Deck 76: Management of Clients with Immune Disorders

Question 1

The nurse caring for a client with allergic rhinitis who is using a decongestant nasal spray would determine that teaching goals have been met when the client says

A) "Nasal sprays must be combined with an oral antihistamine to achieve relief."
B) "Overuse can result in nosebleeds and mucosal ulceration."
C) "Rebound rhinitis (rhinitis medicamentosa) is common with continual use."
D) "The spray should be used round-the-clock at equally spaced intervals."

Answer 1

"Rebound rhinitis (rhinitis medicamentosa) is common with continual use."

Question 2

A client has anaphylaxis. Which action by the nurse takes highest priority?

A) Administering oxygen
B) Giving epinephrine
C) Maintaining an open airway
D) Starting an IV

Answer 2

Maintaining an open airway

Question 3

The nurse instructs the client who has a new prescription for cromolyn sodium (NasalCrom) that the most effective administration schedule is

A) at the start of allergy season, with once-a-day dosing.
B) just after manifestations begin, with twice daily dosing.
C) 1 week before allergy season begins, with four to six doses per day.
D) when manifestations peak only, with two or three doses per day.

Answer 3

1 week before allergy season begins, with four to six doses per day.

Question 4

The nurse instructs a client diagnosed with urticaria on common self care measures, which include

A) antihistamines.
B) corticosteroids.
C) nonsteroidal anti-inflammatory drugs (NSAIDs).
D) warm oatmeal baths.

Question 5

A client with urticaria is frustrated with the chronic nature of the problem. To enhance coping, which intervention by the nurse would be most effective?

A) Assist the client in identifying and eliminating triggers for outbreaks.
B) Demonstrate to the client measures to increase comfort.
C) Let the client vent frustrations and remain supportive.
D) Teach the client the proper way to take antihistamines.

Question 6

A client develops a positive reaction to an injection of purified protein derivative, a screening measure for exposure to tuberculosis. The nurse records this reaction as a

A) type 1 reaction.
B) type 2 reaction.
C) type 3 reaction.
D) type 4 reaction.

Question 7

The nurse explains that a type 2 hypersensitivity reaction results in

A) antibody formation.
B) cell destruction.
C) mast cell production.
D) T-cell stimulation.

Question 8

The nurse concerned about safety encourages a client to stop which medication?

A) Cetirizine (Zyrtec)
B) Diphenhydramine (Benadryl)
C) Fexofenadine (Allegra)
D) Loratadine (Claritin)

Question 9

The home health care nurse who is teaching the client about home environment modifications to self-manage allergies would focus on eliminating allergens that are

A) eaten.
B) inhaled.
C) injected.
D) transmitted by direct contact.

Question 10

The nurse reminds a client that a delayed inflammatory response can occur 2 to 8 hours after exposure to an allergen and is governed by

A) basophils.
B) eosinophils.
C) mast cells.
D) T cells.

Question 11

The nurse assesses an atopic client who has had serious type 1 hypersensitivity reactions. The nurse recognizes that the most severe form of a type 1 hypersensitivity reaction is

A) anaphylaxis.
B) bronchial asthma.
C) cell-mediated sensitivity.
D) dermatitis.

Question 12

A client will undergo testing for possible food allergy to chocolate. The nurse teaches the client to eliminate chocolate from the diet before the testing for

A) 1 to 2 days.
B) 3 to 5 days.
C) 5 to 10 days.
D) 10 to 14 days.

Question 13

The nurse explains that in step 1 (sensitization) of becoming allergic, the body,

A) develops immunoglobulin E (IgE) antibodies.
B) forms mast cells.
C) produces basophils.
D) reacts with rhinitis, urticaria, asthma, or gastrointestinal (GI) manifestations.

Question 14

In teaching self-care measures, the nurse would teach the client who has atopic dermatitis to avoid

A) applying a lubricant after bathing.
B) bathing in hot water.
C) keeping fingernails trimmed.
D) using gentle soaps.

Question 15

A nurse would observe the client for how long to determine whether there is an immediate reaction to a skin test?

A) 1 to 2 minutes
B) 2 to 5 minutes
C) 5 to 10 minutes
D) 10 to 20 minutes

Question 16

A client with a history of type 1 hypersensitivity reaction is receiving immunotherapy (or desensitization therapy). The nurse administering the allergen injection at 1:00 PM would ask the client to remain in the office until

A) 1:10 PM.
B) 1:20 PM.
C) 1:40 PM.
D) 2:15 PM.

Question 17

The nurse caring for a client with rhinitis would anticipate an order for a/an

A) antihistamine.
B) anticholinergic.
C) corticosteroid.
D) decongestant.