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.

Accepted Answer

Epinephrine is the drug of choice for the acute treatment of anaphylaxis as it rapidly reverses airway constriction, reduces systemic hypotension and improves cardiac contractility. Diphenhydramine may be given as an adjunct treatment to reduce itching and histamine-mediated symptoms, but it is not the primary treatment for anaphylaxis. Histamine inhibitors (such as cimetidine) are not effective for reversing the effects of anaphylaxis. Albuterol may be helpful in treating bronchospasm, but it does not address the systemic effects of anaphylaxis.

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

Accepted Answer

In anaphylaxis, the most life-threatening complication is ineffective breathing pattern due to upper airway obstruction or bronchoconstriction. Therefore, addressing the airway and ensuring adequate oxygenation is the primary nursing concern. Identifying the offending allergen is important but is not the priority during an acute anaphylactic reaction. Increased cardiac output and positioning for comfort are not relevant nursing concerns during an anaphylactic reaction.

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

Accepted Answer

Maintaining growth and development is the primary nursing concern for a hospitalized child with HIV infection. HIV can cause delays in growth and development, and it is important for the nurse to monitor the child's growth, provide appropriate nutrition and support the child's developmental needs. Eating foods that the family brings to the child may be important for maintaining adequate nutrition, but it is not the primary concern. Consideration of parental limitations and weaknesses is important, but it is not the primary concern. Resting for 2 to 3 hours twice a day may be important for the child's overall health and wellbeing, but it is not the primary concern specifically related to HIV infection.

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."

Accepted Answer

This statement shows that the mother understands that the dosage of antiretroviral medication is selected based on her child's age and growth. Option A is incorrect as doubling medication dosage without consulting the healthcare provider is not safe. Option B is incorrect as addiction is not a concern with antiretroviral medication, and option D is incorrect as antiretroviral medication is likely to be needed for life to manage the AIDS condition.

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.

Accepted Answer

The immune system distinguishes and actively protects the body's own cells from foreign substances. This is a correct statement about the immune system. Option B is incorrect because the immune system is not fully developed by 1 year of age, it continues to develop throughout childhood and into adolescence. Option C is too broad of a statement, as the immune system protects the child against a range of diseases throughout their lifetime, not just the first 6 years. Option D is incorrect as the immune system responds to an offending agent by producing antibodies, not 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."

Accepted Answer

Absolute lymphocyte counts reach a peak during the first year, indicating the development of the infant's immune system.

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

Accepted Answer

A virus that primarily infects CD4+ T cells is the human immunodeficiency virus (HIV), which causes acquired immunodeficiency syndrome (AIDS). HIV attacks and destroys the CD4+ T cells, leading to a weakened immune system and increased susceptibility to opportunistic infections and cancers.

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.

Accepted Answer

The CDC recommends administering routine immunizations for HIV-positive infants but to assess CD4+ counts before administering the MMR and varicella vaccinations. This is because these vaccines are live attenuated vaccines that could cause serious adverse events in infants with severe immune suppression. The CDC does not recommend eliminating any vaccines for HIV-positive infants.

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

Accepted Answer

The butterfly-shaped rash is a classic symptom of Systemic Lupus Erythematosus (SLE), which is an autoimmune disease. The rash is usually seen on the cheeks and nose, and is also known as a malar rash.

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.

Accepted Answer

Mixing medications with chocolate syrup or following with chocolate candy can help mask the taste and make it more palatable for the child, increasing the likelihood of adherence to the medication regimen.

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.

Accepted Answer

Infants acquire immunity through both humoral and cell-mediated responses as they encounter infections and receive 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

Accepted Answer

Children receiving long-term systemic corticosteroid therapy are most at risk for growth delays. Corticosteroids can inhibit bone growth and decrease bone density, leading to slower growth rates in children. Hypotension, dilation of blood vessels in the cheeks, decreased appetite, and weight loss are potential side effects of corticosteroids, but they are not the most prominent risk for children receiving long-term therapy.

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.

Accepted Answer

Antiretroviral drugs are used to delay disease progression by lowering the amount of HIV in the body, preventing damage to the immune system, and reducing the risk of opportunistic infections. There is currently no cure for HIV. Antiretroviral treatment can also help prevent the spread of disease by reducing the viral load and making transmission less likely. Treating Pneumocystis carinii pneumonia, a common opportunistic infection in people with HIV, may require additional medications beyond antiretroviral therapy.

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

Accepted Answer

The thymus and bone marrow are the primary organs responsible for development and maturation of specific immune cells, including T cells and B cells, respectively. The thymus plays a role in the development of T cells, while the bone marrow is responsible for the production and maturation of B cells.

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

Accepted Answer

According to the American Academy of Pediatrics, an HIV-positive infant can safely receive all childhood immunizations, except for the MMR vaccine, which should be postponed until the child's HIV status and immune function have been evaluated. Therefore, the correct options are A (Hepatitis B), B (DTaP), D (IPV), and 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.

Accepted Answer

High doses of steroids can suppress the immune system, so live virus vaccines should be avoided to prevent potential infections.

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.

Accepted Answer

Supplemental vitamins can help support the child's immune system, trimethoprim-sulfamethoxazole helps prevent opportunistic infections, and the parents should notify the physician if the child develops any respiratory symptoms. Yearly influenza vaccination should be encouraged, not avoided. Missed doses of antiretroviral medication should be recorded and reported to the physician.

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.

Accepted Answer

Prednisone is a corticosteroid that should not be stopped abruptly after long-term use because it can lead to adrenal insufficiency. The dose needs to be tapered down gradually under medical supervision.

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

Accepted Answer

Perinatal transmission (transmission from mother to child during pregnancy, birth or breastfeeding) is the most common mode of transmission of HIV in the pediatric population. Sexual abuse, blood transfusions, and poor handwashing are not significant modes of transmission in this population.

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.

Accepted Answer

The priority nursing goal for an adolescent with AIDS is to prevent infection. This is because individuals with AIDS have a weakened immune system and are more susceptible to infections. Therefore, preventing infection is crucial to managing this condition and improving the patient's health outcomes.

Quiz 42: The Child With an Immunologic Alteration

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

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

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

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

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?

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

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

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?

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

Which statement is true regarding how infants acquire immunity?

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

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

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

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

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

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

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

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