Chapter 48- Common Immunological Disorders. My Nursing Test Banks

 

1.

Why is it important for critical care nurses to be aware of antiretroviral therapy (ART) for AIDS patients? Select all that apply.

A)

To recognize life-threatening toxicities associated with this class of drugs

B)

To keep the patient from taking these drugs

C)

To avoid drug interactions between ARTs and other classes of drugs that are common and potentially life-threatening

D)

To avoid promoting ART drug resistance

2.

A patient is admitted to the critical care unit with pneumocystis pneumonia. Which of the following will the nurse likely need to manage for this patient? Select all that apply.

A)

Intravenous (IV) trimethoprim and sulfamethoxazole (Bactrim, Septra) and corticosteroids

B)

Dialysis

C)

Bloodborne pathogen isolation

D)

Ultrasound

3.

A patient is admitted to the ICU to rule out necrotizing enterocolitis. Management of this patient may include which of the following initial therapies?

A)

Vasopressin

B)

Prophylactic hematopoietic growth factors

C)

Regular diet

D)

NG feedings

4.

A patient is admitted to the ICU with the following symptoms: weak pulse, distant heart sounds, pulsus paradoxis, and distended neck veins. What is the likely diagnosis for this patient?

A)

Cardiac tamponade

B)

Pneumocystis pneumonia

C)

Pleural effusion

D)

Cardiac artery rupture

5.

A 48-year-old patient is admitted with hepatic veno-occlusive disease. Which of the following are likely assessments and interventions for this patient? Select all that apply.

A)

Observe and assess for dehydration.

B)

Obtain serum bilirubin.

C)

Prepare for a liver biopsy.

D)

Prepare for a surgical intervention.

6.

Radiology results come back on a 44-year-old male cancer patient with a significant pleural effusion. He is breathing at a rate of 60 breaths per minute and has already had thoracentesis in the past to remove fluid. Current intervention should include which of the following?

A)

IV antibiotics

B)

IV antiviral agents

C)

Additional thoracentesis to reduce the fluid again.

D)

Bag/mask ventilation

7.

A nurse is caring for a patient with spinal cord compression from a tumor. The family asks the nurse why this happens. Which of the following is the nurses best response?

A)

There is not enough data to answer that question.

B)

Tumors arising within the epidural space through vertebral or lymphatic spread may cause spinal cord compression.

C)

More than 75% of cases are secondary to small cell or squamous cell lung cancers, and 10% to 15% are secondary to mediastinal lymphomas.

D)

This occurs because of a large amount of fluid in the spinal space.

8.

A nurse is caring for a patient with a tracheobronchial obstruction. The nurse should assess the patient frequently and watch for which of the following major complications?

A)

Pleural effusion and tachycardia

B)

Total airway occlusion and hemorrhage

C)

Total airway occlusion and vomiting

D)

Hemorrhage and decreased level of consciousness

9.

A nurse is caring for a patient with a diagnosis of hypocalcemia. This patient likely has a corrected serum calcium level above which of the following?

A)

11 mg/dL

B)

5 mg/dL

C)

25 mg/dL

D)

2 mg/dL

10.

Which of the following are included in the management of a patient with hypocalcemia? Select all that apply.

A)

IV fluids for hydration

B)

Medication to enhance renal excretion of calcium

C)

Dialysis

D)

Glucose

11.

A patient has been diagnosed with human immunodeficiency virus (HIV). HIV results in dysfunction of what specific portion of the immune system?

A)

T lymphocytes

B)

B lymphocytes

C)

T4 helper cells

D)

IgG antibodies

12.

When caring for an HIV-positive patient, what isolation technique should the nurse implement?

A)

Droplet

B)

Aerosol

C)

Contact

D)

Standard

13.

The nurse is caring for a patient with active acquired immune deficiency syndrome (AIDS) in an intensive care unit. What is the most important component of care for this patient?

A)

Psychological support

B)

Infection control measures

C)

Prophylactic antibiotics

D)

Neutropenic precautions

14.

An AIDS patient is to receive zidovudine (AZT, ZDV, Retrovir). What is the most serious side effect that the nurse should include in teaching?

A)

Nausea and vomiting

B)

Bone marrow suppression

C)

Bleeding disorders

D)

General malaise

15.

The nurse is caring for an AIDS patient who is being offered therapy with potent combination antiretroviral therapy (ART). The patient is concerned about the many possible adverse effects of ART medications. What statement by the nurse most accurately represents the rationale for the use of ART?

A)

It suppresses and maintains the viral load at nondetectable levels.

B)

It will ultimately cure AIDS.

C)

Therapy is based on research study results.

D)

Effects are similar in men, women, and children.

16.

After receiving a bone marrow transplant, a cancer patient suffers a cardiopulmonary arrest and needs mechanical ventilation. The family asks the nurse about the patients chances of survival. What is the most accurate information for the nurse to base the answer on?

A)

Cardiopulmonary arrest and mechanical ventilation are associated with low survival rates in patients with cancer.

B)

The hospital has a generally low incidence of death after cardiopulmonary arrest compared to national averages.

C)

Every patient and every situation must be evaluated individually, and no prediction of survival is possible at this time.

D)

The family should be referred to the physician and the chaplain to discuss their concerns about survival.

17.

A patient who has received a bone marrow transplant is suspected to have either engraftment syndrome or sepsis and is undergoing evaluation. If the complication turns out to be engraftment syndrome, what is the most likely differentiating criterion?

A)

High fever, especially in the evening

B)

Pruritic total body rash

C)

Leukocytes less than 2,500/mm3

D)

Dyspnea with pulmonary infiltrates

18.

A patient with leukemia has been admitted with possible leukostasis. What sign or symptom does the nurse most expect?

A)

Critical neutropenia

B)

High and persistent fever

C)

SpO2 82% to 90%

D)

Diffuse erythematous rash

19.

The patient has been diagnosed with leukostasis. What definitive medical treatment does the nurse anticipate?

A)

Supplemental oxygen

B)

Magnetic resonance imaging (MRI)

C)

Serial arterial blood gases

D)

Therapeutic leukapheresis

20.

A patient with acute leukemia is also anemic and is to receive packed red blood cells. What is the most important nursing action when giving the blood?

A)

Give intravenous diuretics before the blood.

B)

Administer the blood with normal saline volume.

C)

Ensure administration of bronchodilators.

D)

Prepare for continuous renal replacement therapy (CRRT).

21.

A patient with cancer has developed probable cardiac tamponade. The patient most likely presents with which of the following symptoms?

A)

Flat jugular veins when erect

B)

Muffled or distant heart sounds

C)

Bradycardia and heart block

D)

Generalized erythematous rash

22.

A patient with thyroid cancer is at high risk for rupture of a carotid artery and has had a carotid artery stent placed. The nurse notices a trickle of blood from the surgical site. What is the first nursing action?

A)

Application of a vascular clamp after digital pressure

B)

Insertion of two large-bore intravenous lines

C)

Constant digital pressure until reaching the operating room

D)

Immediate notification of the surgeon and oncologist

23.

The patient has developed a large pleural effusion as a complication from lung cancer. The patients life expectancy is short. What medical treatment does the nurse anticipate?

A)

Observation

B)

Thoracentesis

C)

Diuretic therapy

D)

Pneumonectomy

24.

A critically ill cancer patient has severe hypercalcemia. What treatment should the nurse initiate first?

A)

Administer high doses of phosphorus.

B)

Withhold antineoplastics.

C)

Give high-volume intravenous saline.

D)

Maintain complete bed rest.

Answer Key

1.

A, C, D

2.

A, C

3.

B

4.

A

5.

B, C

6.

C

7.

B

8.

B

9.

A

10.

A, B, C

11.

C

12.

D

13.

B

14.

B

15.

A

16.

A

17.

C

18.

C

19.

D

20.

B

21.

B

22.

C

23.

B

24.

C

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