing exercises.
Assess the client for signs and symptoms of infection.
An HIV-infected client presents at the clinic for a scheduled CD4+count. The results of the test are 45 cells/mL, and the nurse recognizes the client's increased risk for Mycobacterium aviumcomplex (MAC disease). The nurse should anticipate the administration of what drug? Azithromycin Vancomycin Levofloxacin Fluconazole
Azithromycin
A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that the nursing student should take? A. Immediately see a social worker B. Start prophylactic AZT treatments C. Start prophylactic Pantamidetx
B
A client with acquired immune deficiency syndrome (AIDS) informs the nurse of difficulty eating and swallowing, and shows the nurse white patches in the mouth. What problem related to AIDS does the nurse understand the client has developed? MAC Wasting syndrome Kaposi's sarcoma Candidiasis
Candidiasis
Which condition is associated with impaired immunity relating to the aging client? Increase in humoral immunity Breakdown and thinning of the skin Decrease in inflammatory cytokines Increase in peripheral circulation
Breakdown and thinning of the skin
A client's current immune response involves the direct destruction of foreign microorganisms. This aspect of the immune response may be performed by what cells? Suppressor T cells Memory T cells Cytotoxic T cells Complement T cells
Cytotoxic T cells
A nurse is performing the admission assessment of a client who has AIDS. What components should the nurse include in this comprehensive assessment? Select all that apply. Current medication regimen Identification of client's support system Immune system function Genetic risk factors for HIV History of sexual practices
Current medication regimen Identification of client's support system Immune system function History of sexual practices
Which microorganism is known to cause retinitis in people with HIV/AIDS? Cytomegalovirus Cryptococcus neoformans Mycobacterium avium Pneumocystis carinii
Cytomegalovirus
A nurse has been instructed to place an IV line in a patient that has active TB and HIV. The nurse should where which of the following safety equipment? A: Sterile gloves, mask, and goggles B: Surgical cap, gloves, mask, and proper shoewear C: Double gloves, gown, and mask D: Goggles, mask, gloves, and gown
D
Which of the following client is/are at the greatest risk for contracting HIV? A. a 16 year old who is in a monogamous relationship and uses condoms B. A married couple who are monogamous and use birth control C. A homosexual couple who are tested regularly and use condoms D. A non-exclusive couple in their mid 60's who occasionally use condoms
D
A client is administered foscarnet to treat a case of cytomegalovirus (CMV) retinitis. Which adverse effect should the nurse closely monitor in this client? Electrolyte imbalances Hypotension Peripheral neuropathy Anemia
Electrolyte imbalances
A nurse is preparing a client for allergy skin testing. What precautionary step is most important for the nurse to follow? The client must not have received an immunization within 7 days. The nurse should administer albuterol 30 to 45 minutes prior to the test. Prophylactic epinephrine should be given before the test. Emergency equipment should be readily available.
Emergency equipment should be readily available.
Which blood test confirms the presence of antibodies to HIV? Erythrocyte sedimentation rate (ESR) p24 antigen Reverse transcriptase Enzyme immunoassay (EIA)
Enzyme immunoassay (EIA)
The nurse care plan for a client with AIDS includes the diagnosis of Risk for Impaired Skin Integrity. What nursing intervention should be included in the plan of care? Maximize the client's fluid intake. Provide total parenteral nutrition (TPN). Keep the client's bed linens free of wrinkles. Provide the client with snug clothing at all times.
Keep the client's bed linens free of wrinkles.
Which option should the nurse encourage to replace fluid and electrolyte losses in a client with AIDS? Liquids Gluten Sucrose Iron and zinc
Liquids
The nurse teaches the client that reducing the viral load will have what effect? Shorter time to AIDS diagnosis Longer survival Shorter survival Longer immunity
Longer survival
A home health nurse is reinforcing health education with a patient who is immunosuppressed and his family. What statement best suggests that the patient has understood the nurse's teaching? "My family needs to understand when I can go get the seasonal flu shot." "I need to know how to treat my infections in a home setting." "I need to understand how to give my platelet transfusions." "My family needs to understand that I'll probably need lifelong treatment."
My family needs to understand that I'll probably need lifelong treatment."
Which type of cell is capable of recognizing and killing infected or stressed cells and producing cytokines? Null lymphocytes Natural killer cells Memory cells Cytotoxic T cells
Natural killer cells
Which characteristic has NOT been implicated as a factor for noncompliance with antiretroviral treatment? Active substance abuse Depression Past substance abuse Lack of social support
Past substance abuse
Which intervention is the single most important aspect for the client at risk for anaphylaxis? Use of antihistamines Desensitization Wearing a medical alert bracelet Prevention
Prevention
The period from infection with HIV to the development of antibodies to HIV is known as which of the following? Primary infection Viral load Viral set point Anergy
Primary infection
Which test indicates the quantity of allergen necessary to evoke an allergic reaction? Serum-specific IgE test Provocative testing Scratch test Intradermal test
Serum-specific IgE test
A client asks a nurse, "What can I use to decrease my risk of exposure to HIV?" What will the nurse include as effective in reducing the risk of HIV exposure? Select all that apply. Lambskin condoms Sexual abstinence Latex male condoms Polyurethane female condoms Dental dams
Sexual abstinence Latex male condoms Polyurethane female condoms Dental dams
A nurse caring for a client who has an immunosuppressive disorder knows that continual monitoring of the client is critical. What is the primary rationale behind the need for continual monitoring? So that the client's functional needs can be met immediately So that medications can be given as prescribed and signs of adverse reactions noted So that early signs of impending infection can be detected and treated So that the nurse's documentation can be thorough and accurate
So that early signs of impending infection can be detected and treated
A client is diagnosed with pneumocystis pneumonia (PCP). What medication does the nurse anticipate educating the client about for treatment? TMP-SMZ Cephalexin Azithromycin Garamycin
TMP-SMZ
The nurse is gathering data from laboratory studies for a client who has HIV. The client's CD4+ cell count is 200/mm³, and the client has been diagnosed with pneumocystis pneumonia. What does this indicate to the nurse? The client has converted from HIV infection to AIDS. The client has advanced HIV infection. The client's CD4+ cell count has decreased due to the pneumocystis pneumonia. The client has another infection present that is causing a decrease in the CD4+ cell count.
The client has converted from HIV infection to AIDS
The nurse teaches the client with allergies about anaphylaxis, including which statement? The most common cause of anaphylaxis is penicillin. Anaphylactoid (anaphylaxis-like) reactions are commonly fatal. The most common food item that causes anaphylaxis is chocolate. Systemic reactions include urticaria and angioedema.
The most common cause of anaphylaxis is penicillin.
The nurse educator is differentiating primary immunodeficiency diseases from secondary immunodeficiencies. What is the defining characteristic of primary immunodeficiency diseases? They require IVIG as treatment. They are the result of intrauterine infection. They have a genetic origin. They are communicable.
They have a genetic origin.
The nurse is caring for a patient who has a diagnosis of paroxysmal nocturnal hemoglobinuria. When planning this patient's care, the nurse should recognize the patient's heightened risk of what complication? Venous thromboembolism Acute respiratory distress syndrome (ARDS) Myocardial infarction Hypertensive urgency
Venous thromboembolism
A client's primary infection with HIV has subsided and an equilibrium now exists between HIV levels and the client's immune response. This physiologic state is known as what? Static stage Latent stage Viral set point Window period
Viral set point
A client is prescribed antihistamines, and asks the nurse about administration and adverse effects. The nurse should advise the client to avoid: alcohol. applying skin moisturizers. seafood. exposure to sunlight.
alcohol.
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 urticaria. contact dermatitis. pitting edema. angioneurotic edema.
angioneurotic edema.
The immune system is a complicated and intricate system that contains specialized cells and tissues that protect us from external invaders and our own altered cells. Which term is used to define any substances capable of inducing a specific immune response and of reacting with the products of that response? antigens antibodies lymphokines lymphocytes
antigens
The nurse understands that the laboratory tests that much be assessed while a client is on drug therapy for HIV-AIDS are Select all that apply A. CBC B. Clotting factors C. HIV/RNA D.CD4 Lymphocyte count E. BUN
c and d
A nurse educator is explaining that patients with primary immunodeficiencies are living longer than in past decades because of advances in medical treatment. This increased longevity is associated with an increased risk of what? Chronic obstructive pulmonary disease Dementia Pulmonary fibrosis Cancer
cancer
Which of the following is the most frequent route of exposure to a latex allergy? Cutaneous Inhalation Mucosal Parenteral
cutaneous
The nurse is reviewing various medications with a client that can be used to treat allergic disorders. What medication will the nurse identify as an intranasal corticosteroid? cromolyn sodium fluticasone zileuton fexofenadine
fluticasone
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 Beef Chicken
milk eggs shrimp
A nurse is teaching high school students about transmission of the human immunodeficiency virus (HIV). Which comment by a student warrants clarification by the nurse? "A man should wear a latex condom during intimate sexual contact." "I've heard about people who got AIDS from blood transfusions." "I won't donate blood because I don't want to get AIDS." "I.V. drug users can get HIV from sharing needles."
"I won't donate blood because I don't want to get AIDS."
Family members of an immunocompromised client have asked the nurse why antibiotics are not being given to the client in order to prevent infection. How should the nurse best respond? "Using antibiotics to prevent infections can cause the growth of drug-resistant bacteria." "If an antibiotic is given to prevent a bacterial infection, the client is at risk for a viral infection." "Antibiotics can never prevent an infection; they can only cure an infection that is fully developed." "Antibiotics cannot resolve infections in people who are immunocompromised."
"Using antibiotics to prevent infections can cause the growth of drug-resistant bacteria."
When the body is in contact with an allergen, this lymphocyte, located in the respiratory and intestinal mucosa, triggers the release of histamine. Choose that lymphocyte. Ig A Ig D Ig E Ig G
Ig E
A client develops a facial rash and urticaria after receiving penicillin. Which laboratory value does the nurse expect to be elevated? IgA IgB IgE IgG
IgE
Which immunoglobulin assumes a major role in bloodborne and tissue infections? IgA IgG IgM IgD
IgG
An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurse's best response? "There is no way to know that for certain, but we do know that your baby has a one in four chance of being born with HIV." "Your physician is likely the best one to ask that question." "If the baby is HIV positive there is nothing that can be done until it is born, so try your best not to worry about it now." "It's possible that your baby could contract HIV, either before, during, or after delivery."
It's possible that your baby could contract HIV, either before, during, or after delivery."
Which is an action of cytotoxic T cells? Produce circulating antibodies Directly attack foreign antigens Decrease B-cell activity to a level at which the immune system is compatible with life Lyse cells infected with virus
Lyse cells infected with virus
Which medication classification is known to inhibit prostaglandin synthesis or release? Nonsteroidal anti-inflammatory drugs in large doses Antibiotics (in large doses) Adrenal corticosteroids Antineoplastic agents
Nonsteroidal anti-inflammatory drugs in large doses
Which nursing actions essential before an ELISA test is performed? Obtain a written consent from the client. Perform a Western blot test. Perform a polymerase chain reaction test. Provide the client with plenty of fluids.
Obtain a written consent from the client.
A client will be having a hysterectomy and wants her daughter to provide directed donor blood. What factor would eliminate her daughter from donating the blood? The daughter is 15 years of age. The daughter weighs 124 lb. The daughter is negative for HIV. The physician has been notified of the procedure.
The daughter is 15 years of age.
immunosuppressed. What is the most essential teaching for this client and the family? How to promote immune function through nutrition The importance of maintaining the client's vaccination status How to choose antibiotics based on the client's symptoms The need to report any slight changes in the client's health status
The need to report any slight changes in the client's health status
Atopic allergic disorders are characterized by an IgA-mediated reaction. a hereditary predisposition. production of a systemic reaction. a response to physiologic allergens.
a hereditary predisposition.
A nursing instructor is giving a lecture on the immune system. The instructor's discussion on phagocytosis will include: neutrophils and monocytes. plasma cells and memory cells. regulator T cells and helper T cells. lymphokines and suppressor T cells.
neutrophils and monocytes.
A client has had several recent clinical visits for allergic contact dermatitis. The nurse explains to the client that allergy testing is indicated. Which test will most likely be performed? patch test intradermal injection test scratch test All options are correct.
patch test
A client reports "feeling under the weather" for several weeks and is having blood work done to try and determine the cause. The physician is including an ELISA test in the blood work. What would be the expected next step if the ELISA is positive? repeat the ELISA test perform Western blot repeat Western blot diagnose AIDS
repeat the ELISA test
A pediatric client is recovering from an anaphylactic reaction to an allergen. In the first assessment, the client presents with a periorbital accumulation of blood, a common occurrence in children. What type of allergic reaction presents "allergic shiners"? type I type II type III type IV
type I
Which type of hypersensitivity reaction involves immune complexes forming when antigens bind to antibodies? Type I Type II Type III Type IV
Type III
When do most perinatal HIV infections occur? Through breastfeeding In utero After exposure during delivery Through casual contact
After exposure during delivery
Which statement describes the clinical manifestations of a delayed hypersensitivity (type IV) allergic reaction to latex? They are localized to the area of exposure, usually the back of the hands. They can be eliminated by changing glove brands or using powder-free gloves. They may worsen when hand lotion is applied before donning latex gloves. They occur within minutes after exposure to latex.
They are localized to the area of exposure, usually the back of the hands.
The nurse is teaching a client after a medication allergic reaction has occurred. What is the most important action for the nurse to teach the client to take to prevent anaphylaxis? Avoid potential allergens. Undergo desensitization treatment. Carry an emergency kit. Wear a medical alert bracelet.
Avoid potential allergens.
A 20-year-old patient with an immunodeficiency is admitted to the unit with an acute episode of upper airway edema. This is the fifth time in the past 3 months that the patient has had such as episode. As the nurse caring for this patient, you know that the patient may have a deficiency of what? Interferons C1esterase inhibitor IgG IgA
C1esterase inhibitor
Which is usually the most important consideration in the decision to initiate antiretroviral therapy? CD4+ counts HIV RNA Western blotting assay ELISA
CD4+ counts
A client comes in to get an EIA test done because the health care provider suspects HIV. Which nursing action is essential before an EIA test is performed? Performing Western blotting Performing a polymerase chain reaction test Obtaining a general consent for medical care from the client Obtaining a written consent from the client
Obtaining a general consent for medical care from the client
A client is prescribed didanosine as part of a highly active antiretroviral therapy (HAART). Which instruction would the nurse emphasize with this client? "You should take the drug with an antacid." "It doesn't matter if you take this drug with or without food." "Be sure to take this drug about 1/2 hour before or 2 hours after you eat." "When you take this drug, eat a high-fat meal immediately afterwards."
"Be sure to take this drug about 1/2 hour before or 2 hours after you eat."
A client with a recent diagnosis of HIV infection expresses an interest in exploring alternative and complementary therapies. How should the nurse best respond? "Complementary therapies generally have not been approved, so clients are usually discouraged from using them." "Researchers have not looked at the benefits of alternative therapy for clients with HIV, so we suggest that you stay away from these therapies until there is solid research data available." "Many clients with HIV use some type of alternative therapy and, as with most health treatments, there are benefits and risks." "You'll need to meet with your doctor to choose between an alternative approach to treatment and a medical approach."
"Many clients with HIV use some type of alternative therapy and, as with most health treatments, there are benefits and risks."
A nurse has asked the nurse educator if there is any way to predict the severity of a client's anaphylactic reaction. What would be the nurse's best response? "The faster the onset of symptoms, the more severe the reaction." "The reaction will be about one-third more severe than the client's last reaction to the same antigen." "There is no way to gauge the severity of a client's anaphylaxis, even if it has occurred repeatedly in the past." "The reaction will generally be slightly less severe than the last reaction to the same antigen."
"The faster the onset of symptoms, the more severe the reaction."
While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of what percentage of the total leukocyte count? 1% to 3% 3% to 4% 5% to 10% 15% to 40%
15% to 40%
A nurse is preparing to nasotracheally suction a client with AIDS who has blood tinged sputum with previous suctioning. The nurse plans to use which of the following items as part of standard precautions for this client? A. gloves, mask, and protective eyewear B. gloves, gown, mask C. gown, mask, and protective eyewear D. gloves, gown, and protective eyewear
A
What intervention is a priority when treating a client with HIV/AIDS? Assessing neurologic status Monitoring skin integrity Assessing fluid and electrolyte balance Monitoring psychological status
Assessing fluid and electrolyte balance
The nurse counsels a patient complaining of fatigue and shortness of breath due to AIDS. Which of the following actions by the nurse is MOST important? A. Refer the patient to occupational therapy B. Instruct the patient to sit while preparing meals C. Instruct the Patient to perform all activities in the morning D.Suggest to the patient that he accept his limitations
B
The nurse is caring for the client with acquired immunodeficiency syndrome who is experiencing nigh fever and night sweats. Which nursing intervention would be the least helpful in managing this symptom? A.Keep a change of bed linen nearby in case they are needed B. Administer an antipyretic after the client spikes the fever C. Make sure the pillow has plastic cover
B
A client's health care provider suspects the client has developed an immune system disorder. What will most likely be the first test ordered? CBC with differential blood chemistry complete blood count (CBC) liver enzyme studies
CBC with differential
The nurse in an allergy clinic is educating a new client about the pathology of the client's health problem. What response should the nurse describe as a possible consequence of histamine release? Constriction of small venules Contraction of bronchial smooth muscle Dilation of large blood vessels Decreased secretions from gastric and mucosal cells
Contraction of bronchial smooth muscle
A client is fighting an active infection. What function will cytokines perform in this immune response? Determining whether a cell is foreign Determining if lymphokines will be activated Determining whether the T cells will remain in the nodes and retain a memory of the antigen Determining whether the immune response will be the production of antibodies or a cell-mediated response
Determining whether the immune response will be the production of antibodies or a cell-mediated response
A nurse is caring for a client who has allergic rhinitis. What intervention would be most likely to help the client meet the goal of improved breathing pattern? Teach the client to take deep breaths and cough frequently. Use antihistamines daily throughout the year. Teach the client to seek medical attention at the first sign of an allergic reaction. Modify the environment to reduce the severity of allergic symptoms.
Modify the environment to reduce the severity of allergic symptoms.
Students are reviewing information from the Centers for Disease Control and Prevention (CDC) for a class presentation about preventing the transmission of HIV. Which of the following would the students be least likely to include in their presentation? Nonlatex lambskin condoms are highly effective in preventing HIV infection. Male condoms must be used consistently and correctly to be effective. A dental dam is used for oral contact with the vagina or rectum. Circumcision is an effective means to reduce the risk of males acquiring HIV.
Nonlatex lambskin condoms are highly effective in preventing HIV infection.
A hospice nurse has been providing care for a man who has AIDS. Among the manifestations of the man's disease has been a profound weight loss over the past several weeks. Consequently, the nurse is adjusting the patient's plan of care to reprioritize this problem. When planning interventions for the patient's weight loss, the nurse should be aware that: The patient should simultaneously receive total parenteral nutrition (TPN) and oral nutritional supplements. The patient's weight loss is a sign of the progression of AIDS but is not a direct threat to his health. Nutritional interventions may not necessarily resolve the patient's weight loss. The patient's weight loss is attributable to psychological factors rather than pathophysiological factors.
Nutritional interventions may not necessarily resolve the patient's weight loss.
The nurse is caring for a client who has been admitted for the treatment of AIDS. In the morning, the client tells the nurse that he experienced night sweats and recently "coughed up some blood." What is the nurse's most appropriate action? Assess the client for additional signs and symptoms of Kaposi sarcoma. Review the client's most recent viral load and CD4+ count. Place the client on respiratory isolation and inform the physician. Perform oral suctioning to reduce the client's risk for aspiration.
Place the client on respiratory isolation and inform the physician.
A nurse is preparing to administer saquinavir, which is prescribed for a client who is HIV positive. What type of drug does the nurse identify saquinavir as? Fusion inhibitor Protease inhibitor (PI) Non-nucleoside reverse transcriptase inhibitor (NNRTI) Nucleoside reverse transcriptase inhibitor (NRTI)
Protease inhibitor (PI)
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 Administering prophylactic antibiotics Promoting nutrition and adequate fluid intake Applying skin emollients as needed
Providing thorough oral care before and after meals
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? Deoxyribonucleic acid (DNA) Ribonucleic acid (RNA) Viral core Glycoprotein envelope
RNA
A client has had skin testing and the results are inconclusive. The nurse would expect to prepare the client for which type of testing? Serum immunoglobulin E levels Eosinophil count Complete blood count with differential Radioallergosorbent test
Radioallergosorbent test
A client was prescribed an oral antibiotic for the treatment of sinusitis. The client has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurse's most appropriate response? Encourage the woman to continue with the medication while monitoring her skin condition closely. Refer the woman to her primary provider to have the medication changed. Arrange for the woman to go to the nearest emergency department. Encourage the woman to take an over-the-counter (OTC) antihistamine with each dose of the antibiotic.
Refer the woman to her primary provider to have the medication changed.
A client's current antiretroviral regimen includes enfuvirtide (T-20). What dietary counseling will the nurse provide based on the client's medication regimen? Avoid high-fat meals while taking this medication. Limit fluid intake to 2 L/day. Limit sodium intake to 2 g/day. Take this medication without regard to meals.
Take this medication without regard to meals.
The nurse is teaching the client with HIV about therapy. Which elements are essential for the nurse to include in the teaching plan? Select all that apply. The CD4 count is the major indicator of immune function and guides therapy. Antiretroviral therapy targets different stages of the HIV life cycle. The goal of antiretroviral therapy is to prevent opportunistic infections. Medication therapy is rarely effective. Clients rarely respond to medication therapy.
The CD4 count is the major indicator of immune function and guides therapy. Antiretroviral therapy targets different stages of the HIV life cycle.
A client has come into the free clinic asking to be tested for HIV infection. The client asks the nurse how the test works. The nurse responds that if the testing shows that antibodies to the AIDS virus are present in the blood, this indicates what? The client is immune to HIV. The client's immune system is intact. The client has AIDS-related complications. The client has been infected with HIV.
The client has been infected with HIV.
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. Food labels on baked items are the only labels that need to be read. Carry EpiPen autoinjector at all times.
Wear a medic alert bracelet. List symptoms of peanut allergy. Identify ways to manage allergy while dining out. Carry EpiPen autoinjector at all times.
It is important for a nurse to refer an HIV-positive client to support groups and resources because: support groups and resources provide information about new HIV drug development and clinical drug trials to clients. after a point in time, management of HIV-positive clients is not practical for the nurse. support groups and resources provide better emotional and psychological support to HIV-positive clients. it is mandatory, as per the state health guidelines, to refer HIV-positive clients to support groups.
support groups and resources provide information about new HIV drug development and clinical drug trials to clients
A nurse is teaching a client how to use their EpiPen autoinjector. What client statement indicates the teaching is understood? Select all that apply. "The EpiPen autoinjector needs to be pointed downward." "I will jab the EpiPen autoinjector firmly into my right upper buttock." "The needle needs to be at a 90-degree angle." "After I administer the injection, I will massage the area for 10 seconds." "The EpiPen autoinjector should be held against the injection site for 20 seconds."
The EpiPen autoinjector needs to be pointed downward." "The needle needs to be at a 90-degree angle." "After I administer the injection, I will massage the area for 10 seconds."
A client who is scheduled for a skin test informs the nurse that he has been taking corticosteroids to help control his allergy symptoms. What nursing intervention should the nurse implement? The client should take his corticosteroids regularly prior to testing. The client should only be tested for grass, mold, and dust initially. The nurse should have an emergency cart available in case of anaphylaxis during the test. The client's test should be cancelled until he is off his corticosteroids.
The client's test should be cancelled until he is off his corticosteroids.
A nurse is explaining how the humoral and cellular immune responses should be seen as interacting parts of the broader immune system rather than as independent and unrelated processes. What aspect of immune function best demonstrates this? The movement of B cells in and out of lymph nodes The interactions that occur between T cells and B cells The differentiation between different types of T cells The universal role of the complement system
The interactions that occur between T cells and B cells
A nurse is providing health education regarding self-care to a patient with an immunodeficiency. What teaching point should the nurse emphasize? The importance of aggressive treatment of acne The importance of avoiding alcohol-based cleansers The need to keep fingernails and toenails closely trimmed The need for thorough oral hygiene
The need for thorough oral hygiene
A patient with seasonal allergies has told the nurse that a colleague recommended pseudoephedrine hydrochloride (Sudafed) as a means of controlling signs and symptoms. The nurse should be aware that this drug provides relief for many patients but adverse effects include a risk of: Anxiety Decreased urine output Depression Gastritis
anxiety
A home health nurse is reinforcing health education with a patient who is immunosuppressed and his family. What statement best suggests that the patient has understood the nurse's teaching? "My family needs to understand when I can go get the seasonal flu shot." "I need to know how to treat my infections in a home setting." "I need to understand how to give my platelet transfusions." "My family needs to understand that I'll probably need lifelong treatment."
"My family needs to understand that I'll probably need lifelong treatment."
When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean which of the following? Antibodies to HIV are not present in his blood. He has not been infected with HIV. He is immune to HIV. Antibodies to HIV are present in his blood.
Antibodies to HIV are not present in his blood.
The nurse is preparing to start an IV for a client who is combative. What precautionary measure should the nurse take in order to avoid a needlestick? Have the patient placed in restraints. Ask for assistance. Refuse to start the IV. Give the client a sedative prior to starting the IV.
Ask for assistance
Which of the following factors make it difficult to develop a vaccine for HIV? A. HIV is a virus B. HIV matures early C. HIV matures easily
C
Patient teaching regarding infection prevention for the patient with an immunodeficiency includes which of the following guidelines? Cook all food thoroughly. Refrain from using creams or emollients on skin. Maintain contact only with individuals who have recently been vaccinated. Take OTC vitamin supplements consistently.
Cook all food thoroughly.
A home health nurse is caring for a client who has an immunodeficiency. What is the nurse's priority action to help ensure successful outcomes and a favorable prognosis? Encourage the client and family to be active partners in the management of the immunodeficiency. Encourage the client and family to manage the client's activity level and activities of daily living effectively. Make sure that the client and family understand the importance of monitoring fluid balance. Make sure that the client and family know how to adjust dosages of the medications used in treatment.
Encourage the client and family to be active partners in the management of the immunodeficiency.
A clinic nurse is caring for a client admitted with AIDS. The nurse has assessed that the client is experiencing a progressive decline in cognitive, behavioral, and motor functions. The nurse recognizes that these symptoms are most likely related to the onset of what complication? HIV encephalopathy B-cell lymphoma Kaposi's sarcoma Wasting syndrome
HIV encephalopathy
A client's injury has initiated an immune response that involves inflammation. What are the first cells to arrive at this client's site of inflammation? Eosinophils Red blood cells Lymphocytes Neutrophils
Neutrophils
The nurse is planning the care of a client who has a diagnosis of atopic dermatitis, which commonly affects both of her hands and forearms. What risk nursing diagnosis should the nurse include in the client's care plan? Risk for Disturbed Body Image Related to Skin Lesions Risk for Disuse Syndrome Related to Dermatitis Risk for Ineffective Role Performance Related to Dermatitis Risk for Self-Care Deficit Related to Skin Lesions
Risk for Disturbed Body Image Related to Skin Lesions
The nurse is teaching a client about histamine release during an anaphylactic reaction. What does histamine release in anaphylaxis cause? nasal congestion feeling of impending doom urinary urgency stomach cramps
nasal congestion
A client has been seeing an allergist for 6 months for treatment of allergies. The client's allergies have been insufficiently controlled by symptomatic treatments and the physician has suggested desensitization. The anticipated outcome of desensitization is that repeated exposure to the: weak antigen promotes the production of IgG, an antibody that blocks IgE so it cannot stimulate mast cells. strong antigen promotes the production of IgE, an antibody that blocks IgG so it cannot stimulate mast cells. weak antigen promotes the production of IgE, an antibody that blocks IgG so it cannot stimulate basophils. strong antigen promotes the production of IgG, an antibody that blocks IgE so it cannot stimulate basophils.
weak antigen promotes the production of IgG, an antibody that blocks IgE so it cannot stimulate mast cells.
A nurse is working with a client who was diagnosed with HIV several months earlier. This client will be considered to have AIDS when the CD4+ T-lymphocyte cell count drops below what threshold? 75 cells/mm3 of blood 200 cells/mm3 of blood 325 cells/mm3 of blood 450 cells/mm3 of blood
200 cells/mm3 of blood
The nurse is providing care for a client who has experienced a type I hypersensitivity reaction. What client is having this type of reaction? A child with an anaphylactic reaction after a bee sting A client with a skin reaction resulting from adhesive tape A client with a diagnosis of myasthenia gravis An older adult with rheumatoid arthritis
A child with an anaphylactic reaction after a bee sting
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. Consume large, high-fat meals. Reduce food intake. Increase intake of iron and zinc.
Avoid fibrous foods, lactose, fat, and caffeine.
A Client with AIDS is being admitted to the hospital for the treatment of pneumocystis carinii infection. Which of the following activities does the nurse plan to include in the care of this client that will maintain comfort? A. Assess RR, rate, rhythm, depth and breath sounds. B. Evaluate areterial blood gas results C. Keep head of bed elevated. D. Monitor VS
C
The client exposed to HIV about 3 months ago has seroconverted to HIV-positive status. The nurse anticipated that the client will experience which of the following at this time? A. Oral lesions B. Purplish skin lesions C. No signs and symptoms
C
The patient with AIDS-related complex typically has a history of: A. Hairy leukoplakia of the tongue and a chronic cough B. Oral candidiasis, molluscum, contagiosum, and bullous impetigo C. Severe fatigue, lymphadenopathy, and diarrhea D. Memory loss, night sweats, and disorientation
C
The school nurse teaches a wellness class to a group of high school students. the nurse should intervene if a student makes which of the following statements: A. HIV can be transmitted by the sharing of needles B. A breastfeeding mother who has HIV can infect her baby C. I'm not going to use public toilets ever again
C
A nurse is caring for a patient who has an immunodeficiency. What assessment finding should prompt the nurse to consider the possibility that the patient is developing an infection? Uncharacteristic aggression Persistent diarrhea Pruritis (itching) Constipation
Persistent diarrhea
A client is suspected to have an immunodeficiency disorder. The health care provider orders a nitroblue tetrazolium reductase (NTR) test to diagnose this client. What does the nurse suspect that this disorder is related to? Complement B lymphocytes T lymphocytes Phagocytic cells
Phagocytic cells
A client with human immunodeficiency virus (HIV) develops a nonproductive cough, shortness of breath, a fever of 101°F and an O2 saturation of 92%. What infection caused by Pneumocystis jirovecidoes the nurse know could occur with this client? Mycobacterium avium complex (MAC) Pneumocystis pneumonia Tuberculosis Community-acquired pneumonia
Pneumocystis pneumonia
Which are the appropriate interventions to help a client with autoimmune disorder deal with joint pain secondary to inflammation, malaise, and fatigue? Select all that apply. Rest during periods of severe exacerbation. Exercise regularly during periods of remission. Use nonpharmacological pain management strategies. Rest between periods of severe exacerbation and remission.
Rest during periods of severe exacerbation. Exercise regularly during periods of remission. Use nonpharmacological pain management strategies.
The nurse is providing care for a client who has a diagnosis of hereditary angioedema. When planning this client's care, what nursing diagnosis should be prioritized? Risk for Infection Related to Skin Sloughing Risk for Acute Pain Related to Loss of Skin Integrity Risk for Impaired Skin Integrity Related to Cutaneous Lesions Risk for Impaired Gas Exchange Related to Airway Obstruction
Risk for Impaired Gas Exchange Related to Airway Obstruction
A client in a late stage of acquired immunodeficiency syndrome (AIDS) shows signs of AIDS-related dementia. Which nursing diagnosis takes highest priority? Bathing or hygiene self-care deficit Ineffective cerebral tissue perfusion Complicated grieving Risk for injury
Risk for injury
A nurse has included the nursing diagnosis of Risk for Latex Allergy Response in a client's plan of care. The presence of what chronic health problem would most likely prompt this diagnosis? Herpes simplex HIV Spina bifida Hypogammaglobulinemia
Spina bifida
