Question 1

The nurse is caring for a patient who reports feeling very stressed about her new diagnosis of fibromyalgia.Which response 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 2

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 3

The nurse is caring for an immune compromised patient.The patient displays a low-grade fever and complains of a burning and shooting pain,along with itching and tingling,that progresses from the clavicle to the scapula.The nurse suspects that the patient will undergo evaluation for which infection?

Accepted Answer

The immune compromised patient may experience opportunistic infections.Hepatitis C,bacterial infections,and cryptococcosis are all opportunistic infections,but the symptoms this patient is experiencing are consistent with shingles.

Question 4

The nurse has just administered a new antibiotic to a patient.Which manifestation is the best early indicator that the patient may be experiencing 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 5

The patient scheduled for a computed tomography (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 6

The nurse is caring for a pediatric patient recently diagnosed with severe combined immunodeficiency (SCID)disease.The nurse determines that teaching has been effective after the parent makes which statement?

Accepted Answer

There are two forms of immune deficiency: primary and acquired.In primary immune deficiency disorders (PIDD),the cause is an inherited genetic mutation and some of PIDD are detected during infancy or early childhood.Patients with this type of disorder experience repeated infections that clearly increase their risk of morbidity and mortality as well as the cost of health care.AIDS is an example of acquired immune deficiency and affects pediatric patients as well as adults.Hemophilia is a disorder in which patients can suffer life-threatening bleeds from a fall.Chemotherapy recipients may develop an acquired immune disorder,but chemotherapy would not cause any type of immune disorder in the child.

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.Which nutritional intervention is most appropriate for this patient?

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 vitamin B₁₂ will not address either the need for weight gain or antibody synthesis.

Question 8

MOPP and ABVD therapy for the treatment of Hodgkin disease are treatment protocols that use which combination of factors?

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 9

The nurse is preparing to write a care plan for the patient with fibromyalgia.Which problem/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.

Question 10

The nurse is educating a patient about his diagnosis of stage II Hodgkin disease.Which statement indicates that the nurse's teaching has been successful?

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 11

The nurse is working in a trauma unit and is accidentally stuck with an IV needle following venipuncture of the patient.What is the nurse's first action?

Accepted Answer

The area should first be cleansed in an attempt to flush any pathogenic organisms from the site,followed by reporting the incident to the charge nurse and completing an incident report.Appropriate treatment regimen will then be started.

Question 12

The nurse is educating a patient with lymphoma.Which statement indicates that the patient correctly differentiates Hodgkin lymphoma (HL)and non-Hodgkin lymphoma (NHL)?

Accepted Answer

NHL is less predictable and can spread faster than HL.Additionally,this statement features a comparison.NHL usually begins with unilateral,painless enlargement of a single lymph node.Expressing an understanding about implication of age as a risk factor or need for blood work does not differentiate specific details about either type of lymphoma.

Question 13

The nurse is educating a patient with systemic lupus erythematosus (SLE).Which information is most important for the nurse to include in the teaching plan?

Accepted Answer

Skin protection for patients with SLE is a top priority.The patient should be advised to liberally apply fragrance-free lotions to dry areas at least twice daily.Weight training could cause joint strain.SLE patients should choose a mild soap with a glycerin base and select sunscreen that features SPF of 30 or higher.

Question 14

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 15

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

Accepted Answer

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

Question 16

The home health nurse is teaching the HIV-positive patient and his family members about infection control in the home.Which action indicates that the nurse's teaching has been successful?

Accepted Answer

The nurse should encourage always donning protective gloves when performing household tasks.After cleaning the bathrooms with a regular household cleaner,disinfect with a 1:10 bleach solution.Soiled laundry should be placed into a closed plastic bag before laundering,not left in an open hamper.It is not necessary to refuse visitors based on certain months of the year; infection control involves proper hand hygiene,avoiding actively ill individuals,and adequately disinfecting surfaces and substances that may have come into contact with contaminated body fluids.

Question 17

The nurse is performing an assessment on a patient admitted for diagnostic testing to rule out fibromyalgia.Which assessment finding indicates 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 18

The nurse is caring for a patient with suspected Hodgkin's lymphoma (HL).For confirmation of this diagnosis,the nurse understands that the patient's blood work would reveal which type of abnormal cell?

Accepted Answer

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

Question 19

The nurse caring for a patient with advanced AIDS.While collecting data,the nurse notes a weight loss of several pounds,poor food consumption,and complaint of no appetite.Based on these findings,the nurse should carefully monitor the patient for development of which problem?

Accepted Answer

Anasarca is generalized edema in the trunk,extremities,and around the eyes.It results in patients with advanced AIDS from a severe depletion of albumin when the patient has an insufficient nutritional intake,as is evident with this patient.Lymphedema is an abnormal collection of lymph fluid accumulated in the peripheral and periorbital areas,sometimes seen in AIDS patients.Hypoglycemia and hypotension are typically seen in patients with advanced AIDS who have poor nutritional and fluid intake.

Question 20

The home care nurse is caring for a patient with a severe immune deficiency disorder.What information about infection prevention is most important for the nurse to include in the teaching plan?

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.

Quiz 11: Care of Patients with Immune and Lymphatic Disorders (with HIV and AIDS)