Med Surg I Final Flashcards
1
Q
The nurse caring for an older adult with a diagnosis of leukemia would encourage the client to use an electric razor. What is the rationale for this statement by the nurse?
A
Trauma and microabrasions from a nonelectric razor may contribute to anemia.
2
Q
The registered nurse (RN) and licensed practical nurse (LPN) are preparing an educational program for clients who may be at risk for the development of iron-deficiency anemia. Which clients would receive the greatest benefit from this program?
A
- A young female client with bulimia nervosa
- An older adult client with a fixed income
- A client with crohn’s disease
- A client who is a vegetarian
3
Q
The need for iron increases during periods of rapid growth, pregnancy, and the female reproductive years when intermittent blood loss accompanies menses.
(T/F)
A
True
4
Q
Treatment for sickle cell disease is curative rather than supportive.
(T/F)
A
False
5
Q
Symptoms of hemolytic anemia are similar to those associated with hypovolemic anemia.
(T/F)
A
True
6
Q
Protective isolation is necessary if the leukocyte is extremely low.
(T/F)
A
True
7
Q
Hemophilia is an inherited disorder.
T/F
A
True
8
Q
One of the unique manifestations of sickle cell disease is __________, a type of pneumonia triggered by decreased hemoglobin and infiltrates in the lungs.
A
Acute Chest Syndrome
9
Q
Hereditary hemolytic anemias are referred to as __________.
A
Thalassemias
10
Q
__________ develops when client lacks intrinsic factor.
A
Pernicious anemia
11
Q
__________ refers to a decreased production of granulocytes.
A
Agranulocytosis
12
Q
__________ is a lower than normal number of platelets or thrombocytes.
A
Thrombocytopenia
13
Q
The rate of HIV infection is 6.5 times higher in African Americans than in Whites.
(T/F)
A
True
14
Q
There are only four known body fluids through which HIV is transmitted.
(T/F)
A
True
15
Q
AIDS is the first stage of HIV infection
T/F
A
False
16
Q
If results of a second ELISA test are positive for HIV, a second test is performed.
(T/F)
A
False
17
Q
When drug therapy is begun, clients are generally started on a combination of three antiretroviral drugs.
(T/F)
A
True
18
Q
Infections that usually do not occur in individuals with a healthy immune system are called __________.
A
Opportunistic Infections
19
Q
A type of connective tissue cancer common among those with AIDS is __________.
A
Kaposi’s Sarcoma
20
Q
People with HIV and AIDS are treated with __________ drugs.
A
Antiretroviral
21
Q
Clients who neglect to take antiretroviral drugs as prescribed risk development of __________
A
Drug resistance
22
Q
Immunosuppressed clients may develop serious __________ as a result of infection with a protozoan called Cryptosporidium.
A
Diarrhea
23
Q
The nurse is performing a physical assessment on a client with a suspected lymphatic disorder. What would be the nurse’s primary assessment for all clients with lymphatic disorders?
A
Enlargement of the lymph glands
24
Q
A client has just been admitted to the unit with a diagnosis of Hodgkin’s disease. When doing the initial assessment, what pertinent questions should the nurse ask the client to help determine the correct nursing diagnosis?
A
Are you experiencing fever, chills, or night sweats?
25
A client with lymphadenitis has developed persistent swelling of the affected area. What would be important information for the nurse to teach this client?
How to apply an elastic sleeve or stocking
26
The nurse is caring for a client with Hodgkin's disease who has developed anemia. What would the nurse expect to be ordered for this client?
Transfusions
27
The nurse is caring for a client newly admitted to the unit with a diagnosis of lymphangitis. What interventions would the nurse institute to help promote the resolution of the lymphangitis?
- Elevate the area
- Encourage independent activities of daily living
- Apply warm soaks/compresses to the area
- Note the response to antibiotic therapy
28
A client had a left radical mastectomy with an axillary node dissection 6 months ago and is having a large amount of edema in the left arm down to the fingers. What should the nurse inform the client is the reason for the edema?
An accumulation of lymphatic fluid that results from impaired lymph circulation.
29
The nurse is sending a client to be fitted for a compression garment for the treatment of lymphedema after having a mastectomy and node dissection. What does the nurse inform the client that will do to decrease the edema?
- Prevents tissue refilling with an excess volume of lymph
- Helps muscles to expel lymphatic drainage
- Increases local tissue pressure
30
The nurse is caring for the client with infectious mononucleosis that has inflammation of the pharyngeal mucosa. What foods or liquids would be best to offer to this client?
Vanilla pudding and iced tea
31
A client calls the clinic and informs the nurse that her boyfriend was diagnosed with infectious mononucleosis and wonders how long it would be before she got it. What does the nurse inform the client that the incubation period is for infectious mononucleosis?
30-50 days
32
A client has been diagnosed with non-Hodgkin's lymphoma but has no symptoms at this time. The client has received radiation and chemotherapy with responsiveness to this treatment. How would this disease be classified according to the lack of symptoms and responsiveness to treatment?
Indolent
33
Which client does the nurse recognize as most likely to be diagnosed with non-Hodgkin's lymphoma rather than Hodgkin's lymphoma?
A 55 year old client with an immunosuppression disorder
34
The anatomy and physiology instructor is explaining a cell-mediated response to the pre-nursing students. What actions would the instructor explain occur in a cell-mediated response?
T-cell lymphocytes survey proteins in the body and attack the invading antigens.
35
A child is brought to the clinic with a rash. The child is diagnosed with measles. The mother tells the nurse that she had the measles when she was a little girl. What immunity to measles develops after the initial infection?
Naturally acquired, active immunity
36
An older male adult client, who leads a sedentary lifestyle, and a younger female client, who has a very stressful and active lifestyle, require a vaccine against a particular viral disorder. The nurse knows that in one of these clients, the vaccine will be less effective. In which client is the vaccine more likely to be less effective and why?
The male client because of his age
37
What is the function of the thymus gland?
Programs T-lymphocytes to become regulator or effector T-cells
38
A teenaged client has been brought to the clinic by his mother and is suspected of having an immune system disorder. What tests would the nurse expect to be ordered for this young client?
Complete blood count with differential
39
An adult client has had mumps when the client was a child. The client had a titer prior to entering nursing school and shows immunity. What type of immunity does this reflect?
Naturally acquired, active immunity
40
A laboring mother asks the nurse if the baby will have immunity to some illnesses when born. What type of immunity does the nurse understand that the newborn will have?
Passive immunity transferred by the mother
41
A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide?
Artificially acquired immunity
42
The nurse is administering a skin test for detection of exposure to tuberculosis. How would the nurse determine if the client was exposed to tuberculosis?
The injection area swells if the client has developed antibodies against the antigen
43
A client is admitted to the hospital with a diagnosis of pneumonia. The client informs the nurse that he has several drug allergies. The physician has ordered an antibiotic as well as several other medications for cough and fever. What should the nurse do prior to administering the medications?
Consult drug references to make sure the medicines do not contain substances which the client is hypersensitive.
44
A client is treated in the clinic for a sexually transmitted infection, and the nurse suspects that the client is at risk for HIV. The physician determines that the client should be tested for the virus. What responsibility does the nurse have?
The nurse ensures a written consent is obtained prior to testing
45
What type of immunoglobulin does the nurse recognize that promotes the release of vasoactive chemicals such as histamine when a client is having an allergic reaction?
IgE
46
The nurse understands that which cells circulate throughout the body looking for virus-infected cells and cancer cells?
Natural killer cells
47
The nurse is instructing client's about the importance of taking the shingles vaccine. Which client would benefit from this vaccine?
A 65-year-old who had chicken pox when he was 12 years old
48
Allergies can occur at any age, and the pattern of allergic response can vary in the same person during his or her life.
(T/F)
True
49
To identify food allergens, meticulous record keeping of symptoms and a food diary listing all food and beverages consumed are necessary.
(T/F)
True
50
Autoimmune disorders are usually cured with medications
| T/F
False
51
A triggering event, such as trauma or infection, has been linked to many autoimmune disorders.
(T/F)
True
52
The cause of chronic fatigue syndrome is connected to chronic bacterial infections.
(T/F)
False
53
A(n) __________ is characterized by a hyperimmune response to weak antigens that usually are harmless.
Allergic disorders
54
__________ refers to a process of attracting migratory cells to a particular area in the body.
Chemotaxis
55
The __________ is used to identify the offending substance in allergic contact dermatitis
Patch test
56
The term __________ is used to describe an immune response that is waged against transplanted organs and tissues that carry nonself antigens.
Alloimmunity
57
__________ is a complex of symptoms primarily characterized by profound fatigue with no identifiable cause
Chronic fatigue syndrome
58
Lymphocytes, which are either T-cell or B-cell lymphocytes, comprise 50% to 60% of all leukocytes.
(T/F)
False
59
Memory cells produce antibodies.
| T/F
False
60
The thymus gland becomes smaller during adolescence but retains some activity throughout the life cycle.
(T/F)
True
61
Artificially acquired active immunity results when ready-made antibodies are given to a susceptible person.
(T/F)
False
62
The nurse ensures that a written consent is obtained before testing for HIV and keeps the results of HIV testing confidential.
(T/F)
True
63
__________ is the ability to cooperatively protect a person from external invaders and the body’s own altered cells.
Immunocompetence
64
__________ are chemical substances that destroy foreign agents such as microorganisms.
Antibodies
65
__________ is the process of engulfing and digesting bacteria and foreign material.
Phagocytosis
66
The __________ is made up of many different proteins that are activated in a chain reaction when an antibody binds with an antigen.
Complement system
67
__________ occurs as a direct result of infection by a specific microorganism.
Naturally acquired, active immunity
68
Primary lymphedema occurs as a complication of another disorder.
(T/F)
False
69
Staph infections are usually the cause of both lymphangitis and lymphadenitis
(T/F)
False
70
The symptoms of infectious mononucleosis generally resolve in approximately 1 to 2 weeks unless complications develop.
(T/F)
False
71
The risk of lymphoma is increased in older adults, primarily because of the immunologic changes of aging and prolonged exposure to carcinogens
(T/F)
True
72
The incidence of non-Hodgkin’s lymphomas is six to seven times that of Hodgkin’s disease.
(T/F)
True
73
__________ is an accumulation of lymphatic fluid that results from impaired lymph circulation.
Lymphedema
74
__________ is inflammation of lymphatic vessels.
Lymphangitis
75
The __________ causes infectious mononucleosis.
Epstein-Barr virus
76
The term __________ applies to a group of cancers that affect the lymphatic system.
lymphoma
77
__________ cells are characteristic of Hodgkin’s disease seen in lymph node biopsies.
Reed-Sternberg cells
78
A client has been involved in an automobile accident and is assessed to have an enlarged spleen. What does the nurse understand is the significance of attempting to prevent unnecessary removal of the spleen for this client?
The spleen is a lymphatic structure and assists with phagocytosis
79
A client is in the hospital with a bleeding gastric ulcer and requires a blood transfusion. He has been typed and cross-matched for 2 units of packed red blood cells and found to have type O blood. What type of blood will the nurse administer to this client?
Type O
80
The nurse is discussing vitamin replacement with a client in the clinic. Which vitamin should the nurse discuss with the client in order to increase the absorption of folic acid and iron?
Vitamin C
81
A client is being treated for anemia and has a hemoglobin level of 9.6 g/dL. What does the nurse understand is the basic nutritional component of heme in hemoglobin that the client may be deficient in?
Iron
82
A client is brought to the emergency department with suspected bleeding esophageal varices. Which hemoglobin level should the nurse immediately report to the physician?
5.0 g/dL
83
A client informs the nurse that he is having a difficult time coping with seasonal allergies and have taken some over-the-counter medications to assist with control of symptoms. What results would indicate to the nurse that the client does have allergies?
Elevated eosinophils
84
A client is scheduled for a Schilling test in the morning. What diagnostic results would be indicated if the test is positive? Select all that apply
- Pernicious anemia
| - malabsorption syndromes
85
The nurse is assisting the physician with obtaining a sample to determine the status of blood cell formation. What type of procedure will the nurse have prepared the client for?
A bone marrow aspiration
86
A client is volunteering to donate blood for the second time and was mailed a letter telling him that he has type AB blood. If the client requires a blood transfusion in the future, what type of blood must he receive?
They can receive blood from persons with any type of blood if the Rh factor is compatible
87
A client is taking a medication that has the side effect of depressing the hematopoietic system. What signs of leukopenia should the nurse monitor for while the client is taking this drug?
Fever, sore throat, and chills
88
The nurse is observing the skin of a client who is taking medications that depress the hematopoietic system and notices multiple areas of ecchymosis on the arms; bleeding for a prolonged period after an IV was started; and reports of black, tarry stool. What does the nurse understand may be a side effect of this medication that the client displays?
Thrombocytopenia
89
A client has laboratory studies that determine he is deficient in copper. What does the nurse understand is the importance of copper in the body?
Involved in the transfer of iron from storage to plasma
90
The nursing instructor is talking with her clinical group about coagulopathies. How should the instructor define coagulopathies?
Coagulopathies are bleeding disorders that involve platelets or clotting factors
91
A client is found to have a low hemoglobin and hematocrit when laboratory work was performed. What does the nurse understand the anemia may have resulted from?
- Abnormal erythrocyte production
- Blood loss
- Destruction of normally formed red blood cells
92
A client is experiencing chronic hypovolemic anemia as evidenced by laboratory results. What symptoms does the nurse expect to find for this client when collecting objective data?
Postural hypotension
93
The nurse is caring for a client who is developing hypovolemic shock from a duodenal ulcer bleed. What is the first intervention the nurse can provide to facilitate blood flow to the brain?
Place the client in a modified Trendelenburg postition
94
The nurse is instructing a client about taking a liquid iron preparation for the treatment of iron-deficiency anemia. What should the nurse include in the instructions?
Dilute the liquid preparation with another liquid such as juice and drink with a straw
95
A client is seen in the emergency department with severe pain related to a sickle cell crisis. What does the nurse understand is occurring with this client?
Vascular occlusion in small vessels decreasing blood and oxygen to the tissues
96
A client with sickle cell disease informs the nurse that he is having chest pain. The nurse hears the client coughing, wheezing, and breathing rapidly. What does the nurse suspect is occurring with this client?
Acute Chest Syndrome
97
The nurse is admitting a client with Cooley's anemia to the hospital with a hemoglobin of 6.2 g/dL and hematocrit of 26%. What does the nurse document about the client's skin?
Bronzing of the skin
98
The nurse is assigned to care for a client with polycythemia vera. When the nurse encourages the client to drink 3 L of fluid per day, the client states, Why do I have to drink so much? What is the best response by the nurse?
It helps adequately hydrate you and ensures a sufficient urine production
99
A client is suspected of having leukemia and is having a series of laboratory and diagnostic studies performed. What does the nurse recognize as the hallmark signs of leukemia?
- Easy bruising
- Fatigue from anemia
- Frequent infections
100
A teenaged client with hemophilia sustains a leg laceration after falling off of his skateboard and is brought to the emergency department. The laceration is bleeding profusely even with direct pressure to the site. What does the nurse anticipate will be ordered for administration to control bleeding?
Fresh frozen plasma
101
Yellow bone marrow manufactures blood cells and hemoglobin.
| T/F
False
102
In adults, the normal amount of hemoglobin is 12.0 to 17.4 g/dL.
(T/F)
True
103
Albumin plays a key role in forming blood clots.
| T/F
False
104
The lymphatic system filters and destroys pathogens and removes other potentially harmful substances.
(T/F)
True
105
Some antibiotics and cancer drugs contribute to hematopoietic dysfunction.
(T/F)
True
106
__________ is the manufacture and development of blood cells.
Hematopoiesis
107
The rate of erythrocyte production is regulated by __________, a hormone released by the kidneys.
Erythropoietin
108
An increased number of leukocytes is called __________.
Leukocytosis
109
Blood type is ascertained by identifying the protein, or __________, on the red cell membranes.
Antigen
110
A(n) __________ is used to diagnose pernicious anemia, macrocytic anemia, and malabsorption syndromes.
Schilling test
111
The two variations of PD (Parkinson's Disease) are
young onset and idiopathic
112
In terms of prevalence, PD affects
0.3% of the general population
113
The cardinal symptoms of PD are bradykinesia and
Tremor at rest and muscular rigidity
114
Drugs that cause symptoms that mimicking PD include all of the following except
Valium (diazepam)
115
Which statement about drug induced Parkinsonism is correct?
presentation of symptoms occurs within the first few weeks of drug therapy
116
Which of the following is thought to be a risk factor for PD?
Drinking well water
117
PD is diagnosed primarily through
Clinical signs
118
What percentage of dopamine-producing cells is lost by the time that poor motor coordination occurs?
60-80%
119
Which statement about tremors in PD is correct?
they're the first symptoms in 70% of Patients
120
Bradykinesia is best described as
slowness of voluntary movement and reduced automatic movement
121
Postural instability is a major cause of
falls
122
Some complications from autonomic nervous system involvement are postural hypotension, dysphagia, and
urinary dysfunction
123
The gold standard of antiparkinson medication is
levodopa/carbidopa (sinemet)
124
An important factor to consider when administering levodopa/carbodopa for PD is that
It should be given 1-2 hours before meals
125
Which statement about adverse effects of medication used for PD is correct?
Avoid food with tyramine when taking selegiline (Eldepryl)
126
Which neurosurgical procedure uses a probe to destroy brain tissue in treating musckle rigidity and Bradykinesia?
Pallidotomy
127
Results from brain stem cell transplantation for PD have shown
Worsening of tremors in some patients
128
Which of the following conditions may lead to an ischemic stroke?
a thrombus
129
An Individual who experienced slurring of speech, weakness in an extremity, and a change in LOC that lasted for 10 minutes then disappeared without any long term effects most likely had a
TIA
130
Hemorrhagic stroke can be caused by a
Ruptured arterial aneurysm
131
All of the following are risk factors for a stroke except?
| Looks for wrong answer
Age over 40
132
The "S" in FAST mnemonic refers to
Slurring of speech
133
One of the components of the CPSS assess for
Facial droop
134
The first assessment using the NIHSS should be performed
As soon as a stroke is suspected
135
Which NIHSS score suggests severe debilitation?
24
136
A noncontrast CT scan should be performed within how many minutes of the patient;s arrival to the ED?
25
137
For the patient eith an Ischemic stroke experiencing Hemianopsia, which threatment option may be used?
Thrombectomy
138
According to the AHA stroke algorithm, the patient with suspected stroke should be seen by the stroke team with in how many minutes after arrival to the ED?
15
139
Unless contraindicated, fibirinolytic therapy should be initiated within how many hours of stroke symptoms?
3
140
The gold standard for treating acute ischemic stroke is
tPa
141
A study found that 22.8% of patients with ischemic stroke treatment with tPA experienced which complication
bleeding
142
Administration of tPA is contraindicated for patients with
international normalizing ratios greater than 2
143
Surgical treatment options for a patients who have had a hemorragic stroke include
Aneurysm clipping
144
Which intervention is most appropriate to help prevent aspiration in stoke victims?
Elevate head of bed at least 30%
145
The primary goal of nursing interventions for a patient who's had a stroke is support of
Airway, breathing, and circulation
146
One key characteristic of dementia is
Global impairment
147
The confusion assessment method tool is used to
Identify delirium
148
Which lobe of the brain controls the ability to concentrate and focus
Frontal
149
Patients with deficits in which part of the brain are prone to falls and injuries?
Parietal lobe
150
Which is identified as treatable dementia?
Vitamin B12 deficiency
151
Patients in the second stage of AD develop
Aphasia
152
Which ISN'T included in the four "A"s of AD?
| Looking for wrong answer
Agitation
153
Which drugs may be given to patients with AD for short term increased in functionality?
Cholinesterase inhibitors
154
To help reduce anxiety in patients with AD, nurses should
Establish and follow a routine
155
Vascular dementia is caused by
Reduced blood flow to the brain
156
Which isn't used to treat vascular dementia?
Antipsychotic medication
157
Treating the underlying causes of the disease is the focus for
Vascular dementia
158
Of patients affected by PD for 2 years, about what proportion suffers from Parkinson dementia?
One third
159
Symptoms of Parkinson dementia include
Fluctuations in attention and alertness
160
When do most cases of Frontotemporal Dementia occur?
Before age 65
161
The first symptoms of Frontotemporal dementia are
Behavioral and social skill problems
162
Which type of Dementia is characterized by early executive functioning problems?
Lewy body
163
Which symptom is frequently noted in Lewy body dementia ?
Visual hallucinations
164
The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?
Progressive tissue damage without any verifiable etiology
165
The nurse is caring for a client with chronic fatigue syndrome. What is a realistic nursing intervention when taking care of a client with this diagnosis?
Educate the client about the disease process.
166
The nursing instructor is discussing allergic reactions with her clinical group. What allergic reactions would the nursing instructor talk about?
- Immune complex
- Cytotoxic
- Atopic
167
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?
For their immunosuppressant effects
168
A client with early-stage rheumatoid arthritis asks the nurse what he can do to help ease the symptoms of his disease. What would be the best response by the nurse?
"The doctor could prescribe an anti-inflammatory drug."
169
A client comes to the clinic and states he has broken out in hives and itching since eating strawberries this morning. The client states he has never had problems with strawberries before. What is the best response by the nurse?
It is possible to develop an allergic reaction to something you have had prior exposure to previously.
170
The nurse is talking with a client who was stung by a bee and began having difficulty breathing. What serious complication from injected venom should the nurse discuss with the client?
Airway obstruction
171
The nurse is interviewing a client being admitted to the hospital and inquires about any allergies the client has. The client states he is allergic to aspirin and penicillin. What intervention should the nurse provide immediately to prevent complications related to allergies?
Apply an allergy bracelet and flag the chart
172
A client has been having joint pain and swelling in the left foot and is diagnosed with rheumatoid arthritis. The symptoms began suddenly without any identifiable cause, and the client has significant joint destruction. What type of disease is this considered?
Autoimmune
173
A client with Crohn's disease, an autoimmune disorder, informs the nurse that he has not had any symptoms of the disease in 8 months. What does the nurse understand this asymptomatic period is referred to?
Remission
174
The nurse is collecting data from a client with the autoimmune disorder, endocarditis. What does the nurse recognize as symptom of an acute exacerbation?
Temperature of 100.9
175
A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?
Be alert for signs and symptoms of infection and report immediately
176
A client visits the nurse complaining of diarrhea every time he eats. The client has AIDS and wants to know what he can do to stop having diarrhea. What should the nurse advise?
Avoid fibrous foods, lactose, fat, and caffeine
177
A woman infected with HIV comes into the clinic. What symptoms may be the focus of a medical complaint in women infected with HIV?
Gynecologic problems
178
A client who is HIV/AIDS positive has orders for laboratory tests to be performed. What precautions should the nurse observe whenever there is a risk of exposure to the blood and body fluids of an infected client?
Transport the specimens of body fluids in leak-proof containers
179
A client with AIDS is brought to the clinic by his family. The family tells the nurse the client has become forgetful, with a limited attention span, decreased ability to concentrate, and delusional thinking. What condition is represented by these symptoms?
AIDS dementia complex (ADC)
180
A public health nurse is giving an informational presentation on HIV/AIDS at a nearby college. How would the nurse best define AIDS?
Acquired immunodeficiency syndrome is a potentially life-threatening infection that profoundly weakens the immune system
181
When learning about HIV/AIDS, the student should be able to differentiate the two subtypes of virus by ____.
HIV-1 is more prevalent than HIV-2 subtypes
182
A teenaged client with a diagnosis of HIV presents at the public health clinic complaining of pharyngitis, rash on the palms and soles of his feet, and diarrhea. What would the nurse suspect the client is suffering from?
Acute Retroviral Syndrome (ARS)
183
The nurse is talking with a group of teens about transmission of human immunodeficiency virus (HIV). What body fluids does the nurse inform them will transmit the virus?
- Vaginal secretions
- Breastmilk
- Blood
- Semen
184
A female client informs the nurse that she is considering beginning sexual relations and wants to know the best way to protect herself from a sexually transmitted infection and HIV. What is the best response by the nurse?
Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV.
185
A client requires a blood transfusion for anemia and informs the nurse that he refuses because he doesn't want to contract acquired immune deficiency syndrome (AIDS). What is the best response by the nurse?
The blood is screened very carefully; the risk is approximately 1 in 2,000,000.
186
The nurse is administering an injection to a client with AIDS and, when finished, attempts to recap the needle and sustains a needlestick injury to the finger. What is the priority action by the nurse?
Report the incident to the supervisor
187
The nurse is gathering data from laboratory studies for a client who has HIV. The clients T4-cell count is 200/mm3, and the client has been diagnosed with Pneumocystis pneumonia. What does this indicate to the nurse?
The client has converted from HIV infection to AIDS
188
A client with suspected exposure to HIV has been tested with the enzyme-linked immunosorbent assay (ELISA) with positive results twice. What is the next step for the nurse to explain to the client for confirmation of the diagnosis?
Perform a Western Blot Test for confirmation of diagnosis
189
The nurse is caring for a client with an autoimmune disease. What is
a characteristic of autoimmune disorders?
Progressive tissue damage without any verifiable etiology
190
A client who is symptomatic after having a been stung by a bee is brought to the Emergency room. Which of the following is the initial priority nursing assessment?
Repiratory status
191
When the nurse provides teaching about an autoimmune disorder, what statement by the client demonstrates a correct understanding?
I will be in remission or have occasional exacerbation
192
When all nursing assessment findings are normal for an older adult client who reports being chronically fatigued, it is most appropriate for the nurse to further evaluate the client for which of the following?
Depression
193
A client makes an appointment with a physician because of weight loss and swollen lymph nodes in the axilla and groin. What situation places the client at highest risk for becoming HIV positive?
The client is an IV drug user
194
A nurse is obtaining a clients consent for receiving blood. The client asks if there is any way that HIV can be acquired from the transfusion. Which of the following statements would the nurse be most truthful and accurate in response?
Antibody screening will not detect HIV in donated blood if sufficient antibodies have not yet been produced
195
What causes death in a client with AIDS, which is most correct.
An opportunistic infection
196
Which laboratory test is performed initially to diagnose antibodies to HIV?
Enzyme-linked immunosorbent assay (ELISA) test
197
Patient suspects they have candidiasis. Which signs and symptoms would be observed?
White oral plaque
198
Which statement should the nurse make about an IM injection of immune globulin to a client following exposure to hepatitis A
this Medicaiton provides an immune response more quickly than the body can produce it
199
Preparing to administer varicella immunization to a client. Which should the nurse ask?
Are you pregnant
200
A nurse is reinforcing teaching about self care with a client who has SLE (Systemic Lupus Erythematosis). Which of the following statements by the client indicates understanding?
I should use a milky hair shampoo
201
The nurse is caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?
Progressive tissue damage without any verifiable etiology
202
What is a realistic nursing intervention when taking care of a client with chronic fatigue?
Educate the client about the disease process
203
Client has hives after eating strawberries, they say they have had strawberries and never had issues before, what is the best response by the nurse?
it is possible to develop an allergic reaction to something you have had prior exposure to previously
204
A complete a blood counts indicates that a client is anemic. What disorder in the clients history is most likely a contributing cause for the reduction in the Red Blood Cells?
Renal failure
205
When the nurse reviews a clients complete blood count, what is the most suggestive that the client is at risk for an infection?
A low number of granulocytes
206
A physician tells a client that her body is not making enough blood cells. after the physician leaves, the client appears very upset and states, “I do not even know how my body make blood cells.” what is the simplest, yet correct, instruction for the nurse to give the client at this time?
The bone marrow produces blood cells
207
What blood type could be transfused into anyone if there is no time to perform a type and crossmatch of the recipients blood?
O, Rh negative
208
After completion of a bone marrow aspiration, what is most important for the nurse to monitor?
Bleeding from the puncture sites
209
The nurse is caring for three clients who have the following blood count values: Client A with 24,500/mm3 white blood cells, Client B with 13.4 g/dL hemoglobin, and client C with 250,000/mm3 platelet count. Which statement correctly describes the condition of each client?
Client A has a higher WBC count than normal, Client B has normal hemoglobin count, and Client C has a normal platelet count
210
A Client’s family member asks what hematopoiesis is. What should the nurse tell the family member?
the manufacture and development of blood cells
211
A student is having difficulty understanding the function of globulins. What information can the client provide to the student regarding the function of globulins?
Immunologic agents
212
Undifferentiated cells that migrate to the thymus gland develop into which of the following?
T lymphocytes
213
A client with end-stage renal disease has a decreased red blood cell production. What Medication can the nurse administer with physician’s order that will increase the production of erythrocytes
Epoetin Alfa
214
A client arrives at the emergency room after a motorcycle accident. Vital signs are T. 97.7, P: 122. R 28. BP 96/54. The client has suffered profuse blood loss. From the clinical picture, what position is the best for the nurse to place the client?
Modified trendelenburg
215
The nurse is assessing a client with anemia possibly resulting from malaria. What information would be the most important to ascertain to assist the physician in making a correct diagnosis?
Foreign travel
216
A client has been diagnosed with pernicious anemia. She says “I am worried because my grandmother died of the disease years ago.” What nursing explanation is most accurate?
We now give Vitamin B12 to control the disease
217
The client was admitted to the emergency department after an accident with a chain saw. The client is exhibiting signs and symptoms of acute hypovolemic anemia from severe blood loss. What signs and symptoms would the nurse assess for?
Reduced urine output
218
A client with a diagnosis of pernicious anemia comes to the clinic complaining of numbness and tingling in his arms and legs. What do these symptoms indicate?
Neurologic involvement
219
A client diagnosed with polycythemia Vera has come into the clinic because he has developed a nighttime cough, fatigue, and shortness of breath. From these clinical manifestations, what complication would the nurse suspect in this client?
Congestive Heart Failure
220
The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?
Osteoclasts break down bone cells so pathologic fractures occur
221
A client comes to the walk in clinic complaining of weakness and fatigue. while assessing this client, the nurse finds evidence of petechiae and ecchymoses. the nurse notes that the spleen appears enlarged. what would the nurse suspect is wrong with this client?
Aplastic anemia
222
The nursing instructor is discussing disorders of the hematopoietic system with the pre-nursing pathophysiology class. what disease would the instructor list with a primary characteristic of erythrocytosis
Polycythemia Vera
223
The nurse is instructing the client with sickle cell disease about the use of an inhaled vasodilator that may reduce sickling. what medication is the nurse instructing the client about?
Nitric oxide
224
Which organ of the lymphatic system is responsible for maturation of T-cells?
The thymus
225
What condition is characterized by erythrocytosis, or an increase in circulating erythrocytes?
Polycythemia Vera
226
Cellular and humoral immunity are affected by age-related changes in the lymphatic system, including decreases in primary antigen, T-cell and B-cell responses and antigen production
(T/F)
False
227
Which supplement may play a role in depression, especially for the elderly?
Folic acid
228
While analyzing a client’s complete blood cell count, the nurse finds a decrease number of ____ which indicates a risk for the client to acquire an infection
Granulocytes
229
A nurse is educating an elderly client about the most likely reason they have acquired pernicious anemia. Which of the following of the client's individual factors are the most likely cause of their pernicious anemia?
Use of antacid medication
230
Albumin, which is formed in the kidneys, is the most abundant protein in plasma
(T/F)
False
231
A nursing student is asked to draw a CBC on a patient to check for erythrocyte count. The student knows that factors that influence erythrocyte counts include: select all that apply:
- Age
- Altitude
- Gender
232
A client has been brought to the emergence room do to a MVA and needs a blood transfusion. The nurse knows that because the client's blood type is AB that the client is:
Is the universal recipient
233
The nurse knows that the client needs additional teaching for their diagnosis of Hodgkin’s disease when stress: (Looking for a wrong answer)
I will eat as much as possible during meals to keep my strength
234
A woman is being administered oral radiolabeled vitamin B12, this administration is performed in 4 stages. What test is being performed?
Schilling Test
235
A man presented himself at the hospital complaining of severe swelling of his legs after traveling to India after a vacation. What type of parasite can cause severe swelling of extremities?
Roundworm
236
What type of groups are globulins categorized by?
Alpha group, Beta group, Gamma group
237
What are the clinical symptoms of anemia with inadequate RBC volume?
- Orthostatic hypotension
- Thready pulses
- Oliguria
- Heart murmur
238
Which client statement indicates a good understatement of the nutritional modifications needed to manage iron-deficiency anemia?
Adding fish and eggs to my diet will help reduce my risk of pernicious anemia
239
An elderly gentleman is brought to the emergency room after suffering a major blood loss. He needs a blood transfusion in order to save his life but it will take too long to wait for a blood type and cross test. What blood do you give him?
Type O Blood
240
What infectious agent is a common cause of lymphangitis and/or lymphadenitis?
Streptococcal bacteria
241
All of the following are associated with the lymphatic system except: (looking for the wrong answer)
Kidneys
242
The nurse knows that non-hodgkin’s lymphoma may originate from the following potential causes:
- Genetic factors
- Environmental triggers such as chemical herbicides, pesticides, or hair dye
- The administration of immunosuppressive drugs to prevent transplant rejection
243
A healthy 65 year old male has made an appointment to get his yearly flu shot. After initial assessment, what other vaccines might be appropriate for this patient?
- Shingles vaccine
| - Pneumovax (for pneumonia)
244
Which of the following is the function of macrophages and neutrophils?
Phagocytosis
245
Immunity to a disease after recover is possible because the first exposure to the pathogen has stimulated the formation of which of the following?
Memory cells
246
Which cells are white blood cells with immune functions?
Lymphocytes
247
Which cells have the lifespan of 1 to 2 days and perform phagocytosis?
Leukocytes
248
What immunoglobulin interferes with the entry of pathogens
IgA
249
The Epstein Barr virus causes mononucleosis, and is a contributor to Hodgkin’s lymphoma, what are the key points for this virus?
- Affects people 15-25 years old
- Is transmitted by talking
- Is prevalent in close living quarters
250
The family nurse practitioner is performing a physical assessment on a client with a suspected lymphatic disorder. What would be the nurse practitioner’s primary assessment for all clients with lymphatic disorders?
Enlargement of the lymph glands
251
A client has just been admitted to your unit with a diagnosis of Hodgkin’s disease. When doing the initial assessment, what pertinent questions should the nurse ask the client to help determine the correct nursing diagnosis?
Are you experiencing fever, chills, or night sweats?
252
The thoracic ducts drain lymph from all areas of the body except…
Axillary nodes
253
A pregnant woman receives a T-dap injection at her 34 week OB appointment, the student nurse understands that when the baby is born, it will have what type of immunity because of the Tdap that the mother received?
Passive Immunity
254
The nurse is preparing to assess a patient’s cognitive function. What should the nurse include in this assessment?
- Orientation to time and place
| - Ability to recall recent and past events
255
Autoimmune disorders are those in which…
Killer T cells and autoantibodies attack or destroy natural cells (self cells)
256
After new-hire training for a recent nursing school graduate, the training facilitator realizes the new nurse needs additional training on how to reduce occupational risk for contracting HIV and other blood-born pathogens:
(Looking for wrong answer)
I should always put the cap back on the needle after the blood draw
257
The nurse was accidentally stuck with a needle used on an HIV positive patient. After reporting this, what care should this nurse first receive?
Combination antiretroviral therapy
258
A patient reports “feeling under the weather” for several weeks and is having blood work done to try and determine the cause. The physician is including the ELISA test in the blood work. What would be the expected next step if the ELISA test is positive?
Repeat the ELISA test
259
In the interest of public health, CDC has developed HIV Transmission Prevention strategies. THe strategies address the routes by which HIV can be transmitted and steps that can be taken to reduce or eliminate transmission. Which categories of risk are addressed by these strategies?
- Sexual activity
| - Illegal drugs
260
A nurse is teaching a client about AIDS and HIV and notes that the client needs further education when she states.
(Looking for wrong answer)
AIDS is transmitted before HIV
261
A client is presenting an anaphylactic response to unknowingly ingesting nuts at a family celebration. What action is of primary importance upon admission?
Maintain airway
262
Which are the appropriate interventions to help a client with autoimmune disorder deal with joint pain secondary to inflammation, malaise, and fatigue?
- Exercise regularly during periods of remission
- Use non-pharmacological pain management strategies
- Rest during periods of severe exacerbation
263
TPA (tissue plasminogen activator) is indicated for which of the following:
Ischemic stroke
264
Primary nursing assessments and interventions for a client who recently suffered a stroke includes all of the following except:
Blood glucose levels
265
Which part of the brain is responsible for the sensation of touch, pain, and temperature and responsible for speech, language, and though expressions?
Perietal Lobe
266
How long after patient arrives at the ER with stroke symptoms should CT scan results be available for the stroke team and decision of treatment made?
45 mins
267
The nurse has received a prescription to transfuse a client with a unit of packed red blood cells, before explaining the procedure to the client, the nurse should ask which initial question?
Have you ever had a transfusion before?
268
Dementia can affect adults of any age
| T/F
True
269
Types of dementia include
- Alzheimer's
- Vascular
- Parkinson's
- Lewy body
