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Immunology Practice

Total questions: 20

Worksheet time: 20mins

Name
Class
Date
1.

The nurse reviews the most current laboratory results of assigned clients. Which result should the nurse to the health care provider immediately?

a)

The client who has cellulitis of the log with a white blood cell (WBC) count of 13,000/mm (13.0 X 10 L)

b)

The client who has chronic kidney injury with a hematocrit of 28% and hemoglobin of 9 g/dl

c)

The client who has type 2 diabetes mellitus with a 2-hour postprandial serum glucose of 165 mg/dL

d)

The client who is 1 month post kidney transplant with urinalysis showing WBCs and bacteria

2.

The nurse reviews the serum laboratory results of a client who has seen in the clinic 2 days ago for worsening joint pain from a flare of systemic lupus erythematosus. Which result is of gratest concern and prompts the nurse to notify the heath care provider?

a)

Creatinine of 1.8 mg/dL

b)

Elevted erythrocyte sedimentation rate

c)

Positive antinuclear antibody titer

d)

White blood cell count of 3, 600 mm3 (3.6 X 10 9 /L

3.

The nurse cares for a client with an excerbation of inflammatory bowel disease (IBD). The cleint tells the nurse about being infected with TB 10 years ago, but never beig medicated. Which prescription is of concern and prompts the nurse to notify the healthcare provider?

a)

Lansoprazole

b)

Metronidazole

c)

Prednisone

d)

Sulfasalazine

4.

A parent calls the telehealth triage line with concerns about an allergic reaction to something a child ate. Which symptoms should the nurse instruct the parent to assess for to determine if the child is having an anaphylactic reaction? Select all that apply.

a)

Dyspnea

b)

Fever

c)

Light headedness

d)

Skin rash

e)

Wheezing

5.

The clinc nurse performs an admission assessment on a client diagnosed with systemic lupus erythematosus (SLE). Which charateristic cutaneous manifestation of SLE would the nurse most likely assess?

a)

Petechiae

b)

Butterfly shape rash

c)

Pruritis

d)

Urticaria

6.

The nurse is caring for a cient with sclera derma. Which assessment finding indicates the most serious complication f the diseaseand requires priority intervention?

a)

Abrupt-onset hypertension and headache

b)

Blue and cold fingers

c)

Dry cough and exertional dyspnea

d)

Heartburn and difficulty swallowing

7.

The nurse is caring for a client with immune thrombocytopenic purpura. Which client statements indicate a need for further teahing? Select all that apply.

a)

"I use a soft-brittle toothbrush and mild mouth rinse"

b)

"I enjoy walking and wear nonskid footwear for safety"

c)

"I use a safety razor and gentle shaving creme"

d)

"Sometimes I get constipated, so I have been taking docusate"

e)

"When I have a headache, I take over-the-counter ibuprofen"

8.

The nurse is planning teaching for a client newly diagnosed with Sjogren's Syndrome. Which measures will the nurse include in the teaching plan? Select all that apply.

a)

Chewing sugar-free gum or using artificial salivia

b)

Scheduling regular dental examination

c)

Showering with lukewarm water avoiding harsh soap

d)

Using over-the-counter decongestants to alleviate nasal symptoms

e)

Using over-the-counter lubricants to ease vaginal dryness

9.

A client allergic to bee stings was stung about 20 minutes ago at a pinic. Based on the assessment data , the nurse anticipates which immediate actions? Select all that apply.


Vital Signs:

Blood Pressure 92/40 mm Hg

Apical pulse 140/min and regular

Respirations 36/min labored

Oxygen saturation 86%


AdmissionNotes

1400 Diaphoretic; urticaria noted on upper extremities and torso. Bilateral inspiratory and expiratory wheezing on auscultation. Notes "chest tightness, trouble breathing, and itching." _________, RN

a)

Inhaled albuterol

b)

Intramuscular epinephrine

c)

Intravenous methylprednisolone

d)

Intravenous metoprolol

e)

Intravenous nitroglycerine

10.

A clinic nurse examine a client with a tentative diagnosis of primary Sjogren's syndrome. Which finding observed by the nurse would most likely be associated with this syndrome?

a)

Dry eyes and mouth

b)

Low back stiffness

c)

Multiple tender joints

d)

Thickening of the skin

11.

The clinic nurse reinforces teaching to a client with systemic lupus erythematosus. Which instructions will the nurse include? Select all that apply .

a)

Avoid annual influenza vaccination

b)

Avoid situations that cause physical and emotional stress

c)

Avoid sun exposure and ultraviolet light when possible

d)

Notify the health care provider if you have fever

e)

Use antibiotic soap to cleanse skin

12.

A few minutes after you have given an intradermal injection of an allergen to a patient who is undergoing skin testing for allergies, the patient reports feeling anxious, short of breath, and dizzy. Which action included in the emergency protocol should you take first?

a)

Start oxygen at 4 L/min using a nasal cannula

b)

Obtain IV accesswith a large-bore IV catheter

c)

Give epinephrine (Adrenalin) 0.3 mL intramuscularly

d)

Administer 3 mL of nebulized albuterol (Proventil) 0.083%

13.

Your patient with rheumatoid arthritis (RA) is taking prednisone (Deltasone and naproxen (Aleve) to reduce inflammation and joint pain. Which symptom ismost important to communicate to the health care provider?

a)

RA symptoms are worst in the morning

b)

Dry eyes

c)

Round and moveable nodules just under the skin

d)

Dark-colored stool

14.

You assess a 24-year-old patient with RA who is considering using Methotrexate (Rheumatrex) for treatment. Which patient information is most important to communicate to the health care provider?

a)

The patient has many concerns about the safety of the drug

b)

The patient has been trying to get pregnant

c)

The patient takes daily multivitamin tablet

d)

The patient says that she has taken methotrexate in the past

15.

An 18-year-old college student withan exacerbationof systemic lupus erythematous(SLE)hs been receiving prednisone (Deltasone) 20 mg daily for 4 days. Which medical order should you question?

a)

Discontinue prednisone after today's dose

b)

Give a "catch up" dose of varicellla vaccine

c)

Check the patient's C-reactive protein level

d)

Administer ibuprofen Advil 800 mg PO

16.

A patient with wheezing and coughing coughing caused by an allergic reaction to penicillin is admitted to the emergency department. Which medication do you anticipate administering first?

a)

Methylprednisolone (Solu-Medrol) 100 mg IV

b)

Cromolyn (Intal) 20 mg via nebulizer

c)

Albuterol (Proventil) 3 mL via nebulizer

d)

Aminophylline (theophylline) 500mg IV

17.

You are working with a studentnurse to care for an HIV-positive patient with severe esophagitis caused by Candida albicans. Which action by the student indicates that you need to intervene most quickly?

a)

Putting on a mask and gown before entering the patient's room

b)

Giving the patient a glass of water after administering the ordered oral nystatin (Mycostatin) suspension

c)

Suggesting that the patient should order chili con carne or chicken soup for the next meal

d)

Placing a "No Visitors" sign on the door of the patient room

18.

After interviewing an HIV-positive patient who is considering starting highly active antiretroviral therapy (HAART), which patient information concerns you the most?

a)

The patient has been HIV positive for 8 years and has never taken any drug therapy for the HIV infection

b)

The patient tells you, "I have never been very consistent about taking medications."

c)

The patient is sexually active with multiple partners and says "I always use a condom."

d)

The patient has any questions and concerns regarding the effectiveness and safety of the medications.

19.

An HIVpositive patient who has been started on HAART is seen in the clinic for follow-up. Which test will be most helpful in determining the response to therapy?

a)

CD4 Level

b)

Complete Blood Count

c)

Total lymphocyte percent

d)

Viral Load

20.

As a hospital employee health nurse, you are completing a health history for a newly-hired staff member. Which information given by the new employee most indicates the need for further nursing action, before he/she begins orientation to patient care?

a)

The employee takes Enalapril (Vasotec) for hypertension

b)

The employee has an allergy to bananas, avocado, and papayas

c)

The employee received a tetanus vaccination 3 years ago

d)

TB skin test site has a 5-mm induration at 48 hours