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ATI Medical-Surgical Practice Test: Immune and Infectious Study online at quizlet.com/_5dnlse 1.

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Allergy testing indicates that a client has several environmental allergies and the provider recommends allergy desensitization. after explaining the procedure, the nurse determines that the reinforcement of teaching has been effective when the client states which of the following? A. "At each visit, I'll receive an allergy shot with a little bit less of the allergen than I received before" B. "I'll need to remain in the clinic for 30 minutes after each shot in case I have a bad reaction" C. "Any type of reaction at the injection site is abnormal, and I will need to receive an epinephrine shot" D. "Once my dose is established, I'll be taught how to give myself the allergy shots at home daily"

B. "I'll need to remain in the clinic for 30 minutes after each shot in case I have a bad reaction"

A client admitted to the hospital with active pulmonary tuberculosis (TB) is placed on airborne precautions, prescribed medication and scheduled for a chest xray. While transporting the client to the radiology department the nurse should do which of the following? A. Have the client wear a mask B. Wear a mask and gown for protection from the clients infection C. Ask the radiology staff to do a portable chest xray in the clients room D. Take no special precautions

A. Have the client wear a mask

After desensitization injection is administered, observation for a minimum of 30 minutes is required to monitor the client for any manifestations of an anaphylactic reaction

This intervention protects anyone who may come in contact with the client, including the nurse.

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A client diagnosed with systemic lupus erythematosus (SLE) is concerned C. "Apply moisturizer after bathing the lesions with about skin lesions on the face and neck. the client asks the nurse, "what warm water" should I do about these spots?" which of the following nursing responses is appropriate? A. "Keep the lesions covered with a light sterile dressing when going outdoors" B. "There is not much you can do. The lesions will go away when your disease is in remission" C. "Apply moisturizer after bathing the lesions with warm water" D. "Apply antibiotic cream twice a day until scabs form on the lesions"

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A client has been diagnosed with Raynaud's disease, when reinforcing teaching with the client, the nurse should include information about which of the following? A. Protecting against cold with layers of clothing B. Starting a regular exercise program of 2-mile walks daily C. Increasing niacin and pyridoxine in the diet D. Elevating the hands above heart level during an acute attack

A. Protecting against cold with layers of clothing

A client is concerned about the possibility of contracting lyme disease after being bitten by a tick. the nurse should observe the client for the common early manifestations of lyme disease, including which of the following? A. A diffuse maculopapular rash B. Stiff, swollen, painful joints C. Double vision D. A progressive, circular rash

D. A progressive, circular rash

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Extreme cold can lead to tissue damage, and clients with Raynaud's are prone to more frequent attacks during cold weather.

Early Lyme disease is characterized by fever, flulike manifestations, and erythema migrans, a distinct progressive circular rash that develops often at the bite site.

A client receives instructions about behaviors that increase the risk of C. "I'll stop eating raw clams even though I enjoy developing Hepatitis A. Which statement by the client indicated to the nurse them" an accurate understanding of the information? A. "I won't donate blood anymore" Hep A is transmitted via fecal-oral route through B. "I'll get a booster shot of immune serum globulin every year" consumption of contaminated fruits, vegetables, C. "I'll stop eating raw clams even though I enjoy them" water, milk, uncooked shellfish. Those who eat raw D. "I won't touch another drop of alcohol" or steamed shellfish are at an increased risk

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A client reports bilateral pain and swelling in her finger joints, with B. Rheumatoid factor (RF) stiffness in the morning. the finger joints are erythematous and warm to touch. the clients tells the nurse she has a long family history of arthritis. to Likely RA; RF is found in the serum of most clients help diagnose this client's condition, the nurse anticipates an order for who have RA which laboratory study? A. C-Reactive protein (CRP) B. Rheumatoid factor (RF) C. WBC count D. Erythrocyte sedimentation rate (ESR)

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A client who tests positive for the human immmunodeficiency virus (HIV) asks the nurse, " should i tell my partner that I am an HIV positive/" which of the following is appropriate nursing response? A. "That is your decision alone" B. "I would if I were you" C. "You aren't sure what to say to your partner?" D. "We are required by law to notify your partner"

C. "You aren't sure what to say to your partner?"

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A client with an acute exacerbation of rheumatoid arthritis has an erythrocyte sedimentation rate (ESR) of 65 mm/hr. based on this finding, the nurse anticipates that the client's affected joints will require which of the following? A. Assistive devices B. Heat or cold therapy C. Gentle massage D. Active ROM exercises

B. Heat or cold therapy

A client with reactive airway disease is tested and found to have an allergy to dust mites. The nurse determines that the client understands how to reduce her exposure to this allergen when she states which of the following? A. "I'll run a room humidifier in my bedroom every night" B. "Carpeting the entire house will be very expensive, but it will be worth it" C. "Washing all the bed linens in hot water every week will be timeconsuming" D. "I'll apply insect repellent sparingly to any exposed parts when I'm outdoors"

C. "Washing all the bed linens in hot water every week will be time-consuming"

A human immunodeficiency virus (HIV) - positive client is admitted to the hospital with lung infection. which isolation category should the nurse implement to prevent transmission of the HIV virus? A. Protective isolation B. Droplet precautions C. Standard precautions D. Contact precautions

C. Standard precautions - standard precautions

A nurse checks the morning laboratory results for a client admitted with status asthmaticus. the nurse knows that which result, if elevated on the white blood cell (WBCC) differential, would suggest an allergic basis for the client's illness? A. Neutrophils B. Lymphocytes C. Monocytes D. Eosinophils

D. Eosinophils

A nurse has prepared a sign to hang outside of the room of a client who is on contact precautions because of a confirmed MRSA infection. Which sign, if prepared by the nurse, would indicate a knowledge deficit?

Graphic 4: isolation mask is not necessary with contact precautions

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Elevated ESR indicates an acute inflammatory process. The client will most likely need thermal interventions to control inflammation, as well as activity limitations to rest inflamed joints

Dust mites are vulnerable to high temperatures and because a client may spend up to 1/3 of the day in bed, actions to reduce exposure in bedroom are essential

Implemented with every client, prevent the spread of infection transmitted by direct or indirect contact with infectious blood or bodily fluids. since this is the mode of transmission of HIV, this is appropriate isolation precaution.

Typical with asthma, especially when the disorder is associated with a hypersensitivity reaction. Eosinophils can also be elevated with several autoimmune disorders

A nurse in the health clinic is evaluating the effectiveness of naproxen (naprosyn) following a client's exacerbation of rheumatoid arthritis, which comment by the client requires further intervention with the nurse? A. "I signed up for a swimming class, starting tomorrow" B. "I've been buying an acid reducer to help with the indigestion I've had" C. "I've lost 2 pounds since my last appointment 2 weeks ago" D. "The naprosyn goes down easier when I crush it and put it in applesauce"

B. "I've been buying an acid reducer to help with the indigestion I've had"

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A nurse is assessing a client who has an exacerbation of herpes zoster. the nurse should observe the client's skin for which of the following? A. Confluent, honey-colored, crusted lesions B. Papules, vesicles, pustules and crusts C. Unilateral, localized, nodular skin lesions D. Fluid-filled vesicular rash in the genital region

C. Unilateral, localized, nodular skin lesions

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A nurse is caring for a client who has a latex allergy. the nurse is aware that which of the following items may be unsafe to use while performing this client's care? A. Cartoon-character adhesive bandages B. Vinyl gloves C. Mylar balloons D. Silicone urinary catheters

A. Cartoon-character adhesive bandages

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A nurse is caring for a client who has seasonal allergy symptoms and had radioallergosorbent (RAST) testing completed during a previous clinic visit. The nurse recognize that a positive result is indicated by an elevation of which of the following? A. IgM (Immunoglobulin M) B. IgA C. IgG D. IgE

D. IgE

A nurse is caring for a client who is HIV-positive is reinforcing teaching about the earliest manifestations of AIDS. The nurse explains that they include which of the following? A. Persistent fever, swollen glands, diarrhea, weight loss, and fatigue B. Elevated WBC count C. Increased blood pressure, tachycardia, dyspnea and edema D. Influenza-like symptoms including fatigue, sore throat, muscle pain, headache and swollen glands

A. Persistent fever, swollen glands, diarrhea, weight loss, and fatigue

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NSAIDs like naprosyn can cause serious adverse GI reactions such as ulcerations, bleeding, perforation.

RAST testing involves measuring the quantity of IgE present in the serum after exposure to specific antigens selected on a basis of the clients symptom history. An elevated IgE indicates a positive response and is common among clients with a history of allergic manifestations, anaphylaxis and asthma

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A nurse is collecting data from a client who has had systemic scleroderma for 5 years. In addition to skin changes, which of the following findings should the nurse expect? A. Excessive salivation B. Finger contractures C. Periorbital edema D. Alopecia

B. Finger contractures Scleroderma is a chronic disease that can cause thickening, hardening or tightening of the skin, blood vessels and internal organs. There are 2 types: localized scleroderma, which mainly affects the skin, and systemic scleroderma which may affect many internal organs. The symptoms include skin changes, Raynaud's disease, arthritis, muscle weakness, and dry mucous membranes. With scleroderma, the body produces and deposits too much collagen, causing thickening and hardening. in addition to the clients skin and subcutaneous tissues becoming increasing hard and rigid, the extremities stiffen and lose mobility. Contractures develop with advanced systemic scleroderma unless clients follow a regimen of range of motion and muscle strengthening exercises

A nurse is helping to prepare a client treated for sexually transmitted disease (STD) for discharge. which of the following statements indicates that the client understands what the nurse explained about preventing infection transmission? A. "I will bring my sexual partner in for treatment" B. "Now that I've had my dose of medicine, I can resume sexual activity" C. "Once I have been treated, it is no longer necessary to use condoms" D. "Once treatment is completed and I am free of symptoms, I don't have to return to the clinic"

A. "I will bring my sexual partner in for treatment"

A nurse is helping to prepare a client with systemic lupus erythematosus (SLE) for discharge. which of the following instructions should the nurse include in the client's discharge teaching plan? A. "Avoid the use of NSAIDs" B. "Stop taking the corticosteroids when your symptoms are resolved" C. "Exposure to UV light will help control the skin rashes" D. "Monitor your body temperature and report any elevations promptly"

D. "Monitor your body temperature and report any elevations promptly"

Any sexual partner of this client should receive antibiotics to keep the client and his partner from transmitting the infection back and forth to each other

SLE is a chronic autoimmune disorder that can affect virtually any organ of the body. With SLE, the body's immune system becomes hyperactive, forming antibodies that attack normal tissues and organs, including the skin, joints, kidneys, brain, heart, lungs and blood. SLE is characterized by periods of exacerbation and remissions. The nurse should teach the client to monitor body temp and report any elevations as fever could suggest an exacerbation or a potentially life-threatening infection

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A nurse is preparing the family of an infant with acquired immune deficiency syndrome (AIDS) for discharge. which statement by the child's parent should alert the nurse to a need for further instruction? A. "I'll use disposable diapers, discarding them in separate plastic bags" B. "I'll clean up blood spills immediately with hot soapy water" C. "I know that handwashing is an important preventive measure" D. "Anybody changing the baby's diapers must wear gloves"

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A nurse is preparing to administer a Mantoux skin test to a D. Identify clients who have been infected with mycobacterium client. The nurse should inform the client that the purpose of tuberculosis mantoux skin test using purified protein derivative (PPD) is to do which of the following? A. Identify clients who lack immunity to tuberculosis B. Find out if a client has active tuberculosis C. Decrease hypersensitivity to purified protein derivative D. Identify clients who have been infected with mycobacterium tuberculosis

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A nurse is reinforcing teaching for a client who has frequent allergic reactions about how his symptom develop. the nurse should explain that histamine release causes which of the following? A. Increased mucous secretion B. Bronchial dilation C. Tachycardia D. Vertigo

B. "I'll clean up blood spills immediately with hot soapy water"

A. Increased mucous secretion Histamine is the neurotransmitter the body produces during an allergic reaction. with extreme cases, histamine levels are high enough to cause anaphylactic shock. increase mucus secretion is a common manifestation of histamine release.

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A nurse is reinforcing teaching for a female client recently diagnosed with Raynaud's disease about preventing the onset of manifestations. Which of the following statements made by the client indicates an understanding of the teaching? A. "Its best for me to minimize exercise" B. "I shouldn't drink any alcohol" C. "I must not smoke" D. "I'd better not plan to become pregnant"

C. "I must not smoke"

A nurse is teaching a female client newly diagnosed with systemic lupus erythematosus (SLE) about factors that might trigger an exacerbation of SLE. The nurse determines that the client needs more teaching when she identifies which of the following as a factor? A. Exercise B. Pregnancy C. Infection D. Sunlight

A. Exercise

When assessing a client with Kaposi's sarcoma, the nurse would expect to see which of the following? A. A nonproductive cough with fever and shortness of breath B. Lesions on the retina that produce blurred vision C. Insidious onset of progressive dementia D. Reddish-purple skin lesions

Raynauds disease is a disorder of the blood vessels that supply blood to the skin and cause the distal extremities and the tips of the nose and ears to feel numb and cool in response to cold temperatures or stress. During a Raynaud's attack, these arteries narrow, limiting blood circulation to affected areas. Strong emotion or exposure to the cold causes these areas to become white, due to lack of blood flow in the area. They then turn blue, as tiny blood vessels dilate to allow more blood to remain in the tissues. When the flow of blood returns, the area becomes red and then returns to normal color. There may be associated tingling, swelling, and painful throbbing. The attacks may last from minutes to hours. If the condition progresses, blood flow to the area could become permanently decreased causing the fingers to become thin and tapered, with smooth, shiny skin and slow-growing nails. If an artery becomes blocked completely, gangrene or ulceration of the skin may occur. Smoking cessation is an action the client should take to prevent the onset of the manifestations of Raynaud's disease.

SLE is a chronic autoimmune disease that develops when the immune system becomes hyperactive and attacks normal body tissue. This attack may result in generalized inflammation and the symptoms associated with the specific involved tissues. most clients with SLE can follow an exercise program to increase the aerobic capacity of cells and improve immune function, and the client should develop such a program with her provider's assistance.

D. Reddish-purple skin lesions KS is commonly associated with AIDS

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When planning to reinforce teaching for a client who is HIV-positive, the nurse should explain to the client that the virus can be transmitted A. As soon as the client develops manifestations B. To anyone having contact with the clients blood C. Via the respiratory route through droplets D. Only during the active phase of the virus Which of the following explanations should the nurse offer to an immunosuppressed client concerned about acquiring pneumocystis carinii pneumonia (PCP) A. "PCP is sexually transmitted from person to person" B. "You were most likely exposed to a contaminated surface, such as a drinking glass" C. "PCP results from an impaired immune system" D. "You may have contracted PCP from a family pet" Which of the following findings should alert the nurse to the possibility that a client who is 2 days postop is developing an infection? A. Temperature of 37.8 (100.2) B. Erythema at the incision site C. WBC count of 9,000/mm D. Pain reporter as 6 out of 10

B. To anyone having contact with the clients blood The concentration of the virus is highest in blood and has been isolated in several body fluids; including sputum, saliva, CSF, urine and semen. Clients with HIV are cautioned to practice safer sex, avoid donating blood, and abstain from sharing needles with others

C. "PCP results from an impaired immune system" The organism that causes PCP exists as part of the normal flora of the lungs. It becomes aggressive pathogen when the immune system is compromised.

B. Erythema at the incision site...