Deck 12: Care of Patients With Immune and Lymphatic Disorders

Question 1

The patient scheduled for a CT scan with contrast medium questions the nurse why the technologist asked her if she had any food allergies.Which response by the nurse is correct?

A)"The dye used for a CT scan is egg based, so egg allergies would prevent you from having the test."
B)"People who are allergic to dairy products are likely to be allergic to CT scan dye."
C)"Allergies to shellfish can be a problem because shellfish and CT scan dye are iodine based."
D)"Wheat is the preservative used in CT scan dye, so allergies to wheat may cause allergies to the dye."

Answer 1

"Allergies to shellfish can be a problem because shellfish and CT scan dye are iodine based."

Question 2

The nurse has just administered a new antibiotic to a patient.What sign or symptom should the nurse be alert to that would be an early indication of an anaphylactic reaction?

A)Wheezing
B)Shortness of breath
C)Difficulty swallowing
D)Angioedema

Answer 2

Angioedema

Question 3

The nurse caring for the patient with lymphedema of the left arm will implement what intervention?

A)Encourage patient to keep the arms as inactive as possible to reduce further injury.
B)Clean the arm with mild soap and massage gently.
C)Take blood pressure and give injections in the right arm.
D)Keep the arm below the level of the heart to minimize edema.

Answer 3

Take blood pressure and give injections in the right arm.

Question 4

When the patient has an immediate allergic reaction to the injection of radiopaque dye,the nurse is aware that this immediate response is a type ___ response,which is _____ generated.

A)1, antibody
B)2, mast cell
C)1, mast cell
D)2, antibody

Question 5

The nurse is performing an assessment on a patient admitted for diagnostic testing to rule out fibromyalgia.Which assessment finding would indicate that the patient actually may have the disorder?

A)A decreased response to painful stimuli
B)A pain response to nonpainful stimuli
C)No response to painful stimuli
D)Numbness and tingling in response to painful stimuli

Question 6

The nurse is assessing a 75-year-old patient who has presented to the ambulatory care clinic for an annual physical.The patient tells the nurse she seems to get sick more the older she gets.She questions the nurse about the reason.What response by the nurse is most appropriate?

A)"Your bone marrow does not function as precise as you age."
B)"You are likely coming into contact with more illness, so it isn't just age."
C)"Aging does impact the capabilities of the immune system."
D)"You need to take a flu vaccine to offer more protection against illness."

Question 7

A patient with an immune deficiency disorder has been admitted to the medical unit due to a current infection and weight loss of 12% of his body weight.The most appropriate nutritional intervention for this patient would be to encourage foods high in:

A)fat.
B)vitamin C.
C)vitamin B₁₂.
D)protein.

Question 8

The patient with cancer has experienced sensitivity to past chemotherapy infusions.The best action to prevent a hypersensitivity reaction is the administration of _____ prior to the chemotherapy infusion.

A)a corticosteroid
B)daclizumab
C)antithymocyte globulin
D)epinephrine

Question 9

The nurse is providing teaching to a patient who has undergone a liver transplant.Which statement by the patient demonstrates the need for further patient teaching?

A)"I will need to take medications to boost my immune system for the next year."
B)"I will need to be sure to avoid people that have infections."
C)"I will need to take immune suppression medications the rest of my life."
D)"I will need to be monitored to determine if my medications need adjusted."

Question 10

MOPP and ABVD therapy for the treatment of Hodgkin's disease are treatment protocols using:

A)multiple medications given concurrently.
B)a combination of heat and exercise and chemotherapy.
C)alternating radiation and chemotherapy every 4 weeks.
D)chemotherapy and alternative herbal remedies.

Question 11

The patient reports that he has been diagnosed with stage II Hodgkin's disease.The nurse interprets this to mean that the infected lymph node involvement could be:

A)spreading outside of the lymph system.
B)in a single node.
C)in both axillae.
D)in two nodes in the left axilla area.

Question 12

The home care nurse is caring for a patient with a severe immune deficiency disorder.What patient teaching point should be stressed in regard to the prevention of infection?

A)The patient should monitor his or her temperature daily.
B)The patient should perform meticulous hand hygiene.
C)The patient should monitor for signs of infection daily.
D)The patient should seek medical advice at the first sign of infection.

Question 13

After an influenza immunization,the patient complains of shortness of breath,breaks out in hives,and begins to twitch.What should the nurse initially give?

A)Epinephrine by injection
B)O₂ by mask at 5 L/min
C)Corticosteroid by injection
D)Bronchodilators per nebulization

Question 14

The primary care provider suspects the patient has lymphoma.The patient asks the nurse how the physician will know which type of lymphoma he has.Which response by the nurse is correct?

A)"We will be testing the lymphocytes in your blood for certain types of cells."
B)"We will be performing a bone marrow biopsy to look at your red blood cells."
C)"We will be looking at the number and configuration of the neutrophils in your blood."
D)"We will look closely at your hemoglobin and hematocrit levels for any significant variations in the levels."

Question 15

The patient voices feeling very stressed regarding her immune deficiency diagnosis and the care regimen.Which response by the nurse is most beneficial in addressing the patient's stress?

A)"I can't imagine how it must feel to have this disorder and all of the treatment regimen that goes along with it."
B)"What worries you the most about your immune disorder?"
C)"Light exercise and relaxation techniques may really help alleviate your stress."
D)"Maybe you should talk to your doctor about your stress so he can prescribe some antianxiety medication."

Question 16

The patient has been diagnosed with Hodgkin's lymphoma.The nurse is aware that this patient has which type of cells present in the blood?

A)Abnormal B cells
B)Abnormal T cells
C)Cytotoxic T cells
D)Reed-Sternberg (R-S) cells

Question 17

The patient with rheumatoid arthritis is prescribed an immunosuppressant drug.The patient asks the nurse what this drug is for.What is the nurse's best response?

A)"The doctor prescribes these drugs to strengthen your immune system."
B)"The drug inhibits your immune system's normal response."
C)"These medications are used to prevent organ rejection."
D)"This medication will strengthen your joints and repair any joint damage."

Question 18

Education for the patient with systemic lupus erythematosus (SLE)should include what teaching point?

A)Training with weights to increase strength
B)Using alcohol-based skin products
C)Managing pain with opioids
D)Using potent sunscreen

Question 19

The nurse is assessing a patient's lymph nodes.Which finding would alert the nurse to the possibility of the patient having non-Hodgkin's lymphoma (NHL)?

A)Enlarged lymph nodes that form an adjacent line of enlargement
B)Painful widespread enlarged lymph nodes
C)Noncontiguous enlarged lymph nodes
D)Enlarged lymph nodes primarily in the neck and axillary region

Question 20

The nurse is preparing to write a care plan for the patient with fibromyalgia.Which nursing diagnosis best addresses this disorder?

A)Fatigue
B)Pain, chronic
C)Impaired physical mobility
D)Activity intolerance

Question 21

The nurse makes a list of conditions that can cause acquired immune deficiency,which includes: (Select all that apply.)

A)chemotherapy.
B)viral infections.
C)smoking.
D)malnutrition.
E)bacterial infections.

Question 22

The nurse is caring for a patient with systemic lupus erythematosus (SLE).The patient complains of severe fatigue,a butterfly rash,and joint pain.Which nursing interventions are most appropriate for this patient? (Select all that apply.)

A)Encourage the use of a sun lamp to help with the rash.
B)Assess pain control measures that have helped the patient in the past.
C)Assist the patient with planning rest periods throughout the day.
D)Remind the patient to avoid contact with people who have an infection.
E)Ensure the patient understands the importance of her medication regimen.

Question 23

The patient diagnosed with non-Hodgkin's lymphoma (NHL)asks the nurse about treatment options.The nurse is aware that various treatment options exist,including: (Select all that apply.)

A)bone marrow transplantation.
B)peripheral stem cell transplantation.
C)injection of monoclonal antibodies.
D)radiation therapy.
E)high-dose continuous antibiotic therapy.

Question 24

A patient has been exposed to an allergen resulting in a hypersensitivity reaction.The nurse correctly recognizes that which immunoglobulin has been triggered?

A)IgA
B)IgB
C)IgD
D)IgE

Question 25

When collecting data from a patient suspected of having an immune deficiency,which factor(s)should be included? (Select all that apply.)

A)Family history of immune disorders
B)Age
C)Weight gain
D)Alcohol use
E)Exposure to HIV

Question 26

During assessment of the patient diagnosed with systemic lupus erythematosus (SLE),which signs and symptoms would the nurse expect to find? (Select all that apply.)

A)Hair loss
B)Enlarged cervical lymph nodes
C)Mouth sores
D)Fatigue
E)Rashes