NUR 4500 medsurg -All Med Surge Exams and Quizzes GRADED A+ 2021/2122

MedSurge Quiz 1. A nurse is admitting a patient with an immunodeficiency to the medical unit. In planning the care of this patient, the nurse should assess for what common sign of immunodeficiency? a. Chronic diarrhea 2. A nurse is caring for a patient who has an immunodeficiency. What assessment finding should prompt the nurse to consider the possibility that the patient is developing an infection? a. Persistent diarrhea 3. The nurse is applying standard precautions in the care of a patient who has an immunodeficiency. What are key elements of standard precautions? Select all that apply. a. Using appropriate personal protective equipment b. Using safe injection practices c. Performing hand hygiene 4. A home health nurse is reinforcing health education with a patient who is immunosuppressed and his family. What statement best suggests that the patient has understood the nurse's teaching? a. “My family needs to understand that I'll probably need lifelong treatment.” 5. The nurse is preparing to administer IVIG to a patient who has an immunodeficiency. What nursing guideline should the nurse apply? a. Administer pretreatment medications as ordered 30 minutes prior to infusion. 6. A nurse has created a plan of care for an immunodeficient patient, specifying that care providers take the patient's pulse and respiratory rate for a full minute. What is the rationale for this aspect of care? a. These patients' blunted inflammatory responses can cause subtle changes in status. 7. A nurse is providing health education regarding self-care to a patient with an immunodeficiency. What teaching point should the nurse emphasize? a. The need for thorough oral hygiene 8. A patient's primary immunodeficiency disease is characterized by the inability of white blood cells to initiate an inflammatory response to infectious organisms. What is this patient's most likely diagnosis? a. Hyperimmunoglobulinemia E syndrome 9. A nurse is working with a patient who was diagnosed with HIV several months earlier. The nurse should recognize that a patient with HIV is considered to have AIDS at the point when the CD4+ T-lymphocyte cell count drops below what threshold? a. 200 cells/mm3 of blood 10. A patient has been diagnosed with AIDS complicated by chronic diarrhea. What nursing intervention would be appropriate for this patient? a. Obtain a stool culture to identify possible pathogens. 11. An 18-year-old pregnant female has tested positive for HIV and asks the nurse if her baby is going to be born with HIV. What is the nurse's best response? a. “It's possible that your baby could contract HIV, either before, during, or after delivery.” 12. Since the emergence of HIV/AIDS, there have been significant changes in epidemiologic trends. Members of what group currently have the greatest risk of contracting HIV? a. Gay, bisexual, and other men who have sex with men 13. A hospital patient is immunocompromised because of stage 3 HIV infection and the physician has ordered a chest radiograph. How should the nurse most safely facilitate the test? a. Arrange for a portable x-ray machine to be used 14. A patient's current antiretroviral regimen includes nucleoside reverse transcriptase inhibitors (NRTIs). What dietary counseling will the nurse provide based on the patient's medication regimen? a. Take this medication without regard to meals. 15. A nurse is performing the admission assessment of a patient who has AIDS. What components should the nurse include in this comprehensive assessment? Select all that apply. a. Current medication regimen b. Identification of patient's support system c. Immune system function d. History of sexual practices 16. A patient is in the primary infection stage of HIV. What is true of this patient's current health status? a. The patient is infected with HIV but lacks HIV-specific antibodies. 17. A nurse is aware of the need to assess patients' risks for anaphylaxis. What health care procedure constitutes the highest risk for anaphylaxis? a. Computed tomography with contrast solution 18. A patient with multiple food and environmental allergies tells the nurse that he is frustrated and angry about having to be so watchful all the time and wonders if it is really worth it. What would be the nurse's best response? a. “I can only imagine how you feel. Would you like to talk about it? 19. A nurse is caring for a patient who has allergic rhinitis. What intervention would be most likely to help the patient meet the goal of improved breathing pattern? a. Modify the environment to reduce the severity of allergic symptoms. 20. The nurse in an allergy clinic is educating a new patient about the pathology of the patient's health problem. What response should the nurse describe as a possible consequence of histamine release? a. Contraction of bronchial smooth muscle 21. A patient has presented with signs and symptoms that are consistent with contact dermatitis. What aspect of care should the nurse prioritize when working with this patient? a. Identifying the offending agent, if possible 22. A patient's rheumatoid arthritis (RA) has failed to respond appreciably to first-line treatments and the primary care provider has added prednisone to the patient's drug regimen. What principle will guide this aspect of the patient's treatment? a. The drug should be used for as short a time as possible. 23. A patient with SLE has come to the clinic for a routine check-up. When auscultating the patient's apical heart rate, the nurse notes the presence of a distinct “scratching” sound. What is the nurse's most appropriate action? a. Inform the primary care provider that a friction rub may be present. 24. A nurse is educating a patient with gout about lifestyle modifications that can help control the signs and symptoms of the disease. What recommendation should the nurse make? a. Limiting intake of alcohol 25. A nurse is planning the care of a patient who has a long history of chronic pain, which has only recently been diagnosed as fibromyalgia. What nursing diagnosis is most likely to apply to this woman's care needs? a. Ineffective Role Performance Related to Pain Test Bank Questions Not On Quiz 1 CHP 36 1. A teenager is diagnosed with cellulitis of the right knee and fails to respond to oral antibiotics. He then develops osteomyelitis of the right knee, prompting a detailed diagnostic workup that reveals a phagocytic disorder. This patient faces an increased risk of what complication? a. Neutropenia 2. A patient is admitted for the treatment of a primary immunodeficiency and intravenous immunoglobulin (IVIG) is ordered. What should the nurse monitor for as a potential adverse effect of IVIG administration? a. Anaphylaxis 3. A young couple visits the nurse practitioner stating that they want to start a family. The husband states that his brother died of a severe infection at age 6 months. He says he never knew what was wrong but his mother had him undergo ìblood testingî as a child. Based on these statements, what health problem should the nurse practitioner suspect? a. X-linked agammaglobulinemia 4. The parents of a 1-month-old infant bring their child to the pediatrician with symptoms of congestive heart failure. The infant is ultimately diagnosed with DiGeorge syndrome. What will prolong this infant's survival? a. Thymus gland transplantation 5. A patient who has received a heart transplant is taking cyclosporine, an immunosuppressant. What should the nurse emphasize during health education about infection prevention? a. Perform frequent hand-washing 6. The nurse is caring for a patient who has a diagnosis of paroxysmal nocturnal hemoglobinuria. When planning this patient's care, the nurse should recognize the patient's heightened risk of what complication? a. Venous thromboembolism 7. A patient diagnosed with common variable immune deficiency (CVID) has been admitted to the acute medicine unit. When reviewing this patient's laboratory findings, the nurse should prioritize what values? a. Hemoglobin and vitamin B12 8. Patient teaching regarding infection prevention for the patient with an immunodeficiency includes which of the following guidelines? a. Cook all food thoroughly 9. A nurse has admitted a patient diagnosed with severe combined immunodeficiency disease (SCID) to the unit. The patient's orders include IVIG. How will the patient's dose of IVIG be determined? a. The dose will be determined by the patient's response 10. IVIG has been ordered for the treatment of a patient with an immunodeficiency. Which of the following actions should the nurse perform before administering this blood product? a. Weigh the patient before administration to verify the correct dose. 
 11. A patient with a diagnosis of common variable immunodeficiency begins to develop thick, sticky, tenacious sputum. The patient has a history of episodes of pneumonia at least one time per year for the last 10 years. What does the nurse suspect the patient is developing? a. Bronchiectasis 12. A nurse is admitting an adolescent patient with a diagnosis of ataxia-telangiectasis. Which of the following nursing diagnoses should the nurse include in the patient's plan of care? a. Risk for Falls Due to Loss of Muscle Coordination 13. A 20-year-old patient with an immunodeficiency is admitted to the unit with an acute episode of upper airway edema. This is the fifth time in the past 3 months that the patient has had such as episode. As the nurse caring for this patient, you know that the patient may have a deficiency of what? a. C1esterase inhibitor 14. A patient with Wiskott-Aldrich syndrome is admitted to the medical unit. The nurse caring for the patient should prioritize which of the following? a. Protective isolation 15. The nurse is admitting a patient to the unit with a diagnosis of ataxia-telangiectasia. The nurse's assessment should reflect the patient's increased risk for what complication? a. Cancer 16. The nurse is working with the interdisciplinary team to care for a patient who has recently been diagnosed with severe combined immunodeficiency disease (SCID). What treatment is likely of most benefit to this patient? a. Hematopoietic stem cell transplantation (HSCT) 17. A patient has been admitted with a phagocytic cell disorder and the nurse is reviewing the most common health problems that accompany these disorders. The nurse should identify which of the following? Select all that apply. a. Chronic otitis media b. Cutaneous abscesses c. Pneumonia 18. A nurse is caring for a patient with a phagocytic cell disorder. The patient states, ìMy specialist says that I will likely be cured after I get my treatment tomorrow. To what treatment is the patient most likely referring? a. Hematopoietic stem cell transplantation 19. A nurse educator is explaining that patients with primary immunodeficiencies are living longer than in past decades because of advances in medical treatment. This increased longevity is associated with an increased risk of what? a. Cancer 20. The nurse educator is differentiating primary immunodeficiency diseases from secondary immunodeficiencies. What is the defining characteristic of primary immunodeficiency diseases? a. They have a genetic origin 21. The nurse is caring for a patient with an immunodeficiency who has experienced sudden malaise. The nurse's colleague states, ìI'm pretty sure that it's not an infection, because the most recent blood work looks fine.î What principle should guide the nurse's response to the colleague? a. Immunodeficient patients will usually exhibit subtle and atypical signs of infection 22. A patient with a diagnosis of primary immunodeficiency informs the nurse that he has been experiencing a new onset of a dry cough and occasional shortness of breath. After determining that the patient's vital signs are within reference ranges, what action should the nurse take? a. Assess the patient for signs and symptoms of infection 23. A nurse is preparing to administer a scheduled dose of IVIG to a patient who has a diagnosis of severe combined immunodeficiency disease (SCID). What medication should the nurse administer prior to initiating the infusion? a. Diphenhydramine 24. An immunocompromised patient is being treated in the hospital. The nurse's assessment reveals that the patient's submandibular lymph nodes are swollen, a finding that represents a change from the previous day. What is the nurse's most appropriate action? a. Inform the patient's primary care provider of this finding 25. A nurse caring for a patient who has an immunosuppressive disorder knows that continual monitoring of the patient is critical. What is the primary rationale behind the need for continual monitoring? a. So that early signs of impending infection can be detected and treated 26. A nurse is planning the care of a patient who requires immunosuppression to ensure engraftment of depleted bone marrow during a transplantation procedure. What is the most important component of infection control in the care of this patient? a. Thorough and consistent hand hygiene 27. A home health nurse is caring for a patient who has an immunodeficiency. What is the nurse's priority action to help ensure successful outcomes and a favorable prognosis? a. Encourage the patient and family to be active partners in the management of the
immunodeficiency 28. A nurse is preparing to discharge a patient with an immunodeficiency. When preparing the patient for self-infusion of IVIG in the home setting, what education should the nurse prioritize? a. Signs and symptoms of adverse reactions 29. A home health nurse will soon begin administering IVIG to a new patient on a regular basis. What teaching should the nurse provide to the patient? a. Expected benefits and outcomes of the treatment 30. The home health nurse is assessing a patient who is immunosuppressed following a liver transplant. What is the most essential teaching for this patient and the family? a. The need to report any slight changes in the patient's health status 31. Family members of an immunocompromised patient have asked the nurse why antibiotics are not being given to the patient in order to prevent infection. How should the nurse best respond? a. Using antibiotics to prevent infections can cause the growth of drug-resistant bacteria 32. A 6-month-old infant has been diagnosed with X-linked agammaglobulinemia and the parents do not understand why their baby did not develop an infection during the first months of life. The nurse should describe what phenomenon? a. Passive acquired immunity CHP 37