Deck 34: Caring for Clients With Immune-Mediated Disorders

Question 1

A client with immune disorder has been hospitalized. What information should the nurse pay particular attention to during the initial interview of a client with immune disorder?

A) Information about the client's diet
B) Information about the client's lifestyle
C) Information about the client's work environment
D) Information about the client's family members' history of chronic diseases

Answer 1

Information about the client's family members' history of chronic diseases

Question 2

A client presents at the walk-in clinic with watery eyes, sneezing, itching, and redness in the conjunctiva bilaterally. What might the nurse suspect this client is suffering from?

A) Anaphalactic shock
B) Angioedema
C) An allergy
D) An autoimmune disorder

Answer 2

An allergy

Question 3

A public health nurse is presenting a workshop for a local Parent Teacher Organization. After the presentation, one of the parents takes the nurse aside and asks her what causes chronic fatigue syndrome. What should the nurse respond?

A) "Some people think it is all psychological."
B) "We don't know for sure, it is all just theory and supposition."
C) "Some people think that B cells are activated in the beginning in response to a bacteria and inflammatory cytokines remain elevated."
D) "We don't know for sure but some think that T cells are activated initially in response to a virus and that levels of proinflammatory cytokines, such as various interleukins and tumor necrosis factor, remain elevated."

Answer 3

"We don't know for sure but some think that T cells are activated initially in response to a virus and that levels of proinflammatory cytokines, such as various interleukins and tumor necrosis factor, remain elevated."

Question 4

The nursing instructor is discussing allergic reactions with their clinical group. What allergic reactions would the nursing instructor talk about? Select all that apply.

A) Atypical
B) Unmediated
C) Cytotoxic
D) Atopic
E) Immune complex

Question 5

A client presents to the walk-in clinic complaining of fatigue, headaches, joint pain and unrefreshing sleep. The client is diagnosed with chronic fatigue syndrome. What other symptoms might the client exhibit?

A) Red, tender joints
B) High grade fever
C) Defects in the visual field
D) Halo's around lights

Question 6

Your client is about to have a skin test for an allergic disorder. What critical instruction should the nurse give this client?

A) Avoid red meat for 48 to 72 hours before the test.
B) Avoid strenuous physical activity for 24 hours before the test.
C) Avoid antihistamines and cold preparations for 48 to 72 hours before the test.
D) Avoid sunlight for 48 to 72 hours before the test.

Question 7

What nursing intervention helps reduce itchiness or prevent the client from scratching the skin would you institute with a client who has an allergic reaction and tends to itch due to histamine release?

A) Advise the client to use distracting techniques.
B) Advise the client to avoid superfatted or Castile soap.
C) Advise the client to dress in warm, woolly garments.
D) Advise the client to avoid being in a humid environment.

Question 8

Clients with immune-related disorders are told not to include allergenic proteins in their diet. What foods should these clients include in their diet?

A) Milk
B) Soybean oil
C) Egg whites
D) Peanuts

Question 9

A client has been hospitalized for diagnostic testing. The client has just been diagnosed with Multiple Sclerosis which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?

A) A disorder where the body has to many immunoglobulins.
B) A disorder where histocompatible cells attack the immunoglobulins.
C) A disorder where killer T cells and autoantibodies attack or destroy natural cells-those cells that are "self."
D) A disorder where the body does not have enough immunoglobulins.

Question 10

The clinic nurse is caring for a 74-year-old who tells the nurse they have chronic fatigue syndrome. What important factors should be considered in the case of an older adult who reports chronic fatigue?

A) Diet
B) Activity levels
C) Home environment
D) Mental status

Question 11

A client with Lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?

A) To decrease the body's risk of infection
B) Because an autoimmune disease is a neoplastic disease
C) So the client has strong drug therapy
D) For their immunosuppressant effects

Question 12

You are caring for a client with chronic fatigue syndrome. What is a realistic nursing intervention when taking care of a client with this diagnosis?

A) Educate the client about the disease process.
B) Advise the client to avoid moderate exertion.
C) Instruct the client to reduce the intake of potassium-rich foods.
D) Advise the client to avoid being in crowds.

Question 13

The clinic nurse is caring for a client with an allergic disorder who has received the first sensitizing dose of a new drug. Now, the client is given a second dose. What nursing action is most important at this stage of transition?

A) Assess the client for reduced urine output.
B) Monitor the client for reactions.
C) Assess the client for reduced appetite.
D) Monitor the client for increased heart rate.

Question 14

A student nurse is caring for a client in the clinic diagnosed with chronic fatigue syndrome. The student asks the client what their original symptoms were. What might the client say?

A) Refreshing sleep
B) Myalgia
C) Red, swollen joints
D) Hypersensitive gastrointestinal tract

Question 15

A client being treated for an allergy has been prescribed antihistamines. The Kardex of this client reads as follows:Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully.What information from the Kardex is likely to have the greatest implication in educating the client about antihistamine administration?

A) The client's age
B) The client's smoking habit
C) The client's profession
D) The client's medical history

Question 16

You are caring for a client with an autoimmune disease. What is a characteristic of autoimmune disorders?

A) Unrelenting, progressive tissue damage without any verifiable etiology
B) Absence of a triggering event
C) Profound fatigue with no identifiable cause
D) Affects only older adults and infants less than 3 months

Question 17

A client presents at the clinic with an allergic disorder. The client asks the nurse what an "allergic disorder" means. What would be the nurse's best response?

A) "It means you are very sensitive to something inside of yourself."
B) "It is a hyperimmune response to something in the environment that is usually harmless."
C) "It is a muted response to something in the environment."
D) "It is a harmless reaction to something in the environment."

Question 18

Chronic fatigue syndrome is thought by some to be a disorder resulting from which of the following?

A) Immune-system dysregulation
B) Chronic viral inflammation
C) Depression of cytokines
D) Decrease in interleukins

Question 19

The clinic nurse is caring for a client with episodic periods of acute exacerbations. The client has reacted well to the prescribed medications and is now in a state of remission. What advice should the nurse give this client?

A) Continue administering medicines as prescribed.
B) Discontinue the prescribed medication.
C) Consult the physician for a gradual decrease in the dosage of the prescribed medication.
D) Consult the physician for an increase in the dosage of the prescribed medication.

Question 20

A client with an allergic disorder calls the nurse and asks what treatment is available for allergic disorders. The nurse explains to the client that there is more than one treatment available. What treatments would the nurse tell the client about?

A) Sublingual-swallow immunotherapy (SLIT)
B) Desensitization
C) Sublingual-topical immunotherapy (STIT)
D) Resensitization

Question 21

A client with an allergic disorder is in treatment for their disorder. What might their treatment be?

A) Autoimmune therapy
B) Hypersensitive therapy
C) Resensitization therapy
D) Drug therapy

Question 22

A client has just been diagnosed with an allergic disorder and skin testing has been ordered. What instructions should the nurse give to the client about skin testing?

A) Avoid taking prescribed or over-the-counter antihistamine or cold preparations for at least 48 to 72 hours before testing.
B) Don't eat or drink anything for at least 8 hours before the test.
C) Take a shower with hot soapy water right before coming in for testing.
D) Avoid taking prescribed or over-the-counter medications for at least 48 to 72 hours before testing

Question 23

The nursing instructor is talking with the junior nursing class about autoimmune disorders. What disease process would the instructor name as an autoimmune disorder?

A) Multiple myeloma
B) Systemic duploid disease
C) Fibromyalgia
D) Persistent degenerative myelitis

Question 24

A client with an autoimmune disorder tells the nurse they are not sure they understand what an autoimmune disorder is. What would be the nurse's best response?

A) "An autoimmune disorder is characterized by a decrease in immunoglobulins."
B) "An autoimmune disorder is characterized by progressive tissue damage without any verifiable cause."
C) "An autoimmune disorder is characterized by the body attacking antibodies from the environment."
D) "An autoimmune disorder is characterized by the body being hypersensitive to an environmental allergen."

Question 25

A client with early stage rheumatoid arthritis asks the nurse what they can do to help ease the symptoms of their disease. What would be the best response by the nurse?

A) "The doctor could prescribe anti-inflammatory drugs."
B) "The doctor could prescribe antipyretic drugs."
C) "The doctor could prescribe antineoplastic drugs."
D) "The doctor could prescribe antihypertensive drugs."