Nokea
A client is scheduled to have a prick test to determine what specific allergens are creating problems for the client. What should the nurse inform the client is involved with the testing?
- A. A concentrated form of the substance is applied to the skin and covered with an occlusive dressing for 48 hours and then examined.
- B. A dilute solution of an antigen is injected intradermally and observed for a wheal.
- C. The skin will be scratched, a small amount of the liquid test antigen will be applied to the scratch, usually on the back.
- D. The client will taste several different possible antigens and observe for wheals.
Correct Answer: C
Rationale: The scratch or prick test involves scratching the skin and applying a small amount of the liquid test antigen to the scratch. The tester applies one allergen per scratch over the client's forearm, upper arm, or back. The back is more sensitive than the arm. Results of the test are identifiable in as little as 20 minutes. If a raised wheal with localized erythema appears, the tester measures its length and width in millimeters. The client does not taste in any of the skin tests.
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A client with rheumatoid arthritis expresses not feeling the need to take medication any longer since being in remission without symptoms. What is the best response by the nurse?
- A. If you don't take your medication, you will become very ill.'
- B. Be sure to let the physician know after you stop your medications.'
- C. It is important that you continue to take your medication to avoid an acute exacerbation.'
- D. As long as you are not having symptoms, you can take a medication vacation.'
Correct Answer: C
Rationale: Even with remission, most people must continue taking prescribed medications to avoid another acute exacerbation. The client should be encouraged to maintain the therapeutic regimen in order to avoid an exacerbation and prolong the period of remission as long as possible. The client should notify the physician if considering discontinuation of the medication. The nurse is not at liberty to allow the client to discontinue medication use. Stating that discontinuing the medication will cause the client to become ill does not provide an adequate explanation to the client.
The nurse is instructing a client with chronic fatigue syndrome about what type of dietary sources are the best to eat to supply eicosapentaenoic acid (EPA). What statement by the client demonstrates the instruction is understood?
- A. I will eat shrimp at least twice a week.'
- B. I love crab cakes and will be sure to make them once a week.'
- C. Fresh salmon is one of my favorites, and I will eat it twice a week.'
- D. Lobster is expensive, but I will eat it once a week.'
Correct Answer: C
Rationale: Fish oils provide the only dietary source of EPA. Fatty fish, such as mackerel, sardines, herring, salmon, and tuna, are the best sources. Shellfish, such as shrimp, crab, and lobsters do not offer the dietary source of EPA that is required.
The nurse is talking with a client who was stung by a bee and began having difficulty breathing. What serious complication from injected venom should the nurse discuss with the client?
- A. Hives
- B. Itching
- C. Airway obstruction
- D. Diarrhea
Correct Answer: C
Rationale: Injectants, such as bee venom, and some other allergens can produce systemic and potentially fatal effects, including shock and airway obstruction caused by laryngeal swelling. Although all other answers can occur with an allergen, they are not the most serious complication.
A client sustained an injury in one eye during a basketball game after being hit with another player's elbow. The client reports now having difficulty with vision in the other eye too, although that eye was not hit by the elbow. What does the nurse understand this phenomenon to be known as?
- A. Cataracts
- B. Psychosomatic blindness
- C. Glaucoma
- D. Sympathetic uveitis
Correct Answer: D
Rationale: When a person experiences trauma followed by inflammation to the iris, ciliary body, and choroid layer of one eye, the vision in the untraumatized eye also becomes affected. The term for this phenomenon is sympathetic uveitis. Cataracts do not occur from trauma, they develop over time. Psychosomatic blindness does not relate to the client's visual disturbance because the client is not blind at this time. Glaucoma is an eye disorder that occurs over time and is not related to trauma to the eye.
A client with lupus has had antineoplastic drugs prescribed. Why would the physician prescribe antineoplastic drugs for an autoimmune disorder?
- A. To decrease the body's risk of infection
- B. Because an autoimmune disease is a neoplastic disease.
- C. So the client has strong drug therapy
- D. For their immunosuppressant effects
Correct Answer: D
Rationale: Drug therapy using anti-inflammatory and immunosuppressive agents is the mainstay for alleviating symptoms. Some antineoplastic (cancer) drugs also are used for their immunosuppressant effects. Antineoplastic drugs do not decrease the body's risk of infection; an autoimmune disease is not a neoplastic disease. Drugs are not prescribed just so the client has strong drug therapy.