NRSG 3420: EXAM 1 With 100%
Correct Solutions.
HEME IMMUNE - CORRECT ANSWER✔✔HEME IMMUNE
j j j j j
An office worker takes a cookie that contains peanut butter. The worker begins wheezing, with an inspiratory
j j j j j j j j j j j j j j j j
stridor and air hunger and the occupational health nurse is called to the office. The nurse should recognize
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that the worker is likely suffering from which type of hypersensitivity?
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Cytotoxic (type II) j j
Immune complex (type III)
j j j
Delayed-type (type IV) j j
Anaphylactic (type 1) - CORRECT ANSWER✔✔Correct response:
j j j j j j
Anaphylactic (type 1) j j
,Explanation:
The most severe form of a hypersensitivity reaction is anaphylaxis. An unanticipated severe allergic reaction
j j j j j j j j j j j j j j
that is often explosive in onset, anaphylaxis is characterized by edema in many tissues, including the larynx,
j j j j j j j j j j j j j j j j j
and is often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases. Type
j j j j j j j j j j j j j j
II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the
j j j j j j j j j j j j j j j
body as foreign. Immune complex (type III) hypersensitivity involves immune complexes formed when
j j j j j j j j j j j j j
antigens bind to antibodies. Type III is associated with systemic lupus erythematosus, rheumatoid arthritis,
j j j j j j j j j j j j j j
certain types of nephritis, and bacterial endocarditis. Delayed-type (type IV), also known as cellular
j j j j j j j j j j j j j j
hypersensitivity, occurs 24 to 72 hours after exposure to an allergen.
j j j j j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 37: Assessment and Management of Patients With Allergic
j j j j j j j j j j j j j
Disorders, Anaphylactic (Type I) Hypersensitivity, p. 1061.
j j j j j j j
A client comes to the clinic reporting fatigue and the health interview is suggestive of pica. Laboratory findings
j j j j j j j j j j j j j j j j j
reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the client will be
j j j j j j j j j j j j j j j j j j j j j j
diagnosed?
j
Iron deficiency anemia
j j
Hemolytic anemia j
Sickle cell disease j j
Pernicious anemia - CORRECT ANSWER✔✔Correct response: j j j j j
Iron deficiency anemia
j j
Explanation:
A low serum iron level, a low ferritin level, and symptoms of pica are associated with iron deficiency anemia.
j j j j j j j j j j j j j j j j j j
TIBC may also be elevated. None of the other anemias are associated with pica.
j j j j j j j j j j j j j j
,Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 33: Management of Patients With Nonmalignant Hematologic
j j j j j j j j j j j j
Disorders, Clinical Manifestations, p. 930.
j j j j j
A client who is scheduled for a skin test informs the nurse that he has been taking corticosteroids to help
j j j j j j j j j j j j j j j j j j j
control his allergy symptoms. What nursing intervention should the nurse implement?
j j j j j j j j j j j
The client should only be tested for grass, mold, and dust initially.
j j j j j j j j j j j
The client should take his corticosteroids regularly prior to testing.
j j j j j j j j j
The client's test should be cancelled until he is off his corticosteroids.
j j j j j j j j j j j
The nurse should have an emergency cart available in case of anaphylaxis during the test. - CORRECT ANSWER
j j j j j j j j j j j j j j j j j
✔✔Correct response: j
The client's test should be cancelled until he is off his corticosteroids.
j j j j j j j j j j j
Explanation:
Corticosteroids and antihistamines, including over-the-counter (OTC) allergy medications, suppress skin test
j j j j j j j j j j
reactivity and should be stopped 48 to 96 hours before testing, depending on the duration of their activity.
j j j j j j j j j j j j j j j j j j
Emergency equipment must be at hand during allergy testing, but the test would be postponed.
j j j j j j j j j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 37: Assessment and Management of Patients With Allergic
j j j j j j j j j j j j j
Disorders, Interpretation of Skin Test Results, p. 1063.
j j j j j j j j
, A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency
j j j j j j j j j j j j j j j j
anemia in recent weeks. When providing the client with nutritional guidelines and meal suggestions, what
j j j j j j j j j j j j j j j
foods would be most likely to increase the woman's iron stores?
j j j j j j j j j j j
Beef liver accompanied by orange juice
j j j j j
Yogurt, almonds, and whole grain oats
j j j j j
Mixed vegetables and brown rice
j j j j
Salmon accompanied by whole milk - CORRECT ANSWER✔✔Correct response:
j j j j j j j j
Beef liver accompanied by orange juice
j j j j j
Explanation:
Food sources high in iron include organ meats, other meats, beans (e.g., black and pinto), leafy green
j j j j j j j j j j j j j j j j
vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice)
j j j j j j j j j j j j j j j j
enhances the absorption of iron. All of the listed foods are nutritious, but liver and orange juice are most likely
j j j j j j j j j j j j j j j j j j j j
to be of benefit to iron stores.
j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 33: Management of Patients With Nonmalignant Hematologic
j j j j j j j j j j j j
Disorders, Nursing Management, p. 931.
j j j j j
A nurse is educating a client about the role of B lymphocytes. The nurse's description will include which of the
j j j j j j j j j j j j j j j j j j j
following physiologic processes?
j j j
Correct Solutions.
HEME IMMUNE - CORRECT ANSWER✔✔HEME IMMUNE
j j j j j
An office worker takes a cookie that contains peanut butter. The worker begins wheezing, with an inspiratory
j j j j j j j j j j j j j j j j
stridor and air hunger and the occupational health nurse is called to the office. The nurse should recognize
j j j j j j j j j j j j j j j j j j
that the worker is likely suffering from which type of hypersensitivity?
j j j j j j j j j j j
Cytotoxic (type II) j j
Immune complex (type III)
j j j
Delayed-type (type IV) j j
Anaphylactic (type 1) - CORRECT ANSWER✔✔Correct response:
j j j j j j
Anaphylactic (type 1) j j
,Explanation:
The most severe form of a hypersensitivity reaction is anaphylaxis. An unanticipated severe allergic reaction
j j j j j j j j j j j j j j
that is often explosive in onset, anaphylaxis is characterized by edema in many tissues, including the larynx,
j j j j j j j j j j j j j j j j j
and is often accompanied by hypotension, bronchospasm, and cardiovascular collapse in severe cases. Type
j j j j j j j j j j j j j j
II, or cytotoxic, hypersensitivity occurs when the system mistakenly identifies a normal constituent of the
j j j j j j j j j j j j j j j
body as foreign. Immune complex (type III) hypersensitivity involves immune complexes formed when
j j j j j j j j j j j j j
antigens bind to antibodies. Type III is associated with systemic lupus erythematosus, rheumatoid arthritis,
j j j j j j j j j j j j j j
certain types of nephritis, and bacterial endocarditis. Delayed-type (type IV), also known as cellular
j j j j j j j j j j j j j j
hypersensitivity, occurs 24 to 72 hours after exposure to an allergen.
j j j j j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 37: Assessment and Management of Patients With Allergic
j j j j j j j j j j j j j
Disorders, Anaphylactic (Type I) Hypersensitivity, p. 1061.
j j j j j j j
A client comes to the clinic reporting fatigue and the health interview is suggestive of pica. Laboratory findings
j j j j j j j j j j j j j j j j j
reveal a low serum iron level and a low ferritin level. With what would the nurse suspect that the client will be
j j j j j j j j j j j j j j j j j j j j j j
diagnosed?
j
Iron deficiency anemia
j j
Hemolytic anemia j
Sickle cell disease j j
Pernicious anemia - CORRECT ANSWER✔✔Correct response: j j j j j
Iron deficiency anemia
j j
Explanation:
A low serum iron level, a low ferritin level, and symptoms of pica are associated with iron deficiency anemia.
j j j j j j j j j j j j j j j j j j
TIBC may also be elevated. None of the other anemias are associated with pica.
j j j j j j j j j j j j j j
,Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 33: Management of Patients With Nonmalignant Hematologic
j j j j j j j j j j j j
Disorders, Clinical Manifestations, p. 930.
j j j j j
A client who is scheduled for a skin test informs the nurse that he has been taking corticosteroids to help
j j j j j j j j j j j j j j j j j j j
control his allergy symptoms. What nursing intervention should the nurse implement?
j j j j j j j j j j j
The client should only be tested for grass, mold, and dust initially.
j j j j j j j j j j j
The client should take his corticosteroids regularly prior to testing.
j j j j j j j j j
The client's test should be cancelled until he is off his corticosteroids.
j j j j j j j j j j j
The nurse should have an emergency cart available in case of anaphylaxis during the test. - CORRECT ANSWER
j j j j j j j j j j j j j j j j j
✔✔Correct response: j
The client's test should be cancelled until he is off his corticosteroids.
j j j j j j j j j j j
Explanation:
Corticosteroids and antihistamines, including over-the-counter (OTC) allergy medications, suppress skin test
j j j j j j j j j j
reactivity and should be stopped 48 to 96 hours before testing, depending on the duration of their activity.
j j j j j j j j j j j j j j j j j j
Emergency equipment must be at hand during allergy testing, but the test would be postponed.
j j j j j j j j j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 37: Assessment and Management of Patients With Allergic
j j j j j j j j j j j j j
Disorders, Interpretation of Skin Test Results, p. 1063.
j j j j j j j j
, A woman who is in her third trimester of pregnancy has been experiencing an exacerbation of iron-deficiency
j j j j j j j j j j j j j j j j
anemia in recent weeks. When providing the client with nutritional guidelines and meal suggestions, what
j j j j j j j j j j j j j j j
foods would be most likely to increase the woman's iron stores?
j j j j j j j j j j j
Beef liver accompanied by orange juice
j j j j j
Yogurt, almonds, and whole grain oats
j j j j j
Mixed vegetables and brown rice
j j j j
Salmon accompanied by whole milk - CORRECT ANSWER✔✔Correct response:
j j j j j j j j
Beef liver accompanied by orange juice
j j j j j
Explanation:
Food sources high in iron include organ meats, other meats, beans (e.g., black and pinto), leafy green
j j j j j j j j j j j j j j j j
vegetables, raisins, and molasses. Taking iron-rich foods with a source of vitamin C (e.g., orange juice)
j j j j j j j j j j j j j j j j
enhances the absorption of iron. All of the listed foods are nutritious, but liver and orange juice are most likely
j j j j j j j j j j j j j j j j j j j j
to be of benefit to iron stores.
j j j j j j j
Reference:
Hinkle, J.L., & Cheever, K.H., Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 14th ed.,
j j j j j j j j j j j j j
Philadelphia, Wolters Kluwer, 2018, Chapter 33: Management of Patients With Nonmalignant Hematologic
j j j j j j j j j j j j
Disorders, Nursing Management, p. 931.
j j j j j
A nurse is educating a client about the role of B lymphocytes. The nurse's description will include which of the
j j j j j j j j j j j j j j j j j j j
following physiologic processes?
j j j
