Deck 33: Immunologic Disorders

Question 1

When developing a plan of care for the patient with human immunodeficiency virus (HIV),the nurse includes:

A) Careful aseptic technique to prevent infection
B) Instruction to limit fluids to prevent congestive heart failure
C) Oral alcohol rinses to control mouth infections
D) Selections of high-fat foods in the daily diet

Answer 1

Careful aseptic technique to prevent infection

Question 2

The nurse who is caring for a patient with thrombotic thrombocytopenic purpura (TTP)who is having plasmapheresis every day is alert for the first indication of:

A) Hypotension
B) Seizure activity
C) Diarrhea
D) Intense headache

Answer 2

Hypotension

Question 3

When the nurse has assessed a neutrophil count of 900/mm³,the nurse begins to prepare the patient with acute leukemia for the initiation of:

A) A high-protein diet.
B) Increased doses of steroids.
C) Compromised Host Precautions.
D) Injections of blood-building medication.

Answer 3

Compromised Host Precautions.

Question 4

A hospitalized patient has been prescribed dexamethasone (Decadron)for an allergic reaction.The teaching instruction that the patient should be given with discharge,relative to this drug,is:

A) Report blurry vision.
B) Take the medication on an empty stomach.
C) Do not operate heavy machinery.
D) Take this medication with meals.

Question 5

The nurse is alarmed by a complete blood count that shows a large shift to the left.The nurse assesses this to mean that the cell level count of:

A) Neutrophils have dropped by 10%.
B) Basophils have increased by 25%.
C) Neutrophils have increased by 25%.
D) Neutrophils have increased by 60%.

Question 6

A nurse caring for a patient in the last stages of leukemia is aware that the patient is at risk from the bacteria of his own body as an infection risk source,such as:

A) Beta-hemolytic streptococci
B) Streptococcus pneumoniae
C) Streptococcus viridans
D) Pseudomonas aeruginosa

Question 7

While healthy bone marrow is growing back after chemotherapy in patients with leukemia,the nursing staff recalls that these patients are at greater risk for:

A) Infection and bleeding
B) Hypertension and headache
C) Oliguria and urinary retention
D) Dyspnea and wheezing

Question 8

After a bone marrow transplant,the patient is placed on a protocol of chemotherapy and radiation and the nursing diagnosis of risk for injury is added.The nurse will add the intervention of assessing for:

A) Increased urine output
B) Decreasing bilirubin levels
C) Increasing blood pressure
D) Increasing abdominal girth

Question 9

When a patient is taking dexamethasone (Decadron)complains of insomnia,the nurse advises the patient to take the drug:

A) With milk
B) At breakfast
C) Dissolved in fruit juice
D) At bedtime

Question 10

The laboratory results for a patient with acute leukemia that should alert the nurse to the fact that the drug protocols are not effective is:

A) Decreased prothrombin time.
B) Platelet count lower than 50,000/mm3.
C) Negative Western blot.
D) Neutrophils 50% to 62%.

Question 11

The nurse points out that the spleen's primary function in the immune process is to:

A) Filter microorganisms from the blood.
B) Store lymphocytes used to fight infections.
C) Produce additional RBCs (red blood cells).
D) Stimulate WBC production.

Question 12

A 24-year-old woman is admitted to the hospital for a complete medical examination.Her current complaints are indicative of SLE.Which one of the following symptoms would indicate this diagnosis?

A) Recent weight gain of 10 pounds
B) Difficulty breathing in the morning
C) Frequent episodes of diarrhea
D) Musculoskeletal pain in the hands

Question 13

The symptom that the nurse would recognize as being pertinent to a possible diagnosis of systemic lupus erythematosus (SLE)is:

A) Butterfly rash of the face
B) Protruding abdomen
C) Thinning hair
D) Bloody diarrhea

Question 14

The nurse uses a picture to show the histamine-releasing mast cells that are:

A) Circulating in the blood
B) Circulating in the lymph
C) Attached to organ tissue
D) Embedded in the bone marrow

Question 15

The nursing staff of an oncology unit cautions visitors to be free of infections before visiting patients.The rationale for this precaution is because chemotherapy and decreased bone marrow production can cause:

A) Hemorrhage
B) Neutropenia
C) Edema
D) Hypovolemia

Question 16

The nurse explains that the inflammatory response is initiated by immunoglobulin E (IgE)and the:

A) Eosinophils
B) Lymphocytes
C) Basophils
D) Neutrophils

Question 17

In preparing discharge plans for a patient with SLE,the nurse must include:

A) Need to consume 2 L of fluid daily
B) Close monitoring of daily blood glucose level
C) Use of daily sunscreens with a sun protection factor (SPF) higher than 15
D) Careful concern for certain food allergies

Question 18

The nurse differentiates that passive-acquired immunity means that the antibodies were:

A) Acquired from outside the host and instilled in the host.
B) Manufactured in response to a disease in the host.
C) Innately acquired because of being born a human being.
D) Cell-mediated inside the host.

Question 19

The nurse is preparing a patient for a liver-spleen scan.Which of the following interventions is most important before the procedure?

A) Prepare the biopsy site with a clean field.
B) Check for any allergies to contrast media.
C) Explain the procedure to the patient's family.
D) Have the patient eat a complete regular diet.

Question 20

An 11-year-old girl is diagnosed with idiopathic thrombocytopenic purpura (ITP).The parental statement that helps the nurse evaluate the teaching as successful is:

A) "Our daughter can still be involved in gymnastics."
B) "When our daughter's hemoglobin falls below 3.5, she'll need blood."
C) "Our daughter will need genetic counseling before she marries."
D) "Our daughter should avoid drugs containing sulfonamides."

Question 21

The nursing staff decides on a nursing diagnosis of "Imbalanced nutrition: less than body requirements for a patient with leukemia." The goal that would be realistic for this patient is:

A) To gain 5 pounds, eat foods high in calories at each meal.
B) To avoid nausea, eat slowly and eat small meals.
C) To consume all food at every meal, offer three large meals.
D) To maintain a stable weight, eat small meals and avoid vomiting.

Question 22

The nurse tells the family of a patient who has just undergone bone marrow transplant that to help stabilize the immune response and prevent rejection,________________ will be given.

A) Dexamethasone (Decadron)
B) Filgrastim (Neupogen)
C) Zidovudine (Retrovir)
D) Nevirapine (Viramune)

Question 23

The nurse explains that early in life,lymphocytes migrate from the marrow of the bones to the ________________,in which they mature into T cells.

Question 24

In the preparation to perform skin testing,the nurse should:

A) Select an 18-gauge needle.
B) Inject 1 mL intradermally.
C) Check the site in 2 to 3 days for swelling.
D) Wrap the site with a pressure dressing.

Question 25

The observation by the nurse that would indicate a patient's acceptance of the diagnosis of acute leukemia is that the patient:

A) Plans a 14-day cruise in 2 weeks.
B) States that he will be fine in a few months
C) Asks for educational material about acute leukemia.
D) Rests after a chemotherapy session.

Question 26

The nurse explains that the type of bone marrow transplant that uses the patient's own bone marrow is:

A) Allergenic
B) Allogeneic
C) Peripheral blood stem cell
D) Autologous

Question 27

The nurse explains that in autoimmune diseases,the body identifies its own proteins as foreign matter and sets out to destroy itself.Such diseases are: (Select all that apply.)

A) SLE
B) Type 1 diabetes mellitus (DM)
C) Rheumatoid arthritis (RA)
D) Osteoarthritis
E) Pancreatitis

Question 28

When the skin test shows a redness and swelling a few days after injection,the nurse assesses this as a hypersensitivity reaction of type:

A) I
B) II
C) III
D) IV

Question 29

Cells in the bone marrow that are capable of developing into RBCs,WBCs,or platelets are the ___________ cells.

Question 30

The nurse gives an example of innate immunity by comparing it with a human's immunity to:

A) Hoof-and-mouth disease
B) Measles
C) Rabies
D) Mange

Question 31

The nurse explains that the inflammatory process has four distinct stages,which are: (Select all that apply.)

A) Dolor
B) Rubor
C) Tumor
D) Calor
E) Rumor