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WorksheetsNCLEX - IMMUNE Day1
Total questions: 25
Worksheet time: 25mins
Name
Class
Date
1.
The clinic nurse performs an admission assessment on a client diagnosed with systemic lupus erythematosus (SLE), Which characteristic cutaneous manifestation of SLE would the nurse most likely assess?
a)
Butterfly shape rash (87%)
b)
Petechiae (7%)
c)
Pruritus (2%)
d)
Urticaria (2%)
e)
–
2.
The nurse is caring for a client with immune thrombocytopenia purpura. Which client statements indicate a need for further teaching? Select all that apply.
a)
I use a soft-bristle toothbrush and mild mouth rinse.
b)
I enjoy walking and wear nonskid footwear for safety.
c)
I use a safety razor and gentle shaving cream.
d)
Sometimes I get constipated, so I have been taking docusate.
e)
When I have a headache, I take over-the-counter ibuprofen.
3.
A client receiving a first dose of IV cefazolin has developed a diffuse rash, hypotension, and shortness of breath. Which action should the nurse perform first?
a)
Administer supplemental oxygen (5%)
b)
Give IM epinephrine (15%)
c)
Start IV normal saline bolus (3%)
d)
Stop the infusion and call for help (75%)
e)
–
4.
The nurse has been made aware of laboratory test results for assigned clients. Which of the following test results would require immediate follow-up? Click the exhibit button for additional client information.
a)
a WBC count of 13,000/mm3 (13.0 x 109/L) for a client who has cellulitis of the leg (4%)
b)
a hematocrit of 28% (0.28) and hemoglobin of 9 g/dL (90 g/L) for a client who has chronic kidney disease (17%)
c)
a 2-hour postprandial serum glucose of 165 mg/dL (9.2 mmol/L) for a client who has type 2 diabetes mellitus (3%)
d)
a urinalysis showing WBCs and bacteria for a client who had a kidney transplant 1 month ago (73%)
e)
–
5.
The nurse is reviewing new prescriptions for a client with inflammatory bowel disease and latent pulmonary tuberculosis. The nurse should clarify the prescription for
a)
prednisone (46%)
b)
multivitamin (10%)
c)
lansoprazole (11%)
d)
metronidazole (32%)
e)
–
6.
The nurse is assessing a client with scleroderma. Which of the following findings would be a priority to follow up?
a)
abrupt-onset hypertension and headache (41%)
b)
color changes on the skin of the fingers (22%)
c)
dry cough and exertional dyspnea (14%)
d)
heartburn and difficulty swallowing (21%)
e)
–
7.
The nurse has been made aware of laboratory test results for a client who is experiencing an acute exacerbation of systemic lupus erythematosus. Which of the following test results would require immediate follow-up? Click the exhibit button for additional information.
a)
antinuclear antibody titer (25%)
b)
erythrocyte sedimentation rate (18%)
c)
hemoglobin level (5%)
d)
serum creatinine level (50%)
e)
–
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 saliva
b)
Scheduling regular dental examinations
c)
Showering with lukewarm water and avoiding harsh soaps
d)
Using over-the-counter decongestants to alleviate nasal symptoms
e)
Using over-the-counter lubricants to ease vaginal dryness
9.
A clinic nurse is reviewing charts for clients who have appointments later in the day. Which of the following clients should the nurse recognize as appropriate recipients of a prescription for emtricitabine/tenofovir? Select all that apply.
a)
A client who reports current recreational IV drug use
b)
A client with a latent tuberculosis infection
c)
A female client whose spouse has HIV
d)
A male client who has intercourse with men and women
e)
A phlebotomist at an outpatient blood bank
10.
Exhibit: A client allergic to bee stings was stung about 20 minutes ago at a picnic. Based on the assessment data, the nurse anticipates which immediate actions? Select all that apply.
a)
Inhaled albuterol
b)
Intramuscular epinephrine
c)
Intravenous methylprednisolone
d)
Intravenous metoprolol
e)
Intravenous nitroglycerine
11.
A clinic nurse examines 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 (58%)
b)
Low back stiffness (5%)
c)
Multiple tender points (15%)
d)
Thickening of the skin (19%)
e)
–
12.
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 rashes
13.
The clinic nurse is preparing to administer an allergy immunotherapy injection to a client recently initiated on the therapy. Which statement by the client indicates a need for further teaching?
a)
I can leave right after the shot as I didn't have a reaction last time.
b)
I will be back in a week for my next allergy shot.
c)
I will let the doctor know if I get any itchy hives tonight.
d)
It is okay if I have some redness at the injection site tonight.
e)
-
14.
The nurse provides teaching about methotrexate to a client with rheumatoid arthritis. It is most important to address which topic regarding this drug?
a)
Need for an eye examination
b)
Need for sunblock
c)
Risk for infection
d)
Risk for kidney injury
e)
-
15.
The nurse has taught a client with rheumatoid arthritis who is receiving methotrexate. Which of the following statements by the client would require follow-up?
a)
I will avoid drinking alcoholic beverages while taking methotrexate.
b)
I should take precautions to prevent pregnancy while taking methotrexate.
c)
I should avoid large crowds and people who are ill while taking methotrexate.
d)
I will avoid consuming foods high in folic acid that will decrease effectiveness of methotrexate.
e)
-
16.
The nurse is caring for a child who has had a tonsillectomy. Which of the following are appropriate nursing interventions? Select all that apply.
a)
Anticipate ear pain and give acetaminophen as needed
b)
Educate parents to expect the child to develop bad breath postoperatively
c)
Encourage the child to drink cold liquids through a straw
d)
Notify the health care provider about frequent, increased swallowing
e)
Use an oral suction device regularly to remove secretions from the back of the throat
17.
The nurse is teaching a client with newly diagnosed HIV about antiretroviral therapy (ART). Which of the following statements by the client would require follow-up?
a)
ART consists of several different medications.
b)
I understand that missing doses of ART can lead to viral resistance.
c)
ART can be discontinued once my viral load is undetectable.
d)
I should check for interactions between ART and my current medications.
e)
-
18.
The nurse has taught the parents of a 6-year-old client with chronic allergic rhinitis that is triggered by dust and pollen. Which of the following statements by the parents would indicate a correct understanding of the teaching? Select all that apply.
a)
We are planning to purchase an air purifier with a high-efficiency particulate air filter.
b)
We will keep the windows open during warm weather to air out our house.
c)
We should use hypoallergenic covers on our child's mattress and pillow.
d)
We will clean our wood floors with a damp mop at least once a week.
e)
We are planning to remove the carpet from our child's bedroom.
19.
A client with fibromyalgia refuses to take the prescribed drug duloxetine. When the nurse asks, why, the client responds, "Because I'm not depressed!" What is the nurse's most appropriate response?
a)
Depression is common with fibromyalgia, but a low dose of this drug can prevent it.
b)
It can relieve your chronic pain and help you sleep better at night.
c)
It helps to relieve the adverse effects of your other prescribed drugs.
d)
You have the right to refuse. I will notify your health care provider (HCP).
e)
-
20.
Several 12-month-old infants are brought to the clinic for routine immunizations. Which situation would be most important for the nurse to clarify with the provider before administering the vaccination?
a)
Haemophilus influenzae type b vaccine for client allergic to penicillin
b)
Hepatitis A vaccine for a client with a "cold" and temperature of 99.0 F (37.2 C)
c)
Pneumococcal vaccine for client with local swelling after last immunization
d)
Varicella-zoster vaccine for client recently diagnosed with leukemia
e)
-
21.
A nurse is caring for a client with a diagnosis of fibromyalgia. During care, the client reports having suicidal thoughts. What currently prescribed medication should the nurse question in regard to this new finding?
a)
Amitriptyline
b)
Celecoxib
c)
Cyclobenzaprine
d)
Hydrocodone
e)
-
22.
The nurse is talking with a client with rheumatoid arthritis who has a new prescription for adalimumab. Which of the following statements by the client would require follow-up?
a)
I usually take naproxen for pain twice a week.
b)
I received my annual influenza vaccine injection 3 weeks ago.
c)
I received a negative test result for my tuberculin skin test one week ago.
d)
I started a course of antibiotic therapy to treat a urinary tract infection 2 days ago.
e)
-
23.
A client with ulcerative colitis is prescribed the drug sulfasalazine. Which information should the nurse discuss with the client concerning this drug? Select all that apply.
a)
Drinking 8 glasses of water daily
b)
Stopping the medicine if blood is present in stool
c)
Stopping the medicine if urine turns an orange-yellow color
d)
Taking folic acid supplements
e)
Wearing sunscreen when outdoors
24.
A client is prescribed long-term pharmacologic therapy with hydroxychloroquine to treat systemic lupus erythematosus. Which intervention related to the drug's adverse effects should the nurse include in the teaching plan?
a)
Have an ophthalmologic examination every 6 months
b)
Take the medication on an empty stomach
c)
Take vitamin D and calcium supplements
d)
Wear a MedicAlert bracelet
e)
-
25.
The nurse has provided education about proper use of an epinephrine auto-injector to a client with a history of a severe hypersensitivity reaction to bee stings. Which of the following client statements indicate that teaching has been effective? Select all that apply.
a)
I may have a rapid heartbeat and palpitations after injecting the medication.
b)
I must call an ambulance or go to the nearest hospital following an injection.
c)
I should avoid storing my device in extremely hot or cold temperatures.
d)
The area to be injected should be cleansed with alcohol or soap and water.
e)
The medication is injected at a 90-degree angle into the outer thigh.
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