NSG 430 EXAM 2
The nurse teaches a patient about drug therapy after a kidney
transplant. Which statement by
the patient indicates a need for further instructions?
a. ―I need to be monitored closely for development of cancer.‖
b. ―After a couple of years, I will be able to stop taking
immunosuppressants.‖
c. ―If I develop an acute rejection episode, I will need additional
types of drugs.‖
d. ―The drugs are combined to inhibit different ways the kidney
can be rejected.‖
―After a couple of years, I will be able to stop taking
immunosuppressants.‖
Immunosuppressants will need to be continued for life. The other
patient statements are
accurate and indicate that no further teaching is necessary about those
topics.
An older adult patient has a prescription for cyclosporine
following a kidney transplant.
Which information in the patient's health history has implications
for planning patient
teaching about the safe use of cyclosporine?
a. The patient restricts salt to 2 grams per day.
b. The patient eats green leafy vegetables daily.
c. The patient drinks grapefruit juice every day.
d. The patient drinks 3 to 4 quarts of fluid each day.
The patient drinks grapefruit juice every day.
,Grapefruit juice can increase the toxicity of cyclosporine. The patient
should be taught to
avoid grapefruit juice. Normal fluid and sodium intake or eating green
leafy vegetables will
not affect cyclosporine levels or renal function.
patient is admitted to the hospital with acute rejection of a kidney
transplant. Which
intervention would the nurse expect for this patient?
a. Testing for human leukocyte antigen (HLA) match
b. Administration of immunosuppressant medications
c. Insertion of an arteriovenous graft for hemodialysis
d. Placement of the patient on the transplant waiting list
Administration of immunosuppressant medications
Acute rejection is treated with the administration of additional
immunosuppressant drugs such
as corticosteroids. Because acute rejection is potentially reversible,
there is no sign that the
patient will need another transplant or hemodialysis. There is no need
to repeat HLA testing.
The charge nurse is assigning semiprivate rooms for new
admissions. Which patient could
safely be assigned as a roommate for a patient who has acute
rejection of an organ transplant?
a. A patient who has viral pneumonia
b. A patient with second-degree burns
c. A patient with an anaphylactic reaction
d. A patient with graft-versus-host disease
A patient with an anaphylactic reaction
There is no increased exposure to infection from a patient who had an
,anaphylactic reaction.
Treatment for a patient with acute rejection includes administration of
additional
immunosuppressants and the patient would not be exposed to
increased risk for infection as
would occur from patients with viral pneumonia, graft-versus-host
disease, and burns.
A patient in the health care provider's office for allergen testing
using the cutaneous scratch
method develops itching and swelling at the skin site. Which
action would the nurse plan to
take first?
a. Monitor the patient's edema.
b. Administer a dose of epinephrine.
c. Obtain a prescription for oral antihistamines.
d. Assess the patient's use of new skin products
Administer a dose of epinephrine
Rapid administration of epinephrine when excessive itching or
swelling at the skin site is
observed can prevent the progression to anaphylaxis. The initial
symptoms of anaphylaxis are
itching and edema at the site of the exposure. The nurse should not
wait and assess for
development of more edema. Hypotension, tachycardia, dilated
pupils, and wheezes occur
later. Exposure to skin products does not address the immediate
concern of a possible
anaphylactic reaction.
A patient in the emergency room is anxious and reports difficulty
breathing after being stung
, by a wasp. Which action would the nurse take first?
a. Provide high-flow oxygen.
b. Administer antihistamines.
c. Assess the patient's airway.
d. Remove the stinger from the site.
Assess the patient's airway.
The initial action with any patient with difficulty breathing is to assess
and maintain the
airway. The patient's symptoms of anxiety and difficulty breathing
may have other causes
than anaphylaxis, so additional assessment is warranted. The other
actions are part of the
emergency management protocol for anaphylaxis, but the priority is
airway assessment and
maintenance.
Immediately after the nurse administers an intradermal injection
of an allergen on the forearm,
the patient reports itching at the site, weakness, and dizziness.
Which action would the nurse
take first?
a. Apply antiinflammatory cream.
b. Place a tourniquet above the site.
c. Administer subcutaneous epinephrine.
d. Reschedule the patient's other allergen tests.
Place a tourniquet above the site.
Application of a tourniquet will decrease systemic circulation of the
allergen and should be
the first reaction. The other actions may occur, but the tourniquet
application slows the
The nurse teaches a patient about drug therapy after a kidney
transplant. Which statement by
the patient indicates a need for further instructions?
a. ―I need to be monitored closely for development of cancer.‖
b. ―After a couple of years, I will be able to stop taking
immunosuppressants.‖
c. ―If I develop an acute rejection episode, I will need additional
types of drugs.‖
d. ―The drugs are combined to inhibit different ways the kidney
can be rejected.‖
―After a couple of years, I will be able to stop taking
immunosuppressants.‖
Immunosuppressants will need to be continued for life. The other
patient statements are
accurate and indicate that no further teaching is necessary about those
topics.
An older adult patient has a prescription for cyclosporine
following a kidney transplant.
Which information in the patient's health history has implications
for planning patient
teaching about the safe use of cyclosporine?
a. The patient restricts salt to 2 grams per day.
b. The patient eats green leafy vegetables daily.
c. The patient drinks grapefruit juice every day.
d. The patient drinks 3 to 4 quarts of fluid each day.
The patient drinks grapefruit juice every day.
,Grapefruit juice can increase the toxicity of cyclosporine. The patient
should be taught to
avoid grapefruit juice. Normal fluid and sodium intake or eating green
leafy vegetables will
not affect cyclosporine levels or renal function.
patient is admitted to the hospital with acute rejection of a kidney
transplant. Which
intervention would the nurse expect for this patient?
a. Testing for human leukocyte antigen (HLA) match
b. Administration of immunosuppressant medications
c. Insertion of an arteriovenous graft for hemodialysis
d. Placement of the patient on the transplant waiting list
Administration of immunosuppressant medications
Acute rejection is treated with the administration of additional
immunosuppressant drugs such
as corticosteroids. Because acute rejection is potentially reversible,
there is no sign that the
patient will need another transplant or hemodialysis. There is no need
to repeat HLA testing.
The charge nurse is assigning semiprivate rooms for new
admissions. Which patient could
safely be assigned as a roommate for a patient who has acute
rejection of an organ transplant?
a. A patient who has viral pneumonia
b. A patient with second-degree burns
c. A patient with an anaphylactic reaction
d. A patient with graft-versus-host disease
A patient with an anaphylactic reaction
There is no increased exposure to infection from a patient who had an
,anaphylactic reaction.
Treatment for a patient with acute rejection includes administration of
additional
immunosuppressants and the patient would not be exposed to
increased risk for infection as
would occur from patients with viral pneumonia, graft-versus-host
disease, and burns.
A patient in the health care provider's office for allergen testing
using the cutaneous scratch
method develops itching and swelling at the skin site. Which
action would the nurse plan to
take first?
a. Monitor the patient's edema.
b. Administer a dose of epinephrine.
c. Obtain a prescription for oral antihistamines.
d. Assess the patient's use of new skin products
Administer a dose of epinephrine
Rapid administration of epinephrine when excessive itching or
swelling at the skin site is
observed can prevent the progression to anaphylaxis. The initial
symptoms of anaphylaxis are
itching and edema at the site of the exposure. The nurse should not
wait and assess for
development of more edema. Hypotension, tachycardia, dilated
pupils, and wheezes occur
later. Exposure to skin products does not address the immediate
concern of a possible
anaphylactic reaction.
A patient in the emergency room is anxious and reports difficulty
breathing after being stung
, by a wasp. Which action would the nurse take first?
a. Provide high-flow oxygen.
b. Administer antihistamines.
c. Assess the patient's airway.
d. Remove the stinger from the site.
Assess the patient's airway.
The initial action with any patient with difficulty breathing is to assess
and maintain the
airway. The patient's symptoms of anxiety and difficulty breathing
may have other causes
than anaphylaxis, so additional assessment is warranted. The other
actions are part of the
emergency management protocol for anaphylaxis, but the priority is
airway assessment and
maintenance.
Immediately after the nurse administers an intradermal injection
of an allergen on the forearm,
the patient reports itching at the site, weakness, and dizziness.
Which action would the nurse
take first?
a. Apply antiinflammatory cream.
b. Place a tourniquet above the site.
c. Administer subcutaneous epinephrine.
d. Reschedule the patient's other allergen tests.
Place a tourniquet above the site.
Application of a tourniquet will decrease systemic circulation of the
allergen and should be
the first reaction. The other actions may occur, but the tourniquet
application slows the
