TEST REVIEW 4

A nurse caring for an immune-suppressed patient wants to promote weight gain. Which nutritional intervention is most appropriate?

• High carbohydrate diet

• Protein supplementation

• Low-fat diet

• Vitamin C megadoses

Answer explanation

Correct Answer: B. Protein supplementation

Rationales:

• A: Carbs provide energy but are less effective than protein for tissue repair and weight gain.

• B (Correct): Protein supports immune function and helps restore body mass.

• C: Low-fat diet may not provide adequate calories.

• D: Vitamin C supports immunity but does not directly promote weight gain.

Which of the following statements about fibromyalgia is correct?

• It resolves without treatment within days

• It is a contagious disease

• It is treated primarily with symptom management including medications like Lyrica and Cymbalta

• It has a specific lab test for diagnosis

Answer explanation

Correct Answer: C. It is treated primarily with symptom management including medications like Lyrica and Cymbalta

Rationales:

• A: There is no definitive lab test; diagnosis is clinical.

• C (Correct): Treatment focuses on symptom relief using medications and lifestyle changes.

• B: Fibromyalgia is not contagious.

• D: It is a chronic condition that requires ongoing management.

A patient taking immunosuppressive drugs should be monitored for:

• Increased risk of infections

• Enhanced immune response

• Increased white blood cell count

• Improved vaccine effectiveness

Answer explanation

Correct Answer: A. Increased risk of infections

Rationales:

• A (Correct): Immunosuppressants reduce immune defenses, increasing infection risk.

• B: They suppress, not enhance, immunity.

• C: WBC count may decrease or be variable.

• D: Vaccines may be less effective during immunosuppression.

A patient has lymphedema in the left arm. What is an important nursing intervention?

• Elevate the arm and avoid taking blood pressure on that arm

• Perform frequent blood draws from the affected arm

• Restrict movement of the affected arm

• Apply hot compresses to the arm daily

Answer explanation

Correct Answer: A. Elevate the arm and avoid taking blood pressure on that arm

Rationales:

• A (Correct): Prevents worsening edema; blood pressure cuff can increase swelling.

• B: Avoid venipuncture on the affected side to reduce infection risk.

• C: Movement improves lymph flow; restriction can worsen symptoms.

• D: Heat may worsen inflammation and swelling.

A patient diagnosed with Stage 2 Hodgkin’s disease is most likely to present with:

• Painful, swollen lymph nodes only in the groin

• Enlarged, painless lymph nodes above the diaphragm with systemic symptoms

• Skin rash and joint pain

• Persistent cough without lymphadenopathy

Answer explanation

Correct Answer: B. Enlarged, painless lymph nodes above the diaphragm with systemic symptoms

Rationales:

• A: Lymph nodes in Stage 2 involve more than one lymph node region, often above the diaphragm, and are painless.

• B (Correct): Common presentation includes enlarged neck, mediastinal, or axillary lymph nodes plus symptoms like fatigue, night sweats, weight loss, and itching.

• C: Not typical for Hodgkin’s disease.

• D: Cough may occur if mediastinal nodes are involved but without lymphadenopathy is less typical.

Which type of HIV is predominantly found in the United States?

• HIV Type 1

• HIV Type 2

• Both types equally

• HIV Type 3

Answer explanation

Correct Answer: A. HIV Type 1

Rationales:

• A (Correct): HIV-1 is the most common strain in the US and worldwide.

• B: HIV-2 is mainly found in West Africa and is less common in the US.

• C: Not equal distribution; HIV-1 dominates.

• D: No such type as HIV-3.

Which of the following best defines anasarca?

• Localized swelling in one limb

• Swelling due to infection

• Generalized massive edema from albumin loss

• Inflammation due to immune response

Answer explanation

Correct Answer: C. Generalized massive edema from albumin loss

Rationales:

• A: That’s localized edema, not anasarca.

• B: Infection may cause swelling, but not systemic like anasarca.

• C (Correct): Anasarca is widespread edema due to low oncotic pressure from depleted albumin levels.

• D: Inflammation may cause localized swelling, but this doesn’t explain massive generalized edema.

A healthcare worker had an accidental needle stick from a patient with unknown HIV status. What is the recommended duration of post-exposure prophylaxis (PEP)?

• 7 days

• 14 days

• 28 days

• 90 days

Answer explanation

Correct Answer: C. 28 days

Rationales:

• A/B: Insufficient duration.

• C (Correct): PEP involves a 28-day course of antiretroviral therapy and must be started within 72 hours.

• D: Follow-up testing is done at 90 days, but the medication course is 28 days.

A nurse is teaching an HIV-positive patient about infection prevention. Which pet should the patient be cautious about owning due to risk of toxoplasmosis?

• Dog

• Cat

• Bird

• Fish

Answer explanation

Correct Answer: B. Cat

Rationales:

• A: Dogs pose less risk unless immunocompromised and dog is ill.

• B (Correct): Cats can carry Toxoplasma gondii in feces, which is dangerous for immunocompromised individuals.

• C: Birds can carry diseases, but toxoplasmosis is specifically associated with cats.

• D: Fish pose minimal infection risk.

Which patient populations are most appropriate to be evaluated for immunosuppression? (Select all that apply.)

• Patients receiving chemotherapy

• Patients taking corticosteroids

• Patients with HIV

• Patients with joint replacements

• Healthy young adults

Answer explanation

Correct Answers: A, B, C, D

Rationales:

• A (Chemo): Directly suppresses immune system. ✅

• B (Steroids): Long-term use decreases immune response. ✅

• C (HIV): Impairs T-cell function. ✅

• D (Joint replacement): May require immunosuppressants or be monitored closely post-op. ✅

• E: No indication for immune testing in healthy adults. ❌