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Cellular Pathology: Reed-Sternberg Cell

Total questions: 128

Worksheet time: 1hrs 4mins

Name
Class
Date
1.

In the diagram, which feature most reliably distinguishes the Reed–Sternberg cell from the normal lymphocyte?

a)

Thin elongated nucleus with scant cytoplasm

b)

Abundant cytoplasm lacking nucleoli

c)

Small round dense chromatin nucleus

d)

Irregular nuclear membrane without nucleoli

e)

Bilobed nucleus with prominent nucleoli

2.

A pathologist compares the labeled cells. Which interpretation best explains why the larger labeled cell indicates Hodgkin's lymphoma?

a)

Plasma cell with eccentric nucleus indicating multiple myeloma

b)

Small mature lymphocyte typical of reactive hyperplasia

c)

Eosinophil with bilobed nucleus indicating allergy

d)

Large atypical cell with bilobed nucleus signals Hodgkin's

e)

Macrophage with foamy cytoplasm suggesting infection

3.

You must confirm a suspected Reed–Sternberg cell seen in this image. Which next step most appropriately validates the identification?

a)

Request peripheral blood smear review

b)

Order CD15 and CD30 immunostains on the tissue

c)

Start broad-spectrum antibiotics immediately

d)

Measure serum lactate dehydrogenase level

e)

Perform CT scan of chest and abdomen

4.

Which behavior most increases the risk of acquiring HIV through bloodborne exposure?

a)

Sharing IV needles during drug use

b)

Donating blood at licensed centers

c)

Receiving routine vaccinations at clinics

d)

Working as a lifeguard at public pools

5.

Which group may be underdiagnosed with HIV due to symptom overlap with other illnesses?

a)

Older adults in primary care

b)

Adolescents with acne

c)

Athletes with muscle strains

d)

Infants with colic symptoms

6.

Which sexual practice best reduces HIV transmission risk?

a)

Periodic abstinence on weekends

b)

Consistent condom use with partners

c)

Withdrawal method during intercourse

d)

Using spermicides without condoms

7.

Which scenario represents occupational exposure to HIV?

a)

Mechanic repairs car transmissions

b)

Teacher shares classroom pencils

c)

Nurse sustains a needlestick injury

d)

Chef handles raw poultry daily

8.

Early HIV infection commonly presents with which constellation of symptoms?

a)

Fever, night sweats, rash

b)

Constipation, tinnitus, hiccups

c)

Joint stiffness, hair loss, sneezing

d)

Blurred vision, dry skin, cramps

9.

Which finding is a typical early sign of HIV-related immune activation?

a)

Isolated ankle swelling

b)

Generalized lymphadenopathy

c)

Localized bone fracture pain

d)

Hepatic jaundice only

10.

Which prevention strategy targets transmission via injection drug use?

a)

Inject slowly to reduce trauma

b)

Avoid sharing needles entirely

c)

Rotate injection sites daily

d)

Use cotton filters for solutions

11.

For routine screening, which age range is recommended for HIV testing?

a)

Ages sixty-five and older

b)

Ages five through twelve

c)

Ages thirteen through sixty-four

d)

Ages twenty-five through thirty

12.

Which vaccination is specifically recommended for individuals with HIV risk?

a)

Live smallpox vaccine

b)

Yellow fever live booster

c)

Oral polio sugar cube

d)

Pneumococcal immunization

13.

Which combined approach most effectively reduces HIV risk in sexually active individuals?

a)

Consistent condoms plus routine testing

b)

Occasional condoms plus herbal supplements

c)

Spermicides alone without condoms

d)

Routine testing without barrier methods

14.

Which screening test primarily detects HIV antibodies after sufficient time post-exposure?

a)

ELISA screening assay

b)

Western blot test

c)

HIV RNA PCR

d)

CD4 flow cytometry

15.

After approximately how long do most people produce enough antibodies for HIV detection by standard screening?

a)

About 12 weeks

b)

About 8 weeks

c)

About 20 weeks

d)

About 4 weeks

16.

Which test is used to confirm a positive HIV screening result?

a)

Brain MRI

b)

ELISA repeat test

c)

Western blot or IFA

d)

CBC with differential

17.

What does viral load testing primarily measure in HIV management?

a)

Amount of virus in blood

b)

Antibody concentration level

c)

Platelet aggregation function

d)

CD4 lymphocyte percentage

18.

A CBC abnormality commonly associated with HIV includes which finding?

a)

Polycythemia presence

b)

Thrombocytopenia state

c)

Eosinophilia surge

d)

Hyperleukocytosis

19.

Which nursing priority best reduces the risk of opportunistic infections in HIV patients?

a)

Support hydration status

b)

Prevent infection proactively

c)

Encourage medication adherence

d)

Provide emotional support

20.

Monitoring which two parameters best reflects disease progression and treatment response in HIV?

a)

CD4 count and viral load

b)

BMI and daily weights

c)

Electrolytes and creatinine

d)

Hemoglobin and hematocrit

21.

A patient’s platelets are <150,000. Which complication is most concerning?

a)

Renal failure onset

b)

Hypertension risk increase

c)

Bleeding tendency risk

d)

Seizure threshold drop

22.

Which noninvasive specimen can be used for certain HIV tests besides blood?

a)

Mucosal fluid or urine

b)

Pleural fluid collection

c)

Cerebrospinal fluid sample

d)

Synovial fluid aspirate

23.

Which nursing assessment set is most appropriate during routine HIV care?

a)

Skin biopsy, sputum culture, endoscopy

b)

Pain scale only, gait test, reflexes

c)

ECG only, glucose checks, lipids

d)

I/O, daily weights, nutrition, electrolytes

24.

Which supportive intervention directly addresses hypoxemia during acute HIV-related illness?

a)

O2 administration therapy

b)

Increased oral fluids

c)

Vitamin supplementation

d)

Passive range exercises

25.

Which action best reinforces transmission prevention counseling for an HIV-positive patient?

a)

Stop all physical activity

b)

Recommend high-protein diet

c)

Schedule brain MRI routinely

d)

Discuss safe sex practices

26.

Which ART class blocks HIV fusion with the host cell membrane?

a)

Integrase inhibitors like raltegravir

b)

Protease inhibitors like indinavir

c)

Entry inhibitors like maraviroc

d)

Fusion inhibitors such as enfuvirtide

27.

Maraviroc primarily acts by blocking which host receptor?

a)

CD4 surface glycoprotein

b)

HLA class II molecule

c)

CXCR4 coreceptor protein

d)

CCR5 chemokine co-receptor

28.

Which NRTI example inhibits RNA to DNA conversion by reverse transcriptase?

a)

Dolutegravir as an integrase agent

b)

Zidovudine as a nucleoside analog

c)

Efavirenz as a non-nucleoside drug

d)

Atazanavir as a protease blocker

29.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) like efavirenz primarily:

a)

Inhibit protease-mediated assembly

b)

Allosterically inhibit reverse transcriptase

c)

Block CCR5-mediated viral entry

d)

Prevent viral DNA strand insertion

30.

Protease inhibitors such as atazanavir mainly:

a)

Block viral protein assembly

b)

Target CCR5 coreceptor binding

c)

Inhibit reverse transcription

d)

Prevent membrane fusion events

31.

Integrase inhibitors like raltegravir:

a)

Allosterically block reverse transcriptase

b)

Prevent viral DNA insertion

c)

Block protease cleavage steps

d)

Inhibit CCR5-dependent entry

32.

Primary goals of ART include:

a)

Enhance CCR5 expression on T cells

b)

Eliminate latent HIV reservoirs fully

c)

Increase viremia and induce immunity

d)

Suppress replication and preserve CD4

33.

Routine monitoring for patients on ART should include:

a)

Urinalysis and sputum cultures

b)

ECG and echocardiography

c)

Bone density and DEXA scans

d)

CBC, WBC, liver function tests

34.

Which laboratory values are specifically tracked for metabolic effects of ART?

a)

Lipids and bilirubin levels

b)

Serum amylase and lipase

c)

Ferritin and transferrin

d)

Uric acid and lactate

35.

A normal CD4:CD8 ratio is closest to:

a)

Approximately three to one

b)

Approximately two to one

c)

Approximately one to two

d)

Approximately one to one

36.

A CD4:CD8 ratio less than 1 suggests:

a)

Primary immunization response

b)

Acute hypersensitivity reaction

c)

Effective viral suppression

d)

Disease progression or resistance

37.

Key patient education to prevent resistance emphasizes:

a)

Skipping doses to reduce toxicity

b)

Alternating drugs every other day

c)

Stopping therapy when asymptomatic

d)

Taking medications exactly as prescribed

38.

Common opportunistic infections in HIV include:

a)

Otitis media, sinusitis, impetigo

b)

Lyme disease, tetanus, malaria

c)

TB, PCP pneumonia, candidiasis

d)

Influenza A, norovirus, RSV

39.

Management priorities for wasting syndrome include:

a)

High-protein small frequent meals

b)

Fluid restriction to <1 L/day

c)

Prolonged fasting for ketosis

d)

Low-protein renal-sparing diet

40.

Kaposi’s sarcoma in HIV is best categorized as:

a)

An autoimmune arthropathy

b)

A bacterial opportunistic disease

c)

An AIDS-associated malignancy

d)

A hereditary connective disorder

41.

For fluid and electrolyte imbalance in advanced HIV, typical orders include:

a)

Hypertonic saline bolus therapy

b)

Strict NPO with minimal fluids

c)

2–3 liters fluids daily with labs

d)

No labs unless symptomatic

42.

Which interprofessional team member primarily manages antiretroviral therapy selection and opportunistic infection treatment for a patient with HIV?

a)

Home health nurse

b)

Infectious disease specialist

c)

Rehabilitation therapist

d)

Respiratory therapist

43.

A patient with HIV asks about food safety. Which advice is most appropriate to prevent gastrointestinal infections?

a)

Avoid raw or undercooked foods

b)

Rinse meats with cold water

c)

Choose raw seafood dishes

d)

Use herbal supplements daily

44.

A patient with HIV has two cats. Which recommendation minimizes infection risk related to pet care?

a)

Avoid cleaning pet litter boxes

b)

Clean litter boxes carefully

c)

Use scented litter products

d)

Feed cats raw meat diets

45.

Which statement best describes the pathophysiology of systemic lupus erythematosus?

a)

Bacterial toxins trigger acute fever

b)

Viral replication destroys immune cells

c)

Autoantibodies drive chronic inflammation

d)

Allergy-mediated histamine release

46.

Which form of lupus primarily affects multiple organ systems and can lead to organ failure?

a)

Systemic lupus erythematosus

b)

Discoid cutaneous lupus

c)

Medication-induced lupus

d)

Transient neonatal lupus

47.

A patient develops lupus-like symptoms after starting hydralazine. Which outcome is most likely after stopping the drug?

a)

Permanent organ failure occurs

b)

Cutaneous lesions persist lifelong

c)

Symptoms resolve gradually

d)

Disease becomes systemic

48.

Which trigger is most likely to precipitate an SLE flare?

a)

Ultraviolet light exposure

b)

High-protein diet changes

c)

Routine aerobic exercise

d)

Cold weather alone

49.

Which patient profile reflects a common age and sex distribution for SLE?

a)

Child aged five to ten

b)

Male aged sixty to seventy

c)

Male adolescent aged thirteen to fifteen

d)

Female aged twenty to forty

50.

Which skin finding best suggests systemic lupus erythematosus?

a)

Butterfly rash across cheeks and nose

b)

Coin-shaped plaques on scalp and face

c)

Dermatographism on trunk and arms

d)

Scaling patches on elbows and knees

51.

Which clinical feature commonly indicates an SLE flare?

a)

Isolated pruritus without rash

b)

Severe thirst without polyuria

c)

Productive cough with sputum

d)

High fever with malaise

52.

Which phenomenon is characterized by triphasic color changes of fingers in cold exposure?

a)

Erythema multiforme

b)

Raynaud's phenomenon

c)

Livedo reticularis

d)

Acrocyanosis

53.

Which hematologic pattern is often seen in SLE on complete blood count?

a)

Eosinophilia with basophilia

b)

Isolated neutrophilia only

c)

Pancytopenia affecting all lines

d)

Polycythemia with leukocytosis

54.

Which test is positive in about 95% of SLE cases but lacks specificity?

a)

Anti-Smith antibody

b)

Antinuclear antibody

c)

Direct Coombs test

d)

Anti-ENA panel

55.

A patient with SLE presents with pleuritic chest pain. What complication is most likely?

a)

Pneumonia causing dull ache

b)

Pulmonary embolism painless

c)

Pericarditis causing sharp pain

d)

Esophagitis causing burning

56.

Which urinary finding suggests renal involvement in SLE?

a)

High specific gravity alone

b)

Alkaline urine without casts

c)

Glucosuria without ketones

d)

Proteinuria with red blood cells

57.

Which diagnostic procedure confirms discoid lupus erythematosus affecting skin lesions?

a)

Nerve conduction study

b)

Chest radiograph imaging

c)

Serum ESR measurement

d)

Skin biopsy of the lesion

58.

Which facial pattern corresponds to the malar rash of SLE?

a)

Scaling at nasolabial folds

b)

Pustules around mouth only

c)

Erythema over cheeks and bridge

d)

Telangiectasia on forehead

59.

Which renal finding most strongly suggests SLE-related nephritis requiring prompt monitoring?

a)

Edema with reduced urine output

b)

Polyuria with normal creatinine

c)

Hematuria without edema

d)

Nocturia with stable BUN

60.

Which assessment finding aligns with pleural effusion in SLE?

a)

Enhanced breath sounds bilaterally

b)

Diminished breath sounds unilaterally

c)

Stridor with inspiratory crackles

d)

Expiratory wheezes diffusely

61.

Which musculoskeletal symptom profile is typical during an SLE flare?

a)

Arthralgia, myalgia, polyarthritis

b)

Dislocations with ligament tears

c)

Bone deformities and contractures

d)

Myopathy with muscle wasting

62.

What is the best meal strategy for an anorexic SLE patient experiencing fatigue?

a)

Only liquid meals twice daily

b)

One large high-protein dinner

c)

Intermittent fasting every other day

d)

Small, frequent meals and supplements

63.

Why is salt intake limited during corticosteroid therapy in SLE?

a)

Minimizes steroid-related anemia

b)

Avoids steroid-induced hypoglycemia

c)

Prevents hyperkalemia from steroids

d)

Reduces steroid-related fluid retention

64.

Which laboratory set is most relevant for renal monitoring in SLE?

a)

PT, INR, fibrinogen

b)

TSH, T3, free T4

c)

AST, ALT, bilirubin

d)

BUN, creatinine, urine output

65.

While on corticosteroids, which complication requires surveillance in older adults?

a)

Increased fracture risk with therapy

b)

No change in bone integrity

c)

Improved bone density consistently

d)

Reduced fracture risk over time

66.

Which reason justifies avoiding NSAIDs in certain SLE patients?

a)

They cause universal allergic reactions

b)

They must be avoided with kidney disease

c)

They worsen liver fibrosis directly

d)

They always raise blood pressure severely

67.

What is a key monitoring priority for immunosuppressants like azathioprine or methotrexate?

a)

Daily pulmonary function testing

b)

Electrolyte replacement therapy

c)

Infection and bone marrow suppression

d)

Routine ophthalmologic surgery

68.

Which statement best describes belimumab’s mechanism in SLE?

a)

Enhances complement cascade activity

b)

Inhibits B-cell activation in SLE

c)

Blocks T-cell receptor binding

d)

Stimulates neutrophil proliferation

69.

Which adverse effect mandates regular eye exams with hydroxychloroquine?

a)

Persistent blurred vision changes

b)

Severe tinnitus with ear pain

c)

Sudden anosmia without congestion

d)

Photosensitivity worsening rapidly

70.

Which hygiene recommendation supports skin integrity in SLE?

a)

Apply alcohol-based powders often

b)

Rub skin vigorously after bathing

c)

Air-dry skin without moisturizers

d)

Use mild soaps; moisturize daily

71.

Which precaution reduces infection risk for SLE patients on immunosuppressants?

a)

Share personal hygiene items

b)

Start live vaccines immediately

c)

Avoid crowds and sick contacts

d)

Attend crowded events routinely

72.

Which symptom change requires prompt reporting by an SLE patient at home?

a)

Occasional yawn after fatigue

b)

Mild sunburn that fades quickly

c)

Transient sneezing after dusting

d)

Edema, infection, or sudden changes

73.

Why is ophthalmology follow-up included in interprofessional SLE care?

a)

Monitor cataracts from NSAIDs

b)

Evaluate steroid-induced myopia

c)

Monitor hydroxychloroquine effects

d)

Screen glaucoma from belimumab

74.

Which counseling topic is critical for women with SLE considering pregnancy?

a)

Guaranteed remission during pregnancy

b)

Complete safety of all immunosuppressants

c)

Pregnancy risks with lupus and medications

d)

No medication changes are needed

75.

During assessment, which vital sign needs particular attention in SLE?

a)

Heart rate exclusively

b)

Temperature exclusively

c)

Respiratory rate only

d)

Blood pressure especially

76.

Which nutrition-focused instruction aligns with SLE steroid therapy?

a)

Limit salt to reduce retention

b)

Avoid fluids to prevent edema

c)

Increase salt to prevent cramps

d)

Eliminate all carbohydrates completely

77.

Which neurologic manifestation may appear during severe SLE flare?

a)

Mild situational anxiety

b)

Simple motion sickness only

c)

Confusion, seizures, psychosis

d)

Seasonal allergies and sneezing

78.

Which cardiac monitoring priority accompanies steroid use in SLE?

a)

Monitor for bradycardia only

b)

Monitor for hypertension and fluid retention

c)

Monitor for migraine and tinnitus

d)

Monitor for hyperthermia and rash

79.

Which complication is a leading cause of death in systemic lupus erythematosus and may progress to chronic kidney disease?

a)

Pulmonary embolism causing hypoxia

b)

Hematologic anemia causing fatigue

c)

Dermatitis causing skin breakdown

d)

Lupus nephritis causing renal failure

80.

A client with suspected lupus nephritis presents with facial puffiness and swollen ankles. Which assessment priority best aligns with nursing actions for this complication?

a)

Apply warm compresses to swollen areas

b)

Monitor periorbital and lower‑extremity edema

c)

Encourage high‑protein dietary intake

d)

Schedule daily chest physiotherapy

81.

Which laboratory monitoring is most appropriate to evaluate renal function in lupus nephritis?

a)

Serum amylase and lipase levels

b)

Serum BUN and creatinine levels

c)

Serum troponin and CK‑MB

d)

Arterial blood gas analysis

82.

Pericarditis and myocarditis in SLE primarily involve inflammation of which structures?

a)

Heart muscle, vessels, or pericardial sac

b)

Pulmonary alveoli and pleural lining

c)

Cranial nerves and meninges

d)

Hepatic lobules and bile ducts

83.

Which client education statement best reflects safe management of life‑threatening SLE complications?

a)

Delay reporting chest pain until next visit

b)

Increase fluid intake despite edema symptoms

c)

Use over‑the‑counter NSAIDs for chest pain

d)

Take immunosuppressants and corticosteroids as prescribed

84.

Which mechanism most directly causes thrombocytopenia in idiopathic thrombocytopenic purpura?

a)

Complement lyses endothelial cells systemically

b)

IgG targets megakaryocytes in bone marrow

c)

IgG coats platelets for splenic clearance

d)

IgM agglutinates red cells causing hemolysis

85.

A hallmark result of antibody-coated platelet destruction in ITP is:

a)

High platelets with petechiae

b)

Low platelets and bleeding risk

c)

Elevated platelet count and clotting

d)

Normal platelets with bruising only

86.

Which is a recognized drug that can induce or trigger ITP?

a)

Proton pump inhibitors for GERD

b)

Thiazide diuretics for hypertension

c)

Acetaminophen used for pain

d)

Statins used for dyslipidemia

87.

Which infection is associated with increased risk for developing ITP?

a)

HIV infection increases risk

b)

Common cold consistently causes ITP

c)

Influenza infection decreases risk

d)

Hepatitis B always prevents ITP

88.

In a patient with severe, active bleeding due to ITP, which immediate supportive measure is appropriate?

a)

Start long-term azathioprine therapy

b)

Begin low-dose aspirin prophylaxis

c)

Schedule elective splenectomy next week

d)

Platelet transfusions for severe bleeding

89.

Which second-line option targets the site of platelet destruction in refractory ITP?

a)

High-dose glucocorticoids daily

b)

Splenectomy removes the destruction site

c)

Heparin to prevent thrombosis

d)

IV immune globulin infusion

90.

Which agent is a thrombopoietin receptor agonist used in ITP management?

a)

Rituximab activates TPO signaling

b)

Cyclophosphamide boosts platelet function

c)

Vancomycin stimulates megakaryocytes

d)

Romiplostim increases platelet production

91.

Priority nursing action for a hospitalized patient with ITP is to:

a)

Promote frequent NSAID use

b)

Encourage vigorous physical activity

c)

Assess urine output hourly

d)

Monitor platelet count regularly

92.

Which teaching point helps reduce bleeding risk for patients with ITP?

a)

Use herbal blood thinners daily

b)

Prefer intramuscular injections frequently

c)

Avoid trauma and NSAIDs use

d)

Increase contact sports participation

93.

Which enzyme deficiency most directly leads to microthrombi formation in thrombotic thrombocytopenic purpura?

a)

Plasminogen fibrinolytic enzyme defect

b)

ADAMTS13 metalloprotease deficiency

c)

Factor VIII coagulant protein loss

d)

Protein C anticoagulant activity absence

94.

What primary pathophysiologic sequence best characterizes thrombotic thrombocytopenic purpura?

a)

Antithrombin excess → inhibited thrombin → hypocoagulation

b)

Immune complex deposition → vasculitis → edema

c)

Hyperfibrinolysis → clot dissolution → bleeding

d)

Platelet aggregation → microthrombi → tissue ischemia

95.

Which clinical finding results from red blood cells being damaged while passing through clots in thrombotic thrombocytopenic purpura?

a)

Aplastic bone marrow failure

b)

Iron deficiency anemia

c)

Hemorrhagic anemia after trauma

d)

Microangiopathic hemolytic anemia

96.

Which cause is most commonly implicated in acquired thrombotic thrombocytopenic purpura?

a)

Bacterial endotoxin–induced thrombosis

b)

Vitamin K dependent factor deficiency

c)

Inherited ADAMTS13 gene mutation

d)

Autoantibody-mediated ADAMTS13 inhibition

97.

Which patient scenario is a recognized trigger for thrombotic thrombocytopenic purpura?

a)

Dietary iron restriction over months

b)

Pregnancy or postpartum physiologic changes

c)

High-altitude hypoxia exposure alone

d)

Simple viral upper respiratory illness

98.

Which neurologic manifestation commonly occurs in thrombotic thrombocytopenic purpura?

a)

Isolated cranial nerve palsy

b)

Peripheral demyelinating neuropathy

c)

Chronic progressive myopathy

d)

Confusion with possible seizures

99.

What immediate first-line therapy reduces mortality in thrombotic thrombocytopenic purpura by removing autoantibodies and replenishing ADAMTS13?

a)

Oral iron supplementation

b)

High-dose platelet transfusion

c)

Therapeutic plasma exchange

d)

Routine prophylactic anticoagulation

100.

Why are platelet transfusions generally contraindicated in untreated thrombotic thrombocytopenic purpura?

a)

They cause immune anaphylaxis in all patients

b)

They can fuel clot formation and worsen ischemia

c)

They permanently suppress bone marrow function

d)

They trigger disseminated bleeding immediately

101.

A patient with thrombocytopenia, fever, renal impairment, and neurologic changes most likely has which disorder when microclots are widespread?

a)

Deep venous thrombosis alone

b)

Hemophilia A with inhibitors

c)

Immune thrombocytopenic purpura

d)

Thrombotic thrombocytopenic purpura

102.

Which drug exposure is classically associated with triggering thrombotic thrombocytopenic purpura?

a)

Statin lipid-lowering therapy

b)

Aspirin low-dose regimen

c)

Acetaminophen analgesic use

d)

Clopidogrel or ticlopidine use

103.

Which room setup best reduces infection risk for an immunocompromised patient?

a)

Negative-pressure isolation with closed door

b)

Shared room with doors kept closed

c)

Positive-pressure isolation with sealed entry

d)

Private room with door may remain open

104.

What sign should be posted to alert staff of special precautions for a compromised immune system?

a)

Contact Precautions sign

b)

Droplet Precautions sign

c)

Airborne Precautions sign

d)

Compromised Host Precautions sign

105.

Which environmental control is appropriate to lower infection risk?

a)

Open containers of sterile water daily

b)

Humidifier with tap water nightly

c)

No standing water in the room

d)

Fresh fruit soaking in sink water

106.

Regarding plants and flowers for an at-risk patient, which statement is correct?

a)

Allowed by policy but patient must not handle

b)

Strictly prohibited in all hospital settings

c)

Permitted only if patient waters them daily

d)

Allowed only in negative-pressure rooms

107.

What is the most important infection prevention action for staff and visitors?

a)

Perform hand hygiene before contact

b)

Wear masks at all times in room

c)

Use gowns and shoe covers routinely

d)

Avoid speaking near the patient

108.

Which vital sign schedule is recommended for monitoring infection risk?

a)

Every 8 hours with night hold

b)

Every 2–4 hours routinely

c)

Continuous monitoring only if febrile

d)

Once daily unless symptomatic

109.

In neutropenic patients, which temperature triggers urgent action?

a)

Above 38°C (101°F) immediately

b)

Above 37°C (98.6°F) within 24 hours

c)

Below 36°C (96.8°F) urgently

d)

Exactly 38°C after repeat check

110.

How should cultures be timed during evaluation of a rising fever in an at-risk patient?

a)

Obtain cultures only if chills present

b)

Draw cultures after antibiotics start

c)

Wait for defervescence before cultures

d)

Draw cultures as temperature rises

111.

What is the recommendation for indwelling catheters and tubes?

a)

Change catheters every other day

b)

Remove catheters and tubes ASAP

c)

Keep catheters until antibiotics end

d)

Flush catheters hourly routinely

112.

Which technique is essential for performing procedures on immunocompromised patients?

a)

Strict aseptic technique required

b)

Clean technique with gloves only

c)

Universal precautions without masks

d)

Sterile technique only for surgeries

113.

For equipment management, what approach is recommended?

a)

Share equipment after quick wipe-down

b)

Use dedicated equipment for the patient

c)

Use central equipment without cleaning

d)

Borrow devices from other rooms often

114.

When should the patient wear a mask under these precautions?

a)

When outside the room; change each trip

b)

Continuously inside the room

c)

Only if coughing inside the room

d)

Never, masks are contraindicated

115.

Which hygiene advice is appropriate for the patient?

a)

Avoid showers to protect skin oils

b)

Handwashing before/after meals, toileting

c)

Use bar soap for better lathering

d)

Hand sanitizer replaces all washing

116.

Which fever statement in neutropenia reflects urgency level?

a)

Low-grade fever requires no evaluation

b)

Fever becomes urgent only with hypotension

c)

Fever in neutropenia is a medical emergency

d)

Fever in neutropenia is routine and expected

117.

During plasmapheresis for TTP, what nursing priority applies?

a)

Closely monitor hemodynamics during procedure

b)

Restrict fluids to prevent overload

c)

Avoid blood pressure checks during exchange

d)

Keep patient NPO after the procedure

118.

Which therapy is first-line for TTP management?

a)

IV fluids with diuretics only

b)

Platelet transfusion as initial step

c)

High-dose aspirin anticoagulation

d)

Plasma exchange (plasmapheresis/PEX)

119.

Why are platelet transfusions generally avoided in TTP?

a)

They are ineffective due to renal clearance

b)

They provide no increase in platelet count

c)

They cause severe allergic reactions invariably

d)

They are contraindicated; can worsen clotting

120.

Which adjunct therapy may be used in TTP?

a)

Vitamin K and fresh frozen plasma only

b)

Long-term warfarin and heparin bridge

c)

Therapeutic phlebotomy and iron chelation

d)

Corticosteroids or monoclonal antibodies

121.

What patient assessment is emphasized in TTP nursing care?

a)

Monitor neurologic status and renal function

b)

Check skin turgor and capillary refill

c)

Assess respiratory rate and breath sounds

d)

Evaluate vision acuity repeatedly

122.

Which precaution should be implemented for TTP patients?

a)

Bleeding precautions instituted

b)

Neutropenic isolation precautions

c)

Airborne TB precautions only

d)

Contact precautions for MRSA

123.

Which soap type is preferred for daily hygiene in at-risk patients?

a)

Medicated bar soap with exfoliants

b)

Detergent-based shampoo instead

c)

Antibacterial wipes exclusively

d)

Liquid soap rather than bar soap

124.

Which food choice best aligns with a low‑microbial diet for an immunocompromised patient?

a)

Home‑canned peaches fully boiled

b)

Unpasteurized yogurt with fruit pieces

c)

Sliced melon from a salad bar

d)

Fresh garden salad with raw tomatoes

125.

What is the primary purpose of coordinating diagnostic test schedules to minimize time in public waiting areas for immunocompromised patients?

a)

Improve staff workflow efficiency

b)

Ensure faster laboratory turnaround

c)

Reduce exposure to infectious agents

d)

Decrease patient travel expenses

126.

A neutropenic patient asks about dairy products. Which guidance is most appropriate?

a)

Prefer artisanal unpasteurized cheeses

b)

Choose raw milk for higher nutrients

c)

Select pasteurized dairy exclusively

d)

Avoid all dairy regardless type

127.

Which education priority most directly supports early intervention for infection in an immunocompromised host?

a)

Teach advanced antimicrobial pharmacology

b)

Review when to report fever promptly

c)

Explain lymphocyte maturation stages

d)

Discuss long‑term vaccination schedules

128.

A patient insists on eating fresh strawberries at home. Which nursing action demonstrates appropriate DoK‑3 reasoning for risk mitigation?

a)

Permit after refrigeration overnight

b)

Recommend canned or fully cooked alternatives

c)

Allow if washed with tap water

d)

Approve if peeled before serving