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Advanced Assessment > Chapter 17 Hematological And Immune Problems > Flashcards

Chapter 17 Hematological And Immune Problems Flashcards

1
Q

***7. Which statement about HIV postexposure prophylaxis (PEP) for health-care workers is the most accurate?

PEP should be started within hours of exposure.
b.
PEP should be started within 72 hours of exposure.
c.
Renal and hepatic function tests should be done 6 weeks after beginning PEP.
d.
PEP will prevent potential hepatitis C infection if present.

A

A. PEP should be started within hours of exposure.

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2
Q 
*******8.  Which household solution should be used to clean a bathroom if sharing with a friend who has HIV?
a.
100% bleach
b.
50% bleach and 50% vinegar
c.
Nine parts H2O to one part bleach
d.
The friend must have his or her own bathroom.
A

c.

Nine parts H2O to one part bleach

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3
Q
  1. Reuben, age 24, has HIV and just had a routine viral load test done. The results show a falling viral load. What does this indicate?
    a.
    A favorable prognostic trend
    b.
    Disease progression
    c.
    The need to be more aggressive with Reuben’s medications
    d.
    The eradication of the HIV
A
  1. ANS: A PTS: 1

a.
A favorable prognostic trend

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4
Q 
35.	Which person is four times more likely to develop SLE than a Caucasian?
a.
Persons of African descent
b.
Asians
c.
Hispanics
d.
Middle Eastern Jews
A
  1. ANS: A PTS

a.
Persons of African descent

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5
Q 
34.	Keratoconjunctivitis sicca is a classic sign of which condition?
a.
SLE
b.
Sjögren’s syndrome
c.
CFS/FMS
d.
Lyme disease
A

Sjögren’s syndrome

34.	ANS:	B	PTS:	1
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6
Q 
33.	If left untreated, this condition will progress to complaints that include multiple joint arthritis.
a.
Sjögren’s syndrome
b.
HIV/AIDS
c.
Guillain-Barré
d.
Lyme disease
A
  1. ANS: D PTS: 1
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7
Q 
32.	The exanthem of Lyme disease is:
a.
Erythema infectiosum
b.
Laterothoracic exanthem
c.
Erythema migrans
d.
Morbilli exanthem
A

Erythema migrans

32. ANS: C PTS: 1

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8
Q 
31.	CFS tends to occur in which individuals?
a.
Active, highly functional adults
b.
Depressed middle-aged persons
c.
Individuals with a depressed immune system
d.
Individuals who are hypochondriacs
A
  1. ANS: A PTS: 1

Active, highly functional adults

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9
Q 
30.	What is the mainstay of management for infectious mononucleosis?
a.
Antivirals
b.
Symptom control
c.
Corticosteroids
d.
Isolation
A
  1. ANS: B PTS: 1

Symptom control

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10
Q 
29.	Which test is diagnostic of rheumatoid arthritis?
a.
Rheumatoid factor
b.
ESR
c.
CRP
d.
Anti-CCP titers
A
  1. ANS: D PTS:

Anti-CCP titers

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11
Q
  1. Early rheumatoid disease is characterized by:
    a.
    Pain and swelling in both small and large peripheral joints
    b.
    Rigid joints with diminished range of motion
    c.
    Joint swelling and immobility on rising
    d.
    A cardiac rub or pulmonary friction rub
A
  1. ANS: C PTS: 1Joint swelling and immobility on rising
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12
Q 
27.	Which type of the following is characterized by fatigue on awakening that may improve with exercise?
a.
Functional fatigue
b.
Fatigue with an organic origin
c.
Fatigue of chronic anemia
d.
Fatigue of depression and anxiety
A
  1. ANS: A PTS: 1a.
    Functional fatigue
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13
Q 
26.	Spontaneous bruising may be seen with platelet counts below what level?
a.
100,000 cells/mL
b.
75,000 cells/mL
c.
50,000 cells/mL
d.
30,000 cells/ml
A

. ANS: C PTS: 1

c.
50,000 cells/mL

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14
Q
  1. Which drug category of ARV therapy is generally effective in crossing the blood–brain barrier and may be useful in managing HIV-associated dementia?
    a.
    Nucleoside reverse transcriptase inhibitors
    b.
    Protease inhibitors
    c.
    Integrase inhibitors
    d.
    Nonnucleoside reverse transcriptase inhibitors
A
  1. ANS: D PTS: 1
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15
Q
  1. An important complication of antiretroviral (ARV) therapy in patients with advanced AIDS is which of the following?
    a.
    Immune reconstitution inflammatory syndrome
    b.
    Improvement in opportunistic infections
    c.
    Restoration of immune system to preinfection status
    d.
    Progression to AIDS
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
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16
Q 
23.	The most cost-effective screening test for determining HIV status is which of the following?
a.
Western blot
b.
Enzyme-linked immunosorbent assay
c.
Venereal Disease Research Laboratory test
d.
Viral load
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
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17
Q

____ 22. The current goal of treatment for a patient with HIV infection is which of the following?
a.
Viral suppression of HIV to undetectable levels in the peripheral blood
b.
Compete eradication of the virus
c.
Encouraging the person to have no contact with uninfected individuals
d.
Complete abstinence

A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
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18
Q 
\_\_\_\_	21.	Triggering factors for acute exacerbations of which of the following conditions include exposure to ultraviolet (UV)-B and UV-A rays?
a.
Rheumatoid arthritis
b.
Scleroderma
c.
SLE
d.
Sjögren’s syndrome
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
19
Q 
20.	Dryness of the eyes and mouth is typical of which condition?
a.
Sjögren’s syndrome
b.
CFS
c.
FMS
d.
Hypothyroidism

____

A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
20
Q 
\_\_\_\_	19.	After returning from visiting his grandchildren in England, George, age 59, complains of a flulike illness, including fever, chills, and myalgia. He reports having discovered a rash or red spot that grew in size on his right leg. What disease are you considering?
a.
A viral syndrome
b.
Lyme disease
c.
Rocky Mountain spotted fever
d.
Relapsing fever
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
21
Q 
\_\_\_\_	18.	What is the most common cause of generalized musculoskeletal pain in women ages 20 to 55?
a.
Chronic fatigue syndrome (CFS)
b.
Anemia
c.
Fibromyalgia syndrome (FMS)
d.
Sports-related injuries
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
22
Q 
17.	Infectious mononucleosis results from an acute infection with which of the following?
a.
Epstein-Barr virus
b.
Acute HIV infection
c.
Guillain-Barré
d.
Hepatitis

____

A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
23
Q 
\_\_\_\_	16.	Which blood test is a nonspecific method and most helpful for evaluating the severity and course of an inflammatory process?
a.
Erythrocyte sedimentation rate
b.
White blood cell count
c.
Polymorphonuclear cells
d.
C-reactive protein (CRP)
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
24
Q 
\_\_\_\_	15.	In the United States, what is the second most common connective tissue disease and the most destructive to the joints?
a.
Osteoarthritis
b.
Systemic lupus erythematosus (SLE)
c.
Rheumatoid arthritis
d.
Sjögren’s syndrome
A

… S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
25
Q 
14.	The cardinal subjective symptom of sickle cell crisis is which of the following?
a.
Pain
b.
Nausea
c.
Light-headedness
d.
Palpitations

____

A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
26
Q 
\_\_\_\_	13.	What is the most common cause of microcytic anemia?
a.
Anemia of chronic disease
b.
Sideroblastic anemia
c.
Iron-deficiency anemia
d.
Thalassemia
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
27
Q 
\_\_\_\_	12.	As a rule of thumb, the estimated level of hematocrit is how many times the value of the hemoglobin?
a.
Two
b.
Three
c.
Four
d.
Five
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
28
Q 
11.	Which of the following is identified as an eating disorder in which a person craves food substitutes, such as clay, ice chips, and cotton, and is considered an objective finding associated with severe iron deficiency?
a.
Ferritin
b.
Porter’s syndrome
c.
Hypochromasia
d.
Pica
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
29
Q
  1. If the international normalized ratio (INR) result is above the therapeutic range in a patient with atrial fibrillation on warfarin, what might the clinician do?
    a.
    Stop the warfarin for 1 week, and then repeat the INR.
    b.
    Withhold one or more days of anticoagulant therapy.
    c.
    Restart therapy at a lower dose immediately.
    d.
    The prothrombin time and INR should be reevaluated within 1 month of the dosage adjustments.
A

. S: B PTS: 1

11. ANS:	D	PTS:	1
12. ANS:	B	PTS:	1
13. ANS:	C	PTS:	1
14. ANS:	A	PTS:	1
15. ANS:	C	PTS:	1
16. ANS:	D	PTS:	1
17. ANS:	A	PTS:	1
18. ANS:	C	PTS:	1
19. ANS:	B	PTS:	1
20. ANS:	A	PTS:	1
21. ANS:	C	PTS:	1
22. ANS:	A	PTS:	1
23. ANS:	B	PTS:	1
24. ANS:	A	PTS:	1
30
Q 
\_\_\_\_	6.	Which of the following disease-modifying antirheumatic drugs is a folic acid antagonist?
a.
Methotrexate (Rheumatrex)
b.
Etanercept (Enbrel)
c.
Rituximab (Rituxan)
d.
Anakinra (Kineret)
A
  1. ANS: A PTS: 1Methotrexate (Rheumatrex)
31
Q 
\_\_\_\_	5.	When analyzing synovial fluid, if it is opaque, white, or translucent; has 5,000 leukocytes/Ml; 80% polymorphonuclear leukocytes (PMN); and a low red blood cell count, it may be indicative of which of the following conditions?
a.
This is a normal result.
b.
Scleroderma
c.
Rheumatoid arthritis
d.
Sickle cell disease
A
  1. ANS: C PTS: 1

Rheumatoid arthritis

32
Q 
4.	After the initial treatment for anaphylaxis, which medication should be added to prevent late-phase anaphylactic reactions?
a.
Albuterol
b.
Diphenhydramine
c.
An H2 blocker
d.
Corticosteroids
A
  1. ANS: D PTS: 1

Corticosteroids

33
Q 
\_\_\_\_	3.	During treatment for anaphylaxis, what site is used for the initial injection of epinephrine?
a.
IV
b.
Abdomen
c.
Upper lateral thigh
d.
Deltoid
A
  1. ANS: C PTS: 1Upper lateral thigh
34
Q 
\_\_\_\_	2.	Which type of bone marrow transplant is obtained from an identical twin?
a.
Autogenic
b.
Autologous
c.
Allogeneic
d.
Syngeneic
A
  1. ANS: D PTS: 1

Syngeneic

35
Q 
1.  Sandra is 42 years old and has just been diagnosed with leukemia. She is complaining of bone and joint pain. Which type of leukemia is most likely the culprit?
a.
Acute lymphocytic leukemia
b.
Acute myelogenous leukemia
c.
Chronic myelogenous leukemia
d.
Chronic lymphocytic leukemia
A

. ANS: B PTS: 1

Acute myelogenous leukemia
36
Q 
1. Worldwide, which of the following is the most common type of anemia?
A. pernicious anemia
B. folate-deficiency anemia
C. anemia of chronic disease
D. iron-deficiency anemia
A

D. iron-deficiency anemia

37
Q
  1. Most of the body’s iron is obtained from:
    A. animal-based food sources.
    B. recycled iron content from aged red blood cells (RBCs).
    C. endoplasmic reticulum production.
    D. vegetable-based food sources.
A

Recycled iron content from aged red blood cells

38
Q
  1. Which of the following is most consistent with iron-deficiency anemia?
    A. low mean corpuscular volume (MCV), normal mean corpuscular hemoglobin (MCH)
    B. low MCV, low MCH
    C. low MCV, elevated MCH
    D. normal MCV, normal MCH
A

.Low MCV, low MCH

39
Q
  1. One of the earliest laboratory markers in evolving macrocytic or microcytic anemia is:
    A. an increase in RBC distribution width (RDW).
    B. a reduction in measurable hemoglobin.
    C. a low MCH level.
    D. an increased platelet count.
A

.An increase in red blood cell distribution with RDW

40
Q 
5. A 48-year-old woman developed iron-deficiency anemia after excessive perimenopausal bleeding, successfully treated by endometrial ablation. Her hematocrit (Hct) level is 25%, and she is taking iron therapy. At 5 days into therapy, one possible observed change in laboratory parameters would include:
A. a correction of mean cell volume.
B. an 8% increase in Hct level.
C. reticulocytosis.
D. a correction in ferritin level.
A

.Reticulocytosis

41
Q
  1. A healthy 34-year-old man asks whether he should take an iron supplement. You respond that:
    A. this is a prudent measure to ensure health.
    B. iron-deficiency anemia is a common problem in men of his age.
    C. use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron overload.
    D. excess iron is easily excreted.
A

Use of an iron supplement in the absence of a documented deficiency can lead to iatrogenic iron overload

42
Q 
7. Which of the following is the best advice on taking ferrous sulfate to enhance iron absorption?
A. “Take with other medications.”
B. “Take on a full stomach.”
C. “Take on an empty stomach.”
D. “Do not take with vitamin C.”
A

Take on an empty stomach

43
Q
  1. A 40-year-old woman with pyelonephritis is taking two medications: ciprofloxacin and ferrous sulfate (for iron-deficiency anemia). She asks about taking both medications. You advise that:
    A. she should take the medications with a large glass of water.
    B. an inactive drug compound is potentially formed if the two medications are taken together.
    C. she can take the medications together to enhance adherence to therapy.
    D. the ferrous sulfate potentially slows gastrointestinal motility and results in enhanced ciprofloxacin absorption. (Fitzgerald 325)
A

B. an inactive drug compound is potentially formed if the two medications are taken together.

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