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A client is taking oral corticosteroids after having an exacerbation of asthma. What should the nurse be sure to include when instructing the client how to take the medication?
- A. The medication will cause weight loss.
- B. The medication will cause drowsiness so do not drive.
- C. Take the medication on an empty stomach to increase absorption.
- D. Take the medication in the morning with food.
Correct Answer: D
Rationale: Taking the oral corticosteroids in the morning with food will help reduce the gastrointestinal upset that may be experienced. The medication causes weight gain not weight loss, does not cause drowsiness, and should not be taken on an empty stomach.
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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 has been hospitalized for diagnostic testing. The client has just been diagnosed with multiple sclerosis, which the physician explains is an autoimmune disorder. How would the nurse explain an autoimmune disease to the client?
- A. A disorder where the body has too many immunoglobulins.
- B. A disorder where histocompatible cells attack the immunoglobulins.
- C. A disorder where killer T cells and autoantibodies attack or destroy natural cells - those cells that are 'self.'
- D. A disorder where the body does not have enough immunoglobulins.
Correct Answer: C
Rationale: Autoimmune disorders are those in which killer T cells and autoantibodies attack or destroy natural cells-those cells that are 'self.' Autoantibodies, antibodies against self-antigens, are immunoglobulins. They target histocompatible cells, cells whose antigens match the person's own genetic code. Autoimmune disorders are not caused by too many or too few immunoglobulins, and histocompatible cells do not attack immunoglobulins in an autoimmune disorder.
A client is taking the immunosuppressant medication, azathioprine (Imuran), for the treatment of Crohn's disease. What statement made by the client demonstrates an understanding of the side effects of this medication?
- A. I will notify the doctor if I have a fever or any other signs of infection.'
- B. I will drink at least 3 L of fluid per day.'
- C. I will notify the doctor if I am not having a bowel movement daily.'
- D. I will stop taking my medication if I notice any side effects and then notify the doctor.'
Correct Answer: A
Rationale: The client should be instructed to be sure to report any signs of infection since this drug suppresses the immune system and makes the client susceptible to infections. It is important for a client to drink 3 L of fluid when taking the immunosuppressant drug cyclosporine to prevent hemorrhagic cystitis, but this is not necessary for azathioprine. It is not necessary to inform the physician if the client is not having a bowel movement daily. The client should not stop taking the medication for any reason unless discussed with the physician.
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.
The nursing instructor is discussing hypersensitivity responses with a clinical group. What allergic reaction(s) would the nursing instructor talk about? Select all that apply.
- A. Typical
- B. Unmediated
- C. Cytotoxic
- D. Atopic
- E. Immune complex
Correct Answer: C,D,E
Rationale: Once sensitization occurs, one of four types of hypersensitivity responses can occur. These may be immediate or delayed depending on the time it takes for the immune system to mount a response. An immediate hypersensitivity response is due to antibodies interacting with allergens and occurs rapidly. There are three types of immediate hypersensitivity responses: type I, atopic or anaphylactic, which is mediated by immunoglobulin E (IgE) antibodies; type II, cytotoxic, which is mediated by immunoglobulin M or G (IgM or IgG) antibodies; and type III, immune complex, which is mediated by IgG antibodies. The first two types of responses occur within minutes; type III responses reach a peak within 6 hours after exposure to an allergen. The nurse would not discuss atypical and unmediated hypersensitivity responses in this scenario.