Nokea
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.
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A client with early-stage rheumatoid arthritis asks the nurse what to do to help ease the symptoms of the disease. What would be the best response by the nurse?
- A. The doctor could prescribe anti-inflammatory drugs.'
- B. The doctor could prescribe antipyretic drugs.'
- C. The doctor could prescribe antineoplastic drugs.'
- D. The doctor could prescribe antihypertensive drugs.'
Correct Answer: A
Rationale: Drug therapy using anti-inflammatory and immunosuppressive agents is the mainstay for alleviating symptoms. Antipyretic and antihypertensive drugs are not prescribed for autoimmune diseases. An antineoplastic drug is not prescribed for an autoimmune disorder until it is in its late stages and uncontrolled by the first-line drugs.
A client comes to the clinic and reports having had a mild case of the flu a couple of months ago and not having felt well since. The client expresses feeling fatigued that gets worse after any physical activity and having a recurrent sore throat and joint pain. What does the nurse recognize these symptoms may indicate?
- A. Chronic fatigue syndrome
- B. Rheumatoid arthritis
- C. Ulcerative colitis
- D. Recurrent flu
Correct Answer: A
Rationale: Many clients with CFS report having had a recent illness with flulike symptoms or an upper respiratory infection. Despite having been uncomfortable, most clients do not describe their initial symptoms as being extraordinarily severe. Severe, ongoing fatigue lasts for at least 6 months without any explanation. Even though the fatigue is constant, it worsens after physical activity. The fatigue is so debilitating that it usually interferes with a person's ability to work in or outside the home. Rheumatoid arthritis and ulcerative colitis are autoimmune disorders with symptoms that are more specific than CFS and can be diagnosed with diagnostic testing and laboratory studies. The symptoms that the client is having are not characteristic of the flu.
A client is in treatment for an allergic disorder. What might the treatment be?
- A. Autoimmune therapy
- B. Hypersensitive therapy
- C. Desensitization therapy
- D. Drug therapy for symptoms
Correct Answer: D
Rationale: Besides avoiding the allergen if possible, many clients experience symptomatic relief with drug therapy. It is not likely the client would be in autoimmune, hypersensitive, or desensitization therapy for an allergic disorder.
The nurse is caring for a client with chronic fatigue syndrome. What is a realistic nursing intervention when taking care of a client with this diagnosis?
- A. Educate the client about the disease process.
- B. Advise the client to avoid moderate exertion.
- C. Instruct the client to reduce the intake of potassium-rich foods.
- D. Advise the client to avoid being in crowds.
Correct Answer: A
Rationale: The nurse should educate the client about the disease process and the limitations that it requires because nothing, as yet, holds promise for a complete cure. The client need not be advised to avoid moderate exertion because the physician may prescribe a modest exercise program to treat chronic fatigue syndrome. A client who experiences hypotension may be advised to increase salt and water intake but need not reduce the intake of potassium-rich foods or avoid being in crowds.
A client comes to the clinic and reports having 'broken out in hives and itching since eating strawberries this morning.' The client states never having had problems with strawberries before. What is the best response by the nurse?
- A. It is probably not the strawberries that you are having an allergy to if you have eaten them before.'
- B. It is possible to develop an allergic reaction to something you have had prior exposure to previously.'
- C. Are you sure that you haven't had an allergic reaction before; this doesn't seem possible.'
- D. We will probably be admitting you to the hospital; this could cause respiratory arrest.'
Correct Answer: B
Rationale: Allergies can occur at any age, and the pattern of allergic response can vary in the same person at different points in life. For example, a person may suddenly develop an allergic reaction to a substance such as latex, despite having had multiple prior contacts with latex and no past problems. Although an allergic reaction may cause laryngeal swelling, this client does not exhibit any of the signs and symptoms of respiratory distress that would lead to respiratory arrest.