Question 1

A patient is brought to the emergency department (ED) in a state of anaphylaxis. What is the ED nurses priority for care?

Accepted Answer

A)  Monitor the patients level of consciousness. 
B)  Protect the patients airway. 
C)  Provide psychosocial support. 
D)  Administer medications as ordered.

Question 2

The nurse is providing care for a patient who has experienced a type I hypersensitivity reaction. What condition is an example of such a reaction?

Accepted Answer

A)  Anaphylactic reaction after a bee sting 
B)  Skin reaction resulting from adhesive tape 
C)  Myasthenia gravis 
D)  Rheumatoid arthritis

Question 3

A patient 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?

Accepted Answer

A)  The patient should take his corticosteroids regularly prior to testing. 
B)  The patient should only be tested for grass, mold, and dust initially. 
C)  The nurse should have an emergency cart available in case of anaphylaxis during the test. 
D)  The patients test should be cancelled until he is off his corticosteroids.

Question 4

After the completion of testing, a childs allergies have been attributed to her familys cat. When introducing the family to the principles of avoidance therapy, the nurse should promote what action?

Accepted Answer

A)  Removing the cat from the familys home 
B)  Administering OTC antihistamines to the child regularly 
C)  Keeping the cat restricted from the childs bedroom 
D)  Maximizing airflow in the house

Question 5

An office worker takes a cupcake that contains peanut butter. He begins wheezing, with an inspiratory stridor and air hunger and the occupational health nurse is called to the office. The nurse should recognize that the worker is likely suffering from which type of hypersensitivity?

Accepted Answer

A)  Anaphylactic (type 1) 
B)  Cytotoxic (type II) 
C)  Immune complex (type III) 
D)  Delayed-type (type IV)

Question 6

A 5-year-old boy has been diagnosed with a severe food allergy. What is an important parameter to address when educating the parents of this child about his allergy and care?

Accepted Answer

A)  Wear a medical identification bracelet. 
B)  Know how to use the antihistamine pen. 
C)  Know how to give injections of lidocaine. 
D)  Avoid live attenuated vaccinations.

Question 7

The nurse is creating a care plan for a patient suffering from allergic rhinitis. Which of the following outcomes should the nurse identify?

Accepted Answer

A)  Appropriate use of prophylactic antibiotics 
B)  Safe injection of corticosteroids 
C)  Improved skin integrity 
D)  Improved coping with lifestyle modifications

Question 8

A patients decline in respiratory and renal function has been attributed to Goodpasture syndrome, which is a type II hypersensitivity reaction. What pathologic process underlies the patients health problem?

Accepted Answer

A)  Antigens have bound to antibodies and formed inappropriate immune complexes. 
B)  The patients body has mistakenly identified a normal constituent of the body as foreign. 
C)  Sensitized $\mathrm{T}$ cells have caused cell and tissue damage. 
D)  Mast cells have released histamines that directly cause cell lysis.

Question 9

A child has been transported to the emergency department (ED) after a severe allergic reaction. The ED nurse is evaluating the patients respiratory status. How should the nurse evaluate the patients respiratory status? Select all that apply.

Accepted Answer

A)  Facilitate lung function testing. 
B)  Assess breath sounds. 
C)  Measure the childs oxygen saturation by oximeter. 
D)  Monitor the childs respiratory pattern. 
E)  Assess the childs respiratory rate.

Question 10

A nurse has asked the nurse educator if there is any way to predict the severity of a patients anaphylactic reaction. What would be the nurses best response?

Accepted Answer

A)  The faster the onset of symptoms, the more severe the reaction. 
B)  The reaction will be about one-third more severe than the patients last reaction to the same antigen. 
C)  There is no way to gauge the severity of a patients anaphylaxis, even if it has occurred repeatedly in the past. 
D)  The reaction will generally be slightly less severe than the last reaction to the same antigen.

Question 11

A nurse knows of several patients who have achieved adequate control of their allergy symptoms using over-the-counter antihistamines. Antihistamines would be contraindicated in the care of which patient?

Accepted Answer

A)  A patient who has previously been treated for tuberculosis 
B)  A pregnant woman at 30 weeks gestation 
C)  A patient who is on estrogen-replacement therapy 
D)  A patient with a severe allergy to eggs

Question 12

A nurse has included the nursing diagnosis of Risk for Latex Allergy Response in a patients plan of care. The presence of what chronic health problem would most likely prompt this diagnosis?

Accepted Answer

A)  Herpes simplex 
B)  HIV 
C)  Spina bifida 
D)  Hypogammaglobulinemia

Question 13

Which of the following individuals would be the most appropriate candidate for immunotherapy?

Accepted Answer

A)  A patient who had an anaphylactic reaction to an insect sting 
B)  A child with allergies to eggs and dairy 
C)  A patient who has had a positive tuberculin skin test 
D)  A patient with severe allergies to grass and tree pollen

Question 14

A patient has developed severe contact dermatitis with burning, itching, cracking, and peeling of the skin on her hands. What should the nurse teach the patient to do?

Accepted Answer

A)  Wear powdered latex gloves when in public. 
B)  Wash her hands with antibacterial soap every few hours. 
C)  Maintain room temperature at $75 \mathrm{~F}$ to $80 \mathrm{~F}$ whenever possible. 
D)  Keep her hands well-moisturized at all times.

Question 15

The nurse is providing care for a patient who has a diagnosis of hereditary angioedema. When planning this patients care, what nursing diagnosis should be prioritized?

Accepted Answer

A)  Risk for Infection Related to Skin Sloughing 
B)  Risk for Acute Pain Related to Loss of Skin Integrity 
C)  Risk for Impaired Skin Integrity Related to Cutaneous Lesions 
D)  Risk for Impaired Gas Exchange Related to Airway Obstruction

Question 16

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 childs health problem?

Accepted Answer

A)  Food allergies are a life-long condition, but most families adjust quite well to the necessary lifestyle changes. 
B)  Consistent use of over-the-counter antihistamines can often help a child overcome food allergies. 
C)  Make sure that you carry a steroid inhaler with you at all times, especially when you eat in restaurants. 
D)  Many children outgrow their food allergies in a few years if they avoid the offending foods.

Question 17

The nurse is planning the care of a patient 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 patients care plan?

Accepted Answer

A)  Risk for Disturbed Body Image Related to Skin Lesions 
B)  Risk for Disuse Syndrome Related to Dermatitis 
C)  Risk for Ineffective Role Performance Related to Dermatitis 
D)  Risk for Self-Care Deficit Related to Skin Lesions

Question 18

A patient is learning about his new diagnosis of asthma with the asthma nurse. What medication has the ability to prevent the onset of acute asthma exacerbations?

Accepted Answer

A)  Diphenhydramine (Benadryl) 
B)  Montelukast (Singulair) 
C)  Albuterol sulfate (Ventolin) 
D)  Epinephrine

Question 19

A nurse is aware of the need to assess patients risks for anaphylaxis. What health care procedure constitutes the highest risk for anaphylaxis?

Accepted Answer

A)  Administration of the measles-mumps-rubella (MMR) vaccine 
B)  Rapid administration of intravenous fluids 
C)  Computed tomography with contrast solution 
D)  Administration of nebulized bronchodilators

Question 20

A patient 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 nurses best response?

Accepted Answer

A)  I can only imagine how you feel. Would you like to talk about it? 
B)  Lets find a quiet spot and Ill teach you a few coping strategies. 
C)  Thats the same way that most patients who have a chronic illness feel. 
D)  Do you think that maybe you could be managing things more efficiently?

Exam 37: Assessment and Management of Patients With Allergic Disorders