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A client informs the nurse of being very allergic to poison ivy but expresses enjoying and having several camping trips planned for the summer months. What suggestions can the nurse make to protect the client against poison ivy?
- A. Calamine lotion prior to the exposure of the poison ivy and any time skin gets wet
- B. Bentoquatam 5% applied 15 minutes prior to exposure and every 4 hours
- C. Vinegar and water applied to the skin every 2 hours
- D. Diphenhydramine (Benadryl) 50 mg taken prior to the camping trip
Correct Answer: B
Rationale: To protect against poison ivy, clients can apply bentoquatam 5% to the skin 15 minutes prior to exposure and at least every 4 hours as long as risk of exposure continues. The cream forms a protective layer on top of the skin. Calamine lotion can be used for the itching related to poison ivy exposure. Vinegar and water is not an effective way to manage the prevention of poison ivy. Benadryl will not protect against poison ivy.
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The nurse is collecting data from a client with the autoimmune disorder endocarditis. What does the nurse recognize as symptom of an acute exacerbation?
- A. Temperature of 100.9?°F
- B. Respiratory rate of 20 breaths/minute
- C. Constipation
- D. Nausea
Correct Answer: A
Rationale: Periods of acute flare-ups (known as exacerbations) are completely unpredictable. During acute exacerbations, clients often experience a low-grade fever, malaise, or fatigue. They also may lose weight. A respiratory rate of 20 breaths/minute is within normal range. Constipation and nausea are not characteristic of a flare-up of endocarditis.
A client received 2 units of packed red blood cells while in the hospital with rectal bleeding. Three days after discharge, the client experienced an allergic response and began to itch and break out with hives. What type of reaction does the nurse understand could be occurring?
- A. Delayed hypersensitivity response
- B. Anaphylactic reaction
- C. Sensitization
- D. An immediate hypersensitivity response
Correct Answer: A
Rationale: A delayed hypersensitivity response may develop over several hours or days, or it may reach maximum severity after repeated exposure. Examples of a delayed hypersensitivity response include a blood transfusion reaction that occurs days to weeks after blood administration, rejection of transplanted tissues, and reaction to a tuberculin skin test. Anaphylaxis is a rapid and profound type I hypersensitivity response. Sensitization is the process by which cellular and chemical events occur after a second or subsequent exposure to an allergen. An immediate hypersensitivity response is due to antibodies interacting with allergens and occurs rapidly.
A client is taking a corticosteroid for the treatment of systemic lupus erythematosus. When the nurse is providing instructions about the medication to the client, what priority information should be included?
- A. If the client experiences nausea, omit the dose.
- B. The client should be alert for joint aches.
- C. This medication is commonly used for many inflammatory reactions and is relatively safe.
- D. Be alert for signs and symptoms of infection and report them immediately to the physician.
Correct Answer: D
Rationale: Instruct the client about signs and symptoms of and the increased risk for infection. Instruct the client to report signs and symptoms of infection immediately to the physician. Early treatment promotes a shorter duration of illness and reduced complication. Tell the client to avoid high-risk activities, such as being in crowds, during periods of immunosuppression. The client should not omit a dose if nausea is experienced but instead may take the medication with food. There are many side effects and required laboratory work to detect the side effects from immunosuppressive therapy. Joint aches are vague symptoms and are not a priority for reporting purposes.
A client is scheduled for diagnostic skin testing in 1 week. What should the nurse be sure to instruct the client prior to the scheduled appointment?
- A. Do not take prescribed or over-the-counter antihistamines or cold preparations for at least 72 hours before testing.
- B. Do not take antihypertensive medications the morning of the scheduled skin testing.
- C. Do not take non steroidal anti-inflammatory (NSAID) medications for 1 week prior to the scheduled skin testing.
- D. Prior to having the skin test, have the client take an over-the-counter histamine prophylactically for any possible reaction that could cause anaphylaxis.
Correct Answer: A
Rationale: The nurse instructs clients who are scheduled for diagnostic skin testing to avoid taking prescribed or over-the-counter antihistamines or cold preparations for at least 48 to 72 hours before testing. Doing so reduces the potential for false-negative results. Clients must temporarily discontinue some medications for even longer. Antihypertensive medication should not be omitted the day of the procedure. It is not necessary to omit the use of NSAIDs.
The nurse has four clients who are scheduled to see the physician for 'fatigue' and other general symptom complaints. Which client does the nurse determine is at most risk for having chronic fatigue syndrome?
- A. Male of Hispanic descent, age 28 years
- B. Female of Caucasian descent, age 47 years
- C. Female of African descent, age 42 years
- D. Female of Chinese descent, age 18 years
Correct Answer: B
Rationale: Estimates are that as many as 4 million people in the United States have symptoms corresponding with chronic fatigue syndrome, but fewer than 80% have been diagnosed by a medical provider. Most clients who seek treatment for their symptoms are Caucasian women 40 to 59 years of age. CFS also occurs at lower rates among children, adolescents, and men.