Deck 32: Immunologic Disorders

Question 1

A nurse is assessing a patient with AIDS for risk factors.What is recognized as the most risky behavior in the patient history?

A) Oral sex without contact with the glans penis
B) Oral sex with a condom
C) Use of sex toys
D) Anal sex with a condom

Answer 1

Anal sex with a condom

Question 2

A patient with HIV is diagnosed with progressive multifocal leukoencephalopathy (PML).What should a nurse encourage the patient to do?

A) Take daily exercise for 30 minutes.
B) Avoid excessive fats in the diet.
C) Remove all potted plants from inside the home.
D) Prepare advanced directives.

Answer 2

Prepare advanced directives.

Question 3

A very anxious young man comes to the clinic believing that he may have HIV infection because of his persistent influenza-like symptoms and his risky sexual behavior.What should the nurse anticipate that a positive blood analysis would show?

A) High levels of CD8 cells
B) High levels of HIV-infected cells
C) Low levels of T cells
D) Low levels of antibodies

Answer 3

High levels of HIV-infected cells

Question 4

When is a patient with HIV considered to have progressed to AIDS?

A) Two or more opportunistic infections are diagnosed.
B) Kaposi sarcoma appears.
C) CD4 cell level drops to 200.
D) Patient tested positive for enzyme-linked immunosorbent assay (ELISA).

Question 5

How long does the initial stage of an HIV infection usually last?

A) 2 to 4 weeks
B) 4 to 8 weeks
C) 8 to 12 weeks
D) 12 to 16 weeks

Question 6

A nurse removes a potted plant from the room of a patient with HIV.What is the nurse trying to prevent?

A) Aspergillosis
B) Candidiasis
C) Coccidioidomycosis
D) Cytomegalovirus (CMV)

Question 7

What should a patient be encouraged to do before the initiation of any anti-HIV drug protocol?

A) Give up sexual activity for several months.
B) Follow the strict dietary guidelines.
C) Comply with the drug protocol.
D) Involve the partner in a support program.

Question 8

What should a patient with HIV avoid to prevent bacillary angiomatosis (BA)?

A) Cats
B) Large crowds of people
C) Consuming unwashed fruits
D) Exposure to mosquito bites

Question 9

Which should take priority in the care of an outpatient with AIDS?

A) Therapeutic regimen management
B) Physical mobility
C) Skin integrity
D) Social isolation

Question 10

What is the most common form of transmission of the HIV virus?

A) Injection drug use
B) Heterosexual contact
C) Exposure to contaminated blood products
D) Male to male

Question 11

A young man at the HIV clinic tells the nurse how relieved he is that he does not have HIV because he now has no symptoms at all when just a few weeks ago he felt awful.What is the most appropriate nursing response?

A) "Flulike symptoms frequently are misdiagnosed as HIV."
B) "In the latent stage, the physical symptoms are reduced, but the HIV is still present in the lymph nodes."
C) "A high antibody count can overwhelm HIV infection in the early stage."
D) "Antiretroviral drugs are very effective in the first stage in reducing symptoms."

Question 12

A nurse is caring for a patient with HIV infection taking Retrovir, a nucleoside antiviral that is a reverse transcriptase inhibitor.For what should the nurse be especially observant?

A) Decreased urine output
B) Hypertensive episodes
C) Jaundice
D) Edema of the face

Question 13

A patient with HIV complains to the home health nurse that he has been having watery diarrhea for the past 10 days.The nurse suspects toxoplasmosis.What is the most significant question for the nurse to ask?

A) "Have you stopped taking your antiviral medication?"
B) "Have you been drinking alcohol?"
C) "Have you been eating aged cheese or organ meats?"
D) "Do you have a cat?"

Question 14

What indicates that a patient has entered the third stage of HIV infection?

A) T-helper CD4 cell count of 500
B) Rise in antibody count
C) Drop in viral load
D) Increase in T4 helper cells

Question 15

What childhood exposure causes painful shingles experienced by the patient with HIV?

A) Measles
B) Mumps
C) Impetigo
D) Chickenpox

Question 16

A nurse is educating patients about the progression of HIV infections.Which statement by the patient in the latent stage indicates that teaching has been effective?

A) "I had better get my affairs in order.I don't have a lot of time left."
B) "Whew! I thought when I got AIDS that I was a 'goner.'"
C) "Now I won't have to take all those expensive drugs that I have been using."
D) "I can still enjoy life and live pretty much as I want for the next several years."

Question 17

What does enzyme reverse transcriptase transcribe?

A) DNA to mimic CD4 cells
B) T4-helper cells to RNA
C) HIV RNA to HIV DNA
D) T4 cells to HIV virions

Question 18

A nurse is preparing a teaching plan for a patient with HIV who has been diagnosed with microsporidiosis.Which implementation should be included?

A) Drink 3 quarts of fluid a day to combat dehydration.
B) Include milk products with every meal.
C) Consume liberal amounts of fat for increased energy.
D) Limit protein intake to reduce serum ammonia levels.

Question 19

Which population, according to statistics from the Centers for Disease Control and Prevention (CDC), has the greatest incidence of human immunodeficiency viral (HIV)infection in the United States?

A) Asian Americans
B) African Americans
C) Latinos
D) Whites

Question 20

Which nursing action should be implemented to increase the comfort of a patient with oral hair leukoplakia?

A) Allow aspirin to melt in the mouth and then wash out with warm water.
B) Encourage mouth rinses with warm salt water several times a day.
C) Limit intake of ice cream and other cold foods.
D) Offer fluids through a straw.

Question 21

A nurse assesses a neutrophil count of 900/mm³ in a patient with acute leukemia.What should the nurse anticipate initiating?

A) A high-protein diet
B) Increased doses of steroids
C) Compromised host precautions
D) Injections of blood-building medication

Question 22

The nursing staff of an oncology unit cautions visitors to be free of infections before visiting patients.What can chemotherapy and decreased bone marrow production cause in these patients?

A) Hemorrhage
B) Neutropenia
C) Edema
D) Hypovolemia

Question 23

A nurse is caring for a patient with thrombotic thrombocytopenic purpura who is having plasmapheresis every day.Which assessment alerts the nurse of a complication?

A) Hypotension
B) Seizure activity
C) Diarrhea
D) Intense headache

Question 24

A nurse explains that HIV is introduced to the systemic circulation by the _____, which is found in the mucous membranes.

Question 25

What should a nurse include when developing a plan of care for a patient with human immunodeficiency virus (HIV)?

A) Careful aseptic technique to prevent infection
B) Instruction to limit fluids to prevent congestive heart failure
C) Oral alcohol rinses to control mouth infections
D) Selections of high-fat foods in the daily diet

Question 26

A nurse explains to a pregnant patient with AIDS that her baby will be treated with antiretroviral drugs for _____ weeks after birth.(Use numeric characters only.)

Question 27

Which populations are at the highest risks of contracting HIV? (Select all that apply.)

A) Health care workers who mishandle infected sharps
B) Breastfed infants of HIV-infected mothers
C) Persons sharing living quarters with an HIV-infected person
D) Heterosexual partners of an HIV-infected person
E) Newborns of an HIV-infected mother

Question 28

What is most appropriate for a nurse to include when preparing discharge plans for a patient with SLE?

A) Need to consume 2 L of fluid daily
B) Close monitoring of daily blood glucose level
C) Use of daily sunscreens with a sun protection factor (SPF)higher than 15
D) Careful concern for certain food allergies

Question 29

A nurse explains that in autoimmune diseases, the body identifies its own proteins as foreign matter and sets out to destroy itself.Which are examples of autoimmune diseases? (Select all that apply.)

A) SLE
B) Type 1 diabetes mellitus (DM)
C) Rheumatoid arthritis (RA)
D) Osteoarthritis
E) Pancreatitis

Question 30

An 11-year-old girl is diagnosed with idiopathic thrombocytopenic purpura (ITP).Which parental statement helps the nurse evaluate that teaching is successful?

A) "Our daughter can still be involved in gymnastics."
B) "When our daughter's hemoglobin falls below 3.5, she'll need blood."
C) "Our daughter will need genetic counseling before she marries."
D) "Our daughter should avoid drugs containing sulfonamides."

Question 31

A nurse is caring for a patient in the last stages of leukemia and is aware that the patient is at risk from the bacteria of his own body.Which is an example of internal bacteria?

A) Beta-hemolytic streptococci
B) Streptococcus pneumoniae
C) Streptococcus viridans
D) Pseudomonas aeruginosa

Question 32

Which opportunistic fungal diseases threaten patients with HIV? (Select all that apply.)

A) Aspergillosis
B) Pneumocystis jiroveci
C) Herpes simplex
D) Oral hairy leukoplakia
E) Tuberculosis

Question 33

A nurse is caring for a patient with HIV infection who has been prescribed highly active antiretroviral therapy (HAART).What should the nurse warn the patient that inconsistent administration of the drug can result in?

A) HIV strain becoming resistant to the drug
B) Decrease in antibodies in the circulating volume
C) Addition of another antiretroviral agent to the protocol
D) Rapid increase in the symptoms of AIDS

Question 34

A nurse is designing a teaching plan for a patient with AIDS.What should be included relative to food preparation precautions? (Select all that apply.)

A) Check expiration dates on frozen foods.
B) Leave produce unwashed to preserve protective spray.
C) Drink a small glass of red wine before each meal to stimulate the appetite.
D) Eat three large, well-balanced meals daily.
E) Avoid leftovers.

Question 35

Which symptom should a nurse recognize as being pertinent to a possible diagnosis of systemic lupus erythematosus (SLE)?

A) Butterfly rash of the face
B) Protruding abdomen
C) Thinning hair
D) Bloody diarrhea

Question 36

Which statement by a patient diagnosed with AIDS should lead a nurse to suspect an infection by CMV?

A) "I need to get glasses; I can't see as well as I did a few months ago."
B) "I need to drink more water.This diarrhea has really dehydrated me."
C) "I need to get smaller clothes.I have lost 10 lb in the past 6 weeks."
D) "I need to take some pep pills.I don't have any energy."

Question 37

What sign should a nurse report when caring for the patient with AIDS who has cutaneous Kaposi sarcoma?

A) Nausea
B) Fatigue
C) Abdominal pain
D) Weight loss

Question 38

Which factors explain the increase in HIV infections in persons over the age of 50 years? (Select all that apply.)

A) Older persons are usually not questioned by health professionals about sex or drug abuse.
B) Older persons are more promiscuous in earlier years.
C) Older persons are less likely to seek HIV screening.
D) Older persons mistake HIV symptoms as part of the discomforts of increased age.
E) Older persons tend to use hormonal forms of contraception.

Question 39

A 24-year-old woman is admitted to the hospital for a complete medical examination.Her current complaints are indicative of SLE.Which symptom would indicate this diagnosis?

A) Recent weight gain of 10 lb
B) Difficulty breathing in the morning
C) Frequent episodes of diarrhea
D) Musculoskeletal pain in the hands