Deck 42: The Child With an Immunologic Alteration

Question 1

What is the drug of choice the nurse should administer in the acute treatment of anaphylaxis?

A) Diphenhydramine
B) Histamine inhibitor (cimetidine)
C) Epinephrine
D) Albuterol

Answer 1

Epinephrine

Question 2

What is the primary nursing concern for a child having an anaphylactic reaction?

A) Identifying the offending allergen
B) Ineffective breathing pattern
C) Increased cardiac output
D) Positioning to facilitate comfort

Answer 2

Ineffective breathing pattern

Question 3

What is the primary nursing concern for a hospitalized child with HIV infection?

A) Maintaining growth and development
B) Eating foods that the family brings to the child
C) Consideration of parental limitations and weaknesses
D) Resting for 2 to 3 hours twice a day

Answer 3

Maintaining growth and development

Question 4

Which statement by a mother about antiretroviral agents for the management for her 5-year-old child with acquired immunodeficiency syndrome (AIDS)indicates that she has a good understanding?

A) "When my child's pain increases, I double the recommended dosage of antiretroviral medication."
B) "Addiction is a risk, so I only use the medication as ordered."
C) "Doses of the antiretroviral medication are selected on the basis of my child's age and growth."
D) "By the time my child is an adolescent she will not need her antiretroviral medications any longer."

Question 5

A nurse in a well-child clinic is teaching parents about their child's immune system.Which statement by the nurse is correct?

A) The immune system distinguishes and actively protects the body's own cells from foreign substances.
B) The immune system is fully developed by 1 year of age.
C) The immune system protects the child against communicable diseases in the first 6 years of life.
D) The immune system responds to an offending agent by producing antigens.

Question 6

A nurse is teaching parents about the importance of immunizations for infants because of immaturity of the immune system.The parents demonstrate that they understand the teaching if they make which statement?

A) "The spleen reaches full size by 1 year of age."
B) "IgM, IgE, and IgD levels are high at birth."
C) "IgG levels in the newborn infant are low at birth."
D) "Absolute lymphocyte counts reach a peak during the first year."

Question 7

What is caused by a virus that primarily infects a specific subset of T lymphocytes,the CD4+ T cells?

A) Wiskott-Aldrich syndrome
B) Idiopathic thrombocytopenic purpura
C) Acquired immunodeficiency syndrome (AIDS)
D) Severe combined immunodeficiency disease

Question 8

The Center for Disease Control (CDC,2009)recommendation for immunizing infants who are HIV positive is

A) Follow the routine immunization schedule.
B) Routine immunizations are administered; assess CD4+ counts before administering the MMR and varicella vaccinations.
C) Do not give immunizations because of the infant's altered immune status.
D) Eliminate the pertussis vaccination because of the risk of convulsions.

Question 9

The nurse observes a red butterfly-shaped rash that spreads across the child's cheeks and nose.This assessment finding is characteristic of which condition?

A) Systemic lupus erythematosus (SLE)
B) Rheumatic fever
C) Kawasaki disease
D) Anaphylactic reaction

Question 10

Which suggestion is appropriate to teach a mother who has a preschool child who refuses to take the medications for HIV infection?

A) Mix medications with chocolate syrup or follow with chocolate candy.
B) Mix the medications with milk or an essential food.
C) Skip the dose of medication if the child protests too much.
D) Mix the medication in a syringe, hold the child down firmly, and administer the medication.

Question 11

Which statement is true regarding how infants acquire immunity?

A) The infant acquires humoral and cell-mediated immunity in response to infections and immunizations.
B) The infant acquires maternal antibodies that ensure immunity up to 12 months age.
C) Active immunity is acquired from the mother and lasts 6 to 7 months.
D) Passive immunity develops in response to immunizations.

Question 12

Children receiving long-term systemic corticosteroid therapy are most at risk for

A) Hypotension
B) Dilation of blood vessels in the cheeks
C) Growth delays
D) Decreased appetite and weight loss

Question 13

A young child with HIV is receiving several antiretroviral drugs.The purpose of these drugs is to

A) Cure the disease.
B) Delay disease progression.
C) Prevent the spread of disease.
D) Treat Pneumocystis carinii pneumonia.

Question 14

Which organs and tissues control the two types of specific immune functions?

A) The spleen and mucous membranes
B) Upper and lower intestinal lymphoid tissue
C) The skin and lymph nodes
D) The thymus and bone marrow

Question 15

The mother of an HIV-positive infant who is 2 months old questions the nurse about which childhood immunizations her child will be able to receive.Which immunizations should an HIV-positive child be able to receive according to the American Academy of Pediatrics recommendation for immunizing infants who are HIV positive? Select all that apply.

A) Hepatitis B
B) DTaP
C) MMR
D) IPV
E) HIB

Question 16

Which intervention is appropriate for a child receiving high doses of steroids?

A) Limit activity and receive home schooling.
B) Decrease the amount of potassium in the diet.
C) Substitute a killed virus vaccine for live virus vaccines.
D) Monitor for seizure activity.

Question 17

Which home care instructions should the nurse provide to the parents of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

A) Give supplemental vitamins as prescribed.
B) Yearly influenza vaccination should be avoided.
C) Administer trimethoprim-sulfamethoxazole (Bactrim) as prescribed.
D) Notify the physician if the child develops a cough or congestion.
E) Missed doses of antiretroviral medication do not need to be recorded.

Question 18

What should the nurse include in a teaching plan for the mother of a toddler who will be taking prednisone for several months?

A) The medication should be taken between meals.
B) The medication needs to be discontinued because of the risks associated with long-term usage.
C) The medication should not be stopped abruptly.
D) The medication may lower blood glucose, so the mother needs to observe for signs of hypoglycemia.

Question 19

What is the most common mode of transmission of human immunodeficiency virus (HIV)in the pediatric population?

A) Perinatal transmission
B) Sexual abuse
C) Blood transfusions
D) Poor handwashing

Question 20

The nurse is planning care for an adolescent with AIDS.The priority nursing goal is to

A) Prevent infection.
B) Prevent secondary cancers.
C) Restore immunologic defenses.
D) Identify source of infection.

Question 21

It is important for the parents of a child who has had a severe allergic reaction to either peanuts or tree nuts to talk to their health care provider about whether the child should have medication available at school in case of an unanticipated exposure to nuts.Epinephrine is now available and easy to use in a device known as the ____________.

Question 22

_________________________ is a chronic,multisystem,autoimmune disease characterized by inflammation of the connective tissue.