Exam (elaborations)
520 Immunity (1)
Exam of 12 pages for the course NUR 266 at NUR 266 (520 Immunity (1))
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520 ImmunityAt which time should the nurse instruct the client to take ibuprofen, prescribed for left hip pain
secondary to osteoarthritis, to minimize gastric mucosal irritation?
a. on arising
b. immediately after a meal
c. at bedtime
d. on an empty stomach - CORRECT ANSWER-b. immediately after a meal
Drugs that cause gastric irritation, such as ibuprofen, are best taken after or with a meal, when
stomach contents help minimize the local irritation. Taking the medication on an empty stomach at
any time during the day will lead to gastric irritation. Taking the drug at bedtime with food may
cause the client to gain weight, possibly aggravating the osteoarthritis. When the client arises, he
is stiff from immobility and should use warmth and stretching until he gets food in his stomach.
A nurse is teaching high school students about transmission of the human immunodeficiency virus
(HIV). Which comment by a student warrants clarification by the nurse?
a. "A man should wear a latex condom during intimate sexual contact."
b. "I won't donate blood because I don't want to get AIDS."
c. "I've heard about people who got AIDS from blood transfusions."
d. "I.V. drug users can get HIV from sharing needles." - CORRECT ANSWER-b. "I won't donate
blood because I don't want to get AIDS."
HIV is transmitted through infected blood, semen, and certain other body fluids. Although a
transfusion with infected blood may cause HIV infection in the recipient, a person cannot become
infected by donating blood. The other options reflect accurate understanding of HIV transmission.
A client is admitted with fatigue, shortness of breath, pale skin, and dried, cracked lips, tongue,
and mouth. The hemoglobin is 9 g/dL (90 g/L), and red blood cell count is 3.5 million
cells/mm3(3.5 × 1012/L). What should the nurse instruct the client to do?
a. Limit fluid intake to 1,000 mL per day.
b. Increase the amount of carbohydrates in the diet.
c. Eat a serving of fish with high omega 3 content 2 times a week.
d. Eat foods with good sources of iron. - CORRECT ANSWER-d. Eat foods with good sources of
iron.
The client is demonstrating signs of anemia and should increase the iron in the diet. Foods such
as red meats, beets, and cabbage are good sources of iron. The client should not limit the fluid
intake to 1,000 mL per day, but should maintain an adequate fluid intake of about 3,000 mL per
day. Carbohydrates will not provide the necessary dietary intake of iron. While fish is a healthy
choice, beef, lamb, and iron-rich vegetables are more important in the diet at this time.
Which dietary strategy best meets the needs of a client with acquired immunodeficiency syndrome
(AIDS)?
a. Tell the client to prepare food in advance and leave it out to eat small amounts throughout the
day.
b. Instruct the client to cook foods thoroughly and adhere to safe food-handling practices.
c. Encourage mega doses of nutritional supplements.
d. Tell the client to eat large meals frequently. - CORRECT ANSWER-b. Instruct the client to cook
foods thoroughly and adhere to safe food-handling practices.
, A client with AIDS is immunocompromised, and food safety is an important concern. Food-borne
illnesses and infections can be devastating to the client with AIDS. Large, frequent meals are not
necessary. Mega doses of vitamins can result in toxicities that may aggravate the client's clinical
condition. Leaving food out encourages growth of microorganisms.
The nurse assesses the mouth and oral cavity of a client with human immunodeficiency virus
(HIV) infection because the most common opportunistic infection initially presents with which
symptom?
a. cytomegalovirus (CMV) infection
b. aphthae on the gingiva
c. oral candidiasis
d. herpes simplex virus (HSV) lesions on the lips - CORRECT ANSWER-c. oral candidiasis
The most common opportunistic infection in HIV infection initially presents as oral candidiasis, or
thrush. The client with HIV should always have an oral assessment. HSV and CMV are
opportunistic infections that present later in acquired immunodeficiency syndrome. Aphthous
stomatitis, or recurrent canker sores, is not an opportunistic infection, although the sores are
thought to occur more often when the client is under stress.
A multidisciplinary oncology team of health care providers, nurses, and the social worker notes
that a client who has been undergoing chemotherapy is now experiencing pancytopenia. When
reviewing the laboratory data, which values support this diagnosis? Select all that apply.
a. increased RBCs
b. increased platelets
c. increased white blood cells
d. decreased white blood cells
e. decreased platelets
f. decreased RBCs - CORRECT ANSWER-d. decreased white blood cells
e. decreased platelets
f. decreased RBCs
Pancytopenia is a deficiency of all blood cells that includes a state of simultaneous leukopenia
(decreased white blood cells), thrombocytopenia (decreased platelets), and anemia (decreased
RBCs). Pancytopenia has widespread effects on the body by leading to oxygen shortage and
immune function.
A client takes prednisone, as ordered, for rheumatoid arthritis. During follow-up visits, the nurse
should assess the client for common adverse reactions to this drug, such as
a. abdominal cramps and diarrhea.
b. fluid retention and weight gain.
c. tetany and tremors.
d. anorexia and weight loss. - CORRECT ANSWER-b. fluid retention and weight gain.
Common adverse reactions to prednisone and other steroids include sodium retention, fluid
retention, and weight gain. Tetany and tremors are occasional adverse reactions to certain other
drugs such as antipsychotics. Anorexia, abdominal cramps, and diarrhea are common adverse
reactions to many drugs, but not to steroids.
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative
finding must the nurse report to the physician immediately?
a. Serum potassium level of 4.9 mEq/L
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