Question 1

The patient scheduled for a CT scan with contrast medium questions the nurse why the technologist asked her if she had any food allergies.Which response by the nurse is correct?

Accepted Answer

Allergies to seafood indicate intolerance to iodine.This means there is potential for an allergic reaction to iodine-based contrast agents used in radiologic imaging studies such as CT scans with contrast medium.

Question 2

The nurse has just administered a new antibiotic to a patient.What sign or symptom should the nurse be alert to that would be an early indication of an anaphylactic reaction?

Accepted Answer

The appearance of hives (urticaria)or swelling beneath the skin (angioedema)may signal the onset of an anaphylactic episode.Wheezing,shortness of breath,and difficulty swallowing are later signs of anaphylaxis.

Question 3

The nurse caring for the patient with lymphedema of the left arm will implement what intervention?

Accepted Answer

Taking blood pressure and giving injections in the right arm will reduce the probability of further injury to the left arm.The left arm should be placed above the level of the heart for fluid drainage.Muscle activity enhances the reabsorption of the fluid.Massaging the arm will increase circulation.

Question 4

When the patient has an immediate allergic reaction to the injection of radiopaque dye,the nurse is aware that this immediate response is a type ___ response,which is _____ generated.

Accepted Answer

An immediate allergic reaction is a type 1 response,which is mast cell generated.Type 2 are delayed reactions.

Question 5

The nurse is performing an assessment on a patient admitted for diagnostic testing to rule out fibromyalgia.Which assessment finding would indicate that the patient actually may have the disorder?

Accepted Answer

Allodynia,pain response to nonpainful stimuli,is one of the signs typically seen in the patient with fibromyalgia.Patients with fibromyalgia often experience hyperalgesia,which is a heightened response to painful stimuli.

Question 6

The nurse is assessing a 75-year-old patient who has presented to the ambulatory care clinic for an annual physical.The patient tells the nurse she seems to get sick more the older she gets.She questions the nurse about the reason.What response by the nurse is most appropriate?

Accepted Answer

Aging does not affect the bone marrow to a significant degree.It does cause the thymus gland to become smaller,and T cells apparently diminish in the circulation;B-cell numbers usually remain the same.All the mechanisms involved in decreased immune function are not yet clear,but it is apparent that after age 70 there is a definite decline in the function of the immune system.The patient may indeed need a flu vaccine,but this does not answer the inquiry posed by the patient.

Question 7

A patient with an immune deficiency disorder has been admitted to the medical unit due to a current infection and weight loss of 12% of his body weight.The most appropriate nutritional intervention for this patient would be to encourage foods high in:

Accepted Answer

Foods high in protein will not only help with increasing weight but will aid in synthesizing needed antibodies for this condition.Fats,vitamin C,and B₁₂ will not address either the need for weight gain or antibody synthesis.

Question 8

The patient with cancer has experienced sensitivity to past chemotherapy infusions.The best action to prevent a hypersensitivity reaction is the administration of _____ prior to the chemotherapy infusion.

Accepted Answer

Steroids or corticosteroids,such as dexamethasone,and antihistamines are given prior to administration of substances that are known to cause hypersensitivity reactions in order to prevent such reactions or anaphylaxis.Daclizumab and antithymocyte globulin are antirejection medications used with transplants,and epinephrine is given to treat an anaphylactic reaction.

Question 9

The nurse is providing teaching to a patient who has undergone a liver transplant.Which statement by the patient demonstrates the need for further patient teaching?

Accepted Answer

Immune suppression medications will need to be taken for the rest of the patient's life in order to increase the chances of avoiding organ rejection.Boosting the patient's immune system would lead to organ rejection.Individuals with infections should be avoided since the immune system is depressed.Doses of medications must be evaluated for necessary adjustments throughout the patient's lifetime.

Question 10

MOPP and ABVD therapy for the treatment of Hodgkin's disease are treatment protocols using:

Accepted Answer

MOPP and ABVD are chemotherapy treatment protocols using a combination of four drugs given concurrently.MOPP is the acronym for the drugs mechlorethamine,vincristine (Oncovin),procarbazine,and prednisone.ABVD is the acronym for the drugs doxorubicin (Adriamycin),bleomycin,vinblastine,and dacarbazine.This treatment protocol is usually used for stages III and IV of the disease.

Question 11

The patient reports that he has been diagnosed with stage II Hodgkin's disease.The nurse interprets this to mean that the infected lymph node involvement could be:

Accepted Answer

Stage II indicates that there are two or more involved lymph nodes on the same side of the diaphragm (or body).The lymph nodes affected could be in any part of the lymphatic system.The disease spreading outside of the lymph system indicates stage IV.Single node involvement is stage I,and lymph involvement on both sides of the diaphragm or body is considered stage III.

Question 12

The home care nurse is caring for a patient with a severe immune deficiency disorder.What patient teaching point should be stressed in regard to the prevention of infection?

Accepted Answer

In order to prevent infection,meticulous hand hygiene must be practiced.Monitoring the temperature,monitoring for signs of infection,and reporting signs of infection to the physician are not preventative measures but early intervention if infection occurs.

Question 13

After an influenza immunization,the patient complains of shortness of breath,breaks out in hives,and begins to twitch.What should the nurse initially give?

Accepted Answer

Epinephrine is the initial line of defense to reverse anaphylaxis,followed by high-flow oxygen,bronchodilators,and corticosteroid injection as necessary.

Question 14

The primary care provider suspects the patient has lymphoma.The patient asks the nurse how the physician will know which type of lymphoma he has.Which response by the nurse is correct?

Accepted Answer

Lymphomas are diagnosed by looking at the types of lymphocytes present.Red blood cells,neutrophils,and hemoglobin and hematocrit are not used in the diagnosis of lymphoma.

Question 15

The patient voices feeling very stressed regarding her immune deficiency diagnosis and the care regimen.Which response by the nurse is most beneficial in addressing the patient's stress?

Accepted Answer

Although light exercise and relaxation techniques may be helpful in reducing stress,the nurse should first address concerns and provide information about the disorder.Providing necessary information is a major stress reducer.Stating only that the nurse "can't imagine how you feel" provides no therapeutic value,and medications are not a first-line treatment for stress.

Question 16

The patient has been diagnosed with Hodgkin's lymphoma.The nurse is aware that this patient has which type of cells present in the blood?

Accepted Answer

If Reed-Sternberg (R-S)cells are present,the patient has Hodgkin's lymphoma.If the R-S cells are not present,the patient is diagnosed as having non-Hodgkin's lymphoma.Non-Hodgkin's lymphoma is then identified as either B-cell or T-cell lymphoma.

Question 17

The patient with rheumatoid arthritis is prescribed an immunosuppressant drug.The patient asks the nurse what this drug is for.What is the nurse's best response?

Accepted Answer

Rheumatoid arthritis is an autoimmune disease in which the immune system becomes overactive and the body begins destroying its own tissues;in this case,the joints.The immunosuppressant medication helps inhibit this overreaction of the immune system.

Question 18

Education for the patient with systemic lupus erythematosus (SLE)should include what teaching point?

Accepted Answer

Protection against UV rays with a potent sunscreen is advised.NSAIDs are used for pain relief.Alcohol-based skin application and joint strain should be avoided.

Question 19

The nurse is assessing a patient's lymph nodes.Which finding would alert the nurse to the possibility of the patient having non-Hodgkin's lymphoma (NHL)?

Accepted Answer

NHL typically manifests as enlargement in one node,then one or more nodes are skipped,and then another node is affected (noncontiguous).These enlarged nodes are usually painless with NHL.

Question 20

The nurse is preparing to write a care plan for the patient with fibromyalgia.Which nursing diagnosis best addresses this disorder?

Accepted Answer

Pain is the predominant symptom with fibromyalgia.The pain can lead to other problems,such as fatigue,impaired mobility,and activity intolerance;however,if the pain can be controlled,other health problems may be reduced.

Quiz 12: Care of Patients With Immune and Lymphatic Disorders