Question 1

A patient has a documented history of allergies presents to the clinic. She states that she is frustrated by her chronic nasal congestion, anosmia (inability to smell) and inability to concentrate. The nurse should identify which of the following nursing diagnoses?

Accepted Answer

A)   Deficient Knowledge of Self-Care Practices Related to Allergies
B)   Ineffective Individual Coping with Chronicity of Condition and Need for EnvironmentalModification
C)   Acute Confusion Related to Cognitive Effects of Allergic Rhinitis
D)   Disturbed Body Image Related to Sequelae of Allergic Rhinitis B

Question 2

A patient has presented with signs and symptoms that are consistent with contact dermatitis. What aspect of care should the nurse prioritize when working with this patient?

Accepted Answer

A)   Promoting adequate perfusion in affected regions
B)   Promoting safe use of topical antihistamines
C)   Identifying the offending agent, if possible
D)   Teaching the patient to safely use an EpiPen C

Question 3

A patient 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 patient will present with what alteration in laboratory values?

Accepted Answer

A)   Increased eosinophils
B)   Increased neutrophils
C)   Increased serum albumin
D)   Decreased blood glucose A

Question 4

The nurse in an allergy clinic is educating a new patient about the pathology of the patients health problem. What response should the nurse describe as a possible consequence of histamine release?

Accepted Answer

A)   Constriction of small venules
B)   Contraction of bronchial smooth muscle
C)   Dilation of large blood vessels
D)   Decreased secretions from gastric and mucosal cells

Question 5

A nurse is caring for a teenage girl who has had an anaphylactic reaction after a bee sting. The nurse is providing patient teaching prior to the patients discharge. In the event of an anaphylactic reaction, the nurse informs the patient that she should self-administer epinephrine in what site?

Accepted Answer

A)   Forearm
B)   Thigh
C)   Deltoid muscle
D)   Abdomen

Question 6

A patient was prescribed an oral antibiotic for the treatment of sinusitis. The patient has now stopped, stating she developed a rash shortly after taking the first dose of the drug. What is the nurses most appropriate response?

Accepted Answer

A)   Encourage the woman to continue with the medication while monitoring her skin condition closely.
B)   Refer the woman to her primary care provider to have the medication changed.
C)   Arrange for the woman to go to the nearest emergency department.
D)   Encourage the woman to take an OTC antihistamine with each dose of the antibiotic.

Question 7

A child has been diagnosed with a severe walnut allergy after suffering an anaphylactic reaction. What is a priority for health education?

Accepted Answer

A)   The need to begin immunotherapy as soon as possible
B)   The need for the parents to carry an epinephrine pen
C)   The need to vigilantly maintain the childs immunization status
D)   The need for the child to avoid all foods that have a high potential for allergies

Question 8

A nurse is preparing a patient for allergy skin testing. Which of the following precautionary steps is most important for the nurse to follow?

Accepted Answer

A)   The patient must not have received an immunization within 7 days.
B)   The nurse should administer albuterol 30 to 45 minutes prior to the test.
C)   Prophylactic epinephrine should be administered before the test.
D)   Emergency equipment should be readily available.

Question 9

A nurse is caring for a patient who has allergic rhinitis. What intervention would be most likely to help the patient meet the goal of improved breathing pattern?

Accepted Answer

A)   Teach the patient to take deep breaths and cough frequently.
B)   Use antihistamines daily throughout the year.
C)   Teach the patient to seek medical attention at the first sign of an allergic reaction.
D)   Modify the environment to reduce the severity of allergic symptoms.

Question 10

A patient has been brought to the emergency department by EMS after being found unresponsive. Rapid assessment reveals anaphylaxis as a potential cause of the patients condition. The care team should attempt to assess for what potential causes of anaphylaxis? Select all that apply.

Accepted Answer

A)   Foods
B)   Medications
C)   Insect stings
D)   Autoimmunity
E)   Environmental pollutants

Question 11

A patient has been living with seasonal allergies for many years, but does not take antihistamines, stating, When I was young I used to take antihistamines, but they always put me to sleep. How should the nurse best respond?

Accepted Answer

A)   Newer antihistamines are combined with a stimulant that offsets drowsiness.
B)   Most people find that they develop a tolerance to sedation after a few months.
C)   The newer antihistamines are different than in years past, and cause less sedation.
D)   Have you considered taking them at bedtime instead of in the morning?

Question 12

A patient with severe environmental allergies is scheduled for an immunotherapy injection. What should be included in teaching the patient about this treatment?

Accepted Answer

A)   The patient will be given a low dose of epinephrine before the treatment.
B)   The patient will remain in the clinic to be monitored for 30 minutes following the injection.
C)   Therapeutic failure occurs if the symptoms to the allergen do not decrease after 3 months.
D)   The allergen will be administered by the peripheral intravenous route.

Question 13

A patient is receiving a transfusion of packed red blood cells. Shortly after initiation of the transfusion, the patient begins to exhibit signs and symptoms of a transfusion reaction. The patient is suffering from which type of hypersensitivity?

Accepted Answer

A)   Anaphylactic (type 1) 
B)   Cytotoxic (type II) 
C)   Immunecomplex (type III) 
D)   Delayed type (type IV)

Question 14

A school nurse is caring for a child who appears to be having an allergic response. What should be the initial action of the school nurse?

Accepted Answer

A)   Assess for signs and symptoms of anaphylaxis.
B)   Assess for erythema and urticaria.
C)   Administer an OTC antihistamine.
D)   Administer epinephrine.

Question 15

A patient 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?

Accepted Answer

A)   Immunoglobulin A
B)   Immunoglobulin M
C)   Immunoglobulin G
D)   Immunoglobulin  E\mathrm{E}E

Question 16

A nurse at an allergy clinic is providing education for a patient starting immunotherapy for the treatment of allergies. What education should the nurse prioritize?

Accepted Answer

A)   The importance of scheduling appointments for the same time each month
B)   The importance of keeping appointments for desensitization procedures
C)   The importance of avoiding antihistamines for the duration of treatment
D)   The importance of keeping a diary of reactions to the immunotherapy

Question 17

A junior nursing student is having an observation day in the operating room. Early in the day, the student tells the OR nurse that her eyes are swelling and she is having trouble breathing. What should the nurse suspect?

Accepted Answer

A)   Cytotoxic reaction due to contact with the powder in the gloves
B)   Immune complex reaction due to contact with anesthetic gases
C)   Anaphylaxis due to a latex allergy
D)   Delayed reaction due to exposure to cleaning products

Question 18

A child is undergoing testing for food allergies after experiencing unexplained signs and symptoms of hypersensitivity. What food items would the nurse inform the parents are common allergens?

Accepted Answer

A)   Citrus fruits and rice
B)   Root vegetables and tomatoes
C)   Eggs and wheat
D)   Hard cheeses and vegetable oils

Question 19

An adolescent patients history of skin hyperreactivity and inflammation has been attributed to atopic dermatitis. The nurse should recognize that this patient consequently faces an increased risk of what health problem?

Accepted Answer

A)   Bronchitis
B)   Systemic lupus erythematosus (SL
E)  
C)   Rheumatoid arthritis
D)   Asthma

Question 20

A patient has sought care, stating that she developed hives overnight. The nurses inspection confirms the presence of urticaria. What type of allergic hypersensitivity reaction has the patient developed?

Accepted Answer

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

Exam 37: Assessment and Management of Patients With Allergic Disorders